Friday, September 16, 2016

2927. An Asiatic bear had 2 ranula operation 3 months ago - follow up

HOOK



In June 2016, Dr Sing Kong Yuen from Toa Payoh Vets flew to Yangon, Myanmar to assist in the operation of an orphaned 5-month-old male  Asiatic bear diagnosed with two ranulas, also known as sublingual mucocoeles. A poacher had killed his mother and was trying to capture them for sale to the China market.

The villages rescued the two month-old sibling bears and sent them to the sanctuary of the Buddhist Thabarwa Centre. One sibling bear had two cysts under the tongue and these cysts grew bigger every day. A wildlife vet from Scotland had volunteered to operate on the bear and the operation was done at the Royal Asia Veterinary Surgery, Yangon     



Video footage - before and after operation







Marsupialisation of two ranulas in an Asiatic bear
Is the ranula operation successful for this bear?
Follow-up 3 months after treatment


WARNING. SURGERY PROCEDURES.






INTRODUCTION
What is a ranula?




What are the 2 methods of treatment
1. Marsupialisation - recurrence likely due to closure of opening as in this case (image below)
2. Excision of the ranula and sublingual salivary gland is the choice of treatment






INTRODUCTION
Jun 2016    - 2 surgeries known as marsupialisation. What is marsupialization?





OPERATION AT RAVS IN JUNE 2016 BY WILDLIFE VET, DR BACON
ASSISTED BY DR T T AUNG






DAY 1 OPERATION




DAY 2 REPEAT OPERATION ON LEFT RANULA - ranula is much less inflamed after medication given on Day 1









Dr Sing Kong Yuen visits the bear in September 2016. 
September 2016 - review
IMAGES BELOW - Sep 2016













Sibling bear has normal tongue and grows much larger when seen in September 2016

                                                 
CONCLUSION
One ranula recurs on right side of lower tongue
50% successful - use images
(Edit videos)

Illustration and interview with Dr Sing Kong Yuen


TIPS AND ADVICES

1. The bear has grown to the size of an adult man. There is a bigger risk and danger to staff in handling this bear at RAVS, as this is a wild animal.
2. A repeat operation by marsupialization  on the right ranula is best done by the volunteer services of the wildlife vet as she has the anaesthetic experience of sedation and handling of this larger bear.
3. The operating room with post-op facilities will not be sufficient in the RAVS for this operation.
4. The choice of treatment is by excision of the ranula and sublingual salivary gland. This is a complex operation involving the neck area. This needs more skill and post-op care.

Therefore I advise that Dr T T Aung not to volunteer for marsupialization or excision as the outcome will not be good due to the lack of post-op facilities and nursing care.   





CREDITS





Dr T T Aung of Royal Asia Veterinary Surgery, Yangon

Dr T T Soe (left) of Royal Asia Veterinary Surgery, Yangon

Dr Sing Kong Yuen (2nd from left) of Toa Payoh Vets, Singapore
Consultant Vet to Royal Asia Veterinary Surgery


FOR MORE INFORMATION



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