Wednesday, June 12, 2013

1456. Two You tube videos - canine i/v placement & cherry eye tucked in

I/V catheter placement in a dog


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Date:   13 June, 2013  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Cherry Eye in 2 Dogs in 2002 and 2010 Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case 1 written: 20 Sep 2002
Case 2 written:
01 Sep 2010
Updated: 13 Jun 2013 
Be Kind To Pets
Veterinary Education
Project 2010-0129
Cocker Spaniel, cherry eye,  SingaporeCase 1: Cherry Eye in a Cocker Spaniel puppy in 2002
Case 2: Cherry Eye in a English Bulldog in 2010
8 years had passed since I documented the cherry eye in the Cocker Spaniel case above. In 2010, there are over 200 pet shops and more than 10 approved puppy breeders in Singapore. I got a referral of a cherry eye recently. The man said: "The seller told me to wait till the other eye develops a cherry eye before going to the vet for the surgery." I operated on this puppy and excised the gland. There was no complaint from him since 3 months ago. He did not want any recurrence or popping out of the cherry eye if I did the "tucked in surgery" which costs much more and which is not guaranteed.

Many Singapore pet owners are cost-conscious and therefore do not follow up or wish to pay for repeat surgery which may occur in the "tucked in surgery". 

Some get very upset at having to repeat the surgery.  Therefore, the vet has to be understanding and practical. Any surgery over $200 seem to meet a resistance level from pet owners in Singapore. In such cases, the vet has to snip off the cherry eye although it is said that the dog may develop dry eye if the cherry eye has been cut off.

Using the cheaper method of excision, the veterinary treatment of the excision of the cherry eye in the dog is discussed below:

1. Gas mask isoflurane - no problem
2. Local anaesthestic subconjuctiva below the cherry eye
3. Clamp for a few seconds
4. Remove clamp unless there is space below the clamp to perform step 5.
5. Ligate central vertical area where blood supply to the cherry eye is located
6. Excise gland with scalpel
7. No bleeding post-operation using this procedure
As above, but no ligation. Profuse bleeding post-operation is temporary. I find that this approach is satisfactory.  Excise as little of the cherry eye as possible as it is said to produce 30-40% of the tears.

The re-positioning of the cherry eye and suturing it is usually advised but this approach is costly and does not guarantee that the cherry eye will not prolapse. Extra veterinary costs for additional surgery is not be acceptable by many Singapore pet owner. The vet cannot guarantee a successful treatment outcome in this approach and so the owner is reluctant to pay more for this surgery. The culture for most Singaporean pet owners and travellers is to go for the cheapest although there are more sophisticated ones in 2013 wanting to know more about the quality than quantity of service.
Jun 13, 2013. Cherry eye tucked in surgery videos from You tube

1.  Cherry eye tucked in surgery video seen on You Tube
Electro-excision, continuous sutures,  local anaesthestic, two sutures knots away from the cornea. 7 days later to remove knots. Well filmed video. The suture used is likely to be 2/0.
A video by Neartown Animal Clinic - a vet used absorbable 5/0 and use scissors instead of electro-excision to cut and undermine the conjunctival surface away from the cherry eye. She cuts out the conjunctiva covering the cherry eye. Then she used a continuous suture to close the wound after tucking in the cherry eye. This piece of conjunctiva cut off is shown in the video. Her procedure is described in 4th edition of the Small Animal textbook edited by T W Fossum. She used a corneal shield availabe from Ellman, Item H781. Sutures are placed away from the cornea on the outside skin of the eye area.
Cherry eye surgery at Shinki Vet Hospital

Suture anchoring tack method.

Sharing of knowledge from the video producers benefit many pet owners and vet surgeons as each party provides new ideas and tools about veterinary surgery.

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