Ep 223: Foreign Body Management: A Guide for New Grad Vets, with Dr. Danny Sack

The 'So You're A Vet... Now What?' Podcast

In this episode of "So You're a Vet… Now What?" Dr. Moriah McCauley continues her conversation with Dr. Danny Sack, a first-year surgical resident, to discuss the complexities of managing foreign body surgeries in veterinary practice.

Dr. Sack emphasizes the importance of not jumping to conclusions and considering other potential causes of vomiting, such as Addison's disease, liver disease, kidney disease, or toxin ingestion. The conversation covers the essential steps in diagnosing a foreign body obstruction, including physical exams, baseline blood work, and the importance of taking multiple x-ray views. Dr. Sack also highlights the significance of considering chest x-rays in certain cases to rule out complications like aspiration pneumonia or esophageal issues.

They explore the decision tree for determining whether to proceed with surgery or attempt conservative management. Factors such as the duration of vomiting, the dog's stability, and the location of the foreign body play crucial roles.

Dr. Sack shares insights into the pros and cons of immediate surgery versus conservative management, stressing the importance of context, such as the time of day and the availability of overnight care. A significant portion of the discussion revolves around the importance of clear and honest communication with pet owners. They talk about setting realistic expectations, discussing potential outcomes, and preparing clients for both the best and worst-case scenarios.

Dr. Sack provides valuable advice on how to handle conversations about the risks of surgery, including the critical three to five-day post-operative window where complications like septic abdomen can arise. We touch on the realities of veterinary practice, where ideal textbook scenarios often don't align with real-life situations. Dr. Sack and Dr. Moriah share their experiences and the importance of being adaptable and making informed decisions based on the specific context of each case.

At the end of the episode, Dr. Sack offers words of wisdom for new graduates entering the workforce. He emphasizes the importance of building confidence, seeking mentorship, and knowing one's limits.

Episode Outline

00:01:19 - Topic Introduction: Foreign Body Surgeries

00:02:01 - Soft Tissue vs. Orthopedic Surgery Preferences

00:02:40 - Case Study: Vomiting Labrador

00:03:39 - Initial Diagnostic Steps

00:05:02 - Importance of X-rays and Blood Work

00:06:46 - Decision Making in General Practice

00:08:00 - Factors Influencing Surgical Decisions

00:10:05 - Pros and Cons of Immediate Surgery

00:11:51 - Conservative Management and Monitoring

00:13:04 - Emergency Indicators: Free Fluid and Linear Foreign Bodies

00:14:05 - Preparing Clients for Surgery Outcomes

00:16:03 - Post-Operative Care and Risks

00:18:00 - Communication with Clients

00:20:02 - Building Long-term Client Relationships

00:22:04 - Importance of Honesty and Self-awareness

00:24:00 - Knowing When to Refer

00:26:27 - Final Advice for New Graduates

00:28:36 - Dr. Danny Sack's Social Media and Mentorship

00:30:05 - Conclusion and Additional Resources

Episode Links

See more from Dr Danny Sack: https://www.instagram.com/dr.dannysack/

Connect with Dr. Danny Sack: https://www.linkedin.com/in/dsack16/

Mentioned in this episode:

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