Monday, February 6, 2012

864. Performance counts - no repeat consultations

Sheltie, F, 8 years. Copious purulent nasal discharge on left nostril. There might be slight discharge from right nostril.

Feb 7, 2012 visit today. Case handled by Dr Daniel Sing with me. I did mentoring as I have to ensure that service is done efficiently and up to my standard."

It is Feb 7, 2012 now. The 2nd visit was on Jan 7, 2012. Vet 1 had extracted 9 teeth again. But bad breath still remained as I checked the mouth and noted that the gum of M2 on right upper jaw was inflamed. The tooth appeared shaky but I could not confirm it.

What to do with this case? I took over as the man wanted results.

1. Nasal swab for bacteria and fungus. culture and antibiotic sensistivity test.
2. X-ray of nasal area and lung to check for tumours, abscess or infections.
3. Extraction of the loose teeth as bad breath still persisted.

"This is my 3rd visit for the same problem," the owner said. "I want the vet to be pro-active.
The 3-rooted molar on the right upper jaw was shaky and I extracted it within a few seconds. There could be bacteria entering the nasal passages on the right side causing daily mucus production and pus and right nostril discharge. Altogether I extracted 7 teeth.

Will have to wait and see as persistent nasal discharge is hard to treat if it is caused by fungus and/or infected tumours.

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