Sunday, July 14, 2013

1024. An eventful Saturday Jul 13, 2013

I was on duty in the morning of Sat Jul 13, 2013. The sky was cloudy and there may be some haze. Flooding in China and typhoon in Taiwan.
Case 1. Update on the old Shih Tzu from Bedok.
The 13-year-old Shih Tzu from Bedok with a stroke diagnosed.  The parents and the adult daughter and son brought the dog in early in the morning. The dog is mum's pet and it is nice to see two adult children caring so much for the old dog.

"My dog can walk normally," the mum was most happy as the dog was paralysed on 4 legs just around 4 days ago. I diagnosed stroke as the quadraparesis was sudden but a brain scan would be too expensive to confirm. X-rays did show some disc narrowing the lumbar 3/4 vertebra but the primary diagnosis from me was a stroke and prescribed some medication.  So it was a great surprise that this dog could now be ambulatory and do his own peeing and pooping.

"The ringworm in the belly seemed to have disappeared 99%," I showed the normal skin with just a small areas of scales. This belly ringworm took many months to cure and I had told the owner that this was not the fault of Vet 1 who had correctly diagnosed the disease but it was their management. Still it took at least 2 months to get a cure at 99%.

"The stools are much better with this dry Z/D diet," the mum showed me a smartphone image of well-formed solid stools. I had a Z/D diet trial in case the dog was also allergic to dry food. Nowadays, it is very expensive to test for allergies and the tests may not be of any use. So I tried this Z/D food trial on this old Shih Tzu whose immune system may be down, owing to old age.

Overall, the outcome was a happy one but I still advise confinement in a room for 3 months as the dog was walking all over the apartment. This is to give time for the spinal disc to heal as the dog was on anti-inflammatory medicine which would be tapered off in 4 weeks.

"He will bark if we confine him in the kitchen," mum said.  So there was this problem which I can't resolve.

"Put a fencing between the kitchen and living room," I said. "So the dog can see you all, at least for one month."

It is easy to advise. Home conditions are so much different.
Case 2.  Update on an old stray cat from the Turf Club.  The dutiful daughter asked if an antibiotic injection can be given since the 15-year-old cat now had yellow runny nose again and would not eat. He had recovered twice after my treatment but the runny nose would recur and he would not eat again.  On examination, the cat had a painful bleeding itchy left ear and was dehydrated. Yellow mucus flooded the two nostrils. The cat was weak and not so ferocious but my assistant was afraid. I gave a very low dose of sedation to irrigate the swollen left ear and give SC fluid.  Treatment was given.  Will need to follow up.

Case 3. The young cat came for dental scaling. The cat was ferocious when we wanted to sedate him although he was OK during consultation. "Why didn't you go to the vet so near your apartment?" I asked this new client.

"The vet said she does not do dental scaling."
"It is very strange," I replied. "All vets do dental scaling."

"My cat's jaws were fractured and dislocated," the young man said to me. "He went to Vet 2 who attempted to fix the jaws by wiring the canine teeth. But the jaws became normal again. A very rare occurrence, Vet 2 said to me.

We finally got the cat sedated but he was clawing till his claws bled. I explained the situation to the owner. "He nearly killed Vet 1 when I brought him for consultation on his fractured jaws. But at Vet 2, he was so 'manja' (affectionate in Malay language?) and refused to leave the place. Vet 2 is the one who told me that his fractured and dislocated jaws had become normal by going back to the joints again."   

So the real reason was that Vet 1 did not want to see this cat again. Even for dental scaling. As for Vet 2, I did not ask why he did not go for dental scaling there.

Case 4. Update on the kitten attacked by the dominant cat at a garbage dump. The kitten could eat but could not stand. The young Malay lady would bring him home on Monday. He is very thin and if nursing is good, may recover. Due to financial constraints, no X-rays are taken of his shoulder or spinal area to find out why he can't stand.

Case 5. A 3-month-old kitten would go home on Sunday. There was slight bleeding on the declawed digit 1 on the left foot but otherwise she was active. An e-collar would be worn. "Bandaging is not a good idea," I said to the owner who asked about it on Sunday. "The paw may become infected as there is no ventilation. Gangrene may set in as your friend may not know how to change bandages. The kitten had been bandaged for the past 3 days. As for pain-killers, she had 2 days. As the liver may not be as mature as in an adult cat, less sedation and pain-killer is safer."

Car accident. This Saturday was eventful because I was looking forward to seeing a dance performance at the Singapore Management University at 2.30 pm. Another car failed to give way as I drove uphill from HDB hub basement car park 2 to B1 and my left sided bumper was hit by another same model Mitsubishi Lancer. My car tire punctured at the side wall and I had a lame car driven up and out of the car park to the main road opposite the Toa Payoh Swimming Pool.

The "crunchy" sound made me stop the car and I phoned the emergency car repair mechanic. The tyre was replaced by a much smaller diameter tyre which, acccording to the renter company, was the original tyre of this Lancer.

So the car was unbalanced as I drove it for the weekend. The person who hit me was a mother of 3 children. The younger child and his sister in their primary school age came out from the mother's car after a wjo;e as we took images of the car accident. Both were crying as they were quite traumatised. I comforted the little boy. "Is this the first time they were in a car collision?" I asked the mother. "Yes," she said. I missed the dance performance which would be going to Italy for a competition.

In the end, I was at the the SMU seeing the School of Info System graduates throwing up their mortar hats and taking images as I was too late for the performance.   

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