Triglyceride (mmol/L) 1.2 2.7
AST (U/L) 45 135 ((less than 81)
Neutrophil % 58.7 78.7
Neutrophils Absolute (x10*9/L) 2.11 4.88
Lymphocytes % 21.2 11.2%
Lymphocytes Absolute (x10*9/L) 0.76 0.69
Platelets (x10*9/L) 566 481 (200-500)
Creatinine (umol/L) 54 42 (89 - 177)
TP 40213 Silkie Terr, FS, 11 yrs
The lady owner saw a large dark blue left elbow tumour 2 cm x 1.5 cm x 1 cm on 6 Jul 2020.
Consulted Dr Daniel.
Pre-op blood test done on 6 Jul 2020.
1. High cholesterol
>20.7 mmol/L (3-6.6)
2. High level enzymes
ALT 503 U/L (less than 59)
3 Low White Cell count.
3.6 x 10^9/L (6-17)
N,L % normal (59%, 21% respectively), but absolute numbers lower than normal.
Monocytes 16.9% high (3-10%) but absolute number normal.
Platelets 566 x 10^9/L (200-500)
Pre-op blood test done on 13 Aug 2020.
DIET Fish4Dogs and JerHigh
1. Drastic drop of 2 kg bodyweight from 7 kg on 2 Jul to 5 kg today. Owner stopped JerHigh feeding 3 strips a day for the past 8 years and feed vegetables and home-cooked food.
2. Dog not eating the Hills ID low fat canine kibbles.
CP 25.9% Crude Fat 7.4%
compared to Fish4Dogs Finest Salmon Complete (Small bites). CP 26%, Fat 12%
1. Stop feeding excessive JerHigh said to be 20g/3 days usually.
2. Weight loss drastic. BCS 3/9 thin. Top of lumbar vertebra visible.
3/ Feed ID in small amounts---powdered till 100% in 4 weeks.
4. L elbow tumour to be operated. Teeth had dropped. Thick tartar crust.
5. Liver Zentonil continue
Diet management - ID low fat according to weight wanted, i.e. 6 kg. Now 5 kg thin. .
No dog treats
Home cooked food and vegetables some.
FOLLOW UP ON 23 SEP 2020
Ultrasound - gall bladder leaking (owner said). Surgery done.
This video is part of Dr Sing Kong Yuen's training programme for veterinary students Chloe and Stefanie on a case of pre-surgery assessment of a dog with a large tumour near the left elbow. The owner consulted Toa Payoh Vets as she discovered a large subcutaneous tumour near the left elbow one month ago. A pre-surgery blood test showed that the dog was unfit for anaesthesia and surgery owing to: 1. low total white cell count, low lymphocytes, low neutrophil 2. liver disorder - high liver enzymes 3. high cholesterol level. The dog was prescribed Hills' low fat I/D (7.4% fat) which is less fattening compared to the old diet (12%). She was deprived of dog treats. Today, the owner came for a review and a second blood test. The dog had lost a lot of weight of weight as the dog disliked the new diet and was not given dog treats. ADVICES FOR TODAY 1. High total cholesterol levels. The dog was given around 20 grams of dog treats per day since she was one year old. Now she is 11 years old. For the past month, she was not given dog treats. Strict dieting using Hills' low fat ID was advised by Dr Daniel. The owner is again taught how to mix the slimming diet slowly to get the dog to eat it. NO dog will eat a new diet which is given 100% immediately. Exercise is recommended. 2. Liver disorder. High liver enzymes is usually due to a fatty liver disease. Reduce fatty food and feed liver supplements like Zentonil. The commercial food had 12% fat while Hills low fat diet has 7.4%. The owner needs to give an appropriate amount to reduce the dog's weight but not to underfeed her. There is a food amount for desired bodyweight guidelines on the bag. 3. Left forelimb tumour is large. It was noticed only last month and hence may be cancerous. However the blood test showed a high risk of anaesthetic death as the total white cell count was low. A second blood test will be done today.
4. The owner has to decide whether to get the surgery done or not if the 2nd blood test is not normal.