Sunday, October 12, 2014

Script for Phyllis. Sunday's 4 interesting cases Oct 12, 2014

1. The blinded Siamese cat, male, 2 years old.
The other male cat clawed him. 3 male cats. 5 female cats.
"The females don't like him," the breeder said to me.
"He has stronger competitors and so the female cats usually prefer the stronger males."
"The males start to bully him nowadays and that is why his right eye was injured by claws."
The owner decided on the removal of the badly damaged eyeball but wanted to wait for 2 days.


VIDEO OF CAT'S EYE 

"The house wives who buy my cats are cheapskates. They want instalments, " the home breeder said. " Should I breed dogs instead? What breeds will you recommend?" the lady asked me.

"Breeding of cats and dogs are not a profitable business as the AVA will penalise anybody who tries to sell kittens and puppies without a licence to sell," I said.
"Yes, yes," the lady said. "My friend's HDB flat was raided as she was selling puppies through the Straits Times Advertisements." 
"How do you advertise without the AVA officers coming hard on you and knocking on your doors to investigate?"
"I use the internet or place the kittens in the pet shops but now I cannot even produce one kitten."

"Shih Tzus appear to be a very popular breed in Singapore," I replied to her queries. "Since you work long hours and leave the operation to your helper, the breeding will never be successful," I said. "There is much more knowledge and expertise required with the management of 3 male cats and 5 female cats and you have not produced any kitten.  Normally 1 male cat will do."

"The first male cat had become fat and lazy," the woman said. "So I got the second male. Somebody gave me this 3rd male Persian cat whose right eye was injured by the second male."

"A fat cat could be due to over-feeding," I said. "In any case, 3 male cats will not live peacefully and so they fight to become dominant and cause injury."

The couple decided that breeding was not profitable and would not do it.  They were busy with their meditation exercises in their spare time. So, they have no time for this breeding business. Every venture needs full attention to even have a chance of success and in this case, asking a helper to do it is the surest way to financial ruin.  Helpers are never passionate nor knowledgeable about the art of breeding dogs and cats.

CONCLUSION
A friend of the owner wanted to take over the cat and seek a second veterinary opinion on the eye problem.


2. A black dwarf hamster has an impacted cheek pouch.



HOOK with subtitles
"His right cheek pouch is swollen again," the lady owner placed her beloved hamster on the palm of her hand (video footage). "Her mouth is becoming smelly."

A BKTP VET EDU ....... TITLE ..IMPACTED CHEEK POUCH AGAIN



HISTORY AND EXAMINATION

"5 months ago, his right cheek pouch was packed to the maximum and I had evacuated the thick grass-like material," I showed the medical illustrations (IMAGE OF ACTUAL ILLUSTRATION IN CASE SHEET) in my case sheet to the lady teacher. 


"Yes, her cheek pouch was back to normal size for the first few weeks but become filled up again," the lady said. "I emptied the cheek pouch for her but now I could not do it. This time, her mouth had become smelly." (VIDEO VERY ACTIVE HAMSTER OBJECTING TO POUCH EMPTYING WITHOUT SEDATION)

I weighed the hamster. She was 41 g as she wass 5 months ago. I checked that the cheek pouch area in the face was inflamed and some areas were hairless owing to scratching (VIDEO).

ANAESTHESIA AND SURGERY
I sedated the hamster with Zoletil 50 IM (VIDEO). When she was less active, I emptied the cheek pouch. There was an ulcer at the lip commissure (VIDEO) causing the bad smell.

POST OP
The hamster recovered fast 15 minutes  after the sedation. She was very active. (VIDEO). She would be given the oral antibiotics and painkillers for the next 7 days. 


TIPS AND ADVICES TO PREVENT RECURRENCES

"Some hamsters prefer the right cheek pouch to store food," I said to the owner. "Just like some people who grind food more frequently with one side of the mouth."

 CHEEK POUCH IMPACTED



CHEEK POUCH EVACUATED







"What should I do to prevent recurrence?" the teacher used her handphone to photograph the "grass-like" roll of soft material of around 5 cm lodged taken out from the right cheek pouch (VIDEO). This was similar to the greenish roll removed 5 months ago. 

"You can empty the cheek pouch every 2 days. Give her just sufficient amount of food in the bowl. In that way she has not sufficient amount to store." 


CONCLUSION
Impacted cheek pouches can become infected causing pain, infection and loss of appetite. Some hamsters try to clear the food inside by hand. Sometimes they evert their cheek pouches as shown in the images below. These everted cheek pouches need to be put back inside the cheek by the vet.  Always consult the vet early when your hamster has impacted cheek pouches for more than 3 days.


PAST CASES OF CHEEK POUCH IMPACTION AT TOA PAYOH VETS



VIDEO
http://www.youtube.com/watch?v=pzL_tjwv0g0&feature=youtu.be

IMAGES FROM CASE STUDIES AT TOA PAYOH VETS
http://www.toapayohvets.com/surgery/050609hamsters_ToaPayohVets.htm



IMPACTED CHEEK POUCH
EVERTED CHEEK POUCH DUE TO IMPACTION
EVERTED CHEEK POUCH DUE TO IMPACTION
IMPACTED CHEEK POUCH









3. BKTP......        TITLE: A CAT HAS BUMBLE FEET

"A very rare case in Singapore cats, similar to the condition of bumble foot in rabbits" I said to the young couple who was present at 9 am on this fine Sunday Oct 12, 2014 morning.

"Do you house your cat on  a wired-floored cage with no bedding or pads?" I asked.
"No, no, she has the freedom to run around the apartment!"

"Was there something sharp she stepped upon?" I asked.
"No, no," the couple said.
Yet the underside of both hind feet showed one swollen wound each (VIDEO). There was bleeding and pus oozed out in one of the feet. What was the cause? The cat's hind feet were injured by something sharp but the couple could not feedback any possible cause.

"We did buy an anti-cat mat from the $2-Daiso store," the wife showed me her phone image (IMAGE). "It has sharp ends to prevent a cat from accessing the area behind the sofa. But the cat persisted in getting under the sofa!"   

"This mat would be the cause of traumatic injury to the underside of the hind feet," I said. "The cat was careful with her front feet but the hind feet would be pricked as she walked over the mat to hide under the sofa. Parts of the spike could have penetrated the underside of the two hocks of the hind feet. This resulted in inflammaton and infection with pus formation.

"The treatment is to sedate the cat and drain the infected skin wounds (CLIPPER, CLEANING VIDEO CLIPS). The cat was sedated with xylazine and ketamine IM and a thorough irrigation of the leg wounds was done. The cat's ears were cleaned. The anal sacs were expressed with lots of foul-smelling oil oozing out from the right anal sac (VIDEO). 
 


OTHER PROBLEMS IN THIS CAT
1. Hair shedding is more frequent nowadays. No more soft coat
2. Loose stools now and then in the past 2 months
3. A hairless brownish nose tip is not normal for any cat.

SOLUTIONS
PROBLEM NO. 1 - MORE HAIR SHEDDING. The cat may be stressed by the bumbled feet pain and infections and the stomach upset. The cause of bumbled feet was finally found to be the sharp ended mat bought from the $2-store Daiso. This mat was meant to prevent the cat from stepping onto the area behind and below the sofa. (IMAGE FROM OWNER'S HANDPHONE).

The cat would step over the mat but his hind feet were injured by the sharp ends. Over time, part of the plastic spikes entered the lower feet causing abscess. Treatment was to clip the hair and express the pus and foreign bodies. (VIDEO)

2. Stop using perfumed spray over the cat litter to keep it "clean" and to stop using perfumed shampoo very two weeks for the next 4 weeks. Use a mild shampoo or just brush the cat. The cat could have licked off the perfume, causing gastroenteritis now and then after the young couple had used the spray or shampoo. This is another form of stress leading to more hair shedding.

PROBLEM NO. 2 - LOOSE STOOLS
I advised the feeding of W/D, a high fibre prescription diet (canned) to be introduced slowly at 90% of old food and 10% of W/D initially till 100% for the next 4 weeks to stabilise the intestines and producing solid stools to clear the anal sacs. The right anal sac was impacted with black anal anal oil and infected. I expressed and around 1 ml of foul-smelling thick grey oil was taken out (IMAGE & VIDEO).



A high fibre diet which produces solid stools will help in evacuation of the anal sac oil daily during pooping.

PROBLEM NO. 3. The cat purred whenever the husband stimulated the nose tip for the past year. Daily rubbing caused friction and led to hair loss and brown pigmentation. The wife would tickle the neck area and the cat would purr with happiness. The husband would cease this nasal rubbing and hair would likely regrow some months later. (VIDEO CLIP OF NOSE). A review in 4 weeks time.

CONCLUSION
This was a rare case of bumble foot but the cat had other health problems like anal sacculities and management issues like spiked mat injury.

It was great that the other problems were discovered during this bright Sunday morning and the cat would live a happier pain free life after treatment of the pododermatitis with drainage, antibiotics and pain-killers.

The outcome of treatment should be good as the couple had not delayed seeking veterinary treatment. Delays would have led to tendon and bone infections of the hock resulting in poor prognosis. 


CASE NO. 4. A LABRADOR RETRIEVER HAS OPEN PYOMETRA
Infection of the womb in the older female dog is a common condition in Singapore. The owners came to Toa Payoh Vets as the first vet had prescribed antibiotics but the dog was still passing sticky brown red vaginal discharge during the past 2 days. IV drips and antibiotics were given. The dog was spayed the next day. Image of pyometra uterus. Follow up on Day 3.  VIDEO BEFORE AND AFTER SURGERY.    

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