Sunday, February 23, 2014

1341. Exploratory laparotomy in an old dwarf hamster - recto-vaginal fistula - a rare case

Sunday Feb 23, 2014's interesting case.

TP 44844

Dwarf hamster, F, 2.5 years, 39 g

"My dwarf hamster passed blood in the stools for the last 2 days," the gentleman said.
"Did she pass the normal stool pellets?" I asked.
"None at all in the last 2-3 days. Maybe, a small pellet recently."
"Any urine passed?" I asked as this hamster had a swollen abdomen as if she was pregnant.

"I was overseas for the last 2 weeks and my family members fed her chym sim instead of the normal hamster pellets and seeds."

Blood appeared in the vulval area but the owner said the hamster passed blood in the stools. So, there should be blood in the anus. A case of wet tail well known amongst hamster owners. Yet I saw blood in the vulval area and the anal opening appeared abnormally small. After all, this was a dwarf hamster and I don't see anal openings in all hamsters I examined, unlike in the dog and cat. So, I did not think of atresia ani - the failure of the anus to open during development. This was a 2.5-year-old hamster with no complaint of stools or diarrhoa.  

No stools were passed but bloody diarrhoea for the past 2 days. An old female dwarf hamster. Bleeding from the vagina. This would be a case of pyometra as in old female dogs not spayed.

The high risk solution would be to spay the dwarf hamster to stop uterine bleeding and death. I have never spayed a hamster. I doubt almost all vets do not spay dwarf hamsters. It is just too risky. I asked Dr Daniel if he would do it. "No," he said firmly. I told the owner that this hamster is old and the risk is just too high. She would die.  He said to go ahead. I said this was inoperable.

The hamster's abdomen was very swollen. She would die if not operated. If operated, she might or might not die. Likely to die. An exploratory laparotomy to open the abdomen to check and remove the uterus. The anaesthesia must be just right. Not too little as the hamster would move. Not too much as the hamster would be dead. How much is not too little or too much?

I gave Zoletil 50 0.01 ml IM. Insufficient. Too little. The hamster looked at me. I put her under 5% isoflurane gas + Oxygen till she appeared drowsy. Not more than a few seconds. She did not struggle during the surgery.

The colon was over-distended, probably due to twisting. I massaged it and copious amount of red bloody stools flowed out (see image). I closed the abdomen with 6/0 sutures interrupted. The hamster was drowsy. I injected 0.2 ml Hartmann + glucose + baytril. It was already 5 pm on this fine Sunday afternoon of Feb 23, 2014. The hamster was alive but for how long?

On Monday, at 9 am, she was alert and walking. The tissue papers were blood stained in several areas. Those were bloody stools still passed out after surgery. I took videos.

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