Sean was a young, neutered male, Irish Wolfhound—if you know the breed, he was a big boy; probably 36” tall (or better) at the shoulders, and weighed upwards of 150#. 20 minutes ago he was resting peacefully while his owners ate dinner . . . suddenly he was standing by the table, panting and frantic. The young couple owners (Tom and Patty) , called me at the veterinary hospital in Brookline, MA, pretty frantic themselves. It was about 8 pm, I was alone in the treatment room, and advised them to head right over.
He was a big, gangly, sweet dog—but obviously “not right” as the owners had described. My initial concern was that Sean might have an acute stomach “torsion” (GDV), a not uncommon occurrence in large deep-chested dog breeds. With some help (lifting) from the owners, I managed an X-ray of his abdomen and stomach—normal, but the little bit of lung field I could visualize didn’t look right. With Sean having more difficulty breathing, obtaining the 2nd set of X-rays was problematic, but we accomplished it as a team effort.
The problem was immediately obvious—free air in the chest, collapsed lung lobes, but no evidence of any trauma or cause . . . . what the heck! Once again, something I hadn’t really prepped for during my relatively recent veterinary school education. Luckily, I had “mentors” here . . . and 2 days previously, had assisted my boss, Rod, while he “tapped” the chest of a dog that had accumulated 2 liters of fluid from congestive heart failure. One of Rod’s recommended solutions to many medical issues—skin mass, bladder issues, abdomen or chest with fluid accumulation, abdominal mass—was to “put a needle in it”.
So I quickly shaved and prepped one side of the massive chest and asked Tom to hold Sean’s head and comfort him while I prepared to remove some of this “free air” in the thorax. A big needle was connected to a 60 cc syringe via 2 feet of plastic tubing; then the needle inserted between 2 ribs and directly into the chest cavity. I began rapidly “sucking” air out of the chest, 60 mls per suction. Not immediately, but quickly, Sean became less distressed and began breathing more easily. Things were going well until Tom got “woozy” from being a little too involved in this medical process . . . Patty said “I’m a farm girl”, and efficiently took over the head-holding responsibilities as we pumped away.
After multiple liters of air were sucked off the chest, I felt a little pressure resistance and removed the needle. At this point, Sean’s breathing had returned to normal, so we watched him for awhile. About 10 minutes later, it was obvious that his respiratory rate and effort were increasing—I placed a call to Angell Memorial Hospital, the local veterinary emergency/critical care center, and advised them of what I had going on, and agreed that I had pretty much reached the limits of what I could do for Sean. We again tapped his chest to remove the excess free air, and sent him immediately to the referral hospital.
At Angell, the on-call surgeon placed two “chest tubes’ between his ribs and into the chest cavity, allowing for continual “pressure valve” removal of the offending air. Sean had suffered “spontaneous pneumothorax—meaning a bulla, or cyst-like area on one of his lung lobes had “burst”–the chest tubes allowed his lungs to “heal” the relatively small rupture overnight. When the chest tubes were removed the next day, his lungs inflated normally; Sean was “cured”.
I still remember this episode like it happened yesterday . . . it was the first time I felt like I had been instrumental in saving the life of a dog “in the moment”. That’s one of those memories that tends to stick with you. Even better, I became “Sean’s vet” and got to see him routinely for the next few years that he was in Boston. He was a delightful boy, and actually seemed to remember me and the special bond we had from that night in November—he always made me smile! To be truthful, the memory still has that effect.