Monday, April 12, 2010

27. FAQ - Breast tumours in a 13-year-old Pomeranian

On this first Sunday after my return from Perth, I was still around at 6 pm when a couple came in with their 13-year-old Pomeranian with nodular breast tumours in the MG 4 and MG 5 glands, left side.

HIGH ANAESTHETIC RISK
"We are bringing in our dog for surgery," the couple explained to me that my associate had booked for them the appointment for surgery on Monday. "Will my dog be able to survive the anaesthesia? I hear it is very risky."

PRE-ANAESTHETIC BLOOD TEST
I checked the dog generally and the heart. "The dog's heart was OK and the general health is good," I said. "There is the gum and tooth disease as you had not done any dental work for the dog for the past 13 years. Generally, there should be no anaesthetic problem but please note that your dog is not as young as a 5-year-old female dog. There is the kidney and liver function which can be assessed by a blood test. This costs money." Owners must be advised fully the risks and a blood test will be good. But in practice, the owner may not want to pay for the blood test.

SPAY AND BREAST TUMOUOR REMOVAL
I advised separate anaesthesias to remove the breast tumours and the do the spay. "Won't the dog be having two risks in anaesthesia?" the husband asked.

"Anaesthesia in dogs older than 5 years is risky," I explained. "However, the shorter the surgery, the shorter the duration of anaesthesia. Therefore, the lower the risk of dying on the operating table. If a vet takes 1 hour to do a spay and breast tumour removal in your dog," I explained, "the higher the chance of the old dog's heart failing. If one surgery is done and this takes 15 minutes, the dog will be at much lower risk of death."

"Two surgeries in one is much cheaper," I said. "Many vets do that in the case of breast tumours plus spay. However, which owner will be happy when the dog dies on the operating table? If I charge you $5.00 and your dog passes away on the operating table after I completed two surgeries, will you be happy at all?"

I don't know whether the couple understand my explanation. I ask them to speak to my associate vet who will be handling their case. In old dog anaesthesias, the owner actually understands and takes the risk. The vet must produce a live dog at the end of the day. I mean, if there are 5 breast tumours and you remove all completely. The dog dies on the operating table or 2 days later because it is old and can't take the lengthy anaesthesia and surgery, no owner is going to refer any friends to you. Deaths do occur, but the trick of the trade is to make anaesthesia short and if surgeries need to be performed twice or thrice, inform the owner. An old dog is very much like an old family member. Every owner wants him or her alive at the end of the surgery and go home walking.

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