Friday, August 8, 2014

1443. Neutering an aggressive Jack Russell


5. Restraining an aggressive Jack Russell for neuter

He curled his upper lips up and bared his fangs if any outsider wanted to touch him. I had encountered such aggressive Jack Russells. Usually males. 

What to do in such a case? 

When the owner brings him in for neuter, ask the owner to restrain him for tranquilisation. In this case, I injected 0.2 ml of xylazine 2% tranquiliser IM as the owner arm-locked the dog.

I put the dog into the crate. Normal ones would feel sleepy. This dog was fully alert and baring his fangs 30 minutes later.

"What should you do?" I asked my new vet assistant who has to learn on the job. He took out a dog muzzle. His usual way was to put his hand beside the dog's chest and slowly touch the dog, moving the muzzle up.

The Jack Russell eyed his hand movement and snapped in anticipation of being handled by a stranger. 

"The muzzle is of no use," I said. "What to do if you don't want to be bitten?"

The assistant was silent. He had to get the dog out of the crate to the surgery room for neuter. The dog was a bright as daylight waiting to pounce onto his hand. 

What to do? 
There are 2 ways. Use a thick towel and cover his head. Use a lasso over his neck and get him out. 

He had never seen a lasso before and we used this method. The dog was not as strong as before. Gas mask using 8% gas anaesthesia knocked him down. An endotracheal tube was put into his lungs to bring the anaesthesia to keep him pain free. Surprising 1% anaesthesia instead of the usual 2% kept him pain-free for neutering. He was put in the crate after his skin wound was plastered. 

No dogs would be allowed to go home till around 4 hours after surgery. Preferably overnight but most Singapore owners want their dog home in the evening or earlier. 

In this case, the owner said he had an elizabeth collar but he did not bring it with him. So he needed not purchase one from the Surgery and increased his veterinary cost of neutering.

30 minutes later, my assistant said: "The dog is bleeding a lot!" The dog's muzzle was stained bright red. The newspapers were stained bright red too. The Jack Russell's eyes stared directly at me, pupils dilated, fangs exposed, ready to attack.

What to do?
I did not expect the dog to lick vigorously his surgical wound. Blood flowed and seeped into his scrotum. It looked as if he was not neutered as his scrotum swelled to the full. It seemed to be a "con" job from an outsider's point of view as the scrotal bags should be deflated with the removal of two testes. 

How to handle this bleeding episode?
In this case, the dog's adrenaline level was at all-time high. He should not be given any tranquiliser or painkiller injection in case his heart fails and he dies attributed to adverse drug injections.

"As long as you stand in front of him," I said to the vet assistant. "He will not lick his wound. He has to look at you and anticipate when you are going to nap him." So the assistant stood around him for a full hour while I asked the owner to come down. 

"I can't come down now," the owner said. He was working. 

"You need to come down," I said. "Your dog is bleeding and he is too aggressive. When you come, he quietens down." 

The owner and his daughter came with the e-collar. They did not comment but the bleeding was a lot and the swelling of the neuter site and the scrotum was as big as it could be. A few bright red drops of blood trickled out of the stitched area. 

"This 12.5-sized collar will not stop the dog from licking," I said. The owner put in the 15.0-sized collar from the Surgery. 

What to do now?

So the dog be put under anaesthesia and the wound opened up to drain the blood out? This was one option. 

Now, the vet has to be aware that any anaesthesia or tranquiliser in this highly strung dog may or may not kill him as he had anaesthesia recently. A dead dog is never appreciated by the owner no matter how clever the vet surgeon is. 

I had to choose the safer option of maintaining the status quo. Not doing anything. 

"Take the dog home and put him in a cage. No running around the house." I advised the owner. "Tel me if the swelling gets bigger or there is more bleeding. The bleeding is due to the dog licking the wound vigorously and not due to the bleeding from the neuter." I showed the owner the extensive bluish black skin discoloration of the whole penile area bruised by the dog's tongue.

Could the dog's licking cause the sutures to loosen and cause bleeding from the spermatic artery and veins? 

In my experience, this was not the case. In any case, I had ligated the stump twice and ensured the stump had gone back into the inguinal canal and probably into the abdomen. I ligate quite near the testes so as to minimise trauma by not stretching out the cord and separating the spermatic blood vessels from the cremaster muscle as I used to do. This is the open method. There are two methods of neutering and I use the closed method ligating the whole sheath with the spermatic blood vessels and the cremaster muscle inside nowadays. If the first ligation broke down during licking, there would be a second one. 

Experience gained
An appropriate-sized e-collar should be given to any dog after neutering or spaying. 
This is our usual practice although large breeds are seldom given e-collars. In this case, the owner said he had one. Although he did not bring it, we did not expect the dog to be so vigorous in his licking of the skin wound as he had a xylazine tranquiliser.

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