Saturday, May 19, 2018

3158. Audit of case. Liver disease in a 7-year-old Shih Tzu - ALT enzymes

May 20, 2018
Audit of case

Ref: 45074

On Mar 18, 2017, this Shih tzu, MN, 7 yrs old, 7.7 kg,  much loved by Filipino couple living in Pasir Ris, came for annual check up and vaccination. 
The dog is fed on vegetarian diet. Health screening by using blood test showed elevated ALT.
Dog was fed new dog treats recently.

Mar 18, 2018, 7.7 kg
Liver profile
ALT  1275 U/L   (<59 p=""><121 81="" nbsp="" p="">

Given Zentonil and canned Prescription L/D. Dog was usually fed vegetarian diet. 
<59 p=""><81 p="">
Review with ultrasound. Weight not taken.
Apr 22, 2018
Liver profile is normal
ALT  40 U/L   (<59 p=""><121 81="" br="">
Ultrasound - liver is normal in appearance. Ultrasound does not rule out liver disease.
Back to his usual diet.


May 1, 2014. Seen by me. Painful abdomen, bladder area. growls. Wt. 8.7 kg   38.1. Dipstick Protein +, no blood, pH 8  SG 1.005. UTI.

Oct 11, 2014. 8.5 kg. 37.5C
Fat lump 3 cm x 5 cm Subcut, above right hip excised
Histopath. Fat necrosis, organising granulation tissue and fibrosis.

Apr 29, 2015  8.9 kg  Overweight. Vaccination. To reduce weight by 1 kg.
Anal sac expressed.


Conclusion. The dog did lose 1 kg of body weight. 
<59 p=""><81 p=""><59 p="">It is possible that the elevated ALT could be due to the new dog treats causing liver disorder. The dog is OK now.  Dog treats are sold very cheaply and their quality may be absent. Purchase good quality ones.  

3157. ***Stray cats stories: Who neutered my stray cat?

May 19, 2018


"He was missing for a few days," the worried doctor usually see the stray cat in her garden every night for the past 3 years. "When he returned, he had been neutered by somebody. Who could have done it?  Could this be the other stray cat caregiver in my neighbourhood?"

The caregiver consulted me because the cat stopped eating. He was a ravenous cat whenever he returned from his outings. He was not the type to stay at home.

"Why didn't you neuter him earlier to prevent him straying?" I asked. The lady said that she could not crate him. Most likely, she considered neutering as unnatural and cruel. She wanted him to be a normal cat living a free life.

"I did some internet research," she shared. "There are two types of stray cats, also known as feral cats. One type does not trust human beings. The other type like this one, had been abandoned or lost. Since the latter had contact with people, he does not object to handling.:

I examined the cat on the consultation table after checking his medical record. Last month, he was treated by Dr Daniel for ear mites and had recovered. He had a blood test done, showing very low platelet count. I noticed a large right facial swelling on the lower facial area. The left face was taut.
The owner was not aware of this discrepancy.  His ears were still oozing black wax. I palpated the right ear. The cat moved his head away from me, in protest of pain.

"What is the cause of his loss of appetite?"

"Most likely an infection based on his lifestyle as the tom-cat of the neighbourhood," I said. "His right facial swelling indicated a serious infection from cat fight wounds, leading to a large abscess and pain."

1.  A TOM CAT came into caregiver's house to fight this tom cat. Somersault and meowing. Claws out.  Caregiver was witness and attempted separation.

2. This cat is very loving. But must go out. The night before this consultation, had gone out the whole night. That is his life-style. To look for females and to dominate other tom cats. A good fight. His skin is very thick compared to the normal domesticated short haired. Very difficult to take blood as needle is hard to pierce.


Apr 24, 2018
Platelets 90 (300-800)

May 17, 2018
Platelets 279 (300-800)

Toxaemia in Apr 24, 2018.
No generalised bacterial infection as total white cell count and neutrophil count are within the  normal range. 

Loss of appetite would likely be due to pain in the swollen right face which was scarred by the other cat (evidence - image). No pus was detected. The infection went to the right ear area and so the cat vigorously objected to me touching the right ear as compared to the left ear. If painful, will not eat although active and wanted to go out. 

He was sedated and the ears' dirty black secretions were cleared up once again.
Right facial abscess lanced. No pus. Fibrous tissues healing.

4. SMS ON MAY 19, 2018.

Saturday, May 19, 2018. 22:54
Hi, is Ginger eating today?

Saturday, May 19, 2018. 23:07
Hi Dr Sing. Yes. Thank you so much. Ginger's appetite is much better today. Able to eat packet food. No dry food yet. Started ear drop and antibiotic today.

Stray tom cats in Singapore do fight and suffer horrible infected facial wounds and abscesses.
That is their life-style. Many are hard to trap. This tom cat was trapped by some kind unknown person and neutered at a veterinary place recently. He still wants to go out but is more homely, according to the client. He is very loving and so could have been a lost or abandoned young male cat some 6 years ago. Free to roam and fight as a male cat. He could have wandered into another neighbourhood and got trapped.



June 27, 2017.Swelling on both fore arms. Wound on Right fore arm. Fighting.

Apr 5 - 13, 2018. Missing cat. Returned as neutered cat. Who did it?

Sunday, May 20, 2018. Eats wet food today.
Cat has very thick skin.

May 20, 2018. At home. Has appetite today. Normally he wolfs down his food.

Apr 24, 2018. 6.0 kg.  40.2C  Swollen front limbs.

May 15, 2018. 6.3 kg.  38.5C  Right hind limping. Ears dirty. At home, cat refused ear cleaning and oral medication.

May 17, 2018. 5.9 kg.  38.0C  Anorexia 2 days but active. Right face swollen. Left face and chin have bite scars.  Right ear very painful and dirty. Will not accept oral medication prescribed on May 15. Blood test. FeLv/FIV test negative. He had gone out overnight yesterday.

"It will take about 3 months before the neutered cat's male hormones have gone down and the cat should be more homely.  


May 19, 2018. SMS owner. Appetite is  much better today compared to yesterday. .

Friday, May 18, 2018

3156. Sunda Pygmy woodpeckers seen partially during my morning exercise

Only in 2 mornings, I saw these woodpeckers high up on the tree branches during my exercise.

May 14, 2018. I used zoom lens

On May 12, 2018, Mother's Day. The woodpeckers did not stay still pecking the tree facing me. Appeared to be cautious and flew away within 60 seconds. Zoom lens used. .

3156. Short-lived mushrooms in the plantar box

The size and colour of the big mushrooms are impressive. They live for around 3 days only.

Young mushrooms on May 15, 2018

Bloom on May 16, 2018

Will not be erect but will collapse and shrivel on May 17, 2018

3155. Orange breasted green pigeon

May 18, 2018

The orange-breasted green pigeon (Treron bicinctus) is a pigeon found across tropical Asia

nape blue green
crown yellowish green
uppertail coverts are bronze
lowertail coverts are umarked rufous

male - pinkish band on the upper breast
           a broader orange band below

female - bright yellow breast

An illustration created in

Singapore sightings on a tree opposite my fitness machine in a public park