"You have got your money's worth today," I said to the strict-looking wife as my assistant expressed more than 5 ml of road-tarry grey granular oil from the 8-year-old solid body male neutered Silkie Terrier. "For the past 8 years, no groomer or vet had expressed his anal glands and the normally light yellow oil had turned grey. I am surprised that the dog had not bitten his tail or his backside."
Showing what is wrong is important in vet practice. The woman in her late 30s and her taciturn husband smiled a bit. Humour is sometimes important in connecting with new clients. They were from Woodlands. The wife wanted a health check up from me and had made the appointment the day before. Vet 1 had told her that her dog suffers from Grade 1/2 heart murmurs and so she would want me to give a complete check. "The heart murmurs are confirmed," I said. "But it is not serious since your dog has no coughing or loss of energy." That was good news. "If you want X-ray to see whether the heart is enlarged and the lungs are normal, let me know." The left femoral pulse was of poor quality but I have to check again this Sunday.
"Is it necessary?" she asked.
"No," I said. "It is advised as there are no signs of heart disease.
"There are so many new practices with beautiful furnishings and furniture," I compared my older premises to such new practices and asked where she would come quite far to consult me. Many Singapoean pet owners are impressed by new clinics with their shine. "New furnishings are not important," the wife said to me. "It is the vet's experience."
PHYSICAL EXAM - normal despite complaint of the dog turning his neck to the side sometimes. A painful throat but the dog disallowed mouth opening. He would twist and turn whenever I tried to pry open his mouth. "I will check for infection or tumours of the tonsils and the back of the throat during dental next week," I recorded this finding.
BLOOD TEST - ALT increase double the higher range. Liver or muscle damage but this will need another test.
URINE TEST - "Not a chance that my dog had peed this morning," the wife said to me. "We watched him closely and brought him straight to you from Woodlands." Yet when I passed a urinary cathether into the small bladder, I could get around 10 ml of urine. Why?
Results - Bacteria 3+, protein trace, bilirubin +, SG high, pH 6.5, casts but no urinary crystals. Only the bacteria count was considered significant.
"Your dog may have cystitis - a bladder infection," I said to the wife by phone. The dog was neutered very young at 8 months and his belly and neck were pigmented due to scratching. As to the cause of this black skin pigmentation, it is hard to say but it resulted from skin scratching over a long time of years.
"Does he need antibiotics?" she asked.
"I did give you some baytril tablets 2 days ago for dental scaling, to kill off bacteria in the mouth 7 days before dental scaling," I said.
"Is my dog fit for anaesthesia since he has liver disorder?" she asked.
"The ALT enzymes are not very high and the dog has good appetite. He should be OK for anaesthesia this Sunday."
Today is Wednesday. I will do the dental scaling this Sunday. Overall, the dog has passed his health screening.