M.I.P. (vet school, dairy cows, & Justin Bieber- together at last)

Always be on the lookout for a wolf in cow’s clothing.  This is what they look like right before they attack. (photo courtesy of travelblog.org)

When I write these blogs, I often think back to vet school often because I really enjoyed my time there. The last two years of vet school are undoubtedly the best, mainly because of the variety of experiences you have. In those two years, vet students rotate through different clinics and specialties such as Surgery, Small Animal Medicine, Large Animal Ambulatory, and Equine Medicine & Surgery.  You’re doing practical work. You’re fixing things.  You’re solving puzzles. Instead of sitting in a classroom or behind a microscope, you’ve got your hands on animals. 

The “hands on animals” part is where the unpredictability lies, and nowhere is this more evident than in the Large Animal rotations.  During this time, you spend a significant part of your day working on horses, cattle, sheep, llamas, goats, or whatever else may come along. You’re outside in the barns listening to your instructors talk you through milking cows, suturing up horses with barbed wire cuts, telling you how to avoid having the llamas spit on you, etc. 

But above all, you’re listening to them tell you how not to get “Mocked”. 

A “Mocking” was the most dreaded thing that could happen to you on large animal rotations. It meant that you had been totally outsmarted by an animal and were being made to look like a fool. What made this even worse is that every clinician wore a radio, and whenever a student (or, for that matter, an entire group of students on a rotation) was getting Mocked, a radio call went out summoning all of the other students to the area where the drama was taking place. 

The radio code for this was “M.I.P.”- Mocking In Progress.  Being the object of an M.I.P. was undesirable, but being called to witness somebody else’s M.I.P. was the highlight of the week. 

One Fall afternoon, I was on equine rotation watching a subtly lame horse run to and fro between barns as I desperately tried to figure out where the problem was. There are a lot of reasons that I don’t work on horses. One of the biggest is that equine lameness has always baffled me. When a person who is good with horses tells me where the leg problem is, I figure that there are three possibilities:

 1) they’re really good,

 2) they could be making it up, or 

 3) they might have magical powers.

Just when I was about to have to swallow my pride and tell my rotation mates that I could only tell that the limp was in one of the front legs, I heard our professor’s radio come to life.

“M.I.P at the dairy barn! M.I.P. at the dairy barn!” 

I had been rescued.  All instruction, learning, and productive activity stopped immediately, and the whole group migrated over to the milking parlor to see what was up. 

A circle of people had already gathered to see the spectacle. In the middle of the circle was an angry Jersey cow that had doubled back on the students trying to herd her into the parlor to be milked. She was trying to make a break for it and get back into the open pasture when she was intercepted by two of the students assigned to dairy rotation. They were trying to turn her around and get her into the barn. She was having none of it. 

When a cornered cow is angry, several things usually happen. When we arrived, she was spinning around wildly in circles looking for a way to evade the students trying to interfere with her escape plan.  While spinning, she was bellowing a low, drawn-out, loud moo. She was slinging snot and spit and manure in wide arcs around her as she turned, like a lawn sprinkler filled with… well… the kind of things cows are typically filled with. The cascade was soaking bystanders and students who ventured too close to the whirling beast. 

Eventually, the two saturated and frustrated students literally pushed the cow in the direction they wanted her to go (as dairy cattle go, Jerseys are small). Half a minute later, she had her head in a feed bucket and was eating away as if nothing had ever happened. With the standoff over, the people and cow involved got a standing ovation from the assembled crowd, then it was back to business as usual. We went back over to the equine barns. There was a lame horse waiting for me there, and I hadn’t figured out the puzzle yet. 

That was about 12 years ago, but the memory of a Mocking stays with you. In practice here in Odenville, other kinds of Mockings happen occasionally. This one was pretty good, so I figured I’d take a picture and share it with all of you. I had been gone for a couple of days during the holidays and came back into town to find this: 
In my absence, one of the BAH crew had turned my office door into an homage to Justin Bieber. We’ve had a lot of fun with it. We still occasionally add new images to it, but like all good things, it must eventually come to an end. I figured that I’d share it before the magic is gone… 
 
-RAB 
 

Wide Open!

We are fortunate to have a guest blogger for this post, Dr. Wendy Fraser.  Dr. Fraser is currently out on maternity leave but left us this blog to enjoy in her absence.  Congrats again to Dr. Fraser and her family on their new baby girl!

I am a huge television fan.  It is truly one of my guilty pleasures.  After the kids are finally in bed I like to sit down, relax and let my mind focus on the intriguing plots of Mentalist, House, Criminal Minds and the like.  My selections are admittedly intellectual junk food.  Why do I like these shows so much?  I like them because in one short hour a mystery is solved.  There is always a rewarding answer at the end of an hour, everything is neatly wrapped up and everyone is satisfied.  That rarely seems to happen in real life, particularly in veterinary medicine.  I like the fantasy that everything has an answer and if that answer can be found in under an hour so much the better. 

Real life is much more frustrating.  For example, one Tuesday morning when working at another clinic in the Birmingham area, an owner called about a sick German Shepherd.  The owners were concerned because the dog would not come out of the dog house.  The receptionist recommended that the owners bring the dog in for an exam.  We went about the usual workday until late afternoon when the receptionist said, “I think that sick dog that wouldn’t get out of the dog house is here.”   There were no clients in the lobby so I was curious as to how she knew that that particular dog was here.  When I walked up to the front lobby and looked out the window I knew how she knew:  a truck had pulled into the parking lot and on the back of the truck was a HUGE doghouse.

The driver of the truck and his companion had begun to unload the dog house and carry it into the clinic.  The dog that wouldn’t get out of the doghouse was now in the lobby, doghouse and all.

I started to take a medical history from the owners.

How long had the dog been in the dog house?  Two days.

Has he eaten anything?  No. 

Does the dog ever run loose?  Sometimes. 

Inside the dog house was a 70lb, 3 year old German Shepherd lying on his side, his eyes were unfocused but he was breathing steadily.  To the side of the dog were some scrambled eggs and there were two pieces of toast on top of the dog.   I took the top off of the dog house, dusted off the eggs and toast and moved the dog to an exam table.   At first, the dog appeared to be in great health.  He was a healthy weight, had no skin lesions, was staring straight ahead and breathing deeply.   All the vital signs appeared normal.  What do I know about the dog at this point?  He was young, was healthy three days ago, doesn’t have an appetite for eggs and toast, and is in a coma.  That was all the information I could gather and when presented with a case such as this you have to consider all factors, even beyond what the owners tell you (for any other TV junkies out there, think… House.)  These owners would like to do whatever they can to help the dog.

At this point, my diagnosis of the dog is open, WIDE OPEN.  This means that I have no idea what is wrong with this dog!  Typically in a case like this Dr. Bean, Dr. Compton and I put our heads together and come up with what is called a differential list of possible causes and try to pick diagnostic tests that will help to rule in or out any of the illnesses on the differential list. That’s exactly what I started to do.  The most likely causes in this case were trauma or toxins because the dog wasn’t skinny or sickly looking, indicating that it had not been ill for long.  He looked great and was in fact a beautiful dog.   

It had been almost an hour since he arrived at the clinic and I was still not close to solving this one.  Unlike on those medical dramas on TV, dozens of assistants had not appeared to take samples and whisk my patient away for tests.   I drew blood samples to send to the lab and treat for dehydration, infection and inflammation.  My only options now were to wait until the next day for his blood work results and monitor him for responses to my treatments.

The blood work results from the next day were normal.  We tried every reasonable course of treatment but nothing that I did seems to change the dog’s condition.   After 3 days the owners elected to euthanize him.  Many, many hours were spent thinking about this dog and there was no satisfying answer at the end.  All that we have are unanswered questions, frustration and sadness.

So, how do I cope with cases like this?  I go home, put the kids to bed and watch an hour of junk!                               

You bettah sew dat up, Boy Part 2

It’s another incident from my time with Dr. Livingston…

It was a brilliant stroke of luck that the metro Atlanta practice I was working at was right next door to a Mexican restaurant.  I had just finished another delicious lunch there, heavy on the sour cream and spicy beef, and was walking back to the clinic with a lovely carbonated beverage in hand when a car tore into the parking lot and went sideways into a parking space.  The occupants of the car sprung out of both sides, grabbed a cat carrier out of the back seat, and hurried inside.

I picked up the pace and hit the side entrance to the clinic. Bob The Tech was already looking for me.  

“You gotta see this one, Doc. The owner thinks a bee did it” was all he said.

The two of us headed into the exam room, where the rattled owners pulled a cat out of the carrier sitting on the table. The problem was obvious as soon as Bob The Tech turned the cat’s head toward me. The left eye had ruptured and was shriveled up like a raisin sitting there in the eye socket.  The fluid that should have been contained inside the eye had drained down onto the cat’s cheek and dried there. I had read about these injuries before and the recommendation was always the same. General practitioners were recommended to remove the eye or refer to a specialist to see if some kind of salvage would be possible. The odds on any kind of functionality are near zero, and the odds on complications are very high.

I talked to the owners about options. Their major concern was the way that their 4 year old child would react to seeing his buddy with one eye. In fact, the cat had been playing out in the front yard with the child when the trouble began. The owners had heard the cat howl, and saw a bee buzz away from its face when they turned to see what had happened.

Even though removing the eye seemed the first choice for treatment, the clients simply weren’t ready to own a one-eyed cat.  They had turned down every other option that I had offered.  Just about that time, I heard the side door open, and knew that Dr. Livingston had just come back from his lunch. I asked the owners to excuse Bob The Tech and myself while we stepped out to clean the cat’s cheek.  This gave me a chance to get a better view of the wounded eye … and to get some advice from Dr. L.

I told him what was going on as he calmly sipped his sweet tea.  When we showed him the cat,  he looked at the eye, thought for about ten seconds, and then looked at me and said (drumroll, please) “What would happen if you just sewed dat up? You can tell ‘em dat it might not work, and they’d have to take the eye out anyway, but it would give them some time to think it over.”  What he had suggested was suturing the lids shut over the damaged eye, forming a biologic bandage, and giving Mother Nature a little time to do her thing.

Once again bowing to superior wisdom (I had been out of graduate school less than a year at this point), I went back into the room and talked to the clients. They immediately decided to give it a try. The name of this procedure is tarsorrhaphy. I have thought about nominating it for the “Most Difficult Word in the English Language to Spell” award. Pronouncing it is a lot easier: tar-sore-a-fee, if you’re from the South like me.

Bob The Tech and I sedated the cat and started prepping the eye for surgery. When we were just about ready to start suturing, I noticed something odd about the eyeball.  There was a little splinter-like structure adhered to the middle of it, just to the side of the point on the cornea where it ruptured. I looked at it under a microscope, and it was a bee stinger. The owners were right: a bee sting had been the cause of the trouble. We sutured the lids together, started the cat on antibiotics, and hoped for the best.

Ten days later, the family came back with their cat for suture removal.  I was expecting to see a ruined eye when I pulled the stitches out. Instead of seeing a shriveled raisin sitting in the socket, I uncovered a fully re-inflated eye that was apparently not painful.  The entire cornea (the part on the front of the eye that is supposed to be clear to let light through to the inside) was a milky white from being covered. I shined a light into the eye and there was no response- the pupil stayed the same size.  I told the owners that while the eye had returned to its normal shape, the vision in that eye was gone. Considering that we expected the cat to completely lose the eye, the owners were happy with the outcome, overall.  I asked them to come back in a few days for me to check things over.

Three days later, they were back in the office. My appointment notes from the receptionists said “Owner believes that cat can see.”  I was skeptical.  I went into the room and looked at the eye: almost all of the white discoloration was gone, and there was only a single small scar surrounded by clear cornea again. I shined a penlight in the eye, and the pupil constricted like a normal pupil should... the interior structures of the eye were working.  I moved my hand toward the eye to see if the cat flinched or blinked, and it did. You could have knocked me over with a feather at this point. The cat went from having a  totally wrecked eyeball with little chance of recovery to having a functional eye. It appeared that everything was going to be fine.

While I tried to recover from the astonishment, the  cat just sat on the table, angrily switching its tail from side to side, wondering why I had been so rude as to shine a penlight in its eye.

Thanks again, Dr. Livingston.

Merry Christmas, everybody!

-RAB

"You betta sew dat up, Boy..." Part 1

I’ve had the good fortune to work with some pretty sharp veterinarians over time.  If I was seeing something new or needed a fresh set of eyes to look at a problem I was having, I had some folks to lean on. One of those was a semi-retired veterinarian from South Carolina, Dr. L.  He’s a Korean War vet and has a neat Low Country accent that becomes more pronounced when he’s excited or unguarded.

Dr. L. was in his seventies when we were working together, and I was in my twenties.  He had owned a practice in Atlanta and sold it, and was working two or three days a week in retirement. He had a wealth of experience and a good way with people.  As a matter of fact, he is good people.  I learned a lot from him. Here’s an example:

A dog named Scoot came to the clinic with a lipoma on his elbow.  Lipomas are benign fatty tumors. They rarely pose any kind of health threat to a dog, but they can become so big that they have to be removed. And Scoot had a massive one.  He weighed about 42 pounds at the time of surgery, and a significant portion of that was the massive growth.  It was interfering with the range of motion of his leg and making him unable to lie down on that side… it was about the size of a child’s bowling ball. Taking the growth off was going to make his life a lot better. The growth was so huge that I debated as to what was more correct: Was I removing a tumor from the dog, or the dog from the tumor?

We got Scoot on the table and I made my incision. I started to work around the massive growth with my fingers, and it started to detach from normal tissue at the edges like these tumors usually do. As I started to work my fingers around the underside, I started putting upward compression on the rubbery mass. When I had nearly worked a full circle around the mass, the upward pressure I was putting on it overcame the strength of the tissue holding it in place. It tore away from the thin strands of connective tissue, flexed to get through the incision, and shot out of Scoot’s chest. Gravity did the rest of the work, pulling the massive clump of fat down and onto the table, tearing away the last remnants that held it inside.

Unfortunately, one of the last things holding the tumor inside was a huge blood vessel that had been hidden on the back side of the mass. The weight of the falling growth had torn it in two, and blood was spurting everywhere. It was under tension when it tore, so when I looked into the space where the tumor had been, I saw the end of the vessel slowly retract to its original position… behind a rib.  And it was bleeding heavily.  Needless to say, this was a problem.

I quickly ran out of gauze sponges in the surgery pack trying to keep things in check, but was getting nowhere- gauze was getting soaked within seconds no matter how hard I pressed. Being on the back side of the rib, there was no way to get to the vessel with a clamp without potentially puncturing into the chest. I realized that I was in trouble, and sent the tech to try to find me some help. Dr. L. came into the surgery room within seconds and looked at the mess I was in. I gave him a rundown of what was going on.

“Lemme see dat, young man,” he said in his characteristic drawl.  I took the gauze off the top, and the flood started again. Dr. L’s eyes went wide.

“Woo Hoo! You betta sew dat up, Boy!” he exclaimed.

And then he just walked out of the room with an amused grin on his face, shaking his head.

I was dumbstruck, expecting some sort of complex plan.  A plan devised from his years in practice?  Maybe from something he had seen in Korea?  … Well, no.  But his plan was better than mine, and he had been in practice for far longer than I had been alive, so I decided to go with it.  I pushed my doubts aside and began to sew like the wind. With the first layer, I pulled in all the subcutaneous tissue I could, trying to build the Great Wall of Georgia, filling the space where the tumor had been. I did more of the same with the second layer, and, to my great relief, the bleeding slowed to barely a drip. I finished the closure and monitored Scoot as he began to wake up from anesthesia.

We put a compression wrap around Scoot’s chest after surgery to help prevent any further bleeding.  Scoot went home the next day with a heads-up to the owners about bleeding from the wound.  That turned out to be pointless, because he recovered with no issues.

I learned a valuable lesson that day from a man who had seen a lot more bad situations than I ever had. When all else fails, sometimes the appropriate course of action is to “sew dat up”.

And the tumor?  We put it on the scale after we were done.  It weighed 7.3 lbs.

-RAB

Twenty Minutes Later...

We are very happy to have a guest blogger this week: our new associate, Dr. Jennifer Compton.  Dr. Compton was kind enough to share some of her experiences from vet school at Tuskegee University.   

 

(Dr. Compton, in the blue hoodie jacket, securing the west end of an east bound calf)

Among the most memorable experiences of my vet school career are those of our Large Animal Ambulatory rotation.  There is no better way to bond with your classmates and clinicians than by piling up in the cab of an F-150 and riding around rural Alabama smelling of cow manure.  In addition to the experience in large animal medicine, this rotation taught those special life skills you can only learn in the field….how to improvise, think on your feet, rely on your colleagues, and most importantly, how to catch and restrain a 6 month old calf running rampant around a muddy paddock.

For most large animal calls, it is customary for farmers to have their cattle in a holding pen prior to the arrival of the veterinarian.  To many farmers, this is a small gated area with a chute of some sort. To some farmers, however, a holding pen is nothing more than a half-acre paddock filled with mud and debris from old fencing material and farm equipment.  To a junior veterinary student, this kind of holding pen means herding our patient around a slick, muddy obstacle course.   It was exactly this kind of area that my classmates and I found ourselves in on one particular call.  Facing this, we all filed out out of the truck, fresh in our coveralls and rubber boots and began chasing a lame calf around the paddock. 

Twenty minutes later, we finally managed to herd the calf into a “chute” (I use that term loosely), and close it in with a gate.   During this time, our clinician simply watched from the sidelines while the owner of the calf was strangely absent.  A mere 40 seconds after entering the chute, the calf came flying out wearing the gate around his neck and shoulders.  Not ready to let our patient escape, a couple of classmates and I grabbed the gate and held it steady in an effort to keep the calf within reach.  Not successful.  Our calf kicked free and continued his tour of the muddy paddock.  It’s amazing how fast a lame calf can run. Our clinician, a seasoned large animal vet whose demeanor most closely resembles “Eeyore”, moved slowly from his position on the sidelines only to remind us “You’re not supposed to let him go, hold onto him while you’ve got him!”.  Thanks.  We hadn’t kept that in mind while being tossed around by a calf powered gate. 

Thirty minutes later, our lame calf was claiming victory in pursuit of freedom.  We had nowhere left to herd him now that we are minus a gate.  Our shame and defeat was comical at this point, but we had a job to do and continue on.  But then, out of nowhere, came our seasoned clinician and his rope.  With all the energy of a cinderblock he gave the rope a few swings over his head and effortlessly tossed it in the direction of our calf.  Moments later our patient was captured.  Our group was certainly appreciative of his valiant effort, although we would have liked it sooner.  We then began our next task: to restrain the beast.  This involved a hobble, a firm grasp of his tail (my job), and about 3 of us to hold him once he was down.  So that’s what we did, and only a few minutes later, his injured claw was inspected and cleaned and he was released back to the freedom of his muddy paddock.  Nothing to it.

Forty minutes later, we finally got our truck (not 4-wheel drive) free from the mud pit it was trapped in with minimal damage to the surrounding structures.  Then we were on our way, ready to see what was in store for our next large animal adventure.   It sure is nice to be a small animal vet now, but even better not to be the lowly student anymore!

Here are some of my other favorite quotes from the large animal ambulatory rotation:

Large Animal Vet: “When I say run, you RUN!!!!!”       

Classmate: “What do you say when we get back to school we all take a cattle prod?”

Me: “No.”

Classmate: “Why not?”

Gift from a Client

“We outlive them. It’s sad, but that’s how things are designed.”

I have to say this fairly often to people who are dealing with terminal diseases in pets. We deal with the same sorts of diseases in animals that humans are afflicted with-  cancer, kidney failure, and heart disease for instance. Eventually, a lot of owners are faced with the decisions of whether or not to euthanize a pet, and when is the right time to do so. Honestly, the second one is the hard one for most owners that I talk to.

There was one particular dog that I remember from a few years back. The dog, Jake, had come in for weight loss, diarrhea, and vomiting. None of these is an unusual thing in and of itself, but Mrs. Jeffries said that something was off about Jake’s behavior as well.

As I started the physical exam on Jake, I saw that there was a bulge in his belly that wasn’t supposed to be there. I felt his abdomen, and immediately bumped into a mass the size of a baseball.  Given the location, Jake’s age, and his symptoms, this was more than likely going to be cancer. I talked it over with Mrs. Jeffries and she decided to do an X-ray of his abdomen and chest to see more about what was going on. The images we got didn't hold good news- there were spots in his lungs, and it appeared that the mass had entrapped a couple of different sections of his intestines as well.

Given the prognosis, the owner decided to try to keep Jake comfortable and give her family some time to say goodbye to him. We put him on medications for nausea and any pain that he might be feeling.  We knew that most likely we didn’t have long before his quality of life declined to the point that his owners would have to let him go.  I asked Mrs. Jeffries to call me if anything new developed and she took Jake home.

A couple of days later, I got a phone call from her.  Jake had stopped eating his dog food completely.  Mrs. Jeffries had some time to come to grips with the situation, and was as upbeat as she could be about things. She knew that he didn’t have long, but she wanted to make the most of that time.

“Dr. Bean, he really seemed interested in a McDonald’s hamburger that my daughter brought home last night.  I know that people food isn’t good for them, but do you think it would be O.K?”  Mrs. Jeffries asked.

“Considering the situation, I think that whatever you want to feed him is fine. It’s more important to me that he gets some calories in and for him to be happy than anything else. When my time comes, I want to go out with an empty Snickers wrapper in my hand.”  I replied.

She chuckled a little, and we said goodbye.  A few days after that, Jake’s situation became untenable and she decided that it was time to let him go.

The next week, I came in to work on a Monday morning, and found a wrapped gift box with my name on it lying on the counter in the clinic’s pharmacy area.  I asked my boss what was happening, and he said that he didn’t know- he had found it on the doorstep that morning when he got there.

Inside the box was a thank-you note from the Jeffries family, a picture drawn and colored by their daughter…. And a Snickers bar.

-RAB

One Tough Dog

Another recent event...

Last week, we had a young pit bull mix (we’ll call him Bullseye) come in with what we suspected were gunshot wounds in the hip and the chest. He was somewhat depressed, weak, and had lost an undeterminable amount of blood. Lungs sounded OK, so we kept him for observation overnight. The situation dictated that we not do x-rays at that time.  He was a little better the next morning on meds, so we sent him home. We asked the owner to call us if there was any more trouble, or if his recovery wasn’t steady.

You may be wondering, why not pull the bullet out?

We see a lot of animals that have bullets, airgun pellets, BB’s and lead shot from shotguns in them that the owners never knew about. It’s what we call an “incidental finding” on an x-ray: it’s there, but it’s not causing any trouble where it is because the body has usually walled it off with scar tissue. We’ll often be looking at a broken toe or an enlarged heart on an x-ray, and then have to show the owner the extra metal that their animal is carrying around. There’s normally the potential for doing more harm than good when you go after the metal, so leaving the bullets in place when they’re not a medical issue is pretty standard in animals. 

Back to the dog-

Four days later, the owner brought Bullseye back late in the afternoon for new swelling on the point of his chest about the size of a fist. Dr. Fraser opened it up, and emptied out some bloody fluid. Then she checked inside the wound with a vascular clamp and ran into something hard attached to shredded muscle in an area that was supposed to be all soft tissue. Bullseye was stable and in good spirits, so we waited to do the exploratory surgery until the next day when we would have more time to do it properly.  Anesthesia, x-ray, surgery, and recovery all take time and we prefer to have animals wake up early in the day so we can watch them closely.  So Dr. Fraser patched him up, medicated him for pain, and housed him in a quiet place to rest.

This occurred on my afternoon off, so Dr. Fraser sent me an email describing what she found (the late night email is a pretty common occurrence between doctors at Branchville). I was scratching my head after she described things… neither one of us was really sure about what was going on, but having hard things attached to muscle usually means a piece has broken off a bone.  Not good. Given the direction we thought the bullet had traveled, it was possible that it would be ribs, shoulder blade, or the top part of the humerus (the upper arm bone). I took a little solace in the fact that this dog was still –amazingly- walking around with barely a limp. It couldn’t be too bad, right?

Bright and early, a tech and I got Bullseye sedated and took an x-ray of his chest:

As you can see, there were two metal objects in the front of the chest cavity. The one that looks like a mushroom is the expanded lead core of a hollowpoint .45 bullet. The curly looking one is a side view of the bullet’s copper jacket which peeled away after traveling through the heavy muscles and tissues of the chest wall.

Most hollowpoint pistol ammunition is composed of a cup of metal that touches the barrel, and a core of softer but denser metal that expands on impact with a target. This bullet had simply split into its component pieces, as many handgun bullets do at some point after impact. We went in and removed the bullet pieces - this situation was unusual in that they couldn’t stay where they were.

Here’s what they looked like when we got them cleaned up:

There is a dent in the lead core where it skipped off the humerus and chipped a small piece of bone away, but that damage is pretty minimal.

About 30 minutes after we took the bullet out, Bullseye was walking around. He left that afternoon and has been doing well for the last week.

For all the CSI / Law & Order / Bones fans out there, here’s the technical breakdown of the bullet path and dynamics inside Bullseye: The entry wound was on the left chest wall just behind the point of the elbow traveling slightly downward. The bullet traveled forward under the skin, beneath the shoulder blade, deflected off the head of the humerus, and passed forward across the top of the sternum through the pectoral muscles. Bullet fragments came to rest in the pectoral muscles on the right side of the chest- the bullet crossed the midline of the body. The chest cavity was undamaged.

Total length of the bullet path was 9 inches. The bullet began at .45 inches in diameter, and the expansion of the bullet left it at .70 inches in diameter when it reached the end of its travel. The separated jacket is intact, but sheared into 8 roughly even “petals”.  Recovered weight was 181.1 grains. If the bullet weight started out at 230 grains, then retained weight was about 79%.

Through an incredible set of circumstances, this bullet went from one side of the dog to the other and never hit a critical structure. He was always able to walk. During the 5 days that the bullet was in him, he was never in immediate danger.

Even so, law enforcement data shows that 80-90% of humans hit with a similar handgun round either don’t make it or are too incapacitated to continue fighting (this data is usually compiled from reports of people who are in gunfights with police).

I say all of that to say this:  Bullseye is one tough dog.