When Dr. Jennifer Halverson phoned me in to see if I could put a hip back in place in a dog I gladly offered my services. Trying to put a hip in can be very difficult and experience is often the best teacher so I could understand her reluctance to tackle it herself. After 25 years I had performed the procedure on hundreds of patients but with only a year under her belt Dr. Halverson still wanted assistance.
No one knew for sure what had happened to Chance, a big husky shepherd cross but when he came home carrying one leg we suspected he may have been hit by a car. When we x-rayed the lungs we discovered there was also a fair amount of bleeding into the lung tissue from the trauma and we decided to postpone the hip repair until the dog could breathe better making anesthesia safer.
By the second day the lungs had cleared but Dr. Halverson was concerned that there might be a tear in the diaphragm. I carefully scrutinized the x-rays and disagreed as the majority of tears were higher up and usually resulted in intestines snaking into the chest. My years of experience argued with her youthful scrutiny of the x-rays. I could see the opaque bulge into the chest on the x-ray but was not convinced it was due to a hernia or if it was just the dog's deep-chested anatomy.
We needed to anesthetize Chance to put the hip in and I suggested in order to find out for sure we should surgically have a look in the abdomen and examine the diaphragm. Chance was anesthetized and the hair on his belly was shaved. After the dog was surgically prepped and Dr. Halverson and I scrubbed up it was time for surgery.
As I made my incision into the abdomen there was an immediate sucking sound as air was drawn into the abdomen. I got an immediate 'see, I told you so' look from Dr. Halverson who knew the sound meant the chest was sucking air in because of a tear in the diaphragm. She was right and I was wrong and she was proud of herself for making a difficult diagnosis. Sure enough there was a small tear in the diaphragm and a small part of the liver was tucked into it be pinched off. Left unrepaired the herniated liver could have failed or resulted in fluid accumulation in the chest and abdomen and possibly even death.
Dr. Halverson had saved the dog's life … the student had taught the master ! After the hernia repair I humbly put the hip back in place, proud of at least that accomplishment, but more proud of my fellow veterinarian for making the difficult diagnosis.
