August 8,2010
Sunday, August 8, 2010
Consultation at Vet 1.
The 9-year-old, 5-kg Jack Russell passed out some sticky vaginal discharge and also blood in the stools on Saturday. The young lady and her brother googled "pet clinic" and went to North-east Singapore.
Vet 1 shaved bald the dog's ventral area for an abdominal ultrasound scan. "Lumps of around 3 cm in diameter can be seen", he told the owner. Vet 1 diagnosed pyometra based on vaginal discharge, fever, abdominal palpation and scan. Surgery and anaesthesia quoted was $1,000.
The kind vet advised surgery as soon as possible and presented the young lady a list of vet practices in Singapore. She was living in Toa Payoh and phoned me for a quotation. I was surprised when she told me that she did not know of Toa Payoh Vets existed (since 1982) although she is a Toa Payoh resident.
CHANCES OF SURVIVAL
It is difficult to guarantee 100% survival. The dog had actually been vomiting occasionally in the past 3 months, not just last week.
Vet 1 gave a Rimadyl 0.5 ml (50mg/ml) injection 2 hours ago. The temperature before Rimadyl injection was 39.7 deg C (fever). When I checked the dog 2 hours later, it was 38.5 deg C (normal). So I had to decide to operated soon as the fever would return when the drug effect went off.
I gave an antibiotic (Baytril) 0.6 ml SC 1 hour before surgery. The dog was operated and recovered well.
She was still drowsy when the young lady and her brother visited her 2 hours after surgery but could recognise them.
I showed the pyometra to the young lady and her brother. "Vet 1 said it was 3-cm lumps," she said. "The ultra-sound cannot measure all lumps accurately," I said. "Some of the lumps in this uterine body are 3 cm in diameter and some are more or less." I told her. She was very relieved that her dog was alive and that was what counted.
RIMADYL (a class of pain-killer called NSAID).
1. I have never used Rimadyl before surgery although the manufacturer (Pfizer's website) does recommend it, at 2 hours before surgery so that the dog will not feel any pain after surgery.
2. The manufacturer advised the use of parenteral fluids during surgery to reduce the potential risk of renal complications when NSAID is use perioperatively.
3. In this case, the first vet had given 0.5 ml Rimadyl (50 mg/ml) SC 2 hours ago and no antibiotics. The dog had a fever of 39.7C. When I was consulted 2 hours later, I checked the temperature. It was 38.5C. The owner commented that the dog looked better. Rimadyl had reduced the pain. It also appeared to be anti-fever too.
Calculation of dosage in this case.
Jack Russell, Female, 9 years old, 5 kg.
Manufacturer advised: 4.4mg/kg for 24 hours or 2.2mg/kg two times a day by injection. Same dosage for oral administration.
Therefore, the first vet gave 25 mg SC or 5 mg/kg.
I decided to operate on the dog 2 hours after consultation as the fever had subsided and might return if there was a delay. The dog growled after some time when I checked her gums which were pink but dry-looking. I could feel a large swelling in her lower 1/3 of the abdomen but not the lobes felt by the first vet. She looked "pregnant". Rimadyl might have made abdominal palpation difficult. There was no pain reaction from this Jack Russell.
Rimadyl provides pain relief and was already given by the first vet during consultation. I did not give anymore for the next 24 hours.
SEVERE DRUG REACTIONS ASSOCIATED WITH NSAIDs
include gastrointestinal, renal and hepatic signs and in rare situations, death.
Therefore, in pyometra post-surgery, I don't give NSAID before or after surgery as I don't know how badly damaged the dog's kidneys are. This dog had been vomiting for the last 3 months and would not be considered healthy.
It is safer as the owner wants a dog alive at the end of the surgery.
photos and updates are at www.toapayohvets.com
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