Saturday, December 26, 2015

INTERN. 2894. The rabbit had a big bleeding knee swelling





HOOK
A big bleeding left knee swelling after boarding in Pasir Ris. Bleeding for over a month. Blood stains on the apartment floor needed frequent cleaning..

WARNING
This BKTP video contains surgery. Viewer's discretion is advised.





Sunday Dec 27, 2015. Toa Payoh Vets
Rabbit, male, not neutered, 7 years
Left Knee Swelling
The lady suggested surrending him to the SPCA if surgery is too costly

 

"The lump fell off and disappeared at one time," the lady showed me her smartphone videos of the actual lump as she did not take images when the rabbit's lump had dropped off.


"Was the rabbit boarded alone or with other rabbits?" I asked. "Another rabbit could have bitten him if he shared kennel space."

"I was not permitted to see the kennel," she blamed the boarding operator for the appearance of the lump as the rabbit was normal before boarding. 

View of Pasir Ris kennels, Singapore


The operator got his vet to treat the swelling and paid around $100. The vet texted her the report.
saying that she could not confirm whether the swelling had cancerous cells from doing a FNA (Fine Needle Aspiration). Video footage (partial report).


The first vet did not do surgery and referred her to another vet in the practice. The boarding operator also referred her to a vet. But she had phoned Toa Payoh Vets. Dr Daniel patiently explained the probable causes and quoted her the cost of surgery. So she decided to come today but Dr Daniel had gone overseas.

"This swelling could be a lick granuloma," I told the two interns. "After many weeks of licking, the injured area developed into a hard lump. "It could also be an abscess or a tumour."

video footage close up


The rabbit was operated under isoflurane and oxygen mask anaesthesia. Electro-surgery and blunt dissection. (video). Two layers of stitching. A subcuticular and a skin horizontal mattress pattern. The rabbit wore an e-collar.
Images (text to be narrated slowly)









 


Edited Video footage of surgery with subtitles

I gave pain killers and antibiotics for the next 10 days.

The lady came back 3 hours later to bring the rabbit home.
(Video, post op)

"The lumps are multiple soft white fatty nodules under the skin of the knee," I showed the lady the cyst-like swellings measuring more or less 1 cm across (image).  "As you did not want the tumours to be sent to the laboratory for histopathology, I am unable to say whether they are cancerous or not. They may recur again." 

"So, you think that the boarding operator was not responsible for these?" the lady asked me.
"The left knee was not swollen when I boarded the rabbit for 6 days till November 26, 2015".

In my opinion, the fatty nodules would have developed and the boarding kennel operator was unfortunate not to have done a general physical examination for lumps before accepting the rabbit. The owner said that the rabbit had no swellings before boarding.


CONCLUSION

I am glad that the rabbit was able to survive the anaesthesia as he is considered old. Old patients have a much higher risk of dying under anaesthesia.

I am sure the 13-year-old daughter will be most happy to have her companion back. He will  not be given to the SPCA and will no more have a bleeding knee soiling the apartment. This rabbit is not allowed to roam freely for the next 2 weeks. Strictly cage confinement and an elizabeth collar to let the knee wound heal. 



TIPS AND ADVICES
Small tumours are easier to remove and the medical cost is much lower. Many pet owners shop around for a vet to get a quotation to fit your budget. Fees vary depending on the time taken to operate. In this case, the fee was around $300.   




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