Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

CASE 1.  THE UNDESCENDED TESTICLE

 

This Maltese looked healthy. Solid body. Good weight. He was much loved by the couple in their late 30s. We could spend lots of time talking about him just as parents loved to talk about their children if the world cares to hear.

"How was he toilet-trained?" I asked as this Maltese lapped up all attention. This was a case of paper-training in a confined playpen which could not be unhinged. The playpen had a door unlike most playpens sold at Singapore's pet shops. The newspapered floor area was 100% at first. Gradually, the papers covered only a corner where the Maltese eliminated. The Maltese was given commands and praises to use the papers.

"How long does it take to paper-train him?" I asked.

"We can't remember. It was 3 years ago. It took a few weeks" the wife said. Working couples take longer to paper-train a puppy as they don't have full-time attention to do it. 

The Maltese was coming in for neuter. Although not all undescended testicles become cancerous during old age, the owners heeded my advice to get the undescended testicle removed. Just in case they are not aware of the growth of the hidden under the skin undescended left testicle in later years.

As the dog grows older, the owners tend to be busier. They are not aware of the cancerous growth of the undescended testicle hidden under the skin as there are no signs and symptoms of illness from the dog. Most owners do not check the cancerous size of undescended testicles as they are well tucked under the skin. The cancerous testicle grows hidden under the skin. It becomes discoloured with the cancerous cells rotting over the passage of time. It can be big as a hen's egg in aged dogs but are not obvious as owners seldom check the belly of the dog.     

I thought this would be a simple routine neuter. What is so difficult about neutering a docile Maltese that never bites and that looks as strong as any Maltese can be?  Gas mask 8% knocked him down fast. He was not the aggressive type so it was much easier to anaesthesize him.

I put in the endotracheal tube to connect the gas to his lungs as is my normal routine. It is best to intubate all dogs I always advise young vets. In this case, the dog stopped breathing and the tube could deliver emergency oxygen if required.

General anaesthesia using gas without tranquilisation in some quiet dogs is the safest method of anaesthesia	Undescended testicle (X) is much smaller than the normal one. It tends to become cancerous but not all undescended ones will become cancerous during old age
Plaster covers skin incision. Take it out 10 days later. Normally, the dog does not bother with it. Stitches will dissolve in 21-35 days. The dog normally eats 24 hours after surgery and not disturb his  skin incision in 99% of neuter cases at Toa Payoh Vets

Anaesthetic complications do happen and intubation is important just in case of emergency. In this routine neuter case, the gas mask would do. But it is hard to predict which dog will stop breathing. I would expect this Maltese to take gas mask anaesthesia with no problem. But he did stop breathing for a few seconds. Emergency cardiac massage to get the blood flowing and temporary removal of the gas revived this beloved dog.  

The dog recovered well and the owners were most happy. Their e-collar was loose and had to be fitted so that the dog would not pull it out of the neck and lick his skin incision. Pain-killers were given. Just in case the dog licks the wound due to pain and irritation.  Removal of the undescended testicle is a simple surgery when it is not cancerous. When it is cancerous, the dog is usually quite old and there are high anaesthetic risks in the surgery.
 

CASE 2.  THE UNDESCENDED TESTICLE

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