Reflections on Ah Miao’s case of complications arising from medical procedures

Ah Miao was brought in for a routine spaying procedure yesterday, but it ended up as an emergency where she almost lost her life.

Upon administration of the general anaesthesia, Ah Miao started heaving for breath and stopped breathing. The surgery was immediately aborted but she still stopped breathing a total of three times while being on the table.

When she finally woke up, her breathing was still laboured. Ah Miao was discharged later, after hours, so that she could recuperate at home (there is no monitoring at the vet’s). The vet expected her to recover in a few days.

Last night, we helped the caregivers monitor Ah Miao’s breathing through videos. We consulted our vet and was advised that Ah Miao be sent for emergency if her breathing does not improve.

As I write this now, one of the caregivers is driving Ah Miao to our vet for oxygen supplementation.

Yesterday’s vet explained that sometimes, there are underlying problems which even the most sophisticated and modern instruments cannot detect. It only surfaces when a medical procedure is done. Reactions could be due to an unexpected allergy to medication or undetected underlying health problems already present in the animal.

Vets normally will use the stethoscope to listen to the heart and lungs, and do a physical examination before the neutering procedure. It is of great importance that the caregiver also gives the vet a detailed history of the animal too. But many street animals have lived a life on the street before they are rescued, so that part of the history is not available.

So, we take a chance. We weigh the odds, take all possible precautions and do it because neutering is important.

In all our 15 years of giving aid for neutering, we have not encountered such a case as Ah Miao’s before but we are aware of such risks. The vet yesterday said he had encountered one before and the kitten did not make it despite the best efforts of the vet. Post-mortem investigation showed that the kitten actually had a diaphragmatic hernia. So the vet suspects that Ah Miao may also have one, undetected, with no symptoms before this.

Long ago, when we first started and had panel vets, one of our senior vets had already told me, from his vast experience in his practice and at the university, that animals can die from general anaesthesia and in very rare cases, even vaccination and deworming. Hence, all medical procedures carry risks.

I remember during the days where I accompanied every case to our panel vet, one lady was seeking our help to get her seemingly healthy street dog castrated. But it was at our panel vet, so our vet had to explain all possible reactions to her (that was his SOP). He wrote a long list and it ended with “death from GA”. The poor lady broke into tears and I had to comfort her and eventually ask her daughter to take her home while I waited for the castration procedure of her dog at the clinic. Nothing untoward happened. Her dog was successfully neutered, got up and all was well. Only then did I call her to come collect her dog.

I’ve been so used to this particular vet back in the day because he was my personal vet too. So, I am aware of risks and that is why even up till today, I get all jittery whenever any of my cats have to go for any medical procedure. I know that anything can happen.

Yesterday’s vet is also a very senior vet whom I trust. He too repeated, “anything can happen” when medical procedures are done. In his words:

With the advance of science and technology, we are now able to do a lot of tests and screenings to find out any abnormalities. But there are still parts of body that science n tech do not know. All the positive results from tests and screening does not mean it is 100% safe.

And he is absolutely right.

The same goes to humans too.  Many decades ago, I went for my first Hepatitis-B vaccine. As you all know, it’s so safe that it is given to babies too. The moment the GP jabbed the vaccine into me, I went into anaphylactic shock. An anaphylactic shock is the strongest allergic reaction in the body. Anaphylaxis causes the immune system to release a flood of chemicals that can cause a person to go into shock — blood pressure drops suddenly and the airways narrow, blocking breathing and it can result in death if not treated immediately.

Luckily the GP quickly gave me an adrenalin jab and I was revived. I could have died that day too, if not for the quick actions of the GP. When I came to, the GP’s overalls were covered in spatters of blood. He must have panicked and jabbed himself as well.

Who would have expected this type of reaction from such a safe vaccine?  He had to report the case and apparently, this was the first case in Malaysia.

So yes, I am personally very aware of the risk of any medical procedure. Even for my Covid-19 vaccine, I could only be given the Sinovac and nothing else, and it was done by a doctor at a hospital. For any procedure at the hospital, I tell the doctor my medical history and if jabs are needed, I ask the doctor if they have adrenalin.

This is what we need to do for everyone of the animals under our care. Please compile their medical history in writing and give it to the vet (if it’s a new vet). This practice is very, very important.

I keep all our cats’ medical record in my gmail box so that I can access it from my phone as well. It contains dates, procedures done, medication given, etc.

Nomi and Ah Miao, both on oxygen now, at the vet’s.

Get well soon, both!!


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