Moderately dehydrated as his skin stood up when I pinched it. This dwarf hamster was thin unlike the plump ones of his peers at 1.5 years.  The young couple had brought him in for treatment as he had stumbled. That was due to the weight of the massive growth to the side of his left cheek. The growth was around 1 cm in diameter and had extended to his left shoulder blade. A hard lump that was spherical in shape trying to rupture out of his glistening pink skin that had become paper thin. The skin was now hairless and ready to rupture soon. The hamster still ate. He lives to eat but he did not put on weight.

Surgery was the only option. The hamster needed to be pain free during surgery and that meant anaesthesia. Anaesthesia kills when the patient is not in excellent health. The dosage must be sufficient so that the cheek pouch growth could be removed without the hamster feeling the pain. A bit more, he would die. A bit less, he would be moving. How much to give such that he would not die? How about giving an I/V drip to combat the dehydration. Well, this was not possible as the hamster was too small. Subcutaneous drip. Yes.

"You do understand that the hamster may die on the operating table as your hamster is not in good health, being thin and dehydrated," I phoned the owner. "Yes," the husband said. The wife had noted pus in the left ear of the hamster some 6 months ago and Vet 1 had cured him. Then 3 months ago, Vet 2 told her that there was a swelling and the hamster might need surgery to remove the growth. Vet 2 was not confident of the surgery. Now, the growth was massive and fiery.

It was a firm nodular mass, more likely a cheek pouch tumour or nodular abscesses now hardened. Histopathology of the growth would be useful but that cost money. I did not propose doing histopathology as it would increase the cost of treatment.
 

What if this hamster die on the operating table?  This was a very challenging case. A patient in poor health. A growth so large. Lots of nerves in this area. If the nerves were damaged during surgery, the hamster might not be able to close his eyes eat properly. His face might be paralysed. Such a big growth would be supplied by a bigger blood vessel and there would lots of bleeding. The hamster could bleed to death if the big vessel ruptured during removal of the growth.

If this was a dog or cat, the surgery would be so much easier as the anatomical structures would be larger. Of course, dogs and cats don't have cheek pouches unlike hamsters but the operating areas would be much bigger and easier to handle.

ANAESTHESIA
Zoletil 50 IM in a very low dose with isoflurane gas to top up. The hamster could not stand around one minute after the Zoletil injection. He looked like he was going to pass out. His eyes were open.

SURGERY
Clean the skin of the growth. Scalpel cuts the skin. The ophthalmic sharp pointed scissors undermine the skin to separate the growth as one large mass without breaking it up to pieces. Extended the incision to more than 2 cm to get the tumour. So far so good. No bleeding. The whole encapsulated nodular growth was taken. A gush of red blood spurted as the growth was excise. Artery forceps clamped the source of the bleeding. There was no defined blood vessels to ligate and the hamster could bleed to death if a major blood vessel was cut or damaged. Bleeding stopped but the hamster's head and legs were splattered with blood. I cleaned up the blood. 

5/0 absorbable sutures interrupted closed the skin incision. The hamster was sleeping throughout the surgery. Surgery needed to be fast. Around 10 minutes.  There was no need for isoflurane gas anaesthesia top up in this case.        

The hamster looked dead for the next 2 minutes. Surgery was successful but the owners only accepts one outcome - a live hamster.

After 5 minutes, the hamster stirred and woke up as if he had a nap. He ate. This is a hamster that lives to eat. He went home on the same day.
 

The wife was joyful when she came to take the hamster home. "She's the caregiver," the husband said when I asked more about the history as the hamster stayed overnight at the Surgery as I was not on evening duty.

The hamster now had no large facial swelling. He looked particularly handsome with his sharp snout and big shiny black eyes.

I showed the young couple the tumour and the two  abscessed melon seeds that I could have missed after taking out the growth. I don't expect two seeds pushed and hidden deep in the recess of the wound. If I had closed the skin wound, the hamster would not have had recovered well. It is natural to assume that the cheek pouch growth was the sole cause of this spherical swelling. But there were two melon seeds enclosed in part of the cheek pouch. Trapped and forming yellow pus.

The hamster wanted to eat the tumour but I took it away quickly. He went home with antibiotics. He is a hardy hamster. Living day to day. He enjoyed eating and lives life to the fullest.     

HAMSTER OWNERS
Always get small tumours removed early. It is not so easy to get a happy ending as in this case. No animal can be expected to survive anaesthesia when he is not in excellent health. Even if he survives, he may not live long as the stress of the surgery and infection in a poor health hamster kill him in the next few days.

VETS
Always check for other objects like seeds once the cheek pouch growth is removed. Life is full of surprises. The vet needs to be more thorough in cheek pouch surgery and look for seeds and other food impacted below the growth!  In this case, some "superior powers" must have placed the two melon seeds to test the thoroughness of the vet. Are there such beings as  "superior powers"? Readers may disagree with me. In any case, I was fortunate to spot the seeds. The hamster would continue scratching his left face and that would not be good for him or the owner as the outcome was unsatisfactory.