Sunday Feb 24, 2013
6.23 pm Yishun
public library to
type this report
Communications
post-op is most
important. The cat
owner phoned me
twice and left his
name and phone
number. My
receptionist
reminded me to phone
him after my
consultations. I was
kept busy with the
owners of a cat from
an American couple
regarding removal of
the claws, a rat
with nasal swelling
on the right and a
large skin lump on
its back and a
rabbit from
Woodlands for "spay"
from a Malay family
who had
stated incorrectly
the gender. Two big
terrapins came
yesterday for Dr
Jason Teo - one
would not eat and
the other one had
puffy eyes and I had
them cleaned and
given eye
drops and bask in
the bright morning
sunshine. I had to
supervise a new vet
technician as Mr Min
would be moving on
to better future
after having worked
two years with me,
increasing his value
to the new employer
as an experienced
vet technician.
Back to the cat with
the bladder stones
was operated on
Thursday, 3 days
ago. The owner
phoned me yesterday
and today to provide
me feedback and that
was important.
"My cat did not
vomit after eating
food. He drank a
lot, around 375 ml
of water and peed a
lot," he said.
"He laid on his
urine and so his
surgical wound is
very red."
"It is good news
that he pees a lot,"
I said. "This shows
that his bladder is
normal." I tried not
to joke that this
showed that his
bladder was not
leaking after my
surgery.
"What should I do to
the red area of his
wound?" the owner
asked.
"It is very
difficult for me to
know what you are
describing," I said.
"Was the cat licking
the wound since you
did mention about
taking off the
e-collar?"
"No, he is still
wearing the
e-collar."
Since the owner was
working, I suggested
that he changed the
plaster covering the
wound and replace
with a new square
one. "It could be
the blood clot from
the skin after
stitching," I said.
Will wait and see.
It seems that the
cat with the renal
impairment based on
blood tests taken by
Vet 2 on Wednesday
(4 days ago) is
doing well. He did
not vomit his food.
I asked the owner to
give 2 cans 6
times/day instead of
feeding him one can
of the K/D diet
yesterday. He has a
good maid and with
home care, this cat
should thrive.
Before I forget, the
Thursday surgery in
brief is as follows:
ANAESTHESIA
5 kg bodyweight. I
gave xylazine 0.2
and ketamine 0.8 ml
IM in one
syringe. Isoflurane
gas top up was
necessary for a
short while.
Rectal temperature
was 36.8 C after
sedation as the cat
was angry and we
could not want to
antagonise him more.
SURGERY to remove
bladder stones seen
on X-rays taken by
Vet 2.
1. Catherise the
bladder
2. Withdraw
urine for urine
analysis
3. Inflate bladder
with 40 ml normal
saline so that it is
palpable.
4. Incise skin and
linea alba.
5. Press out the
distended bladder.
6. Incise at apex of
8 mm as I know the
stone was around
this diameter.
7. I insert an
artery forceps to
grab and take
out the stone
without making too
big a bladder
incision.
8. My assistant Min
pumps in more normal
saline as I closed
the wound for a
while.
9. 3 small pieces of
stones of around 3
mm x 2mm flowed out
with the bloody
mucus and blood.
10. More irrigation
of the bladder.
11. I stitched the
mucosa 3/0
absorbable -
inverting layer
12. I stitched the
serosa similarly -
another inverting
layer.
13. To check
leakage, I asked Min
to pump in more
saline via the
catheter to inflate
the bladder. No
leakage.
14. I put the
bladder back into
the abdomen and
closed up the linea
alba (2/0
absorbable) and skin
(2/0 nylon).
14. I put the
bladder back.
15. Post-op baytril
and tolfedine
16. Cat goes home in
the evening as
the cat was quite
ferocious and
nursing at home
would be better as
the cat would be
hand-fed food
(K/D) and
medication.
Friday - Day 1 after
surgery. I phoned
the cat owner.
"Vomiting one
hour after food and
medication," the
owner reported as he
had given medication
on the evening of
the surgery. I
advised not giving
the tolfedine
tablets, just the
Baytril tablet from
Vet 2 and give honey
water by hand.
Saturday - Day 2
after surgery.
Vomiting once.
Drinks a lot. Pees a
lot. "There could be
gastric ulcers due
to the high BUN
kidney disorders," I
said. "That would
account for
vomiting. Feed less
amounts"
Sunday - Day 3 after
surgery.
Feedback in above
paragraphs. Will
need to summarise
all later,
Discovered and
borrowed two thick
books published in
2012 and 2013 from
Yishun library.
1. Web Marketing
All-in-one for
Dummies. 8 books in
one.
2. Social Media
Marketing All-in-one
for Dummies. 9 books
in one.
Thick as a bible. No
wonder most doctors
and vets give them a
miss.
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