Sunday, July 29, 2012

Sunday 29 Jul 2012 afternoon cases

1. Dog with dead grey skin below throat of 20 cent area. Some pain. Could it be due to penetration by hard dog bone treats? Few days only.  The owner was flying and would be back tomorrow. Large area of cellulitis. conservative treatment. IV drip first and blood test.

2. Owner phoned wanting to de-mat the cat under sedation. A man here told him that there are 2 types of sedation. One without recovery and one with recovery. The former type is safer. I was surprised. "Much depends on the cat's health like heart, liver and kidney problems," I said. If the cat is not healthy, both types may kill the cat.

3. Beagle, 13 years old follow up on high liver enzymes by Dr Vanessa. Had vomiting and diarrhoea last visit. I insisted on IV drip with medication and to bring the dog home with the drip as the young lady did not want hospitalisation. IV drip gives direct effect. The dog recovered the next 2 days. "Just giving an injection and some medication to give at home will not work," i said to the father. "The intestines are  not well and so there wil be more bloody diarhoea overnight and unhappy owner having to clean up the mess."  As to the request for liver supplementation, I educated the young lady to take another blood test to check the status of the liver health rather than getting supplements. "For all you know, the liver was damaged due to an infectious organism at that time and has now recovered. The monocytes were 36% last time while the normal should be around <5%. So there was a chronic infection somewhere. The blood test showed "degenerative changes in the blood cells" too indicating something toxic at that time. A blood test was agreed upon by her father.

4. "Thank you for your help," the woman with red eyes said to me after her 18-year-old shih tzu was euthanased as I had interrupted Dr Vanessa to treat her case first as an emergency of a suffering crying old dog. "I wonder whether I should have her anal tumour removed when it was very small." Earlier she had wanted a house-call to euthanase the dog but we could not spare a vet to do it on a busy Sunday.

"When was that?" I asked. 
"2 years ago."
"Did you neuter the dog as the male hormones encourage the growth of this circum-anal tumour?" I asked.
"No," she said. "The tumour just exploded and grew large only in the last few weeks."
"The other vets would not advise operation as the dog was very old and high anaesthetic risk," I explained.  "This dog has a long life."
"My female dog has been spayed and is 18 years old and alive. I didn't neuter the male."

I checked the recent blood test results:
Only significant changes were in the differential blood count with N=83% (60-70) and L = 8% (12-30) and M=1% (3-10). But total WBC was normal at 8.8 (6-17). 

In conclusion, it is still best to neuter your dog and to get small anal tumours in male dogs removed by your vet when it is very small, even if the dog is "old".

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