Wednesday, March 28, 2012

Sunday's Mar 25, 2012 interesting cases

Today is Thursday. Before I forget, I record Sunday's interesting cases.

1. ADOPTED YOUNG FEMALE CAT. The couple had decided to spay their cat adopted from the Cat Welfare Society on Sunday. However, I found that this cat was small in size and advised waiting one month since she was not caterwauling and had just stayed with the couple for 2 weeks. She looked healthy and her full set of permanent teeth had some plaque.

I estimated her age to be around 6-7 months. In the interest of the cat, spay should not be done. However, some owners do go to other vets later and so there is this need to do what the customer wants.

In spaying young cats less than 6 months, the uterine tubes are usually very thin since the cat has not matured, as narrow as 3 mm in diameter. Spaying can still be done as some humane shelters overseas do it even at <5 months of age. Since this is a well cared for cat, spaying is best done at an older age of 7-8 months. Case written at: 2. RUPTURED EPIDERMAL CYST IN AN OLDER MINATURE SCHNAUZER "What to do now with the big hole," I asked Dr Daniel who was assisting me with this surgery. A big hole after excision using electro-surgery of a skin lump 1.5 X 2 cm x 1 cm above the neck, behind and between the shoulders. "Just stitch up?" I asked. Actually, the best way is to use Z-plasty. This is described in

CASE 3. Beagle with itchy lower body.
"Did you express the anal sacs?" I asked Dr Daniel who disagreed that itchy lower body would be related to any anal sac. The dog's backside was not itchy, so no anal sac problem.

"It is not as clear cut as that," I said to him. Sometimes, the itchiness is not related directly to the itchy area.

He expressed the anal sacs from the older Beagle put on the table in the waiting room. The whole waiting room filled with a pungent smell for several mintues while his hands were full of >20 ml of dark brown oil. This was really revolting. I had to open the door. The other vets had not been able to resolve the skin problem and so the owners brought it to Toa Payoh Vets. This was a case of ventral contact dermatitis with infection. A blood test would be useful. The owner had said: "The other vets did everything, so no need to do it."

"If you let the owner dictate to what you can or cannot do," I told Dr Daniel and Vanessa in the meeting on chronic skin diseases, how are you going to diagnose the problem? What had been done by other vets would not be linked to what is present now although it is still skin disease. You need to educate the owner. At least, you have to record AMD (against medical advice).

Got to rush off now.

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