Wednesday, January 16, 2013

1248. Two interns: Electro-excision tumours in 2 dwarf hamsters


Date:   17 January, 2013  

Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Electro-excision of a large ear wart or tumour in 2 hamsters 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   17 January, 2013 
Be Kind To Pets
Veterinary Education
Project 2010-0129
CASE 1. Ear wart or tumour

Nowadays, Singapore's pet owners are much more sophisticated and educated. I got an e-mail (below) with 4 images of the hamster's ear wart or tumour from the young couple in a yellow car.>
to judy
Dear Sir/Mdm,

I have just discovered a tiny growth on the ear of my hamster. Attached are the pictures for your reference.

I would like to know if there is any treatment for my hamster and the cost of it.

If so, pls advise on an appointment date and time. Thank you.

Name of owner

Kong Yuen Sing <99pups"">
I am Dr Sing from Toa Payoh Vets. Thank you for your email. The "tiny" ear tumour needs to be removed by surgery and under anaesthesia. The ear canals need to be examined for other growths.

The approximate cost is $150-$200 for consultation, anaesthesia, surgery (+/- stitching) and medication. Appointment is by phone 6254-3326.

Bring hamster at 9.30 am and it goes home by 4 pm usually. Best wishes.  

Sent from my iPhone
Although it is troublesome to set up the electro-surgery equipment just to excise a "small" ear wart, I am in favour of using electro-excision as the cutting needle is much more precise in cutting the skin. It takes time to sell my idea to Dr Daniel as he said it would be easier to snip off the wart with a scalpel. We did electro-excision and he is quite convinced it is a useful method as bleeding is minimal.

In retrospect, I would have used the circular electrode needle to go under the ear wart and slice it away. The straight needle electrode was used in this case but both achieved the same results in taking out the "small" ear tumour.

Image from hamster owner in the e-mail   Remove distracting objects (right) to avoid wasting time on cropping the image   Cropping required to take out the distracting object
The rule of thirds for better image. The hamster's eyes or body should be at the intersection of 1/3 of 3 horizontal and vertical lines to produce interesting images for the viewer
Straight needle electrode used. I should have recommended a  circular one to loop off the tumour   Very little bleeding and more precise cut when electricity has been use to cut off the ear tumour


Yesterday, Jan 16, 2013, two older women from "Street 12" came with a 64-g female dwarf hamster aged 1 year and 6 months. She had a gigantic tumour near her left hip. "She's biting the lump", one woman said to me. There was a scab of 2 mm x 2 mm due to the hamster's bite.

Dr Daniel seems convinced that electro-surgery is useful and efficient as he  used electro-excision of the skin. He excised the tumour which had some abscesses. I weighed the hamster after surgery. She was 50 kg. A heavy weight had been taken out. It was a high risk anaesthesia as the hamster was quite plump and the tumour was massive. However the hamster was still eating.

3 drops of Zoletil 50 was insufficient. "Don't use a large volume of normal saline to top up the syringe," I said to Dr Daniel. "The back muscles of the dwarf hamster is very little. It will be like the doctor injecting 20 ml of liquid into you back muscles. I usually top up the 3 drops of Zoletil up to 0.05 ml in the 1-ml syringe with normal saline before injecting the back muscles of the hamster (see video).

I had to use the mask to gas the hamster with isoflurane gas as the Zoletil 50 was insufficient in this plump hamster. Possibly 4 drops would be more effective in a 64-gram hamster or it could be too much and causes death. Much depends on the vet's judgment and experience.

This is where the risks of death increase because it is not possible to monitor the hamster's breathing and heart rate (ECG etc not practical in a dwarf hamster).

Any overdose of the isoflurane gas meant instant death. No such thing as resuscitation. So, I monitored the anaesthesia top up while Dr Daniel operated. It was touch and go. I had to make sure that the hamster was just below the surgical anaesthesia stage and so you would see some leg movement during stitching. It is NOT possible to achieve the ideal surgical anaesthetic stage as in the dog and cat.

The dwarf hamster is so small. "Surgery must be speedy," I said to Dr Daniel. "Undermine the skin, isolate the tumour, clamp the base with a curved forceps, excise the lump and stitch the skin with 6/0 interrupted sutures. All these to be done in less than 3 minutes."  The slower the vet operated, the more the anaesthesia had to be given and this is where the hamster "dies" on the operating table.  

The had written "Street 12" in the address. I asked whether she had left out "Bishan Street 12"? Vets must check the records of addresses. She said "Pasir Ris Street 12". I asked an intern to do this case study. She did a video and case report.    

The hamster took some time to wake up. Two female interns were present. One of them was a single child. She spent much time with this hamster. "Look, she is vomiting the seeds," this lady intern said to me as she observed the surgery and did some video filming of the operation. "The hamster is dislodging the food from her cheek pouch as she is stressed by the surgery and anaesthesia," I told her. "This is a common occurrence. She is not vomiting." Her parents allowed her to keep one cat. Yesterday I told the parents whom I knew from 20 years ago that this daughter  should adopt more stray cats in her apartment. The mother wanted to kill me. "Don't you dare to suggest this," the mother said to me.

Many Singapore parents dote on the single child and will tolerate them bringing home stray dogs and cats or buy a puppy. In the end, it is the parents who have to care fore them. Yet yesterday, I met an aged mother, an old client, slim woman with white hairs at the side, from Bukit Panjang. Her 15-year-old Maltese X bought by her daughter long ago is so precious to the mother. The dog came in as she behaved aggressively when carried. The mother knew it was due to false pregnancy. Lots of white milk were present in the dog's swollen mammary glands. This dog still had estrus bleeding 2-3 months ago. At the age of 15 years which is equivalent to 105 years in a human being . This is in contrast to menopause in women at the age of 50 - 60 years. I asked permission for my intern to take pictures for her case study and she said OK. My intern would have written the case in 2013Vets blog.  

"Don't feed her," I said to the single child as the hamster wanted to store the seeds. The plump hamster laid on her back and sipped water from the water bottle while lying on her back. The owner came in the afternoon to take the hamster home. The vet must deliver a hamster alive at the surgery. The anaesthesia is the killing part and this is where a vet's reputation is smeared if the hamster dies on the operating table. No deaths should occur if the anaesthesia is minimal and the surgery speedy, but this cannot be guaranteed.

I can't link this webpage to the video taken by the intern as the video is in another blog called 2013Vets. See for the link to 2013Vets and get the video.   

Name of webpage:
More info at: Dogs or Cats
To make an appointment:
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research

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All rights reserved. Revised: January 17, 2013

Toa Payoh Vets

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