Yesterday, Saturday March 27, 2011, I attended a continuing education lecture by a veterinary anaesthesia specialist, Dr Kieren Maddern, BVSc (Hons), MACVSc, Dip ECVAA, European Specialist in Veterinary Anaesthesia. The topic was "Overcoming the odds - Anaesthesia for difficult situations."
It was a very well attended lecture - some 70 people there. An excellent lecture. I caught up with a senior vet who has done a few thousand dog and cat surgeries over the last 40 years and asked his advices about young vets referring corneal ulcer cases to other practices.
He said: "The young vet may find that it is a difficult case or that the owners are the type liable to sue. So, just refer the case out. Or the young vet thinks that you can't do the surgery! He or she does not usually ask for advice but just refer!
"When the case goes from Toa Payoh Vets to the other vet, the other vet will just laugh and say 'Dr Sing does not even know how to operate a simple corneal ulcer case! What's wrong with him?' Maybe you should give instructions that all cases that your younger vets want to refer to others should go through you!"
I was not alone in having this problem of the younger vets doing their own thing without consulting the senior vets in the practice.
The senior vet told me: "Tarsorrhapy is very effective in corneal ulcer cases. Even in cases where the eyeball collapses. Just sew up the two eyelids and the outcome is usually very good. I find that the eyeball is seldom infected even with perforated ulcers."
I listened attentively for the free advice. The senior vet is 5 years older than me just in case but he puts in the very long hours and do the after hours emergencies. High energy and therefore he has more caseload experiences.
"By the way, how do you treat corneal ulcers in the dog?" my mentor asked.
"I am more kiasu," I said. "I do the 3rd eyelid flap and tarsorrhapy." Not all the time, but sometimes.
The pictures of my case in a Jack Russell are shown below.