Sunday Aug 5, 2012's interesting cases

Sunday

CASE 1.  A lady in her late 50s came to buy S/D diet in cans for her Jack Russell and complained that it was rather expensive. She had been buying S/D without her dog being checked for urinary stones as she just popped in from her lorry and bought the food. I was surprised and told her that S/D diet is not meant for more than 6 months. In any case, the dog has no blood in the urine nowadays.

HISTORY
Jack Russell, Male, 9 years old today.

7 years old. Mar 24, 2010 - Vomiting. Thick urine. Blood in the urine.
UTI. S/D can recommended by Dr Jason Teo.

I advised urine test. She said she got the urine collection bottle.
"Nobody told me anything about taking S/D diet for a long time," she said.
"It is unfortunate that you did not consult any vet, but just dropped in to buy the S/D." I happened to be present at the receptionist table when she came in this morning.

I got her to take the urine sample first.

CASE 2.
A boy doing his N levels came in with his 2-year-old grey dwarf hamster, itching in the right side of the face and ear. "How much is the consulation fee and overall treatment?" his lady friend asked. "You need to put the hamster here for 7 days, the overall charge is around $80," I said. "From my experience, your hamster has something dropped inside his right ear. I need to put him under gas anaesthesia and irrigate the ear."

"Can he do it?" the lady friend asked.
"Not possible as he does not know how and the hamster may die of fright if he forced the hamster to irrigate his ears."
Much explanation must be given to satisfy the lady friend.
After they left, Dr Daniel put the hamster under anaesthesia and fished out a big brown waxy lump from inside the right ear. Problem resolved. I took a picture.

CASE 3. 9-year-old male cat can't pee.
Catheterised by Dr Vanessa after sedation. Blocked. She injected 2 ml of saline and relieved obstruction. Bloody urine came out. "Any urine test?" I asked. outShe said yes. I am strict on making sure that urine be analysed in urethral obstructions to check for urinary crystals and other factors causing it. Many vets tend to forget about it since the obstruction is resolved but there must be a certain procedure and process in such cases to maintain a high standard of vet care and medicine.

CASE 4. CATARACTS IN A 9-YEAR-OLD FEMALE SHIH TZU.
Dr Daniel phoned me as I was out buying lunch at around 12.30 pm saying a client wanted to consult me only.  He was worried about the eye and skin disease. As the famous chicken rice stall in Lor 4 had a long queue, I drove back and saw my old customer.

1. Mature cataracts - nothing much can be done unless the owners want expensive surgery of around S3,000/cataract removal.
2. Vulva was swollen 3X. I checked the mammary glands. Still a bit of milk was seen though the dog had heat 2 months ago. "Lots of milk," the thin 9-year-old girl told me. I advised spaying but the husband had objected some years ago. "He is afraid of bad news," the wife said. "What bad tumours?" I asked. "Like a tumour. You had removed a tumour from her head last time. So, tumours are bad news." I advised blood test and spay if possible 2 days later.

3. Skin disease. Scales of elbows and fore-arms, neck skin almost bald, Anal sac impaction? I asked Dr Daniel to express the gland after checking them with my fingers. "There should be nothing," I said. Dr Daniel took a piece of tissue and expressed a small drop of brown oil. I took another try. There was no swelling. Suddenly 5 dark brown oily spots squirted onto my right elbow, missing the sleeve of my white shirt. It was unexpected as I had said: "Not to stand behind the dog while expressing her anal glands. Some oil may shoot into your face!"

Since the owners lived in Admiralty Road and would be working, I proposed warding the dog for clipping of coat and spaying if blood test showed normal results. Suddenly, the little girl's eyes teared. "Why are you crying?" I asked. "She sleeps with her dog every night," the mother said.
"Is she your only child?" I asked. "Yes," she said. I explained to the little girl that her dog needed treatment for the skin disease so that there would be no scales dropping on the floor. "Did you see the dandruff on the floor?" I asked. "Can't see, the floor is white," mum laughed. As the little girl was still crying silently, I had to console her rather than laughing with the mum. 9-year-olds are smart nowadays.

Although the dog is 9 years old, I advise spaying to stop the false pregnancy. "There are signs of bilateral alopecia coming," I showed Dr Daniel the lesser hair on both flanks. "Actually, I had shaved off the hair," the husband said to me. "Well, the hair is finer in the flanks as compared to the thicker hair on the forehead and chest," I showed Dr Daniel. "Bilateral alopecia could be endocrine, ie. hormonal cause and sometimes spaying resolved  the problem."

I said to the owner: "Your dog is very thin. I can feel the spinal bones."
"I don't know why," the husband said. "She eats a lot." A blood test was approved and would be done.