Tuesday, January 4, 2011

290. Jan 4, 2011 interesting cases

Tues Jan 4, 2011

Case 1. The 15-year-old Beagle with mouth pain. I was worried that she might not make it under anaesthesia. The dog was hospitalised overnight. Had IV drip and antibiotics IV. At 9.30 am, I had her under surgery.

No sedative. Just straight isoflurane gas mask and intubated as this was the safest method. But quite troublesome as the dog puts up a strong struggle to be given gas without sedation injection.

Gums were very pink. Painful mouth due to long ulcers at the gum/teeth line. Only 2 teeth extracted. The 15-year-old has better teeth than most 10-year-old dogs. The gentleman owner came at 10.30 am while I was operating the 2nd dog with testicular tumour. He brought a pillow. I told him not to visit the dog. The dog was OK. Shivering and drowsy due to anaesthetic effect and her old age (not recovering as fast as young ones). Dog went home to a happy couple.

Case 2. The dog with testicular tumour was hospitalised yesterday and given IV drip and antibiotics. 12-year-old is a big anaesthetic risk. I was not looking forward to doing this surgery. The big testicular tumour was stuck to the underside of the scrotum. It would not be the simple testicular neutering surgery which would take less than 30 minutes.

Yellow white fluid shot out from the tunica and later from the testicular tumour. The other testicle was shrunkened. So, this was not only a tumour but an infected nasty growth. I needed to cut off the whole scrotal skin as the tumour was sticking to the scrotum (due to infection probably. INTERESTING HISTORY. 4 weeks ago, had high fever and Vet 1 gave antibiotics without examining the testicles - vets seldom inspect testicles actually. 2 weeks ago, visited Vet 1 to consult about testicle size. Couple consulted me yesterday as I had removed bladder stones from this dog in 2007!).

Dog groggy. I gave Antisedan to revive him. Overall, he was alive but I wanted him to be hospitalised as he had a 15-cm incision wound (will post pic later) after cutting off the sticky scrotum and base. If he went home and jumped about, the big hole will be hard to stitch again. The surgery is called SCROTAL ABLATION.

Other medical cases were the usual vaccination and not interesting to readers.


"What do you want me to do?" the 9-year-old girl pulled my hand. She was the intelligent one I mentioned in my writing sometime ago and I had asked the mother to send her to a better neighbourhood school. The mother said to me: "I have a client who is a teacher there. She tells me that the principal will need to interview and then there will be a test before admission. But my daughter does not want to go. So the teacher advised that it is better for my daughter to be happy where she is rather than be unhappy in a better school."

What kind of advice is that? I did not comment. Environment plays a big part in nuturing a child's academic performance. Many Singaporean parents go to great lengths, even renting a condo to be near a good school (2-km ruling gives advantage).

So, this girl had lost the opportunity to excell. Anyway, her mother saw her tugging my hand and said: "You can't do this. It is not good manners."

I said to the little girl: "I want to buy an exercise book. Can you buy for me from the bookshop nearby?"

"No bookshop. Must go to the school. Must cross road. So I can't go."

Her older brother of 10 years volunteered to buy for me. She has 4 siblings and she is No. 2 in age. Her friend Christobel was with her. So we went to the school.

The guard permitted me to enter.

1. Book shop closed. "What time does it close?" I asked. The children dashed inside the dentist's room. Why? There was a clock there. I went in the room after them. A dental nurse was shocked. It was past 4 pm. So the shop was closed.

2. Catching tadpoles. The big brother suddenly said: "Dr Sing, you pay $1.00 to buy a bottle of drink. I can use the bottle to catch the tadpoles (in the school pond). I took out $1.00 coin but the children did not want to buy. I saw a dustbin and got out a discarded water bottle for him. "Very dirty," the children refused to touch it as it was from the dustbin. "Just go to the bathroom to wash it," I said to the brother. He did it and used the cap to catch 2 tadpoles.

The little girl also wanted to catch tadpoles now.

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