The Jack Russell needed to be unconscious so that the gigantic mouth tumour could be excised using electricity. Yet he had a weak heart. Anytime his heart could fail and he would be gone from this world. Therefore, general anaesthesia using isoflurane gas was kept to the minimum.
The gas was like the force shield in Star Trek's Enterprise, protecting the starship from powerful killing forces.
As the electricity shot through the electro-cutting bladder to slice off the tumour at the edges of the gum, the dog started to jerk. The protective force shield was insufficient to protect the dog's systems.
His tongue moved and he opened his mouth. His heart stopped pumping blood. I could see that his tongue changed from pink to purplish in colour.
"Increase the dose to 5%," I stopped the electro-surgery. The dog was feeling the pain. The force shield needed to be at its maximum. However, it could overload the dog's heart and kill him. There was a need to know how long the 5% had to be given. One minute or more? There was no formula. The longer, the higher the risk of death on the operating table.
The dog started to slip into unconsciousness. The electro-cutting blade transferred electric current into the tumour. Zap, zap, zap... the electric sparks flew.
"Smells like burnt meat," Intern 1 who had never seen electro-surgery probably thought of her barbecue parties. The 9-sq m operating room with 2 interns, 2 assistants and myself was packed.
The faster the operation was done, the better chances of survival it was for this old dog. 15 minutes had passed. Now the dog was unconscious at 1% gas anaesthesia. The 2nd tumour in the hard palate was zapped and removed. Now, the electro-cautery electrode was used. The blood flew profusely from the gum after the tumour had been cutting. The red light at the end of the electrode blinked indicating that electricity was coursing through. However, the bleeding continued.
"Turn the dial to higher intensity," I said. The assistant turned the knob to No. 3. I put the electrode onto the bleeding point. The steam rose as the electricity burned the blood vessel as I stepped onto the foot-switch. The surgical area was now dried. No more bleeding.
The dog moved suddenly and darted his tongue in and out of his mouth. His tongue changed to a deep purple.
I looked at Intern 2. "Is the indifferent plate still in contact with the dog?" She was to ensure that the dog's abdomen was in contact with the "indifferent plate" which had been moistened with a wet gauze swab in normal saline. This plate conducted the electricity away from the dog to the machine. A complete circuit.
"Yes," Intern 2 said. I checked. The interns were inexperienced students from the Junior College waiting to study veterinary medicine. They had never seen electro-surgery in their 18 years of living. Neither did the two Myanmar assistants. Electro-surgery is seldom performed as there are not many indications requiring this machine.
Therefore, I had to be extra vigilant and yet needed to educate the younger ones on the application of electro-surgery. Seeing is believing for them.
"OK," I said to my assistant. "Take out the endo-tracheal tube now. The operation is completed." There was not a single drop of bleeding from the gum. The dog got up as if he had a short nap. It took team-work to complete the surgery in 18 minutes.
The Jack Russell wagged her tail. She was a most friendly dog and would never threaten people unlike some crazy Jack Russells I had encountered. She was not able to communicate as a human being. But she appeared quite happy as the she could now close her right upper lip normally.
NOTE: Oral tumours form when there is poor dental hygiene in dogs. In old dogs, it would be best not to attempt surgical removal of the oral tumour and dental scaling and extraction at the same time. This increased anaesthetic time considerably and the risk of anaesthetic death. Therefore, do the surgery and forget about the dental for the time being if you want a positive and happy outcome.
