"I am the cheapest vet in Singapore in Singapore," a vet said to me as more than 65 vet practices have been set up in Singapore. "So, no other nearby vets can compete." At the end of the day, there is little net profits for purchase of new equipment or renovations.
In this 15-year-old dog, the family vet prescribed steroids to bring down the soft facial swelling of 5cm x 5cm. "Your dog is too old for anaesthesia. He may die on the operating table. Take some medication."
The dog became very hungry and thirsty but the facial swelling did not disappear. Old dogs do die under anaesthesia. So, the owner must give an informed consent.
In this dog, the facial swelling was a cluster of cysts. A rarity. He had some coughing earlier but the coughing became continuous and worse.
"He could not sleep on his neck," the lady said. "He could sleep with the head turned sideways." At one time, he could not sleep on his sternum. So what is the cause of this problem?
I advised X-rays. There were sinister findings of multiple nodules inside the lungs. Now the serum calcium is higher than normal. Why? A parathryroid tumour?
But neoplasia can lead to hypercalcaemia and this neoplasia is likely from the lungs. The dog keeps coughing and has. So, to give him a better quality of life. I prescribed low doses of pred. to stimulate his appetite and relieve some inflammation in the throat. The owner was much delighted.
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