"I tied her ear tips with a rubber band," she had watched and adopted the same procedures done in a Korean TV program on Malteses. Shih Tzus do get their long hair tied up above their forehead so that they can see and look pretty.
"The blood supply to the ear tips is no more," I explained. "The ear tips have no blood supply due to the rubber band cutting off the flow of blood. Now the tissues are dying. This is called gangrene. Did you use a groomer's rubber band for Shih Tzus?"
"No," the lady showed me a red rubber band normally used for tying things.
What to do with these two dying ear tips? Nothing much could be done to reverse the cell death. 3 days later, the young lady came as the left ear tip had become black and hard. I asked Groomer Aung to clean it.
"The ear tip dropped off," Groomer Aung showed to the dead triangular piece to me and the lady owner. She cupped her hands to cover her eyes. It was too much for her to see.
I took away the gangrenous ear tip. What to do now?
"The right ear tip is becoming black," I showed the owner. "It will also drop off in a few days' time. I advise cutting it off now."
"How much it will cost me?" the lady had a tight budget as she was studying in Singapore. Many foreign students in Singapore and I am sure, even in Australia and other countries survive on a tight budget as their parents skim and save to pay for their expensive undergraduate fees and accommodation.
In theory, such students ought not keep any dogs to minimise expenses. But they are not from the frugal baby-boomer generations that have had experienced the deprivations of World War Two. So, some of these Internet Generation do buy puppies and if they do make great companions in a foreign land. If they don't fall sick, expenses are affordable.
"$60.00 to cut off the gangrenous right ear tip," I said. It was take less than 10 minutes of anesthesia and cutting off the tip would be two seconds. Potassium permanganate powder applied on the wound would stop bleeding. Hence the quotation was low.
"Can you make both ears of the same size?" the fair lady assumed that cutting off a larger piece of the right ear tip instead of the small gangrenous tip would be the same effort.
To the owner, aesthetics are important. Which owner wants to see her companion with uneven sized ears every morning? Friends would ask awkward questions too.
I thought of a Singapore boy with a Bichon Frise studying in Murdoch University. He was on a tight budget as his parents had to pay for his high undergraduate fees and accommodation of at around $50,000 a year.
So I understood the financial situation of this fair Korean lady. It is expensive living in Singapore. Fortunately she did not buy a car but taxi fares add to the veterinarian add up. Pet dogs are not permitted on buses and the subway in Singapore and so taxis are the sole transportation.
I did not explain that it takes 10 times longer to give Gom ears of equal sizes and therefore the veterinary fees would be much more than $60.00.
Gom was a happy puppy. I masked him and tubed him to give him the isoflurane gas anaesthesia. He did not sleep well under intubation and was gagging as if he did not like the endotracheal tube.
The anaesthesia was uneven and delayed my surgery. I had to worry whether he would die on the operating table since he could not get to the surgical stage of anaesthesia unlike other puppies.
When I took out the endotracheal tube and just gave him gas via the mask, he slept like a baby. The gangrenous left ear tip was placed against Gom's right ear to get the area to be cut. I drew the incision line with a marker pain. Pulled back some skin so that I could suture over the cut cartilage. It was not possible in Gom as her skin was taut. A curved artery forceps was clamped below the black marker line and the cartilage was covered with an inverting 5/0 absorbable suture, as in stitching the uterus during Caesarean sections.
The left ear tip was clamped and similarly cut to remove the gangrenous edges and dead cells. There was much less bleeding and the suturing stopped the bleeding. The right ear tip area bled a lot as it was normal tissues cut by me to ensure that both ear had equal sizes. The bleeding was not serious, so I did not bandage up the right ear to stop the bleeding. I would have had done in a Doberman after ear cropping.
Ear cropping by vets for cosmetic reasons is prohibited in Singapore in the past decade or so. However, it was not prohibited when I started practice some 25 years ago.
Gom had to stay one night for observation. Early the next morning, her owner came to take her home. The bleeding had stopped. Everything should be all right for Gom (Bear in Korean language).
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