Saturday Dec 27, 2014 interesting cases - perineal hernias x 2, testicular neoplasia, facial swelling of a cat

This Saturday was unusual for me. Just non-stop consultation cases today. No time for intern Goh too.


3 most interesting cases will be made into a video by Ms Goh. They can be classified under tumours (neoplasia), inflammation and others.

1. Facial swelling in a cat is an example of inflammation.
2. Two perineal hernias in two dogs on one day are lucky for Intern Goh as this is rarely encountered. They are classified under "others."
3. Testicular neoplasia in a Japanese Spitz is an example of tumours. So Intern Goh gets to see 3 types of very interesting clinical conditions..





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What is the treatment for this cat? Vet 1 extracted the tooth without anaesthesia as the cat is old. Vet 2 prescribed antibiotics and steroids but now the cat is not eating. The swelling had gone down.
The owner had done his internet research and consulted me on oro-nasal fistulas or carnaissal tooth abscess which he believed his cat had suffered from. Cats do get carnaissal tooth abscesses just like dogs.

I thought this was a case of nasal carcinoma or malginant nose tumours. Yet on examination and X-rays, there were no obvious signs of tumour. Based on the history of sudden yanking out of the left upper cheek tooth by the first vet, there could be traumatic damage to the area and residual remnants of the roots. X-ray of the maxillary sinus swelling (X) indicated inflammation and a possible fracture fragment (Y) of the maxillary sinus.  

What is the solution?  Which cheek tooth was extracted by Vet 1 the owner did not know. It was an upper left cheek tooth.