1. The Internet Grandmother

"Flies just would not go away when I swat them," the 65-year-old grandmother with a fair 5-year-old grandson came to the surgery. She was surprised at the tenacity of flies: "They just stick onto the dog's vaginal discharge."

This was not good news. Flies are attracted to decaying flesh. The 12-year-old Golden Retriever had some vaginal discharge 2 months ago. Recently she passed out thick glue-like mucus from her vagina. She stopped eating for 2 days and had vomited.

"Your dog had a severe womb infection. She vomited because toxins could have damaged her kidneys and internal organs, " I did not give much hope of survival for this dog. "Why didn't you spay the dog after the breast tumour operation?" My past procedure was to remove the breast tumour and get the dog spayed so that the female hormones feeding any new breast tumour would not be available after removal of the ovaries and uterus.

The slim and fair grandmother laughed: "You said that the dog would not survive 9 months. That there was no point getting the dog spayed. Her breast cancer was as large as a tennis ball!"

I checked my records. It was September 2005 when the large tumour was removed and nothing was heard from the grandmother. The dog had a small breast growth but nothing outstanding. It was now June 2007 and my 'prediction' of 9 months' life had been way off the mark. Why would I give a definite 9 months, I cannot remember. Why not 3 months or any other number? No vet can foresee the future. But I did not argue.

Now the dog was very sick. She had fever of 40.5 degrees C. She was not eating. She yelled in protest of great pain when I stretched her legs to see the long 15-cm scar of the tennis-ball-sized breast lump. The dog survived the surgery. But now, she was in poor health. If flies just zero into her vaginal discharge, it indicated that her womb tissues had rotted. Flies are not interested in less smelly tissues.

The grandmother understood the big risk in surgery. I boarded the dog one day to give her antibiotics, anti-fever and drips. She felt good the 24 hours later and ate a full meal. Now I had to decide. To operate 36 hours after admission or wait another day? The infected womb might rupture anytime as it was decaying. Her temperature had dropped to 37.5 degrees C, one degree below normal.

The dog was given just gas anaesthesia and intubated. Her large thin-walled uterus and ovaries were removed.

She survived the surgery done at noon. Before waking up, she vomited a big mass of food on the operating table after I had taken out the endotracheal tube. This was an abnormal event as she had been starved >12 hours prior to surgery and should not vomit anything. Another abnormal feature was the dark bluish black blood of her omental blood vessels. Normally they would be reddish.

I asked the grandmother to come to see the dog after surgery at around 3 p.m as I had a bad feeling that this dog would not make it. However her two sons needed her at the airport - one going abroad and one returning. At 7 p.m, the Golden Retriever just passed away due to heart failure. Her gums and tongue were cyanotic. The grandmother and her grandson came around midnight to see the dog. This dog was family.

5 days later, the grandmother came to pay the bills. We reminisced. Grandmother said that the dog behaved strangely the night before going to the vet. The dog went to the back garden to stroll. She also went to the daughter's bedroom to sit till the daughter gave her a second piece of Pokey biscuit. "Mommy will scold me," the daughter told the dog. But the dog would not go away till she got a second Pokey biscuit strip.

Was the dog saying good-bye to the family? It is hard to explain divine happening. Grandmother said to me: "My grandson keeps asking when Jesus will bring Joy back." Would spaying her when she was younger prevent pyometra and prolong her life? Without the womb, she would not have pyometra and therefore would live to a ripe old age of another year or two? It is hard to say. Anaesthesia in dogs older than 8 years are high risk.

No vet can be assured of 100% survival in such cases. Sometimes it is best to pass such high risk cases to other vets. The daughter still grieved her loss. Grandmother was stoic in my presence. This dog was adopted as a puppy when there was a newspaper advertisement. She saw the advertisement when the newspapers were delivered at 5 am, instead of at 7 am 12 years ago. She went with her two sons to adopt this dog.

At one time she had 8 dogs dumped onto her house from friends who asked her to rehome them. She had to manage 3 children. Not much time for herself. At 65 years of age, she looked much younger than a 55-year-old.

"I cured one terrapin with enlarged closed eyes just by researching the internet," the grandmother said to me. That was great news. Most Singapore women of her age would not touch the computer.

"I can remember important dates and do calculations fast," the grandmother said to me. "I would tell my children the price per kg for things they bought. But lately, I am not able to remember so well. I can't stay long to chat. I have to go to Hong Kong."

"Why do you have to rush to Hong Kong?" I asked.

"To look after my grandson for a week." she said. All grandsons must surely love her vey much.