Thursday, July 27, 2017

3112. Single pup syndrome

There is such a condition as single pup syndrome. The single pup grows to a large size and usually need to be delivered by Caesarean section as in this case. Failing to do so will result in the pup's death.












Both dam and pup are OK on following up 7 days later.  

3111. Unusual case of 4 dead foetuses in one uterine horn - Caesarean Section

The breeder requested an emergency Caesarean section as there was some blackish green vaginal discharge.

4 dead mummified foetuses bathed in blackish green fluid were in the left uterine horn, but 3 normal Corgi pups were found in the right horn. They were rescued just in time.



Wednesday, July 26, 2017

3110. Urinary stone prevention diet. Does it work? 3 case studies

CASE 1. BLADDER & KIDNEY STONES
HISTORY
Shih Tzu, MN, born 2006
In Sep 2014, the dog had difficulty passing urine. Vet 1 palpated a "bladder stone" and advised surgery, saying X-rays were not necessary.
The owner consulted me at Toa Payoh Vets. X-rays showed one bladder and 2 kidney stones.



After bladder stone removal at Toa Payoh Vets in Oct 2014, the owner did not feed the prescription diet to prevent bladder stones regularly.

In April 2016, the Shih Tzu passed blood at the end of urination. Soft bladder swelling palpated 
Urine analysis. pH 6.5, SG 1.02, Protein 4+, Blood 4+, White blood cells 900. No urinary crystals.
suggestive of bladder stone or tumour with cystitis. 

X-ray showed more than 2 kidney stones and a soft bladder mass was palpated. 

The owner fed prescription diet regularly and there is only occasional turbid urine but no more blood in the urine or difficulty in urination.




FEEDING PRESCRIPTION DIET RECORD FROM TOA PAYOH VETS


Oct 7, 2014  bladder stone removal surgery

Sep 11, 2015  Urinary S/0 7kg
Dec 12, 2015  Urinary S/0 7kg

Mar 26, 2016  Urinary S/O 7 kg


April 20, 2016. blood in turbid urine. No large stones palpated in bladder.  Cystitis? Bladder tumour or non-opaque stone in X-ray. Switched to Hills' C/D/

April 27, 2016  C/D  17.6 lbs
Owner did not come to Toa Payoh Vets for C/D. 

Jan 31, 2017 C/D  17.6lbs
April 30, 207 C/D 17.6 lbs
Jul 27, 2017 C/D  17.6 lbs.

 Owner says that the Shih Tzu, MN, now 11 years old, has no urination problems and is fed C/D. The other dog, a younger Schnauzer eats commercial food and has no urinary problem. The Shih Tzu consumes the 17.6 lb bag every 3 monthly. 


Conclusion. Difficult to get the owner to do further tests like urine analysis or X-rays as the dog had no problem in 2017. He had been feeding the Shih Tzu solely on the Multicare C/D which is said to reduce oxalate and struvite reccurrence. No other dog food or treats. 

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CASE 2   Miniature Schnauzer, M, N, 12 years. FEEDING OF PRESCRIPTION DIETS
The dog's urine pH is acidified by the feeding of Royal Canin Urinary S/0 as shown in the urine test on July 2017.  In Oct 2016, the pH was 8.0 (alkaline) and it had amorphous phosphate crystals.
However, the dog had dysuria in July 23, 2017 attributed to cystitis.
There was some urethral obstruction at the bend of the urethra during catheterisation, but no big stones are seen on X-rays. The dog has recovered. X rays are shown below. 




  The owner has 2 dogs as in Case 1. So, there may be eating of commercial diet of the other dog affecting urinary pH, causing cystitis. The dog is OK now.

CASE 3.
Shih Tzu, M, 11 years. ATTEMPTED DIETARY DISSOLUTION OF URINARY STONES
The owner attempted to dissolve the urinary stones diagnosed by Vet 1 some one year ago, by feeding Royal Canin Urinary SO. However in July 2017, the dog had great difficulty peeing. X-rays show 2 large urethral stones in the os penis. These 2 stones were flushed back into the bladder which was opened to take out the stones. The dog is OK now.  Stones are sent to the lab for analysis. X-rays are shown below.






Dietary dissolution of urinary stones can be done for struvite stones but these stones must be struvites and must be small.
X-rays of Vet 1 was requested, but the practice said it had no such client. .

Tuesday, July 25, 2017

3109. A difference of veterinary opinion. A hamster has hairless backside and ear area

My opinion may differ from another vet. This hamster had a right ear wart of 4 mm across and kept scratching his ear. His left backside is bald. So, I advised ear wart removal and lateral ear canal resection.

The other vet was the opinion that ear irrigation would do and it would be cheaper. However, the owner consulted me one month after the other vet's treatment as the itchy ear had not resolved. The left ear also had hairless bump and left ear itchiness.

Treatment:
Anaesthesia. Both lateral ear canal resected.  The right ear wart at the entrance to the ear's vertical canal was excise3d.

A follow up 8 weeks later will be good. If the backside and ear area hairs re-grow fully, the outcome is a success.







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Sunday, July 23, 2017

3108. A 10-year-old Beagle passes blood in the urine and has seizures.

Jul 23, 2017


X rays show "sand" in the bladder. Tests pending.



3107. A 12-year-old male Miniature Schnauzer has difficulty peeing

Air contrast bladder X-rays show no stones and no inflamed bladder wall.
Dog likely to have urinary tract infection.





Miniature Schnauzers are very prone to urinary stones, but in this case, there was none.
The owner had been feeding Royal Canin Urinary S/O, hence preventing struvite stone formation.
Follow up 7 days later, on the diagnosis of cystitis.
The dog lis back to normal now.