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The 37 degree
Corgi cross has a heart attack
"AH........................................." A long ear-piercing scream shattered the
stillness of the evening. One long scream from the cage where a bitch was
warded after surgery. A scream of painful
death by heart attack evoking from deep inside the
chest.
It was already 7 p.m but it was still a bright tropical
evening with no wind and low humidity in March. I rushed to the cage and pulled out the bitch. Put her on the
consultation table and examined her mucous membranes of the
mouth and eye conjunctiva. Her gum and tongue were a
pale yellowish white unlike the normal pink colour. Two eye
pupils were dilated. I touched the eye lashes and
normal dogs would blink. There was no such blinking
reflex.
This was the end of a life. I should not have performed this high risk surgery.
I opened her mouth wide and blew air in to stimulate
respiration. I massaged her chest with both hands
vigorously to stimulate the heart to beat. Time was
of the essence and every second counted. There was
no time to give the emergency drugs by injections.
No cardiac stimulators as seen in the human medical
television series ER (emergency room) to apply
electrical shocks to start the heart beating.
Would this bitch be revived by the mouth to mouth
resuscitation and the cardiac massage. Every second
counted as she would be brain dead soon. She would
lapse into a coma if the delay was longer than two
minutes or so.
The cross-bred Corgi bitch's nostrils flared open.
She started breathing. I felt an intense feeling of
joy within my chest. There was a glimmer of
life. I pressed the inside of her thigh to check on
the femoral pulse. There was a weak and slow beat.
Her heart had started beating. I put her on an
intravenous drip when she was stronger in her vital
signs of heart beating and respiration.
The bitch recovered overnight and looked as if
nothing had happened. She went home to a loving
owner. This would be the last time I would operate
on high risk dogs but sometimes it was not possible
to avoid such surgeries.
Middle aged and fat bitches are not
good risks for anaesthesia. Their heart may fail any time. In addition,
this bitch had a rectal temperature below the normal 38.5 deg C. It was
37.5 deg C at admission and dropped to 37.0 deg C. She was put
on intravenous fluids and antibiotics and the owner
had wanted the operation to be done on the same
day.
The owner had acknowledged that there was a high
risk of her bitch dying and with this "informed
consent", I operated to remove the womb.
"Lots of dirty brown sticky discharge from her vagina. My bitch is
having a miscarriage," Mrs Chan, a realtor of over sixty
years old said.
"Yes," I said.
"She suffers from pyometra which is an
infection of the womb and is in a state of shock due
to the toxins and bacterial infections in her blood
for the past few days."
This was the first time I
was presented with the bitch and had no other history.
"How could this bitch be pregnant when she was in the house all the time
and there were no male dogs?" I asked. "Unless a
male dog had climbed over the fence into the
house?"
"She escaped from the house for one day when the gate was
opened," Mrs Chan said.
"Around 5 weeks ago," Mrs Chan's Filipino maid confirmed.
"Can a bitch be pregnant when she had a one night stand?"
Mrs Chan asked in a serious tone.
"Yes," I said. "If the bitch is in
the fertile period of her estrus cycle. In your
bitch, there is a veterinary medical condition
called misalliance. A hormone injection given within
24 hours of unwanted mating is said to be quite
effective in preventing conception and therefore
unwanted pregnancy. If it is given later, the rate
of success is lowered."
I recommended the surgery called ovariohysterectomy
or spay to remove the ovaries and the womb, but Mrs
Chan had the perfect solution to prevent further
unwanted pregnancies.
"Please remove her uterus but do not remove the ovaries so that she would
still be having her female hormones produced,"
Mrs Chan said. "I do not want her to have a
premature menopause and to need HRT (hormone
replacement therapy)."
HRT in women had been on the news recently and there
was a trial of the effects of HRT on women and the
report said that women would get cancer if
they undertake HRT. Therefore Mrs Chan must have
thought of retaining the ovaries and therefore
preventing the development of breast cancer.
This would not be absolutely correct. However,
it was too technical to discuss the pros and cons of
retaining the ovaries as Mrs Chan was in a
hurry.
Many time-pressed Singapore owners do not have the
patience or money to ferry the dog to the
veterinarian for several visits and will want
instant service.
High
risk surgeries on demand are best not performed.
Turning away the prospective client will only lead
to the perception that the veterinary surgeon is
somehow incompetent as there will be another
veterinarian who will accept the risks of
anaesthesia and surgery. Education of the owner to let the dog be operated
only when it is healthy will be essential to the
interest of the dog.
___________________
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