Sunday, March 29, 2015

1157. Kidney disease FLUTD cat passes blood in the urine - follow up

Mar 30, 2015

Cat is eating and drinking a lot. Wet food plus Royal Canin Renal. But he passes blood, the owner phoned today.

1. Stop medication
2. Urine test
3. Switch to dry Renal within 3 days.

The cat has not fully recovered from kidney disease. He went home 2 days ago, meowing and eating a bit of his canned food. Alert.

Bulying in guinea pigs

Mar 30, 2015

Dear Dr Sing

Just to let you know that Mochi is doing well so far after the UTI & diarrhea last month. In fact, she still had blood in her urine after the second visit for diarrhea. I suspected it may be bladder stones so I continued to monitor for a while. Then one day, I discovered some transparent jelly like substance in the litter box...bladder stones? Subsequently no more blood in the urine which brought much relief to me. 

After that couple of weeks of isolation from Mocha, Mochi was so afraid of her when I tried to put them back in the same cage. They were so tensed & nervous that I had to assemble another cage for Mochi. Now they seem happy having their own space.

Mochi used to bully Mocha so Mocha is now more relaxed being alone. Previously, Mochi competed with Mocha for food, water & litter box. She's happy to have everything to herself at present.

Last visit, I promised to send you info on how I assembled the cage for my guinea pigs. Please refer to attachment.

Best regards


Guinea pigs do compete for dominance and space like people. Bullying is quite common but the owner is not aware of it. 


1155. Sunday Mar 29, 2015 Remembering Lee Kuan Yew

I closed Toa Payoh Vets in the rainy afternoon so that the staff can watch the State Funeral possession of Mr Lee Kuan Yew and listen to the 10 eulogies. I feel great sadness as he had done alot for the ordinary Singaporean esp. with undergraduate scholarships given on merit, rather than on favouritism.  In this way, the poor can better themselves if they excel academically.   

Saturday, March 28, 2015

1154. A stray cat trapper in Singapore

Mar 27, 2015

I met a cat activist, a lady in her late 40s,  bringing in stray cats for sterilisation at James Tan Vet Centre. She was washing the metallic cat traps outside. Her black car was a SUV. The seat was packed with carriers, dry cat food and  cat traps.  

"I would have liked to buy a bigger commercial vehicle," she said. "But I don't have a company to register this van."
"You don't need a private limited company to do it," I said. "You can register a sole proprietorship."
"The ROC (Register of Companies) will close it down as I don't make profits."

"I don't think the government will close a private company that is not making profits annually," I said.

"It can be quite costly for the feeders if there is more than one stray cat," she said. She was a volunteer who would trap stray cats if the feeders agree to pay for the petrol costs, sterilisation and hospitalisation fees at the Vet Centre. The Cat Welfare Society had approved her project.

"Over the years, there have been many stray cats trapped and sterilised," I said. "How come there are still stray cats still breeding? " I don't see more than one stray cats in the Toa Payoh housing estates, the hawker centres and the public parks. Some town councils even employ pest controllers to cull them and at one time, the government AVA was active in doing it."

"There are people who dump their pregnant cats," she said.
"How do you know these cats are not really stray cat?"
"They are not feral cats as they behave, being friendly to people," she replied.
"Where do you she find such cats?" I asked.
"In the Kim Chuan industrial parks. I place food inside the cat traps. They are hungry and so enter the traps."

"I notice you have only one type of dry cat food and one colour," I said. "Instead of the multi-coloured pellets."

"Those multi-coloured pellets are too high in salt," she said. "These light brown ones are better." 
"What brand is it?" I asked.
"SAVA brand. You can buy them from any pet shop "
"Where are they made?" I enquired.
"From Thailand. They are good enough for the strays."

She had her career but spent rime trapping stray cats for sterilisation and release if the cat feeders are willing to pay for the costs. .

Friday, March 27, 2015

A guinea pig has sudden onset bloat - clostridial infections?

This 4-year-old male guinea pig was OK the day before but overnight, became lethargic and would not eat. The owner consulted me. I noted a large abdominal distension, esp. the left side. There was gas inside the bloated stomach. The guinea pig was hypothermic at 36C and the gums were pale and cyanotic. I got the X-rays done and released the gas using a 23G needle and 10ml syringe to suck out. The guinea pig felt better. 

The stomach deflated. SC drips plus baytril antibiotics did not help. Around 2 hours later, he passed away.  Toxins from Clostridial bacteria could have killed him. Gastric volvulus or distension was present. The prognosis was poor.  No more hay for the other guinea pig which was still OK and eating the same hay.

Bubbles in the abdomen indicate that the intestines had lost blood supply and leak gas into the abdomen. The guinea pig died from septicaemic shock as Clostridial bacteria is highly pathogenic. No post-mortem or bacterial culture was done. 

Thursday, March 26, 2015

Empathy in medicine

Educating For Empathy - Journal of General Internal Medicine 2006.

Empathy in doctors significantly influences patient satisfaction, adherence to medical recommendations, clinical outcomes and professional satisfaction. Frequency of medical errors among doctors decrease as the empathy levels increase

1151. Video on annual health screening for a 10-year-old Shih Tzu

This trim fair lady loves her female, spayed 10-year-old dog very much as she will present her dog yearly for the vaccination. She had made an appointment today after receiving my vaccination reminder card.

This time she requested a blood test. I was surprised that she was well informed.
As for the dental scaling, she said: "I am worried about anaesthesia. Maybe another time."
The back teeth were full of tartar but the teeth were still strong and solid. When I opened the dog's mouth wider, she gasped although the shy Shih Tzu with clear corneas did not flinch a bit.

 "It is necessary to check for mouth ulcers and tumours," I explained to her.

Normally, some of my vets just give the vaccination and general examination or just the vaccination owing to the owner's financial cost constraints.  So no blood and urine tests were done or advised by my vets.

I did a health check video for the benefit of the younger dog owners. The dog was a good patient. The overall experience was eventful as more and more dark brown anal sac oil kept discharging as I expressed the anal sacs. Yet the dog did not bite her backside. The tell-tale sign was just some hair loss and skin irritation at the end of the tail. The ear canals were dirty and need cleaning.

This was a happy interaction for the vet, the dog and the lady dog owner on this Friday morning.