Yesterday, I reviewed 3 cases of Miniature Schnauzers with closed pyometra.
CASE 1. This was operated by me in 2009. The father prohibited surgery as the first dog died when given by an injection by Vet 1. However, the dog continued vomiting and so there was no choice. The surgery was a success but the dog continued vomiting. I had already told the young lady that the blood tests revealed kidney failure before I operated. The dog did survive but since the kidneys had failed, she vomited for the next 10 days. Euthanasia was done. This was a case whether the older baby-boomer generation has not much knowledge of the high fatality of procrastination in seeking surgery early.
CASE 2. In this case, operated by my associate vet recently, the older baby-boomer generation was the 60-year-old mother who did not want any surgery in case her vomiting dog died on the operating table. vomit and so why not wait. My associate vet warded her for 3 days with treatment given. One sister (Sister 1) took the dog back as the dog did not vomit. Conclusion was that the dog had some stomach infection. Then on the next evening, she brought the dog back and told me she was vomiting again. I was on reception duty and that is the best place to pick up complaints and feedback from clients. Three days had passed and the mis-diagnosis was gastritis. I examined the dog in the presence of the associate vet (Vet 1).
"A history of heat somewhere around Christmas" Sister 2 meant that this dog had heat around June. Now it was August, 2 months after the end of heat and so it was possible that pus had accumulated in the Schnauzer and caused vomiting. Abdominal swelling and pain on the lower 1/3 of the abdomen.
"It is closed pyometra," I based my diagnosis on the 3 factors mentioned above. "An X-ray will be useful but it is not necessary. The solution is to spay her soon." The sister did not believe me. Vet 1 stuck to the diagnosis of stomach infection (gastritis) as the history given was that the heat period was more than "3 months ago" or "unknown" and advised an X-ray of the abdomen. So there was a delay of one day. "How's the X-ray interpretation?" I asked the associate vet. "Is there closed pyometra?" Sister 1 came and requested that the operation be done the next day as Vet 1 was busy with cases till past 8 pm during her visit. and Sister 1 wanted a vet who would be not so tired doing surgery. This is the situation with multi-family interactions on the veterinary duties. "This dog could still be operated after 8 pm," I said but since Sister 1 had said so, I did not object. This closed pyometra dog had already been over 6 days since the first consultatio by Vet 1 and delays in surgery are not good for the dog's health and prognosis.
Vet 1 did not think the X-ray showed closed pyometra although I disagreed with Vet 1. "However the owner did not mind getting the dog spayed," Vet 1 said.
Spaying showed closed pyometra. The dog was standing and barking the day after the operation. However, post-op complications set in after 3 days of hospitalisation. Complications of wound breakdown do occur in surgeries for all vets. The dog became recumbent and the 3 sisters and mother were visiting her every day. "Why is the dog vomiting?" one sister asked me at one visit one evening. I told her that the dog would be operated by Vet 1 to close the stitch. Vet 1 operated late at night at around 10 pm on Aug 27, 2012. A drainage tube was inserted. As post-op complications do happen, I monitored this dog daily.
Yesterday, Aug 29, 2012, she started eating, wolfing down the steamed fish but ignoring the whole bowl of cut pears yesterday morning at 10 am. The mother had cooked the fish and came to give her the food. On Aug 28, 2012, this dog also wolfed down the fish given by the mother.
"Since she eats the food fast, she has recovered from the operation," I said to Sister 2 who came yesterday evening to visit and asked me if the dog could go home. Vet 1 was busy consulting and could not spend time with multi-family visits. "We have to wait and see the next few days," I said to Sister 2.
CASE 3. Another Schnauzer with closed pyometra was operated by Vet 1 on Aug 28, 2012. The uterus was packed full with pus, much fuller than that of Case 2. In the evening, I could see that the dog post-op was not well. She was shaking in her body and then she pushed her head against the crate's bar, as if trying she had headache. "What's wrong with the Schnauzer? She looks very sick," one young lady who was visiting her vomiting Shih Tzu hospitalised asked me. I told her that the dog had an operation.
I had seen such head butting against the crate behaviour from distemper puppies with fits and it is not a good sign of health. The young lady owner came in the evening and wanted to take this dog back. "A dog that is not eating should be hospitalised and given drips," I said to her and Vet 1. "Why is the dog not on drips?" I asked Vet 1 who was preparing to send the dog back home as requested by the young lady who would not be in Singapore till the next Saturday (10 days later).
Vet 1 said, "The dog flung off the IV set." I said to Vet 1: "If the dog dies at home, all the family members will not only bad-mouth you, but also Toa Payoh Vets. This dog should not be allowed to go home (to give her a better chance of survival on IV drip. The lady owner had been shown the swollen pus in the uterus). I could not believe that the young lady wanted the dog back on the same day after surgery as most owners accept the vet's advice. Maybe it was economics, but here there was the dog successfully operated but could die a few days later due to the lack of IV drips. "Get the owner to sign a letter stating the possiblity of death and that the dog was discharged against medical advice by you and I," I instructed Vet 1.
It is tough nowadays for vets as clients want their own way. But there must be a firm action to let the lady owner and her family members know that the dog could die due to the lack of post-op IV support. The vet has to be alert and mindful of the consequences of the failure of IV support since this dog was not in good health. The young lady phoned her family. I noted that the dog was hospitalised. In this case, it was likely economics.
In conclusion, in all 3 cases, had the dogs been spayed when they were younger and healthier, closed pyometra would never be present and much financial expenses and more worries would not be present. But many Singaporean owners think it is cruel to spay the dog. So, there are more cases of pyometra seen and it is not guaranteed that a dog that survived the operation would remain alive after surgery as you could see in Case 1.
Thursday, August 30, 2012
1066. Black lump on the older roborovski hamster
On Thu, Aug 30, 2012 at 3:59 AM, ....@hotmail.com> wrote:
Hi Dr Sing,
I came across your website while searching for more info regarding the lump on my robo hamster. It was quite a big one and black in colour. I am not sure how long it have been there (assuming 2 weeks) because as robo is a very active hamster and does not like to be handle so i usually only observe it through the cage and close the cage after i feed her on my hand. Her movement and everything else seems normal, no limping etc. As i am the second owner of my robo, i am also not sure how old it is (she is already with me for 1 year and 2 month). Merry was abandon by her previous owner and she was left outside the house to hibernate without food and water bottle dried up. She was given to my cousin by the previous owner's sister.
I would like to seek your advice on this and would like to check with you if you have come across black lump on hamster. I would also like to know the cost if operation is needed and if it is within my means.
Hope to hear from you soon Dr Sing.
Thank You
Regards,
Name of lady owner
EMAIL REPLY FROM DR SING DATED AUG 30, 2012
Thank you for your email. It is difficult to say what your hamster's "black" lump is. Based on his old age, it is likely a tumour, probably a melanoma. It could be a black gangrenous tumour that has lost its blood supply.
As you did not provide any images, I can't say whether I have had seen similar "black" lumps in other robo. Older hamster has various lumps of various sizes on various parts of its body and some do have "black" ones.
Anaesthesia and surgery for the removal of the lump is estimated at around $100-$200 depending on its size and time to excise it. Pl make an appointment one day in advance at 6254 3326 and come at 9.30 am on a weekday preferably. Best wishes.
Hi Dr Sing,
I came across your website while searching for more info regarding the lump on my robo hamster. It was quite a big one and black in colour. I am not sure how long it have been there (assuming 2 weeks) because as robo is a very active hamster and does not like to be handle so i usually only observe it through the cage and close the cage after i feed her on my hand. Her movement and everything else seems normal, no limping etc. As i am the second owner of my robo, i am also not sure how old it is (she is already with me for 1 year and 2 month). Merry was abandon by her previous owner and she was left outside the house to hibernate without food and water bottle dried up. She was given to my cousin by the previous owner's sister.
I would like to seek your advice on this and would like to check with you if you have come across black lump on hamster. I would also like to know the cost if operation is needed and if it is within my means.
Hope to hear from you soon Dr Sing.
Thank You
Regards,
Name of lady owner
EMAIL REPLY FROM DR SING DATED AUG 30, 2012
Thank you for your email. It is difficult to say what your hamster's "black" lump is. Based on his old age, it is likely a tumour, probably a melanoma. It could be a black gangrenous tumour that has lost its blood supply.
As you did not provide any images, I can't say whether I have had seen similar "black" lumps in other robo. Older hamster has various lumps of various sizes on various parts of its body and some do have "black" ones.
Anaesthesia and surgery for the removal of the lump is estimated at around $100-$200 depending on its size and time to excise it. Pl make an appointment one day in advance at 6254 3326 and come at 9.30 am on a weekday preferably. Best wishes.
Tuesday, August 28, 2012
1065. Malocclussion in a lob rabbit
Lower jaw longer, upper jaw shorter. So malocclusion.
Trimmed 2 months ago. The rabbit's front teeth overgrows every 6 weeks due to malocclusion.
I advised filing the teeth after I have had clipped them short but the gentleman was busy working as a cabin crew. He used the cloth to wrap around the rabbit to file the front teeth. But the rabbit struggled and so he could not do it.
He asked whether there were solutions as he would not want to come every 2 months to file the rabbit's teeth. "Hold the scruff of the rabbit's neck firmly with your fingers of one hand," I showed him. The rabbit was immobile and he was impressed. "However, you need a person to do it while you file the front teeth."
The other solution would be to extract all the 4 front teeth under anaesthesia. "Usually, the teeth would not grow back again if the root is completrely removed.. There is always an anaesthetic risk of death," I said. "What is the cost?" the wife asked. "Around $250."
Trimmed 2 months ago. The rabbit's front teeth overgrows every 6 weeks due to malocclusion.
I advised filing the teeth after I have had clipped them short but the gentleman was busy working as a cabin crew. He used the cloth to wrap around the rabbit to file the front teeth. But the rabbit struggled and so he could not do it.
He asked whether there were solutions as he would not want to come every 2 months to file the rabbit's teeth. "Hold the scruff of the rabbit's neck firmly with your fingers of one hand," I showed him. The rabbit was immobile and he was impressed. "However, you need a person to do it while you file the front teeth."
The other solution would be to extract all the 4 front teeth under anaesthesia. "Usually, the teeth would not grow back again if the root is completrely removed.. There is always an anaesthetic risk of death," I said. "What is the cost?" the wife asked. "Around $250."
1066. Advise on a caterwauling cat without carrier
Cat was spayed on Monday yesterday. Came in on Sunday as she was caterwauling and was a noise nuisance.
A young Malay lady (nurse from Kandang Kerbau Hospital) came to take cat home after spay by Dr Daniel. Her father came into the clinic while her mum was in the car.
"Bising, neighbour complained," the father said. "Will she still make noise.?" So, the mother decided to put the cat here for 2 days after spay. Today, bring home.
She wanted to carry the cat out of the clinic to the car.
"No," I said. "Put it inside a carrier. Take the carrier to your car."
That should be the way.
"When can I bathe the cat?" the mum had come in while the father had gone to the car.
"You can bathe the cat if you don't wet the bandage covering the wound," I said.
"Better not to bathe," the daughter said.
"How long must wear the e-collar?" the mum asked.
"10 days," I said. "This is to prevent the cat biting the bandage and then the wound. Intestines may pop out if she does it."
"Will the cat still be noisy?" the mum was worried that neighbours were complaining.
"Possibly," I said. "It depends on the hormone level. As a precaution, give 1/4 of the Ovarid 20mg/day for the next 4 days and this would stop the meowing."
I advised feeding a cat food for "fat cats" as this cat was overweight at 6.5 kg at 11 months of age.
Also deworming and vaccination. This owner education is important and most vets don't do it as the cat came in only for spay. And so spay would be done.
FEEDBACK
I asked the young lady why she came from Woodland to Toa Payoh Vets to spay her cat. "There is one vet in Woodlands and one in Admiralty," she said. "I was referred to you." Referrals are very important in this type of business.
A young Malay lady (nurse from Kandang Kerbau Hospital) came to take cat home after spay by Dr Daniel. Her father came into the clinic while her mum was in the car.
"Bising, neighbour complained," the father said. "Will she still make noise.?" So, the mother decided to put the cat here for 2 days after spay. Today, bring home.
She wanted to carry the cat out of the clinic to the car.
"No," I said. "Put it inside a carrier. Take the carrier to your car."
That should be the way.
"When can I bathe the cat?" the mum had come in while the father had gone to the car.
"You can bathe the cat if you don't wet the bandage covering the wound," I said.
"Better not to bathe," the daughter said.
"How long must wear the e-collar?" the mum asked.
"10 days," I said. "This is to prevent the cat biting the bandage and then the wound. Intestines may pop out if she does it."
"Will the cat still be noisy?" the mum was worried that neighbours were complaining.
"Possibly," I said. "It depends on the hormone level. As a precaution, give 1/4 of the Ovarid 20mg/day for the next 4 days and this would stop the meowing."
I advised feeding a cat food for "fat cats" as this cat was overweight at 6.5 kg at 11 months of age.
Also deworming and vaccination. This owner education is important and most vets don't do it as the cat came in only for spay. And so spay would be done.
FEEDBACK
I asked the young lady why she came from Woodland to Toa Payoh Vets to spay her cat. "There is one vet in Woodlands and one in Admiralty," she said. "I was referred to you." Referrals are very important in this type of business.
1063. Rainy morning and how many years of experience in spay
Tuesday, Aug 28, 2012
For the past months, I have been taking the bus 238 from the Toa Payoh bus interchange to outside the Polyclinic and then walking to the Surgery every weekday, at around 8.30 am. Today, it rained dogs and cats. I drank coffee at Ya Kun coffeeshop and waited till 9am.
It is important for a vet to be around to answer phone calls as many are technical questions. I usually attended to the phone calls instead of leaving them to the receptionist and there have been good responses in the sense that the new clients come for treatment after knowing the technical details which a receptionist will never be able to advise with authority.
However, this morning I received a most direct phone call with the following questions from a lady who wanted her 2-year-old Maltese to be spayed by an experienced vet.
1. Do you have an experienced vet to spay my dog?
2. How long is the spay operation?
3. How long is the whole process?
4. Can I bring her to spay and wait?
5. Can I bathe her?
6. How long will she recover from spay?
7. Since she eats several times a day, how is she going to eat after spay and not starve to death?
8. Can I spay her on Saturday or Sunday?
9. How many years of experience do you have?
ANSWERS
1. We do have experienced vets like Dr Jason Teo, Dr Vanessa Lin and myself (Dr Sing Kong Yuen).
2. For experienced vets, it should take less than 15 minutes for the surgery.
3. The whole process should take less than 30 minutes if there are no complications.
4. The owner can't wait and take the dog home immediately. The dog has to rest and recover for the next 3 hours post-op. "Sometimes, the dog may die during transportation as the dog is not fully normal," I said. "Really?" the caller asked. "The blood and body systems need to stablise after anaesthesia and that would take at least 3 hours of rest."
5. Yes if she covered the op area.
6. Around 10 days normally and without complications and infections.
7. The dog would not eat for the first 24-48 hours after spay and would not starve to death.
8. Best time to spay the dog is on weekdays as the weekends are usually busy. Make an appointment one day before. No food and water after 10 pm the previous day.
9. I have around 30 years of experience.
For the past months, I have been taking the bus 238 from the Toa Payoh bus interchange to outside the Polyclinic and then walking to the Surgery every weekday, at around 8.30 am. Today, it rained dogs and cats. I drank coffee at Ya Kun coffeeshop and waited till 9am.
It is important for a vet to be around to answer phone calls as many are technical questions. I usually attended to the phone calls instead of leaving them to the receptionist and there have been good responses in the sense that the new clients come for treatment after knowing the technical details which a receptionist will never be able to advise with authority.
However, this morning I received a most direct phone call with the following questions from a lady who wanted her 2-year-old Maltese to be spayed by an experienced vet.
1. Do you have an experienced vet to spay my dog?
2. How long is the spay operation?
3. How long is the whole process?
4. Can I bring her to spay and wait?
5. Can I bathe her?
6. How long will she recover from spay?
7. Since she eats several times a day, how is she going to eat after spay and not starve to death?
8. Can I spay her on Saturday or Sunday?
9. How many years of experience do you have?
ANSWERS
1. We do have experienced vets like Dr Jason Teo, Dr Vanessa Lin and myself (Dr Sing Kong Yuen).
2. For experienced vets, it should take less than 15 minutes for the surgery.
3. The whole process should take less than 30 minutes if there are no complications.
4. The owner can't wait and take the dog home immediately. The dog has to rest and recover for the next 3 hours post-op. "Sometimes, the dog may die during transportation as the dog is not fully normal," I said. "Really?" the caller asked. "The blood and body systems need to stablise after anaesthesia and that would take at least 3 hours of rest."
5. Yes if she covered the op area.
6. Around 10 days normally and without complications and infections.
7. The dog would not eat for the first 24-48 hours after spay and would not starve to death.
8. Best time to spay the dog is on weekdays as the weekends are usually busy. Make an appointment one day before. No food and water after 10 pm the previous day.
9. I have around 30 years of experience.
1062. Antisedan is the antidote to be given routinely
"No point giving Antisedan," Dr Daniel was behind me and saw the deep purplish blue tongue tip of the 8-year-old Jack Russell as I was making a post-op check on this beloved dog of a lady in her 30s. "The dog has died."
"Get the dog out of the cage," I said but did not waste time informing him that I could see the dog's eye flickering, meaning he is still alive. "I am getting the Antisedan injection." 30 minutes ago, the dog had 75% of my Dom+Ketamine IV formula and had dental scaling and ear irrigation. I did the ear irrigation personally as that was what the owner wanted me to handle her dog's ear itchiness problem which had persisted for the last 2 months after Vet 1 had been consulted and given her ear drops. The 8-year-old female Jack Russell was still scratching her ears and dark black pigment and rough skin developed near the ear canal opening.
Many of my old clients had disappeared as proximity is important for them since around 50 vet clinics have been opened in recent years. I checked my case records.
In Oct 30, 2005, this dog had vaccination and false pregnancy. No more visit till Mar 5, 2008 when I diagnosed false pregnancy as there was milk. "My dog had ear infection and you had treated her successfully," the lady said. Dog owners always remembered their pet's medical history and the vet who can deliver results and those who failed them. It is a tough competitive world in Singapore vet medicine and all over the world in 2012!
I reviewed my case sheets. Sure enough. In August 17, 2009, I did an ear irrigation of the left ear otitis externa and teeth scaling as well as vaccination and deworming. "Left ear drawing - I wrote "red+, pus, 1 week".
In Dec 13, 2009, I treated the dog for inflamed D3/D4 interdigital right hind lameness. That meant the ears were no problem anymore.
So, that was why she came to consult me after 2 months of ear drops cleaning from Vet 1.
Back to the present situation, I injected Antisedan 0. 4 ml IM. The dog was walking and OK. I went out to buy surgical equipment and the surgical gloves at Jalan Besar. Later, the lady came and was most happy to see her dog. The dog's tongue was pink. As to why the tongue tip which protruding out and in between the teeth turned cyanotic, I don't know. The dog was resting on her chest and the head was on her paws. The teeth clamped on the protruding tongue tip. Cyanotic tongue colour meant no oxygen flow and in that stage, it would lead to death.
From now, I would insist on Antisedan to be given routinely. As the associate vets have their own judgment, they don't usually given Antisedan. I had advised but each vet has his or her own ideas as do all doctors. This case showed the importance of Antisedan as there would be no such drama if the associate vet under my mentorship had given Antisedan routinely as instructed by me.
It is not necessary to give Antisedan reversal in all cases, but in old dogs, this should be done. But my associate vets sometimes do it and sometimes don't and this case clearly illustrated the importance of getting the antidote and letting the dog recover faster from sedation.
"Get the dog out of the cage," I said but did not waste time informing him that I could see the dog's eye flickering, meaning he is still alive. "I am getting the Antisedan injection." 30 minutes ago, the dog had 75% of my Dom+Ketamine IV formula and had dental scaling and ear irrigation. I did the ear irrigation personally as that was what the owner wanted me to handle her dog's ear itchiness problem which had persisted for the last 2 months after Vet 1 had been consulted and given her ear drops. The 8-year-old female Jack Russell was still scratching her ears and dark black pigment and rough skin developed near the ear canal opening.
Many of my old clients had disappeared as proximity is important for them since around 50 vet clinics have been opened in recent years. I checked my case records.
In Oct 30, 2005, this dog had vaccination and false pregnancy. No more visit till Mar 5, 2008 when I diagnosed false pregnancy as there was milk. "My dog had ear infection and you had treated her successfully," the lady said. Dog owners always remembered their pet's medical history and the vet who can deliver results and those who failed them. It is a tough competitive world in Singapore vet medicine and all over the world in 2012!
I reviewed my case sheets. Sure enough. In August 17, 2009, I did an ear irrigation of the left ear otitis externa and teeth scaling as well as vaccination and deworming. "Left ear drawing - I wrote "red+, pus, 1 week".
In Dec 13, 2009, I treated the dog for inflamed D3/D4 interdigital right hind lameness. That meant the ears were no problem anymore.
So, that was why she came to consult me after 2 months of ear drops cleaning from Vet 1.
Back to the present situation, I injected Antisedan 0. 4 ml IM. The dog was walking and OK. I went out to buy surgical equipment and the surgical gloves at Jalan Besar. Later, the lady came and was most happy to see her dog. The dog's tongue was pink. As to why the tongue tip which protruding out and in between the teeth turned cyanotic, I don't know. The dog was resting on her chest and the head was on her paws. The teeth clamped on the protruding tongue tip. Cyanotic tongue colour meant no oxygen flow and in that stage, it would lead to death.
From now, I would insist on Antisedan to be given routinely. As the associate vets have their own judgment, they don't usually given Antisedan. I had advised but each vet has his or her own ideas as do all doctors. This case showed the importance of Antisedan as there would be no such drama if the associate vet under my mentorship had given Antisedan routinely as instructed by me.
It is not necessary to give Antisedan reversal in all cases, but in old dogs, this should be done. But my associate vets sometimes do it and sometimes don't and this case clearly illustrated the importance of getting the antidote and letting the dog recover faster from sedation.
Monday, August 27, 2012
1061. Sunday Aug 26, 2012's interesting cases
I was away in Hong Kong from last Monday to Friday. So, I had to catch up with my admin work on Saturday morning. Sunday was a bright sunshine day.
CASE 1. Rabbit abscess
A vet (Vet 1) told the young couple today, that she was too busy to operate on their rabbit's abscess and gave some injections and medication. They could phone her on Monday to make an appointment a week later. I would have just asked the couple to go to another vet as abscesses will enlarge with time. So, the couple came to consult me and told me their encounter. Sundays are always busy for vets. I had 2 cat spays (noisy caterwauling), one dog spay booked in and I know that another associate vet would have to operate on the closed pyometra Schnauzer suffering from post-op complications of stitch breakdown. There were clinical cases waiting too.
The young couple were knowledgeable about the rabbit abscesses as they had surfed the internet and so it was easy for me. "The abscess would recur," the husband said. "Sometimes," I said. "It depends on whether the tooth root is still infected. Do you want an X-ray done?"
The rabbit was a gentle brown sturdy creature. Isoflurane gas by mask.
"Anaesthesia must be short and surgery must be fast," I said to Dr Daniel who was present. "Rabbits may die if anaesthesia is prolonged, although not every rabbit will be affected."
I incise the skin, undermine the subcutaneous and a big bulge popped out. "It looks like a tumour," Dr Daniel said. "There are numerous blood vessels and nerves in this neck area." The abscess was at the angle of the jaw near to the neck.
"Get a syringe and 18G needle to aspirate the abscess," I did not rule out tumour in this young rabbit, but the most common condition is abscess. Dr Daniel drew out 0.1 ml of yellow cheesy stuff and then nothing. I incised the muscles of the abscess which was 3/4 size of a golf ball. Thick cheesy yellow pus spurted out. The rabbit squealed as the anaesthesia was just sufficient. I top up the anaesthesia again and completed the pus aspiration within 2 minutes. I informed the owner who had earlier come again with the rabbit's pelleted food, squarish glass bowl, log of hay and his packet of white treats.
Rabbits are family members, just like dogs and in this case, this rabbit was free to roam around the apartment. As a new baby was present, the rabbit's old litter box was discarded and the rabbit lost interested in eating the hay. "We can't find another," the husband said. "Well, it may be the smell of the box," I said. "A new one may not help. Hay is good for rabbits."
In retrospect, as I review the case now, at 10.07 am on Monday, the cause of not eating hay or food could be the cheek abscess being formed. This lead to pain. "Did the rabbit eat after Vet 1 gave the injection?" I asked. "Yes," the couple said.
Large rabbit abscess are best operated as soon as possible. But Sundays are hectic days. Some vets may not wish to operate during lunch breaks as staff also need to rest. Much depends on the vets and the staff's attitude and their caseload.
CASE 1. Rabbit abscess
A vet (Vet 1) told the young couple today, that she was too busy to operate on their rabbit's abscess and gave some injections and medication. They could phone her on Monday to make an appointment a week later. I would have just asked the couple to go to another vet as abscesses will enlarge with time. So, the couple came to consult me and told me their encounter. Sundays are always busy for vets. I had 2 cat spays (noisy caterwauling), one dog spay booked in and I know that another associate vet would have to operate on the closed pyometra Schnauzer suffering from post-op complications of stitch breakdown. There were clinical cases waiting too.
The young couple were knowledgeable about the rabbit abscesses as they had surfed the internet and so it was easy for me. "The abscess would recur," the husband said. "Sometimes," I said. "It depends on whether the tooth root is still infected. Do you want an X-ray done?"
The rabbit was a gentle brown sturdy creature. Isoflurane gas by mask.
"Anaesthesia must be short and surgery must be fast," I said to Dr Daniel who was present. "Rabbits may die if anaesthesia is prolonged, although not every rabbit will be affected."
I incise the skin, undermine the subcutaneous and a big bulge popped out. "It looks like a tumour," Dr Daniel said. "There are numerous blood vessels and nerves in this neck area." The abscess was at the angle of the jaw near to the neck.
"Get a syringe and 18G needle to aspirate the abscess," I did not rule out tumour in this young rabbit, but the most common condition is abscess. Dr Daniel drew out 0.1 ml of yellow cheesy stuff and then nothing. I incised the muscles of the abscess which was 3/4 size of a golf ball. Thick cheesy yellow pus spurted out. The rabbit squealed as the anaesthesia was just sufficient. I top up the anaesthesia again and completed the pus aspiration within 2 minutes. I informed the owner who had earlier come again with the rabbit's pelleted food, squarish glass bowl, log of hay and his packet of white treats.
Rabbits are family members, just like dogs and in this case, this rabbit was free to roam around the apartment. As a new baby was present, the rabbit's old litter box was discarded and the rabbit lost interested in eating the hay. "We can't find another," the husband said. "Well, it may be the smell of the box," I said. "A new one may not help. Hay is good for rabbits."
In retrospect, as I review the case now, at 10.07 am on Monday, the cause of not eating hay or food could be the cheek abscess being formed. This lead to pain. "Did the rabbit eat after Vet 1 gave the injection?" I asked. "Yes," the couple said.
Large rabbit abscess are best operated as soon as possible. But Sundays are hectic days. Some vets may not wish to operate during lunch breaks as staff also need to rest. Much depends on the vets and the staff's attitude and their caseload.
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