I type the following 2 interesting cases I had while I visited the National Library at Victoria St at 5 pm while the details are fresh in my mind.
Sharing knowledge of anaesthesia for Giant Rabbits.
1. Usually, Singapore pet owners keep small rabbits of around 2-3 kg.
Giant Fleming Rabbit, 5.2kg
Extremely hyperexcitable. This type of temperament is a high anaesthetic risk
METHOD 1. One method is to use injectable anaesthesia of zoletil IM, 5 minutes later, give domitor IV via the ear vein.
However, this method seems to be unsuitable as restraint and injection causes the rabbit to move a lot.
Zoletil 50 0.2 ml IM
Waited 15 minutes
Wanted to give Domitor 0.2 ml IV, ear vein.
Still struggling. Abandoned this method in favour of Method 2.
METHOD 2
Zoletil 50 0.2 ml IM given. In around 7 minutes, the rabbit staggers and by the 15th minute, the rabbit was recumbent. However it exhibited excitation when the ear vein was pricked and moved away. So, I used isoflurane 5% gas by mask.
Isoflurane gas - mask - maintenance at 0.5% - 1% was excellent.
METHOD 3
Xylazine IM, Ketamine IM is another method I used for smaller rabbits.
CONCLUSION:
The interesting thing about this case is that my staff under-quoted the cost of neutering as we usually neuter the non-giant rabbits at $75.00/neuter! Life is full of surprises even after graduating 40 years ago!
Sharing knowledge of anaesthesia for 3-month-old German Shepherd puppy.
This is a high-risk age group as the puppy is still young.
However there was no choice as the domestic worker's hair band occupied the 100% of the stomach (seen during surgery) and would not be vomited out nor passed out with the stools. Surprisingly the puppy did not vomit at all.
No food and water after 10 pm yesterday.
No stools passed out. Only urine this morning.
Surgery started at 1.30 pm today (5th day after swallowing of the hair band).
IV dextrose saline drip given
Xylazine 0.2 ml IV via the drip.
5 minutes later, isoflurane gas by mask. Intubate. 2-3% maintenance. No problem.
Skin incision around 6 inches (15 cm long). Linea alba excised. The tip of brownish red liver was visible. The stomach was just below. It was swollen and looked "crumpled". Deep pink in colour suggestive of an inflammation going on due to the foreign body hair band being there for 5 days. I could exteriorise easily as it was impacted with the hair band inside.
Stomach incision 3-cm long. Between both ends at avascular area (no blood vessels).
Hair band covered with brownish green feed. I thought it was the dog feed. Would the hair band come out from this 3-cm incision? The shorter the incision, the better in this case.
I used the scissors to cut the hair band but did not manage to cut the rubber band inside. Surprisingly, the hair band could be manipulated out of this incision.
Suturing the stomach.
1. Mucosa. Quite thick. Reddish brown. Inverting suture - one layer closing the mucosa only.
2. Muscle layer. As in a Caesarean section, I stitch 2 layers of inverting suture.
3. Abdominal muscles - simple interrupted sutures one cm apart.
4. Skin - horizontal mattress suture.
5. IV baytril given. Dextrose saline drip is continued. Electrolytes for next 2 days. No solid food to permit the stomach to heal.
Best not to go home for the next 7 days. How long should the stomach not be given solid food? How long does it take the mucosa layer to heal? The answers vary. By the 3rd day, I give A/D diet. Antibiotics are given by injections. Careful monitoring. The owners were phoned to visit the puppy as this is a high-risk case and anything can happen.
3rd year vet student from Murdoch Univ saw the surgery. His job was to take pictures. During an earlier discussion, he had thought that the hair band would be easily passed out and therefore wait and see rather than operate on a high-risk puppy. What if the puppy dies on the operating table?
After seeing the hair band was large, he agreed that the only option was surgical removal. He found the surgery interesting as he was going into the 4th year. This operation would bring veterinary surgery alive during his lecture. I asked him to write a report. No way! He had enough of writing for his examinations. The young ones are a visual breed. Writing and recording help in archiving and understanding the process. One can review the records at leisure or refer to them. Sometimes, what steps to improve for the next surgery can be forthcoming after the review.
More info at www.toapayohvets.com
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