A Quick In and Out Procedure...

I have a word of advice to everyone in the veterinary profession and especially to veterinary students - Never, and this means NEVER, go into any surgical procedure (or for that matter any procedure at all) needing to go to the bathroom regardless of how quick it is supposed to be done.

Today, I broke my own rule that I've had since before vet school. It was an extremely busy and frustrating day; everyone seemed to have gotten up on the wrong side of the bed and no one wanted to pitch in and help the day go better. In the late morning, after having been delayed by worried owners with 1000 plus questions, a harried boss who was freaking out because there were 2 sick patients and 2 rooms waiting (I don't know why he was so freaked out, he's been doing this for over 30 years now), and routine surgeries that were not going so routinely, I was asked by my boss if I could go ahead and get the prostatic biopsy done next. Sure, no problem. It should just be a quick in and out procedure...

The story as was told to me was that the poodle had a large prostate, suspected neoplasia but not sure yet so a biopsy was to be obtained. Radiographs had been done, not too helpful, bloodwork was overall boring except an elevated white count. I examined the dog and he did, indeed, have a large, firm caudal abdominal mass. The whole thing started to prove not quick and easy when hitting the dog's vein became a multi-person challenge.

I opened the abdomen only to discover the bladder that ate Manhattan as the source of the mass. Slight, gentle pressure did not yield voiding but resulted in the bladder trying to tear. I requested assistance so that we could pass a urinary catheter; it would go no farther than the proximal end of the os penis. With a little manipulation, I could then palpate a tiny stone in the urethra. Try as we might, the stone would not move. I had already opened the bladder and could not pass a catheter that way either, running into obstruction past the prostate slightly.

The prostatic biopsy became a cystotomy, urethrotomy, castration, and scrotal urethrostomy. Needless to say, it was not a quick in and out procedure. Got 2 small stones out and the dog passed two more that were smaller during recovery that apparently I did not get flushed out. The prostate was normal, by the way, as was the rest of the explore. And, much as I love surgery, I was rather glad to be finished because the bathroom was sure calling my name...