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Blood out
of thin air - Part 1

INCREDIBLE BUT TRUE STORIES
Blood out of thin air - Part 2.
Case updated: Dec 14, 2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS

Thursday May 8, 2008
"Doc," the lady in her late forties pointed to my left hand holding a small breed for examination while my right hand held a thermometer to take the dog's rectal temperature, "You have blood on your finger!"

The lady and her husband had asked me whether this dog's skin disease would spread to their own dog if she rehomed her. She would care for this dog in the meantime prior to finding a new home for her. Her HDB (Housing & Development Board) apartment's condition of sale does not permit more than one dog to be kept and so she had no choice.     

I was surprised at her observation as I had not encountered such blood on my finger in front of clients over 2 decades of practice.

On the top side of my left index finger, at the second phalanx (to use the veterinary term), a patch of pinkish blood of around 1.2 x 1 cm painted my finger prominently. 

"Could it be the blood from the dog I had just neutered?" I thought as I had just completed the operation. 

However, I had washed my surgical set after neuter. Normally vets would leave the washing of surgical instruments to the assistant, otherwise what would they do?

I remembered distinctly that I washed the surgical instruments myself because recently I discovered that my new veterinary assistant had not removed the blood stains from the artery forceps which I wanted to sterilise in the autoclave. I had decided to wash all my surgical instruments just after surgery so as to maintain them in top condition for cutting and clamping. Left-over blood stains in surgical instruments cause them to rust. 

Therefore, this pale pink serum-like blood on my forefinger would have been washed away during my washing of the surgical instruments and subsequently rubbing my two hands to wash the hands. 

"Could the blood be from this dog?" the lady asked. I turned this female dog upside down to see whether she was on heat. No blood from her vulva or anal areas. No blood stains were present on the stainless steel examination table too. 

The presence of blood was inexplicable and mysterious to me and anybody present.  

"I had just neutered one Jack Russell," I said. "Maybe the blood is from the dog." Yet, how could it be? I had washed the surgical instruments and my hands with running tap water.

Adult male Jack Russell managed to bruise its surgical area despite e-collar. Toa Payoh VetsThis lame excuse only indicated to the couple that the vet was not clean in his practice of veterinary medicine as he did not wash his hands after surgery and before the next case. The couple did not say about me "forgetting to wash my hands" on that day but the husband did say that 2 days later when they came to collect their dog left in my surgery for 2 days.

Actually, I had just washed my hands as I saw reddish brown patch of blood of around 3 cm in diameter on the palm of my right hand.

They were a cluster of small bleeding points clotted up on the palm. So I stopped consulting and washed my hands just a minute or two ago. Then I continued to examine this dog and that was when the lady pointed to blood on my left index finger.

The dog was the pet of their daughter's classmate. Some weeks ago, the classmate's mother wanted me to euthanase this dog without her daughter's knowledge. I had advised the mother not to do it till she had spoken to the teenaged daughter as there would be grave implications for the mother-daughter relationship. Also, I could not support the mother's request to advise the daughter that the dog was suffering from cancer and therefore had to be put to sleep.  

The daughter came to the Surgery and took back the dog home. She was not happy. The mother later asked the dog to be treated. The skin disease was ventral dermatitis. The dog's lower body was black as tar due to continued scratching and scratching. Skin flakes scattered everywhere.

Skin diseases are costly to treat as they require a few veterinary visits in some cases and are incurable in some dogs. 

The cause of ventral dermatitis was not known and recurrence could result in more veterinary costs as the dog becomes obsessed with continual scratching to relieve her itchiness. Euthanasia of the dog would ease the financial problem a lot.  

Nothing was heard from the single mother and daughter until the kind couple took the dog to ask me whether this dog's skin disease would affect their healthy dog at home. The dog had been given up to the couple's daughter who was the classmate. The teenaged girl who stopped the euthanasia had asked her classmate to take over the dog and would not interfere in their decisions regarding this dog.

That was how the dog came to my surgery. During consultation, the prospective caregiver saw the blood on my finger and told me so. 

Does blood materialise from thin air and onto my hands? Is it logical in the first place? Is it possible at all? What's the significance?

The day before, I had seen blood spots appearing on my right hand and on other places, while helping a friend in her new logo design for her global business. She had phoned me to ask me to go to her office finalise the placement of wordings. It seemed that blood spots appeared on the draft paper onto the logo design when her staff tried to get the logo looking professional during the past 9 days. After some 8 hours, the logo looked good after inputs from my friend, her manager and partly due to my inputs as to font size and height, matching of fonts  and not retaining the copyright global graphics. See:
Blood out of thin air - Part 1

Back from my digression to the kind couple wondering about the blood in my finger. There were no skin wounds on my left forefinger and on my right palm when the blood was discovered, as with the previous day's incident. 

The couple did not comment when I told them of my "blood incidents" just the day before. Their logical explanation would be that I did not wash my hands after the neuter surgery if I read their mind. That was what the husband said to me 2 days later when they collected this dog from the surgery on Sunday May 11, 2008.

He asked me in a diplomatic manner: "Doc, is it possible that you had forgotten to wash your hand after the neuter?".

I related to him my experience with blood appearing out of thin air as narrated in Blood out of thin air - Part 1. I said: "I don't expect you to believe my story of blood appearing in my hand the day before we met. I don't know what you will call this phenomenon."   

Ventral dermatiis 6-year-old dog. Less itchy after treatment.Toa Payoh VetsBlood appearing from thin air is inexplicable and mysterious to the ordinary person. Seeing is believing and since they don't see its manifestation, how could I expect them to believe? My explanation was unreasonable and illogical to them. A cock and bull story from a veterinarian who did not wash his hands in between cases - probably that would be the thoughts of this couple.

Later the client whom I helped in the logo design returned my telephone call. As she spoke to me, blood appeared in her right hand and ring finger (left hand) according to her. She asserted that the presence of blood in my finger and hand had nothing to do with my neuter surgery. As to the significance, she could not tell.

 As for the dog, I noted that the tar-black skin of the lower body and vulval area had lightened considerably by 80% due to the veterinary treatment by my colleague some 4 weeks ago. The mother had used the money pre-paid for euthanasia for treatment.

I noticed that the redness of the skin was reduced by 50%. The skin flakes still snowed on my consultation table during examination on the 3rd day (see two pictures) after I asked a groomer to clip the dog bald. The groomer left some head and tail hair as many groomers
Ventral dermatiis 6-year-old dog. Less itchy after treatment.Toa Payoh Vetslove to do so. I had to ask him to come to the Surgery and do it again.

Chances are very good that this dog will recover on medication after two visits and groomed daily.

There was a common link between this couple and my friend who asked me to help design her new logo. One day, a black cross dog appeared outside her house's gate.  Her front legs were slashed and one back leg had cuts. Somebody had been cruel to this dog, she said to me although I thought it could be a car accident. The dog just came to her house. She sent it to me for surgery instead of phoning the animal shelter which would have euthanise it.

This couple received the dog from their daughter's classmate. The classmate's mother could not afford to treat her. She could not keep her dog. She would not want the dog euthanased. The couple sent it to me for treatment.

So there seemed to be a connection. A tenuous one perhaps?  The two dogs were in distress and needed veterinary treatment. The alternative was death by lethal injection or abandonment. Both dogs were saved by the kindness of strangers. Blood signifies life and is a blessing, the sister of the lady who asked me to design the logo made this comment when I visited her family on Mother's Day (Sunday, May 11, 2008).

Somehow, the presence of blood in my hand seemed to have something to do with life and living. Therefore it is a blessing. Many incidents in life such as a person with terminal cancer recovering and living to an old age are also illogical but there are such cases. I keep an open mind. I would find it very hard to believe anyone telling me the above incident. It was an inexplicable and mysterious incident and defied logical analysis. Blood appearing out of thin air? A cock and bull story from a veterinarian! 

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