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up a forceps , I grasped the edge of the foreign body and tried to ease out the irregular, elongated mass. I winced as the sharp edges snagged the delicate lining of the gut. Having pulled out a piece approximately ten centimetres long, I unravelled it to find out what it was: the shredded remains of a Chinese takeaway container. If this had been the only section of the gut to be damaged, I could have just removed the damaged necrotic section and rejoined the healthy ends, but it was nowhere near that simple. Gently, I manipulated the next portion of damaged gut out of the abdomen and carried on easing out loop after loop of intestine, in varying degrees of necrosis. By the time it was all spread out over the sterile laparotomy sponges, it was clear that there was precious little healthyintestine left. I wondered how on earth Gemma could have looked so well and shown so few clinical signs with the extensive damage inside.
    Without remembering the exact detail, I could recall a study from college days where dogs had survived with large portions of their intestine removed. However, the damage to Gemma’s intestine was so extensive that I wasn’t confident that she could survive if I were to remove it all in one piece. My only alternative was to remove each section separately. I began the painstaking job of repairing the damaged gut as best I could. I struggled trying to decide which pieces to remove and which to retain. I sweated as I made long incisions into the damaged tissue, as there was no way I could pull out the metallic container without tearing the gut. I vaguely remembered from my surgical lectures how an incision should never be more than … was it one and a half times the diameter of the gut?
    My fingers ached as I rejoined lengths of gut where I had had to remove a dead section. It seemed to take hours as I fiddled with the tiny lengths of suture material. My back ached and my eyes were blurring by the time I had finally finished. I flushed large volumes of warmed saline through the abdomen, hoping to remove any intestinal fluid that might have leaked out. With the last syringeful, I added some soluble antibiotic. Carefully, I wrapped all the repaired sections in the glistening omentum , the supportive sling that cradles the internal organs. I hoped it would do its job and soak up any leakage from the rejoined sections. Soon, all that remained visible ofmy work was a neat row of sutures in the skin. I shuddered to think of the horrors that lay hidden beneath.
    While waiting for Gemma to wake up, I rang Teresa. The phone was answered on the first ring. I recognised the babyish tones of Kate.
    ‘Is my dog better now? Mummy told me you’re going to cut out the bad bits.’
    ‘Gillian, I’m sorry about that.’ Teresa sounded flustered. ‘How is she?’
    I paused. ‘I’m sorry, Teresa, but it’s not looking good.’ As painlessly as I knew how, I explained my worries.
    Teresa couldn’t hold back the tears as I told her what the culprit was and she remembered. ‘We had a Chinese on Wednesday night. When the container was gone the next morning, I assumed Frank had thrown it out. I should have known better. How could I be so stupid? It’s just the sort of thing she’d go for.’
    ‘Don’t blame yourself,’ I consoled her. ‘It can happen so easily. But right now it’s up to Gemma. She’s a strong dog. She may just pull through. I’ll let you know how she is tonight.’
    ‘Of course, and listen, thanks so much for everything. You sound absolutely exhausted.’
    I sincerely hoped she would have something to thank me for. A niggling doubt in my mind kept asking if I should have operated sooner.
    By Tuesday night when the Kennys returned, Gemma was ready to go home. I had been in touch with them a few times a day and I had reassured them that everything was going as well as could be expected. Despite mycautious warnings, Teresa became more enthusiastic with every passing hour.
    ‘I just know she’ll