Page 2 - Clinical Connections - Autumn 2023
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RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
        by the  RVC’s pioneering Blood Donor
        Service.
          Rocco  initially  recovered  well  from  his
        emergency  surgery.  A  few  days  post-
        operatively his right testicle and scrotum
        became  markedly  inflamed  and  swollen,
        due to the previously suspected testicular
        artery  injury.  Rocco’s  family  consented  to
        castration. He underwent continued close
        monitoring and management of his AKI and
        once his azotaemia had stabilised, Rocco
        underwent castration with scrotal ablation.
        The opportunity was also taken to place an
        oesophageal (feeding) tube.
          He recovered well and over the
        subsequent days the critical care team
        continued to manage his AKI carefully, while
        the surgery team evaluated the progress   CT images showing subcutaneous gas, urinary bladder herniation and poor contract enhancement
        of his surgery sites and drains. The wound   of the right pelvic limb
        drain was removed a few days post-
        operatively.                        unremarkable, although a mild pyrexia was   Rocco sustained numerous and severe
          Rocco was fit for discharge approximately   noted,  and  Rocco  was  diagnosed  with  an   injuries as a result of his bite wounds.
        two weeks following injury. The team elected   abscess of his amputation site. Rocco had   His recovery was made possible by the
        to keep his o-tube in place for discharge   open wound management, with daily wound   committed  and  collaborative  efforts  of  the
        to ensure adequate caloric intake.  The   flushing and antibiotic treatment based on   services at the QMHA. Rocco undoubtedly
        primary care practice was asked to repeat   culture results.            benefitted from emergency admission and
        biochemistry monthly in order to monitor   Rocco’s  owners  said  they  felt  confident   stabilisation  and immediate  out  of  hours
        Rocco’s ongoing kidney function.    continuing  wound  management  at  home.   care from the anaesthesia, imaging  and
                                            They were provided with instructional   surgery teams. He also received input from
        Rocco’s returns                     videos and were able to take Rocco home   the transfusion medicine team and on-going
        Three days after discharge, Rocco was re-  for continued care from the comfort of his   management  with  the  critical  care  and
        presented to the RVC Emergency Referral   own home.                     surgical teams.
        Service. He had been vomiting and had a   Clinical  Connections  spoke  to  Rocco’s
        reduced appetite. On presentation, he was   owner,  Benjamin  Wong,  some  time  after
        quiet but alert and responsive on physical   discharge, who said: “Rocco’s been doing
        examination.  Emergency  assessment,  really well.  The experience didn’t change
        including point of care ultrasound scanning,   his personality and he’s been fine on three
        did not reveal any emergent abnormalities.   legs. He had kidney issues for a while and
          His oesophageal tube site was inspected   so we had to monitor his diet, but his kidneys
        and was unremarkable and the o-tube   and liver are okay now. He’s lively, happy
        was removed.  The surgical site appeared   and back to his normal self.”












                                                                                 Rocco enjoying a walk after his recovery
                                                                                 Rocco  was  a patient  that  required  true
                                                                                transdisciplinary care and it was a pleasure
                                                                                for all teams to contribute to Rocco’s
                                                                                extraordinary outcome. All of those involved
                                                                                are delighted with his progress.


         External appearance of Rocco’s wounds following clipping and draping for exploratory surgery (left
         image). An exploratory coeliotomy was performed. Severe injury is appreciable to the right pelvic limb     For small animal referrals, please call:
         musculature with numerous severed muscles and concurrent right coxofemoral luxation (middle). A   01707 666399
         right coxofemoral amputation was performed. The biceps femoris and semimembranosus muscles     Email:
         of the pelvic limb were found to be viable and were used to augment Rocco’s body wall repair.  qmhreception@rvc.ac.uk


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