Today, Sep 23, 2011,
I was reviewing some medical records today as part of my
performance assessment of myself and my associates. What
went wrong and what could be improved?
Reviews improve operational efficiency and productivity
as much can be learnt from the past case experiences.
Such reviews add up, providing real life experiences as
the vet ages.
In a histopathology report dated May 12, 2011, the age
of a Jack Russell's nodule at the dorsal vulval lips was
stated to be 5 years old. It had a leiomyoma, 2x1.3x1.2
cm.
The histopathology report:
Dermal circumscribed nodule. Whorled fascicles of bland
smooth muscle cells. No necrosis, cytological atypia or
increased mitotic activity. No evidence of malignancy.
Why did the lab report state the dog as 5 years old? I
checked my records. In 2006, 3 Jack Russell pups came in
for tail docking. The dam did not come till 2009 when I
excised 3 breast tumours. She was said to be 14 years
old then. The owner did not want to spay the dog in her
younger days as he believed that she would become fat
when spayed.
With this big
growing vulval tumour, he agreed to the dog being
operated to excise the tumour and spayed in May 2011.
This was done by my associate vet. The vulval tumour was
sent to the laboratory for histopathology by my
assistant who wrote 5 years as the age.
So, I phoned the gentleman who is in his mid 60s today.
He said the dog would be more than 14 years old.
Definitely not 5 years old. This dog could not be 5
years old and I informed my assistant and the vet to
check with the owner every time. In the Singapore
General Hospital, the nurse will ask the patient going
for surgery, several times his name and what operation
he or she would be going for on the way to the operating
room. I know this because I went for an operation.
Sometimes, they even took a picture of the area to be
operated.
"Is she OK after
the surgery (to spay and remove leiomyoma)?" I asked.
"Yes," he said. If the dog is more than 14 years old, it
still had false pregnancy before the spay. How old
should a female dog be before they go into "menopause"?
Do dogs go into menopause?
Sometimes clients cannot remember the exact age of their
dogs or they may have more than one of the same breed.
It is best practice for the vet to ask the client at
EVERY consultation what is the age of the dog patient.
Some practices take one facial image of the dog patient.
In my opinion, there needs to be front and two side
views in order to identify the dog. If there are
markings and the dog is of one colour, it will be wise
to ask the owner to identify the dog.
TOA
PAYOH VETS
