Goose's case required close collaboration between the ECC, Radiology, Surgery, and Anesthesia services. We could not have saved him without everyone working diligently, quickly, and together to find the source and stop the bleeding. Technical support is vital for us to be able to do what we need to do to help our patients.
Foster Hospital’s ECC Team Springs into Action to Save Golden Retriever
Three additional services jump in to treat Goose, bleeding out from an internal injury
Driving to work in a downpour last summer, Rachel Ahern fishtailed on the slippery road after the car in front of her stopped abruptly, subsequently setting off an unlikely trauma in their Golden Retriever, Goose. The Emergency Medicine and Critical Care (ECC) team at Henry and Lois Foster Hospital for Small Animals (FHSA) at Cummings School of Veterinary Medicine at Tufts University worked in tandem with the Anesthesiology, Diagnostic Imaging, and Surgery services to save Goose, in a severe state of internal blood loss from the impact of bumping back and forth in the car.
Ahern describes four-year-old Goose, “He very much embodies a goose. He brightens the room; his energy is infectious. He's got that big goofy golden smile. He's our whole world—even more so now.”
When Ahern dropped Goose off at daycare after the incident, the owner called her shortly after, concerned about Goose’s demeanor. He had vomited and was quite lethargic. Ahern immediately took Goose to an emergency veterinary hospital, where they found fluid in his chest. The clinicians attempted to treat him, but his condition worsened so rapidly they advised Ahern to rush Goose to emergency care at FHSA.
Ahern met first with Dr. Herdest Bethel, ECC resident at FHSA, in the Department of Small Animal Clinical Sciences at Cummings School. “Dr. Bethel is our hero. It's been a year, and I think of him and all of Goose's other doctors often. They have such a strong place in our hearts,” says Ahern.
Goose was in a state of compensated shock when he arrived at the ER, his heart rate high and his body compensating for the trauma. His body soon reached a point where it could no longer handle the internal bleeding. His condition quickly deteriorated.
The ECC team determined that Goose was losing blood into his thorax (between his lungs and chest wall). To find the source of the bleeding required the expertise of the Diagnostic Imaging service, but they first needed to stabilize him.
“I'm glad he got here when he did, because half an hour in a different direction might have been a very different outcome,” says Dr. Alexia Berg, assistant clinical professor in the Department of Small Animal Clinical Sciences, on FHSA’s ECC team. “We ended up having to give him lots of blood product pretty quickly.”
The ECC team sourced blood from Cummings School’s Blood Bank and auto-transfused blood from Goose’s chest, so that he was receiving both his own and donor blood.
“Our blood bank team was great—they were well-stocked and prepared for a situation like that,” says Berg, who treated Goose alongside Bethel and ECC veterinary technicians. “We were squeezing the bags trying to keep him alive until we could get the bleeding to stop.”
The Anesthesiology and Diagnostic Imaging teams were at the ready to locate the source of the trauma. While the ECC team worked to keep him stable, the Anesthesiology team sedated Goose for a computed tomography (CT) scan.
“It was a focus on trying to keep him as stable as we could to optimize everything that the team had already done and to facilitate surgery. It was all hands on deck,” says Dr. Emily Wheeler, V17 (she/her), assistant professor in the Departments of Small Animal Clinical Sciences and Large Animal Clinical Sciences, with FSHA’s Anesthesiology service.
While the operating room (OR) vet techs prepped Goose for surgery, the Diagnostic Imaging team quickly analyzed the scans and identified a torn vertebral artery deep in Goose’s chest just under his spine.
“We were trying to be as efficient as possible because all this time we're still pushing blood and auto-transfusing to try to keep him from bleeding to death,” says Berg.
FHSA’s Surgery team was up next.
“The imaging was so important because once we knew where the bleeding was coming from, we knew exactly where to go into his chest to find the vessel and stop the bleeding,” says Dr. Miriam Talaat, assistant clinical professor in the Department of Small Animal Clinical Sciences, on FHSA’s Surgery team. “The vessel was bleeding profusely, so it took myself and two other surgeons to visualize the area and seal the vessel. Everyone on the team was focused, purposeful, and worked beautifully together.”
The Anesthesiology team stayed with Goose from the initial scan through surgery, keeping him safely sedated in his rapidly changing condition.
“Dynamic patients require quick adaptability and quick decision-making,” says Wheeler. “This is a case where we’re constantly communicating with the surgeons through every stage of the process. Being at this institution, we can approach these critical cases with such a team effort, having the voices of multiple specialties. Seeing the positive outcome is great.”
Talaat agrees and expresses gratitude for the vet techs. “Goose's case required close collaboration between the ECC, Radiology, Surgery, and Anesthesia services. We could not have saved him without everyone working diligently, quickly, and together to find the source and stop the bleeding. Technical support is vital for us to be able to do what we need to do to help our patients.”
After surgery, Goose remained in the intensive care unit for six days, while the ECC team monitored his recovery from the trauma, shock, and surgery, and to ensure bleeding did not recur.
“There are different reasons that hemorrhagic shock happens in dogs. This level of it from such a minor injury is a bad bit of luck, but one that I'm glad that we were able to be there for,” says Berg.
During his recovery, the Aherns shared with the ECC team that Goose would be in their wedding in a few weeks. The team felt bad that his fur had been shaved down to almost a mohawk for the surgery, so bought him a doggy tux for the wedding.
“We went to visit him, and he comes out in this full-body tux to cover the hairless spots,” Rachel Ahern recounts. “We both just started crying. It's one of those things where we were like, ‘We hope we never have to see you again, but we will never forget you.’ I couldn’t have asked for better care from start to finish.”
That same week, the Aherns found out they were pregnant. “Here we are a year later, beyond blessed to have both of them,” Rachel Ahern says of Goose and their three-month-old son, Owen.
The Aherns sent the FHSA team a Christmas card with a picture of Goose next to an ultrasound image of the baby.
“I really appreciate when families send updates,” says Wheeler. “I don't know if they know how much it means to us to know that they're out there living their best lives.”
The FHSA team sent a congratulations card back to the Aherns, signed by the entire team that treated Goose.
“These are the kinds of cases we live for,” says Berg. “This is why we do what we do. It all came together for Goose.”
Department:
Foster Hospital for Small Animals