Sunday, September 29, 2019

3294. INTERN. A pug swallows a fish hook.



VIDEO CREATION BY INTERN. The 2-year-old Pug vomited after swallowing a fish hook. 



HOOK

Many Singapore dog owners take time to walk their companion daily. The Lentor area in North Singapore is a leafy residential suburb. Houses with their manicured gardens and plants. Birds tweeting. It is a pleasant place to enjoy a brisk morning or evening walk with your dog.







As the young lady appreciated Nature in an evening walk, her pug swallowed an object attached to a 90-metre long nylon string.  She did not see the pug swallowing the fish hook but only a long green nylon string hanging out from her favourite dog's mouth.

She tugged but the string stayed stuck inside the pug's mouth. The pug vomited but nothing came out of his mouth. The green nylon string was still hanging loose from his mouth. Suspecting he had swallowed a fish hook, she rushed him to Toa Payoh Vets.





This is a Be Kind To Pets Veterinary Educational Video sponsored by Toa Payoh Vets




A pug swallows a fish hook







SURGERY at Toa Payoh Vets

Gastrotomy by Dr Daniel Sing under general anaesthesia.


Stomach is over-distended with gas and froth due to the penetration of the fish hook



Dr Daniel incised a 1-cm stomach incision.  He inserted a long tissue forceps into the stomach to grasp the fish hook. He could not get the hook out. He extended the stomach incision and used his 2 fingers to unhook the hook from the stomach mucosa. The stomach was stitched up. Then the abdominal muscles and skin were stitched up.  


Post-operation - Day 1. Skin stitched up. 



A fish hook is taken out from the stomach. No X-ray was done as the owner saw the fish hook being swallowed.


The dog recovered well after 2 days and went home. He was not confined to a small cage. He jumped and scratched his operation area with his back legs. He could not bite his stitches as he wore an Elizabeth collar but his back legs were free.

On Day 3 after surgery, a big subcutaneous swelling bulged under the skin stitches. The owner phoned as there was blood coming out from the stitched area when they changed the bandage. So they had to bring the dog in for examination. 

The stitches were not breaking down. There was a big swelling (another video) below the stitched area. The "blood" accumulated under the skin stitches. The vet slowly compressed the swelling and removed the blood and fluid.


The pug goes home after 4 days of in-patient nursing. However, the owner complained of seeing blood leaking out from the operation site when changing bandages. This was on Day 6 after operation. The pug struggled to prevent the change of dressing. So, the owner had to bring the pug down to Toa Payoh Vets for examination of the "bleeding".

There was indeed blood under the skin as shown in the video. The blood was expressed and the pug bandaged round the abdomen. (see video, edit video).  He was in-patient again for the next 3 days. 



VETERINARY TIPS AND ADVICES

1. POST-OPERATION BLEEDING

The pug was not confined to a small cage for the next 14 days after surgery. He jumped and scratched his operation area vigorously with his back paws. There was a large skin swelling by Day 4 and blood oozed out from the wound.

Pug is active and eating 4 days and more post-operation


POST-OP COMPLICATIONS
Bleeding from the wound is a post-op complication. The pug was active in the home. Although he had worn an e-collar, he could use his back legs to scratch the operation site. This resulted in a large swelling filled with blood as seen in the video below:



Sep 29, 2019, Day 4 after surgery to remove a fish hook from the stomach. The pug came in as the owner complained that there was bleeding from the wound. The pug was not confined to the cage and was using the back legs to paw at the operation site.



Oct 3, 2019. The pug goes home after being hospitalised for 4 days at Toa Payoh Vets.
Very little bleeding. There is no stitch breakdown and swelling has reduced considerably.
The owner bought a cage to confine the pug for another 10 days.









CONCLUSION


Today is Day 9 after surgery (see video, edit footage). The pug had been warded for the past 4 days. . He is active, eating and has no fever. There is little "bleeding". He goes home.

The bleeding is caused by the pug using his hind paws to scratch the operation site. The traumatic injury caused bleeding and swelling. Blood leaked out when the bandage was changed.
Since the pug was hospitalised for the past 4 days in a confined cage and given painkillers and medication, his bleeding had stopped and he was able to go home to rest in a cage. He will wears his E-collar for at least 10 days.

CREDITS
include Intern's name

vet assistants x 2








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