Monday 4 February 2013

4. Internship. Enucleation of Winter White Dwarf Hamster

Surgical procedure:
1.       The hamster was gassed with Isoflurane in a small container for approximately 10 seconds until its body was limp.
2.       First we must incise 4mm of the lateral canthus so that we can have adequate exposure of the internal structure of the eye
3.       Then we can clamp the optic nerve stalk with the smallest forceps, however it is not possible to ligate the stalk because it is way too small.
4.       Next, is to incise the optic nerve stalk. Some bleeding may be expected after the incision however it will clot soon because the vessels are tiny.
5.       Then, we have to trim the upper and lower eyelids so that the skin will heal when opposed together. If these eyelids were not cut then the skin will not close even when stitched together.
6.       Lastly is to close up the wound using 6/0 absorbable suture.
7.       The whole eye enucleation procedure should take less than 1 minute because the anaesthetic effect wears off very fast in small animals especially when using gas anaesthesia.
8.       Clean the external of the wound and the surrounding fur that is stained.
9.       It is not possible to put E-collar on a hamster. So the best way to avoid self inflicted injury is to administer analgesic drug.
10.   This is because analgesic will provide comfort and the animal won’t feel irritated and pain. Thus, it will not scratch its eye.

NB: There is a simplified illustration of the procedure below.

Differences:
1.       No 360˚ paralimbal incision to remove eyeball from its socket.
2.       There is no ligation of the optic stalk below the clamp.
3.       Lots of bleeding controlled by stitching of eyelid.
4.       Excision of upper and lower eyelid to create fresh wound.
5.       Excision of extraocular muscle attachment.
6.   Removal of the third eyelid or nictitans membrane


Prepared by
Erica chai Hui Ling
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Sunday 3 February 2013

3. Internship. A Golden Retriever With Two Big Lumps Below the Sternum





History:

Ace is a 10 year old, male, Golden Retriever that came in with subcutaneous tumour and ruptured abcess (10”x5”x5”) below the sternum. He had been inappetance and had trouble walking for 10 days. During examination, he was down with slight pyrexia (T: 40.7˚C), deep ear infection, abscess, tumour and ulcerated foot pad of the right forelimb.


Possible treatment option:
1.       The dog required surgery to remove both the abscess and subcutaneous tumour.
2.       Excise about 1cm from the margin of the tumour to ensure complete removal.
3.       Then surgically debride the affected area and remove pus by flushing the abscess.
4.       Use hydrogen peroxide followed by chlorhexidine, diluted povidone iodine and then smear mixture of antibiotic cream and dermapred on the wound.
5.       Depending on the size, the gaping wound can be stitch up or left open for second intention healing and that would need daily wound cleaning.
6.       If the wound is big, we need to stitch up and reduce the dead space to avoid fluid accumulation. We also need to insert drainage such as Penrose drain to allow daily flushing of the wound.
7.       If the wound is small then second intention healing is intended. 
8.       The animal also needed systemic antibiotic, analgesic and anti-inflammatory medicine.
9.       If there is swelling, then apply warm compression twice daily.
10.   The dog had to wear a e-collar to avoid self trauma.
  
Prepared by
Intern: Erica Chai Hui Ling

Wednesday 16 January 2013

2. Internship. Swollen right fore paw in a 12 year old shih tzu cross

Swollen right fore paw in a 12 year old shih tzu cross

Shih tzu cross, Male, 12 years old, not sterilised
Active: 5.8kg, in good condition
è Heart and lungs are okay
è No history of panting/ breathing difficulty
è No medical history
è Low risk
Problem: Foreign body under paw. Right front paw is swelling. Big scab/wound about 6mm in diameter. Might have stepped on something.

Treatment: Surgery to remove foreign body (found out to be a tumour)
History: Went for grooming about 2 weeks ago
Owner worried about effects of anaesthesia
Owner does not want dog to undergo histology (old age)

1. Internship. False pregnancy in a very old dog


False pregnancy in a very old dog 


Active, in good condition
History:
è Food: Caesar can, Dog food (soaked in water) A & F dog food for old dogs, 1 egg everyday
è Drink: when asked to do so
è Pee: ??
è Poo: Once/ twice a day
Menses: Red, dark brown discharge, colour gets lighter towards the end,
Duration: 2 – 2.5 weeks (since young)
è Last menses: start of October
Has a breast tumour
Problem: False pregnancy
è Signs: Milk in breast
Problem: Itchy paw
è May be due to allergy to Dettol
Conclusion: Should have sterilised it 



- Toh Ming Hui