Wednesday, June 29, 2016

2967. Abdominal ultrasound and X-ray - poodle passes a lot of urine past 2 months

Tuesday, June 28, 2016

2966. Follow up: what happened to the Dachshund puppy with the crooked tail and swollen umbilicus?

Jun 29, 2016

4 days have passed. What happened to the puppy with the crooked tail and swollen umbilical cord?

This morning, I visited the C-section 634rd-day pregnant Dachshund. She's OK but was not permitted to nurse her own new born puppies. The poodle was the surrogate for the 3 puppies. The 4th with the crooked tail and swollen umbilicus had passed away the 2nd day although the umbilicus had dried up.

"I had tied up the intestine which was inside the swollen umbilical cord," the breeder said. "So the intestine was deprived of the blood supply, killing the puppy. I had a few of such cases."

Each breeder or vet has his or her own theories about medical conditions and so I did not say that this puppy had been severely stressed as the amniotic sac was filled with yellow meconium unlike the normal 3 siblings. In human medicine, ultrasound scans showing meconium in the baby will lead to an emergency Caesarean section to save the baby. But costs prohibit the breeder from spending on such ultrasounds.

The umbilical cord was twisted and so it swelled 4X. But I know the experienced breeder would not accept my theory and so I did not expound my theory.  "Maybe, next time, I should check the swollen umbilical cord for any intestines inside and push them inwards before you tie the cord," I said.

"I should assist you during C-sections," he said as I usually asked him to be outside the operating room unlike one lady vet who had 100% no-death in puppies in C-sections with him and so she was an excellent vet.  Unfortunately she had retired from doing C-sections for him and he had been to various vets throughout the past years. He advocated an assistant to elevate the lower body of the dam so that C-sections can be completed faster. Or the assistant holding part of the uterine horn while I take out the puppies faster.

The latter suggestion was preposterous as the gravid uterine horn is not that long unlike that of the cow's. There is just no space for another assistant to hold part of the uterus while the vet milk out the puppy.

Many sensitive younger vets may not be happy with his presence or suggestions of assistance or his criticism of puppy death being due to delay in pulling out the puppy and so the puppy had an overdose of the isoflurane and therefore die the next day. I don't permit outsiders into the op room during C-sections to keep the room as sterile as possible.

In this 63rd-day pregnant, the breeder had outsourced the 3 puppies to the poodle and is pleased with his decision as the puppies are thriving. He believed that the other Dachshund had toxic milk killing all the 3 puppies I delivered alive on C-section and so was not taking chances with this Dachshund. This Dachshund had snow-white milk whereas the other had no milk and the next day, produced thick yellowish milk deemed toxic to the 3 puppies.

Breeders have their beliefs. He even suggested that a longer incision bringing out the whole gravid uterus would compromise the milk production of the mammary gland and so vets who incise the abdomen from umbilicus to pelvis as stated in the vet books have had damaged the milk system, leading to poor quality milk production.



Saturday, June 25, 2016

2965. A 63rd-day-pregnant Dachshund had C-section

Sat Jun 25, 2016  6.30 pm

I had closed my surgery at 4 pm as usual on Saturdays. The breeder decided on a Caesarean section at 6.30pm since his 63rd-day pregnant Dachshund had not given birth and was starting to scratch. He did not want to wait till midnight. He could have the C-section at 3 pm as his worker had told him that his Dachshund's rectal temperature had dropped to 37.7 deg C in the morning. With a drop of temperature, the dog is ready to give birth and could have an elective C-section. The breeder decided to wait to "save money" paying the vet. But no puppy came out and without much delay, he phoned me.

4 puppies and dam are alive. Milk was present. The breeder was over the moon.


1 of the 4 had yellow stools (meconium) inside the amniotic sac. He had pooped a lot. His umbilical cord was swollen 4-6X and this would be due to his placenta being twisted.

In this operation, I made a larger cut to exteriorise the elongated uterine horns (Dachshunds have long bodies). This would speed up the taking out of the pups instead of my usual smaller cut without needing to exteriorise the uterine horns.

I phoned the breeder 24 hours later. He said all 4 pups are OK. They were nursed by two surrogate poodles as he had a bad experience of the previous Dachshund providing "toxic" milk to the 3 large pups I had delivered by C-section. Those 3 pups died on the next 2 days, attributed by the breeder to the toxic milk. So he was not taking chances. He fostered the present Dachshund dam with older puppies as they would be stronger in case this Dachshund has toxic milk.

I was most surprised that the other Dachshund had all 3 puppies dead as they were alive and OK before they went home from C-section at Toa Payoh Vets.  "Did you use anti-tick wash on the dam before C-section?" I asked this experienced breeder as yesterday's Dachshund had many small ticks. The breeder normally hand-picked the ticks and might use Frontline spot-on to get rid of the ticks. The breeder said he does not use tick insectides and so the mystery of the "toxic milk" remains.


Friday, June 24, 2016

2964. Calcium oxalate in Miniature Schnauzer cuase hind limb lameness

The dog was limping in the hind for some years as the owner did not want to remove the urinary stones stuck inside the urethra and bladder. When he decided to do it at Toa Payoh Vets, the dog's lameness is much less and he looks better. 

2963. A 5-year-old terrapin yawns. Why?

Jun 24, 2016

Terrapin, 5 year old, F was rescued from the pond 1 year ago.
Goes for walk in playground.
UVB light 1-3 hrs/day. Tank. No filter
Overturned basket as basking area, not ramp.

Mar 12, 2016. Consulted Toa Payoh Vets
New tank
Bubbles from nose, open mouth breathing
Tank chemical likely cause resp. problem.

Jun 2016. Another Vet clinic.
7 injections alternate days of oxytet IM
Tobradex eye drops into eyes and nose
"Yawns" or gasping returns after treatment course. Why?

X rays - normal

Allergy to playground environmental substances?

Wednesday, June 22, 2016

2962. A 3-year-old guinea pig is restless and loses appetite - gastric & caecal bloat

Jun 22, 2016

The couple fed a better quality of guinea pig feed earlier but the pet shop had no stock to replenish. So, they bought a cheaper lower grade which had pellets. The guinea pig ignored the pellets. When the first brand had appeared, the couple bought it and fed the guinea pig around 4 days ago.

Yesterday, the guinea pig was not eating and tried to hide his head under the elevated feed tray hooked onto the side of the crate. He is an introverted type and would not want to play with the couple who used to play tug-of-war with the feed, by giving and taking back. He would have no such nonsense and refused to participate. He preferred to be home alone, inside his crate.

He demonstrated to me by scurrying up into the crate when I placed him after examination. He had painful cries when I palpated his bloated abdomen. I suggested an X-ray which showed two large gas-filled swellings - the stomach and caecum.

"Looks like GDV," Dr Daniel said. GDV = gastric dilatation and volvulus, seen in dogs. I thought it was bloat as in sheep being fed with high protein food. Sheep get swollen abdomen of  enterotoxaemia when fed a diet rich in grains but low in fibre, or are in poor bodily condition and infested with parasites.

This 3-year-old guinea pig is thin, BCS = 3 (lumbar vertebra palpable), had abdominal discomfort, refused to eat the harder hay and pellets of the older feed and was restless (excitable). He had loose stools but no diarrhoea.


Tuesday, June 21, 2016

2961. Hernia mesh or not?

Jun 20, 2016

In Jan 19, 2015, the 9-year-old Maltese had a right perineal hernia repaired at Toa Payoh Vets. 
Neuter of the old dog would be done 1 month later in order to minimise risk of anaesthetic risk with combined hernia and neuter surgery.

The hernia recurred around August 2015 and the dog was neutered then. No hernial repair. I advised a hernia mesh as the hole is too big. 

No pain, no problem peeing and pooping. The dog was active and eating. This was the situation in August 2015 and now Jun 20, 2016.  Just no problem with a normal lifestyle. Except that the right perineal hernia is now 1.5 x the size of a golf ball (Video).

As the owner was worried about the pain for the dog on repair with the hernia mesh, I advised wait and see. I could not guarantee no pain and no infection on using the mesh. No vets can guarantee.  The dog was normal and not in pain. The main problem of skin infections in the back area was resolved with medication now. The anal sacs were expressed and some brown oil squirted out.

What is my recommendation? Since the dog's blood test show he was healthy and the heart was normal, I would advise the hernia mesh repair if he was my dog. The owner has to decide and wait till the hernia was double the size like a tennis ball or the dog had pain or difficulty in peeing and pooping.