Jesse Terry, 33
Small-Animal Surgeon
Ogden, Utah
When I came out from vet school, I was leaning toward emergency and critical care. I was in my rotating internship, working long hours. I was exhausted. I realized that I felt most fulfilled when I was doing surgery. I loved the speed — the adrenaline rush, if you will. I did a second internship, like an apprenticeship, which allowed me to do surgery at a “higher level.”
My clinic is about 30 minutes north of Salt Lake, in a suburb called Ogden. Most of my patients are companion animals from suburban homes with a white picket fence — the golden retriever that lives with 2.3 kids. I’ve seen ducks. Some cats. But 80 to 90 percent of my patients are dogs. The surgery we do is at a pretty high level. For example, you hear about people getting cameras put in their knee to scope their meniscus or their ACL. We do that in dogs.
There’s been a real shift in our attitude toward pets. Fifty years ago, it was the farm dog. When they got old, you put them down. Now, we’re treating them like family members. That’s why specialists are becoming more common.
I may repair a broken bone or treat diseased joints. I also do neurological surgery. Dogs herniate their intervertebral discs pretty routinely. We do advanced imaging like MRIs, and then we can decompress the spinal chord if we find a disc that’s bulging. I do a lot of soft-tissue surgery —usually a major tumor removal. I remove a lot of tumors from the lungs. There’s a select few heart procedures we can do.
Dachshunds are the poster children for herniated discs. It’s the way they’re built. Their discs like to degenerate and weaken over time. It puts pressure on their spinal cord. These dogs will typically come in with back pain and weakness, or paralysis in their hind limbs. They can use their front limbs pretty normally, but they’ll drag their back legs like a drunk. Most owners would know something is up because suddenly the dog is tripping over itself. This form of surgery was almost a weekly occurrence during my residency, and it’s super common in hospitals across the state. It’s rewarding because most of those dogs do quite well if you can get to the disc and decompress the spinal cord in time. Most go on to walk again.
Heading into surgery, my typical fears include losing the animal, anesthetic complications, and death. A surgeon is always concerned when working around the spinal cord, as we know we could make the problem worse, and the dog could be permanently paralyzed and never walk again. It really takes the right owner and the right situation to be able to handle a paralyzed dog. We can order dog wheelchairs: carts that can be fitted to dogs. Some of them get put down, unfortunately.
There is also the fear that dogs could bleed out. I haven’t had a dog hemorrhage to the point of death, but they can bleed quite a bit. For neurosurgery, the infection rate is pretty low, but if they get one, it can be a nightmare. Sometimes, the surgery can affect the dog’s ability to urinate or defecate, so that can be a post-op complication. The dog might require bladder expression (squeeze its bladder to release the urine), which is asking a lot of an owner. The hope is that those things are transient, and that as the dog recovers, it regains its ability. But there are no guarantees, not in life or in dog surgery.
A big part of my job is educating the owners, really preparing them for what to expect: whether or not we do surgery, how the recovery’s going to be, the prognosis. That’s the stuff that falls on the owner because they’re going to be the nurses once the dog goes home. If they have a 130-pound dog and it’s going to require assistance to walk around the house because we just did major orthopedic surgery, they need to understand that’s a big undertaking.
I often think: “I wish I could just cut to the chase and talk to the dogs.” It would make my life easier. You meet owners from all walks of life, and they all more or less love their animal. They’ve taken time to bring it to the hospital, but everyone varies in terms of time and finance. There are cases where I feel like the owner doesn’t get it, regardless of how much we try to explain. Or I thought we were all on the same page, and then they weren’t monitoring the dog the way they should have, or weren’t giving the antibiotics or pain medications the way we spelled it out. As a vet, you’re the advocate for that animal, and you’re the one who really needs to make sure — if you’re going to go through major surgery — that you’re maximizing that animal’s chances for a successful outcome.
A lot of times that comes down to how the animals are cared for once they leave our hospital. Maybe the dog’s going to need a pill every eight hours, and the owner works 12-hour shifts: They have to get someone to come over. Maybe this animal’s going to need more frequent walks, or it’s going to need assistance walking, or it’s going to need to have its incision iced.
It’s a mistake to try to prejudge what owners are willing to do. During my internship, there was a dog that was hit by a car. He was bleeding and needed a blood transfusion, and I was looking at the owner — this kid in his late teens, early 20s — and I was just thinking, there’s no way he’s going to be able to finance the thousands of dollars that it’s going to take. I gave him the estimate, and he didn’t bat an eye as he walked over and paid. But I’ve also seen people pull up in $50,000 vehicles, only to scoff at a $100 X-ray.
During my residency, I had a heeler who had an adrenalectomy (removal of the adrenal glands, in this case due to tumors). It was a big deal. I guess I got attached to both the owners and the dog. The dog stayed in the hospital for close to a week. The surgery went really well, and the initial outlook was good. And then she started to decline. She did this roller coaster for several days. The second I thought she might be done, she would rally and have a good day. I’m on the phone with her owners and her referring vet throughout the whole process, and we’re consulting the other specialties in the hospital, talking to our medicine team and our oncologist and the criticalist. Everybody is just rallying around this dog. And again, she looks good, and then she looks bad, and then she looks good, and then she looks bad — ultimately, she arrested and passed away on the front lawn of the hospital with me and the owner. It was tough. So many people had been behind her. We invested so many resources into her.
Luckily, death for a specialist is not as common as it is for general practitioners and shelter med vets. Sometimes, we find more cancer than what we’ve expected, or it’s more diffused than we suspected — and that’s always a difficult phone call, when we tell the owner that the surgery isn’t going to be successful.
The debate becomes: Do we wake the animal up and allow the owner to say good-bye? Or do we euthanize the animal on the table? My preference would be to not wake it up because it’s got a lot of drugs in its system, it just had surgery, and then we’re going to put it down right after. But a lot of people need to see their animal before they put it down. That’s a tough one. I try to encourage them to make peace, for lack of better terms, before surgery.
When I was a rotating intern, I did a lot of emergency and in emergency, you see a lot of critical cases. There were shifts where I would euthanize three, four, or five animals. It’s hard to get off a shift like that and feel good. It’s horrible because when a family says good-bye to their pet, it’s usually a dog or cat they’ve lived with for five, ten, or 15 years. It’s a family member.
There’s a pretty high suicide rate in our profession. I think part of it is that the type of people attracted to veterinary medicine are type A. I think vets feel like they’re having to cut corners to keep the cost down, and they know the care could be better, and it just gets stressful. And they’re saying good-bye to the patients they’ve been seeing for years, and when you lose a patient — especially unexpectedly — you start wondering, “did I do anything wrong, or is there something that I missed on my last exam?” You take that home every night.
Surgeons are notorious for maybe being a little colder. I think to be a good surgeon, you have to have at least a little bit of disconnect. When we do surgery, the animal is covered in a big sterile drape. You’re not really looking at the dog’s face. You’re not thinking about the 8-year-old girl who owns this wiggly, cute, little puppy. You’re looking at the draped-out portion of what you need to focus on. You’re just looking at red wires and blue wires.
If you can’t turn that off, it adds to your anxiety, and that can impact your job. Afterward, I can go back to thinking about the cute schnauzer.