Monday, July 29, 2019

3369. Day 3 of inpatient review. A rare case of severe ear infection in a dwarf hamster





Saturday, July 27, 2019

3368. Stock photography. Register with shuttlestock for beginners

https://submit.shutterstock.com/


Jul 28, 2019
TIPS FROM NICOLE GLASS

1.  https://www.shutterstock.com/g/zdenkadarula
I love to photograph people, business, medical, children and abstract.

Zdenka Darula spoke on Nicole Glass website

1. Videos earn more. Learn how to do it.
2. Can make a full-time if research trends, effort and skills, and create more of the in-demand images for shutterstock.
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2. Uploading branded products to shuttlestock - illustrative editorial images

ILLUSTRATIVE Editorial image  (need really amazing and good quality), high demand but not supersaturated categories..

Smaller brands
Famous Combine with other products or unique ways.
MUST KEY in "Illustrative" "Editorial".
Cannot add or remove  ie.. NO ALETERATION. Can colour enhance



v. regular editorial image (document event e.g. politics, protest,  no need so sharp and high quality)




Friday, July 26, 2019

3367. A panting Shih Tzu. Lung nodules, enlarged heart and liver.



Not photoshopped








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Thursday, July 25, 2019

3366. Teaching case. Hyersalivation & nystagmus in a 14-year-old FS Silkie Terrier

Thur Jul 25, 2019
Day 5 of inpatient treatment


RESEARCH must be part of clinical practice so as to become a better vets or vet assistants. Today, I got my two assistants to understand and videoed their case presentation.

.

Hypersalivation, nystamus and anorexia.

"Drooling" is not a scientific word for a vet to use in case studies. One of my assistants used "drooling". The other said it should be "hypersalivation."  So, there is learning as I get them to review this case being she goes home soon. 
 
Case study with my 2 assistants by creating a video.

Digital photography should be better and well lit. Positioning of right lateral view was not done.
Too wet tissue paper to show rotten teeth well. These were my comments. I hope they do better next time. 

In this way, they learn and remember better than just observing the case being handled by Dr Daniel.
On Day 5, this video was done. 12 teeth were extracted. The dog has recovered with better appetite now.  The owner was happy.












VIDEO


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Photoshopped images















The handphone images were taken by my assistants and they are as follows:


Right lateral view is required





Use dry paper and arrange teeth in proper order

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She had another dog which had dysuria. This dog's X-rays showed no stone but in 2017, another vet had removed stones.

Thursday, July 18, 2019

3364. Anaemia in a 14-year-old female spayed pug

Jun 26, 2019.
For the past 14 years, the pug did not have any physical examination or dental work. She has an enlarged nipple mass 8 cm x 5 cm.

Not eating. Blood work showed decreased red blood cells and haemoglobin for 3 blood work done on Jun 27, Jul 16 and 20, 2019.

X-rays - lung tumours and enlarged spleen.




Bleeding and iron-deficiency
Regenerative (check if there is an increase in reticulocytes) or non-regenerative anaemia?
Reticulocytes = 0.9% (normal) on Jul 20, 2019 


The pug used to have excellent appetite. 3 decayed teeth were extracted. The epulis (gum tumour) on the left upper canine tooth is unlikely to cause loss of appetite and anaemia.  

July 11, 2019. The owner complained that the pug was still not eating normally. She has inappetance and anorexia on certain days.  I advised the owner to put the dog inpatient for further IV treatment and get X-rays done. Dog came in on Jul 14, 2019.

2nd and 3rd blood work on Jul 16 and 20, 2019 showed low RBC and . Poor appetite. Needed syringe feeding to prevent weight loss.

1. decreased red blood cells and haemoglobin.
2. increase in total cell count and neutrophils suggesting a blood-borne bacterial infection.
3. increase in liver enzymes indicating liver disoreder - hepatitis or cancer.

4. Urine tests on Jul 19, showed urinary tract infection. Very smelly urine. 
5. X-rays (lung tumours, spleen enlarged), bone bone marrow biopsy (not done).
6. Blood babesia and E. canis - Nil
7. Faecal check for parasites.- Nil.





Tentative diagnosis: Lung tumours and severe anaemia
Poor prognosis.

3363. Anaemia in dogs



Reference:   https://vcahospitals.com/know-your-pet/anemia-in-dogs

 

Anemia in Dogs

By Ryan Llera, BSc, DVM; Ernest Ward, DVM
Medical Conditions, Pet Services

What is anemia?

Anemia  is caused by a reduced number of circulating red blood cells (RBC's), hemoglobin (Hb or Hgb), or both. It is not a specific disease, but rather the result of some other disease process or condition.
Red blood cells are produced in the bone marrow and are released into the blood, where they circulate for approximately three months. As the RBCs age or become damaged, they are removed from the bloodstream and their components are recycled to form new red blood cells. The number of red blood cells may become reduced because of decreased production, lysis (cell destruction), or increased loss as seen with hemorrhage (bleeding).
Hemoglobin delivers oxygen to the cells and tissues of the body, and a dog that is anemic will suffer from symptoms related to a lack of oxygen.

What are the signs of anemia?

The most easily observed and common clinical sign of anemia is a loss of the normal pink color of the gums; they may appear pale pink to white when examined.
Anemic dogs also have little stamina or energy, so they seem listless or tire more easily. Additionally, weight loss, labored breathing, loss of appetite, a faster heart rate, or signs of blood loss (bloody nose, blood in the stool, urine, or vomit) may also be seen. Pale gums and lethargy indicate the need to perform blood tests.

How is anemia diagnosed?

There are several tests that are performed on the blood sample to diagnose anemia. The most common test is the packed cell volume (PCV) or hematocrit (HCT). These tests are often performed as part of a complete blood cell count (CBC). In a normal dog, 35% to 55% of the blood will be red blood cells. If the PCV is below 35%, the dog is generally considered anemic. Others tests to determine if a dog is anemic include the red blood cell count and the hemoglobin count.

What other tests are important when a dog is anemic?

When there is evidence of a low red blood cell count, it is important to know if the bone marrow is producing an increased number of new red blood cells in response to the lost red blood cells. When the body senses anemia, it releases immature (young) red blood cells from the bone marrow prematurely, and these immature red blood cells, called reticulocytes, can be stained for easier identification on the blood smear. The presence of increased numbers of reticulocytes indicates that the anemia is responsive. This means the body has identified anemia (responding) and is attempting to correct the deficit by releasing immature red blood cells. Most automated blood analyzers will detect the presence of reticulocytes to help your veterinarian quickly determine the body's response to anemia.
A careful study of the blood smear is also important to look for blood parasites that might be causing red blood cell destruction and abnormal cells that could indicate leukemia (high white blood cell count). Additionally, a slide agglutination test can be done to help rule out the presence of autoimmune hemolytic anemia (see handout “Autoimmune Hemolytic Anemia in Dogs” for more information on this condition).
A bone marrow biopsy or aspirate is obtained if there is concern that the bone marrow is not responding appropriately to the anemic state (unresponsive or non-regenerative anemia). A sample of bone marrow is withdrawn and analyzed, providing valuable information about its condition, and occasionally revealing the cause of the anemia.
Biochemical profiles and urinalysis are other important tests for anemic dogs. These tests evaluate organ function and electrolyte levels providing important information about the overall health of the dog.
A fecal parasite exam is important to identify the presence of parasites in the intestinal tract that might be causing blood loss.
Imaging studies such as radiographs (X-rays) or ultrasound may be recommended to help determine the cause.

What causes anemia?

There are many diseases that can cause anemia. These are grouped into:
  • diseases that cause blood loss
  • diseases that cause hemolysis (red blood cell breakdown or destruction)
  • diseases that decrease the production of red blood cells through bone marrow suppression

What diseases cause blood loss?

The main causes of blood loss in dogs include:
  • trauma or injury to blood vessels or damage to internal organs, causing persistent bleeding
  • heavy infestations of blood-sucking parasites, such as fleas, ticks, and hookworms
  • tumors (benign or malignant) of the intestinal tract, kidneys, urinary bladder, and spleen that begin to bleed
  • diseases that prevent proper blood clotting

What diseases cause hemolysis?

The main causes of hemolysis include:
  • autoimmune disease, especially immune-mediated hemolytic anemia (IMHA or AIHA)
  • blood parasites (e.g., Babesia)
  • chemicals or toxins (e.g., zinc, rat poisons, onions, or garlic)
  • cancer

What diseases prevent red blood cell production through bone marrow suppression?

The main causes of bone marrow suppression that result in decreased red blood cell production include:
  • any severe, chronic (long-lasting) disease (such as chronic kidney or liver disease, Ehrlichia)
  • very poor nutrition or nutritional imbalances
  • autoimmune disease
  • hypothyroidism
  • chemicals or toxins (estrogen-based drugs, lead, some chemotherapy drugs, rarely some antibiotics such as chloramphenicol and trimethoprim-sulfadiazine)
  • cancer

Do dogs get iron deficiency anemia?

Iron deficiency anemia is a somewhat common disease in people, especially women. Iron deficiency can be common in dogs and is usually secondary to some form of chronic blood loss. It is occasionally seen in puppies that are being fed very poor diets or who have severe hookworm infections. If the underlying cause is addressed and iron is supplemented, the prognosis can be good.

How is anemia treated?

If your dog's anemia is so severe that it is life-threatening, a blood transfusion will be needed. Before giving a transfusion, blood samples will be taken for diagnostic testing, or blood typing. The main purpose of a blood transfusion is to stabilize the dog while the underlying cause of the anemia is determined, and other treatments can begin to take effect.
Further, more specific treatment can be determined once the underlying disease causing the anemia has been diagnosed. Treatments may include corticosteroids (particularly for autoimmune hemolytic anemia), anthelmintics (de-worming medications such as pyrantel or fenbendazole), vitamin K1 in cases of some rodenticide toxicities, antibiotics such as doxycycline with some infectious causes, or surgery (in cases of a damaged organ such as the spleen or liver). Your veterinarian will outline a treatment plan specific to your dog's needs based on diagnostic test results.

What is the prognosis for anemia?

The prognosis for dogs with anemia is based on the specific diagnosis, as well as the dog's general condition at the time of diagnosis.
If the anemia is diagnosed early and the dog is in relatively good health, the prognosis is good. Dogs that have severe anemia, either caused by toxins, cancer, or autoimmune diseases, or as a result of severe trauma have a less favorable prognosis.