Saturday, April 16, 2016

A 8-year-old Chinese girl dislikes Chinese

Sat Apr 12  2016

It is extremely difficult for a 30- year old single mother to earn a living in Singapore.  She was the boss of a pet shop and had as many as 4 groomers at one time. She opened pet cafes in petrol kiosks.The landlord increases the rental during the boom if past 3 trs.

Wednesday, April 13, 2016

A 2-year-old female hamster has an irritating interdigital wart

April 14, 2016

Anaesthetic death is always a worry for the Thai lady owner and her husband. So, when she came to take back the hamster post-op, she snapped a picture from her handphone to show her husband that Spiky 2 had survived the anaesthesia.

Isoflurane gas + oxygen anaesthesia for a few times as it is hard to assess the depth of anaesthesia. The hamster reacted to the electrosurgery twice when I started cutting. So, she needs gas again. Finally, I managed to get out the wart which is friable and measured 3 mm across. See video.

The hamster has such a thick coat. On her right chest, there was a tumour around 1.3 cm across. To operate or not?

Tuesday, April 5, 2016

2950. A 7-year-old male Shih Tzu is totally blind

Mar 24, 2016

The male 7-year-old Shih Tzu is totally blind and now has a severely infected eyeball.
"Your vet said to put him to sleep," the owner told me.
"Are you sure? Dr Daniel will never suggest that. The dog is blind but is still active."
"Maybe it was my friend who suggested it as the dog is blind in both eyes."

He brought the dog in for eyeball removal since his 80-year-old father is against euthanasia.
Blood test showed high total white cell count at 22.6 (6-17) and high neutrophils 89% (60-70%) and high absolute numbers 21  (3-11.5).

Dr Daniel did the op, warded the dog for 2 days and gave medication. The dog is OK now. Blindness is surprising but the owner had not requested detailed check up.

Thursday, March 24, 2016

A 40th day pregnant Corgi vomits twice and has no appetite - acute kidney failure

Mar 18  2016
I got a tel call at 8am from the breeder. The 2-year-old Corgi is heavily pregnant. Vomited once yesterday and today  yellow vomitus. No appetite. Why?

Blood test.
High blood urea and creatinine. Leucocytosis - a higher than normal number of total white cell count indicating a possible bacterial infection.

"Acute kidney failure," I gave the breeder the bad news. The sudden onset of uraemia causing vomiting led me to diagnose acute kidney failure in contrast to chronic kidney failure. 

"Why and how the Corgi suffers from kidney failure?" the breeder asked. "She is only 2 years old and this is her first litter."

"There are many causes," I explained. "Infections, dietary management, toxicity, kidney injury, kidney pressure on the ureters due to too many foetus (the Corgi was later found to have 10 foetuses). It is possible that there is a kidney infection based on leucocytosis."

I gave IV therapy and antibiotic. The IV therapy was continued at the farm for the next 3 days. The dog still vomited after drinking and had no appetite for the next 3 days.

Mar 20, 2016
The dog miscarriaged with 2 premature puppies born. I gave oxytocin as the others would be dead too. There were 10 puppies in total. Most of the 10 placentas came out the next day. The dam was more alert but had no appetite. "The IV drip for the next 3 days is critical. It is for dialysis to clear out the waste products of urea by the functioning glomerulus cells of the kideys to filter the toxic waste.  It provides the dextrose energy and fluid to prevent dehydration," I explained to the breeder. 

Mar 23, 2016
I phoned the breeder. He said that the dam started eating yesterday and is ok.  He was most happy. "Breeders will not be happy with the vet if the dam dies during Caesarean or treatment as they tend to blame the vet for being incompetent for achieving a poor outcome," I said.
"Well," he replied. "If the factory is shut down, there will be no production."
I had never thought of the dam as being a factory but this analogy is realistic.

Tuesday, March 15, 2016

2947. First vaccination of 11 pups - one good image out of over 20

8.5x11 in 300 ppi    16.67% 31.5M/42.3M

8.5x11 in 300 ppi    16.67% 28.9M/32.9M

Bright sunny 9.30 am   Breeder's farm one day after vaccination of 11 puppies.
Puppies put inside a styroform box but difficult to get all to pose together.

A greenish-black Caesarean section - Breeder could hear only one puppy's heart sounds

March 15, 2016


Visit to Farm to check whether my Dachshund patient had given birth naturally. She had not been eating on Mar 8, 2016 and recovered on Mar 10, 2016 being very active. Had visited on Mar 11 (video, very active running about, eating)

Dachshund in whelping crate. The Dachshund looked at me. She was quiet with slight increase in respiratory rate.  I noticed a greenish-black vaginal discharge on the towels.
Temperature 37.9C was below normal. Breeder showed that she had milk Plenty of it.

But she looked bad. "The big abdomen had shrunk," I had seen her since 10 days ago. "That is not good".  In retrospect, this meant that the two puppies had died and the water bag had ruptured. Shrinkage of the abdomen.

He decided on an emergency Caesarean section saying: "I can only hear one loud heart beat of one puppy," the breeder said. "The others have had died."

10 am
The way she responded to anaesthesia showed she was very weak.

Masked and given isoflurane gas + O2 gas. Intubated. Tongue pale. Eyeball rotated downwards, pupils dilated - very deep anaesthesia. Surveillance. No gas at all unlike normal procedure of connection to gas directly. Dog took around 1 minute to recover. 

Thick greenish-black liquid flowed out from incision instead of the usual colourless water bag. 2 dead pups drowned in melted placental material pulled out.

Third pup at the brink of death. Still in the normal water bag with the clear colourless fluid. Placenta had separated and not wholesome. Melting. No sound. Gave to the experienced breeder.

Closed up the dog as fast as possible.
Dog only on 0.5% isoflurane gas  + O2. (normal strong dam needs at least 2% to be painfree)
Death on the operating table - not good for the vet's reputation no matter what is the cause.

Recovered. Cleaned up. Given IV drip (baytril, vitamins, amino acids). Puppy went home first. 

8pm  tel breeder. Dam and puppy OK.