Friday, December 6, 2019

4024. INTERN*****. Is it possible to use electro-surgery for entropion surgery?


HOOK. Use some entropion footage from the following video as hook.

Case 3. An older Sharpei has acquired entropion


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Is it possible to use electro-surgery for entropion surgery in the dog?
Case studies of 4 Sharpeis and 1 Chow Chow.

Dr Sing Kong Yuen, BVMS (Glasgow),  Toa Payoh Vets, Singapore



Singapore is a city state where around 80% of the residents live in high-rise apartments.
Most dog owners have small breed dogs as pets. 


Some canine breeds are prone to suffer from Entropion which is the in-rolling of the eye-lids.


Some vets believe that electro-surgery should not be used for entropion surgery aa it causes poor wound healing as compared to a scalpel incision. I do not agree as I have used it in various surgeries when it is indicated.




What is electrosurgery and when is it used? Do some research.



Two cases of entropion surgery performed in the Chow Chow and the Chinese Sharpei produced excellent healing. These are presented here. 

Intern to read the text in the slides. Do not narrate like a bullet train.
Case 1.  An adopted older Chow Chow has severe entropion














JUST AFTER ELECTRO-SURGERY




EYES OPEN WIDER AFTER ENTROPION SURGERY




FOLLOW UP 3 YEARS LATER. THE OWNER IS PLEASED WITH THE EXCELLENT OUTCOME.






CONCLUSION



Case 2.  Chinese shar-pei puppies have entropion



I was at the pet shop vaccinating the puppies.  The pet shop owner thought the persistent eye discharge and corneal ulcerations in his Sharpeis, for the past few weeks were due to eye infections. He used eye drops without success.  After electro-surgery, the 4  puppies had no more eye discharge (epiphora) and the corneal ulcers healed. He was able to sell the 4 puppies.










CONCLUSION
Entropion may be mis-diagnosed as eye infections. Get a veterinary examination and a veterinary surgeon who performs entropion surgery as not all vets do it. Scalpel incision or electro-surgery are both good methods to excise the exess skin strips. Usually the outcome is excellent in that there will be no more eye pain and discharge some 14 days after surgery.


Case 3. An older Sharpei has acquired entropion

4023. Entropion surgery on Chow Chow - Email query

EMAIL QUERY to Toa Payoh Vets dated Dec 6, 2019.

I wanted to ask whether you perform Entropion surgery for dogs? My dog needs to be operated. She was previously operated by Dr. X from another veterinary practice but she is unavailable (my dog has gone through 2 entropion surgeries before). She is 3 years old female chow chow. 

Would appreciate your advice on the matter.

Thank you in advance.

Best regards,
Name


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EMAIL REPLY dated Dec 7, 2019

Thank you for your email. We do entropion surgery for the Chow Chow. Please bring in the dog for examination and the history of the dog's previous entropion surgeries. Phone 6254-3326 for appointment.


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CHOW CHOW ENTROPION CASE STUDIES




https://2010vets.blogspot.com/2016/08/2906-entropion-surgery-in-adopted-3.html



FINAL VIDEO


https://www.youtube.com/watch?v=BEIGUPUIYnc


shar-pei entropion surgery

4022. Spaying and neutering rabbit - email query Dec 7, 2019


EMAIL QUERY to Toa Payoh Vets - Dec 6, 2019
Hi there,

We would like to spay / neuter our rabbits. 
Would we need to arrange a pre-op consultation, or would we only need to book a time for surgery?

Also, could you advise us on cost and recovery time and advice please? 

We are hoping to do this between 10 and 15 Dec if possible, as we will be travelling overseas from 16 to 25 Dec. 

Thank you!
Name


----------------------------------------------------
Dec 7, 2019
Thank you for email. The reply to your queries are as follows::

1. Castration (neuter) & anaesthetic - male cats, hamsters, rabbits. Excludes e-collar, antibiotics, painkillers  
$200 - $250 for male rabbits, depending on size.

2.  Spay female rabbits, guinea pigs. Excludes antibiotics, painkillers, Elizabeth collars. $380 - $480 depending on size

3. We don't usually require a pre-op consultation. We will examine the rabbit on the day of surgery and if they are OK, they will be operated.

4. Full recovery takes around 14 days. Most rabbits will eat the next day after operation, if given medication and confined for around 14 days esp. for female rabbits. We do provide in-patient post-op services at $20/day/rabbit, preferably for at least 3 days to monitor the rabbits' temperature and health and to clean the wounds and give medication.

5. Surgery from Dec 10 -15, 2019 is OK with us. Please phone 6254-3326 to book an appointment, preferably on weekdays.

4021. Singapore wildlife: Kesser Dart - Forewings vertical and hindwings flat

 a Lesser Dart (Potanthus omaha omaha) was resting on a leaf with its unique skipper pose -  forewings vertical and hindwings flat






A Hubner's Wasp Moth (Amata huebneri) seen during the walk.

Thursday, December 5, 2019

4020. INTERN*****.A red-eared slider swims lop-sided. Why?






Dec 5, 2019. Day 7 of in-patient treatment. The slider is syringe fed Critical Care daily and has put on weight. He is more active. Today, Dr Sing tested whether he still swims lop-sided by putting him in a tank filled with water. He appears to be struggling to float and swim normally as seen in the above two videos.

The cause of lop-sided swimming is usually pneumonia in one side of the lung. Treatment is antibiotics, anti-inflammatory and syringe feeding of Critical Care to sustain the life of the anorexic slider.

He was taken out of the tank and not submerged in the water.


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Other cases




Tuesday, December 3, 2019

4019. INTERNS TO NOTE: An excellent interesting video produced during Internship - carnassial tooth abscess


A good write up by an intern for video creation




An easy to understand veterinary educational video on dental hygiene created by another intern. 

Final Video:
https://www.youtube.com/watch?v=rT8JyykVJzM

4018. Advices to Young People. Dr Sing'sTravel Stories.Mt Ararat, Armenia


This group was a congenial group as none quarrelled or were unhappy with the tour.

As regards relationship issues, some people may be sensitive about relatives or friends asking about their single status.

This nursing sister was not angry when I asked about her private life. She had a great a way to answer such nosy questions. Life is about relationships and if one takes singlehood negatively, one can  become frequently upset and self-stressed with such nosy queries.   

Monday, December 2, 2019

4017. Singapore Wildlife: The Esplanade Oriental Garden Lizard sighted on Dec 2, 2019

Dec 2, 2019

I inspected Trees 1, 2, 3 and 4 for the Oriental Garden Lizards I saw previously. None was found from 10 am to 10.30 am. In Tree 1, the gardener was trimming the yellow flowers and the noises would frighten them off the tree or supporting iron poles. Around Tree 3, another gardener was hosing the grounds. Noises made them hide.

I was taking some photos of the silver-leafed plants with purple flowers, near the main road.  Suddenly I saw this Oriental Garden Lizard on top of the leaves and branches. Its dark brown coat was in stark contrast to the silvery leaves.

Oriental Garden Lizard is at the central point of this image










He did not move for some minutes and I managed to video him trying to snap at a passing insect (see video). Later, he moved further inside the plants.

 

Sunday, December 1, 2019

4016. INTERN.***** A 13-year-old Bichon Frise woke up lethargic and recumbent. Why?.

HOOK

13-year-old much loved by the young man who bought him as a puppy in Perth Australia. The dog is walked every morning for around an hour, but today, he just would not want to go out. He was very lethargic and laid down on his side, under the dining table as if he was "dying". USE some 2-minute footage of the video below as hook.







The body Condition Score 4/9 good. Occasionally, he has this retching sound in the morning as if he tries to clear his throat. Appetite is excellent.

He goes for morning walks of half an hour daily for the past few months. However, on Nov 17, 2019, he was lethargic and recumbent under the dining table. He was OK yesterday after the walk.Nov 27, 2019
Gatsby's blood tests showed slight anaemia and elevated liver enzymes. No bacteraemia and no fever. Monocytosis. Thrombocytosis.  


MonocytesHigh levels of monocytes may indicate the presence of chronic infection, an autoimmune or blood disorder, cancer, or other medical conditions. ... This may occur as a result of a virus or an infection, such as tuberculosis. It may also be linked to specific lymphomas and leukemias.

Monocytes
Monocytes are often found in higher numbers during a stress response and also during inflammation. They are involved in the immune response and remove dead and damaged cells as well as microorganisms.

Thrombocytosis is defined as increased number of circulating platelets.
Fundamental causes The fundamental causes responsible for thrombocytosis in dogs are:
  • It may be a temporary response to epinephrine release.
  • It may be a reaction to a disorder or disease in another part of the body e.g. liver disorder in Gatsby and slight anaemia in this dog.
  • It may be a sign of an underlying disease in the bone marrow e.g. blood cancers. 

In some conditions, the spleen is present but either it does not function properly or it is shrunken and the total platelet count is sometimes increased in these conditions.
Some cancers can cause an increased total platelet count either by causing damage to tissues, causing blood loss or by erroneously producing a cytokine that stimulates the bone marrow to produce platelets. 


“There are typically five types of white blood cells—neutrophils, lymphocytes, monocytes, eosinophils, and basophils—that we look at in a leukon, which is a white blood cell profile,” . “Knowing the levels of each of these cells in the body helps us to understand what type of process might be going on.”



Liver disorder - ALT enzymes are above normal. X-rays show slight
enlargement of the liver. Edges of liver are still sharp, not rounded as in severe
liver disorder.

Total red cell count is low. Haemoglobin is on the low side of the range.
Mild anaemia is present in Gatsby




Nov 27, 2019
Gatsby's X-rays


Heart is not enlarged. Retching usually in the morning could be due to clearing
of the throat or lungs of mucus. Nothing was vomited out.
 

No tumours or inflammation in the lungs

Liver is enlarged. Liver enzymes are elevated.




TREATMENT
A cause of chronic inflammation would be the periodontal disease.



Periodontal disease in dogs is an inflammation or infection that results in the weakening or loss of support structures of the teeth. Periodontal disease happens when food and bacteria accumulate along the gums and form plaque, which turns into calculus (also known as tartar).

ADVICES TO DOG OWNERS

Give your dog chew toys and perhaps consider dog food specially formulated to address dental disease. You can also provide your pet with chew treats treated with enzymes that help reduce the formation of tartar and calculus. The chews do not take the place of brushing but is a great supplement and a treat for your pet. Yearly dental examination and scaling by your vet will help prevent periodontal disease.

In this case, the dog had dental scaling some 4 months ago, but no tooth brushing. The periodontal disease is now present.   


OUTCOME
Many old dogs do suffer from heart diseases. The signs include retching, coughing after waking up, loss of energy and stamina during walks, short of breath and lethargy. X-rays of a serious case of heart disease in a Shih Tzu are as follows:

The heart is much enlarged

Fluid due to heart failure is present in the lungs. Hence the lungs
are black as in a normal dog (see Gatsby's normal lungs).  .


Iron tablets and heart medication to help the heart were given. The dog recovers his normal self 2 days later. He goes for  his morning walk, has good appetite and barks when strangers come to the door.