1086. sunday July 22, 12 interesting cases

July 22, 12
Bright sunshine, blue skies, white clouds
6 pm

1. Maltese with fever last night. Saw Vet 1 and given treatment. Blood test showed unusual high RBC and Hb. So, unlikely to be tick fever. "Sudden onset, not wanting to move yesterday evening" was the clue. I palpated spinal area inT7 - 13 area. Dog was already on pain killers from Vet 1 but responded with a soft "ha ha " sound which I could reproduced to let the young lady owners hear. As to the cause of fever 40C today at 10 am, I suspected there could be extreme pain and panting - increasing body temp but why increase in RB  C and HB? Gave IV drip and tolfedine and to observe. "Must I come back on Monday?" the young lady asked. "No need if the dog is active and eating." I said. "Continue with anti-fever and other medication. I will check the blood." A case of PUO? Pyrexia of unknown origin.

2. Golden Retriever with the most smelly neck. Can't stand this smell. Cellulitis.  "Must we complete 10 days of medication?" the lady asked me. "Yes," I said. "The stinking smell is due to a flesh-eating bacteria and 3 days will not be sufficient." "Need antiseptic daily?" she asked. "Yes, use the wash." "Any cream?" she asked. "No need." I said.

3. Roborskvi with backside cellulitis. Lady owner could not cure it. On 29 Jun 2012, one of  the two siblings was treated by Dr Daniel for similar backside wound and had healed after 5 days of hospitalisation. Owner asked to separate the siblings but she put them together again. "What happened to the other hamster?" I asked. "He drowned." "How?" I asked as she was living in a Toa Payoh HDB flat. "He fell into the hole," she said. "What hole?" I was shocked. "The hole where my washing machine pipe discharged the water."  Now, this sibling's backside had got bad and needed hospitalisation. 

3. Chihuahua spayed 5 days ago with pyometra came at last minute. "Dog was licking the side of the spay wound causing a reddish patch to the side. Why?. Also a blood spot on my cushion," the lady owner said. "Is this normal?"
"This is normal in that residual blood get passed out after spay from pyometra, but is not serious. Is the dog active and eating?"
"Very well," she said. "Probably plaster is irritating," I checked the spay wound and removed the plaster. No inflammation on wound, so that was ok. Gave injection and sent the dog home. No need plaster. 

4. Shih Tzu with both ear pinnae inflamed. "Came at 3.30pm, now it is nearly 6 pm", the lady said to me. I had done the eye ulcer tarsorrhapy on one eye and Dr V had done the other. Both eyes are OK but she said ear problem came soon after wearing the e-collar. She had the dog spayed at another practice. The vet said ears were dirty and prescribed ear drops of 2 bottles. Now the ears are itchy.  She preferred Dr V and had to wait. Personalised services are like that, otherwise the clients will be assigned to me or Dr Daniel Sing if they can't wait. "Ear problems are common in Shih Tzu," she was so busy that she has no time for the dog and would not want hospitalisation. So she was waiting for ear irrigation. I sedated the dog first and told Dr V about it, so she could save some time. It was already 6 pm and the client from Changi had to pick up her daughter from the enrichment lessons somewhere.  

5. A young cat vomited food half an hour or more after eating 4 x in the past 4 months. Losing weight compared to the other cat. Both fed separately.

Is this a case of some foreign bodies inside the stomach or a stomach diverticula? The couple wanted immediate X-rays and blood test and I referred them to another vet with complete facilities but who does not work on Sunday.