Max's First Surgery

Our fur baby, Max, is an 11 year old border collie.

Something awry

Our helper told us in the afternoon that Max had thrown up, and later on updated us that he didn’t appear able to pee. Of course, we were at work so we couldn’t just drop everything and rush home to see for ourselves. We asked her just to avoid giving him snacks and not to engage in too vigorous play.

Rushing Maxie to the vet

We got home pretty late, like about 10PM. It turned out he hadn’t been eating, and he was just letting out occasional growls as if he were in pain. Our helper noted that his hind side seemed to be enlarged, like a large lump. We figured something was blocked, especially since he had been trickling pee.

We realised that he couldn’t seem to sit or lie down for very long. He’d lie down or sit down for less than a minute before getting up slowly and walking around slowly and miserably. He just wasn’t himself and he was definitely bothered by something!

It was about 11PM so we had to turn to 24hr vets. We Googled and called based on a couple of family recommendations and also Google reviews. Being wayyyy after hours, all the clinics had at most 1 vet on duty. All of those we called were busy with surgery!

After almost an hour of stress and periodic repeated calling (yes, it must’ve been annoying to the vet tech on duty but we aren’t taking any chances here), we managed to get an affirmative answer that someone would be available to for consultation.

Just as we arrived at Veterinary Emergency and Specialty Hospital (VES), someone from another vet we had bothered earlier called me back. He was from Stars Veterinary Clinic (Stars) and asked how our dog was and that they were available now. I told him we were good and we’d found someone but thanks so much.

The consultation

The vet tech brought Max into the treatment rooms for a check while we waited in the waiting room. After about 10 minutes, the vet came out to talk to us about Max.

It turned out that his urinary tract was blocked! The lump we had felt was his bladder - hella full and engorged. Dr James Blanshard gave us a thorough briefing on the background, the issue at hand, and the future possibilities. I really liked how he was clear and matter-of-fact while still making us feel like he really cared about Max and he knew his shit. He was also rather full-disclosure in a way that made us believe we were making informed decisions, as opposed to having decisions thrust upon us because “IN CASE” as many other vets do.

The most likely issue was that Max had bladder stone(s) that travelled into his urethra and got stuck. If the stones don’t move, you’d need surgery and a catheter - it would be an emergency. Dr James said we were lucky to have come at that time because if we had waited a few more hours, Max’s bladder would likely have burst and then we’d have a really dire situation on our hands.

The alternative cause was that it was a mass effect, like some part of the tissue became a mass and just blocked it. However, this is extremely rare (see, full disclosure!).

Dr James said that we only realise there’s a problem when it’s at a pretty bad stage as it’s likely to have gone on longer than you’d think. The dog would just try to manage and we wouldn’t know any better! It is also possible that the blockage causes back pressure to the kidneys and causes damage to the kidneys which thereby results in high potassium levels, heart problems, and a whole slew of other shit. I found this remarkably similar to human kidney stones, eh?

At this point, he was telling us that right now he would need to stabilise Max but they’re generally not great anaesthetic candidates (imbalance of electrolytes, etc.) and we don’t have the luxury of time to get them in better shape first (e.g. diet change).

First things first, we need to unblock the bladder. Max would need to be anaesthetised, put in a catheter and flush it out. No surgery can be done for removal of stones (if that was indeed the cause) without first getting all that backed up pee out. It is possible to kind of puncture the bladder to get it out directly, but at this point Max’s bladder was way too big so that pressure would be nasty.

Max needed to stay the night so they could do the draining and assessment of the problem. Dr James was upfront that the stone removal process is like the bread and butter for vets, and that we could go to our own vet if we have one we are familiar with and it would also probably be cheaper (since these guys are specialists). This process of bladder release and the stone removal process was estimated to be about S$2-2.5k including the first 24 hours of care. They’d have a specialist for the ultrasound to see, once unblocked, if any stones were there at all. They would also have to check if any damage had been caused to the urethra, the bladder, or the kidneys. Hopefully the stone wasn’t too big and was easy to remove. If it were a tissue mass instead, that would incur additional charges.

We were given the consent form and Dr James iterated and reiterated that it’s important we read the disclaimers, and he even verbally highlighted the potential risks and the important things we can choose to consent to (like CPR if anything goes wrong) regardless of how small the risk. Max is an old dog so the risk of surgery is, of course, higher than if he were a puppy.

I really liked this place because they assured us that they would call us as soon as possible once the bladder was relieved. They let us see where Max would be kept and answered any questions we had. Max was anxious to escape and was gently pawing at the glass door as we were leaving - which was absolutely adorable and sad at the same time.

So much was going on at the clinic, by the way. Who knew vets would be so busy in the middle of the night? There was a blood transfusion going on and a puppy that was crashing. 1 vet to help them all. There were like 4 vet techs, though, to be fair.

As we were leaving in the car, Stars called again! He bothered to check up on how our dog was doing again and I updated him he was just glad that we found someone and wished us well. Lovely.

By the time we got home it was about 2:30AM.

The bladder is free!

As promised, we received a call from VES a few hours later. Everything went smoothly and Max was a good boy. No issues other than that the bladder was a little bruised from the pressure.

Then came the discussion on removing the stones. This was where there would be actual cutting up and suturing. There would be a small hole into which they put a long spoon-thing to scoop out all the sediments and stuff, too. Of course we said, “please, go ahead!”

The stones are free!

They had some other things to do, so they only called back at about lunch time or just before. This time it was Dr Francois.

They brought in a specialist pet anaestheticist to do the deed and monitor. Wew, this is what we pay for.

The stones were relatively easy to remove - not too big but also not very small. So they were just that size where you could leave ‘em in but it would almost definitely become a recurring problem. There was some mention of a balloon catheter or some device that sounded like a balloon catheter.

Max was strong and a good boy! Dr Francois, in his glorious French accent, said that Max was “alert, always watching.” When we got off the phone we joked that Max was planning his escape.

The next step was to allow Max to recover, and to analyse the stones. Dr Francois offered a biopsy on the stones just to rule out cancer. He said it was totally optional, and the risk was low, but the option is out there for an extra $50. What’s $50 for peace of mind, especially in the grand scheme of several thousands of dollars?

Visiting Maxie

We went down to see Max in the early evening. He was wearing a cone, his tail was wrapped, and there was of course bandages around his crotch area. He was on a drip, but was still active! He was partially just trying to escape by darting through gaps between our bodies (lol) but otherwise was just a lovely and active and excited boy.

Unfortunately, he hadn’t been eating. They did give him chicken which he didn’t eat (which he wasn’t supposed to eat anyway as it causes his skin to act up, so I guess a blessing in disguise). We did bring some soft foods (boiled down rice and a bit of his soft dog food) for him so we passed that to the vet tech and told them about chicken.

This time, as we left, he was calmer. He just flattened his body into his suckling pig position and watched us silently. ):

We’re bringing Maxie back!

Max stayed for another night, and we just waited for them to call us to tell us when Max would be ready for us to bring home. We went to pick him up after work today and he was so happy to see us!

Apparently Max was the vet techs’ favourite and they kept playing with him, and they even took him for a walk! Yes, yes, Maxie the goodest boy!

We had antibiotics (2x a day, pills) and an anti-inflammatory (1x a day, 1ml syringe liquid). It’s paramount that the anti-inflammatory is taken with or after food or else it could cause gastrointestinal issues. The nurse showed us how they administer it and Max was, of course, squirmy af.

We are to return to the vet for a follow up in 10 days. Until then, we should watch for any symptoms of pain or infection. These include atypical lethargy, rapid breathing, coughing, and not eating/drinking. Another thing was that given the surgery, it would be normal to see some blood in his pee, but it should only be a little bit and it should not be fresh blood. And, of course, if he has trouble peeing that’s a clear problem.

We can remove the plaster on his wound tomorrow evening. We got to bring him home with the cone since he’s not supposed to lick the wound, as dogs would tend to do. We should also watch for any discharge or redness/swelling at the wound site. Max also should not be jumping or climbing stairs since it may tear the sutures. His movements should be limited for about 3 weeks. We also should not bathe him for 3 weeks.

We are so happy to have Max home with us again! The house just felt so empty without him.

The total vet bill came up to about S$6k. We did not have pet insurance (even then, only one provider covered surgery and only up to S$2.5k with 30-40% co-paid) so that burnt a hole. As if the holiday period didn’t start enough pocket fires! But it’s okay, our goodest boy Max is home and safe.

Hopefully this can help some of you dog owners understand what may be going on with your dog if they’re showing the same signs of distress. This was pretty enlightening for us and overall I am just really glad it was a ‘routine’ procedure rather than the beginning of the end.