Sunday, August 26, 2012

1061. Sunday Aug 26, 2012's interesting cases

I was away in Hong Kong from last Monday to Friday. So, I had to catch up with my admin work on Saturday morning. Sunday was a bright sunshine day.

CASE 1. Rabbit abscess
A vet (Vet 1) told the young couple today, that she was too busy to operate on their rabbit's abscess and gave some injections and medication. They could phone her on Monday to make an appointment a week later. I would have just asked the couple to go to another vet as abscesses will enlarge with time. So, the couple came to consult me and told me their encounter. Sundays are always busy for vets. I had 2 cat spays (noisy caterwauling), one dog spay booked in and I know that another associate vet would have to operate on the closed pyometra Schnauzer suffering from post-op complications of stitch breakdown. There were clinical cases waiting too.

The young couple were knowledgeable about the rabbit abscesses as they had surfed the internet and so it was easy for me. "The abscess would recur," the husband said. "Sometimes," I said. "It depends on whether the tooth root is still infected. Do you want an X-ray done?"

The rabbit was a gentle brown sturdy creature. Isoflurane gas by mask.
"Anaesthesia must be short and surgery must be fast," I said to Dr Daniel who was present. "Rabbits may die if anaesthesia is prolonged, although not every rabbit will be affected."
I incise the skin, undermine the subcutaneous and a big bulge popped out. "It looks like a tumour," Dr Daniel said. "There are numerous blood vessels and nerves in this neck area." The abscess was at the angle of the jaw near to the neck.

"Get a syringe and 18G needle to aspirate the abscess," I did not rule out tumour in this young rabbit, but the most common condition is abscess. Dr Daniel drew out 0.1 ml of yellow cheesy stuff and then nothing. I incised the muscles of the abscess which was 3/4 size of a golf ball. Thick cheesy yellow pus spurted out. The rabbit squealed as the anaesthesia was just sufficient. I top up the anaesthesia again and completed the pus aspiration within 2 minutes. I informed the owner who had earlier come again with the rabbit's pelleted food, squarish glass bowl, log of hay and his packet of white treats.

Rabbits are family members, just like dogs and in this case, this rabbit was free to roam around the apartment. As a new baby was present, the rabbit's old litter box was discarded and the rabbit lost interested in eating the hay. "We can't find another," the husband said. "Well, it may be the smell of the box," I said. "A new one may not help. Hay is good for rabbits."

In retrospect, as I review the case now, at 10.07 am on Monday, the cause of not eating hay or food could be the cheek abscess being formed. This lead to pain. "Did the rabbit eat after Vet 1 gave the injection?" I asked. "Yes," the couple said.

Large rabbit abscess are best operated as soon as possible. But Sundays are hectic days. Some vets may not wish to operate during lunch breaks as staff also need to rest. Much depends on the vets and the staff's attitude and their caseload.

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