Sunday, February 14, 2016

2933. Two-of-a-kind cases - rabbit feet, dog abdominal tumour, dog swollen tummy

Sunday  Feb 14, 2016

It is very unusual for me to receive two similar medical conditions within 3 days.

1. Case of sore feet in 2 rabbits.
    Today, Feb 14, 2016, a young man came with his rabbit having no hairs and wounds on the underside of the front and back feet. "I researched the internet and got the diagnosis," he could not recall. "It is sore something...Yes, it is sore hocks!". He was spot on for the hind feet and hocks. Only that 4 feet had the similar problem.
"I have an in-patient rabbit with large sores only on the back limbs but your rabbit has 4 legs affected!", I was surprised to see two-of-a-kind cases, known as pododermatitis in rabbits.    
Videos are shown.

2. Case of abdominal tumours in a Miniature Schnauzer and a Fox Terrier. I was talking to the owner just 3 days ago as regards the importance of taking out the bladder stones (seen in X-rays) as the dog had an emergency urethral obstruction resolved some months ago after midnight by an emergency vet. I had diagnosed bladder stones for him earlier but his lady friend did not want an operation. "No more blood in the urine," the man in his 50s said. "Maybe the stone had disappeared."  

Then yesterday, he phoned me distressed as his Schnauzer had passed away from a ruptured tumour spilling blood inside the swollen abdomen. Vet 1 had given this dog a series of anti-heartworm injections but in the last injection, the dog's abdomen became swollen. Vet 1 quickly referred to Vet 2 who said that the dog's abdominal tumour had ruptured spilling blood into the abdomen. The dog died soon after admission by Vet 2. So the owner wanted me to do an autopsy to find out whether Vet 1 had been negligent in not discovering the tumour earlier and before anti-heartworm injection. I have a conflict of interest, being a competitor and so I advised that he contact AVA or A-Star vets. It was Saturday and he had taken the body back from Vet 2. "Put the body in a freezer," I advised. "Otherwise it is not possible to do an autopsy properly."  He said he put it inside a fridge.

"The disadvantage of autopsy by the AVA is that we will not get back the dog's body for creamtion," he told me today. "As for A-star autopsy, the vet wanted a referral from another vet."

"It will be costly to do autopsies and engage lawyers," I told him that the burden of proof on negligence is on him, not the veterinarian. He would think about his next step after getting all the medical records from Vets 1 and 2.  The Fox Terrier came in for consultation as he always leaves a puddle of urine after lying down to sleep. The owner thought he was naughty, urine marking at this old age of 8 years and so had him neutered.
"There are 4 abdominal tumours, one of which is a gigantic one I could feel on palpation," I said and got the dog X-rayed. Dr Daniel had the tumours confirmed by ultrasound.

What to do?  Chemotherapy is too expensive. The neutered dog still leaks urine when lying down to sleep overnight but otherwise could control his bladder. 

"One large tumour is said to be near a major blood vessel," I said. "The descending aorta and so there is a risk of bleeding to death during removal of this large golf-ball tumour." The owners could not decide what to do. "The dog is still young, at 8 years," the wife said.

Case 3. An old Pomeranian and a Maltese had swollen abdomen. Both had dirty vaginal discharge a few days ago. Both were very ill and were unlikely to survive anaesthesia.  Closed pyometra in both cases. The Pom owner brought the dog to Vet 1 but she died on arrival.  The owner of the Maltese did not want any surgery as the dog would "die" anyway during the operation to remove the pus-filled uterus. I could not help feeling sad that the two old female dogs would have been alive if they had been spayed at 6-12 months of age. Both were in good bodily condition but time had run out for them.

The above are the twin cases appearing within a day or two and this was such a coincidence.

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