Thursday, November 16, 2017

3193. *TIPS FOR VETS: Picking up a Corgi for dental work and eyelid stye removal

Friday Nov 17, 2017

The patient lives in Toa Payoh Lorong 3 which is a short 5-minute drive from Toa Payoh Vets. The vet can wait for the owner to be free or provide a free transport service to pick up the dog at 10 am today. I did the latter. "Business cannot wait for the service provider, the service provider waits for business."

I went to the surgery and forgot the appointment at 10 am to pick up the Corgi, as promised yesterday when the dog came in for vaccination. After all, there are the inpatients and other matters to distract the vet.

I had this reminder in a note taped to the front door so that I cannot miss reading it. The dog is now in the surgery after my assistant helped me to get him from the apartment in Lorong 3. A fine sunny morning.    

3192. A 5-month-old Syrian hamster bit off her stitches on Day 2

Nov 16, 2017

Korean lady bought this Syrian hamster. Very gentle at home, but made a lot of hissing sounds when i handled him.

Big right inguinal swelling. It was an inguinal hernia which grew larger every day. See previous video.



On Nov 16, 2017, the owner phoned about stitch breakdown. I asked him to bring in quickly as guts may fall out if the hamster continued bitting off the inside muscle stitches.

Only the skin stitches were bitten off. A foul smelly pus inside. The muscle stitches were OK. I drained the pus, used 6% hydrogen peroxide and give oral antibiotics. Warded the patient.


3191. A 21-month-old dwarf hamster has a large neck lump - email query about surgery





29/10/2017, 18:55 - Messages to this chat and calls are now secured with end-to-end encryption. Tap for more info.
29/10/2017, 18:55 - Hamster query la: Hi there
29/10/2017, 18:56 - Hamster query la: There seems to be a growth near my hamster’s neck. She’s been struggling to drink water recently. Do you have an available appt on Tuesday 9.30am?





29/10/2017, 18:57 - Hamster query la: IMG-20171029-WA0005.jpg (file attached)

29/10/2017, 18:58 - Hamster query la: Can I check how much do you charge for consultation, lumpsectomy or euthanasia? Pebbles (my hamster) quality of life has dipped significantly and it’s v difficult to watch. So I want to know if there’s such an option
29/10/2017, 18:58 - Hamster query la: Thank your
29/10/2017, 18:58 - Hamster query la: *you!

29/10/2017, 20:31 - Sing Kong Yuen: Thank you for msg. Consult $40. Lumpectomy around $200 as tumour is large.  Euthanasia $60

30/10/2017, 03:09 - Hamster query la: Ok. Can I make an appointment on Tuesday 930am? Typically what is the success rate of lumpectomy surgeries? My hamster is about 1y9months now

30/10/2017, 05:57 - Sing Kong Yuen: Appt 9.30am  Tuesday ok
Success rate generally 100% in lumpectomy of tumours that are under the skin and not inside muscles or involve bones or joints and are less than 1 cm across. Hamster must be active and eating if he is over 2 years old.

30/10/2017, 06:07 - Hamster query la: Ok. Great, see you on tues. pebbles is moving fine (less than before tho) and still eating and drinking (we need to feed manually as she struggles to get to her water bottle). if we proceed with the surgery, will we be able to do it on the same day?

30/10/2017, 06:43 - Hamster query la: Sorry for asking so many questions, rlly appreciate your help and patience!
30/10/2017, 07:33 - Sing Kong Yuen: yes. on the same day

30/10/2017, 13:02 - Hamster query la: Sorry can I change the appointment to wed 0930 instead?
30/10/2017, 14:11 - Hamster query la: I was going to ask my Sister to bring pebbles over tomorrow but I’m going to fly home tomorrow instead. I’ve been in Australia for a holiday
30/10/2017, 18:51 - Sing Kong Yuen: ok

31/10/2017, 19:10 - Hamster query la: Hi we can cancel the appointment tomorrow. My hamster has passed on
31/10/2017, 19:13 - Sing Kong Yuen: ok

Monday, November 13, 2017

3190. Clinical research. X-rays. Red-eared sliders compared. 300pixels





Compare above 16-year-old slider, not eating 1 week, had swollen eyes 1 week, with the others below.







3189. A 16-year-old slider stopped eating for 7 days. Why?

Monday Nov 13, 2017

The woman in her late 40s love the two 16-year-old red-eared sliders. The bigger sized one eats and is still eating while the smaller one had stopped eating for the past 7 days.

"Both are females and are housed separately on the bathroom floor because they will fight," she told me.
"What do you feed them and how much?" I asked when she told me she fed pellets solely.

 She was happy to WhatsApp 3 images from her mobile phone. Lots of pictures of the sliders showing how much she loves them.

I got the slider X-rayed. No eggs inside. So no cloacal obstruction of eggs.

Video of X-ray at:


Obstruction of alimentary tract?






The slider is lethargic as I can see she is stationery most of the time. She did open her mouth to try to bite me when I pulled her forelimbs to check her paws. No shell rot. Will give antibiotics.



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Compared to other sliders' X-rays

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Saturday, November 11, 2017

3188. Oxytocin in reptiles

Egg binding in combination with calcium (calcium glubionae).

1) Calcium glubionate  10-50 mg/kg IM as needed until calcium levels back to normal or egg inding is resolved. Oxytocin 1-10 IU/kg IM. Not as effective in lizards as in other species. Use care when giving multiple injectons.

2) To induce oviposition:
1-30 IU/kg. 10 IU/kg appears effective in many chelonians. May repeat in several hours, but risk of oviduct rutpure if cloacoa is obstructed* or eggs cannot pass for other reasons.

MONITORING
Uterine contractions, status of cervix
Fetal monitoring



*take X-rays

Egg binding




Impaction

3187. Images of Singapore houses, airports


Terminal 4, Changi Airport, Singapore








3186. Singapore cats. Trap, Neuter, Release program

Two cats from a loving home are sent for sterilisation by the vet. They are not stray cats. 


3185. Rectal prolapse in dwarf hamsters

Youtube video
https://www.youtube.com/watch?v=cgFFngOD11A







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Unusual case of rectal prolapse. The hamster is still active and eating and pooping via the prolapsed rectum (evidence - see below). The prolapse was double the size of usual rectal prolapse. I ward him for 2 days and gave antibiotics.

On Day 2, lots of yellowish pus spilled out from the prolapsed rectum. The rectum itself had a large abscess. You can see the scab closing the wound of the abscessed area.

On Day 3, the hamster went home. He bit off the stitches, but no prolapse.  Around 4 days later in Nov 15, 2017, I phoned the owner. There was no rectal prolapse at all. The outcome was excellent.







Friday, November 10, 2017

3184. Ah Boy JR blood in urine weak legs


M, not neutered, Jack Russell, 13 yrs    blood in urine   unable to get up normally on hind legs  "constipated" now Nov 10, 2017



Tense swollen abdomen when consulted 5 days ago.
Now, no blood in urine but still has difficulty standing up on hind legs.
Difficulty in giving medication. Will follow up.

Wednesday, November 8, 2017

3183. A 4-month-old kitten fractures her right hind limb. Salter-Harris fracture type 2 distal femur


INTERN. VIDEO PRODUCTION

HOOK

"Why do you bathe your adopted kitten weekly?" I asked the couple.
"She is adopted. She does not groom her backside after pooping," the husband said. "The cat will clean her backside for her!"
The husband held the kitten after bathing her in the kitchen sink. The kitten wriggled and fell onto the floor. Vet 1 took an x-ray and advised him to go to a vet for surgery to align the broken femoral bone.





Video of kitten before op.


 BKTP IMAGE AND TITLE
A kitten breaks her leg after bathing


PRE-OP VIDEO


SURGERY

Vet 1's X-ray.
Best practice is to take X-ray of both limbs for comparison. Sedation is needed.
I got another X-ray taken as shown:


Salter-Harris fracture Type 2.
Vet 1 said that the fracture was Type 1 but he was not sure whether it was Type 2.

ILLUSTRATION OF SALTER-HARRIS FRACTURES, NORMAL,  TYPE 1 TO 5 



 SURGERY
1. Some vets use short pins to anchor the fractured femoral head to the main shaft. This meant external pins and involvement of the joint.
2. In my case, I used intra-medullary pin and plaster of paris cast. (Intern to read text in X-ray)








POST-OP VIDEO

 Hospitalised for around 1 week
Antibiotics and painkillers daily.
Check for swelling of toes, infection of cast edges
To take out cast in 1 week to check the skin incision wound and replace cast.
 Cast removal 6 weeks post op.





VIDEO OF KITTEN ON DAY 3



CONCLUSION


"Will the kitten walk and jump normally 6 weeks later?" the couple asked.
With the cast to immobilise the femoral head part to the shaft, chances are good that there will be union and the kitten will have a normal leg again.

CREDITS




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BELOW IS NOT FOR INTERN

Vet 1 had taken the X-rays twice and advised surgery for the Salter-Harris type 1 or 2 fracture.
The owner phoned me the next day, Nov 7, 2017. Surgery was done on the same day.


X-rays done by Vet 1. Only one leg was X-rayed






TIPS FOR VETS
x-ray should include the normal leg for comparison and as best practice.







Salter-Harris Type 1 fracture involves only the physis.
Type 2 fracture involves extension of the fracture to the metaphysis or epiphysis
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A cast is needed as this fracture near the joint is unstable. If the fracture is mid-shaft, there will not be any need for casting as the pin will hold the two broken bones together to heal.

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Be Kind To Pets Veterinary Educational Video
Salter-Harris Fracture Type 2 distal femur


X-rays need two normal femurs to be X-rayed, not only one injured femur as done by Vet 1.




Above X-rays done by Vet 1. Only one leg is X-rayed. The kitten was in pain and struggling.








Nov 13, 2017

6 days of hospitalisation. The left knee incision wound to insert the pin is not infected as there is no bad smell and the kitten is active and eating, pooping and urinating in the litter. See video.

The kitten goes home today, confined in small cage as in Toa Payoh Vets for the next 10 days. The kitten will need to come back for review and the cast taken out for checking whether the skin incision wound is infected or damp under the plaster of paris cast.

Strict confinement to the cage for the next 10 days is necessary to prevent movement of the pin away from the femoral head.