June 15, 2012
The "Voice For Dogs" refered the owners who adopted a breeder's Chihuahua to Toa Payoh Vets. All teeth encrusted with tartar. Pus dripped from the vulva.
"What's the age? She is very thin, at 2.2 kg" I said.
"We don't know," the couple said.
"When's the last heat? 2 months ago?"
"April 14, 12"
I diagnosed open pyometra and advised spay the next day, after IV drip and treatment. The dog's temperature was 37.2 deg C.
Dom + Ket at 25% (0.02 ml + 0.03 ml) as the dog is old and thin. A bit of isoflurane gas. Intubated. Maintained at 1-2%. Swollen uterine horns 1.5 cm in diameter.
Ovarian fat very fragile. Ligated and both broke loss. Bleeding seen.
A: Induction Drugs injected IV at 25% calculated dosage: 10.07am
B: Isoflurane gas first given: 10.09am
C: Isoflurane gas stopped: 10.51 am
D: First skin incision: 10.18 am
E: Last stitch: 10.44 am
E-D = 26 minutes.
Swollen uterus was seen easily and hooked out.
Dental scaling and extraction after that.
Complication: Bleeding. The ovarian fat was "watery". The suture ligation broke in both. Some bleeding. Owner was told of the risks of bleeding.
BLOOD TEST RESULTS
Total WCC 14.4 (6-17).
N=59%, L=21%,M=15%, E=2%, B=3%
Total RBC 6.9 (5.5 - 8.5). Hb 16.6 (12-18).
This case illustrates the high risk (bleeding) of operating a thin, old Chihuahua with pyometra. It was not recommended to delay surgery as the pus was toxic. Pyometra can be diagnosed based on history of estrus 2 months ago and vaginal discharge of pus. Blood tests, ultrasound, X-rays add up to the costs but are usually necessary. In this case, the total WCC was still normal though vet books say that WCC will be increased in pyometra..