Larry ID A527443 arrived at Orange County Animal Services as a stray on 5/25/23. On veterinary examination he was noted to have a large healing wound so his head, unkempt nails and tested positive for heartworm disease. The following day he was also noted to have crusting on his cropped ears.
His wounds were cleaned and treated with iodine over the following days.
On June 5th Larry was neutered at the shelter clinic.
The next medical check for Larry was his 7 day post neuter incision recheck on 6/12/23. His assessment was “Edema/Swelling”. He was given laser treatment and prescribed carprofen for 7 days.
Two days later during a cage side visual exam his assessment was “Worsening scrotal hematoma”. He was taken to the clinic for a physical exam, replacement of his cone which had been removed on 6/12 and more laser treatment.
On 6/15 Larry was again seen on routine rounds of the kennels and on visual exam his assessment was that he was expressing mild pain from the scrotal hematoma. He received additional laser treatment.
On 6/16 Larry was triaged to the clinic. His scrotal swelling was noted to be severe at this time (approximately grapefruit sized) and his incision was oozing to the extent that the discharge was draining along his hind limbs. He was prescribed enroflaxin in addition to the carprofen, repeated laser treatment and cleaning daily until recheck 3 days later on 6/19.
When brought for laser treatment that day 6/16 there was a “newly noted nole on the prescrotal region”. His hind limbs were cleaned of discharge with chlorhex solution soaked gauze and they “flushed hole with betadine”. Due to his “worsening condition” management approval was sought and given for Larry’s transfer to the VEC from that day Friday 6/16 until Monday 6/19.
Larry was transferred to the VEC that evening ……………………………..
At 10:02 am on Saturday 6/17 a rescue please was issued for Larry. It stated –
Meet Larry!
He is one of our ready to go shelter dogs.
He is very friendly and although he is intrusive, he has been paired with other dogs (females). He had a scrotal hematoma developed after his neuter surgery on 06/05/23 that rapidly declined. He is at the VEC being monitored and having treatment but would benefit from rescue placement.
Please let us know if you can take him!
This animal needs to receive a rescue request by 06/19/2023.
but was picked up next day Saturday 6/17. He was taken to the clinic for exam. The reason noted for exam is “requested return from VEC, no records provided”.
The findings were – ” severe ulceration right inguinal area approximately 7cm
x 4cm with SQ and muscle exposure, appears to have right testicular pedicle present with suture
present, moderate caseous material and granulation tissue, moderate serous discharge.
Moderate swollen scrotum with moderate bruising (smaller than previous), weight of swollen
scrotum noted to be pulling open ulcerated area. Dog noted to lay frog style on floor with
ulcerated area touching floor. No signs of URI.
Recommendations: continue Enrofloxacin. Continue E collar, request tech to place additional
plastic E collar due to donut E collar too short. Request tech exam, laser, flush with chlorhex,
place bandage. Recommend outcome ASAP, recommend follow up at own veterinarian after
adoption, rescue, or RTO for further testing and treatment of severe ulceration right inguinal area.
Discussed with HM and ARV. Completed 6-18 vet exam, Recheck due to exposed to URI
Q3days. Refill Carprofen, current rx ends on 6-18, continue new rx starting on 6-19.”
He was again given laser treatment. “Applied splash block. Flushed wound with dilute chlorhex solution. Placed “jock strap” style bandage with vet wrap and tell pad over inguinal areas, leaving penis and rectum clear, loops around proximal thighs. Continue donut E-collar, added plastic E-collar. High priority tech exam tomorrow to check bandage with DVM.”
At 3/23 pm an Urgent Rescue plea was issued for Larry – ” Larry is back from the VEC and needs placement TODAY! ….. This animal needs to receive a rescue request by 5:00PM TODAY.“
The following day 6/18 Larry was “Brought up to clinic for bandage change. After removed bandage, dog began bleeding moderate amount continuously from inguinal area, suspect from penis, cannot rule out caudal superficial epigastric or femoral artery or vein. Discussed with ALS. Immediate 300 due to severity of wound.”
There are several inconsistencies in the explanation given by Christine C Cowgirl- Fiorito
- Medical records show no request for rescue being made on Friday 1/16
- The first rescue plea issued for Larry was Saturday 1/17 at 10:02 am. It states that he is at the VEC.
- VEC records state – ” OCAS officer dropped off for weekend monitoring of scrotal swelling post neuter. Spoke with on call DVM Downs and offered scrotal ablation to be performed by VEC DVM. Declined scrotal ablation, plan to keep on orals and OCAS to call if they findfoster/rescue for pt over the weekend or they will keep here till Mon.”
Communication from Christina C Cowgirl-Fiorito, Program Manager, Clinic
My understanding is that kennel staff (not sure who) brought Larry up to the clinic sometime during the morning or early afternoon of 6/16/23 due to observing abnormal swelling of Larry’s scrotum. Dr. Glotfelty-Ortiz was the only vet that day and was in surgery so she did a brief visual exam and had Larry scheduled to be looked at more closely that afternoon. When Larry was brought back to the clinic for the hands-on exam that afternoon, Dr. Glotfelty-Ortiz noted that Larry’s condition was worsening and notified Kristin Tsukamoto and Heidy Matos (the Communications Program Manager and the Rescue Coordinator) to see if we could get Larry to a rescue who could pursue additional vet care. Unfortunately, no rescue was able/willing to pick him up that evening, so Larry was sent to the VEC to be monitored and treated until rescue could pick up. Some time between the evening of 6/16/23 and the morning of 6/17/23, the VEC vet called the OCAS on-call vet and explained that Larry would need an ablation. While we don’t do scrotal ablations routinely, they can be done here when necessary. Larry was transferred back to OCAS Saturday morning so that Dr. Haas could do the ablation. When Larry arrived back at OCAS, his scrotum was much worse than we’d thought it would be based on the VEC’s description and it was determined that a normal scrotal ablation was probably not going to be successful. It appears that, while at the VEC, someone had taken off Larry’s e-collar (cone) and replaced it with a donut style collar which had allowed Larry to reach his scrotum and damage it further (see before and after photos). The e-collar was placed back on Larry and Communications again made an appeal to rescues to pick Larry up to get him to a higher echelon of care. Bully Love requested him but was unable to pick up same day. While waiting for rescue pickup, Larry was medically managed with an antibiotic and anti-inflammatory/pain medication. By the next hands-on exam the afternoon/evening of 6/18, Larry’s condition had declined to the point where it was no longer appropriate to hold him in facility and, after Dr. Haas discussed the case with Amy Sullivan of the Communications Team, the decision was made to euthanize him.
In the shelter environment, it is not feasible, due to staffing constraints, to do daily hands-on incision rechecks of all the animals who have had surgery. Most post-surgical complications are caused by the animal licking or chewing at their incision, therefore, following surgery, dogs wear an e-collar for at least 7 days to prevent them from accessing their surgery site. At day 7, their incision is checked by a veterinary technician. If the veterinary technician deems the incision to be sufficiently healed, they remove the e-collar. If the veterinary technician has any concerns about the incision, they leave the e-collar on and bring the dog to one of the veterinarians for further examination; the veterinarian will usually extend the duration of the e-collar and, if appropriate, prescribe additional treatments.
In Larry’s case, the 7 day recheck on 6/12/23 resulted in the tech bringing Larry to Dr. Haas who noted that the incision was closed, had no redness, but did have some swelling. She administered a cold laser treatment and prescribed an anti-inflammatory. The e-collar “prescription” was set to run until the 19th. Dr. Haas also scheduled future cold laser treatments for the 14th and 16th. By the 14th, the scrotal hematoma had worsened but Larry was in with another dog and his e-collar had come off or been removed at some point between the 12th and the 14th (there are no notes indicating how the e-collar came off and, per the e-collar prescription, it should have been on; it is quite possible that he got it off himself or the other dog in his cage played a part in getting it off). His e-collar was put back on and he received his cold laser treatment. By the 16th, a hole was found on the pre-scrotal region and Larry was becoming reactive to handling. It was then that he was transferred to the VEC.
Improve OCAS Movement 