"The definition of an emergency is when you don't have time to refer to your emergency manual." This piece of wisdom was handed on to me the day before a very distressed Yorkie presented to the Cornell Veterinary Emergency Service. I was the on-duty doctor, and being only two months into my internship, the adrenaline provided unusual focus on "the ABC's of emergency care" (Airway, Breathing, Circulation). Based on the the blue gums and the lack of air movement despite violent gasping, I was able to stop at "A" and quickly came to the realization that I would be performing my first tracheotomy.
Hands shaking, I quickly gave some sedation, incised the roughly clipped skin on the neck, and made the stab incision into the trachea. A rush of air, several breaths, and the gums were turning pink again! 15 minutes later we had a very happy Yorkie and client.
It turns out that this pup had gotten ahold of a snake skin, part of which he had aspirated. During the tracheostomy it was dislodged (and swallowed!) After a night in the ICU for observation, the Yorkie was sent home and a healed beautifully. Several days later I received a thank you card from the client with Snoopy on the front. I forget what the card said, but the owner had drawn a little hole over Snoopy's trachea and written "ahhhhh". I still smile thinking about it. LR
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