Monday, June 17, 2013

1466. Sunday June 16, 2013 - Interesting cases

I rushed to see the overweight Jack Russell who drank and drank for the past 2 days. As if he had diseases of the liver or kidney or diabetes after the 10 little bladder stones were removed by Dr Daniel 2 days ago. We did not do a blood test as there was a need to reduce medical costs for the taxi-driver owner, a white-haired gentleman from the heart lands. His friend and his wife came to visit the dog the past 2 days and therefore I deduced that this Jack Russell was much well loved.

There was another gentleman who loved his Poodle much too. Her bladder stone was solitary and removed by me and the dog went home the 2nd day after surgery yesterday as she was as active as before surgery. She did vomit yellow gastric juice after surgery, which was unusual. But she had kidney stones.

Both owners took home the urinary stones. They  were advised to do chemical analysis of stones but owing to economics, both did not do so and I did not insist since urine tests showed calcium oxalate for the Jack Russell and triple phosphate for the poodle. For the poodle, I strongly advised taking S/D to dissolve the kidney stones but it seemed that the dog would have none of the S/D. "Give 90% her food and 10% of the S/D first," I advised. Much depends on the owner's compliance.

As for the Jack Russell, I said to the taxi-driver, "No dry dog food, no dog treats. Just home-cooked rice and fish or chicken and vegetables."

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Teach and learn for Intern Terrence

"Some interns can't solve the problem but you should be able to since you are from a top school," I said to Intern Terrence. "You are a student of Raffles Institution."  He was new to producing the first video for me, using Windows Movie Maker on a Samsung laptop. The problem was that there was no visual but voice only when he ran the video.  Two weeks ago, he replaced the Movie Maker by downloading a newer version. "It takes a long time to download," he said. Toa Payoh has poor internet connections although I have this dongle. Then I took the laptop to Khin Khin's Myanmar IT manager who did something and the visual appeared. "I studied computer for 4 years," he would not tell me how he did it.

However, the visual disappeared again and so I asked Terrence to spend half an hour researching Microsoft's FAQ which he did not do so last time. He did googled and got some internet forum but could not solve the problem.

This Sunday, he solved the problem within 5 minutes from Microsoft FAQ telling him to update one Window's file. So, he learnt a bit rather than just observing vet work. I asked him to video a white hamster with an orange stain on the left cheek and head tilting to the left. He was new to the video and some parts were blurred. Will need to teach him and learn more. I put the hamster and he videoed as it dashed towards him. There was now evidence that the hamster indeed tilted his head to the left, as complained by the owner! It is not easy as the head tilt was not obvious when the hamster was still, unlike in a big dog, rabbit  and cat.        

As to the cause, I anaesthesized the hamster while Terrence was supposed to video my work. The cheek pouch was impacted. Orange stain came from a soft food tissue embedded deep inside. Left ear not inflamed but irrigated. Left cheek commissures ulcerated. We have to wait and see if the head tile is no more.

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