Thursday, April 30, 2015

1184. A hardy hamster

May 1, 2015

Two brothers in their early 20s brought in a hardy hamster on this bright morning of Labour Day. The hamster weighs 33 g and has two black ulcerated tumours. One below the chest at 2 cm x 2 cm and the other below the left armpit at 8 mm x 6 mm.

"Why didn't you get the tumour removed when it is small?" I asked.

"We asked a vet and he said to leave it alone," the elder brother said that the tumours were present for around 2 months and could be cancerous. As the hamster exercised, the lower part of the tumour got worn out and became infected and now blackened.

I checked the thin hamster's teeth. He had short teeth indicating that he was still eating to survive.
"He had lost a lot of weight," I said. "He does eat judging by his short front teeth being worn out, but he lost weight due to the stress and the tumours sucking up the nutrients." 

The elder brother googled " hamster tumour surgery" or something like that and found Toa Payoh Vets. Now, the hamster is so thin, the anesthetic risk is very high. If he can survive the anaethesia, he would be OK with the chest tumour removed first as the left armpit tumour is large too. There would be insufficient skin to stitch up if both tumours are removed. In any case, the chest tumour can be sliced off in 2 seconds as it is now loose under the skin.

Vets who do not wish to operate on hamster tumours may do the owner a service by referring him to another vet who does it. 


1183. **How to treat kidney failure in an old cat

May 1, 2105

Most Singapore owners do not comply with instructions on home treatment of the cat with kidney diseases.

Fatty, female spayed, 10 years old.

April 29, 2015
Anorexia 3 days. Not drinking 3 days. Diarrhoea (dark chocolate stools) 4 days.
Fever 40.5C.

I review the medical records today

Feb 2, 2015. 
Mastectomy. Left mammary gland 1 (MG1) tumour with left axillary lymph node enlarged. Histology -  Invasive ductal carcinoma (malignant tumour).  Blood test - Urea 5.3 (7.2-10.8), creatinine76 (71-160).  No leucocytosis. Platelets low  60 (300-800).
However, the cat had been vomiting for the past 2 weeks and the "left" kidney was painful on palpation.

Feb 28, 2015. Vomiting. Treated by Dr Daniel.

Mar 7, 2015
Has vomiting for the past 7 days. Thin but no fever. Kidneys painful on palpation.
Blood test - kidneys normal.  Urea 7.3 (7.2 - 10.8), creatinine 93 (71-160). Total white cell count 2.3 (5.5 - 19.5). Neutrophils 24% (35-75), Absolute 0.55 (2.5-12.5). Platelets low 78 (300-800).
Tiger Balm ointment smell in apartment.  Not to use Tiger Balm ointment which might have been inadvertently rubbed onto the cat.

Apr 29, 2015
X-rays as kidneys are painful on palpation and enlarged with the cat growling during palpation.
Kidneys enlarged  No blood or urine tests to reduce medical costs. Given drip + baytril before going home.
Advised dialysis 200 ml Hartmann's Solution/day, next 4 days. Fortekor 5 (1/2 tab/day),, Baytril and Prescription K/D for 5 days.

May 1, 2015
Cat is his normal self. No diarrhoea. Eating the usual Friskie dry food.
Did not accept Fortekor and K/D.

Although the blood test did not show kidney disorder so far, it is possible that the kidney failure has just started. Probably the cancer cells had gone to the kidneys, causing pain and enlargement. Owing to the need to reduce medical costs, no further are done to check on the kidneys.

I advised crushing the Fortekor dose into 4 portions of powder. Mix with honey and feed the cat. The K/D is to be fed by hand at 5% till 100% or switch to the dry K/D. The owner had given one SC drip. It is difficult to do it.  Wrap the towel around the cat to prevent clawing.


Tuesday, April 28, 2015

1182. A stray cat eats but spits out canned food

April 27,2015

In Singapore, this stray cat has no proper home but the cat feeders ensure that she has food and water. "For the past 3 days, she would eat but spit out the canned food," the retiree said to me.
"There could be a fish bone lodged inside the throat," I advised X-rays. Stray cats love fish and some people will feed them with left over fish with bones.

The cat pawed me when I tried to open his mouth. Foul breath. The lower sides of his gums appeared blood red with ulcers. Hence the bad breath.

X-rays showed ulcerated pharynx and proximal oesophagus with gas.

After an anti-inflammatory and antibiotic injection, the cat was active and ravenous and the caregiver is much happier.  

Monday, April 27, 2015

1181. **How to prevent a hamster's subconjunctival abscess from recurring - video

Sunday April 25, 2015.
Recurrent eye abscess.
The owner wanted the hamster home on the same day as the treatment of the abscess some 5 weeks ago. She disputed that I had advised her how to do post-discharge care. I had told her verbally to use a cotton bud tip to rub above and below the skin wound to express out the pus, daily. In this way, any residual pus would be let out and the abscess would not recur. She only put eye drops.     

This educational video teaches vets how to handle this problem and to prevent the abscess from recurring. 

A small skin incision heals too fast if the owner does not express the pus on the second day. There will be pockets of pus still inside the skin. So the abscess recurs. This video shows how an abscess is treated by me at Toa Payoh Vets. Isoflurane + oxygen gas anaesthesia is used here. The whole process of lancing, curetting, irrigating and draining the abscess takes around 5 minutes.
The hamster is OK and will be in-patient for 2 days.

On Day 2, I reviewed this gentle chubby hamster. I expressed more yellow pus from the incision wound. By inching out the residual pus, the wound can heal without another abscess popping out in the next week.

The owner phoned and her male friend came to check the hamster. She asked whether the hamster could go home. I said no. Hamsters are family members and so the lady owner did not want her in-patient but would not want to pay for a recurrent abscess.   

The vet must let the owners wanting to bring the hamster home on the same day, they will have to bear the responsibility of post-discharge nursing and to pay in full should the hamster recur. This should be in writing to prevent any misunderstanding of the responsibilities of post-discharge care and much unhappiness in having to pay again for treatment. 

This hamster stayed 2 nights in-patient and was cleared of pus on Day 3.
On Day 2, I could express pus from the closed wound.
On Day 3, more pus was expressed although the wound had closed (video). After that, I phoned the owner to bring her home. She should not have any recurring abscess within the next 2 weeks.


Thursday, April 23, 2015

1180. ** A FLUTD cat recovers from acute kidney failure

Friday Mar 27, 2015
2nd in-patient period at Toa Payoh Vets
Male, not neutered cat, 1.5 years old
Owner wants him to stay another 2 days. He went home after 2 days in-patient during the first visit.

Bladder obstruction some 2 weeks ago. The first vet had unblocked the bladder and sent the cat home after 5 days in-patient.
Yet the cat was still passing blood in the urine and had inflamed prepuce. He was not eating and was dehydrated.

The owner consulted me as a 2nd opinion on Mar 17, 2015.

I had palpated much enlarged painful kidneys (X-rays in another video). Therefore, the urethral obstruction blocking the flow of urine, putting back pressure enlarging the kidneys 3-6X and also causing bacterial infection and kidney failure (blood test results of high blood urea nitrogen and creatinine, leucocytosis and neutrophilia from the first vet).

After the first vet sent the cat home, the cat would not eat and it was difficult to give medication orally. Anorexia, tongue and lip ulcers are signs of uraemia as the cat had acute kidney failure. The cat was dehydrated and hypothermia (below 38C). Lethargy. No hope of survival?
This was acute kidney failure due to bacterial infections of the kidneys.

The first vet's clavulox antibiotics and treatment did not eliminate the bacteria. I got a bacterial culture and antibiotic sensitivity test of the urine. The bacteria was resistant to clavulox.

The video shows the cat after 2 days of treatmet at the 2nd in-patient treatment at Toa Payoh Vets

After antibiotics of Baytril, SC fluids of 200 ml for the next 2 days, the kidneys reduced in size (by palpation).The cat was not happy when the kidneys were palpated as there was still nephritis (see video).

The enlarged kidneys would be due to the back pressure of the urine from the obstructed bladder. The owner did not know that the cat had difficulty in urination as he shares a common toilet floor with the other 3 cats. The first vet relieved the obstruction and had treated him as an in-patient for 5 days.

This was a gentle cat and so did not claw the vets during fluid therapy. As the family could not accept pork in the prescripition diet, the Royal Canin Renal diet was reported not to contain pork. This was fed to this cat since he went home after the 2nd in-patient treatment.

April 23, 2015
The owner was contactable by SMS. The cat is back to normal, eating only the Royal Canin Renal food. Normal temperature. So, it is good outcome. This cat is a favourite of the father as this cat meows as if talking to a person whenever he is spoken to. Unlike the other 3 neutered cats in the apartment. 

So, he is much loved by the father who told me that he did not want to neuter him as he would become dumb like the other 3 cats.

There is a learning lesson here. Many young Singaporeans do not greet or say good morning to the parents or superior officers. Be communicative and you will be most appreciated by the hand that feeds you or mentors you. 

Blood test values

 Normal Feline & Canine Blood Chemistry Values
Blood, Temperature , Urine and Other Values for Your Dog and Cat  by Ron Hines

Wednesday, April 22, 2015

1178. A cat drinks toilet water

April 22, 2015

"Your cat has a very low platelet count and liver disorder," I showed the blood test report to the very busy bearded husband who shook my hand as he arrived at 7.25pm to take back his cat.

I know he is very busy. He works in the car parking software field which demands all his waking hours of his life as the various car parks seems to have much bugs, needing his help to resolve the problems. "Your cat has been toxic. He also has pale gums but is now pinker. Did he drink toilet water?"

I had given the cat at least 200 ml of electrolytes, amino acids and antibiotics and the cat meowed when he saw the owner.

"Some cats love to drink from the water splashed or drippinig onto the bathroom floor," I said. The man reflected and thought that this cat could have lapped toilet water.

"I have 6 cats," he said. "The other 5 have no problems."
"It all depends on how much poison the cat drinks and for how long. Why do you have 6 cats? I thought you have only one?"
"The female becomes pregnant and it is against my religion to get an abortion," the husband explained. Fortunately, my relatives have booked a kitten from my latest pregnant cat!" 
"Why don't you give some of the 6 cats away?"
"No, no," he replied. "We love them."

I can't understand why he did not neuter or spay the 6 cats. Now one is pregnant again.  

1177. An 8-year-old Shih Tzu has an arched back

April 21, 2015

"I better have him checked as she had been having an arched back during the past 2 days," the fair tall lady in her 30s, wearing a contrasting dark blue dress showed me a video clip of her dog walking with a "camel's bump".

"He would go to the bathroom and lie down there," she noted this unusual behaviour.
"Did he have difficulty in peeing?" I asked as house-trained dogs go to the bathroom to avoid peeing onto the apartment.

"No problem."

I palpated the dog's abdomen twice. During the first time, he winced slightly when I palpated the kidneys but the spinal column palpation showed no pain. I got the dog onto the floor to walk. He was walking normally with no hunched back.

"My dog will recover whenever he is at the vet," the lady laughed. Yet there was something wrong with him.

On the second palpation after the walking, I had my assistant do a video. This time, the dog reacted when I pressed the thoracic-lumber spinal column. There was some degeneration or pain in the spinal disc and that was why the dog hunched his back the last 2 days.

"The problem is with his disc at this T/L junction," I said. "He feels the pain and so does not walk to walk much. He walked with a hunched back and went to the bathroom to lie down. In case he needed to pee, he did not need to walk far." This was my hypothesis.


In Singapore, many young pet owners are well educated and do research. They use the smart phone to video unusual behaviours or clinical problems. For this lady, she would not permit me to do dental scaling since I use anaesthesia. "My groomer will do the dental work," she was afraid that her dog could die from anaesthesia.

Some dog groomers now provide dental scaling without anaesthesia and this is what some owners are interested.


Tuesday, April 21, 2015

1176. When parents separate, what happens to the ferocious cat?

The young lady phoned me. She was worried that the nervous stray cat, now housed indoors would be thrown out and left to fend for herself. "My parents are separating next week," she said. "I would not want my cat to suffer from attacks, starvation and diseases but I can't catch the cat."

When parents separate, there is a lot of damage. I recommended her a cat trapper.   

Monday, April 20, 2015

1175. A Chihuahua vomits blood after going to the park

"Heat stress" was diagnosed as the 5-year-old black and white Chihuahua vomited blood and panted after half an hour at the park.

Blood test showed elevated liver enzymes. "The dog had been panting since young," the owner said. "He is fat." 

Could this case be a case of fatty liver?

1174. A 5-year-old Chihuahua has a ruptured uterus

This Chihuahua passes pus in the vagina. Blood test showed neutrophils at 92.8% (normal 60-70%) and platelets very low indicating toxaemia. After treating for 2 days as an in-patient, the dog had to be spayed to remove the pus-filled womb.

The ruptured womb was seen only during the surgery. There was a large inflamed spot adhered to the intestines. This was separated.  The dog passed away 5 hours after recovery from anaesthesia.

The dog was a high anaesthetic risk in view of the very low platelet count. She passed away 5 hours post-op and this was very sad.

Sunday, April 19, 2015

*A Shih Tzu keeps having eye discharge

Sunday Apr 19, 2015

"His left eye keeps discharging thick pus daily" the lady had consulted a vet 2 weeks ago. The vet prescribed eye gel and eye drops and advised normal saline eye wash daily. "She said the dog's eye would recover soon."

"Did the vet really guarantee that?" I asked.
"If not," she replied. "I should go back to her again. But I am not doing that!"
"When was the left eye injured?"
"About 2 to 3 months ago." she was not sure of the exact date. She had been treating the eye injury with eye drops herself but the eye got worse.
"Shih Tzus have protruding eye balls," I said. "The eyes get injured easily, becomes ulcerated and scarred. Eye injuries are emergencies. Treatment by the vet should be done within 24 hours to prevent scratching of the eyes. Did the vet advise an Elizabeth collar to wear?"
"No," she said.
"The left eye cornea is dull compared to the right eye," the owner noted the scarring.

Dr Daniel sedated the dog, got the hairs around the face and ears clipped off so that the eyes do not get loose hair irritations. The eyes were irrigated with saline. The 3rd eyelid was elevated to flush out any hairs and debri. I gave a subconjuctival injection of antibiotic and anti-inflammatory. The dog went home with eye drops and a dry eye ointment as well as e-collar. He will have to stay away from the wind and sun and wear the E-collar 24 hours daily for 2 months. There was no deep corneal ulceration based on fluorescein stain test.

I cannot guarantee normal tear production as the owner had delayed seeking vet treatment for 2-3 months. It is hard to predict the outcome as to whether the eye will recover fully.  To follow up in a month's time.

A Shih Tzu's eyes are most easily injured. Treatment within 24 hours by your vet is important to save the eyesight.     

Friday, April 17, 2015

1172. A rare case - A cat has jet black anal sac oil

Sat April 18, 2015  11 am

"The ferocious cat will never be injected or examined," I said to the mother and daughter who tried to coax the cat out of the carrier. The cat hissed warnings but they ignored her.
"Once out of the carrier," I advised. "The cat will bolt and be even angrier!."

"This is a country pumpkin cat," the adult daughter said. "She has never gone out of the apartment." Her brother who loves this cat very much was at work selling outdoor exercise equipment. The whole family loves this angry cat.

It was 2 years ago that she was spayed and I did not see her again for the annual vaccination last year. "Too busy," the working daughter said. But in the past 3 months, the cat was losing hair on both flanks.

"It is just not possible to examine her as she will scratch anyone approaching the carrier," I advised giving the cat isoflurane gas and oxygen anaesthesia. This was done and the cat was examined. Hair loss of 50% on both flanks due to licking.

A case of bilateral endocrine alopecia since she was spayed by me 2 years ago? Flea bite dermatitis earlier as there was no signs of fleas. A case of anal sacculitis which is rare in cats.

As the cat was sleeping, I pressed the anal sacs. Jet black oil oozed out in copious amounts (see video). More  dried grey granular oil ssquirrelled out from one sac and the owners could see the oil.

"The normal oil is light yellow, like cooking oil," I said. "Your cat's black anal sac oil is rarely encountered.  One in 1000 cats possibly. The cat could feel the itchiness in the anal sacs and alleviated her itchiness by licking the flanks.

The oil was expressed.
"Her stools may be too soft and so, the anal sac oil could not be discharged," I asked whether the owners had seen the stools.
"No," the daughter said. "The maid cleared up the stools."

This was a beloved cat who would growl and hissed at family members too. So the mum clipped her claws two at a time when the cat was sleeping.

This cat came for a check up for the hair loss early. I noted in my record that the anal sacs were OK 2 years ago. So, this problem of anal sac impaction happened in the last 2 years. 

Jet black anal sac oil is very rarely seen in cats and so this will be considered a rare case. 

Thursday, April 16, 2015

Spondylosis L2-L3. A 12-year-old Shih Tzu has arched back

"My dog has more muscular front legs than the back," the owner said. "The back leg muscles are withered and my dog could not walk properly. The owner wondered why the dog had very weak back legs and an arched back. I noted that she made the dog wear diapers too.

"The arched back is due to pain behind the rib cage," I said. This was a case of spondylosis deformans, a chronic disease of degenerated intervertebral discs. In this disease, the joints between the vertebral bones become unstable as the intervertebral discs become abnormal and unable to act as cushions to absorb shocks when the dog jumps.

Bony spurs called osteophytes form on the sides of the vertebral bone, as can be seen in this dog's X-rays.

"Blood test showed high total white cell count and neutrophils, indicating a bacterial infection of the blood," I explained to her the blood test results.  The dog had skin diseases which would have had led to such infections.

1. None if there is no pain.
2. In this dog, there is some pain of arched back and wasting of the back leg muscles. Painkillers may be prescribed. Weight loss is not necessary as he is not fat. Physical therapy and exercise are not practical.
3. Surgery if the spinal cord is compressed. This will be costly.

REFERENCE: Spondylosis deformans

Tuesday, April 14, 2015

1170. Schwannoma in a 10-year-old Miniature Schnauzer

April 13, 2015

This male 11-year-old Miniature Schnauzer had a big grey skin lump, 1.3 cm x 0.8 cm x 0.7 cm on the skin of his toe. It could be a melanoma. Dr Daniel suggested excision and histology.

Benign peripheral nerve sheath tumour suggestive of schwannoma. No evidence of malignancy. Good news. Otherwise, the toe will need to be amputated.


As the dog is old and the growth is greyish and growing "fast", the owner should be given an alternative surgery - excision of the digit (toe) in case the tumour is malignant as there is not sufficient margin to remove all tumours.

In this case, "some of the spindle cells ae seen to reach the deep resection margin focally" meaning that the whole schwannoma could not be excised fully. There is a possibility of recurrence and a need for toe amputation later. The owner was aware of this possibility.

1169. Deep spreading pyoderma in a young female pug

Pustules on chin, nose and ears first  --- chin acne or nasal pyoderma. Ear pustules.

Skin scraping - demodectic mites and dermatophytes  ----- No demodecosis, dermatophytosis yes No bacterial culture and sensitivity done to lower costs

Spreading. Very itchy

Skin biopsy on collarettes when lesions get more - ruptured epidermal cysts --- pyogranulamatous processes
No fungal culture
No cytology

Ciprobay, ketoconizole, amitraz wash, atopica, pred at different times.
e-collar, booties for hind paws, pain relief.

Healing after more than 4 weeks of treatment
Folliculitis or impetigo?
Deep spreading pyoderma

Tuesday, March 24, 2015

1146. Pug with folliculitis

Mar 24, 2015
Review of the pug. 9 days. Still has inflamed skin. Appeared spreading.
Ringworm +ve some hairs
Skin scrapings 3 areas - no mites seen.
Allergy?  Plastic biting of handles of mum's bedframe - allergic on chin and face.

COMPLEX DEEP PYODERMA - seborrheic conditions - follicular and sebaceous disease.
A skin biopsy showed ruptured epidermal cyst - pyogranulomatous inflammation.

A very difficult skin disease to treat with antibiotics in this pug as the pyoderma keeps spreading and the pug keeps scratching every day uncontrollably.  

Skin biopsy is important in this case. Report
 -- ruptured epidermal cysts

VIDEO AS AT APRIL 12, 2015    MORE THAN 4 WEEKS OF TREATMENT OF THE DEEP SPREADING PYODERMA. Not fully recovered yet. Will the pustules and collarettes recur?

armpit left side - infection caused by left hind leg traumatic scraching  ---foreign body material like plastic and hair keratin scratched into the dermis --- collarettes?

Still has 7 days of medication and on amitraz wash. Appears to be healing now. Owners are happy.


APRIL 14, 2015
Always palpate and press the skin lump. It was painful as the pug reacted to palpation. I suspected an abscess. Histology report of skin lump from central sternal area - acute suppurative inflammation and abscess formation. Noevidence of malignancy. 

1168. How to examine a Beagle's swollen closed eye?

Yesterday, Apr 13, 2015, a gentleman brought in a Beagle with the left eye swollen and closed 90% while the right eye was 60% closed. Both eye conjunctiva had bulged and swelled to a large soft mass. What was the cause? He had been barking the whole night.

"I suspect that some naughty  had splashed chemicals onto his eye or he had contacted such chemicals from the fertilisers or plant."

"My Beagle is leashed and so it is not possible for boys to do it," the man said. "Besides, I live in a very good neighbourhood."

"It is possible that there are naughty boys who splashed acid onto his eyes," I replied. "There are always the fringe extremes of human behaviour."


Dr Daniel sedated the dog and gave an IV drip with dexamethaone and baytril. The conjunctiva had reduced much in swellings after the use of 0.1 ml of dexamethasone as you can see in the images..


The white debris are hairs. A video shows clearly the fluorescein stained green corneal ulceration. The next day, the owner came to visit. Swelling of the right eye had subsided by 90%. Should go home tomorrow.

The dog could have splashed himself with cleaning detergent as he had been leashed near the washing area and mop. So, there was no naughty boys.

Significant finding is low platelets  106   (200-500) indicating that there was toxaemia.
The white cell count is normal  11.9 (6-17),  N 74%  (60-70%),  N absolute 8.8 (3-11), L 19%, L absolute 2.21, M 4%, M absolute 0.45%, E 3.9%, E absolute 0.46, B 0.1%, B absolute 0.01

He looked much better today. The image was taken when he was sedated to check his eye ulceratios. The left eye was normal.

Left eye cornea no longer stains green with fluorescein indicating that the corneal surface is not ulcerated. However, I can see faint cloudiness in the central area.

The left eye white (sclera) is severely congested indicating that there was severe inflammation and pain when the chemicals spill over the left cornea.. E-collar is applied.  VIDEO

Dog goes home with painkillers and eye drops.

Saturday, April 11, 2015

1167. Miniature Schnauzer has itchy flanks again and again - ear pain or bilateral endocrine alopecia?

"What is the solution?" the lady asked. "In any case, give my dog the anti-itch injection."
I did explain to her that an ear surgery may be needed to provide ventilation and drainage as the ear pinnae showed hyperpigmented markings of chronic scratching. She said I had not mentioned it before. I showed her the illustration I had in her case file, of the ear surgery called lateral ear canal resection.

It is good practice to illustrate the surgery and keep a record. Owners have short memories and in this case, I had the evidence of having explained to her. Another cause could be bilateral endocrine alopecia.


1166. Playpen and pee pad toilet training of 4th Miniature Schnauzer pup - Video

April 12, 2015

5 siblings came for vaccination at 6th and 7th weeks of age.

4th pup from the same seller came for vaccination and microchip yesterday.
Video on how owners train it.

1165. Toilet-training. I asked. I aCross-bred pup from K9 Missions no longer anaemic

Sunday Apr 12, 2015


Stray puppy, female, cross-bred,  rescued by K9 Missions, Singapore.
Duration: Around one month of toilet training.

1. Commercial Dog Pee pads 3/day put outside the Crate
2. Does not like pee tray.
3. Sleeping, eating and drinking area inside the Crate
4. Poop after eating 2-3 X a day but not always on the pee pad. Prefers corner with privacy away from the owners' view.
5. Success is 50% as the dog does not want to poop onto the pee  pads.

The couple brought in the 3-month-old female cross for the 2nd injection of Imidox injection.
"How is the other sick sibling?" I asked as K9 Missions had mentioned that there was a sick sibling last time and had checked on this puppy recently.
"He is fine after treatment."
This puppy is now pink in gums and had gained weight. Active. So, it is good news. I gave her the 2nd jab of Imidox 0.75 ml for 7.5 kg bodyweight. 0.3ml IM and 0.45 SC. The puppy should recover.

"How do you toilet train her?" I asked as it was already one month of living in the apartment.
"This timid puppy is the smallest in the litter and would take her food to eat in a corner, away from the other 5 siblings."
I guess she was bullied.
"Successful in peeing on the pee pad but not successful on pooping," the husband said.
3 pee pads are used per day. The puppy would poop on the pee pad if needed to be.
"But she would wait till we are not around before she would poop," the husband laughed. "Somewhere away from the crate which has the water and food bowl and the bed. She would poop elsewhere in a corner."
"This puppy valued privacy," I said. "It is what she did before adoption."

1164. Toilet-training a 4-year-old dog

Dear Judy,

I need help with training my 4 year old dog to do his business at the right place. When he was a puppy, our family was not sure of how to train him and so many people had many different ways of teaching or scolding him that I believe he got confused and didn't learn it well. We later moved to another home and it got worse! As a male (but neutered), he started to mark places like our sofas, mats and even beds and we had absolutely no way of stopping him that my father decided to confine him to an area for good.

I have been very busy at work and next week, my father is travelling for 1 week so I have decided to take a week's leave and train him proper. I am unsure of how to do it; should I get a pee tray with walls or without since he lifts his leg while he pees, or should I get a belly band etc. I noticed he responds quite well to clicker training and I plan to implement that while training him.

So far, my plan is to get a pee tray (please advise on whether I should get one or not, and should I get one with height or without) and then soil it with his own pee so that he can smell it but should I click it when he sniffs it or when he steps on it? I am not even sure if he will want to do his business there or not!

Please help!

Thank you so much and I truly appreciate it that you're posting useful information to guide dog owners!

Amanda H.

I am Dr Sing Kong Yuen. Thank you for your email.
1. Your dog is 4 years old and therefore will need more than one week to toilet train him, unlike a 3-month-old puppy.
2. Your home is full of urine smells. Neutralise the smells.
3. Confinement to an area is still important. Pee tray with walls will be needed.
4. Belly band is not a method of toilet training but to prevent him urine-marking by some dog owners.
5. Urine marking is due to belated neutering. When did you neuter him?
6. Your clicker is meant to replace verbal cue. Therefore, click when the action is desired (e.g  stepping on the pee tray to pee). Give a food treat reward.
7. One alternative is to take him downstairs twice or thrice a day and use clicker training.   

Wednesday, April 8, 2015

Pregnancy Diagnosis - X-rays v ultrasound

A tricolour young female Pom X looking like a minature Sheltie was mated by a male Poodle.
One lateral X-ray view of the Pom's abdomen is sufficient. The ultrasound scan is an alternative if the owner is worried about radiation to the puppies. However, one X-ray is not known to harm the puppies. In ultrasound scan, much depends on the expertise of the vet interpreting the scan. Some vets cannot ascertain the number of puppies when there are multiple ones and would give a report as "four or five" puppies. For the X-ray, the number of spinal columns will show clearly. In this case, there are 2 and therefore 2 puppies.      

Tuesday, April 7, 2015

Toilet training a Golden Retriever

Follow up on 8-year-old Pom with non-stop coughing

Apr 4, 2015

No more coughing since March 28, 2015 when the Pom was continuously coughing. "Coughing ceases completely on the 3rd day,"  the lady owner said that there was much less coughing after the heart medication was prescribded by me.

But the dog had vomited late at night the past 3 nights and was inappetant. The dog was lame on the hind leg, having jumped down from the sofa. There was some pain in the left hind hip but nothing serious.

I had X-rays taken. The young lady owner remarked that the heart looked "better" as compared to the earlier X-rays taken by the other vet on March 28, 2015. "Less swollen"


A rabbit had feasted on cardboard boxes

After checking on the teeth and finding them normal wear and tear, I asked: "Did the rabbit eat wires?"
"No," the lady said.
"He eats cardboard boxes. I have just shifted to a new apartment."

Moving to a new apartment, the rabbit feasted on the cardboard boxes. The slim young lady said that he passed sticky stools of small amount and was not his usual active self.

I felt the stomach distended with a soft mass. The rabbit was given drips but still did not pass much stools. I asked the owner to X-ray the rabbit the 2nd day and the X-rays showed stomach impaction.  Full of cardboard pieces!  No more free roaming without supervision now!

Follow up: Fever, anaemia and leucopaenia in an adopted puppy

Mar 28, 2015
A X-bred puppy was rescued by the Canine Missions 8 days ago and adopted 8 days ago.
She was female, 2 monthsold and was anaemic and had no appetite for 3 days. Temperature was 39.9C. 2 siblings had passed away, 2 were OK and 1 had become lethargic. E canis Ab, Heartworm Ag, Lyme Ab and Anaplasma Ab were negative. Babesiosis was suspected.


March 28, 2015.
Hb  4.5  (12-18)
Red cell count 2  (5.5 - 8.5)
Total white cell count  4.5  (6-17)

N  56% (60-70%)          Abs 2.52 (3-11)
L  27%           Abs 1.2
M 17%           Abs 0.75

PCV 0.14  (0.37-0.55)
Platelets  less than 10 (200-500)
Imitox was given IM. IV drip, baytril and Vit K1. Doxycline 100mg at 1/2 tablet/dayfor 6.4 kg puppy for 21 days.   The puppy was active, had a good appetite for the next few days and came on Apr 4, 2015 for review.


April 4, 2015.
Hb  10.6  (12-18)
Red cell count 4.6  (5.5 - 8.5)
Total white cell count  11.7  (6-17). Back to normal.

N  35.9% (60-70%)          Abs 4.2 (3-11)
L  53%           Abs 6.2
M  9.7%           Abs 1.14

PCV 0.34  (0.37-0.55)
Platelets 259 (200-500)

Negative for Dirofilaria immitis antigen, Ehrlichia canis antibody, Borrelia burgdorferi antibody and Anaplasma phagocytophilum/Anaplasma platys antibody.

Babesia blood smear was not done.

The puppy was active and had put on weight from 5.8 kg to 6.4 kg on April 4, 2015.