Hanging tough

I've practiced veterinary medicine for 27 years. But in the early years I had a lot to learn. One Saturday I received an emergency call from a local rancher. His working dog had been run over.

Aw, nuts! Like most veterinarians, Dr. Frank Grasse (shown here with his staff member's dog, Tangles) is proficient at taking testicles out of pets. With one of his earliest clients, however, the procedure was a little different.

The truck pulled into the parking lot and the rancher carried his dog into my clinic wrapped in his jacket. I had seen a few emergencies by then, and not all of them had turned out successfully, so I hoped I would be able to help the pet and send it home with its owner. I was nervous.

"Hi, I'm Dr. Grasse," I said in my most professional manner. The rancher placed his dog on the examining table still wrapped in his jacket.

"Well, Doc, Jeb here has a problem down below," he said as he gently pulled the jacket apart.

My fears of abdominal rupture, broken ribs, and broken legs were immediately dismissed as I looked down on the most unusual injury I had seen up to that point. Jeb's testicles had ruptured through the scrotal sac. I realized with relief that this emergency would be simple; all I had to do was neuter Jeb and close the two scrotal injuries.

But before I could tell Mr. Richter my plan, the rancher tilted his cowboy hat off his forehead and fixed me with a grave look. "Doc," he said, "this here Jeb is my best working dog and I intend to use him for breeding. My friends can't wait to have a dog sired by this boy."

I looked closely at Mr. Richter's face, waiting for the smirk. It didn't appear.

"Mr. Richter," I replied, "as you can see, Jeb's testicles are lying on his abdomen and they're covered with dirt."

"Yep."

"But, Mr. Richter, what do you think I can do with this?" I was starting to panic.

"You're the doc. I expect you to put them back in."

"Back in?"

"Yep."

"But they're contaminated, and if I put them back in an infection could travel up the spermatic cord into the abdomen and he could end up with peritonitis. At the very least the testicles will probably abscess inside the scrotal sac, and even if all those things don't happen, I really doubt if he'll successfully breed."

"Oh."

"So surely you can see that the best option would be to neuter Jeb."

"You want to castrate my best working dog!"

"Well, yes. I mean, it would be the best thing to do. You can see that, can't you?"

"Nope."

I was pleading at this point. "But, Mr. Richter, what else can I do?"

Mr. Richter was clearly losing his patience with this young veterinarian. "I expect you to do your job, Doc. I expect you to put those nuts back where they belong."

There was a moment of silence as the words sank in and the blood drained from my face. I tried to control my voice and not sound desperate; I really didn't think I could do such a task. In my short career I had only taken testicles out, never put them back in.

"When are you going to do it, Doc?" the rancher asked.

"Well, I'm—I mean ... I'm going to do it right now. And since I don't have any staff here on Saturday, you're going to help me."

A broad smile came over Mr. Richter's face. "OK, Doc. Let's get started."

I was so upset and nervous that I didn't even move Jeb to the presurgery treatment area or into the surgery room. Right there on the exam room table I anesthetized Jeb and began meticulously cleaning his testicles, picking off all the specks of dirt, and washing and disinfecting the area. I repeated this process over and over again.

"Now, Mr. Richter, I want you to hold Jeb's legs like this and watch his chest to be sure he's breathing."

I put my head and eyes so close to Jeb's privates that all I could see were the scrotal tears, the spermatic duct, and the vessels attaching the testicles to Jeb. I lubricated the testicles with an antibiotic ointment and one by one placed them into the proper scrotal tear, making sure they hadn't been compromised. I sutured the inner wall of the scrotal sac separately and then stitched the skin of the scrotal sac.

When I was done, I looked up at Mr. Richter. I don't know what I expected—maybe recognition for completing the most miraculous surgery of my career. But he just wore a solemn expression. Like we had simply vaccinated a few steers.

"Well, that's done. I'll be taking Jeb home now."

Now I finally lost it. No composure, no professional manner. "Take him home?" I shouted. "Jeb needs to stay here! I need to continue IV fluids and antibiotics and check his incisions and his temperature in the morning."

"Well, fine then. I'll see you in the morning."

"But tomorrow is Sunday, Mr. Richter."

"Yep. What time, Doc?"

I was too tired to continue arguing. "Nine a.m.," was all I could muster.

"See you then, Doc."

And with that he was out the door and in his truck.

I moved Jeb to the kennel area and put him on a big blanket. I put an Elizabethan collar on his neck so he wouldn't injure the surgery sites. I adjusted the intravenous fluids and went about cleaning up the mess left after the preparation and surgery. The next day I sent Jeb home with Mr. Richter with instructions on caring for the incisions and giving the antibiotics.

Mr. Richter never came back for the suture removal, so I didn't find out what became of Jeb. He could've died, been destroyed, been taken to another veterinarian to fix what I'd done, or any number of possible scenarios. I was too scared to call and find out.

Years went by. I didn't see Mr. Richter in town or hear anything about Jeb from another veterinarian. But during a rabies vaccination clinic, a dog was presented to me. I'd vaccinated hundreds of pets that day, and I was exhausted. I was on my knees looking wearily for the spot on the rear leg to inject the vaccine when I heard a familiar voice.

"Do you recognize him, Doc?"

I looked up to see Mr. Richter holding the end of the pet's leash.

"Mr. Richter!"

"Yep."

"Is this Jeb, Mr. Richter?"

"Yep."

"And he's OK?" I couldn't believe my eyes!

"Take a look for yourself, Doc. He's sired five litters since we saw you."

Veterinarians do strange things. When we're out in public we can clear the room in no time flat as our conversations turn to surgery, blood, necropsies, and other gory topics. So I don't think too many people took notice when I crouched down and performed a closeup inspection of Jeb's privates. To my relief, satisfaction, and excitement, Jeb had two normal-looking testicles.

"Thank you, Mr. Richter," I said. "I'm glad you brought Jeb down so I could see him."

"Well, he needed a rabies shot, Doc." And with that he turned, loaded Jeb into his truck, and drove away.

Dr. Frank Grasse owns East Hill Veterinary Clinic in Willits, Calif., and is the winner of our 2007 article contest. Do you have a great story to share? Watch for our 2008 contest in the fall.