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CHEAP AND GREEN
VETERINARY SERVICES
RABBIT LIMB ABSCESSES
Dr Sing Kong Yuen,
BVMS (Glasgow), MRCVS
First written:
28 January, 2010
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0127
"How much do you charge to neuter
a stray cat?" the woman, probably
over 40 years old phoned me
yesterday. "You had operated on
some of my stray cats before."
I quoted her a fee lower than my
usual charges. She phoned later
after checking out the other vets
and said, "Will you be using
anaesthetic for the neuter? I want
my cat to be operated under
anaesthesia." Providing
cheap vet services raise doubts
about the veterinarian's ethics
and morals. "I use anaesthetic to
neuter the stray cat," I said to
the woman. "It is not possible to
neuter a cat and it is very
painful for the cat." I
don't subscribe to some practices
in other countries where the cat
or dog is held by force for
surgery. Or during the old days
where people are operated without
anaesthesia.
A cheap and good vet. That is what
many Singaporeans want. The
cheaper the vet, the busier he is.
He must be a good vet since he is
busy. This is the Singaporean
mindset: The longer the queue at
the hawker stall, the better is
the hawker's quality of cooking.
Unfortunately, cheap and good
seldom applies to medicine and
surgery that require more
extensive treatment.
I illustrate 2 similar cases of
rabbit limb abscesses below and
their outcome. Some history is
written in:
In the first rabbit, I presumed
that, in this competitive
veterinary industry, there was a desire to provide
an affordable vet service and
obtain the loyalty of
the rabbit owner. The vet lanced the
abscess and gave a cream to be
applied. Lancing the abscesses to
get out the pus would do in many
cases of abscesses in the dog and
cat. However, in this
rabbit, the abscess persisted and
the cream was applied for a long
time.
So, how should I treat such cases?
As if the Divine Powers were
challenging me, the
10-year-old rabbit was presented
to me some 3 days later. It must
be a coincidence if you are
scientific.
I handled
this case differently. Lancing the
abscesses was part and parcel of
the standard treatment. However, I
had the rabbit under general
anaesthesia of more than 20
minutes as I needed a
much longer time to irrigate and
flush away the pus.
I removed as much of the capsule
of one of the two encapsulated
abscesses as possible. Pus from
the other side leaked as you can
see from one of the pictures.
I made a much longer skin incision
to clear the pus and bacteria
lingered in the recesses of the
big abscesses. The wound was more
than 3 cm long and on both sides
of the leg. I stitched to close
the big hole with 4/0 nylon
interrupted sutures. Absorbable
sutures might encourage bacterial
infection into the wound and
therefore I did not use them.
At home, I followed up with phone
calls. Apparently, the rabbit did
not bother with the wound. "Just
licked it," the father reported.
Mum had delegated the nursing to
the father and son.
"Buy a bandage that can self
adhere, at the pharmacy and cover
the stitches," I advised over the
phone. The owner got the leg
bandaged effectively but it was
not the type of bandage I
recommended. But it did the job.
Pain-killers given to the rabbit
for 7 days prevented attacks on
the wounds.
I 14 days later, the father phoned
me and really came back for stitch
removal unlike some owners who
ignored medical advices (to save
money).
The anaesthetic and surgical cost was much higher
at over $300 compared to less than
$50 in just lancing the abscess,
squeezing out the pus. Was the
extra cost worth it? The outcome and cosmetic results
were satisfactory for the owner.
Most important of all, the rabbit
would not continue licking and
biting the foot.
CASE
OF THE FIRST RABBIT.
For many months, the cream
was applied to the big
swelling in the foot. Now,
the skin is bald and the
problem of abscessation
still persists. The thinning
of the skin could be the
effect of the
anti-inflammatory wound
applied
for a very long time. Owners
must seek second or third
opinions when abscesses do
not heal as many
abscesses do heal with
ordinary lancing unlike the
case of the second rabbit
described below.
CASE
OF THE SECOND RABBIT.
The boy who is now a young adult
was permitted one rabbit as a pet.
I had not seen him once only some
7 years ago. His father contacted
me when the rabbit developed a
large swelling on his hind limb.
It was a pure coincidence as I had
just seen a rabbit with a similar
leg abscess problem. What should I
do to cure this second rabbit once
and for all? Owners don't like
repeated treatments. Was it
possible to resolve this rabbit's
problems at one visit? The answer
is yes. The costs would be treble.
CASE OF THE SECOND
RABBIT. 14 DAYS LATER
I performed a very thorough
removal of the pus. The father was
warned that the rabbit could die
on the operating table as he was
really at the end of his life
span. Rabbits live up to 10 years
and this rabbit was 10 years old.
The father phoned his son to
inform him. But the son did not
answer the phone. So, the father
granted the permission to operate.
More pictures
of the surgery are at:
14 days later, the father came to
get the rabbit's stitches removed.
I gave him an
anti-inflammatory cream to
be applied strictly for 7
days only as the stitch
wounds looked inflamed. I
seldom do that but this was
an exceptional case as I was
worried that the rabbit
might attack the wound.
Owners want the rabbit to
look normal and prefer not
to have to apply cream for a
long time. Some of my owners
do come for cream and do
not bring in their dogs for
review despite being advised.
The pet's welfare
depends much on the
education and sophistication
of the pet owner as pets
can't complain. They can
scratch but if the owner
ignores such scratching but
applies cream, that is the
reality of life and the vet
can't do much for the pet.
Many owners of rabbits all over
the world, and not in Singapore want "cheap and green"
veterinary services. A veteran
salesman always used
this favourite phase regarding Singapore's
pet owners with skin diseases.
They want "cheap and green" vet
services.
Economics and competition dictate
the reality of the private
practice.
This "cheap and green" phrase is
the Chinese Hokkien dialect
equivalent of "cheap and good".
In some skin disease cases and
rabbit abscessation, it is just
not possible to provide such
services to achieve a satisfactory
outcome.
This must be
communicated effectively to the
prospective client. If it is not
possible to provide a sustainable
profitable
service, it is best to reject the
client or the dog breeder. It just
does not make economic sense to
provide below-cost services as the
vet will go bankrupt one day or
will be unable to upgrade his
facilities. The laws of the
concrete jungle are as harsh as
the laws of the natural jungle in
the survival of a business.
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Be Kind To Pets
Veterinary Education
Project 2010-0127
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PAYOH VETS
