34. Infected facial tumour. Dwarf Hamster

HAMSTER SURGERY
Dwarf Hamster, 1 year. Young lady
Dehydrated, Not eating
Facial swelling 2-3 weeks growing fast. Rounded, 1cm X 0.8 cm.
Abscess?

Zoletil 50 IM. Duration 5 minutes. Need to be prompt in surgery. But large tumour is not easy to remove in <60 seconds. Therefore I needed to use isoflurane gas to maintain the anaesthesia.

Tip:
Give isoflurane gas when it moves. If you continue without anaesthesia, the hamster will struggle and die of fright and pain.



1 cm incision. Watery pus drained. Multiple rounded fat-like cells of 1 mm globules widespread. Can't remove all without affecting nerves. Owner informed.
Hamster OK. Picture.
Advice: Removal will have been easy and effective when it is around 2-4 mm in diameter some 2 months ago.

Goes home on Day 3. It is likely that the tumour will recur as it is widespread inside the cheek.

33. Large infected skin tumour in an old dwarf hamster

In the dog or cat, this would be an easy surgery as general anaesthesia using isoflurane gas is very safe and predictable in these two species.

In a 2-year-old dwarf hamster, the successful outcome depends greatly on the anaesthesia. Insufficient anaesthesia may kill the hamster due to great pain and fright from surgery. Lots of movement hampered surgery. Death could be due to fright during restraint and not due to anaesthesia.

Pre-operation
In the dog and cat, pre-operation examination and blood tests are helpful. In the dwarf hamster, ask the owner about the amount of stools passed and water drank. In this case, the lady owner was very observant. The hamster was eating as faecal pellets could be seen. She noted that the hamster recently drank at least 3x more water than normal in a week by judging the amount of water in the water bottle drank per week. Based on her observation, the hamster was drinking 18 ml/day compared to the normal 5 ml/day. This polydispsia is abnormal.

Warded for 2 days
Oral Baytril antibiotic was given on Day 1 and 2. Surgery started on Day 3 as the hamster was suffering from a red itchy infected skin tumour.

Anaesthesia and Surgery
It is extremely difficult to see the signs of surgical anaesthesia in the hamster under isoflurane gas (gas into a plastic container with the hamster inside) and Zoletil sedation. A bit more will mean death. So, it is a matter of observation of anaesthesia to effect. What does that mean when the vet can't check the pedal and eyelid and other reflexes as in the dog? It is just not possible. "Count to 10" I advised my assistant when the hamster has been placed in the container. This is not scientific. We took the hamster out for surgery. When it moves, we put it in again. This happened 3 times. By the 3rd time, the hamster looked "dead".

"The hamster has died," I tried to revive it by rubbing the skin of its neck above the shoulder area. "Can give Biolapis," my assistant proposed. I was busy trying to revive this hamster. Blow air via a 3-ml syringe into its nose area may be useful.
Cardiac massage?



In this case, my assistant put a drop of Biolapis which is an oral electrolyte for small animals like rabbits and hamster. An oral respiratory stimulant and oxygen would be useful.

The hamster was still breathing as I could see its chest movements. I left it alone, under the warmth of light.

In around 30 minutes, it was up and alert. As if it had a good lunch-time nap. The Caucasian school teacher was very happy as she was prepared for the worst. Always examine your older hamster daily for small tumours. Small tumours less than 3 mm in diameter take less than 1 minute to remove and the chances of survival are very high.

Not all stories have happy endings as vets are not Gods.

P.S.
More pictures and update at www.toapayohvets.com, goto "Hamsters"

32. Retained puppy teeth in a Yorkshire Terrier

Yorkshire Terrier, Male, 8 months.

Most dogs have no more deciduous (temporary, puppy) teeth by 8 months of age. Yet in this rare case, this tea-cup Yorkshire Terrier had 14 puppy teeth that should have dropped off.

The permanent teeth erupts in an abnormal position as their place is occupied by the puppy teeth. He resisted strongly when I tried to open his mouth as he had a very painful mouth. If only he could talk. Tartar had formed in the retained canine teeth and soon, there will be tooth decay.

Many Singapore owners don't bother with such dental problems due to economic and anaesthetic risk reasons. What if the puppy dies under general anaesthesia?

This mindset is unfortunate for the puppy. General anaesthesia is safe in puppies over 3 months old. Much depends on the selection and experience of the veterinarian. Worried owners have to look for more experienced vets if they are worried about anaesthetic risks.



Timely removal of the retained deciduous teeth enable the permanent teeth to erupt in normal position and angle. In older dogs, food and dog hair get trapped between the permanent and retained teeth, leading to tartar formation. Bad breath. Painful mouth. But the uneducated owner just ignore such dental problems. Teeth start dropping off. So what? The dog gets his food and water. What more can a dog want?

The introduction of the internet has benefitted many puppies through education of the newer and younger owners. Compared to 10 years ago, more lady owners and young couples are aware of the future dental problems in retained puppy teeth and have got them extracted.

After checking that his heart is OK, I used general anaesthesia isoflurane gas prior to extraction of the puppy teeth. Intubation was done. Still it took >30 minutes to extract 14 teeth. After extraction, I note that it was not such a difficult struggle to open this Yorkshire's mouth for photography.





I am happy for this Yorkshire Terrier as he will be able to chew and bite without oral pain anymore. Tooth brushing ought to be done and should be easier nowadays.

His market value is S$2,500 as Yorkshires are very rare in Singapore. It sure was an expensive present given to this young lady owner.

TO REDUCE ANAESTHETIC RISKS
1. I don't use tranquilisers. Just isoflurane gas mask to induce.
2. Intubate
3. An assistant who just monitor anaesthesia and nothing else.
4. Minimal gas at 1% to effect.
5. Extraction of teeth as fast as possible.

A pre-anaesthetic blood test will be good but most owners are interested in least cost. Checking of overall health and heart will be the cheaper alternative but it is not ideal.

31. Electro-surgery in 3-day-old pups

The home-alone first-time-mother Shih Tzu bit off the ear lobes of her 3-day-old pups. "She must have scratched off the ears," the male owner would not believe that mothers would bite progeny. "The male dog may be responsible." The pups had full rounded abdomen showing that they had suckled well.

I showed him one puncture wound of 3 mm above the ear of one pup and one wound on the chin of the second pup. These wounds would heal.


Surgery: Stitching.
Four tattered ears in 2 pups. What should the vet do? The first thought would be to suture the skin and cover the ear cartilage. However the bite wounds were irregular in shape with more skin torn off in some parts of the ears and there would be insufficient skin to stitch up.

Cosmetic Surgery:
This was my first time in over 3 decades of practice to encounter two 3-day-old pups being presented with bitten ears and were still alive. In most cases, the dam just killed the pups by biting their skulls, neck and abdomen.

Lacerated ear wounds are usually treated by stitching. So, my assistant took out a rabbit anaesthestic mask to give isoflurane gas anaesthesia to the puppy after washing the ear area for surgery. He got out a small hair clipper which we use to clip the coat of hamsters.

"Puppy anaesthesia is high risk," I said. "The rabbit mask is not suitable for flat-nosed 3-day-old puppy. Use the plastic container. Some vets use plastic bags to contain the gas.

Electro-surgery
Stitching the torn ears would not present a good appearance for these Shih Tzus when they grow older. Buyers will notice that two ears of the pups are not symmetrical in shape and size. Therefore I decided on the use of electro-surgery. But can electro-surgery be performed in such a young pups? Would they die of heart failure due to the passage of electricity into their bodies? If you know the theory of electro-surgery, this does not happen as the electricity passes through the surgical area and incise and coagulate. But theory may not translate into practice. I could just incise the ears using scalpel. But the results would not be so good. Therefore I commenced electro-surgery.

Electro-surgery in 3-day-old Shih Tzus.
After cleaning the ears and after light gas anaesthesia, I placed the puppy's belly onto the saline-damped gauze which was placed on the indifferent electrode. This electrode was placed onto of a plastic tray which was then placed on the stainless steel operating table. Stainless steel does conduct electricity*

I used the artery forceps to clamp the remaining part of the ear, exposing the jagged ends. Electro-incision electrode cut off the tattered ends. Then electro-coagulation electrode sealed all bleeding. The results were 2 "ear-less" pups. When they grow up, their lack of ear pinnae is obvious but will not be distracting as one ear bigger and more irregular than another.







The dam was isolated. She was watched while she suckled her pups after 24 hours of my assistant hand-feeding the pups. The pups are then removed from her. Today is Day 5. The pups are OK and have had reduced their earlier puppy fat.

Conclusion

*Stainless steel operating table conducted electricity. Therefore do not place your elbows onto the table. At one stage, I had an electric shock during electro-surgery as my elbow touched the operating table.

Electro-surgery is safe in 3-day-old Shih Tzu pups. The use of saline-moist gauze on top of the indifferent electrode helps to conduct electricity better.

More pictures and final report will be at www.toapayohvets.com