Wednesday, September 22, 2010

Chewy the Hamster

On Sunday Anna asked me to look at her little hamster, Chewy, because her eye was tearing.  There was a swelling on the right side of her face/neck causing the problem.  The swelling was pretty soft and movable.  I figured she had an abcess or a cheek pouch impaction - that hamster is always shoving huge things in her cheek pouch.  I promised to take her to work the next day to lance the abcess.

When I got there the next day, the hamster's swelling was worse.   I gassed her down, then explored her cheek pouch with an otoscope.  It was empty and otherwise normal.  I felt this swelling, which felt much firmer now, not so fluidy.  I aspirated it with a needle and no pus.  Clearly this wasn't an abcess; it was a tumor.

This was going to be a big task, so I decided I needed to bring Chewy home and talk to Anna about it first, and also let her see her hamster before the big procedure.  "Yes, do it, if it will keep her from dying!" Anna said earnestly.  Well, maybe it will keep her from dying, and maybe not.  She might die under anesthesia.  Anna was tearful but still gave consent.

The next day after all my regular surgeries were done, and during my lunch hour, I sedated Chewy again.  The tumor had grown significantly again overnight.  Now it was pushing her mouth to the side.  With one technician holding a miniscule mask to her face, and another monitoring her heart and respiratory rates, I cut the skin over the tumor.

Sometimes there are benign, well-encapsulated tumors that peel right out.  A few times, when people are willing to spend money on their pocket pets, I have done these surgeries with great success.  This was not going to be one of those surgeries.  This massive tumor was irregular and had adhesions to everything.  It was extending under her eye and ear, into her oral cavity, down to her shoulder, shoving her trachea up and over like a snaking river.

Delicately I teased the tumor away from the vital structures.  I feared that if I hit a big vessel beneath (the carotid or jugular) she would rapidly bleed out.  My technician noted her heart rate slowing.  We added heat support and adjusted her gas.  It was frustrating that I could not intubate her and ensure her airway, or give her IV fluids, but of course that would be impossible with such a small creature.  After 45 minutes I had the mass about 3/4 of the way free, but Chewy developed a lot of edema (swelling) around her contorted trachea, and she expired.

The whole clinic was sad, for the little hamster and the girl who loved her.  When I got home, Anna burst out of the house, and I gave her the bad news.  She cried, hard, for about an hour.  When she had regained some composure, she said, "I know its not your fault, Mommy, I know you tried.  I'm glad she died while she was under anesthesia, so she wouldn't be in pain." Anna never ceases to amaze me. She also asked me to thank the technicians who assisted me and helped Chewy, and for the coworker who had made a precious clay momento with Chewy's pawprints.  She held her pawprint clay to her heart, and asked me if I would have her cremated ("I want to have her burned.").

Poor Chewy certainly couldn't have lived more than a few more days before that tumor would have choked her.  I was surprised how well Anna understood that.  Chewy was a "rescue" hamster that we got from a girl who basically ignored her once she became a teenager.  Skittish at first, she became quite friendly and curious, and let all kinds of children hold her.  She was in our home for only 4 months, but I think they were good ones.

Friday, September 10, 2010

My passion, my pup

Sunday Francesca was chewing her nightly "boney," her rawhide chew, when she suddenly stopped.  She kept bringing it to me, which was annoying.  "Go eat your boney, I'm watching a movie," I told her.  But she wouldn't eat it, and kept nudging me for attention.

She went to bed with her boney.  And carried it around the next morning.  "What is wrong with you?" I said as I lifted her lip.  Then I saw that she had broken her big molar, and there was a large red spot where the nerve was exposed.


I am collecting cases as I work on my dental fellowship, but I did NOT want to practice on MY dog!  Poor Francesquita, no wonder she couldn't eat her boney.

Fractured teeth are very common in dogs, and this tooth is the most commonly fractured.  If the fracture exposes the pulp, or nerve, of the tooth, there are only two choices:  extraction, or root canal.  Do nothing, and eventually the pulp will die and fill with bacteria, and the tooth will abcess.  Meanwhile, its painful and unhealthy.

I got myself mentally prepared to perform the root canal.  Its a complicated, 3 rooted tooth, and I don't have as much experience with fixing it as I do single rooted teeth (like the fang).   Also, it is awkward working on your own dog, if you think about it too much.  Anthony put it in perspective for me, though, when he said, "What is the worst that could happen?  She could lose a tooth?"  Right.

So today, I fixed it, and it was the best I've ever done.  Just like in a human root canal, fils are introduced into the pulp chambers in each root:

Then, using progressively larger files, all the organic material/pulp is removed.  Once its cleaned, the pulp chambers are filled with an inert material called gutta percha:

Then the holes you made in the tooth and the rest of the crown is restored with composite.  The tooth is dead but functional.  Once it fractured, it would have died anyway.

Francesca is woozy and drunk from the morphine, but she is painfree tonight.  That is my gift to her; she gave me a great case to work on and a little more self confidence.

Tuesday, September 07, 2010


Lots of good bloggy ideas in my head.  Little time or energy to get them out.

But look at this gift I got today!  I have a wonderful client who has gifted me with some of her gently used things, like a Waterford crystal bowl, Italian table linens, and a Lladro figurine.  (Can you tell she doesn't have a daughter?)  But today she gave me a gift I will really treasure:

Those are hand knit socks! Merino wool with just a touch of cashmere! Such beautiful tiny stitches!

I can't wait for chilly weather!

(PS these are NOT gently used.  They are brand new, never worn, knit just for me!)