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Date:   30 August, 2012  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
 
Closed Pyometra In A Miniature Schnauzer
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Article written on:  15 March 2009. Upd
ated: 30 August, 2012  
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Be Kind To Pets
Veterinary Education
Project 2010-0129
Old Miniature Schnauzer, Not Spayed. Closed Pyometra. Toa Payoh Vets
Closed Pyometra. Spayed 12 hours ago.  Miniature Schnauzer 10 years vomit next 2 days. Toa Payoh Vets.
Closed Pyometra

All owners do not want a dog to die on the operating table. This dog was at death's door. Surgery could not be delayed.

When to operate and how much IV fluids must be given to maximise the dog's chances of survival during surgery will depend on the veterinarian's judgment and experience.

A dead dog on the operating table is never forgiven by the owner and bad mouthing of the veterinary competence might be the consequence. 
The risks and options are explained clearly to the owner and recorded. An informed consent form must be signed in case of litigation as Singapore is becoming a litigious society as the country develops into a "first world".

During litigation, the medical notes will be referred to and if there are no records of informing the owner of the risks and alternative treatments, the medical negligence suit will not be in the doctor's favour.
 
UPDATE ON AUGUST 30, 2012:
In 2012, I have implemented a work process in which all vets performing operations at Toa Payoh Vets have to be responsible for recording in their own book of anaesthesia and surgical templates the details of their anaesthetic dosages and times taken as well as surgical procedures. This book of records will be their defence in cases of litigation and investigations.
TIPS FOR VETS

Each vet has his or her own judgment as to the use of IV drips during surgeries.

I notice one vet inserting an IV catheter without attachment to any IV drip set during surgeries. 

I will advise all vets to connect an IV drip to the IV catheter when performing spays and surgeries rather than just inserting an IV catheter into the cephalic vein by itself.

This is because, during emergencies, the IV catheter will be clogged by the blood clot while an IV drip will give instant IV access to emergency drugs during the surgery.  In some cases, I give antibiotics and pain-killers prior to the start of surgery as the dog is not well and needs prompt surgery. In some pyometra cases, I run the IV drip overnight first to re-hydrate the dog and give her the antibiotics and pain-killers. This gives her a better chance of survival rather than rushing into surgery immediately. 

In the above case, about 100 ml of glucose is given IV, not the whole bottle! Know your IV infusion well.

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