A one-year-old male American Pit Bull Terrier mix presented to the Virginia Beach SPCA for evaluation of a traumatized left pelvic limb after having been transferred to this facility. The patient was previously found as a stray and on initial examination at an emergency facility, determined to have self-traumatized his limb by chewing off the limb distal to the metatarsus. The remaining limb had significant infection and inflammation. Due to the severity of his condition, it was determined that pelvic limb amputation was the treatment of choice.
The most serious potential complication of a pelvic limb amputation is hemorrhage. For amputation procedures, particularly in large dogs, methods of adequate hemostasis must be available (MacPhail). It is essential to securely clamp and ligate the major vessels in a pelvic limb amputation. Due to the large number of muscles that must be transected in addition to ligation of the major vessels, there is significant additional hemorrhage that occurs. In facilities with access to electrocautery and surgical laser, these tools can achieve hemostasis in a timely manner. However, these surgical capabilities are costly and not available in many practices.
VETIGEL® is a sterile hemostatic gel that can be utilized as a cost-efficient alternative to electrocautery or surgical laser. This is a widely available product that provides quick hemostasis, allowing veterinarians to minimize both the hemorrhage experienced by their patients as well as time spent under anesthesia.
In this case, VETIGEL® was used to provide hemostasis to all bleeding vessels encountered during the transection of the muscle bellies. Previous to having VETIGEL® these vessels would have required a combination of clamping and ligation and utilizing an assistant to apply pressure to the bleed. These techniques are time consuming for the veterinarian performing the procedure. VETIGEL® provided rapid hemostasis within seconds and did not require further time or attention from the author. The major vessels were clamped and ligated.
Utilizing VETIGEL® in this patient led to a shorter surgery time as well as minimizing complications seen commonly post operatively in limb amputations. These complications include incision problems such as seroma, hematoma, and dehiscence (MacPhail). Therapeutic laser was also utilized in order to minimize postoperative complications, as well as placement in a foster home to minimize activity and possible infections that can more commonly occur in a shelter setting. The patient was healed completely within two weeks and adopted out thereafter.
Overall, the use of VETIGEL® in this case led to a better patient outcome both in surgery and recovery and cost savings from decreased use of other resources to achieve hemostasis including surgeon time and supplies.
MacPhail, DVM, PhD, DACVS, Catriona. Full and Partial Limb Amputation. 2019. ABVP Speakers, https://www.vin.com/doc/?id=9242907.