Sunday, September 29, 2019

3294. INTERN. A pug swallows a fish hook.



VIDEO CREATION BY INTERN. The 2-year-old Pug vomited after swallowing a fish hook. 



HOOK

Many Singapore dog owners take time to walk their companion daily. The Lentor area in North Singapore is a leafy residential suburb. Houses with their manicured gardens and plants. Birds tweeting. It is a pleasant place to enjoy a brisk morning or evening walk with your dog.







As the young lady appreciated Nature in an evening walk, her pug swallowed an object attached to a 90-metre long nylon string.  She did not see the pug swallowing the fish hook but only a long green nylon string hanging out from her favourite dog's mouth.

She tugged but the string stayed stuck inside the pug's mouth. The pug vomited but nothing came out of his mouth. The green nylon string was still hanging loose from his mouth. Suspecting he had swallowed a fish hook, she rushed him to Toa Payoh Vets.





This is a Be Kind To Pets Veterinary Educational Video sponsored by Toa Payoh Vets




A pug swallows a fish hook







SURGERY at Toa Payoh Vets

Gastrotomy by Dr Daniel Sing under general anaesthesia.


Stomach is over-distended with gas and froth due to the penetration of the fish hook



Dr Daniel incised a 1-cm stomach incision.  He inserted a long tissue forceps into the stomach to grasp the fish hook. He could not get the hook out. He extended the stomach incision and used his 2 fingers to unhook the hook from the stomach mucosa. The stomach was stitched up. Then the abdominal muscles and skin were stitched up.  


Post-operation - Day 1. Skin stitched up. 



A fish hook is taken out from the stomach. No X-ray was done as the owner saw the fish hook being swallowed.


The dog recovered well after 2 days and went home. He was not confined to a small cage. He jumped and scratched his operation area with his back legs. He could not bite his stitches as he wore an Elizabeth collar but his back legs were free.

On Day 3 after surgery, a big subcutaneous swelling bulged under the skin stitches. The owner phoned as there was blood coming out from the stitched area when they changed the bandage. So they had to bring the dog in for examination. 

The stitches were not breaking down. There was a big swelling (another video) below the stitched area. The "blood" accumulated under the skin stitches. The vet slowly compressed the swelling and removed the blood and fluid.


The pug goes home after 4 days of in-patient nursing. However, the owner complained of seeing blood leaking out from the operation site when changing bandages. This was on Day 6 after operation. The pug struggled to prevent the change of dressing. So, the owner had to bring the pug down to Toa Payoh Vets for examination of the "bleeding".

There was indeed blood under the skin as shown in the video. The blood was expressed and the pug bandaged round the abdomen. (see video, edit video).  He was in-patient again for the next 3 days. 



VETERINARY TIPS AND ADVICES

1. POST-OPERATION BLEEDING

The pug was not confined to a small cage for the next 14 days after surgery. He jumped and scratched his operation area vigorously with his back paws. There was a large skin swelling by Day 4 and blood oozed out from the wound.

Pug is active and eating 4 days and more post-operation


POST-OP COMPLICATIONS
Bleeding from the wound is a post-op complication. The pug was active in the home. Although he had worn an e-collar, he could use his back legs to scratch the operation site. This resulted in a large swelling filled with blood as seen in the video below:



Sep 29, 2019, Day 4 after surgery to remove a fish hook from the stomach. The pug came in as the owner complained that there was bleeding from the wound. The pug was not confined to the cage and was using the back legs to paw at the operation site.



Oct 3, 2019. The pug goes home after being hospitalised for 4 days at Toa Payoh Vets.
Very little bleeding. There is no stitch breakdown and swelling has reduced considerably.
The owner bought a cage to confine the pug for another 10 days.









CONCLUSION


Today is Day 9 after surgery (see video, edit footage). The pug had been warded for the past 4 days. . He is active, eating and has no fever. There is little "bleeding". He goes home.

The bleeding is caused by the pug using his hind paws to scratch the operation site. The traumatic injury caused bleeding and swelling. Blood leaked out when the bandage was changed.
Since the pug was hospitalised for the past 4 days in a confined cage and given painkillers and medication, his bleeding had stopped and he was able to go home to rest in a cage. He will wears his E-collar for at least 10 days.

CREDITS
include Intern's name

vet assistants x 2








FOR MORE INFORMATION























































Saturday, September 28, 2019

3293. A 14-year-old red-eared slider has a spreading backside abscess




Small wound above the tail. Bacteria entered the wound from the environment and waters. Spread under the skin sideways. Yellowish skin patch kept growing bigger.










Owner's photos above
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Bald patch, dry and spreading from original wound.
Only the smaller one is affected.




Free-roaming on toilet floor|
Drink water onlhy when fed 2 tablespoonfuls of pellets every 3 days in the water.





Sep 29, 2019
Washed area. Smelly necrotic skin.




















CAUSE

Cause - traumatic injury. Bitten by the bigger slider?


VIDEOS



Overview



Friday, September 13, 2019

3293. A 10-year-old red-eared slider stopped eating pellets.

Eats only pellets, but for the past 1 week, she stopped eating. Pale tongue and oral mucosa and bad breath are signs of stomatitis. I could smell a fishy odour from the mouth on closer examination of this 10-year-old female slider.



Pale tongue, whitish floor of mouth, bad breath



Inflamed hard palate?




VIDEOS.
DAY 1. CONSULTATION
Not eating any pellet for around one week. This slider eats only pellets. No other food.
.


DAY 3. INPATIENT. OWNER WANTS HER HOME BY DAY 3.
Ate 2 pellets. Owner does not want X-rays yet. X-rays can reveal egg problems, constipation or foreign bodies and gas in the intestines.


ORIGINAL FILES





Thursday, September 12, 2019

3292. INTERN. A 28-year-old red-eared slider has "bloodworms" and a white tongue

Thur  Sep 12, 2019 report

A rare case of midge larvae (blood worms) was present in a 28-year-old female red-eared slider.

The slider also had a snow-white tongue which indicated a severe anaemia and swollen limbs. She had not been eating for the past 1-2 months and is very lethargic.

Several midge larvae and pupae were extracted from inside the skin folds of the slider, under the collar and on the limb folds. Those worms that were seen as bright red are called "blood worms".

They are able to survive in the soil and debris inside the fresh water of reservoirs and lakes. They are sold as bait for ornamental fish trade. They are not the usual worms in that they have hairs and are larvae of midge.


The owner phoned me as she did internet research which showed "blood worms" being common in turtles. She  asked if this slider who was fed vegetables only for the past 20 years could be infested with "blood worms" The worms seen in this turtle are likely midge fly larvae. The newly hatched larvae has blood (red blood cells) inside their transparent cylindrical bodies and hence are described as "blood worms." They are classified as insects and not as blood worms.



The slider had swollen neck folds and skin folds between the hind legs. These are signs of odema relating to retention of fluid under the skin. Causes may be heart, liver or kidney diseases. The severe anaemia resulted in a snow-white tongue which is softer than normal.

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Larvae of midges in the tank of this slider





TONGUE COLOUR - WHITE. SEVERE ANAEMIA







Normal tongue is pink in colour




CONCLUSION
A rare case of a red-eared slider infested by midge larve (video and image).
The slider was housed in a tank in a balcony and so was exposed to the midges for the past years. These midges are adult flies and are present in large numbers in areas where there are lakes and reservoirs.





These midges are a nuisance to residents living nearby. They are non-biting as adults unlike mosquitoes. The larvae flourish in the waters of the tank and suck blood from the body of this slider for many months or years. The slider became anaemic as shown by the whiteness of the tongue. A normal tongue should be pink in colour.



See Reference:
 https://www.pub.gov.sg/Documents/Midge%20webpage%20guide%20PDF.pdf







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VIDEOS x 3 below.
to be edited. Show combined footages of the "blood worms" in the tank and on the body of the slider.
Most likely, the heavy infestations of these midge larval sucking blood from the slider over the past months resulted in a severe loss of blood. Hence the tongue is snow-white in colour. The slider is very ill now as she has swollen limb, neck and collar folds suggestive of heart, liver or kidney failure.

  

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5% DISCOUNT ON CONSULTATION OF YOUR RED-EARED SLIDER

FROM FEB TO MAY 2020. Phone Toa Payoh Vets
6254-3326 for appointment


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ORIGINAL IMAGES



Wednesday, September 4, 2019

3290. A Golden Retriever vomited for 4 days. Anuria. Why?

Case study: Golden Retriever, MN, 15 y
Vomiting  4 days and painful right armpit.

Sunday. Painful right armpit and large swelling (haematoma). Bruised skin further down the sternum is evidence that the dog injured himself when startled and over-extended his right elbow to get out from the front of the car.

The dog loved to sleep with front half of the body below the car bonnet. On that day, he rushed out from below his car, causing himself probably overextension of the armpit, a very painful right armpit area and a large swelling.






The next 3 days, he vomited and was not able to stand up. No appetite. Blood test showed acute renal failure.

 
1. Acute renal failure & urinary tract infection. No urinary stones (holding urine in bladder overnight inside masterbedroom for years - stasis of urine - bacterial growth to blood borne bacteria infection, leucocytosis ). 2. Haematoma (blood swelling) of right armpit and chest area due to sudden exertion getting the front half of the body from under the car (his habit of sleeping this way is to be discouraged).  Prognosis is poor as dog has anuria (not passing urine despite 1500 ml of IV drips).



Sep 5, 2019 Thursday. Day 4 of injury and vomiting.



















Peritoneal or haemodialysis is needed when
BUN = or more than 100 mg/dL
Serum creatinine = or more 10 mg/dL
Convert mmol/L to mg/dL = x18