Sunday, December 20, 2015

INTERN CLARA. Video: Aural haematoma in a Ragamuffin cat

 
 
This veterinary educational video shows surgical procedures. Viewer discretion is advised.
(narrate according to the image).


Pause
Then show the hook video of the cat pawing his side and ear being swollen. Narrate the action seen in the video. At least 10 seconds of footage.


HOOK

The cat has a very painful swollen ear (video). 
Video footage of the cat's hind legs keep moving when the vet fingers the ear.

What is the problem with this cat?





BKTP IMAGE









INTRODUCTION
On Dec 17, 2015, a young Ragamuffin cat came to Toa Payoh Vets. He lived in an apartment (2 images as shown below) in Singapore. He kept scratching his right ear. The ear bleeds and blood collects inside the ear flap. The right ear becomes much swollen (image) unlike the left ear (image). The cat lost appetite and meows frequently.


The owner's wife was much distressed. So the husband drove the cat to Toa Payoh Vets for treatment.



 


AT TOA PAYOH VETS, Dr Sing examined the cat.
The outer ear canal of both ears is packed with dirt. However, the one in the right ear became itchy and inflamed. This condition is called otitis externa (outer ear infection).

The cat keeps scratching the ear flap to relieve his itch. His claws hits the ear flap repeatedly. The blood vessels inside rupture and bleed. A large painful swelling in the ear flap appeared. The cat will not eat and feels miserable.





MIDDLE

What is the solution?

1. Large bore needle to drain out the blood.  (text/illus).  There will be recurrence and the owner will have to spend more money and time to do surgery.

2. Surgery. Incise, drain and stitch.


An ear surgery is presented. The procedure is as follows:

STEPS (narration) + subtitle for the video

The following is the footage of the surgery done by Dr Daniel of Toa Payoh Vets
1. Anaesthesia using xylazine and ketamine injection IM. The owner gives consent as regards the  anaesthetic and surgical risk

MOV 385.  The ear irrigation process of the normal other ear is shown in this video. The procedure is similar to the affected ear.


 

subtitle  0:19 - 1:52  Ear solution into the outer ear, massage, cotton swabs to clear dirt. Clear ear mites if any.

2:01 TO 2:25    Sedation is needed to clean ear thoroughly and to prevent the cat stressed out


MOV 354 + 357. Prepare for surgery. Cleaning and disinfection of the ear  flap and the ear canal


MOV 358  Haematoma due to ear scratching. Trauma ruptures blood vessels inside the ear flap. This swelling of the ear is called aural haematoma.


MOV 359.
Scalpel incises skin of concave side of the ear flap. The blood is drained. Blood clots are removed.





MOV 360. A narrow strip of skin on the concave side to cut to enlarge the incision wound. This enables drainage and prevents early closure of the wound and recurrence of the haematoma.

MOV 362.
0:34 to end.

After lancing and drainage, the stitching if from skin of the concave side into cartilage and out of the convex side of the ear. The stitches are parallel to the incision. Transverse stitches will ligate the ear blood vessels which run parallel to the incision and cause ear tissue cell death.






MOV 374. 
0- 0:38
Completion of surgery.
MOV 386. 
0:32 - 1:39.  Subtitle.    Interrupted sutures from skin of concave side into cartilage to skin of the convex side.  Elizabeth collar to prevent scratching. Injection of antibiotics and anti-inflammatory.






CONCLUSION

Dogs have aural haematomas. Similar surgical method as in this cat.
Skin incision can be S-shaped  (image) or straight (image) but outcome is the same.





Stitches can be through the skin of both sides of the ear. They can be into concave side and the cartilage only without coming out the other convex side skin.




WHAT HAPPENS IF YOU DO NOT SEEK VETERINARY TREATMENT
Your pet tolerates the pain, keeps scratching ear and lose appetite.
The ear becomes deformed as its blood supply is interrupted. Scarring and contraction of the skin and cartilage leads to the  formation of a cauliflower ear. VIDEO OF A CASE 17-year-old Silkie Terrier.





 
Many Singaporean pet owners work long hours.





Some do not know how to handle the un-cooperative cat and clean the cat's ears.  The cat runs away when the owner attempts to clean the ears. In such cases, get the groomer or vet to clean the ears before infection sets in.


Regular ear cleaning with ear drops or ointments will prevent ear haematoma. It saves you money and time. (elaborate) + pet suffers if the ears get infected for a long time (footage of cat scratching)
The pet will shake its head continuously, paw its ear flaps, cry in pain. The pet's body might smell because of the infection


Credits






Narrate as you show the images



(For more information:
contact judy@toapayohvets.com  +65 9668 6468.  www.toapayohvets.com)  Narrate from image below.





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