Monday, December 31, 2012

1232. 2 years and 2 months old hamster with breast tumour

Dec 31, 2012
Last hamster case of the year.
"I still have to pay for cremation if the hamster dies on the op table?" the mother asked me about the chances of survival if I operated on her dwarf hamster with an infected black-scabbed leaking pus breast tumour below the neck.
"Yes, you need to pay or you can bury the hamster yourself," I noted that the hamster was alert and had passed several stools indicating he was eating.

"How long more can he live?" the mother asked me.
"Normally, dwarf hamsters live up to 2.5 to 3 years," I said.
"He is now 2 years and 2 months," the mother calculated that it was not worth the $200 to operate and stitch the tumour.
"One month of the dwarf hamster's life is equivalent to 2 years of the Singaporean human life," I said. "If he survives the surgery, he could live, provided the tumour does not come back again." The mother had waited 2 months before her daughter asked her to send him to Toa Payoh Vets for surgery. She could not decide what to do now. "I phone my daughter," she said. "He is her pet.". Her daughter would not decide in view of the high risks of death on the operation table. Finally her her husband said to proceed,

HOW MUCH ANAESTHETIC TO USE?
"Isoflurane gas will not give sufficient time to operate," Dr Daniel said to me.
"This is correct," I said. "Zoletil injection by IM will give you 60 seconds of operating time if the dosage is just right."
How much to give? This is where the judgment and experience comes in. Too little, the hamster needs top up with isoflurane gas to sleep. Too much, he dies.
"This is a very old dwarf hamster," I said. "His body weight is 54 g which is good sized. He is alert and eating and that is good. But he is aged and so the Zoletil dosage should be reduced so that the hamster is alive at the end of the operation."

The theory is easy. The practice is not. How much of Zoletil 50 to give by IM?
Dr Daniel decided on 2 drops which I approved. "They must be full drops," I said as I saw Mr Min's hand trembling as he held the 1-ml syringe to draw out Zoletil drops from Dr Daniel's 1-ml syringe.
"Hey, your hands are shaking!" I said to Min. "Shaky hands cannot be a surgeon! Rest your elbows on the op table to stabilise the syringe."

Dr Daniel injected IM. The hamster has very little muscle and so the needle must just get into the muscle and this can be difficult to assess. Practice makes perfect. "There is so blood on the operating cloth," Dr Daniel said after his injection. "Unusual to see it," I had never encountered such a situation. "It could be from the muscles after injection."

Soon the hamster felt sleepy. I asked Intern Gina to video this case study. The tumour was excised. Lots of yellow pus inside the tumour which was 1.5x1x1 cm globular in size which black scabs. The skin was excised and undermined. The tumour was cut off from the clamped area. Skin was stitched with 6/0 absorable sutures.

It was most likely a malignant tumour which was put nside a plastic bag for the owner to see. The hamster went home alive and that was what the owner wanted. Now, there was another subcut lump near the left inguinal area. "Never operate on two tumours at one time," I said to Dr Daniel. "The hamster will die as op time has been too long." So we left the other tumour  of around 0.8x0.8 x 0.5 cm alone. This was New Year's eve and the famiily wanted the hamster home to celebrate life and a new year.      
  

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