Saturday, August 20, 2016

2916. Review of 2-year-old pug with urticaria

August 21, 2016

The 10-kg pug started to itch again. Pustules and red skin between the thigh and belly area (video).
Rashes in armpits. Several rashes at left and right sides of the body. Ears no longer inflamed and painful as the owner had used a steroidal ear ointment but the hair loss and shorter hairs of the flanks tell a story of ear itchiness.

"The hind legs start to hammer at the flanks when the dog has ear pain or itchiness," I told the young couple as this hair loss area is commonly seen in other dogs with ear canal infections. (video).

"The 4 paws are also itchy now," the lady said after the end of medication with the white tablets. These were anti-fungal tablets. In reality, the pug was itchy despite the Royal Canine Hypoallergic diet soley fed..

The allergy test report from the US had arrived 1 week ago. said that the dog is allergic to chicken, corn, oatmeal, malassezia but not allergic to beef, pork, turkey, carrots , milk, eggs or two dust mites.

PLAN
1. Home-cooked pork + brown rice + carrots
2.  E-collar 14 days 24 hours per day
3. Amitraz wash for the rashes
4. Review in one months
5. Medication for rashes
6. Ear ointment once a week and massage


ADVICES
1. Anal sac expression weekly before bathing (grey oil seen/expressed today)
2.Lateral ear canal resecetion and tail fold surgery advised in 6 months.
3. No treats and other food for next 3 months except the above-mentioned diet of pork + brown rick and carrots. 

Friday, August 19, 2016

2915. Throat X rays of the dog and cat - A 14-year-old Miniature Schnauzer has a large neck abscess

Aug 19, 2016










It is very important that old dogs get their dental work done and all rotten smelly loose teeth extracted. In this dog, in March 2014, I was consulted about a big lump on the dorsal part of the tail end. "It is a sebaceious gland tumour," I said. Surgery removed the tumour and no more visit from the dog.

Today, the old dog came in gasping for breath and crying. Panting a lot. "The dog cannot stand for the past 2 days. Not eating. He has a large swelling under the chin, also diarrhoea," the mum said. The daughter was working and so she brought the dog down.

A soft firm swelling across the neck below the chin. Around 3 inches x 4 inches x 3 inches. I got an X-ray done as I suspected an abscess. Lanced and reddish-brown pus flowed out. Around 100 ml collected.








No anaesthesia is given as the dog's tongue turned deep purple when restrained for examination. The dog had great difficulty breathing. Rotten teeth spread bacteria into the heart valves.

BLOOD TEST ON ADMISSION ON AUG 19, 2016
Glucose 2.6  (3.9 - 6.0). Dog was not able to stand up.

Liver enzymes   ALT/SGPT    117  (less than 59)<59 p="">
                           AST/SGOT    133 (<81 br=""> less than 81)                   
Urea                   15.3 (4.2-6.3) but creatinine is within normal range. Kidneys are normal in this case.
Total white cell count  39.8  (6-17)
Neutrophils  90%  (60-70%), Absolute 35.8  (3-11.5%)
Lymphocytes 10%  Absolute 3.98
Monocytes, eosinophils and basophils are zero.
Platelets 431 (200-500)

<59 p="">
<59 p="">
<59 p="">CONCLUSION
What the owner wants is a dog alive. Therefore, the diagnosis must be correct and X-rays are needed to provide the evidence of neck abscess. Aspiration of the neck swelling confirms pus. Incision of 2 cm drains out most pus. The next day, syringing the abscess and removal of the gelatinous pus which is formed due to the medication of baytril and a low dose of dexamethasone. 
<59 p="">
<59 p="">As you can see the video, the dog is much comfortable on Day 2 after treatment and no longer pants in great pain.  The outcome is good and the dog will go home on Day 3, after another IV drip today.<59 p="">Teeth scaling and check up every year for a senior dog would have had prevented such a condition of neck abscess and great pain in the neck. Owners need to spare some time to bring dogs older than 5 years old for yearly dental check up and vaccination.  However, a majority do not do it.
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<59 p="">

<59 p="">

<59 p="">

<59 p="">

<59 p="">OTHER X RAYS OF THE NECK

looking for bone inside the throat

normal throat and neck


normal throat and neck.  Normal oropharynx (No. 4)  is not swollen


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the cat has normal nasopharynx (throat)


cat has normal nasopharynx (throat)
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Submandibular Abscess causing great breathing difficulty. This 14-year-old Maltipoo had pus in the right ear for many weeks.The bacteria inside this area finally penetrated into the right neck area, forming a very painful right submandibular abscess. See lateral view of X-ray as evidence. The dog's abscess was lanced and drained under general anaesthesia. The dog is normal now. This is a case where ear canal infections can lead to right neck abscess. The owner had consulted a vet earlier for the ear infections but had not followed up when the infections had not gone away. The bacteria went into the neck via the eustachian tube and multipied, form a gigantic abscess.




BLOOD TEST
Dec 9, 2014

Abnormal
Total white cell count 68.5 (6-17)
 N 98%  (60-70%)       N absolute 67.13  (3-11.5)
L  1.6%    L Absolute 1.10
M 0.1%  Absolute 0.07
E  0.3%   Absolute 0.21
B  0%

Platelets  142  (200-500). 
Several abnormal lecuocytes seen. Occasional nucleated red blood cells seen. Large platelets present. 

HISTOLOGY report from 2 biopsy punches on side of submandibular swelling.
No malignancy


 









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heart disease (swelling in throat due to fluid from heart disease)



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GR with premolar 4 abscess


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special type of equipment is needed if you want to x-ray a terrapin's throat




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do not copy this image into video
normal throat (no neck abscess) with a pellet inside the gullet. For illustration.


<59 p="">
<59 p="">-------------------------------------------------------------------




In dogs, an ear abscess is not obvious. But in a terrapin you can see a swelling of the ear to know that he has an ear abscess. Treatment is similar. Incise and drain the pus.  
<59 p="">
<59 p="">

2914. A 2-year-old multipoo passes bloody watery stools for 2 days - X rays

Aug 19, 2016

"My multipoo was passing bloody watery stools for the last 2 days," the lady owner was worried and showed the picture of the stools in her smartphone.
 No abdominal pain. X-rays show some spherical balls inside the colon and watery stools inside the descending colon. IV drip and sent home.




It was a puzzle as to what the spherical balls were. 
.

Tuesday, August 16, 2016

2913. Asiatic Bear with sublingual mucocoele 3 weeks & 8 weeks post operation




























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3 - 4 wks  post op





Aug 17, 2016







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8 weeks post op
The bilateral sublingual mucocoeles have recurred. The affected 7-month-old bear is fed better and given spacious accommodation. He shifts his tongue sideways to swallow the food such as dog food and bear.

The other normal sibling bear with the normal tongue has grown up to a bigger size.








Saturday, August 13, 2016

2912. Toilet-training advices - A 9-week-old poodle prefers grate to blanket for lying down and sleeping

EMAIL TO DR SING KONG YUEN

From: ",,,vic@gmail.com>
Date: 11 Aug 2016 11:02 p.m.
Subject: My toy poodle loves to sleep on pee tray
To: <judy@toapayohvets.com>
Cc:

Dear Dr Sing
I happened to chance onto your website and sincerely hope that you can help me with some advise. I just brought back my 9 weeks old toy poodle two days ago. I put the dog in a crate and provided a pee pad for her. (Please see picture attached)
She has been pee pad trained over at the pet seller shop. She can pee and poo at the tray, no problem. I usually clean her poo almost immediately. However, the pad is only change the next morning.
A) My problem is my poodle likes to sleep on the pee tray/pad (see attached picture) I tried carry her back to her blanket but after a while she returned to the tray. I clean the 'sleeping area' well and make it comfortable for her but still fail. What should I do?
I will only bring her food bowl in during meal time. She has a water feeder at the right hand side.
Meal time: 10.30am and 6.30pm
Takes a 1-2 hours after meal to poo.
Every morning, there will be lots of poo at the pee tray. By then, she's awake and sitting upright at her blanket area. When she's excited, she will be stepping all over her poo if I don't clean them fast enough.
B) I was told to confine her in the crate till her 3 vaccination (Mid Sept) However, I do let her out of the crate for a 30 mins run around my living room for some form of exercise, twice a day to exhaust her energy. If not she will be whining during the night. Is this acceptable?
C) In the future, I wish that my dog could roam around my house without restriction but toilet trained. How do I migrate from pee tray to common toilet bathroom floor? When will be a better age to start such training?
D) How long should we crate our dog?
Thanks! Your help is greatly appreciated.
Cheers
 Name













REPLY DATED AUG 14, 2016

Thank you for your email. Possible answers to your queries are in CAPITAL LETTERS:

Dear Dr Sing
I happened to chance onto your website and sincerely hope that you can help me with some advise. I just brought back my 9 weeks old toy poodle two days ago. I put the dog in a crate and provided a pee pad for her. (Please see picture attached)


She has been pee pad trained over at the pet seller shop. She can pee and poo at the tray, no problem. I usually clean her poo almost immediately. However, the pad is only change the next morning.

MOST LIKELY, THE SELLER CHANGES THE PAD MORE OFTEN AS PUPPIES ARE VERY CLEAN CREATURES. IF YOU CHANGE ONLY ONCE, THE PUPPY AVOIDS THE SOILED PEE PAD OVERNIGHT AND SLEEPS ON THE GRATE (you refer "grate" as "tray" which is an incorrect term).




A) My problem is my poodle likes to sleep on the pee tray/pad (see attached picture) I tried carry her back to her blanket but after a while she returned to the tray. I clean the 'sleeping area' well and make it comfortable for her but still fail. What should I do?

FROM YOUR IMAGE, THE PUPPY PREFERS THE GRATE AS IT IS CLEANER THAN THE PEE PAD (CHANGED ONLY ONCE/24 HOURS) + BLANKET AREA.  SO THE GRATE IS THE CLEAN AREA TO SLEEP AND LIE DOWN AS SHOWN IN YOUR IMAGES. THE BLANKET IS SOILED AND SMELLY AS THE PUPPY WITH SOILED PAWS STEPS ON IT DURING YOUR VISITS.

I will only bring her food bowl in during meal time. She has a water feeder at the right hand side.

WATER BOTTLE SHOULD BE POSITIONED ON THE SLEEPING AREA WHICH IS CLEAN AND IS ON THE LEFT SIDE. 

Meal time: 10.30am and 6.30pm
Takes a 1-2 hours after meal to poo.
Every morning, there will be lots of poo at the pee tray.
LOTS OF POO ON THE GRATE?   DOES IT MEAN THAT THE PUPPY SLEEPS ON THE PEE PAD AND BLANKET AT NIGHT AND PEES AND POOPS ON THE GRATE?


By then, she's awake and sitting upright at her blanket area. When she's excited, she will be stepping all over her poo if I don't clean them fast enough.

B) I was told to confine her in the crate till her 3 vaccination (Mid Sept) However, I do let her out of the crate for a 30 mins run around my living room for some form of exercise, twice a day to exhaust her energy. If not she will be whining during the night. Is this acceptable?
YES

C) In the future, I wish that my dog could roam around my house without restriction but toilet trained. How do I migrate from pee tray to common toilet bathroom floor? When will be a better age to start such training?

THE CRATE IS SMALL. NOW IS THE BEST TIME TO MIGRATE TO THE TOILET BATHROOM FLOOR.  BUY A FENCE. PUT PEE PAD IN FAR RIGHT. CLEAN SLEEPING AREA AND BLANKET ON LEFT SIDE.  NO WATER AFTER DINNER AND OVERNIGHT.
D) How long should we crate our dog?
MUCH DEPENDS ON YOUR SUCCESS IN TOILET TRAINING, YOUR TIME SPENT IN TRAINING AND THE SIZE OF THE CRATE.  SOME OWNERS TAKE 2 WEEKS. SOME TAKE 2 MONTHS OR MORE.  

I hope the above advices are useful. Do let me know 4 weeks later.