| 9015Singapore Chihuahua
anal sac abscess rupture, pet health and welfare educational for animal lovers, excerpts
from The Glamorous
Vets, Singapore, sponsored by AsiaHomes Internet. The Chihuahua may die, says the vet  "I
noticed a big hole to the right of the anus," said Mr Neo. "What could be the
cause?" Mr Neo was bringing his 2-year-old Chihuahua for a booster vaccination
with two lovely slim daughters aged eight and eleven years old."Its right anal sac had been swollen and is now ruptured through the skin," I said. "The dog has two anal sacs which discharge a scent to mark its territory. Its left anal sac is normal. Did you see the dog biting its tail, chasing its tail or rubbing its back on the floor?" Mr Neo had noticed one of these behaviour and had thought nothing was significant. After all, dogs do behave that way. "What's the remedy now?" Mr Neo asked. "You have two choices. To get the dog's wound stitched up or use an antiseptic to clean the wound daily so that it will heal. In the first choice, the wound should heal within 7 to 14 days. In the second option, you will have to prevent the dog from licking its open wound and the faeces may drop onto it and contaminate it. A contaminated wound takes a long time to heal. " I said. How much it would cost to operate?" Mr Neo asked. "It is estimated to be around $150 with general anaesthesia gas required to perform the surgery," I said. "However, your dog is very thin. It may or may not die under the anaesthesia as it is not strong." I checked the dog's heart and lungs. Nothing unusual except that the heart sounds were particularly soft for a thin dog. The thinner the dog, the louder the heart sounds auscultated in most cases. This dog had a faint heart sound and that was not normal. Blood tests ought to be taken for examination. The lungs could be X-rayed but this would add to more costs and in the real world, veterinary costs must be as low as possible. Should the dog go under anaesthesia in this case? It may not be able to take it. "You must be prepared to accept the risk of it suffering from a heart attack during anaesthesia," I said. Mr Neo was undecided when he heard about the anaesthetic risk. Disclosure of risks to pet lovers usually worry them as they bear the responsibility of life and death. Failure to disclose risk may led to the veterinarian being sued if the pet dies under treatment. Being sued for medical negligence is getting common in Singapore in the 1990s. Judges no longer except the Bolam Ruling* as they use the Bolitho Ruling* to decide on the reasonable and logical aspects of the defence of medical experts used as witnesses for the defendant doctor.  The hole was large as the Chihuahua was a small toy dog. It was
around 1.5 cm x 2 cm in diameter. It could be contaminated and would not heal
well if not stitched up. The silence was punctured by a loud sobbing cry from the
elder daughter. This was unexpected. I had not expected an eleven year old to know
the ramifications of our adult discussion on death. We stopped discussion to console the
older girl. Should we just take the second option?The younger one started to cry too after seeing her sister crying non stop. Should there be surgery or not? Should I take the risk or not? The dog may not die too. This was the first time I encounter this situation. Should the peri-anal hole be stitched up so that it will heal within fourteen days? Alternatively, Mr Neo could clean it daily and it may close up within thirty days if it is not contaminated by the stools and dirt. The dog may lick it continuously it, retarding the healing process too or resulting in an ugly big granulation lump of tissue. That was the decision he had to make on the spot. What if the dog passed away during or after anaesthesia? Mr Neo decided on the surgery. Nurse Ann clipped and shaved the surrounding area and cleaned up the open wound in preparation for surgery. A faint smell of anal sac oil filled the air conditioned room. It was a musky smell, the type of strong odour, like strong perfume which penetrates your nose. The dog was given a light dose of gas anaesthesia after tranquilisation.  The edges of the wound were trimmed as the edges were ragged
and the wounds would not heal well. Red fresh blood filled the area as this is an
area with lots of blood vessels. The blood was swabbed off.  "The dog stopped breathing," Nurse Ann
said as the ventilation anaesthestic bag stoppedmoving. Was the patient dead? I checked the heart beat and stopped the anaesthesia. Oxygen gas was given quickly before the brain got deprived and the tissue die, leading to coma. The last of the four nylon stitches closed the wound. The dog recovered and started breathing.  An Elizabeth collar to prevent it attacking the stitched up area and
opening up the wound. It was time for lunch. Nurse Ann who had started work, did not have any appetite after seeing the blood and tolerating the anal sac smell. As for me, the musky anal sac smell was the least pungent of all encountered in veterinary practice. I was densisitized to the domestic dog's anal sac smells. I was able to take my lunch. This case also tells me to be aware of the sensitive feelings of children above the age of nine years old. It is said by family experts who want to vigilant about their children watching not wholesome television that children aged under nine years have not yet grasped the concept of death. They confuse TV with reality and there are horror stories of little boys who think they can fly like Superman.  This nine-year-old limit seems to apply in this
episode as the younger girl was blissful till she saw her elder sister crying as the
latter had grasped the concept of death. The Chihuahua did recover and had put on more weight as the elder sister gave it more feed. Some small breeds, like children are finicky and do not eat the dry feed such that they become very thin. Hand feeding or change of feed may encourage it to eat more and put on more weight. It was vaccinated during this time.  This was an unusual case in that the
Chihuahua's left anal sac was infected and ruptured one month later. It was treated
by washing and healed. Picture shows a healthy dog that has put on some weight six months
after the backside problems. *Source: Singapore Straits Times July 21,
2001. "When medical experts no longer hold sway". |