TOA
PAYOH VETS
toapayohvets.com
Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074 Tel: 6254-3326, 9668-6469, 9668-6468.
judy@toapayohvets.com
19 August, 2015
Focus: Small animals - dogs, cats, guinea pigs, hamsters, turtles &
rabbits
Unacceptable Veterinary Advices
Dr Sing
Kong Yuen, BVMS (Glasgow), MRCVS
First written: 15October,
2011 Update:
19 August, 2015
2011 Case
"When the hamster's tumour
starts to bleed, bring her
to me and I will put her to
sleep, Vet 1 advised us,"
the mother brought her
teenaged daughter and her
hamster to me today 11.30
am, Friday Oct 7, 2011. "I
consulted Vet 1 three days
ago and my daughter has been
crying since."
Vet 1 had said that the
dwarf hamster, being 2 years
old, would die under
anaesthesia and surgery.
Therefore, wait till her
abdominal tumour bleeds, to
bring the hamster in to be
euthanased. The mother could
have surfed the internet and
phoned me.
"It
is not a guarantee that all
dwarf hamsters with tumours
will die under general
anaesthesia," I don't
understand why Vet 1 would
not have asked the owner to
see other vets if Vet 1
would not perform surgery. I
just rejected a koi owner
who phoned up to ask if I
treat kois. It is the right
thing to do and is in the
interest of the animal. Not
to advise waiting till the
tumour bleeds and bring the
hamster down for euthanasia.
"Much depends on the health
of the hamster, the size of
the tumour and the duration
of anaesthesia," I happened
to pick up the phone today
as I was in the Surgery to
interview a job applicant
who wanted to work with
animals and teach 3 Temasek
Polytechnic volunteers on
cases involving an old
Maltese with cystitis, a
stray cat with FIV and a
puppy on an IV drip, amongst
other pets.
"How big is the tumour and
is it a breast tumour?" I
asked. The mum did not know
and spoke to the daughter.
"It is best I examine the
hamster."
"How much is the
consultation fee?"
"$30.00," I said. "But you
already had consulted Vet 1.
The decision should be
whether you would want to
take the risk of this old
hamster being operated and
pay the operation and
anaesthetic fee.
"If the hamster survives the
operation, she lives another
6 months as dwarf hamsters
live up to 2.5 years of age.
If she is not operated, the
tumour gets infected and
bleeds as the hamster keeps
nibbling it. Lots of blood
stains and great distress
for your daughter in the
next few days, leading
ultimately to death by
lethal injection. In such
cases, your daughter would
be much traumatised after
seeing the hamster suffer
from bleeding all day long!"
It is extremely difficult to
be a mother of young
teenagers nowadays. I could
see that the slim fair
14-year-old was from an
elite school. The cream of
the crop, now much
distracted by her hamster's
poor health. She did not
know when the tumour
developed and so whether it
was fast-growing or not, it
was difficult to say .
"My daughter has her
examinations till Monday,"
the mother said. I could
sympathise with her as she
wanted her daughter to excel
in the highly competitive
academic environment. How
could she revise her lessons
when she cried daily as her
beloved hamster had no hope
of survival?
As a veterinarian, the best
interest of the pet must be
priority. If the vet cannot
handle a case, refer to
other vets or ask the owner
to find another vet.
I don't treat birds and
fishes and I don't accept
such pets in the first
place.
The dwarf hamster is old at
2 years of age, but she is
full of energy. Weighed 36
gram and has an excellent
appetite. Trying to escape
when the cage door is lifted
up. Big black eyes. Well
endowed.
"The chances of surviving
anaesthesia are 70%," I said
to the mother who had asked
if I provided services to
euthanase the hamster to
prevent pain and suffering.
"Did you hear that?" the mum
asked the quiet girl.
"Quite a good chance of
survival," I said.
"You had operated on hamster
tumours?" she asked.
"Yes," I said.
The
3 Temasek Poly students, Dr
Vanessa, Mr Min and I
attended to the dwarf
hamster. "This is a case
where Zoletil sedation is
needed as isoflurane +
oxygen gas will not give you
sufficient time to excise
and stitch up in less than 5
minutes."
I said to Dr Vanessa, "With
Zoletil sedation, you have
around 5 minutes of surgical
anaesthesia to complete the
surgery. But you can top up
with isoflurane gas." I told
Mr Min to switch on the gas,
just in case.
"All the theories of dosage
per kg in vet books are not
applicable usually in the
real practice," I said to
the 3 students - a young man
and two young ladies. "This
dwarf hamster weighs 36 g.
How many ml of Zoletil to
give without killing her?
This is why many vets all
over the world do not like
to anaesthesize hamsters.
The safety range is very
narrow."
I got the Zoletil
50 ready. Two one-ml
syringes were placed on the
table. Mr Min got me a 25G
needle which I told him was
inappropriate.
I got 2
drops of
Zoletil from a syringe.
"These would not even
fill up 0.01 ml of the
syringe," I
said. "I
will add normal saline
0.05 ml," I said. "Just a
little bit
to top up to 0.05ml."
This dwarf
hamster has no bulky
backside muscles like the
dog or cat or even a rabbit.
So, intramuscular injection
(IM) of the Zoletil was
deemed not possible.
I stretched out the
hamster's left hind leg
while my
assistant Min held
the front body. I pointed
the 25G needle at the
appropriate backside and
injected.
"If the hamster does not go
groggy within 1 minute of
injection," I said to the
students. "It means the
dosage was insufficient or
that I had not injected
directly into the muscle."
The students were very
silent. Within 60 seconds,
the dwarf hamster went down
on her side. "I
have less
than 5 minutes to complete
the excision of the tumour
without isoflurane gas," I
said. Everything has been prepared
for surgery.
I use a
scalpel,
nicked the tumour for
0.8 mm long, undermined
the tissues,
clamped the
lower stalk. Then I used the scalpel
to excise off the lump. The
hamster moved a bit as the
anaesthesia was lighter.
It is extremely difficult to
get the ideal dosage without
causing death as the hamster
is so small," I said to one
student who later commented
that the hamster had moved
during the stitching up.
"This high anaesthetic risk
is the reason why many vets
do not want to do surgery to
remove big tumours."
The 3 students had a rare
opportunity to see the whole
process from pre-op to
post-op.
TIPS FOR VETS
Sometimes it may be wise to
pass up a case rather than
to offer unacceptable
veterinary advices as they
do stress out the hamster
owner and force her family
members or mother to seek
another opinion.
If you add value to the
hamster owner by offering
alternative advices other
than unacceptable advices,
you may retain the goodwill.
However, some of the younger
generation just surf the web
to look for "hamster vets"
when the tumours get larger
as in the 2015 case written
below.
Two brothers in their 20s, brought in a hardy
hamster on this May 1, 2015, Labour Day.
The hamster was thin and weighed
33 g instead of the average 45 g. He has two
black ulcerated tumours. One below the chest at 2 cm x 2 cm and the
other below the left armpit at 8 mm x 6 mm.
"Why didn't you get the tumour removed when it is small?" I asked.
"We asked a vet and he said to leave it alone," the elder brother
said that the tumours were present for around 2 months and could be
cancerous. As the hamster exercised, the lower part of the tumour
got worn out and became infected and now blackened.
I checked the thin hamster's teeth. He had short teeth indicating
that he was still eating to survive.
"He had lost a lot of weight," I said. "He does eat judging by his
short front teeth being worn out, but he lost weight due to the
stress and the tumours sucking up the nutrients."
TOA
PAYOH VETS
