tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   10 January, 2009

 Small animals - dogs, cats, hamsters & rabbits

*10 a.m - 5 p.m (Mon - Sun, except Sat). Dr Sing Kong Yuen. By Appointment Only.

*6 p.m - 10 p.m (Mon - Fri). 10am - 5pm (Sat). Dr Jason Teo. House-calls available.

Appointment preferred.
Tel: 6254-3326, 9668-6469
11 p.m to 6 a.m
Dr Teo
9668-6469, 6254-3326
Fax: +65 6256 0501
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Case written: Dec 21, 2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS

Dec 21, 2008

Shih Tzu X Silkie. 7 years. Mammary tumours, nodules. MG4. Toa Payoh Vets"You can tie the dog up and care for her," the daughter wanted the dog back, if possible, on the day after the mastectomy surgery. The dog was standing on her two legs inside the crate and was all ready to jump off.

"It is not so easy for your father to manage," I had advised a crate to confine the dog for the next 14 days. If the stitches break down, the hole is too large to be re-stitched. It looks so easy to the layman. Just pull the two ends together and stitch up. A second surgery and stitching will cost the owner money and in this time of recession.

Shih Tzu X Silkie. 7 years. Mammary tumours, nodules. MG4. Toa Payoh VetsI understand the need to save money in this time of recession. The daughter wanted the dog home after surgery.  She did not think that the stitches will get infected and break down. The wound may not heal properly as the dog jumps up and down.

If the dog suffers a second anaesthesia and surgery. More money needs to be spent and this is much more than warding charges.

A patient release form stating that the owner has been informed that the dog's wound may break down due to a lack of confinement and nursing and against veterinary advice and that there will be fees charged for re-stitching must be given nowadays to avoid misunderstanding and litigation in a litigious and complaining society like Singapore. 

Mastectomy MG4 and MG5. Female Dog. 7 years. Toa Payoh VetsI have bad experiences of some Singapore owners getting nasty and demanding "free" consultation and treatment when the wound breaks down or the skin disease did not get cured after one visit.  

After all, they have paid a "big" sum for the surgery/treatment. They expect no charge when the wound breaks down or the disease does not resolve.

In this case, the dog starts traumatising areas around her wound edges (bruises seen on Day 2 despite an Elizabethan collar, pain killers and confinement in the crate. The stitches were not affected as the collar had prevented direct licking.        

The skin wound is stitched up under high tension. A subcutaneous suturing and a need to get skin from the other half of the breast to close the big wound of around 2 cm in width. To the owner, the wound looks tight and firm after surgery. (Note: Ligation of the caudal superficial epigastric artery and vein is very important to prevent subcutaneous bleeding and swelling. Ligation was in 3 areas to ensure no bleeding from this spurting artery).  

But the dog traumatises the wound by licking despite being required to wear an Elizabeth collar and given the nonsteroidal anti-inflammatory drug (NSAID) Tolfedine and antibiotics. She will infect and stretch the wound through jumping and running inside the apartment. The dog feels good and pain-free because she is on pain-killers. So, the owner thinks that there should be no problem and wants the dog home.

It is best that the mastectomy dog be warded for at least 10 days to get proper nursing and wound healing. 

Mastectomy MG4 and MG5. Female Dog. 7 years. Toa Payoh Vets

If the wound is small, the dog goes home on the day of the surgery. But in mastectomy in this case, the wound is under high tension and may not even heal well inside the Surgery. Few Singapore owners are able to nurse the wound at home.

The vet will be wise to
the case if the owner is insistent on not complying with advices to ward the dog for a few days.

A big hole in the dog due to wound breakdown is extremely painful to the dog.       

It is always unpleasant when the owner comes back with a big wound breakdown and expects free or cheap re-stitching under anaesthesia.

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