Sunday, May 11, 2014

1363. Travel stories - Dubai

May 11, 2014

I was in Dubai from May 8 to 10. This was my 3rd visit to Dubai. Many new changes. The Kinokoniya book shop in Dubai is bigger than the basement floor of the National Library in Victoria Street and around 10 times bigger than the Singapore branch!

Today, May 11, 2014, I am in Athens, Greece now. Some interesting images of Emirates on the flight from Singapore to Dubai, taking 8 hours.

A very successful global airline - Emirates





 











Taxi drivers are probably 100% foreigners.




 
 
 
 
Videoing the Musical Fountain at 6.30 pm



Earning a living at the Musical Fountain, Dubai. Cross-selling products brings in more revenue rather than just depend on photography alone

Wednesday, May 7, 2014

What do do if a cat can't poop?

What to do if a cat can't poop?

An old cat did not eat and could not pass motion for a few days. Rectal enemas were given by the other vet but no stools came out. I gave rectal enemas with no result. X-rays revealed rectum impacted with stools and more faecal lumps in the large intestine, numbering around 15 balls of stools. What to do?

1. Open up the large intestine and take out the balls of faeces.  Then change to a high fibre diet. This was successful in the few cases.
2.  Using a gloved finger and extract the stools in the anaesthesized cat. This was my choice as the cat was fat. 



Saturday, May 3, 2014

VIDEO PRODUCTION FOR NICK. The Aunty's dwarf hamster will not eat. The Aunty's dwarf hamster tilts his head


Many Singaporeans address Chinese women much older than themselves as "Aunties".  These are women usually older than 40 years of age. The senior citizens would dress in  a certain conservative fashion. They would wear short-sleeved blouses and trousers. They are usually more conversant with the dialects or Mandarin. They don't surf the internet to look for hamster vets as they don't use computers.

(WET MARKET SCENES OF AUNTIES IN TRADITIONAL BLOUSE AND SLACKS)

So, I was much surprised to see an "Aunty" who lived quite distant from Toa Payoh, bringing a plump snow white dwarf hamster to Toa Payoh Vets for consultation instead of going to the practice in her neighbourhood. Nowadays, there are over 60 veterinary clinics as in Taipei where it is so convenient to find a vet.

"Mimi, does not want to eat, " Aunty said. "She would scatter the seeds and pellets with her front paws instead of eating them nowadays!"

"Her head is tilting to the left," Aunty pointed to Mimi's left side.

VIDEO OF HEAD TILT

I could see that Mimi loved food as she weighed much more than the average hamster. She was filled up and was as round as a big hen's egg. So why was she not eating? The head tilt would be painful and she would not be able to grasp the seeds properly and eat.

Dr Daniel anaesthesized Mimi, checked that there were no embedded seed fragments in the cheek pouch and irrigated the ears. After 5 days of oral medication, Mimi recovered.


Yesterday on May 2, 2014, this Aunty brought Brownie, a one-year-old male dwarf hamster to consult me saying "He is losing weight day by day, unlike Mimi you treated last week.He weights 38 grams today. Every day, I gave him water by syringe as he would not eat, unlike Mimi who weighed 72 grams when you saw him."

"How's Mimi's head tilting nowadays?" I asked Aunty.
"She is OK now."
"No more head tilting?" I asked.
"None at all. After 5 days of medication, her head is upright and she eats."

This was good news as it is difficult to treat head tilt in hamsters and rabbits as there are many causes.

I weighed Brownie. He was indeed 38 grams. His body looked long as he was very thin. My first diagnosis would be ingrown front teeth and so I opened Brownie's mouth. I saw two upper front teeth growing backwards and upwards hitting the hard palate. The lower front teeth were short and normal in wear.

"He cannot eat because his upper front teeth cannot bite the seeds as they are overgrown and have curled inwards and upwards," I said. "This is the second case as I just treated another hamster with a similar malocclusion problem.  Clipping his teeth will resolve his not eating problem."

VIDEO OF THE FIRST CASE OF HAMSTER WITH INGROWN UPPER TEETH AND SURGERY DONE BY ME

As for Brownier, Dr Daniel anaesthesized him and clipped the teeth and got the action videoed for Aunty.

VIDEO CLIP OF SURGERY

Aunty was delighted to view the clip.

FOLLOW UP THE DAY AFTER SURGERY

Today, a bright blue sunny Saturday morning of May 3, 2014, I phoned Aunty. "Is Brownie eating?" I expected a positive reply.
"Yes, Yes" she said happily. "He ate a small piece of Brocolli. I need to buy something for him to chew. Do you know? He bit me when I tried to clean his belly button!"

"If Brownie can bite, it is good news," I said. "He should be able to crack open the sunflower and melon seeds. Chewing such seeds will be more useful as his teeth can wear down.

"I need to buy him a chewing toy," Aunty said.

Some hamster owners buy mineral blocks or wooden sticks for the hamster to chew upon. In this way, the hamster does not chew on the wired cages, making them rusty.  

VIDEO OF CHEWING BLOCKS AND WOODEN BLOCKS FOR HAMSTERS

A hamster's tooth grows continuously and if it is not worn down by eating hard food, it grows and grows and curves inwards or sideways as this was what had happened to Brownie and the other hamster.

CONCLUSION OF THE CASES
The inward and upward growing of the two front teeth in these two hamsters is an uncommon condition. During the past years and treatment of a few hundred hamster cases at Toa Payoh Vets, these are the first two cases of malocclusion of teeth in dwarf hamsters. Good anaesthesia is essential as the tip of the tongue of the moving hamster may be accidentally cut off if the vet does not use anaesthesia thinking that he or she can just grip the hamster and snip off the ingrown teeth.

These two hamster cases illustrate the diversity of illness and diseases even in the dwarf hamster. They make a day of veterinary medicine filled with surprises and challenges. The vet has to "deliver the goods" to sustain and grow his practice.

REFERRALS
For this Aunty, she told me that her niece had referred her to Toa Payoh Vets as the niece's hamster was treated with a good outcome. So, it was not the internet that brought her here.      










     

Thursday, May 1, 2014

1360. Time is running out - closed pyometra in an old dog

When the vet said that the dog has very low chances of survival on the operating table and the medical costs are high as in this closed pyometra case, it is very difficult to justify paying for a probable anaesthetic death. The owners decided to bring the dog home to die. But there was this 12-year-old boy who cried his heart out. Usually vets don't follow up as the owners had decided but this little boy did love this 14-year-old dog very much and knew the outcome. I phoned the owner the next morning. The dog was still passing bloody vaginal discharge and was inactive. He decided to get her operated and I reduced the surgical costs to give this high anaesthetic risky canine a chance to live. Time is running out on her,

If she survived the anaesthesia and surgery, the little boy would be most happy to get his companion back to health and that was what mattered in this case.  "Don't wait till you have finished work this evening to bring the dog down," I advised the father. "Bring her down now while she still has a fighting chance to live."  Time is running out. Dr Daniel operated, removed a gigantic womb filled with brownish-red pus, about to burst if surgery is delayed.



The little boy was most happy to have his companion back home the next day.

This would surely be how a vet can make a difference if he makes time to follow up before time has run out for a little boy's best friend. Happiness in the boy's face when the dog went home the day after surgery would be hard to describe. "Are you happy now?" I asked him as he sat at the back of the car with this old dog. "Yes," he nodded vigorously. Time was running out but the father's decision to operate and the intensive IV drip and medication given prior to surgery stopped the time running out.    


Thursday, April 24, 2014

1358. An old Miniature Pinscher can't pee

"It is always best to get an X-ray done rather than just unblocking the bladder," I said to Dr Daniel as the owner of the overweight Miniature Doberman Pinscher dribbling urine wanted to save on medical costs and so the dog was warded for 2 days. So today, I got the dog X-rayed. Several big urinary stones obstructed the urethra at the os penis area and many more were in the bladder.

"The bladder is about to rupture," I advised an emergency surgery. "Around 10 stones in the os penis and more than 16 inside the bladder!"

The owner had delayed seeking veterinary treatment for many weeks. Blood tests showed kidney failure, thus explaining the persistence of daily vomiting by the dog.

The owner gave permission for the emergency surgery. The dog survived anaesthesia and surgery done by Dr Daniel. However, he passed away 3 days later.

Chances of survival after surgery are much lower if owners have been dragging their feet in getting their dog treated early by the vet.  


1357. An old Miniature Schnauzer leaks urine soiling his belly



On Good Friday, this 12-year-old, male Miniature Schnauzer came in the morning. A strong urinary smell. "My dog has not been eating for two days," the owner said. I palpated an enlarged bladder half the size of a mango and diagnosed "bladder being blocked." Dr Daniel told me that he did not think for reasons I don't remember. He inserted a catheter and confirmed "urethral blockage." As he did not tape the catheter, it came out.

The next morning, after breakfast, the owners came to check on the dog when I was exercising him. I brought the dog out and he lifted his back left leg to pee. We waited. No urine at all. The young adult son and daughter were much worried. "Go ahead with the surgery," the mum said. The dog was still lethargic owing to being infected with bacteria in his blood stream and urinary system as confirmed by lab analysis of the blood and urine.








It is always highly risky to operate on such an old dog. That is why the young adult children were worried.
I gave him 2 bottles of IV drip, with amino acids, baytril and spasmogesic on the day before surgery to be done by Dr Daniel. To strengthen him.

I got the dog X-rayed using air-contrast to check for bladder wall tumours as well. No tumours.

"There is no need for surgery as the stones are small," Dr Daniel commented.
"It is possible that the stones can be dissolved by dietary management," I said. "But the owner has to be diligent to monitor and get X-rays and urine tests done. Most Singapore dog owners just don't have the time to do monitoring and testing."

During surgery, the stones were small and gritty and 7 were found. The biggest was 4 mm across. The dog stayed for 5 days and went home able to pee freely.