They are a necessary evil at my job - Elizabethan collars.
So many different names, including e-collar, cone of shame, plastic cone, and my personal favorite - the party hat. Hey, it's best to make them a fun as possible, since they're not at all fun.
Monday morning our tech was bringing up each surgery patient for me to examine. I got a good laugh out of the last dog.
Harry was a Cocker Spaniel mix who had a rough go of it last week. He got attacked by a pack of loose dogs, and let me tell you, he is lucky to be alive. His entire body from the shoulders back were a series of bruises, puncture wounds, and lacerations. He had surgery early last week to repair the damage, and the end result was a Frankendog with drains. Because of the nature of these wounds (bite wounds are nasty), we warn clients to expect 2 surgical procedures, as some of the tissue that looks okay at the first surgery will often die and need to be "debrided" at a later time.
Sure enough, a patch of skin on his back had "died." The skin blackens and dries out as it dies - this is kind of a gross analogy, but it feels like a potato chip - crispy. We go in and remove the dead tissue, and if the dog is healing appropriately there will be a layer of bubblegum pink (ha! another food analogy)healthy tissue underneath. We close the skin over that new tissue and voila, in most cases they heal up fine after that. Ug, sometimes there ends up being 3 surgeries, but not too often.
So anyway, back to Harry - I promise I wasn't laughing at him because of his wounds. We had sent him home with an e-collar to keep him from chewing his sutures and drains out. Apparently the e-collar we sent home had met some unfortunate end, because he had a new - homemade - one. . . . made out of a Miller Light case.
It was awesome! And not just because it was funny - it meant that the owners were being compliant! Yay, they listened to us!
Honestly, I think 50% of all e-collars sent home go straight in the trash.
I go through the same routine multiple times a week. Dog with a hot spot, cat with an abscess, various surgeries. I address the problem, prescribe the appropriate medications, then bring up the e-collar. You wouldn't think it would be such a touchy subject, but it is.
My favorite e-collar story is about Bubba, a 100 pound fat (not just overweight, but fat) Shepherd mix who came in for a mass removal. I had seen Bubba 6 months earlier for his annual exam and vaccinations. At that visit I found a mass on his hip that I recommended removing. It was under the skin and about the size of a walnut. But instead of being soft and freely moveable, it was hard to the touch and firmly adhered to the underlying muscle. And let me tell you, Bubba - who wasn't a big fan of the lady in the white coat anyway - did NOT appreciate me messing with it. I explained that I was suspicious the mass was cancerous and quoted the owner $300 for surgery - that included anesthesia, surgery, and pathology on the mass so that we could see what it was.
As is common, the owner balked at the price and elected to just watch it for the time being.
Six months later when Bubba returned I could smell him before I saw him. The walnut size mass was now the size of a cantaloupe, and had ruptured open. It was a big, nasty, infected mess. And weirdly, Bubba acteed like he could've cared less about the oozing second head coming off his hip. He was still happily chasing tennis balls, he hadn't lost any weight, and he still wanted to eat my fingers.
The owners said that as they had watched the tumor enlarge, they had decided that due to Bubba's age that they didn't want to put him through surgery. They new it was probably cancer, but he still seemed happy. The wanted him to just enjoy the time he had left.
But now it was oozing all over their house, and by the way could I take it off now?
I calmy explained that at it's current size that not only would be almost impossible to remove the whole tumor, but it would also be very difficult to close the void that it would leave in his side. I went on to say that it would be best if they took Bubba to a board certified surgeon and oncologist.
They didn't want to spend that kind of money, so the next day Bubba was on my surgery table. The other doctor at the practice and I removed our first ever Siamese twin. The surgery took forEVER, and I remember the other doctor (who had been in practice 15 years longer than me) saying repeatedly, 'This is NOT ideal.' As predicted, we weren't able to remove all of the tumor, but were able to get the wound closed. The owner didn't want to pay for pathology on the mass, so I'll never know what it was. Boo.
I left that practice 2 years later, and Bubba was doing fine. I'll be darned if that tumor never came back. This after I assured the owner that it would. Bubba was one lucky pooch.
We discharged Bubba a few days later. I always go over discharge instructions BEFORE bringing the animal in to the owner, because if I do both at the same time the owners don't listen to anything I say.
Me (after going over Bubba's meds): Well, the last thing to go over is the E-collar.
Client: The E what?
Me: The Elizabethan collar, to keep him from bothering his incision.
Client (as a look of dawning horror crosses his face): You mean he has to wear one of those lamp shades?
Me: Yes. It's extremely important that he wear it at all times.
Client: . . . . . .Bubba's not going to like that. . . .
Me: They don't like it, but if he doesn't wear it he will chew his sutures out, and then we'd have to do surgery
again. Bubba wouldn't like that very much.
(Neither would I as Bubba hates me a little more because of this whole ordeal, and hasn't been a model patient during his hospitalization)
Client (sighs dramatically): Well . . . I guess we'll see how this goes.
We bring Bubba up to his owner, and it's truly a Kodak moment. His owner cries with joy to see him, and Bubba is the happiest of happy 100 pound, fat dogs. He nearly knocks to owners legs out from underneath him with the e-collar (which, being the extra larger size has a wingspan of about 4 feet). I warn the owner to remove every thing breakable from Bubba's level as he will destroy it.
Dogs and e-collars are funny - they either use it as a weapon, or they stand stone still for several hours until they realize it isn't coming off (then they proceed to use it as a weapon).
Two days later I came into work, and was horrified to see Bubba on the surgery schedule. Apparently the first night at home, Bubba stood up the whole night and didn't sleep. The next morning they took the collar off, and he didn't bother his incision all day long he was sooooo good so they left it off and went to bed. Bubba happily curled up on the end of their bed and went to sleep.
And chewed all of his sutures out during the night.
The receptionist said the owner wasn't very talkative when he dropped Bubba off.
That whole shebang cost a LOT more than the original $300 estimate.
Keep the e-collars on, folks. It hurts you a lot more than it does them.