Wednesday, July 1, 2015

2481. Profuse bloody vaginal discharge - 10-year-old Cocker Spaniel




Jul 1, 2015

"She has a bad life," the lady owner visited the sleepy old cocker spaniel at 7 pm. "She had 3 surgeries - first for a durian seed in her stomach and twice for breast tumours!"

After swallowing the durian during the time the family was feasting on durians, the dog developed diarrhoea and vomiting. A vet operated to remove the seed.  Just around 2 years ago, the dog had a gigantic breast tumour, bigger than mangoes, excised by Dr Daniel and I.

This case was documented at:
http://www.asiahomes.com/book2/20150521mammary_adenomas_breast_tumours_dogs.htm









"Why didn't you spay the dog?" I asked.
"You did advise and remind me, but the dog is so old. She would be getting menopause and so no more breast tumours."
"Dogs do still pass blood during heat even at an old age of 15 years in some cases," I said.

Then around June 16, the dog had heat and passed blood for a few days. Nothing after that. Then, on Jun 29, blood kept gushing out, as if a dam had burst.

On Jun 30, 2015, the dog was rushed to Toa Payoh Vets. "She was soiling the apartment. She licked and vomited her discharge!"


Tuesday, June 30, 2015

2480. Professionalism in veterinary surgery - video - rat mastectomy

June 30, 2015

Today, I spent much time discussing "Professionalism in veterinary surgeon" with Intern Ms Poh, intern who is  in her first year of animal health studies in Melbourne University. The veterinary degree is a second degree in this University.

PROFESSIONALISM IN VETERINARY SURGERY.
To prepare a video. She had to do her research and produced a report. Finally, I gave her a flow chart with the main subheadings as follows:




1. Hook  - An old rat with large breast tumours. To operate or not?

2. Theme.  BKTP - Professionalism in Veterinary Surgery

3. Pre-op
Correct diagnosis
Client education - Financial costs of op
Health screening costs  (blood tests, x-rays, urine tests, ultrasound)
Informed consent form signed. Old rat - high risks



4. Op
Correct treatment - surgical excision rather than drugs and painkillers
Referral to other experienced vets
Aseptic surgery
Ligation of the caudal superficial epigastric artery and vein. Less than 3 mm across in the rat unlike in the dog. Bleeding continuously if cut off without ligation.

No major nerves resected in this location

SAC  
Speed  - Knowledge of vet anatomy, skills and experience. Focus - no cracking of jokes.
Accuracy - Ensure correct tissues removed, blood vessels ligated
Completeness - all the tumours excised. 1-inch margin around tumour ideal but no practical in the rat.

No distractions during anaesthesia and surgery by cracking jokes.


5. Post op.
Painkillers and antibiotics
Histology report advised
Post-op complications - bleeding, infection, stitch breakdown, pain


6. Impact - financial costs, social costs, worries about anaesthetic deaths

7. Conclusion - What happens to this rat?

Credits

Produced by:
Videography by:
Veterinary surgeon operating on the rat: Dr Daniel Sing
For more information:

For more videos:


2479. A new puppy has a swollen belly



Post-purchase vet examination. 
Swollen belly in this beagle just purhased. Worms? Over-eating?
X-rays show fluid in the abdomen. A diagnosis of ascites.

"Can it be cured?" the pre-teen daughter was reluctant to return the puppy to the seller.
"It depends on the cause," Dr Daniel said. "It could be a liver or heart problem."
"You are not fated to keep a puppy," the mother said to her as one of her previous 2 dogs died and the other had to be given away owing to excessive barking.
 

Monday, June 29, 2015

FIC in a female cat?

Jun 30, 2015

One month ago, this cat, FS, 7 years old vomited and was not eating. She  had dysuria and frequent urination.  two strips of hair loss along her flanks and several patches of hair loss around her anal area. This was caused by anal sac abscess. 

Today, she had the same problem of dysuria and frequently going to the litter box to urinate.
Abdominal palpation - no enlarged or painful kidneys. No full or painful bladder. Large cylindrical column of stools in the colon felt.


1. Since young, the cat would drink for 5 minutes when the owner came back from work and switched on the running tap water.  Water bowl water seldom drank. Buy water fountain.

2. Single house-hold cat. No stress from other cats.

3. Litter box changed every 3-4 days. I advised daily picking up of the stools.
4. Litter box fine sand to be changed to paper.

5. Will eat only dry food. Feed feline C/D and observe for 1-3 months. With water fountain, may encourage more water drinking.

6. Foams when given oral medication. Disliked antibiotics.

TREATMENT
1. No urine for urinalysis.
2. Baytril inj.
3. Depo-medro 0.3 ml IM  (50mg/ml)

Will observe for next 1 month.

VIDEO

Friday, June 26, 2015

2477. Travel pics. Milan Airport going home

Jun 27, 2015

Back to Singapore. Felt the humidity here. Jet lag. Went to the tour leader's office to give her a tip. She was not in. Her business depended on referrals not on NATAS expo and advert.


Some memorable incidents are captured in the images.



Getting cash tax refund at the Milan Airport  for buying a Burberry bag in Milan.





A group of Hokkien and Mandarin speaking tourists enjoy picture taking and selfies.





Wednesday, June 24, 2015

2476. Travel pics. Milan

Jul 25, 2015  
Hotel Piacenza Fiera, Italy, Rm 111
facing open patio
At 7 am, will leave for airport for Singapore


Much drama, joy and laughter in this trip


Hokkien and Mandarin speaking group
Vocal minority
Tour leader ticked off for not "waiting" for all
Pregnant local tour guide abandoned us
Italian coach driver fainted from altitude sickness for 5 minutes flat on the grounds of Mt Blanc
One member had nose bleeding and puffy eyes
One member felt nauseous up mountain drive
Sunblock every 2 hours keeps a fair lady fair









Tuesday, June 23, 2015

2475. Travel pics. Foxtown Mall. "WhatsApp stops working" solution

Jun 24, 2015
Arrived MH Hotel Piaxenza Fiera  Rm 111
Big patio outside window. Some worries about security.
Free Wireless needed 10-digit code whereas other hotels needed just email address.
Singles complained that the room was too small - one bed lined against the wall on one side.
"You are all right as the room is bigger for your size," the slim fair lady said to a bigger sized lady friend. Then she hugged her and apologised.

Yesterday, WhatsApp had a message saying "WhatsApp has stopped working" on my Samsung. Fortunately, I googled and there was a solution.

www.fixedbyvonnie.com

How to Fix that stupid “Unfortunately (your app) has stopped.” error on your Galaxy S4
Inside settings, touch the More tab and flip open the Application Manager

Tap it open and touch the Clear data and Clear cache buttons.  This essentially resets the app to its initial state and should resolve the problem for you.

Swipe three screens to the right to open the section that displays ALL apps.  Now scroll down the list until you find your unruly app.

The solution worked for me. I had to confirm from a phone call from Colorado giving me a code. 


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Best to take pic without "objects" growing out of the head or the right ear. 3rd image was photoshopped to remove the driver of the truck. A waste of time. Plan ahead.


 





Foxtown Mall has a big Burberry presence. Yesterday, we had a woman who wore a Burberry scarf at lunch time at the train station in Chamonix. PK warned her that she could be arrested or jailed for wearing fakes in Europe. PK looked at the scarf and I thought she could differentiate the real from the fake. The woman's 23-year-old daughter had presented her this scarf. Was it the original or not? She did not wear it today at Foxtown Mall.