Thursday, January 17, 2013

Update: Large tumour video and case follow up - hamster's 14-g large tumour


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toapayohvets.com

Date:   18 January, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Electro-excision of a large tumour in a dwarf hamster 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   18 January, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Yesterday, Jan 16, 2013, two older women from "Street 12" came with a 64-g female dwarf hamster aged 1 year and 6 months. She had a gigantic tumour near her left hip. "She's biting the lump", one woman said to me. There was a scab of 2 mm x 2 mm due to the hamster's bite.

ANAESTHESIA & SURGERY
Dr Daniel is convinced that electro-surgery is useful and efficient as he used electro-excision to incise the skin (see video 
http://www.youtube.com/watch?v=J6d03LrHZS8). He excised the tumour which had some abscesses. I weighed the hamster after surgery. She was 50 kg. A heavy weight had been taken out. It was a high risk anaesthesia as the hamster was quite plump and the tumour was massive. However the hamster was still eating.

3 drops of Zoletil 50 was insufficient. "Don't use a large volume of normal saline to top up the syringe," I said to Dr Daniel. "The back muscles of the dwarf hamster is very little. It will be like the doctor injecting 20 ml of liquid into you back muscles. I usually top up the 3 drops of Zoletil up to 0.05 ml in the 1-ml syringe with normal saline before injecting the back muscles of the hamster (see video
http://www.youtube.com/watch?v=J6d03LrHZS8).

I had to use the mask to gas the hamster with isoflurane gas a few times as the Zoletil 50 was insufficient in this plump hamster. Possibly 4 drops would be more effective in a 64-gram hamster or it could be too much and causes death. Much depends on the vet's judgment and experience. The tumour was 14 g in weight!

This is where the risks of death increase because it is not possible to monitor the hamster's breathing and heart rate (ECG, blood pressure monitoring are not practical in a dwarf hamster).

Any overdose of the isoflurane gas meant instant death. No such thing as resuscitation. So, I monitored the anaesthesia top up while Dr Daniel operated. It was touch and go. I had to make sure that the hamster was just below the surgical anaesthesia stage and so you would see some leg movement during stitching. It is NOT possible to achieve the ideal surgical anaesthetic stage as in the dog and cat.

The dwarf hamster is so small. "Surgery must be speedy," I said to Dr Daniel. "Undermine the skin, isolate the tumour, clamp the base with a curved forceps, excise the lump and stitch the skin with 6/0 interrupted sutures. All these to be done in less than 3 minutes."  The slower the vet operated, the more the anaesthesia had to be given and this is where the hamster "dies" on the operating table.  

CHECKING THE ACCURACY OF OWNER'S ADDRESS
The had written "Street 12" in the address. I asked whether she had left out "Bishan Street 12"? Vets must check the records of addresses. She said "Pasir Ris Street 12". I asked an intern to do this case study. She did a video and the link is:    

http://www.youtube.com/watch?v=J6d03LrHZS8. There is a problem with the  absence of sounds, using Windows movie maker. There appears to be no solution from the interns.

  CONCLUSION
The hamster took some time to wake up. Two female interns were present. One of them was a single child. She spent much time with this hamster. "Look, she is vomiting the seeds," this lady intern said to me as she observed the surgery and did some video filming of the operation. "The hamster is dislodging the food from her cheek pouch as she is stressed by the surgery and anaesthesia," I told her. "This is a common occurrence. She is not vomiting." Her parents allowed her to keep one cat. Yesterday I told the parents whom I knew from 20 years ago that this daughter  should adopt more stray cats in her apartment. The mother wanted to kill me. "Don't you dare to suggest this," the mother said to me.

Many Singapore parents dote on the single child and will tolerate them bringing home stray dogs and cats or buy a puppy. In the end, it is the parents who have to care fore them. Yet yesterday, I met a mother, an old client, from Bukit Panjang. Her 15-year-old Maltese X bought by her daughter long ago is so precious to the mother.

The dog came in as she behaved aggressively when carried. The mother knew it was due to false pregnancy. Lots of white milk were present in the dog's swollen mammary glands. This dog still had estrus bleeding 2-3 months ago. At the age of 15 years which is equivalent to 105 years in a human being . This is in contrast to menopause in women at the age of 50 - 60 years. I asked permission for my intern to take pictures for her case study and she said OK.

"Don't feed her," I said to the single child as the hamster after surgery, wanted to store the seeds. The plump hamster laid on her back and sipped water from the water bottle while lying on her back, making her laugh.

The owner came in the afternoon to take the hamster home. The vet must deliver a hamster alive at the surgery. The anaesthesia is the killing part and this is where a vet's reputation is smeared if the hamster dies on the operating table. No deaths should occur if the anaesthesia is minimal and the surgery speedy, but this cannot be guaranteed.


FOLLOW-UP 24 HOURS LATER

 

1250. Follow up on plump dwarf hamster 64kg with large tumour

 
Jan 17, 2013

I phoned the Pasir Ris lady at 11.45 am and reached her on her home phone to ensure she does the proper post-op nursing and medication. Sometimes, vets are too busy and will not phone if the mobile phone does not answer.

"She is eating and drinking water and active," the Indian lady said. "She is more active than before (surgery). I didn't know she has stopped exercising. I pushed the 1-ml syringe too much and spilled the medicine..."

"It's OK as the hamster just needs 2 drops/day for the next 3 days and the syringe has more than sufficient."

"Can I shampoo her?" she asked. "I do it every week. She was not happy at first but now she looks forward to the water bath as the weather is too hot nowadays."

"No bathing for the next 14 days," I said. The instructions are:

1. Use a facial cotton piece, add clean warm water and clean the surgical wound 2x/day for the next 14 days.
2. Stitches will dissolve on their own in 21-30 days. No need to come for stitches being taken out.
3.  No wood shavings as bedding.
4. No exercise wheel.
5. Give medication
6. No bathing for 14 days

A video on the surgery to excise this gigantic tumour by Dr Daniel Sing was produced by the interns:  http://www.youtube.com/watch?v=J6d03LrHZS8. I was the assistant and you can see me doing the IM injection.  There is a problem with the absence of sounds, using Windows movie maker. There appears to be no solution from the interns. Readers with solutions, please e-mail to me.
More info at: Dogs or Cats
To make an appointment:
e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
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