tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
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Date:   29 May, 2009
   
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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

Will electro-surgery kill the old Jack Russell?
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written: May 28, 2009

 

Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh VetsThe Jack Russell needed to be unconscious so that the gigantic mouth tumour could be excised using electricity. Yet he had a weak heart. Anytime his heart could fail and he would be gone from this world. Therefore, general anaesthesia using isoflurane gas was kept to the bare minimum.

This anaesthetic gas was like the force shield in Star Trek's Enterprise, protecting the starship from powerful electrical-like blasts from the enemies during space fights.

As the electricity shot through the electro-cutting blade sliced off the tumour at the edges of the gum, the dog started to jerk. The protective force shield was insufficient to protect the dog's systems as the anaesthesia was at the lowest level at 1%.

Her tongue moved. Her heart stopped pumping blood. I could see that his tongue changed from pink to purplish in colour.

Isoflurane Gas Anaesthesia. Electro-cutting removed gum tumour first. Note hard palate tumour. Toa Payoh Vets"Increase the dose to 5%," I stopped the electro-surgery. The dog was feeling the pain. The force shield needed to be raised to its maximum level at 5%. However, it could overload the dog's heart and kill her. There was a need to know how long the 5% had to be given. One minute or more? There was no formula. The longer, the higher the risk of death on the operating table.

The dog started to slip into unconsciousness as the anaesthesia  shielded her against pain of electro-surgery. The electro-cutting blade transferred electric current into the tumour. Zap, zap, zap... the electric sparks flew.

"Smells like burnt meat," Intern 1 who had never seen electro-surgery probably thought of her barbecue parties. The 9-sq m operating room with 2 interns, 2 assistants and myself was packed.

Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh VetsThe faster the operation was done, the better chances of survival it was for this old dog. 15 minutes had passed. Now the dog was unconscious at 2% gas anaesthesia. The 2nd tumour in the hard palate was zapped and removed.

Next, I took out the electro-cutting wire and replaced it with an  electro-cautery electrode. The blood flew profusely from the gum after the tumour had been cut. The red light at the end of the electrode blinked indicating that electricity was coursing through. However, the bleeding continued.

"Turn the dial to the higher intensity," I said. The assistant turned the knob to No. 6. I
Electrosurgery stops profuse bleeding during gum & hard palate tumour removal. Toa Payoh Vetsput the electrode onto the bleeding gum as I stepped onto the foot switch. The vaporising steam rose as the electricity burned the blood vessel. The electrode started to coagulate all the bleeders.

The dog moved suddenly and darted his tongue in and out of his mouth. His tongue changed to a deep purple again. Anytime he would die of heart failure.

I looked at Intern 2. "Is the indifferent plate still in contact with the dog?" She was to ensure that the dog's abdomen was in contact with the "indifferent plate" which had
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vetsbeen moistened with a wet gauze swab in normal saline. This plate conducted the electricity away from the dog to the machine. A complete circuit allowed the electro-surgery to be performed.

"Yes, yes" Intern 2 said. I checked myself. The interns were inexperienced students from the Junior College waiting to study veterinary medicine. They had never seen electro-surgery in their 18 years of living. Neither did the two Myanmar assistants. Electro-surgery is seldom performed as there are not many indications requiring this expensive machine.

Gum and hard palate tumours in old dogs can be prevented with good dental hygiene and health. Toa Payoh Vets.Therefore, I had to be extra vigilant and yet needed to educate the younger ones on the application of electro-surgery. Seeing is believing for them.

"OK," I said to my assistant. "Take out the endo-tracheal tube now. The operation is completed." There was not a single drop of bleeding from the gum. The dog got up as if he had a short nap. It took team-work to complete the surgery in 18 minutes.



 

The Jack Russell wagged her tail. She was a most friendly dog and would never threaten people unlike some crazy Jack Russells I had encountered. She was not able to communicate as a human being. But she appeared quite happy as the she could now close her right upper lip normally. The owner and her daughter were happy to take her home later in the evening. Large cancerous gum and hard palate tumou excised. Jack Russell, 10 years. Toa Payoh Vets

Jack Russell, Gum & Hard Palate Tumour excised. Vet Intern. Toa Payoh Vets.NOTES: Oral tumours form when there is poor dental hygiene in dogs. Regular dental check up every year will prevent the formation of such gigantic oral tumours.

In old dogs, it is best not to attempt surgical removal of the oral tumour and dental scaling and extraction at the same time. This increases anaesthetic time considerably and the risk of anaesthetic death. Therefore, do the surgery and forget about the dental for the time being if you want a positive and happy outcome.

tpvets_logo.jpg (2726 bytes)Toa Payoh Vets Clinical Research
Be Kind To Pets

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