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BACK TO THE BEGINNING IN JULY 2011, THE FIRST
CONSULTATION PICTURE - Stinky smelly right ear
complaint. A simple case of necrotic otitis externa? No.
Case recorded at 2
webpages:
http://www.sinpets.com/hamsters/20110808dwarf-hamster-break-a-leg-a-ear-Singapore-ToaPayohVets.htm
http://www.sinpets.com/F5/20110732hamster-otitis-externa-bone-tumourop-Singapore-ToaPayohVets.htm
2ND CONSULTATION AND SURGERY - EAR CANAL ABLATION FOLLOW
UP. RIGHT EAR WAS STILL ITCHY. IRRIGATE WOUND - MORE
YELLOW PUS AND GRANULES FLUSHED OUT
Case recorded at:
http://www.sinpets.com/F6/20110725reasonable-man-test-court-of-law-Singapore-ToaPayohVets.htm
3RD CONSULTATION AND SURGERY - BIG CYST AND TWO BIG
ABSCESSES
There appears to be another two abscesses in front of
the blue stitches. I did not continue incision to drain
it as the surgery had been over 15 minutes. Any more
anaesthesia would result in a death on the operating
table. Some days later, the area became inflamed (see
first picture).
Case recorded at:
http://www.sinpets.com/F6/20110906dwarf-hamster-cyst-abscesses-ear-canal-ablation-singapore_ToaPayohVets.htm
E-MAIL FROM
OWNER DATED SEP 4, 2011 REGARDING RED AREA IN
HAMSTER EAR ABOVE AND BEHIND THE RIGHT EYE. THREE
ANAESTHESIAS AND SURGERIES HAD BEEN PERFORMED BY
ME.
Thanks for the follow-up, Dr Sing.
E-MAIL FROM DR SING DATED SEP 5, 2011:
> Thanks for the picture (below). There may be
some growing internal abscess/cyst in the reddish
area to the upper right quadrant of the ear canal
opening. That is why the hamster is scratching it
as in the previous time.
>
> See if the medication can work.
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The hamster came in for the 4th anaesthesia and surgery.
The lady owner was very worried as the risks of dying on
the operating table increase with every anaesthesia. But
there was no choice as the hamster could not stop
rubbing her right ear (XY). The surgery is shown
below:
4TH CONSULTATION AND SURGERY - RIGHT UPPER QUADRANT
SWOLLEN WITH PUS - TRACKED DOWNWARDS TO BEHIND THE MOUTH
LATEST STATUS AS AT SEP 22, 2011
As at Sep 22,
2011, the hamster is recovering. Had passed loose
stools. Stopped the vegetables. I have advised small
amounts of mashed pelleted food and water, hand-feeding
10X/day as the hamster ate little and drank less.
Continue the melon seeds. Very nervous when the owner
handled her as well as when I did it prior to surgery.
This was to be expected as she is in pain. Surprisingly,
no major facial nerves appear to have been damaged by
the large vertical incision to flush out the yellow
purulent granules.
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E-MAIL
FROM OWNER DATED SEP 22, 2011
Thanks for checking in. XXX is active. Her wound
is dark and dry around the edges but moist in
the centre. (will try to take a photo)
Sometimes, the wound has that odour, even after
swabbing. She grooms and rubs the area quite
often.
She is being
given water from a syringe (0.05ml every 3h or
so) and seems to urinate fairly regularly. Her
stool count is still under 10/day but the
consistency of the stools appears to
have returned to normal.
She nibbled
on the mashed up food pellets once, but on
subsequent occasions, did not want any. She is
willing eat (perhaps two or three) sunflower
seeds that have been shelled for her and also
seems to like this triangular black seed (can't
identify) from the mix. Will mash up some
peanuts and see if she will eat that. Will also
try to find a proper weighing scale.
E-MAIL REPLY FROM DR SING DATED SEP 23, 2011
I did smell this rotten bad smell when I
operated recently on your dwarf hamster. It was
a faint foul smell from the wound and did not
persist. The smell is from the bacteria deep
inside the wound. It could be an anaerobic type
of bacteria.
Buy a bottle of 6% hydrogen peroxide from the
pharmacy. Put some on the cotton tip and try to
swab deep inside the wound once or twice per
day. If the smell persists, the hamster needs
the antibiotics. This will be given, if
necessary, after she has produced normal stools.
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It is a long story
of worries for the lady owner. Four short surgeries and
anaesthesias in this case provided a good clinical
outcome. What the owner wanted is a hamster alive at the
end of surgery. The hamster is family but it is a very
high risk anaesthesia doing ear canal ablation, cyst
removal and making such big incisions. Therefore the
responsibilities of the vet are much higher and worrying
when dealing with such a complex surgery. Post-op
nursing care and hand feeding are especially important
to the survival of this hamster. She has the strong will
to live. The owner must know how to prevent dehydration,
malnutrition and diarrhoea and she is doing a good job.
But that "rotten smell" comes back again.
A complete surgery in one anaesthesia would be perfect
and ideal in theory. In practice, it would be a dead
hamster on the operating table as it would be too
stressful for any dwarf hamster, especially old ones
like this case, to undergo more than 15 minutes of
surgery, unlike in a dog or person. In one dog, I
did a massive bilateral perennial repair for 2.5 hours.
There was no stopping in such surgeries as the big hole
in the backside cannot be partially repaired for the
next time. The old dog survived and it was a happy
ending for an old companion. Case at:
http://www.bekindtopets.com/animals/20100625
constipation_perineal_hernia_old_Boston_Terrier_male_singapore_ToaPayohVets.htm
This dwarf hamster has a sibling. No problem at all.
What was the cause of this necrotic otitis externa?
Definitely there was a type of bacteria producing bad
smells (as in rotten teeth in a bad dog's breath). Where
did it come from originally? From the cheek pouch
perforation? From the ear canal? From the rotten tooth
root? It is not possible to say as the hamster is so
small that it is not practical to X-ray to help
determine the cause.
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TOA
PAYOH VETS
