The three-month-old pit bull mix puppy arrived at Ryan Hospital’s Emergency Service from the Animal Care and Control Team of Philadelphia (ACCT). His fur was matted with feces, he couldn’t bear weight on his left hind leg, his skin was extremely pink and painful to the touch, and his ear was swollen.
Dr. Erin McGowan, Resident in Emergency and Critical Care, triaged the pup upon arrival, and administered pain medications and antibiotics right away.
“The damage to his skin looked like either a chemical burn or urine scalding,” said McGowan. “Whatever the situation was, it wasn’t good.”
But the dog named Punky was in good spirits from the moment he entered the hospital on March 30. “He had all the reasons in the world to be miserable, but this was the best day of his life,” McGowan said.
A Second Chance
A good Samaritan brought Punky to ACCT, where he was deemed a perfect candidate for a unique program at Penn Vet that gives shelter dogs a second chance at life.
Through the Shelter Dog Specialty Medical Treatment Project, made possible by the Richard Lichter Charity for Dogs, experts at Penn Vet’s Ryan Hospital provide specialized medical care to dogs in need from area shelters. The program is run by Penn Vet’s Shelter Medicine Program, led by Dr. Brittany Watson, Director of Shelter Medicine and Community Engagement.
All diagnostic and medical services are covered free of charge to Penn Vet’s shelter partners, which often do not have the resources necessary to address these more complicated concerns. Following treatment, the dogs are placed in foster homes and made available for adoption. Many of the dogs in the program remain in the Penn Vet family.
“I love being able to provide this deep and meaningful connection between shelters and Penn Vet to give these animals the best possible care without reference to cost,” said Watson. “It is something that is unheard of in shelter medicine. Richard’s vision has been life changing for so many shelters, dogs, and clinicians.”
"Our collaboration with the Richard Lichter Charity for Dogs, and ongoing relationship with Penn Vet, has helped ACCT Philly provide the best in veterinary medicine for several sick and injured homeless dogs,” said Dr. Hillary Herendeen, staff veterinarian at ACCT Philly. “These are dogs whose needs were so urgent that euthanasia was the only alternative. Through this program, many lives have been saved, and even more made more comfortable, more quickly."
ACCT identifies and evaluates dogs that might benefit from this program. If an animal seems like a good candidate, they contact Penn Vet’s Shelter Medicine team.
Students in Penn Vet’s Shelter Medicine rotation assessed Punky under Watson’s guidance. Given the severity of his injuries and the potential need for surgery, the program was his best chance for survival. The team knew Punky would benefit from the multitude of experts at Ryan Hospital, and recommended consultations with vets in the emergency, dermatology, and surgery services. ACCT quickly organized transportation for Punky to Penn Vet.
An Amputation
Following his stay in Penn Vet’s Emergency Service, Punky was transferred to the surgical team. Dr. Brian Brophy, Surgery Resident, took over the case.
“Punky wasn’t using his hind leg appropriately,” Brophy said. “It was very stiff and he was dragging it. His hind legs were covered in what appeared to be old, inactive burns.”
Experts from Penn Vet’s Dermatology Service were called in to examine Punky’s skin. They determined that his legs were covered in either chemical or thermal burns.
Next, radiographs were taken to determine the cause of the leg injury.
“Everything looked OK orthopedically,” Brophy said. “So we suspected that the burns were likely the primary injury. Because of the way the skin healed, Punky was unable to straighten and use his one hind leg.”
As a result, the young puppy had developed a quadriceps contracture, an irreversible problem that prevented Punky from bending his left hind leg. Because the limb was no longer functional, amputation was necessary. Brophy oversaw the surgical procedure.
“Dogs that undergo amputation, especially young dogs, get around very well and adjust very quickly to being on three legs,” said Brophy. “Two hours after surgery, Punky was hopping around without any problems.”
Foster Care
Punky was recovering from surgery in the orthopedic wards when Amanda Kiselak, then a fourth-year Penn Vet student, locked eyes with him. The moment Kiselak saw the small, white puppy, she fell in love. She texted a photo of the dog to her fiancé, Adam Nebzydoski, then a third-year Penn Vet student, noting that he needed a foster family. Adam’s response was immediate: “We can foster him.”
“We were not in the market for another animal, let alone a three-legged puppy,” said Kiselak. “But there was just a feeling that it was meant to be.”
She and Nebzydoski immediately got in touch with Dr. Brittany Watson to make foster arrangements.
The first hurdle was introducing Punky to Sierra, Kiselak’s dog-reactive dachshund. Surprisingly, Sierra took to Punky right away. “It was a huge relief,” said Kiselak. “We thought, maybe this really is meant to be.”
It didn’t take long for the foster family to become Punky’s forever family.
“In our heads, we were fostering him,” said Kiselak. “But in our hearts, we had adopted him.” Soon, Kiselak and Nebzydoski were filling out adoption papers. They quickly changed Punky’s name to Lieutenant Dan, in honor of the amputee in Forrest Gump. He is affectionately referred to as “Louie.”
An Infection
After four days with Louie at home, Kiselak noticed that his incision appeared to be leaking. Nebzydoski was tasked with taking Louie on walks every four hours. He kept a close eye on the incision throughout the day. When the time came for their 3:30 am stroll, Nebzydoski saw that Louie was covered in sticky liquid. Suspecting an incisional infection, Kiselak immediately emailed Dr. Heidi McDevitt, Surgery Resident. Despite the early hour, McDevitt responded within minutes. “She told me to bring him to Ryan Hospital right away,” Kiselak said.
“Louie’s incision site was swollen and had some discharge, and the middle sutures were coming apart,” McDevitt said.
According to McDevitt, incisional infections happen in about 10 percent of patients. They commonly occur when animals lick their incision sites. McDevitt hypothesized that Louie outgrew his e-collar and was able to reach around it to lick a small portion of the incision.
Thankfully, Louie’s vital parameters were normal and he did not have a fever. McDevitt collected a culture, flushed the incision, and started the puppy on antibiotics. She did not have to debride or re-close the incision.
Throughout the procedure, Louie maintained his delightful demeanor. “He was so happy the entire time he was in the hospital,” said McDevitt.
Kiselak and Nebzydoski brought Louie back to Ryan Hospital regularly to have the incision inspected. It healed on its own within days, thanks to the antibiotics and a larger e-collar that prevented Louie from licking the site.
Thanks to his owners’ vigilance, Louie avoided more serious complications. “If they had waited to seek veterinary care, it could have become an abscess,” explained McDevitt.
“It’s not always obvious that this is a complication,” added Brophy. “Sometimes people think the sutures are coming out, as they’re supposed to, and so they don’t worry about it. Because Amanda and Adam are vet students and have been through surgery rotations, they recognized the red flags.”
The Gold Standard
Today, Louie is loving his second chance at life. Sierra has become very maternal with him. And he is quite popular in his neighborhood, where he’s known as the “Mayor of West Philly.” It’s when he visits Penn Vet that he reaches true celebrity status, though.
“Everyone [at Penn Vet] is so proud of their roles in his story,” said Kiselak. “Dr. McGowan announces that she admitted him. Dr. Brophy tells everyone that he did the surgery. And Dr. McDevitt says she picked up the pieces.”
The one thing they all comment on is Louie’s remarkable spirit throughout it all. “He’ll have scars forever,” said Kiselak. “But he’s not a ‘woe is me’ dog. He’s always just so happy.”
Seeing dogs like Louie triumph over adversity is rewarding for everyone involved in the Shelter Dog Specialty Medical Treatment Project.
“These dogs come from nothing and now they have everything,” said McGowan. “It makes me proud to work at Penn Vet.”
"This relationship, unlike the more traditional rescue, enables our staff and foster families to see a pet make the full journey from traumatic intake to happy re-homing,” said Herendeen. “This has become a very special experience for our hard working teams at ACCT Philly."
“These are highly adoptable animals with significant but fixable medical issues,” said McDevitt. “Rather than face euthanasia, they come here and receive the gold standard of care. And it’s without financial constraints. Mr. Lichter makes this all possible, and we are so grateful.”