Yesterday Monday,
Jun 17, 2013, I was
on evening duty
after having time
off to watch "The
Man of Steel" at Ang
Mo Kio Hub at
3.30pm. A male gold
and white Shih Tzu
with very thick coat
that had bladder
surgery by Vet 1 had
come in for
re-stitching. It
seemed there was
stitch breakdown and
the owner claimed
that all the time
the Shih Tzu had
been wearing the
e-collar. By
inference there
would be no way that
the Shih Tzu could
lick the incision
wound beside the
penile length.
The wife who came to
collect this Shih
Tzu said: "My dog
had hair inside the
stitches when he
went back. There
should not be hairs
inside the
stitches!" I
reviewed the case
record. The Shih Tzu
had been warded for
4 days and then sent
home. Many owners
are unhappy when
their dogs return
for wound breakdown
and would blame the
vet.
I examined the dog's
lower body and
showed it to the
owner. The whole of
the lower body was
clipped bald from
the neck to the
scrotum by Vet 1
before surgery. So
there was no
possibility of hairs
being "stuck" inside
the stitches. The
owner had not
cleaned up the
stitched area.
"If I was operating,
I would have the
whole dog clipped
bald," I said to the
owner. "Your dog has
many turfs of matted
hair in the hind
legs and the whole
body. In such cases,
the vet should
insist on the dog
getting clipped bald
as loose hairs from
the matts could
stick onto the
wound. If the owner
did not want to do
it, then don't
operate on the dog
to prevent such
complaints.
"I have just
operated on a
bladder stone poodle
with similar matted
hair in her body and
back and I got it
clipped bald. There
is no complaint
about hairs stuck
inside her stitches
as she had no hair."
The vast majority of
dogs coming in for
bladder stone
surgery don't have
matted hairs and so
Vet 1 would not have
thought of getting
this one clipped
bald unlike me.
I phoned Vet 1 and
let her talk to him.
But she did not
mention about the
"hairs being in the
stitches" on handing
over by him. She
just asked about the
medicine.
A senior citizen was
present in the
waiting room and he
overheard the
complaint. As the
dog was being
discharged, the
whole conversation
demonstration were
in the waiting room.
He had come in to
buy a special diet
for his Golden
Retriever who had
put on lots of
weight. This R/D
diet gave
instructions on how
much to feed to
target the ideal
weight. The bag
mentioned how many
"cups" to feed or
how many grams of
the kibble to feed
to attain the
targetted weight.
"Use grams as the
American
manufacturer's cup
is not the same as
the Singapore's cup.
Usually I don't
stock R/D bags as
Singaporeans in
general don't buy
them although they
are effective. But
there is a bag I
reserved for a lady
who buys regularly
and her Golden
Retriever now is
quite slim."
This gentleman is
one of those rare
kind men as he
spends his money to
bring the stray cats
in his neighbourhood
to be sterilised at
normal rates,
without quibbling
with the vet to
reduce fees to the
bare minimum.
Most stray cat
carers in Singapore
are women and men
are rarely seen.
"If a large
operating skin area
is clipped, there is
usually no complaint
about wound or
stitch breakdown," I
said. "This Shih Tzu
is badly matted but
Vet 1 did not think
of getting the whole
body clipped clean
before surgery. So
loose hairs get
"stuck" onto the
stitches causing
infection and
irritation and
stitch breakdown."
"You are an old
vet," the gentleman
implied that
experience counted.
"I had a Husky and
the Golden Retriever
sterilised by you
and I had no problem
(of stitch or wound
breakdown)." Frankly
I cannot remember
neutering his two
big dogs but owners
don't forget the
operating vet who is
responsible. For
better or for
worse.
"Sometimes, it is
common sense," I
said. "A badly
matted dog must be
clipped bald when
there is major
surgery." In this
case, the dog had
been clipped bald
from the neck to the
scrotal area by Vet
1. This was a large
area as normally
vets would shave
only the lower half
of the body for
bladder stone
surgery.
Feedback from the
owners is excellent
if not viewed
negatively. From now
onwards, I
instructed my
assistant that all
badly matted dogs
must be clipped
totally bald before
bladder stone
surgery as he had
seen me doing for
the poodle. There
should be a proper
handing over, with
digital images taken
during handing over
and signature of the
vet on the state of
the sutures and
wound on handing
over.
This is ideal but
not done usually,
even by me. A
systematic process
of handing over is
best for all parties
concerned and I
shall implement it
from today. Negative
feedback is very
useful as it helps
to improve the
service standard.