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 bare minimum.
This anaesthetic gas was like the force shield in Star Trek's
Enterprise, protecting the starship from powerful electrical-like
blasts from the enemies during space fights.
As the electricity shot through the electro-cutting blade sliced
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 as the anaesthesia was at the lowest level at 1%.
Her tongue moved. Her 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 raised to its
maximum level at 5%. However, it could overload the dog's heart
and kill her. 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 as the anaesthesia
shielded her against pain of electro-surgery. 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 2% gas anaesthesia. The 2nd tumour in the hard
palate was zapped and removed.
Next, I took out the electro-cutting wire and replaced it with an
electro-cautery electrode. The blood flew profusely from the gum
after the tumour had been cut. The red light at the end of the
electrode blinked indicating that electricity was coursing
through. However, the bleeding continued.
"Turn the dial to the higher intensity," I said. The assistant
turned the knob to No. 6. I
put
the electrode onto the bleeding gum as I stepped onto the foot
switch. The vaporising steam rose as the electricity burned the
blood vessel. The electrode started to coagulate all the bleeders.
The dog moved suddenly and darted his tongue in and out of his
mouth. His tongue changed to a deep purple again. Anytime he would
die of heart failure.
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 allowed the electro-surgery to be performed.
"Yes, yes" Intern 2 said. I checked myself. 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 expensive 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.
NOTES:
Oral tumours form when there is poor dental hygiene in dogs.
Regular dental check up every year will prevent the formation of
such gigantic oral tumours.
In old dogs, it is best not to attempt surgical removal of the
oral tumour and dental scaling and extraction at the same time.
This increases 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.