Sunday, June 20, 2010

105. Sunday Two Highlighted Cases - Can't stand up on hind legs + backside swelling

Sunday's Highlighted Case - June 20, 2010

I was surprised to see the young couple bringing the old Miniature Schnauzer with the large cheek tumour I had excised on Jun 14, 2010 to see me on Sunday. The case is recorded in: Large cheek tumour & 15 rotten teeth.

"What happened?" I asked.
"He had been crying loudly at night for past 3 nights (Jun 17-19)," the young lady said. "The neighbours thought the dog was abused and enquired about him. He just could not stand up. Previously a vet had diagnosed hip arthritis."

PALPATION
1. T/L to L/S spinal area painful.
2. Extended right hip. Dog screamed in pain.
3. Extended left hip. Dog showed painful reaction.

CHEEK TUMOUR EXCISION EXAMINATION
"The dog will not allow me to open his mouth," the lady said when I wanted her help. I wanted to see whether the large ulcer after excision of the cheek tumour had healed well. I put the dog on the table and opened the right cheek. The stitches had broken down. The ulcer was reddish but otherwise not infected. The dog did not object to the lady opening his mouth now.

"He had painkillers called tolfedine tablets of 60 mg/day for the last 7 days," I said.

"Did he behave like a young puppy by running wild?" I asked. "Painkillers made him feel good and over-exert his muscles and joints."

"Yes," the lady said. "He was most active unlike other times when we took him outdoors. He would lift his hind leg, either left or right and pee at every vertical surface till the last drop of urine. This is his usual habit."

I explained: "The reason he cried at night and could not get up on his hind feet is that he has painful hip joints and back after the exercises. Now you have to restrain him from any activity for at least one month."

I proposed that the dog be neutered to reduce his urine-marking obsession. But the owner was not keen on the idea. The male dog lifts up mainly his right hind leg to balance weight while peeing on vertical surface. So, the extra weight puts pressure on the right hip. Therefore the right hip became very painful. However, he would switch to the left leg. So both hip joints are painful. What did he do then since he had to urine-mark at all cost? "Oh, he just squat and pee on the ground," the owner said. After enjoyment during the evening of urine-marking, the dog felt the intense pain at night for 3 nights. The neighbour was concerned and so the owner came for consultation.

I did not suggest any X-rays as the owner wanted the least cost treatment and a vet had previously diagnosed hip arthritis. X-rays are needed for more detailed examination and diagnosis of hip arthritis but economics prohibit me from further investigation.

CHANGES OF LIFE-STYLE ADVISED
1. No walking over the drainage grate from void deck to grass during outdoors exercise for the next one month or more.
2. Use of a anti-obesity dry food diet. If the dog loses 1 kg, his hip joints would bear less weight. It is easier said than done as some old dogs just love to eat and put on weight easily.

Neuter your male dog at around 6 months to prevent obsessive urine-marking. During old age and weight gain, the hip joints may be worn out due to weight bearing from the lifting of the hind leg to urine-mark.


PERINEAL HERNIAS
Boston Terrier, Male, 7 years (not neutered because it is too cruel).
Two moderate sized swellings on perineal area.


Complaint: "Squats down longer to poop than usual for past 3 weeks. Hard for stools to be passed out during the first week." Vet 1 prescribed stool softeners 3x/day yesterday. Stools loose now.

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