TOA PAYOH VETS
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Date:   04 December, 2012  

Focus: Small animals - dogs, cats, hamsters, guinea pig, turtle & rabbits.

TOA PAYOH VETS 
Be Kind To Pets
Veterinary Education
Project 2010-0129
2008 Case
The hamster has a large facial tumour
 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case study written in 2 Sep 2008
Updated: 
04 December, 2012  
2012 Case
The hamster has a large facial swelling
 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case study written in
04 December, 2012  

In 2008, more Singaporeans keep hamsters but they are mostly dwarf hamsters nowadays. 

In 2008, a mother and daughter surfed the internet. "There seems to be a case similar to ours," the mother informed me of my hamster case in 2002. "Only that in that case, the hamster dies." Well, I could not remember what happened to that hamster with the large facial tumour.  Did the hamster die on the operating table? I went back to review the case. The hamster indeed had a similar facial tumour to the left side as in this 2008 hamster case!
 

This 2008 hamster has a "similar" facial tumour and the owners consulted me. "But our hamster is only one year old and is healthy," the mother and daughter must have done their hamster tumour research thoroughly. The younger the hamster, the better the chance of survival on the operating table. 

Should the veterinarian operate or not? Will this hamster survive the general anaesthesia?  Will the tumour recur? 

The mother remarked, "Such a large tumour. There must be a large blood vessel supplying nutrients to it. To enable this tumour to grow so big!"

"Yes, " I said. You are correct." In this case, the removal of the tumour is an easy job. The problem is to stop the bleeding as the big blood vessels feeding the tumour is cut. Unlike a dog, I cannot see the large vessel, separate it and ligate it before cutting off the tumour.

There is just a 3 mm stalk of this tumour connecting it to the face. A small stalk with big blood vessels supplying the tumour such that it grows to be gigantic. A malignant tumour that keeps growing. If this bleeding is not controlled, the hamster's mouth and lower neck will be full of bright red blood.

The hamster was put under general anaesthesia gas for a few seconds. His big black eyes closed sleepily. He was taken out of the gas container. His tumour was snipped off at the base. Bright red blood shot out as if a dam had burst.

I pressed cotton swabs onto this small wound of around 3 mm after removal of the tumour. But the blood would not stop flowing. The blood spilled over the lower lips to the neck and shoulders. What to do now?  Obviously the owners can't be expected to keep pressing the wound to stop the bleeding. The hamster started to groom himself. To wipe away the bleeding. To prevent me from doing it. He was awake now and just would not tolerate foreign interference.

A more detailed report follows:

Blood just can't stop flowing
Case of the hamster with a gigantic facial tumour

Big black eyes. He keeps trying to pull his gigantic tumour every moment when he is not running around or stuffing his cheek pouch with more seeds. This tumour just will not fall away. Horrors! It keeps growing to 10 times the size of his paw.

He is one year old. In the prime of his life. Life is so wonderful. He eats well and his beautiful grey and white coat and chubby body reflect his good life. His tumour has various side lobes, as if it is a wart. Friction on the floor and from his rubbing. The tumour starts to get ulcerated and bacteria starts to grow inside. He is still able to fight off the bacteria. But for how long?  His owners decides to get him treated at a veterinarian. 

I thought of cutting off the tumour myself," the mother or the daughter commented. "It is not advisable," I mumbled. 

"There must be a big blood vessel supplying this tumour of around 1 cm x 0.5 cm hanging loose from the hamster's left lip corner," the mother in her late forties said. "Otherwise, how can this tumour grow so big." Sounds logical.

This lady must have some medical and surgical anatomical knowledge of tumours. She or her adult daughter or both may even be a human doctors. I do not ask as I am focusing on how to remove this problematic tumour without losing the hamster due to bleeding to death. 

There will be a lot of bleeding if I cut off the tumour. No doubt about it.  I will have to severe a large blood vessel when I snip off the large tumour. Now, in the dog, there is plenty of time and skin to identify, isolate and ligate the large blood vessel before I remove the tumour. I can even see the abnormal blood vessels commandeered by this hungry tumour. I recall this canine case --- an old dog with a gigantic breast tumour. There was a gigantic blood vessel pipe supplying the breast tumour --- see pictures at  The Buddhist Singapore Tzu Chi Foundation volunteers saved an old dog from death by infections.

But this Winter White dwarf hamster is so small. It is not so easy to identify, isolate and ligate the equivalent blood vessel due to the much smaller size of the hamster. But the blood supply to this hamster's tumour will be large. It will be bloody and hellish once the tumour is cut.   

Under general anaesthesia, the normal dog sleeps and it is so easy to operate for more than 30 minutes. For this normal and slightly overweight hamster, general anaesthesia must be very short. A few seconds, not 30 minutes, so as to reduce the great risk of death under the anaesthesia.

The hamster wakes up and use his front paws to interfere with any surgical manipulation. He is given some anaesthesia gas to continue the surgery. Anaesthesia must be short and cannot be prolonged or repeated too often. What to do now?

To the reader, this is a simple snip case. Just cut off the stalk of the tumour.

Not that easy. I put the hamster in a gas chamber.  The hamster falls asleep as isoflurane gas anaesthesia is breathed in. I take him out on the operating table.

I pull the tumour up to see normal skin below it. One snip of the stalk. A sessile tumour. Easy to remove, no doubt about it.

Bright red blood shoots out like a fountain, flowing down the mouth and onto the operating table. The blood just cannot be stopped. An artery has been cut. The cut skin has a hole of only 3-4 mm. But the blood from inside this wound just does not stop bleeding. What to do now?

The hamster wakes up. Smells the blood. Uses his paws to clean himself. 

"Put him back into the gas chamber," I said to my assistant. "A few seconds of gas".  The less the hamster is restrained between the towels, the better. The shorter the gas the better for his survival.

As the hamster half closes his eyes when smelling the gas, my assistant takes him out of the gas chamber and puts him onto the table. He was semi-unconscious but this is much safer. After all, he just needs one stitch.

I stitch 5/0 dissolvable suture to close the wound. One interrupted stitch. The bleeding stops. The hamster wakes up instantly. He smells blood. He starts to rub his face vigorously. Blood just will not stop flowing. What to do now?

I use wet cotton wool to remove the blood now covering the neck and front shoulders of this hamster. The hamster looks like he is not going to make it. He is in shock. The smell of blood. The smell of isoflurane anaesthesia gas stresses him and makes him weak. The grip of his shoulders by my assistant for me to stitch him. His black eyes bulge out bursting from the eye sockets. Will they pop out?  Anytime, his heart can fail. No second chance for a vet if a pet dies at the Surgery. The client will just go to the competition. Death is not forgotten by the owner. Death of the beloved pet at the operating table is not acceptable by most owners and the cause of death is directed at the surgeon.  

If only the owner has had the surgery done when the tumour was just a 2 mm piece. It will be so much easier. But back to the reality of life. The owner expects a live hamster at the end of the surgery. Otherwise she may as well do it herself. 

Fortunately, the owner has not Do-It-Yourself to remove the tumour. The bleeding is so profuse such that the hamster will have died of stress and haemorrhage. In this case, the stitching stops the bleeding. 
 

The owners are very happy to see him without his signature tumour. I hope he lives a long life. Without tumours.

BE KIND TO DWARF HAMSTERS.
GET YOUR VET TO REMOVE THEIR SKIN TUMOURS PROMPTLY
---- WHEN THE TUMOURS ARE SMALL!   

In December 2012, I have 2 cases of large facial swelling in 2 dwarf hamsters. One of the cases is shown below:

The nose had a small swelling around 6 weeks ago. The owner waited and it grew bigger. After 2 weeks, he consulted Vet 1 who pricked one pimple but the nasal swelling grew bigger. Medication could not help.

"It could be a tumour," I said. "It would need to be cut off but there is a high risk of anaesthetic death and infections."

I put the hamster on medication and observation. After 6 days, I told the owner that the facial lump would be a tumour. "Is it possible to cut it off?" he asked. I checked the hamster again and there were 3 yellow bulging pimples.

"The inflamed hard nasal lump had softened with time and medication," I said. "You did not give Vet 1 time to get the lump ripened to become an abscess." The owner was commenting that Vet 1 did not do a good job.

Under isoflurane gas, Dr Daniel incised the pimples with a scalpel. Pus oozed out.  4 days later, the area was no longer inflamed and was hardened as you can see in the images below. 
4 days after hospitalisation and treatment, the pimples can be seen. Under anaesthesia, Dr Daniel lanced the abscess and drained it.
24 hours after lancing the abscess, no more swelling
 
Day 4 after lancing the abscess, a hard lump appear. It would be granulation tissue and should disappear after a few weeks.
 
tpvets_logo.jpg (2726 bytes)5779 - 5788. Hamster nose abscess.
The other similar case I saw in Dec 2012 is shown below:
tpvets_logo.jpg (2726 bytes)5773 - 5778. Hamster nose abscess.
Nov 2002 & Nov 2012 case studies

tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
 Clinical Research

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All rights reserved. Revised: December 04, 2012

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