Complications during spay

[Itims]

Biba had her spay surgery today. The doctor just called me and told me the following things:

1. her uterus and ovaries were 1/4 or 1/5 of the usual size expected in a 6 month puppy 

2. they were also more pushed back (towards the tail) than usual

3. her spleen had a tear 

4. her intestines looked thickened but otherwise normal (spasming and good blood flow)

5. they want to monitor her tonight at the hospital to monitor the spleen / make sure there is no internal bleeding. She will be free to go home tomorrow if the night passes without incident.

Spleen tear:

The vet said that EITHER the spleen tear could be because something bad that she ate could have protruded out of her intestines and poked the spleen OR her recent GI issues could have caused some inflammation that results in organs to be 'sticky'. The vet might have caused the tear as spleen was sticking to the other organs and with the small ovaries/uterus, it required more looking and manual movement of internal organs. The vet said there was no way to be sure. My husband thinks it has to be something that happened during surgery since a dog with a tear in her spleen couldn't be running and playing and eating happily like she has been doing. There has been no blood in her stool. Since she started eating the Iams (see 'other background' below) about 3 or 4 weeks ago, her stool has been very consistently dark to medium greenish-brown but very well formed. He wants to question her more thoroughly to understand what happened. I don't know what fighting with the vet or assigning blame will achieve for Biba. He wants to change vets since she seemed antibiotics-happy during the diarrhea issue, didn't give us a confirmed diagnosis on the diarrhea issue and prescribes Iams as a good food for dogs with GI issues.

Other background:

Biba had an non-painful but large umbilical hernia, vaginitis and has had GI issues (consistently soft stool or diarrhea for about 4 weeks or so). The diarrhea could have been due to a mix of eating something bad and the effect of antibiotics. We never found out but the poop improved almost immediately after we moved her from boiled chicken and rice to Iams Low Residue + probiotics. Prior to the diarrhea, her poop was average to bad on Taste of the Wild. The doc had suggested an intestinal biopsy during the spay but since her poop had been good over the last 2 weeks, I declined the biopsy. 

I'm going to go and pick her up from the clinic and take her to the hospital in a few hours. Does anyone have any questions that I should ask or similar experience or ideas? I'm trying to not think too much about it other than trying to research and read about these issues but keeping having unpleasant and negative thoughts.

Thank you for any suggestions, questions and prayers.

UPDATE AS OF FRIDAY PM:

We got her back from the hospital. She seems good, very happy to see us, not groggy at all though shes on a sedative called Tramadol. I have to add in the Rimadyl which helps with pain and inflammation. The Tramadol is to be given on as needed basis. The hospital asked us to feed her 3-4 smaller meals and about half the usual food (2 cups of chicken and rice for the day). The hospital doc said probiotics are OK. 

We need to watch for lethargy (that will be confusing since she will be on pain meds), vomiting, diarrhea, pale gums. We have to keep her totally calm and inactive for the next 2 weeks. Luckily, we will have a quiet week with July 4 and my SIL is coming on Tuesday and will be staying with us for a month so someone will always be at home to watch her.

The hospital surgeon was backing up the whole sticky organ ("adhesion") theory. He did say that its very rare and has happened to him before too..Our usual vet talked to the hospital a couple of times since yesterday and asked me to give her an update tomorrow. 

Also, is there any thing I can do to make the skin around the sutures more comfortable so she doesn't have the urge to lick them?

[Karen, Jasper and Jackdoodle]

I'm sorry to hear all this. It might have been a good idea to go ahead with the scope while she was under, since intestinal biopsy is the only way you can definitively diagnose most inflammatory GI diseases, and some of her symptoms (the chronic diarrhea and thickened intestines) do sound like that might be an issue. (My JD was diagnosed with Inflammatory Bowel Disease via endoscopy 18 months ago.)  I also agree with your DH that another vet might be a good idea. I'm not sure, but for a vet to say that a torn spleen could have been the result "something bad she ate that could have protruded out of her intestines" sounds really crazy to me. I'll be interested in what F has to say about that. 

I hope that Biba heals quickly and that you can get an answer to all of these issues. 

[Itims]

I'm kicking myself a bit about the biopsy now..I backed off since she seemed fine on the restricted food and I assumed that biopsy means more pain during recovery. 

About the "something bad she ate that could have protruded out of her intestines", that is my language. She might have said ingested something harmful that passed through the intestine etc. But you are right, if a stick or plastic etc. were poking out of the intestine, wouldn't the intestine look more traumatized? Wouldn't we see some bleeding in stool? 

During the diarrhea issue, we did 2 rounds of blood work (testing general blood profile, pancreatic function, pancreatic value) and 1 x-ray. Nothing came out of it except that something was 'off' in her intestinal values and we could only know with a biopsy. By then her poop was fine so I wasn't worried anymore..Anyways, we never got anything more than a theory out of those tests. I wish she would give us a more likely diagnosis than "could be x, could be y, we can't know without doing another ABC test". 

 

Thank you, Karen. I'll be in touch as we continue on this. 

[Karen, Jasper and Jackdoodle]

A GI blood panel to check cobalamin (B12) and folate (B9) can be helpful in diagnosing intestinal disease. That has to be sent out and takes a bout a week to get results. You might ask if that was done, it's pretty straight forward. 

Intestinal biopsy done by endoscopy or colonscopy doesn't cause any pain at all. :-) They are under during the procedure, and afterwards there is no incision or anything that requires healing.

If a stick or anything else were poking out of the intestine, believe me, you would have known about it. And you would have a dog in critical condition. "Passing through" and "poking out" are two very different things. I believe that the only way something could poke out of the intestine would be if the intestine were pierced, and that would be life-threatening. 

[Camilla and Darwin]

So sorry to hear about the complications. Thinking of you guys and hoping Biba has a speedy recovery.

[Nicky, Riley & Boris]

I really hope you find the answers to what is going on with Biba she is such a doll. Your husband is right Iams is NOT a good food by any stretch of the imagination. 

[F, Calla & Luca]

I have no idea why her ovaries and uterus might be small. I am also certain the vet caused the splenic tear. I would worry about blood loss but the blood would not be seen in her stool and would collect in her abdominal cavity. This can be life threatening and Biba needs super close monitoring tonight and might need removal of her spleen. The idea that she had an intestinal perforation by an object that then lacerated her spleen, without causing rampant peritonitis and making her very ill is absurd. You do need a new vet.

[Allyson, Peri & Taquito]

I will say some prayers. Hugs.  Please keep us posted.

[F, Calla & Luca]

Make sure the hospital has someone who will be closely monitoring Biba all through the night and taking her vital signs frequently. Ask the vets at the hospital what they think of your vets explanations if you get a chance.

[Jane, Guinness and Murphy]

I am so very sorry....I can imagine how frightening this is for you.  I'm happy you'll be taking her to the hospital.  You are a better person than I am....I would definitely be assigning some "Vet blame" right about now.  You're focus is right where it should be at this point in time....on Biba.  Sending hugs and prayers.  Please keep us posted.

[Karen, Jasper and Jackdoodle]

I just noticed your discussion recently about the hair elastic that Biba had swallowed and you also mentioned that she had an umbilical hernia that was going to be repaired during her spay. Was that done? Did the hair elastic ever turn up/ I am wondering if these issues have anything to do with what was found today. 

[F, Calla & Luca]

Well, neither the hair elastic or the hernia have anything to do with Biba's spleen nor probably anything else. But she does need a good evacuation eventually by a competent vet, perhaps an internist.

[Valarie]

Saying prayers for Biba's quick recovery.  I think a second opinion is always advisable.  I agree with other posters make sure they are monitoring her very closely for the next 24 - 48 hours  Best wishes.