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Date:   20 September, 2008

                              Focus:
 Small animals - dogs, cats, hamsters & rabbits

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Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

CHEEK POUCH IMPACTION IN A HAMSTER
Case written: Dec 20, 2000. Case update: Sep 20,2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS.

The hamster saves for a rainy day

"My one-month hamster is not walking properly, as if he is in pain or lame," said Miss Chan, a slim and fair girl.  

Like almost all teenagers, she was as careful of her weight and was fashionable, wearing a white blouse exposing the belly button, the fashion of the year 2000. 

She took out a small shoe box full of shredded newspapers from a large paper shopping bag. A baby hamster emerged.

"There is a big lump below its neck," her mother said. She was short haired and wore blouse and snacks. A lady in her late 40s, dressed as  conservative in contrast to her daughter trendy fashionable clothing.

The baby hamster had stuffed seeds in its left pouch which swelled to large 1 cm irregular mass on the left cheek.

"Is it still eating?" I asked. A piece of normal faeces was passed as the answer came from the hamster. Hamsters poop almost every few seconds if they are normal.

This hamster certainly looked and behaved normally.

"She has an excellent appetite but she staggers, as if she is drunk," commented Mrs Chan.

"The mass would be the seeds stored in the pouch," I said.

"Do you have an injection to get the seeds out? They seem to cause a difficulty in walking, as if she was carrying a heavy baggage," Mrs Chan was worried.   

It may be best to leave the baby hamster alone and stop offering food to her for a short time. But will this guarantee that the hamster will empty its pouch? What if the pouch was badly infected and therefore the food got stuck inside? 

But which owner would want to do that?  The hamster might starve to death.

What if the hamster got choked since the mass was so big relative to the size of the hamster?

Would I be negligent in not dealing with the "choke"?
 
Getting seeds out of the pouch is difficult.
Baby hamster saving for a rainy day.

This wasn't a real choke, well known in cattle cases in Scotland in the 1970s.

In some cows in Scotland, a very big potato swallowed blocked the gullet, I remembered my seeing practice days.

In this baby hamster, the gullet was not obstructed but this mass could block food going down the gullet from pressure to constrict the oesophagus.
    
I said, "No such injection is available. Anyway, it is too risky to inject such a young hamster. It may be possible to massage the lump out."    

Was this a very hungry baby hamster? Certainly, it would not be short of food from her caring owners. 

The eyeballs popped out as I  tried to massage the seeds out of the mouth. 3 big seeds of about 0.4 cm long were extruded. Some broken down masticated greenish black food material oozed out.

The blackish stuff could be the ink as she had licked and ingested the newspapers as her bedding was the Singapore Straits Times.

The hamster suddenly lapsed into a comatose-like state. She stopped struggling. Her front paws were motionless. I sweated. The mother and daughter looked at me.

"Is she dead?" asked the mother.

"Wait a while, Mrs Chan," I said. There was no way in knowing as the hamster is too small to auscultate with the ordinary stethoscope.

Tears welled up in the eyes of her daughter. The baby was only one month old and life had just begun.
 
3 big seeds extracted from the pouch

The whole process of manipulating the seeds and crumbs out of the cheek pouch might have stimulated the neck vagal nerves next to the big lump. The nerves then send impulses to slow down of the heart and the hamster collapsed.

After what seemed like an eternity but was probably over 30 seconds, the baby hamster got up as if she has woken up from a nightmare.  She was wobbly but was all right. 

No hamster will cooperate with the vet

"No more big seeds for this baby," I said. "She could be just putting everything in her pouch, as all one-year old (human) toddlers would put all things in their mouth. Most likely the baby hamster was saving for a rainy day!"

RETROSPECTIVE REVIEW OF THIS CASE IN 2008

Hamsters are easily stressed if restrained for several seconds. They may then die of heart failure as the vagal nerves get overstretched, leading to slowing the heart rate and then heart failure.

In a retrospective review of this case, a whiff of the isoflurane anaesthetic gas for around 30 seconds would have not stressed this baby hamster. When the hamster is sleepy after breathing the gas, the stuffed food in the cheek pouch can be taken out without much resistance using a pair of forceps.

However, the trick of the trade is to use a correct anaesthetic dose. The hamster may die from breathing a slight overdose. The vet needs to be vigilant. Once the hamster closes its eye-lids, take it out of the anaesthetic chamber and treat it.

From the experience of the above case, severely impacted cheek hamsters treated in Toa Payoh Vets are given anaesthetic gas to avoid stress and excessive stimulation of the vagal nerves as the hamster struggles while the vet dislodges its cheek pouch contents.

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