Tuesday, August 13, 2013

Ear abscess in a terrapin

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Date:   16 August, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
The terrapin has a large ear abscess   
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   16 August, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

I palpated the tense and painless hard painless swelling of around 1 cm x 1 cm x 0.5 cm behind the right eye and below the red stripe of the red-eared slider, also known as a terrapin. I had diagnosed "ear abscess" as I brought the gentleman into the consultation room at 7 pm on August 13 and announced this diagnosis to the vet on duty.

I told this vet that the owner wanted to know the fees involved in the treatment. The vet quoted him at $200 for anaesthesia, surgery and post-op care and the man went out to make a phone call to his son. After all, a new terrapin costs only $1.50 or less at the pet shop! The vet suddenly said to me: "You do it."     The Australian vet school probably does not lecture on terrapins and hamsters and so the Australian-trained vet may not be familiar with the conditions. I am a  UK-trained vets and I was not lectured on this species at Glasgow University in the 1970s. 
The vet on duty had never seen such a case in the past 12 months of practice or in his undergraduate studies in Australia. I had not seen such a case during my over 3 decades of practice too. Maybe that was why he said that I should do it. Maybe he probably thought terrapins have no ears since you don't see any ear lobes! So, how could I diagnose 'ear abscess' so confidently? Do you think terrapins have ears? If they don't have ears like dogs, cats and hamsters, how can the vet diagnose "ear abscess" so arrogantly. Actually, I had seen such cases in the internet. See:
http://www.chelonia.org/Articles/Terrapene_Ear_Infection.htm

"Well, they may have ear slits," the mother of the vet said to me when I met her and her other son later.  Definitely, it is very hard to imagine ears in terrapins when they are not obvious.
"So, did he operate?" the vet's brother wanted to know impatiently.
"He was present in the operating room ready to operate. We anaesthesized the terrapin using isoflurane gas. Then something happened...."
"Did he do the surgery?" the brother asked me again.
"Well, he was about to. But he was saved by a client who came in to get his dog checked and vaccinated for export to Thailand."
I lanced 5 mm into the abscess of the anaesthesized terrapin with a scalpel. Serous fluid leaked out. Then thick yellow pus. Then blood. I expressed as much of the pus as possible. I syringed water into the wound. The swelling disappeared and as I videoed the result. The terrapin opened his mouth to bite.
Ear abscess Pus drained
12 hours after surgical drainage, the terrapin was OK but the swelling was present but at 50% of the size. There would be inflammation of the surrounding cheek muscles.  I asked the owner to take the terrapin home and give medication. The terrapin was not eating at the Surgery as he used to eat with four others. So, he would be better off at home.

P.S
Ear abscesses must be operated, otherwise the pus would go to the brain and it would be too late. In Singapore, this is the first time I encounter the ear abscess in a terrapin as terrapin owners seldom consult the vets for treatments. There were 4 other terrapins in this home but they were OK.  The feed was commercial pellets and apparently this affected terrapin had an excellent appetite. 
The other vet commented to me that the terrapin would hold his breath and therefore would take a much longer time to anaesthetize. However there is no need to fully knock the terrapin out. Around 1 minute of 5% isoflurane + O2 will do.  I wanted to use a gas mask but in the end, the container in which the terrapin was placed was used.  A video would be produced for vet students and pet owners later.
Updates will be on this webpage:
www.sinpets.com/F6/20130815ear_abscess_terrapin.htm




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