June 13, 2013
7.35 pm review
I may or may
not work in
the evenings
as Dr Daniel
would be
present.
However, on
June 13,
2013,. Dr
Daniel had
gone to a
"Dirty
Dancing"
concert at
Marina Bay
Sands and so I
handled the
cases after 6
pm.
Surprisingly
two dogs had
intense ear
and skin
itchiness were
brought in by
two couples in
their 30s. I
used the UVL
to show and
tell. One dog
was an
aggressive
Jack Russell.
The other was
a Shih Tzu.
Both
ringworm-infested
hair shafts
fluoresce
apple-green
while the
normal hair
showed plain
lighting. This
was quite
impressive to
the owner. I
asked intern
Ms Toh to
video the UVL
procedure but
I know it is
difficult to
capture the
real images
owing to our
lack of
experience in
videography.
"Lots of hard rubbing of the skin and ear irrigation and medication is
needed," I
emphasized to
the two
couples.
"Review in 3
weeks."
Case 1. The
ferocious Jack
Russell that
all vets avoid
The first
couple had
seen a few
vets and skin
scrapings were
negative. "The
main problem
is the painful
itchy left
ear," I said.
"There is a
red circular
skin patch in
front of the
left ear of 4
cm across. It
would be
ringworm .
Also, the left
inguinal area
is extremely
red while the
right is
normal white.
Therefore, I
can say that
this is not a
case of
contact
dermatitis
although some
vets will say
it is ventral
contact
dermatitis. In
such cases,
both the left
and right
inguinal areas
are inflamed.
Your dog only
has the left
side blood
red, now
obvious after
clipping the
whole body
bald." The
couple had
brought the
dog in the
morning. I
gave him
immediately a
Dom + Ket 0.1
ml + 0.11 ml
IM and the dog
was sedated
for dental
scaling and
hair clipping
without biting
my assistant
and me.
The owner came
in the evening
after work to
take the dog
home and I had
a lengthy
discussion
with them as
generalised
skin diseases
are not so
easily treated
by owners
despite seeing
several vets.
"If you see 10
vets, you will
have 10
different
opinions as to
the cause of
the skin
disease.
"From my
observation,
the dog uses
his left hind
paws to
scratch
vigorously the
left inguinal
area because
the left ear
is extremely
painful. Most
owners will
wonder what
the left
inguinal
area's
itchiness has
to do with the
left ear being
infected?
There is a
nerve
connection and
you will see
the dog's hind
leg moving
whenever the
same sided ear
is itchy. Only
in this dog,
the leg
scratches the
inguinal area.
Normally it
scratches the
flank and
belly area."
The Jack
Russell shook
his head
sideways and
this was a
clue that he
has ear
problems. As
to which ear
he scratches
more, the
couple did not
know. "I saw
both ears
being
scratched,"
the husband
said. I would
say it is the
left ear as
the inflamed
skin was
present mainly
on the left
ear base and
the left
inguinal area.
Only the dog
knows and he
cannot talk!
Case 2.
The timid Shih
Tzu is a tiger
at home.
As for the
Shih Tzu, he
bites the
owners but was
docile at the
consultation
table. He did
not bite me or
my assistant.
I advised:
"Feed the
anti-fungal
and antibiotic
medication
tablets inside
cheese balls
when he is
hungry.
Irrigate his
ears with ear
drops
downstairs
away from his
home base as
he may be more
docile.
"Do you sell
muzzles?" the
wife asked me.
"This Shih Tzu
is hard to
muzzle as he
has a flat
face," I said.
"Use the net
from the
oranges for
sale to cover
his face but I
doubt it will
work." I
muzzled the
dog with my
muzzle but it
was too long.
"More for a
Jack Russell
with long
nose," the
wife laughed.
Still the
owner must
work hard on
the ear to
resolve the
problem.
Going
downstairs to
clean the ears
may be
successful as
the dog
appears timid
in the clinic
but ferocious
at home.
In the Jack
Russell, it is
unusual as the
left inguinal
and scrotal
area were very
red. Neck skin
and paws also
were red. One
paw showed
fluorescence
at the pad
junction but
the dog wanted
to bite me
when I tried
to lift the
paw up to
shine the UV
light. The
wife was
convinced.
In the Shih
Tzu, the neck
showed a large
circular patch
of 5 x 4 cm
which
fluroesce
green in
certain parts,
confirming
ringworm. The
wife was quite
impressed with
this show and
tell. The chin
was inflamed
too. Ear
surface were
rough but not
much pain when
I pressed both
ears. In this
case, the main
area of
itchiness was
inflamed by
ringworm and
the belly,
flank and
inguinal area
were OK.
THREE
URINARY STONE
CASES.
Case 1. Urine
crystals 3+
but no stones
in the X-rays.
This morning,
I got a
2-year-old
female cross
X-rayed as her
urine test
showed triple
phosphate 3+
crystals.
X-rays did not
show any
stones. S/D
diet for 2
months advised
by Dr Daniel.
Case 2. 10
little stones
Yesterday's
X-ray of the
male,
overweight
older Jack
Russell,
emptied
bladder and
catherised
showed at
least 6
bladder stones
of 3 mm
across. Dr
Daniel
operated today
and removed 10
stones. Urine
test showed
Calcium
oxalate. The
dog is resting
as I typed
this report
and is given
IV drip. "His
bladder bleeds
and tears
whenever I
stitch the
tissues," Dr
Daniel says.
"His bladder
wall is thin
as he is not
badly infected
for some time.
There is
little
inflammation
and so there
is a
difficulty in
stitching with
3/0 monosyn."
As for me, I
used 3/0
absorbable
braided with
smaller needle
but the
monosyn comes
with a bigger
needle. Each
vet has his or
her own
preferences.
Case 3.
Update on
blood in the
urine
 |
 |
 |
 |
 6189
- 6192.
Female dog urethral
catherisation and 30 ml of
air into bladder provides
excellent contrast X-rays.
Against Medical Advices |
Female Poodle
with one big
bladder stone
and small
kidney stones.
The owner
phoned for
appointment
tomorrow
Friday for
surgery. I
will be
operating.
This case was
infected as
the total WCC
was high at 25
but now the
dog is OK and
active. Case
is at:
Against
Medical
Advices.
So, my
operation can
proceed
tomorrow, Jun
14, 2013.
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