"Since the dog may die on the operating table, put the dog to
sleep," the dog owner wiped tears from his face. Men
usually don't cry at the veterinary surgery. I had told
him that the dog had less than 50% of surviving the
anaesthesia and he felt it was better put to sleep with lethal
injection rather than being operated on the table.
The dog had not been eating for the past few days after the
first consultation. The dog had been given antibiotics and the
owner had not phoned me to schedule the surgery some 10 days
later. The surgery and transportation of the dog would be paid
by the Tzu Chi Foundation. No financial burden for the family
if the dog got her gigantic breast tumour removed by the vet.
Yet there was just absolute silence
from the family.
The Singapore Tzu Chi Foundation Medical Secretary, Ms Ng had
e-mailed to ask whether I had followed up on the case after
the first consultation. She was the one who contacted me
initially about this dog too.
I told Ms Ng that the family had to decide themselves. I could
not solicit the family. In the interest of the dog, I ought
to.
So, no response from the owner since I did not sell myself, I
mean my services. Not a good businessman.
Ms Ng and her volunteers numbering more than 10 had helped to
bring the dog to the surgery during the first consultation.
She and her volunteers contacted the owner. The dog came in
for surgery in a worse condition than during the first visit.
|
Tzu Chi volunteers send the dog
to Toa Payoh Vets for surgery |
The dog could barely stand up.
"Are you sure that your over 70-year-old mother had agreed to
euthanasia?" I asked the representative. This dog was close to his mum and there
was no way I could verify that all family members consented
since the mum was not present at the Surgery.
|
On arrival, the dog was barely able
to stand outside the Toa Payoh Vets |
"I represent the wishes of my family," the man in his fifties
was decisive but his body was trembling. He wiped tears
streaming down his face.
The Tzu Chi Foundation
volunteers were shocked at his decision. Though there was a
high anaesthetic risk of dying on the operating table, there
was a probability that the dog might survive.
By electing for euthanasia by lethal injection straight away, this dog had
zero chance of
survival. As to why the decision to elect for death by lethal
injection was made, I cannot understand to this day. Maybe it
was economics.
One Tzu Chi volunteer, Ms Seow, a lady in her late thirties
and working for an advertising agency sat beside the dog owner
in the consultation room. She talked to him quietly for some time.
She convinced me to go ahead to operate. The
representative signed the surgery consent form. This form informed
the owner that he knew of the anaesthetic risks. This was a
standard surgery form used in all hospitals to confirm in
writing that the person had been aware of the risks.
The
clinical outcome of this case would be so poor that I would
rather not risk my professional reputation to operate on this
dog. But the Tzu Chi volunteers were now waiting.
A death of a dog spreads like wildfire to all family
members and friends and all Tzu Chi Foundation members. Why
take risk of ruining my hard-earned reputation over the years?
There was no turning back. To operate or not?
I gave the 500 ml of 9% dog dextrose saline and amino acid drip overnight.
It was so difficult for the volunteers to get the dog for
surgery. So, no delay is best for the dog.
I operated the next day. I dissected the skin carefully. Don't
just snip off the tumour at the stalk as this will be the
normal approach in a case of a very small skin tumour.
There
was a monstrous blood vessel bringing in nutrients to grow the
tumour and this was ligated twice. The operating field was
bloodless as if all blood vessels had been commandeered by the
tumour warlord to nourish him only. Not a drip of bleeding in
the big cut of the skin. Incredible. Usually there is lots of
bleeding from the subcutaneous blood vessels.
The dog survived the anaesthesia which was just gas. No
tranquiliser. Just straight gas.
|
A
monstrous artery and vein in a sheath of over 3 cm in
diameter is present at the stalk of the tumour at (X).
They supply nutrients to the breast tumour,
enabling it to grow to such a large size. Be careful.
Dissect the skin, undermine the skin with scissors.
Identify, isolate and ligate the big blood vessel. Then
cut off the tumour. No bleeding in this approach.
|
|
Not one drop of blood oozes in such a big skin wound
during and after removal of the tumour. As if the tumour
has had requisitioned 99% of the blood supply from the
surrounding tissues. Or was it the power of the
collective prayers of the Tzu Chi volunteers to ensure a
safe surgery? |
"Our volunteers prayed hard last night that the dog would live." Ms Seow
told me later. Do prayers work? Do you believe in
miracles?
Killing a life is
never an option with the Buddhist volunteers. If there is a
chance of survival, take the chance.
Some 20 volunteers came
to the Surgery to transport the dog back and forth and to see
him. These volunteers were not paid by the Foundation. Their
intervention save a dog from death by lethal injection or a
horrible painful death from the infected breast tumour.
Some 6 weeks passed. Did the dog survive after the surgery? I
had not phone the owner. What if the dog had died after the
surgery?
If the dog survived, she could live for a few more years
keeping the aged grandmother company every day.
Ms Ng reminded me that I had not billed the Foundation for the
services. This Foundation is good at accounting and pays for
services rendered promptly even to the extent of reminding the
tardy veterinarian to send the invoice.
Did the dog survive? Is she fatter? I asked Ms Ng in the
reminder e-mail.
Ms Ng wrote:
Jan 26, 2008
Hi Dr. Sing,
I heard from those who paid visit to see the dog and the
owner. The dog looks good and better now. Thanks for your
concern.
黄燕芯
慈济新加坡分会
电话:65829958 分机:204
|
This incredible story is
hard to believe. No bleeding during surgery. No death. The old
dog just woke up after surgery and was able to walk normally.
Freed at last from a 2.2 kg encumbrance. She wagged her tail
and looked much younger when I put her on the table to take a
picture. This was the first time she had wagged her tail. As
if she was so glad to be free of a heavy burden. Was it her destiny to survive?
When the vet thinks the
dog that is emaciated, weak and has been sick for a long time has little chance of survival
on the operating table, the dog proves the vet wrong. When the vet
thinks the dog has no problem under anaesthesia and surgery is
a piece of cake, the dog dies on the operating table.
If one believes in fate and prayers, this dog was destined to
live. However, without the care and follow-ups of the numerous
Tzu Chi Foundation volunteers, this dog had little chance of
survival. Bacterial infection and sepsis would have killed her
in the next 1-2 years as the ulcerated tumour starts rotting
spreading toxins into her liver and kidneys.