Monday, January 22, 2018

3341. Veterinary Stories: Three sisters never forget what the vet did 15 years ago

Jan 23, 2018

Veterinary Anaesthesia Stories from Dr Sing Kong Yuen, Toa Payoh Vets
- Three sisters never forget what the vet did 15 years ago

"You said your anaesthetic machine would knock out my Golden Retriever fast as it delivered 80% gas unlike the usual machines used by vets," the eldest sister had invited me for dinner and now recalled a past-midnight service done by me to help her continuously vomiting dog some 15 years ago. "Yet my dog woke up when you tried to insert the stomach tube into his mouth!"

I did not bother to explain the technical aspects of veterinary gaseous anaesthesia to a layman.
She continued, "You stepped on the foot pedal and your operating table rose upwards. When you stepped to lower it, the table just would not come down!"

I needed a higher position to stomach tube this overweight Golden Retriever. My assistants were this lady and her two sisters who had transported the sick dog into the operating room on a large towel" stretcher" in the old spacious solidly built Mercedes 500 belonging to the eldest sister.

The "80%" referred to my anaesthetic vaporiser which delivered 8% of the isoflurane gas. 8% gas knocks down the dog faster than the 5%.

It was very useful for my over 200 Caesarean sections done past midnight with only the dog breeder and myself in the operating room. I did not need to inject the pregnant dams IV or IM. So I had purchased this 8% which the eldest sister recalled as 80%.

The 3 sisters could not help professionally as they were laymen. The dog raised his head as the anaesthetic effect had worn off. "Where am I?" she looked at the eldest sister who was the one who cared most for him, loved him to bits and worried when he was not eating. Whenever he fell ill, she would drop her work and got the dog to the vet.  

I tried to mask him again with the 8% gas vaporiser. It was past 1 am now and I had committed to help this dog instead of rejecting the plea for help. So, one sister held the dog's backside, The other put her hand on the body to steady him. The eldest sister tried to open the jaws and angle the dog's mouth for me to insert the tube.

I was the only vet to respond to her plea for help, without my veterinary assistant. The dog's abdomen was much swollen and auscultation revealed intestinal sounds. A judgment had to be made on the spot. I decided on stomach tubing to release the bloated stomach of its gas under gaseous anaesthesia.

I had told the eldest sister that the 8% vaporiser could deliver a knock out faster than the usual 5% vaporiser.  Now she mentioned "80%" as she knew nothing about the technical details of a vaporiser.

The 3 sisters were not of much help. The dog raised his head again and wanted to come down. I aborted this procedure and stepped on the foot lever of this expensive Shoreline operating table ordered from the USA. It cost as much as $5,000 at that time. I could get a simple table made for much less or purchased a second-hand human operating table.

"You stepped and stepped on the foot lever," the eldest sister was the one who had watchful eyes said. "But the table would not descend!"

She laughed so loudly as she recalled poor Edgar stranded high up. "The hydraulic mechanism had failed me," I replied. The 2 sisters were not impressed.

Then I gave the dog an antispasmodic and antibiotic injection.Four of us carried the around 50-kg dog down from the table. An average adult Golden Retriever weighs around 35 kg.

"I could see poor Edgar wobbling as he walked out of the operating room," the eldest sister laughed so loudly at the dining table where I had been invited for dinner earlier. Why was she so tickled with hearty laughter again?

"As I slided open the sliding door, it fell off my hands!"  The other 2 sisters at the dining table did not laugh so loudly but I am sure they would have advised this sister not to patronise me any more.

In 2018, I had a new Shoreline operating table and no more sliding door for my operating room. I had a proper swing door installed.

I should not have attended to this emergency but the other vets had not responded to the phone calls after midnight. Some 15 years ago, Singapore had less than 10 veterinary clinics compared to over 80 clinics in 2018. There were few emergency after midnight clinics. The eldest sister is most forgiving of the events as she had invited me to dinner and recalled this incident.  I am sure that the two sisters were not impressed with my poor outcome for Edgar and the falling out of the sliding door.
The next morning, I visited the home of Edgar. He was as bright as a sunny day and had dashed out of the main door to bark at me vigorously with his cautious brother trailing behind."He lived up to 16 years of age," the eldest sister said to me. "He had no health problems except for the need to have regular injections for his hip pain."




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