Sunday, December 4, 2011

755. Sunday's interesting cases. The male cat bit the mother is neutered

Sunday's interesting cases of two male cats that got neutered

I was on duty in the morning of Dec 4, 2011. Bright sunshine although showers come in the afternoon. My first case was a Malay family bringing in a muscular male yellow cat with brown dots of 10 months for neuter. "I phoned yesterday for appointment at 10 am," she said. "This cat bit my mother and so I want him neutered!"

"Cats in Singapore apartments don't bite people, unlike dogs," I said. "Why would he bite your mother?"

"He was chasing away a stray cat that came to our apartment door," the lady said. "My mother grabbed him to stop him. He bit my mother's hand!"

Never interfere in fighting cats or dogs - that is the morale of the story.

5.5 kg. My formula is xylazine 0.1 ml + ketamine 0.4 ml IM for cats <4 kg for a female cat spay. In this male cat, the above dosage was given. It was effective even after a delay of 15 minutes as I had to vaccinate the Chihuahua who had bitten me when I visited the apartment some years ago. He was neutered and adopted by Theresa and daughter, a Myanmar family in Toa Payoh, that loves him very much. This dog was given up by another family in Mandarin Gardens as he was a handful, peeing and pooping everywhere. "Does he pee all over the apartment?" I asked. "No," the mother and daughter said. "He just goes to the toilet." This was a good ending for this naughty male dog who had put on considerable weight. As I had injected the above-mentioned cat, I informed Theresa that I had to rush and it was OK with her as she had to go to the market. She had started her employment agency business. "How's your business?" I asked her. "Not good," she said. "The MOM (Ministry of Manpower) keeps rejecting every application nowadays." There is a political shift of not granting work visas for foreigners as liberally as before since the locals are not too happy as these foreigners affected their salaries. CAT NEUTER NO. 2
A woman with a son with dark blue pierced ear studs on his left ear came with 2 cats that had been neutered and spayed 9 days ago by Vet 1. "The female cat is OK," I said. "The stitches will dissolve soon. There is one small hole due to stitch coming out but it is not a problem." She asked: "Can I bathe her? She is so smelly!". "Yes," I said. "Just put a plaster onto the wound and bathe her."

As for the male cat, there was an open hole in the right scrotal area with reddish discharge coming out. "This is very rare," I said. "I have not encountered such a case in my more than 30 years of practice." Vet surgery is always full of surprises. I said: "It could be something stuck inside the wound and that is why it is not closing. There is no pain at all when I press it. Still the cat must be sedated and the open wound examined."

"I have asked my friends and they say that cat neuter wounds usually close within a few days."

All surgeries do give rise to complications of one kind or another in some cases for all vets including some of my cases. Like infection, bleeding, pain. In this case, there was yellowish nodules coming out as I pressed the 5 mm vertical hole in the right scrotal area.

I gave the cat a very low dosage of xylazine 0.05 ml + ketamine 0.2 ml combined IM and collaborated with
Dr Vanessa to handle this case as part of my coaching program. "Put the artery forcep into the gap at 12, 3, 6 and 9 o'clock and pull out any strands of tissues." Systematically. She flushed with normal saline. I wanted the cat to go home as the owner mentioned about loose stools in both cases, since the two cats was given Clavulox for the past 9 days and I am worried that the cat would develop full diarrhoea in the Surgery. But Dr Vanessa advised keeping the cat in for observation and I was OK with it. From my experience, this wound would close after removal of debris inside. But it is wise to listen to other vets.

I phoned the owner who was at the back coffee-shop that the male cat remained in for observation. "This is my first cat," she said. "It is like first love," I said. "It is always remembered. Usually it is puppy love as we usually don't marry our first love! Have you got a first love, young man?"

The pre-teen boy who love jazz music seemed to nod his head. "But mum, you are a doggy person," the pre-teen son said to the hard-working mum who had much conferences to organise. I had more time to talk to them as Dr Vanessa handle the majority of Sunday's cases after 12 noon. It was good to see mother and the music son being close.

"The previous Shih Tzu had no eye problem," the lady in her late 30s brought back a young Shih Tzu with the right eye white red and tearing. The left eye had a central white scar but the eye white was not reddish.

I had not seen the other Shih Tzu but from what I had seen from other owners, the Shih Tzu could have less protruding eyeballs and its corneas would be pigmented and black due to irritation over time. "It is hard to say that your old Shih Tzu had no problem," I said. "Many Singapore Shih Tzu owners, in the old days, just ignored the eye problems as the Shih Tzu scratches to relieve its eye itch and pain. I would expect your Shih Tzu to have black or brown corneas unless its eyeballs were less protruding."

"You did stitch up the eyelids of both eyes some weeks ago," the lady told me. "Yes," I referred to my medical record where I illustrated two eyes. The left eye had a central ulcer which is now healed white spot of 3 mm with some blood vessels. The right eye cornea was written as "cloudy," but not ulcerated and would have healed.

Dr Vanessa put in the fluorescein strip and flushed off the green dye with a syringe of saline. There were 3 corneal opacities seen. At 3 o'clock, central and 9 o'clock but they were not stained green at all after flushing off the green dye by Dr Vanessa. "It is surprising," I said. "These ulcers are over 3 mm in diameter and yet they don't stain green as expected." The dog had been rubbing his right eye despite an e-collar of size 12. I recommended size 15 and eyelid stitching up again for 14 days. The owner wanted the dog home on the same day although I advised retaining him for a day or two.

"The solution to this case is to get the facial fold cut off by the vet," I advised. I took out the Canine Opthalmology book and showed her the operation and the illustratons in this old book.

"Your dog goes to the groomer regularly to get the fold hairs snipped but the hairs grow fast and irritate the cornea causing ulcerations. You also snip the hairs but it is not easy to do it frequently. The hair grows and the water and liquid is trapped in between the facial fold and the lower eyelid leading to itchiness."

The owner was not in favour of surgical resection of the facial fold as it cost money. It is important that the vet informs the owner of a long-term solution to the problem for Shih Tzus and Pekineses as many owners are not aware of such a solution.

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