Green Cross Vet Hospital Macau

Minimal invasive procedures : endoscopy to retrieve the tip of a tablet introducer inside the stomach of a cat.
We have lost count of how many times we had to retrieve this tips from cats stomach.
Please be careful, only use new tablete introducers , dispose old ones and always make sure the tip is well attached. If you can, please avoid them

Triple drainage.
Bebe produces large quantities of fluid in the thorax and in the abdomen.
to quickly remove it , we placed 4-5 weeks ago ,bilateral pleural ports and this week we had to place a mila abdominal catheter to drain the abdomen.
Without removing the fluid weekly ,bebe would die and and with these catheter’s in place we can in 4 minutes drain all 3 cavities which would probably take more than one hour with normal draining. This is also pain free compared with normal drainage

Large squamous cell carcinoma (SCC) on the forehead ( frontal sinus ) of a dog. This type of tumor is a very agressive type of tumor and caries a poor prognosis. The best form of treatment is to combine agressive surgery and radiation therapy.
In this case ,the tumor had already eroded the frontal / orbital bone so we had to remove the right frontal and orbital bones and enucleation. To close the defect we made and advancement flap.
Surgery is just part of treatment so , the dog is going to shanghai to perform the second stage of treatment ( radiation therapy)
Very demanding and interesting case.

Placement of a permanent abdominal mila catheter to drain a chronic abdominal effusion caused by severe right heart disease ( severe tricuspid regurgitation)

Little poodle with a large right adrenal mass. For the moment will monitor the situation and if in the future the dog starts to show clinical signs related to the enlargement gland , will perform an adrenalectomy

Ct 3D rendering image of a cat with large mandibular lymph nodes. Biopsy revealed a necrotising lymph node , the nodule
Was surgically removed

Laparoscopic cat spay , 2.5 kg body weight.

Toffee , the definition of perseverance, survival, belief.
A couple of months ago , toffee started to develop a “ round appearance shape belly” which turned out to be accumulation of a vast amount of fluid in the abdomen.
To understand what was the cause of this massive amount of fluid we performed a contrast study CT exam and it revealed a very complex case of multiple extrahepatic abnormal blood vessels ( shunts ) and a portal vein obstruction. Since there was not a solution to stop this abnormal production of fluid ( neither medically or surgical), we decided that to extend toffee’s life we had to find a way to constantly drain the abnormal fluid.
We then , placed a permanent mila catheter attached to a reservoir bag that toffee caries all the time ( like a backpack).
Nowadays toffee is doing great, weight is back to normal , eating well and leaving comfortably with the new system.

Surgical excision of a skin mass in the ear of a dog. In this case it was not performed wide safety margins because the ulcerated mass was benign.

Large retro pharyngeal lymph node cyst removed surgically.
The dog presented severe pain and swelling in the neck region. Ct confirmed only an abnormal structure ( medial retro pharyngeal lymph node ) and fna was inconclusive ( just necrotic cells ). We followed up with surgery to remove the lymph node and biopsies are pending. A jackson pratt suction drain was placed for 36 hours to drain any fluid accumulation caused by the dead space created by removing the large node.
Gigu is pain free and will be discharged tomorrow

Follow up on the dog we placed bilateral pleural ports to treat chronic pleural effusion. 4 weeks ago we placed the subcutaneous ports and we have been draining the chest once a week. The dog is doing extremely well and from the video it’s visible how comfortable and relaxed he is during the procedure that only takes a few minutes

Last evening emergency surgery: pyometra in a dog

Hip toggle procedure in a dog with a coxo- femoral hip luxation. We placed a prosthetic ligament to mimic the rupture coxo - femoral ligament. This dog could not place the leg on the ground before the procedure and just 48 hours after surgery this dog is almost waking normal.

Linear foreign body in a cat.

Large liver tumor successfully removed in a corgi dog named iggy.
Dog is currently doing very well, already at home.
It was an open surgery procedure with help of videoendoscopy using a VITOM system

Ct of a dog that had mammary tumours which spread to the lungs and brain

Ding Ding , little kitten saved and rescued from
The street with a wound/ fracture of the head of the femur. the kitten was also suffering from severe blood loss and a lung infection. To save the kitten we performed two blood transfusions and 4 weeks on antibiotics. The fracture femoral head started to become a permanent source of infection, creating an internal abscess deep in the muscles of the leg / with a purulent discharge. Surgery was then performed to remove the fragment which already had migrated quite considerable. Cat made an uneventful recovery

Bilateral pleural port placement in a dog with chronic pleural effusion.
Pleural ports are devices that are placed under the skin and stay permanently so we can drain abnormal fluid from chest of dogs and cats. The advantage of placing these ports compared with draining with a needle is that every single time we drain the chest , we don’t take a risk of laceration the lung or heart when placing a needle, its much faster and more comfortable. The dog stays in a normal standing position without even noticing we are doing the procedure.

Possible case for placing a urethral stent in a female dog with a Bladder / urethra mass.

We received a challenging case last night of a dog with blood in the urine. On ultrasound it was confirmed a very large bladder mass which had been previously checked by other clinics.
This morning we decided to perform a biopsy under endoscopic guidance and at the same time perform a contrast study using radiography / ultrasonography.

Bladder cancer is common condition in dogs. It can cause clinical signs such as :blood in the urine, difficulty in urination / frequent urination and even urine blockage.

In cases were the mass causes a severe blockage of the urine flow , we can order a an urethral stent to dilate the urethra and allow the dog to urinate.

To place an uretral stent is of upmost importance to measure the size of tumor, the length of the obstruction and the normal size of the urethra.

After having the measurements we can order the perfect size stent from the united states.

Ha mui , 1 year ago ,removed a very large liver tumor . Yesterday came for a check up and all is well. Cancer free

Male dog with urethral urinary stones.
Today we had a difficult surgery, a male dog with multiple urinary stones , which some of them were deeply stuck in the pe**le urethra.
In the beginning it was literally impossible to pass an urinary catheter ove the stones or flush them backwards. The only way we managed to dislodge them was to place a very small wiggly wire around the stones and slowly dislodge them one by one. After the stones were back in the bladder we removed them with a Dakota urinary stone basket.
All stones were removed and dog is back to normal urination

Bladder mass / bladder stones removed surgically in a male dog

Linea alba , abdominal hernia repair in a dog

They deserve a better spay
Female cat laparoscopic spay surgery. Less invasive, less pain, better recovery

Emergency thoracotomy in a cat.
We received a late night referral from other clinic with a cat with a suspected diaphragmatic hernia.
The ultrasound images were not conclusive and there was an abnormal image on the left thorax with a large amount of thick fluid surrounded by what possibly could be a capsule.
The cat was stabilised in our iuc however its condition deteriorated and a few hours later its Respiratory rate was over ( 100 breaths per minute) and presented mouth breathing.
With this in mind we decided to perform emergency surgery. With the cat under assisted ventilation, we first performed an exploratory laparotomy to rule out any hernia ( which he didn’t have) and then an exploratory left thoracotomy was performed. The thorax was drained , lavage , and samples were taken for further analysis. A mila catheter was placed for continuous drainage and the cat made an uneventful recovery.
Soon after surgery its respiratory rate went back to normal ( 22 breaths per minute) and 24 hours kater the cat was eating.