Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures
MEDIAL ENTROPION IN THE SHIH TZU
Canthal Closure + Nasal Fold Excision
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS. First written in 10 Apr
08 February, 2010
Be Kind To Pets
Saturday Feb 6, 2010 was my day off.
However, a person wanted a meeting. So, I was flexible and took the time
to meet the 3 young vets and had an interesting discussion with them and
at the same time educate myself regarding the veterinary industry and
One of the problems of young vets is the prospective clients' remark: "You
look so young...can you perform the surgery (e.g. repair the bite wounds)?"
Well, this is a common remark and applies even to medical surgeons. Last
year, I was at the Singapore General Hospital for an operation to be done
by an experienced surgeon in his late 50s and an old
friend. All prospective patients will be impressed and comforted by the appearance of
his grey hairs when they consult him at Clinic J. They testify to his abundant surgical experience over the
His surgical assistant, a young surgeon known as "The Registrar" attended to me in
the administrative matters. I asked her how's her posting as we walked to
another section to make the booking and she said to me: "Singaporeans look
at me and query whether I am capable of doing their operation." I was not
surprised at her comments as Singaporeans say the same thing to newly
minted veterinary surgeons too.
How should one reply to such queries? It will be difficult unless one is a
show man and produce testimonials. The business of surgery is serious and
is not a theatre. I guess, the young ones who don't have senior vets in
the practice have to take such remarks in their stride and assure the
prospective client that his dog is in good hands. "Such remarks are made
about the young vets in established vet practices in Singapore," I told
the 3 young vets. "All vets will have to go through such challenging
Other than real people in this real world, is there another invisible
world supervising us?
I ask this question because I was looking for an old Shih Tzu who had
medial entropion. A 1-year-old Shih Tzu had come in 3 days ago for medial entropion
surgery (pictures below). Next day, a 10-year-old Shih Tzu with
bloodshot eyes came in for treatment. He had corneal ulcers, acute
conjunctivitis and black pigmentation in both eyelids. His left eye was
filled with sticky pus.
This 10-year-old Shih Tzu was my answer to "what happens if there
was no medial entropion surgery done for the Shih Tzu?"
Well, you can call it a coincidence. I have had 3 Shih Tzus with corneal
ulcerations in the last 7 days and one of them was this 10-year-old Shih Tzu.
"All these eye infections can be avoided if the dog had an operation to
roll out the inward rolling eyelid near the nose when he was a young
puppy," I remarked.
"I don't know there is such a
surgery," the lady owner told me patiently. She was worried about
veterinary expenses. This surgery, known as medial canthal closure is seldom mentioned by vets
in any case.
The following pictures of the 1-year-old Shih Tzu illustrates the surgery.
Be Kind To Pets
All rights reserved. Revised: February 08, 2010
Toa Payoh Vets