Thursday, August 30, 2018

3256. INTERN. A 15-year-old English Cocker has 40 skin warts and one ear tumour

HOOK

Some of us are fortunate to live to a ripe old age. With old age, some people do get one or multiple skin warts. These are cauliflower-like skin tumours, said to be caused by a virus.  Old dogs do get skin warts too as in this case.

Get footage of video showing warts in ear and skin on Day 1 and Day 3.















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Singapore is a modern city where more than 80% of the residents live in high-rises. Singapore's Toa Payoh town is over 50 years old. New apartments are being built over the land from demolished ones.  The new ones such as the image shown was completed in 1980.

NEW APARTMENTS


 

OLD APARTMENTS, some as old as 50 years.











The population has a high percentage of older people as the town is over 50 years old. Younger people love to buy apartment in this old town as it is near to downtown Orchard Road.








Dogs live a longer life compared to 30 years ago as they are better cared for. With old age, there are chronic diseases that need to be treated and controlled. In this case, the 15-year-old male neutered English Cocker Spaniel develops around 40 skin warts all over his body. He had warts in his right upper lip and a large ear tumour. His teeth had thick crusted tartar.

The lady owner decided to get him treated and WhatsApp me the images of the warts for a quotation.

WA IMAGES








TREATMENT - Electrosurgery is a process of using electricity to cut away the warts and ear tumour instead of using a scalpel blade.

This is a very old dog. He has a high anaesthetic risks of death. The owner signed the Consent Form for anaesthesia after being informed of the risks.

Sedation of a very low dose of domitor and ketamine at 0.15ml each given IV was given to this 15 kg dog. The dog was maintained on isoflurane gas anaesthesia at 1.5% although 2.5% would be needed in young dogs.

The dog gagged in the middle of electro-surgery cutting off the skin warts, as if he was going to vomit. "Take out the endotracheal tube which brings gas to the lungs," I told my assistant. "Do not push it in further as the dog may want to vomit."  I gave gas by mask and the dog slept through the 1.5-hour surgery including dental work.  40 warts and an ear tumour were cut off using electricity.




IMAGE OF ELECTRO-SURGERY EQUIPMENT






DAY 2




 









DOG POST-OP VIDEO DAY 2




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DAY 3. Review before going home.








CONCLUSION

Old dogs do die during anaesthesia if they are weak, e.g. having anaemia and bacteria in the blood stream. It is best to treat and postpone the surgery.

In such old dogs, the lowest sedation must be used. Or use only 100% gas anaesthesia to ensure no death on the operating table.  The shorter the surgery, the higher the chance of survival. In this case, it took 1.5 hours to excise the warts and stitch up the bleeding wounds as well as do dental work. An IV drip with multivitamin Bs and Baytril antibiotic was also given.

Blood test showed that the dog had a bacterial infection of the blood (high total white cell count) and anaemia (low total red cell count and haemoglobin). Iron injections, multivitamins and antibiotics are prescribed for this old dog.  


The owner was happy with the good outcome because the dog is OK after anaesthesia.He goes home on Day 3 with teeth scaled. This dog had good teeth at this age. Warts are likely caused by the papilloma viruses spreading into the skin. No histology of the ear tumour is done to lower medical costs.


UPDATE ON SEP 7, 2018. The owner is satisfied with the outcome.



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