Wednesday, August 24, 2011

Never discharge a spayed dog with a "hole" home

I was in Hong Kong when I received a phone call from an owner who said that his dog still had a "hole" some 10 days after spaying by Vet 1. "I thought all vets will not discharge a dog when she has a wound that does not heal," he said from Singapore, rather annoyed.

As I was not in Singapore, I told him that I would check the dog out. In the meantime, I asked Dr Vanessa to examine the dog and get the infected surgical wound re-stitched. It was not her case. I had to make sure that I communicate with the owner and that she would do so as the owner was very upset.

I made a phone call to Khin Khin to ensure that she contacted the owner on my behalf and to ask him to bring the dog to Toa Payoh Vets for treatment. It was a Sunday and I felt that it was not Dr Vanessa's job to phone the owner and therefore I phoned Khin Khin. She did that. When the dog was re-stitched, I ensured that Khin Khin phoned the owner to let him know too.

Post-operation wound infections do occur to every vet. It is important that the vet check the dog carefully and not discharge the dog if the spay wound is infected.

On Wednesday, Aug 24, 2011, I was back at Toa Payoh Vets. The dog was OK. Dr Vanessa had stitched up the dog. The wound was clean. No inflammation. I phoned the owner to update him. He was quite happy that everything was OK. Many unhappiness and complaints and litigation can be avoided with good updated communications. This dog was not spayed by me. However, it can be quite time-consuming in answering to complaints from authorities and lawyers even if I am not involved. I will still have to be a witness and write reports. So, I normally handled such post-op complications of other vets with as much care as if they were my complications. A happy owner will seldom bad-mouth a practice.

The important thing is to keep spaying simple. No fanciful subcuticular sutures. But each young vet has his or her own ideas. In this case, there wasubcuticular sutures which could have had hindered healing of the skin incision or introduced infection. I don't know as I did not see the "hole" but I had asked Dr Vanessa to take some pictures. As every vet will encounter post-op complications and infections, it is best to keep skin suturing simple. I use horizontal mattress.

I note that Dr Vanessa has her own appositional stitching as she has her own success with them and experiences. Both type of stitching pattern will work. Some dogs just can't stand the stitching or they could be allergic to them. Not all dogs but a small percentage and subcuticular sutures would be very intensely itchy.

Even with e-collars. The spayed dog could just rub her tummy directly onto the floor, the mat and get the wound opened up. Hence the complaint of the "hole"

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