Monday, April 23, 2012

Follow up: Lateral ear resection poodle, cat eosinophilia

Monday April 23, 2012 report
LATERAL EAR CANAL RESECTION POST-OP COMPLICATONS

All vet surgeons will encounter post-surgical complications no matter how experienced they are. So, I got one case now. Yesterday Sunday, I re-stitched the two ears (day 5 of surgery). Took over 1 hour under isoflurane gas only. Stitch breakdown uncommon but does occur in any surgery. Phoned owner not to take the dog back as scheduled as I need to nurse it again. Why stitch breakdown? Many reasons probably.

1. I noted that the ears had oozed thick fluid on Day 2 and Day 3, unlike other dogs and took some images.
2. High tension stitching?
3. Handling of ears by my assistant Min to give oral medication painkillers and antibiotics, ear powder, cleaning surgical area, disturbing the stability of the ear sutures? Most likely. I told Min not to touch the dog. Today I used a scoop and drop water at a height to wash away the oozing fluid in one ear (left?, check images). The other ear was dry.
4. I need another 5 days.

UPDATE ON APRIL 26, 2012. Ear wounds still oozing with fluid. Unusual. Used antibiotic powder to dry wound. Owner visited yesterday.



CAT EOSINOPHILIC GRANULOMA COMPLEX Cat went home on last Saturday. Gum and palate ulcers have shrunk 30% by observation of less redness and size after the steroid injection.

Advised 4 weeks to review and cat is on medication.

Blood test results on April 17, 2012
Glucose 11 (normal 3.9 - 6)
SGPT/ALT 294 (121) SGOT/AST 121 (67)
Total WBCC 13.5 (5.5 - 19.5)
N 64.4 8.69 (absolute)
L 23.6 3.19
M 5.7% 0.77
E 6% 0.81 B 0.3% 0.04


GOLDEN RETRIEVER,  9 YEARS, MALE, TICK FEVER
PASSED AWAY YESTERDAY
Positive for Ehr +ve  Babesiosis +ve
4 weeks ago

Apr 21, 2012 haemoglobin 5.2 (10.8 -15.6)
Total RCC 2 (3.8 - 5.8)
Total WBCC 102 (5.5 - 19.5)
Dog died one day later

Extremely high total WBCC and loss of blood.
For some reasons, the owner did not follow up and delayed treatment of the tick fever.

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