1808. Too risky pyometra surgery

EMAIL TO DR SING DATED JUL 24, 2012
On Tue, Jul 24, 2012 at 2:17 PM, Jan Cavan wrote:

Hi Dr Yuen,
I was researching about Pyometra and came across your blog. I really need your help. I'm very desperate.

My dog has pyometra, but the vet does not recommend surgery for the following reasons. If they ever perform surgery (when she gets better), they won't do it without injectable anesthesia/complete sedation. But based on your blog, gaseous anesthesia is actually okay to use too.

1. her age (she will be 13 years old this December)
2. she has kidney problems (creatinine was 5.0, gone down to 2.0 after some medication, but is now back up to 13)
3. she is anemic

But I believe that 2 and 3 above are caused by pyometra. Right now, she is taking:
1. antibiotics for pyometra
2. Nefrotec to make her urinate and release the toxins
3. Red Cell for some iron supplement
4. She is currently in IV fluids to rehydrate her as she appears to be dehydrated

I am in California and my dog is in Cebu, Philippines with my parents. I wish I could fly her out to Singapore so you can maybe help her out, but that is no longer an option at this point since we need to make decisions immediately as my dog is getting weaker. I would actually also fly you to Cebu to perform the surgery and we rent out a veterinary clinic's equipment here. If that is something you would consider, please let me know as soon as you can. It's 11PM here and I might sign off soon. If this is something you would consider, would you be able to please contact my parents? The Philippines and Singapore have the same timezones.
....
I understand that you may not be like the usual emails that you get, but I'm really, really, very desperate right now. My initial plan was to postpone surgery until she recovers so I can bring her to CA with me. But now, I am desperate. I really, really, really need your help. I am a complete wreck.
Looking forward to hear from you.
Thanks,

EMAIL REPLY FROM DR SING DATED JUL 24 2012
There will be other vets in Philippines that can operate on pyometra using gaseous isoflurane anaesthesia and IV drips. You need to find them, esp. those in bigger practices and hospitals, maybe in the city? Your country is large, unlike Singapore and there will be more vets who can do the surgery. You may need to drive the dog to the particular vet or vet school.

I am sure there will be one vet who will do it but it may be too far from your place.
However, gaseous anaethesia is NOT a guarantee that your dog will survive the surgery or post-surgery and you need to understand and give the informed consent you have to give to the vet.
Best wishes.