Soki, a 2-year-old French Bulldog, was one of 58 pets scheduled to be vaccinated on April 17 at the ASPCA Community Veterinary Clinic (CVC) in the Bronx.

“She came in for a simple vaccine but was wearing a diaper,” says Dr. Evelyn Cintron, a Community Medicine staff veterinarian. “When we asked why, we learned she’d been having bloody vulvar discharge.”

During her physical exam of Soki, Dr. Cintron felt an abdominal wall hernia and noticed Soki was in heat. The hernia, a weakness in the abdominal wall muscles that caused her abdominal contents to protrude, had resulted from a previous surgery performed elsewhere, according to Dr. Lori Bierbrier, Senior Medical Director of Community Medicine, Eastern Region.

Doctors chalked up the bloody discharge to Soki’s heat cycle and scheduled Soki for spay surgery and hernia repair the following day.

As Soki was prepped for surgery, Dr. Kathleen Jones, Veterinary Staff Manager for the Bronx CVC, noticed a large volume of thick, bloody discharge. Soki had an infected uterus, called a pyometra. During surgery, doctors saw her uterus was attached to other internal organs making it difficult to remove, unlike a normal uterus.

“Dr. Jones acted quickly, addressing each hurdle as she approached it, with a calm demeanor,” says Desiré L. Marulanda, Client Operations Manager. “Dr. Bierbrier stepped in to assist as complications arose, but it was apparent Soki’s spay would be difficult.”

Dr. Jones and Dr. Bierbrier decided Soki’s surgical challenges would best be handled by a board-certified surgeon and contacted Dr. J’mai Gayle, Director of Surgery at the ASPCA Animal Hospital (AAH).

Following a phone consultation, Dr. Gayle suggested doctors close up Soki and transport her to the Hospital, which has the surgical and anesthesia support for more complicated surgery and an ICU for animals needing intense overnight care.

“If we had known about Soki’s difficulties in advance, we would have referred her directly to AAH,” says Dr. Jones. “Had she only had a pyometra and body wall hernia with no additional complications, we would have been able to complete her surgery.”

Desiré arranged for Soki’s transport to the hospital by Kofi James-Deanes, Transport Coordinator for Community Medicine.

Dr. Gayle removed Soki’s uterus by making a longer incision and using abdominal retractors to keep the incision open.

“This allowed me more room to work so I could better determine which tissues were involved,” says Dr. Gayle. “Soki’s infected uterus was leaking fluid into her abdomen and there were multiple adhesions, or scars, on her small intestine and other abdominal organs.”

To further complicate matters, multiple gossypibomas were found in Soki’s abdomen.  Gossipybomas are scarred masses that had formed around pieces of cloth like a towel or gauze sponge which had been mistakenly left behind from Soki’s initial surgery.

“Gossipybomas create a sterile inflammatory response which can lead to abdominal scar tissue and pain,” Dr. Gayle says. “In some cases, these chronic granulomas, tiny clusters which form because of irritants or foreign objects, can metamorphose into cancerous masses.”

Soki required an abdominal drain and a prolonged course of antibiotic therapy following surgery. Charlene Curry, Senior Veterinary Assistant on Soki’s case and her ICU nurse, kept the Community Medicine team updated.

“Charlene’s updates gave us hope, and it was reassuring to have another link in the communication between our two medical teams — Community Medicine and the Hospital — which made Soki’s case a success,” says Dr. Bierbrier. “It took a lot of in-the-moment decision-making to determine when it was time for us to stop and get Soki safely to the Hospital so Dr. Gayle and her team could step in.

Soki with Johana Pineda, Medical Manager at the Bronx CVC, and Dr. Kathleen Jones.

“Soki came to us for a routine vaccine and was not initially thought to be a sick dog,” adds Dr. Bierbrier. “That her pyometra and other issues were discovered at the time of her hernia repair saved her life.”

Dr. Jones echoes how collaboration was a crucial element in Soki’s complicated case.

“Having Dr. Bierbrier's guidance and encouragement helped me persevere,” says Dr. Jones. “And speaking with Dr. Gayle on the phone during surgery gave me more courage and guidance to stabilize Soki and pass her on to more skilled and experienced hands. Knowing she was at the Hospital and being able to track her progress gave me and our team a great sense of fulfillment and reassurance.”

Soki after her surgery at the ASPCA Animal Hospital.

Soki’s owner, Carmen C., is thankful for the quick actions of ASPCA surgeons and staff.

“They had the utmost concern and care for Soki and love her so much,” Carmen says. “They communicated everything that was going on and truly saved her life.”

At the end of May, Soki returned to the CVC for a vaccine booster and was joyfully reunited with the team and two of the veterinarians who tackled her challenging case: Drs. Jones and Bierbrier. 

Drs. Bierbrier and Jones greet Soki during her visit for a vaccine booster.

“Seeing Soki healthy and bouncing around our clinic a few weeks later was one of the most fulfilling moments of my career,” Dr. Jones says. “And speaking with Carmen about Soki’s new lease on life and how happy they are to stay together as a family made all the stress and challenges worth it.”