Monday, August 28, 2017

3128. VIDEO INTERN A Syrian Hamster has 2 large tumours below the throat

August 28, 2017e

"I note that you can remove a hamster's tumour in 5 minutes," the young lady had decided not to let the first vet operate on her Syrian hamster with 2 large subcutaneous tumours below the neck. The hamster had been scratching the affected neck area bald but her appetite is excellent.

If the tumour can be removed in 5 minutes as contrasted to an hour's operation estimated by the first vet, that means that her hamster would likely not die on the operating tumour.  The owner had to sign a consent form for anaesthesia and surgery and she was aware of the anaesthetic death risks.

"5 minutes is possible if the tumour is as small as 5 mm across, but your hamster's tumours are over 2 cm across," I said. "It takes much longer than 5 minutes."

The first vet had warned her: "The tumours are near the major blood vessels and nerves of the neck and the hamster may die during excision of the tumours!"

"What the first vet says is correct," I replied. "If you had got the tumours excised by the vet when it is very small, less than 5 mm across, the risk of damaging the blood vessels and nerves are practically nil."






INTRODUCTION

Hamster tumours usually develop as small lumps in hamsters over one year old. Many young Singapore hamster owners live hectic working and personal lifestyles. Some do not even have time for their retiree parents, let alone the pet at home.










Singapore has so many distractions and entertainment outlets for the young hamster owner and so the hamster's tumour is left to grow. 

VIDEO OF SUNTEC CITY


Many young Singaporeans procrastinate visiting the vet till the tumours are gigantic as in this case and many others seen at Toa Payoh Vets.

(10 images of hamster tumours operated by Toa Payoh Vets over the 10 years). Many vets do not wish to operate on large hamster tumours. Some will advise oral medication and euthanasia when the infected ulcerated tumours are too large causing the hamster poor health.

Surgical excision is the only treatment but the owner needs to find a vet who does hamster surgery.


DIAGNOSIS AND TREATMENT by electrosurgery 

This Syrian hamster had 2 mobile subcutaneous tumours.  The smaller one of 1-cm across is nearer to the major blood vessel.  The larger one of 2.5 cm across is below the throat. This is not going to be a simple operation as the owner expected the hamster to be alive at the end of the surgery.

Surgical excision is the only option. Zoletil 100 IM is given at 0.01 ml and it was sufficient for me to remove the 2 tumours without the need for topping up with isoflurane gas.
I undermine the skin to detach the tumours. Then I clamp the base and excise the tumour using electro-excision to clot the area. For the larger tumour, I ligate the stump of the large tumour to prevent any bleeding. There was no need to ligate the stump of the smaller ltumour. There was no bleeding.  3/0 absorbable sutures were used. The skin was closed by continuous sutures.
VIDEO FOOTAGEi

POST-OPERATION





The Syrian hamster was all right and went home around one hour later. The owner and her Taiwanese mother were pleased and would give the oral antibiotics and painkillers. It is a joy to see the Syrian hamster alive.

CONCLUSION

Anaesthetic death is possible if large tumours are operated as they take a much longer time.
Do not procrastinate as hamster tumours never disappear but will grow larger daily.
A 5-minute surgery is possible if the tumour is less than 5 mm across and the risk of anaesthetic death is practically zero.


CREDITS





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OTHER IMAGES NOT FOR THIS VIDOE




Wednesday, August 23, 2017

3127. INTERN. Single pup syndrome - Expensive Dachshund puppy saved by Caesarean section







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July 18, 2017   Elective Caesarean Section.  Judgment of breeder to save the pup as it is too large to be born naturally.


2064   Breeder worried. No strong uterine contractions. One large pup palpated. Single pup syndrome.   At Toa Payoh Vets now.

2065. Prepare for surgery.
2070  Cone mask. No IV sedatives like propofol. Just isoflurane and oxygen gas only. By cone mask first, then intubate with endotracheal tube and 2-2.5% isoflurane gas for maintenance.








2071. Intubated.
2072. Uterus taken out of the body.
2073. Stiching in 2 rows.  Illustrations shared with the Corgi pup C-section
2074. 2nd row completed.
2075. Dam awake fast. Washed. oxytocin, antibiotic and painkiller injections.
2076.   Footage of normal water bag with clear fluid inside. Placenta is not normal firm and turgid in size but "melting". The C-section was just in time.

2083. single pup alive.


 



FOLLOW UP 3 WEEKS LATER visit to breeder's farm

See footage in Corgi video in the other blog.




FOLLOW UP AT BREEDER'S FARM    3   WEEKS LATER.
PUPS OK.

 E:\2017TPV_JUL_SEP\20170806Review_3_C_sections


2750     Edit  00:00 - 1:26
Footage shows one of 3 Corgis thriving
Footage shows the single pup (Dachshund) thriving under the poodle. Its mother has not sufficient milk. 
The poodle is the surrogate mother of this single pup syndrome Dachshund and one Corgi. The other 2 corgis are nursed by the Corgi dam.

2773     2 Corgi pups
2772  Dachsund single pup syndrome 
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 CONCLUSION
LIFE AND DEATH depend on the judgment and knowledge of the breeder.

Some do wait for the pup to be born naturally. Generally, the single pup syndrome requires an elective Caesarean section as it is too big to be born naturally in small breed dogs. Death of the pup is expected if the breeder waits past 70 days. The suitable time to operate is 63 days when the pup is fully formed.  The general time of birth for dogs is 59-63 days.












3126. INTERN. Unusual case of one uterine horn filled with dead pups, one with normal pups

VIDEO shows an emergency Caesarean section for a 2-year-old Corgi.

The Corgi's uterus consists of 2 uterine horns. The left and right uterine horns.
(Image). Normally both uterine horns will be filled with healthy pups in clear water sacs.


In this unusual case,
The entire left uterine horn was filled with black fluid and 3 dead pups and melted placentas.
The entire right uterine horn was filled with normal pups in clear water sacs and placenta.













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Videos
2011    Black vaginal discharge. Breeder phoned Toa Payoh Vets for an emergency Caesarean section.

2012 + 2013   Prepare for surgery. IV drip, isoflurane gas anaesthesia only. No sedatives like propofol IV.


*2014  Left uterine horn. Black fluid filled the inside of the uterus. All 4 pups dead, mummified with no placentas.


Image

Right uterine horn

2016. Right uterine horn is ready for incision
2017, 2018    normal pups pulled out.

Illustration of stitching showing 2 rows
*2019. Uterine horn stitched up in 2 rows of inverting stitches.
  lst row is  parallel to the incision
*2020  lst row completed. Footage shows 2nd row started.
*2021  end of stitching of 2nd row


2022  End of surgery. Dam cleaned up. Oxytocin, antibiotic and painkiller injections will be given.

2023 + 2024   Healthy pups from right uterine horn.
 2029, 2034    Goes back to breeder farm



FOLLOW UP AT BREEDER'S FARM    3   WEEKS LATER.
PUPS OK.

 E:\2017TPV_JUL_SEP\20170806Review_3_C_sections


2750     Edit  00:00 - 1:26
Footage shows one of 3 Corgis thriving
Footage shows the single pup (Dachshund) thriving under the poodle. Its mother has not sufficient milk. 
The poodle is the surrogate mother of this single pup syndrome Dachshund and one Corgi. The other 2 corgis are nursed by the Corgi dam.

2773     2 Corgi pups
2772  Dachsund single pup syndrome 













Monday, August 21, 2017

3125. INTERN VIDEO. Digital evidence of hamster's eye stye inspires confidence in the pet owner

HOOK

Eye problems - painful, blindness unless treated early.
Small creatures like hamsters, eyes too small to be seen by the owner unlilke canine eye problems.

E.g. Pimples in the eyelid known as stye.

 



BKTP


INTRODUCTION
Why, What, How
Why need vet treatment?  Painful, rubbing eye, lose appetite, infections, eyeball rupture
What is stye?  Define eye stye

How to convince the owner that her hamster has eye stye?
Digital photography  Day 1, Day 7




How is it treated?  Eye drops may work.  Surgery - incision and drainage under gas anaesthesia in the dwarf hamster.





Hook?

"Your hamster has an eye stye," Vet 2 who was referred to this case by Vet 1 in the branch clinic announced.

The owner of this half-closed, sometimes opened right eyed dwarf hamster applied Vet 2's eyedrops for the next 7 days. The cure was not there. So, the owner sought a 3rd opinion from me.

Nowadays, the young Singaporean pet owner is knowledgeable. Just stating "eye stye" or eyelid pimple in this case is insufficient. 

 



Digital evidence is needed but this takes a lot of time and some skill to develop the evidence to inspire confidence in the young ones. It takes over an hour of digital photoshopping to develop the evidence as shown below.

DAY 1. Gas anaesthesia is necessary to examine and produce sharp photographs the hamster's eye.




Anaesthesia to get proper closed eye examination. Fluorescein eye stain test showed no corneal ulcers. The corneal areas did not show green spots which would have been evidence of eye ulcerations.  









I showed the digital evidence of eye stye and advised surgery (incision and drainage) to resolve the problem as the eye pimple is large. The pimple is on the left upper eyelid as at Day 1.

 The owner wanted the hamster home on the same day and would apply eye drops and give medication. 





DAY 7. The owner returned for the surgery (incision and drainage) after self-treatment for the past 7 days.  








 The pimples are now on the left and right upper eyelid as at Day 7.



Conclusion

This case shows how digital evidence inspired the owner to return 7 days later for the surgery of incision and drainage to resolve the eye stye problem.  The hamster was operated and hospitalised for 3 days.





To acquire digital imaging skills, I practise during my travels and usually daily taking pictures of places and friends and use Photoshop to develop better images as shown below.


Lens for close up and zoom


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Hamster hospitalised for 6 days. On Day 4 after operation, images are taken. They show the conjunctiva of the upper eyelid is inflamed due to the healing of the wound after incising the styes (see Day 7 - 2 styes).  Now Day 4 after surgery, no styes on close up image.  Show hamster video eye open more, even under operating light (video)






                                      


                                            Close up image.  Day 4 after incision of the stye.
The styes are not present. The conjunctiva is inflamed as it is early in the healing stage.



Digital photography provides evidence of the scar of the incision (arrows). The wound is healing well.

Conclusion.   Many younger Singaporean pet owners are knowledgeable as they research the internet for their pet's diseases.

Digital photography evidence inspire confidence in the owner in the vet. She knows that her pet is properly diagnosed (stye) and treated (post op.  Day 4 images).







Day 7 after consultation. The owner came to Toa Payoh Vets for surgery as advised.
This is Day 1 of surgery.


Day 4 of surgery, showing the incision scar (arrow) and the disappearance of the styes.


CREDITS

includes Dr Daniel Sing




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