Thursday, July 30, 2020

3383. CHLOE. A Golden Retriever had a large facial lump. What to do? Plastic surgery technique.

Some copyright-free soothing music.



Skin tumours may be present when we age. Facial tumours can cause a loss of self esteem in a career lady. After all, first impressions count.   One of my clients used to be very particular about her appearance and would have regular beautician appointments when she climbed the corporate ladder and managed 200 staff.

When I met her in 2020, she had retired for some years, I noted that she had a small skin lump below the left eye canthus.



Can you see the small facial lump below the left eye canthus?
Early removal by a plastic surgeon as it may become a bigger hard "cholesterol" lump.
In real life, first impressions do count.



NARRATE THE IMAGE TEXT 


This retiree reminded me of a Golden Retriever with a facial tumour further below her 
left eye canthus.





This is a 
BE KIND TO PETS VETERINARY EDUCATIONAL VIDEO.........(see image below)









(NARRATE THE TITLE) 



(INTRODUCTION)


In 2005, I was a dog breeder veterinarian for the major dog breeding farms in Pasir Ris  and Seletar in Singapore. (SHOW FOOTAGE OF THE BOARDING KENNEL) AT:



Show footage of one breeding kennel in Singapore
0:29  - 1:07  and 2:04 – 2:36


I saw this female 4-year-old Golden Retriever with a large facial tumour lying quietly in her kennel.

The dog's facial tumour was large. It was 6 cm across.




1.  The face had little skin for me to stitch up after excision of the tumour.
2.  Complete excision was best as this tumour could be cancerous or pre-cancerous. I would have to cut a large area. I need to have a margin of 5 mm to 10 mm around the tumour to exclude any 'cancerous cells' present in the margins.
(ILLUSTRATION by hand).


3. The cranial nerves must not be severed, otherwise the dog's eyelids and face will be paralysed.
(ILLUSTRATION by hand --- ANATOMY OF FACIAL NERVES).







The surgical procedure is known as plastic surgery. The skin from a nearby area is used to close the big facial wound. It is known as Y-plasty in this case as the stitched up wound looks like a "Y".



I put the dog under general isoflurane anaesthesia. I used an ink marker to map out the areas where I would take the surrounding skin to cover the large defect after complete excision of the tumour.





See the "Y" stitching pattern?


Y-PLASTY


OUTCOME
A histopathology of the tumour was not performed to reduce medical costs for the breeder.


The Golden Retriever recovered and did not have any recurrence of the tumour. She eyed me suspiciously whenever I passed her by kennel several weeks later. She has an elephant memory and considered me as her nemesis!

As for the retiree lady, her small facial tumour had grown a bit more, but being "old", she couldn't care two hoots about first impressions!


CREDITS








FINAL VIDEO




























Tuesday, July 28, 2020

3382. Chloe: VIDEO. A dwarf hamster has a "boxing glove" wart---cryosurgery







Treatments are: Surgical excision and amputation, laser therapy or cryosurgery

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In March 2009, a fair lady in her early 30s consulted Dr Sing of Toa Payoh Vets.
Her hamster's warts had enlarged and fused warts.
7 months ago, Vet 1 prescribed medication which was ineffective.




An alternative treatment is Cryosurgery







Hamster goes home. The owner was warned that
the wart would recur as she did not want surgery---paw amputation


















CONCLUSION. 


   

1. Three treatment options.
Surgical Excision, Cryosurgery and Carbon Dioxide Laser Therapy are three treatment options.

2. Cryosurgery. Recurrence soon. Less than 2 months. Not recommended.

3. Laser Therapy burns off the whole tumour but affected the paw blood supply. Pain too. 

4. Surgical Excision in this case will be amputation of the paw. In other locations on the skin on the body, a wide excision with a 5 mm margin is best.  Electro-excision may be used inside of scalpel incision.




ORIGINAL REPORT WAS WRITTEN :

























3381. "hamster vet Singapore" - google by owner

29 Jul 2020

One new client told me she googled "hamster vet Singapore" as her vet does not practise hamster surgery.

I google to check.  There was an unpaid listing further down the first page.

http://www.toapayohvets.com/surgery/050609PAGE1_hamsters_ToaPayohVets.htm

Sunday, July 26, 2020

3380. Case studies. Bladder and urinary stones in the dog



Blog:
SURGERY (CYSTOTOMY) TO REMOVE BLADDER STONES CASE STUDIES ARE AT: http://www.toapayohvets.com/surgery/20080815Maltese_Uroliths_Male_ToaPayohVets.htm
Case study:

3379. Dragonflies in Singapore


Not photoshopped except sharpening. Bright sunlight. Handheld.
Yio Chu Kang Cres, Sun 26 Jul 2020, 8 am


Saturday, July 25, 2020

3378. How to be successful in your home bakery or any business?


How to be succeed in any business 
1. Start a NICHE business e.g. cakes
2. Open a shop front in https://www.instagram.com/ 
3. Post attractive high quality images
4. Share your knowledge of recipe and method.  
5. Use relevant # tags up to 30 tags 
6. It will be hard work.
7. Success comes after some months.











3377. Preventing Ear Abscess in your red-eared slider

Source:
https://www.wikihow.pet/Treat-a-Turtle%27s-Ear-Abscess


1

Supplement your turtle’s diet with vitamin A. What causes turtle ear abscesses is not fully understood.[21] Commonly, though, the abscesses are related to a vitamin A deficiency.[22] Vitamin A plays an important role in the proper development of cells lining a turtle’s ears and respiratory tract.[23]
  • Without enough vitamin A, these cells will develop abnormally and eventually allow for the accumulation of debris. This debris then causes an inflammatory reaction, during which inflammatory cells accumulate in the ears and lead to pus production and abscess formation.
  • Your veterinarian can prescribe oral or injectable vitamin A for your turtle. Injectable vitamin A is usually reserved for more serious cases of vitamin A deficiency.[24]
  • It is important that you follow your veterinarian’s instruction for supplementation to prevent a condition called hypervitaminosis A (too much vitamin A).[25]
  • You can also add more vitamin A to your turtle’s diet by feeding him such vitamin A-rich foods as carrots and squash.[26] Sweet potatoes, greens (collard, mustard, turnip), and papaya are also high in vitamin A.[27]


2
Improve the water quality in your turtle’s tank. Poor water quality is another common culprit of turtle ear abscesses. For example, a weak or malfunctioning water filter can cause an accumulation of urine, feces, leftover food, and microorganisms that can irritate your turtle’s skin. This skin irritation can eventually lead to infection and abscess development.[28]
  • Replace the tank’s filtration system if you suspect that it is too weak or no longer functions properly. There are several available filtration types (biological, chemical, mechanical). The website http://redearslider.com/index_water_quality.html has a comprehensive overview of each filtration type.
  • Water that is not at the proper temperature can also contribute to ear abscess development by weakening your turtle’s immune system.[29] For adult red ear slider turtles, the optimal water temperature is 75 to 78 degrees Fahrenheit (24 to 26 degrees Celsius).[30] Use a thermometer to monitor the water temperature.


3
Provide your turtle with adequate lighting. Inadequate lighting can also affect your turtle’s health and leave him more susceptible to ear abscess development. To provide him with more lighting, place several fluorescent light bulbs about 18 to 24 inches (46 to 61 cm) above his tank.[31] These bulbs are a good source of ultraviolet light (UVA and UVB) that will allow your turtle to produce vitamin D3.[32]
  • Replace the bulbs every six months.[33]


4
Minimize your turtle’s level of environment stress. Aspects of your turtle’s environment can be stressful to him. This stress can lead to a weakened immune system and subsequent illness. For example, your turtle may be stressed if his tank is too small.[34]
  • In general, your turtle’s tank size should be 10 gallons (37.9 L) per inch of shell length.[35]
  • Other stressors include overcrowding, not enough dry docking areas, and excessive handling.[36]
  • Talk with your veterinarian if you are unsure how to identify and/or address environmental stressors.



Friday, July 24, 2020

3376. A Jack Russell has large left thigh muscles

Thur 23 Jul 2020.

The 15-year-old Jack Russell could not bear weight on his hind limbs anymore. The owner consulted a few vets. "Look at the left backside muscles," I asked the lady owner to see the difference between the left and right hip and thigh muscles. The right muscles are bulging and bursting compared to the flat area of the right thigh and hip1"








Thursday, July 23, 2020

3375. Hamster tumour images from email queries

24 Jul 2020

Many Singapore hamster owners email to judy@toapayohvets.com regarding their hamster tumours.
A recent case is shown:

Image is not clear but the tumour is visible
It is hard to figure out the lcoation in the body. 

A clear image. Looks very much like the backside of the hamster

The 3rd image adds to the mystery of the precise location of the tumour




It is best practice to send images showing where the tumour is located in the body of the hamster. 

I have edited the images and advised surgery. The fees are estimated from $150 to $250 which include general anaesthesia and surgery.


An example of good images of tumour is at:
https://2010vets.blogspot.com/2017/09/email-to-toa-payoh-vets-sep-4-2017-dear.html


Tuesday, July 21, 2020

3374. Everything happens for a reason

21 Jul 2020. 12 noon.

I was on the way back from my exercise. Mike is one of my dog customers. Today, he drove me in his 7-seater to McDonald's drive in at Ang Mo Kio. We had not met for over 3 months.  






Safe distancing measures in place in Singapore as the Covid-19 pandemic was rampant. The counter girl in yellow and masked in a blue disposable took Mkie's credit card and said, "Wait for the food to be delivered." She gave Mike a big plastic tag with a green number 26.

"Doc, You look for seat first," Mike wanted to make some phone calls. He gave me the plastic tag. The occupancy was full as many seats were reserved with a "cross"  as part of social distancing measure. That meant 50% of the seats were not permitted for customers. 

A waitress in her late 40s, wearing the McDonald's T-shirt with the "fry" logo asked me where I would be sitting. She cleared a window seat for me and laid down the tray of 2 drinks and one apple pie for me and took my plastic tag No. 26.

Mike was somewhere, making phone calls. S
oon he arrived, carrying a tray of similar drinks and pie too. 

"What to do now?" Mike asked. "Return the tray," I said. "Be honest."

"We have double drinks today (for the price of one)," he exclaimed. "I could give the apple pie to my dog!"
"No, no, give the tray back to the counter girl!"

Mike returned the tray. We chatted. He talked about the secrets of life. An online subscription called Skills Growth. It is about Life Purpose, REBT, Self Esteem, Human Psychology on Perception, Neurosis, CBT and so many courses that I will find helpful on the neurotic disorders that we are suffering.


Soon we completed our drinks. He drove his car towards the exit barrier. The barrier would not open. Another driver was behind. He reversed his car to let the driver exit first. He tried again. Still the barrier was inert. Another two times, he let other drivers past him. But the barrier stated that his card was faulty.

"You need any help" a driver in an Audi asked when Mike reversed and let him pass through. "Yes," Mike said. "The barrier just would not lift up!"

"This is what you should do," the man in his late 50 said. "I drive my car out as the barrier opens. You drive your car quickly behind me!"

I was surprised at this suggestion and looked at Mike.

"It will not do," Mike explained. "There are CCTVs that will record my car number!". It is a traffic offence to tailgate. "If you let me use your cash card, I will be able to get out. I will pay you 0.80 cents!"

That was a good honest solution. It is a pity that Mike did not possess an extra cash card as I would have done so in my car.

The driver exited, parked his car to the side of the road and handed Mike his cash card. Mike went back to his car, inserted the card and drove out in a jiffy. He searched for 0.80 cents in his trouser pockets but he had no coins. He looked at me, "Doc, do you have 0.80 cents?"


"I am sorry," I told Mike. "I do not have my wallet with me. I was exercising this morning when you phoned me out of the blue. Then you picked me up to come here for our breakfast chat. I am sorry. I did not carry my wallet!"

Mike handed the driver a $50.00 note. The driver checked but he had no change. He returned Mike's the money. So Mike got scot free without paying the $0.80.

"Everything happens for a reason," Mike told me. "The driver was there when I needed help. Thank god!"

Mike drove to buy some chocolates from a supermarket. His cash card was operational as the car park barrier opened up. Why did the McDonald's car park barrier did not open up for him even though he tried 3 times? Was it a test of his integrity as he was offered tailgating by the other driver?

I don't know. As Mike had said: "Everything happens for a reason!" 


 

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