Case 1. A Vet's Signature Surgery

"Everything was OK for the past 2 weeks after spay," the cat owner I had not met before brought in a black cat with yellow pus in her spay wound matching the colour of her yellow eyes. "Suddenly, I see yellow pus and an open wound in my cat."

As I did spay a black cat with yellow eyes recently, I assumed that this was the cat I had spayed and there was the post-spay complications of wound breakdown or infection which do happen in rare cases.

In the black cat I spayed recently, the owner pressured me to charge him $35 for spaying as it was the fee offered by some vets. Spaying of a cat is commoditized such that the lowest priced vet should get the most spays.

"The reason I do not pay $35 to the vet who charges much lower than you is that my cat's left ear tip must be snipped off after the spay."

It is difficult to sustain the profitability and upgrading of a veterinary practice if I compete on "lowest spay price". So I was prepared to let the case go as I don't want to lose money doing a surgery as prospective customers like to play one vet against another to get their cheapest price.
I will become bankrupt providing loss-making services in time to come.

Unlike a human general practitioner, a veterinary practice has surgical and anaesthetic equipment to buy and maintain. The rentals and staff overheads are high. Therefore, going down the path of the being the lowest priced vet is not sustainable for profitability in the long term.

Back to the black cat on my consultation table, the owner said he did not know who had spayed his cat as he was not the one who brought the cat to the vet. One look at the cat's incision wound told me that my "signature surgery for cat spay" would be around 1 cm from the umbilical scar (US). This cat's wound was at least 2 cm away and closer to Mammary Gland 5 (MG5) whereas mine would be closer to Mammary Gland 4 (MG4). Therefore I did not spay this black cat.

The cat I spayed was 7 days ago and I had never heard from the gentleman. The latter did not want antibiotics or pain-killers for his cat but there were no problems.       

As for the cat presented, I noted some brown stains of an iodine-like antiseptic further away encircling the wound. I did not ask the owner whether he applied antiseptic which had been licked off. How could his black cat do it when she had worn an Elizabeth collar?

"Do you have another cat in the house?" I asked him.
"Yes."
"It is likely that the other cat cleaned up the wound for this black cat," I said. The owner nodded his head.

So, what's the solution? The cat had a fever. It would cost the owner more money to get her treated. In times of recession, this post-surgical treatment is not kindly accepted by a pet owner.

I removed the stitches, warded the cat and gave antibiotic injections for 3 days at minimal cost of $50.00. For the next  7 days, I did not hear from the owner and presumed that the cat had resumed a normal life.

Other pets licking the wound of the spayed cat or dog are unexpected causes of post-spay complications. Vets seldom if ever ask the owner to separate the spayed pet from another as we never think of such situations.

As for the use of "signature surgery" in this story, I can tell which of the cats I had spayed from the location of the surgical scar. It is usually 1 to 1.5 cm near to the umbilical scar (US) than the one in the black cat.  3 examples are shown below:

Dr Sing's signature surgery - surgical incisions (XY) for cat spays are closer to Mammary Gland 4 (MG4) and around 1 cm distant from the umbilical scar (US). The black cat in the 4th picture was not spayed by Dr Sing.

A crime detective can identify a criminal based on his  "modus operandus" or method of operation. A serial murderer also has certain "signatures" in his killing. A singer may have a signature bird nest hair-style.

Can a veterinary surgeon'ss spay scar identify his work? Well, not really as there are not many ways to make a spay incision but the location of the incision can be a signature surgery for each veterinarian as he or she prefers a certain spot to incise the skin.       

Case 2. To Spay A Cat with Fleas or Not?
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case recorded: Sunday, November 4, 2007

It is a hard decision. Some flea dirt on the face. An active flea seen clearly against the white hairs of the back of the leg speeding faster than sound and so was not caught.

If the cat is sent back to be defleaed, it costs the owner time and money. Few owners appreciate this procedure. The caterwauling cat continued to make lots of noises, offending neighbours in the HDB apartments and stopping the owner and family members from having a good sleep.

There was only one flea seen. About 4 mm long and very highly mobile. Singapore cats still have fleas but rarely are they seen in domestic cats housed at home. So, it was a puzzle to me why this cat had some fleas. It was possible that she was allowed freedom outside the house and had contacted fleas from other cats.

My decision was to spay her as Singaporeans are living in a time-pressed world where the cost of living shoots up every year. Another increase in the electronic road pricing rates. Some increase in bus fares. Of course, salaries of civil servants are also increased. The private sector employees in the lower ranks, such as cleaners, do not seem to benefit from the economic boom as there is massive underpricing of fees from contractors.

I don't know the earning power of the cat owner. The cat was brought in for spaying. If there are too many fleas, I would stop the spay. This would be negligent. What if one flea hop into the incision and contaminate the inside of the cat?

This was a clean cat, except for some flea dirt on the face and the only flea I saw at her backside. It was not possible to catch this flea as it had bolted inside the coat. Such a small cat yet it is not that easy to catch a single flea. After spaying, the flea re-appeared and I caught it.

On camera.

I was taking picture of the swollen ovaries and uterine horns for research. The owner had got rid of most of the fleas before sending in the cat for spay. For practical purposes, it is best to spay a cat with one or two fleas to prevent breeding of unwanted kittens. Waiting another day may mean a litter of unwanted kittens being born and homeless.  Therefore, I spayed the cat after making sure that there were not many fleas hopping about the body.