Tuesday, January 14, 2014

1303. Two paw warts keep growing despite medication

Surgery is the only treatment, not anti-inflammatory medication.












Monday, January 13, 2014

1302. The man who buys a sports car for $175,000 for his wife

The man who survived the bike accident and is blessed by the gods came to buy 2 small bags of H/D dry food for his wife's dog ( husband of the story in "Damsel in distress")

A shiny white 2-door BMW 3.55 double exhaust sports car bought with cash at $175,000 in cash. "The Bukit Batok salesman asked me to get a loan as he has lost money since the car is with him for the last 6 months! I told him why not he give me the car free or further discount?"

"The low mileage of 30,000 km in this BMW of 3 years. Is it correct? Could the salesman re-wind the mileage?"

"Not possible in sports cars," he said with an air of authority. "My other Mitsuibishi car can be rewound. I paid Performance Motors to confirm the mileage. They asked if I want a senior or junior technician or a rookie. The senior one charges more and the junior grade is young and knows better!"

What sort of logic is this? Oldies are not up to standard?

"Has it got an accident?" I asked.
"None," he said. "The driver wanted to upgrade to a Maserati and seldom drove this car. I told the salesman I would sue if he misrepresented as accident free. There is the lemon law to protect buyers nowadays! In any case, I had the car inspected by the STA"

So he had a good deal.

"Try not to speed and live longer," I said as he told me that many Singaporeans are not aware of some straight long roads to trash a sports car.. He was nearly 40 years old but he had taken courses in car racing in Johore and knew how to handle this thoroughbred. He is hands-on on sports car mechanics as a specialist of sorts and so he is no ordinary person like a vet who does not know in depth that a sports car must be handled differently from an ordinary car.

"The bumper is very low," I said. "Will the car hit the road humps in car parks like Junction 8? I note that the Audi can't take it."

"Drive in an S-shaped way across instead of directly on the hump," he advised. That is a good tip.
"Sometimes it is not possible in a confined space," I said.

I wish him well and hope the traffic police would not catch him trashing the car. It is not wise to buy a second-hand sports car as it will have been fully trashed on the road.





1301. Case 1. Lose a foot to save a toe - toe warts in a hamster. Case 2. The fat hamster keeps licking his toe wart.

Case 1.  Jan 13, 2014

The owner phoned to say that the anti-inflammatory drugs prescribed by Vet 1 had not worked.

Last week, I had advised surgical excision of the two toe warts but did not say that the toe would have to be amputated, as there is a possibility of slicing off the warts by electro-excision. So, the toe would remain but there is a chance that the wart may re-grow. 

With amputation, there is zero recurrence as the toe is gone.

When Vet 1 told the mother and daughter that the toe may need to be amputated, both did not want the surgery. To prevent the hamster from continuously licking the toe warts, Vet 1 prescribed anti-inflam as an alternative.

Now, the owner said that the medicine does not "work" as the hamster still licks.

"Warts keep growing every day and the hamster tries to bite them off as they are burdens to movement," I said. "Vet 1 mentioned that toe amputation may be needed. However, you did not want the toe amputated and so you try to save a toe. 

In the end, saving a toe will result in losing a foot as the hamster bites the warts and the whole paw becomes infected and gangrenous later!"

The owner agreed to the surgical excision. No oral drugs including pain killers can dissolve the skin warts and usually the owner becomes unhappy with this method of treatment as in this case. 

Each vet has his or her own judgment but surgery is the only option in hamster wart treatment. For dogs, toe warts may be tolerated, but not the nimble dwarf hamster!    








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Case 2.  Oct 25, 2016


 Case 2. The fat hamster keeps licking his toe wart






SINGAPORE - 15 OCT 2016. The overweight 88-gram Sapphire dwarf hamster eats a lot. Normal weight should be 45-50 grams. He comes to Toa Payoh Vets for toe wart removal surgery.  









1300. Lion Dance Point Veterinary Surgery

http://youtu.be/yFToiXjm4bI



http://youtu.be/SdXj0ORhqfk










7 days after the ear surgery, the wound is healing well. The lady owner cleans up the bleeding with cotton swab. It appears that bleeding still persists but overall, the wound is clean. The "yellow" piece is the ear cartilage below the ear canal while the red black piece is the blood clot on the ear cartilage.

"I have watched the Youtube videos of other cases and I know what the operation is meant to do," the young lady said to me. So there was no need to educate her. "I have a video done by an  intern, but it is not ready yet!" 

Sunday Jan 12, 2014's interesting cases of 6 dental cases.




Sunday Jan 13, 2014

"You have 10 surgeries to do," I said seriously to Dr Daniel who took over at 12 noon while I went to attend the official lion dance opening of Dr Jason Teo's Telok Blangah Vet Surgery. It is difficult to do surgeries and consultation from 12 noon to 5 pm on Sunday if only one vet is working.

So I returned to work in the afternoon as well as in the morning when I had the following 6 dental scaling and check up to do.

Case 1. The deaf Jack Russell. He became deaf suddenly yesterday. The owner requested dental work as the foul bad breath got worse in the past month. "The sudden onset deafness is unlikely to reverse with dental work," I explained. "The origin would likely be in the brain. A blood test will be taken but more tests need to be done." Brain and ear canal scans need to be done but it would cost  more than $1,000.

Case 2. The 14-year-old Papillon came in for dental work. The lady was referred to me as the dog had fits. "Blood tests show kidney failure, likely to be aging as the dog is very old," I said. "Dental extraction of all the rotten infected loose teeth may stop his fits and reliance on anti-fits medication. I had only one case where dental work eliminated fits but most causes of fits are unknown."
"My dog was very wobbly yesterday but had not fits after being given a (30-mg phenobarb) tablet," she said.
"The medication causes drowsiness and incoordination," I replied. "It controls fits if taken but is not a cure."
"Will my dog die under anaesthesia?" she had never done any dental on this old dog before.
"There is a high risk esp. when he has fits, kidney failure and now a low rectal temperature of 37.1C," I replied. "Dental extractions do not stop the kidney failure in aged dogs," I made it clear to her to prevent misunderstanding. I got the teeth out under gas anaesthesia and the dog was OK.

Case 3. A young lady adopted a poodle from a Voices For Dogs and went to 2 vets. Her friend in a blue Volkswagon drove her to Toa Payoh Vets to consult Dr Daniel who was not yet at work. So I talked to them as they were referred to me by two Straits Times journalists whose pets were treated by me.

"The first vet says all teeth must be extracted. A second vet says that not all teeth need to be extracted. We are confused. We spoke to Ms A and she said to send the dog to Toa Payoh Vets and we have phoned Dr Daniel for an appointment."
"Dr Daniel will be here soon," I said. So, this was the 3rd dental case. When Dr Daniel came, I had a look at the dog's teeth. Due to poor nutrition or tetracycline drugs as a puppy, his teeth lost the enamel covering at the tips. I left this case to Dr Daniel so as not to confuse the two ladies. He estimated the dog to be 3-4 years old and extracted 2 black loose teeth.

Case 4. A young lady studying in Tasmania back on holiday in Singapore, came with her mother for a dental scaling for the old Miniature Schnauzer. "I cannot be bothered to spend time and money on this dog," the mum told me. "But she keeps pestering me and so I bring this dog in for dental scaling." The young lady was silent as mum was the paymaster. Dental scaling prevents bacterial in the tartar spreading toxins inside the mouth and spreading to the heart causing heart disease or oral tumours and loss of teeth. But there was no point educating the older baby boomer generation who feels that it was a waste of money and time doing dental health for an older dog. And probably thinking the vet would have personal interest in recommending dental.

Case 5. This working lady in her 30s was too busy to seek veterinary treatment for her 9-year-old Maltese who kept passing dark brown vaginal discharge in the past 3 years. Last week, the dog was not eating and I palpated nodular lumps in the dog's uterus. Small balls of around 2 cm x 2 cm of various sizes big and small. A blood test was done but no X-rays owing to economics.

"Do the dental at the same time as spaying," she said and so the dog had the appointment today for spay and dental scaling. So this was the fifth case of dental. The Maltese has mult-lobulated uterine horns and the surgery took a much longer time than a simple spay. "This could be uterine cancer," Dr Daniel said. I thought it was a case of chronic open pyometra not treated over a long period of 3 years. Surprisingly the blood test did not show a high total white cell count. No histology of the uterus was advised by me as the owner wanted the least medical costs. I showed her the 200-gram flaming purple-red womb asking my assistant Naing to retrieve them from the bin as he had discarded them. Nothing is more impactful as the real womb. Digital images are of no use in showing the seriousness of the infection of the womb. The lady was thankful that her dog survived.
"No dental work is done," I showed her the pale gums as she came one hour post-surgery to take the dog home. "My dog never leaves home," she said.





Case 6. Cellulitis. The 13-year-old Maltese had raw seeping ear flaps and neck skin due to many weeks of rubbing by the back legs. Previously she had ear canal infections and was treated but the owner failed to maintain ear cleaning. "The teeth are all rotten," I said to the lady. "Since the dog needs to be sedated to clip and clean the cellulitis areas of the ear flaps and neck. The dental was done by Dr Daniel and the dog went home the next day.

I usually schedule one or two dentals on Sundays as they take at least 30 minutes per dental. But on this Sunday, 6 prospective dental cases flowed in. So I had to work on Sunday afternoon and let Dr Daniel handle the dental and pyometra cases without the stress of doing consultations in between. 

Sunday, January 12, 2014

Sunday Jan 14, 2014's interesting case - uterine carcinomas?

Maltese, Female, 9 years old.  

"My dog has this dirty brown vaginal discharge for a long time," the busy working lady had no time for veterinary check up. The dog was lethargic 8 days ago when I first checked her. Dripping vaginal discharge. Vulval lips and the area above it were swollen due to licking. I thought it was a case of hyperestrogenism. On abdominal palpation, numerous swollen nodules in the uterine horns of sizes as big as 2 cm x 2 cm.




blood test
low calcium 0.7 (1.5-3.6)
total white cell count is normal at 8.0 (6-17), but neutrophils 91.7% (60-70%),
platelets 63 (200-500)

This appears to be the start of a closed pyometra as the total white cell count is normal.

SURGERY today
Multiple lobulated uterine lumps with dirty brown pus + blood.Weighs 200g.The dog weighs 4.2 kg.
No dental is done as the surgery is quite lengthy.