Sunday, July 8, 2012

1068. Sunday Jul 8 2012's interesting cases

Sunday Jul 8, 2012
Bright, sunny, blue skies

1. Shih Tzu review. Came 3 days ago for two eyes with ulcers and eyelid discharge indicating that the owner was unable to provide post-tarsorrhaphy eye care. Hospitalised. Today, I stained fluorescein. Eye ulcers had healed more. Continue treatment at Toa Payoh Vets

2. Roboroskvi with large inguinal lump 8 mm x 8 mm x 6 cm.
I noted that this aunty came all the way from Bukit Batok with this sleepy Roboroskvi, female, 11 months old. "My niece referred you to me," she said. "She had a robo with grey cement discharge and it was treated by Dr Daniel."
"What happened to it?" I asked.
"OK, but the backside hair did not grow back."
Her Robo was so quiet that I suspected that it was extremely ill. Normal 11-month-old robos are like rockets. They don't stay still at all. The large tumour was hard and maroon, probably a malignant bleeding breast tumour with blood. It died peacefully sitting up and I told the owner the bad news at 5.10pm. Always check the underside of the hamster as tumours are quite common in this area.

3. The driver's Lab Retriever was panting hard last night. He was treated 10 days ago by Vet 1 who did not open today. The wife remembered me from 20 years ago when I treated her dog. "Has he a swollen abdomen," I said. "He lost weight, so the abdomen looks swollen," the husband said.
Vet 1 suspected leukaemia based on blood smear but CBC was not possible due to machine breakdown. He also told the owner that the dog ought to be neutered as it had prostatic hypertrophy. "He put a finger into the rectum," the husband said. "He advised me to neuter the dog."
So what's wrong with this dog?

Vet 1 faxed over the case sheet but he did not do the CBC although he did the biochemistry. He treated with Tardak injection and so I presumed he diagnosed prostrate hypertrophy or prostatitis. But I could not feel any prostate pain or enlargement. I asked Dr Daniel to do a digital rectal examination. He said there was no prostate enlargement. "It could be that Tardak injection had worked," I explained.

The owner did not want to pay for any blood test or X-ray of the chest. I examined the heart (left pulse weak, mitral valve sounds needed further examination.  I palpated the abdomen (spleen slightly enlarged) but no pain in the prostate. No fever.

I took a blood test for examination using the grant for such cases.

4. A lady brought a very thin 16-year-old Shih Tzu, not spayed with 4 breast tumours for antibiotic jab. The dog vomited and had some fits. "It is towards the end of her natural life," I said. So there was no point in advocating dental work as the teeth were all fully plugged with tartar. She went home after treatment by Dr Vanessa. Shih Tzus at 16 years old are extremely old.



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