"When the hamster's tumour starts to bleed, bring her to
me and I will put her to sleep, Vet 1 advised us," the
mother brought her teenaged daughter and her hamster to
me today 11.30 am, Friday Oct 7, 2011. "I consulted Vet
1 three days ago and my daughter has been crying since."
Vet 1 had said that the dwarf hamster, being 2 years
old, would die under anaesthesia and surgery. Therefore,
wait till her abdominal tumour bleeds, to bring the
hamster in to be euthanased. The mother could have
surfed the internet and phoned me.
"It is not a guarantee that all dwarf hamsters with
tumours will die under general anaesthesia," I don't
understand why Vet 1 would not have asked the owner to
see other vets if Vet 1 would not perform surgery. I
just rejected a koi owner who phoned up to ask if I
treat kois. It is the right thing to do and is in the
interest of the animal. Not to advise waiting till the
tumour bleeds and bring the hamster down for euthanasia.
"Much depends on the health of the hamster, the size of
the tumour and the duration of anaesthesia," I happened
to pick up the phone today as I was in the Surgery to
interview a job applicant who wanted to work with
animals and teach 3 Temasek Polytechnic volunteers on
cases involving an old Maltese with cystitis, a stray
cat with FIV and a puppy on an IV drip, amongst other
pets.
"How big is the tumour and is it a breast tumour?" I
asked. The mum did not know and spoke to the daughter.
"It is best I examine the hamster."
"How much is the consultation fee?"
"$30.00," I said. "But you already had consulted Vet 1.
The decision should be whether you would want to take
the risk of this old hamster being operated and pay the
operation and anaesthetic fee.
"If the hamster survives the operation, she lives
another 6 months as dwarf hamsters live up to 2.5 years
of age. If she is not operated, the tumour gets infected
and bleeds as the hamster keeps nibbling it. Lots of
blood stains and great distress for your daughter in the
next few days, leading ultimately to death by lethal
injection. In such cases, your daughter would be much
traumatised after seeing the hamster suffer from
bleeding all day long!"
It is extremely difficult to be a mother of young
teenagers nowadays. I could see that the slim fair
14-year-old was from an elite school. The cream of the
crop, now much distracted by her hamster's poor health.
She did not know when the tumour developed and so
whether it was fast-growing or not, it was difficult to
say .
"My daughter has her examinations till Monday," the
mother said. I could sympathise with her as she wanted
her daughter to excel in the highly competitive academic
environment. How could she revise her lessons when she
cried daily as her beloved hamster had no hope of
survival?
As a veterinarian, the best interest of the pet must be
priority. If the vet cannot handle a case, refer to
other vets or ask the owner to find another vet.
I don't treat birds and fishes and I don't accept such
pets in the first place.
The dwarf hamster is old at 2 years of age, but she is
full of energy. Weighed 36 gram and has an excellent
appetite. Trying to escape when the cage door is lifted
up. Big black eyes. Well endowed.
"The chances of surviving anaesthesia are 70%," I said
to the mother who had asked if I provided services to
euthanase the hamster to prevent pain and suffering.
"Did you hear that?" the mum asked the quiet girl.
"Quite a good chance of survival," I said.
"You had operated on hamster tumours?" she asked.
"Yes," I said.
The 3 Temasek Poly students, Dr Vanessa, Mr Min and I
attended to the dwarf hamster. "This is a case where
Zoletil sedation is needed as isoflurane + oxygen gas
will not give you sufficient time to excise and stitch
up in less than 5 minutes."
I said to Dr Vanessa, "With Zoletil sedation, you have
around 5 minutes of surgical anaesthesia to complete the
surgery. But you can top up with isoflurane gas." I told
Mr Min to switch on the gas, just in case.
"All the theories of dosage per kg in vet books are not
applicable usually in the real practice," I said to the
3 students - a young man and two young ladies. "This
dwarf hamster weighs 36 g. How many ml of Zoletil to
give without killing her? This is why many vets all over
the world do not like to anaesthesize hamsters. The
safety range is very narrow."
I got the Zoletil ready. Two one-ml syringes were placed
on the table. Mr Min got me a 23G needle which I told
him was inappropriate. Dr Vanessa got the 25G needles
from the consultation room.
A person learns by doing and making mistakes. No other
way. I asked Dr Vanessa to get 2 drops of Zoletil from
the first syringe of Zoletil held by Mr Min. She got 2
drops. This would not even fill up 0.01 ml of the
syringe. "Add normal saline 0.05 ml," I said. "Just a
little bit."
She did it. Overall, the amount was less than 0.05 ml.
The students watched in silence as Dr Vanessa adjusted
the drug inside the syringe. She pushed up the plunger
up a bit. Suddenly a spray of anaesthetic shot out from
the needle as she had not contained all at one lower
end, if you know what I am talking about.
The students kept silent. Nobody dared to laugh as I am
the serious type when it comes to training and surgery.
I guessed the students were astonished.
"We have to start all over again," I said to Dr Vanessa.
"Use a new syringe." This time I adjusted the drug
content inside the syringe and then asked Dr Vanessa to
inject the hamster IM.
"Inject IM?," Dr Vanessa said I should do it. I
understand. This dwarf hamster has no bulky backside
muscles like the dog or cat or even a rabbit.
I stretched out the hamster's left hind leg while Min
held the front body. I pointed the 25G needle at the
appropriate backside and injected. I have a big bandaged
right hand but I could still do the injection.
"If the hamster does not go groggy within 1 minute of
injection," I said to the students, "It means the dosage
was insufficient or that I had not injected directly
into the muscle."
The students were very silent. Within 60 seconds, the
dwarf hamster went down on her side. "You have less than
5 minutes to complete the excision of the tumour without
isoflurane gas," I said to Dr Vanessa. Everything has
been prepared for her.
I handed her the scalpel. She nicked the tumour for 0.8
mm long, undermined, clamped and used the scalpel to
excise off the lump. The hamster moved a bit as the
anaesthesia was lighter.
It is extremely difficult to get the ideal dosage
without causing death as the hamster is so small," I
said to one student who later commented that the hamster
had moved during the stitching up. "This high
anaesthetic risk is the reason why many vets do not want
to do surgery to remove big tumours."
The 3 students had a rare opportunity to see the whole
process from pre-op to post-op.
TIPS FOR VETS
Sometimes it may be wise to pass up a case rather than
to offer unacceptable veterinary advices as they do
stress out the hamster owner and force her family
members or mother to seek another opinion.
If you add value to the hamster owner by offering
alternative advices other than unacceptable advices, you
may retain the goodwill and that is good for you.
The above case
study took 57 minutes to create. National Library Board
(NLB) Victoria Street, 5.12 pm, Oct 7, 2011
Something wrong with the NLB computer, 8th floor. The
text automatically became so small as to be unreadable.
So, had to stop writing. The time taken to write the
above was 57 minutes!
TOA
PAYOH VETS
