1146. Anaesthetic risk for old dog surgery to remove eyelid tumour

TOA PAYOH VETS toapayohvets.com Date:   20 September, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits Anaesthetic deaths     Dr Sing Kong Yuen, BVMS (Glasgow)  Date:   20 September, 2013     Sep 15, 2013 Dear Dr Sing Kong Yuen  We – my wife Pri and I - have been at your clinic half a year ago with our two Huskies. Cee - 6 years old, the male Husky, had strained his back legs muscles, but slowly he can run again after you had advised us what to do and how to treat him. It is still not perfect, but we get him there. Our female Husky Al, now 9 years old,  has at her right upper eye-lid an abscess since some years (please see picture 6996), but we get the impression it is growing and causes her some problems, because sometimes she is scratching it and the eye ball is inflamed. We hope it is not malignant. Nonetheless we think it must be removed now somehow. Therefore we are asking you to get us an appointment for Friday, 20th September, at any time, but best would be in the morning. We are prepared to take all the time it would need to stay with April at your clinic. Please get us your answer by email. Thank you for your attention and I am looking forward to hear from you soon. With warm regards EMAIL FROM DR SING DATED SEP 16, 2013 Thank you for your email. Pl bring Al in at around 11am on Friday. Surgery and anaesthesia will be done using electro-surgery in the afternoon. She goes home at around 6 pm after recovery from anaesthesia. No food and water after 10 pm the night before. Please note that old dogs undergoing anaesthesia are at risk of death from anaesthesia. In most cases, there are no deaths if the dog is healthy and the surgery is short duration as in this case. The dog will be examined before surgery as there is inflammation and infection in the eye.  Pl give antibiotic eye drops for at least 3 days before surgery as I don't advise operating on an infected area.  Sep 19, 2013  Dear Dr Sing This afternoon we have been at your clinic and discussed with Dr Daniel the operation of Al’s eye lid tumour, he took a blood sample and checked her general health which should be OK.   Everything is clear and we fully trust to be in good hands due to your experience. However, having in mind yours and Dr Daniel's repeatedly mentioned remarks that Al could die due to the anaesthesia, even afterwards, you may understand that we are still concerned that the worst could happen to our precious dog Al. Both our dogs are like children to us. That’s why we are still reading everything about this surgery and found the below article of a dog clinic from Washington D.C. May we ask you, what is your opinion regarding  local anaesthesia after drug sedation and the described “freezing” of the wound? Please forgive us our nervousness. QUOTE: 2.   EYELID TUMORS. Older dogs commonly develop eyelid tumours (cancer). As in humans, cancer can be either benign or malignant. Fortunately, eyelid tumours in dogs are usually benign and do not spread to distant tissues.  However, eyelid tumours do slowly or quickly grow, and can destroy the structure of the eyelid, in addition to rubbing on the eye. It is usually best to remove them when they are still small. Eyelid tumours are treated by surgical removal. While there are many different surgical procedures possible, most eyelid tumours in old dogs can be removed at Animal Eye Care without requiring general anaesthesia.  The patient is given a sedative, and then a local eyelid anaesthetic is given to numb the eyelid. The tumour is removed and the site frozen with liquid nitrogen (cryosurgery) to kill any remaining tumour cells.  Tumour cells are usually very sensitive to freezing, and normal eyelid tissue is more resistant. After surgery, the eyelid margin turns pink (de-pigmentation), but usually re-pigments within 4 months. ------------------------------ EMAIL REPLY FROM DR SING DATED SEP 19, 2013 I can understand your concerns as the dog is old and thank you for your research in the article on eyelid tumour removal by one vet practice which claims that general anaesthesia is risky and the practices claims that it uses sedation and local anaesthesia to avoid the risks.  Updates will be on this webpage: www.sinpets.com/F6/20130920 anaesthetic_risk_old_Husky.htm