Friday May 10, 2013
"Remember the cat? You
said it would die under
surgery!" the busy
gentleman drove over to
buy the C/D dry food and
canned food for his cat
after ensuring that these
were available. He had
ordered earlier and
deliveries by the Science
Diet supplier arrive only
on Thursdays of the week.
His cat had run out of the
canned food.
"Yes, I remember your cat"
I said. Cats with bladder
stones are relatively a
rare occurrence in
Singapore and this was one
with impending kidney
failure according to the
vet who had taken blood
test. The owner wanted an
immediate surgery since
his vet who diagnosed the
condition would not do it
owing to lack of
experience while the
senior vet had a full
schedule of surgery.
It is best not to operate
on a cat with impending
kidney failure as the cat
would die. I waited one
day so as to give
antibiotics since the
other vet did not do it.
The cat die not die under
surgery but the owner
never forgets the "cat
will die if operated upon"
informed consent.
"How's the cat?" I asked.
"Put on weight. Back to
his naughty pesky self
now, as normal." he said.
"Can I keep the
prescription diet inside
my car as I cannot go home
immediately?"
"No," I advised finding a
covered car park.
He was such a busy person
but he took time off to
buy the special food for
his cat before the stock
runs out. His cat eats one
can per day. Most
Singaporean cat owners
will not be bothered. He
told me his cat will eat
the canned food whether it
was refrigerated and cold
and also any brand of cat
food. This is surely an
unseal cat as most cats
are fussy.
I am glad his cat is
normal and there is the
chance to follow up with
him. I told him that the
supplier will deliver to
his home if he pays me
first for the next order.
"The supplier does not
want the hassle of
collection," I said. He
would transfer the money
to my account
electronically first.
Actually he could have
bought the food from the
vet nearby but he did not
do so. The vet was the one
who diagnosed the bladder
stone and I am sure she
would just sell him the
special diet.
Pet owners have their
preferences of vets and it
is up to the vet to build
up the relationship of
trust and goodwill as
there is nowadays a vet
round the corner. Owners
have to make an extra
effort just to go to a vet
"far away" just to buy the
special diet which is
easily available at most
vet practices in
Singapore.
An
informed consent
must be given prior to
anaesthesia and surgery.
It should be in writing
but in this case, I
emphasized orally the high
risks of death since the
cat has kidney disorders
based on blood tests and
surgery could not be
postponed for a week. I
suspected the cat could
suffer from a
bacterial
nephritis based on
high total white cell
count so a pre-emptive
antibiotic injection which
the other vet did not
administer would increased
the chance of success.
In this case, the odds
were in my favour after a
Baytril antibiotic
injection SC 24 hours ago.
The cat survived the
bladder stone removal
surgery. Unfortunately for
me, the owner never
forgets my warning that
"the cat will likely die
during the anaesthesia and
surgery" and will remind
me whenever possible.
Many vets will suffer my
situation when the cat
they say will die from a
serious disease lives up
to a ripe old age!
He had Hobson's choice and
I had been fortunate that
the cat did not die on the
operating table and the
fact that this owner
detected loss of appetite
in less than a week. Many
cat owners wait and see
for several weeks before
they seek vet
consultation.
No vet can predict the
surgical outcome in taking
on high-risk anaesthetic
cases. Use evidence-based
medicine always but
sometimes the owner's
financial situation
prohibits blood testing
and in this situation, it
is difficult. In such
situations, use minimal
injectable sedatives, use
IV drips and isoflurane
only.
TOA
PAYOH VETS
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