Sunday, September 30, 2012

1126. Audit - intestinal surgery - removal of foreign body

Every vet at Toa Payoh Vets is required to maintain a proper record of anaesthesia and surgery in a book dedicated to each vet. I audit some cases now and then.  This case is interesting as it has been performed in a short time, using only domitor and ketamine, without isoflurane gas.

AUDIT OF ANAESTHESIA & SURGERY BY ASSOCIATE VET
Bichon, Male, 3 months
Vomiting over 5 days
Ate prayer food

Hard lump 3x2x2 cm in large intestine. Painful

ANAESTHESIA
Sep 30, 2012 (Sunday) 1.8 kg 3 months

Dom/Ket  0.07/0.09
50% given  0.04/0.05 IV

A: Injection D+K IV   3.47 pm
D: First skin incision   3.56 pm
E: Completion of skin stitching  4.11 pm
No isoflurane gas used for enterotomy

E-A  = 24 min
E-D  = 5 min

SURGERY
Around 3 cm incision. Big greenish hairy hard lump taken out.
"Apricot seed," my vet said.
3/0 monosyn appositional stitches.
I saw the intestinal wall as over 4 mm in width. Blackish edge over red inflamed patch where hard Foreign Body was lodged. Gangrene had set in. That was why dog was vomiting.
Vet has 3 years of experience. A good surgery done.

No blood test and no x-ray due to financial reasons. The owner decided on surgery on Friday evening but I advised the associate vet to wait 2 more days to strengthen the health (vomiting for past 5 days due to financial reasons, not seeking vet treatment). On Sunday afternoon, this dog was operated and today, he looks as good as gold.
Day 2  Oct 1, 2012  11.32 am, I checked the dog and took some pictures. Active. Disliked e-collar.

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