Friday, November 6, 2020

3438. ****Eyelid abscesses in a dwarf hamster in 2008. Case study 1.

8 Nov 2020. Video creation.

HOOK
Eyelid Abscesses in dwarf hamsters, like Ear Abscesses in red-eared sliders in Singapore are surgical conditions presented at Toa Payoh Vets. Abscesses in late stages may recur. The vet must give the owner in writing that there is a possibility of recurrence to prevent misunderstanding. 




BE KIND TO PETS IMAGE TITLE The owner is unhappy when her hamster's eyelid abscess recur. DEFINE ABSCESS An abscess is a pocket of pus. It can be present anywhere in the body. When an area of your body becomes infected, white blood cells fight the bacteria within the damaged tissue. The area becomes inflamed and in some cases, pus forms in an area. This is known as an abscess. TREATMENT OF RECURRENT ABSCESS: 1. SURGERY. INCISION AND DRAINAGE. Incision and drainage under general anaesthesia. The vet uses a scalpel to cut the abscess so that the pus will drain out. Normal saline is used to wash or irrigate the wound. I recommend a LONGER CUT (more than 5 mm, if possible) to permit residual pus to be drained out post-operation. A video is shown:  https://youtu.be/2MToYprOA0Y 
2. REMOVAL OF THE CAPSULE OF THE ENCAPSULATED ABSCESS. This procedure applies to abscesses enveloped by a thick shell. Hence it is called an encapsulated abscess. Incision and drainage will not be effective. Such encapsulated abscesses are not found in dwarf hamsters but can be found in guinea pigs and rabbits. POST OPERATION NURSING CARE FOR THE FIRST 3 DAYS 3 days of inpatient care to prevent recurrence of the abscess in the dwarf hamster and red-eared slider (ear abscess). We use cotton bud tips to express any residual pus from above and below the incision daily. Then we drip antibiotic eye drops onto the eyes and wound. TIPS AND ADVICES TO VETS COMPLAINT OF RECURRENT ABSCESSES Some owners insist on bringing the hamster home on the same day but do NOT know how to provide the prescribed nursing care for at least 3 DAYS. It costs money to treat a recurring abscess. Some owners dispute that they had been advised on the post-operation care as they just applied eye drops onto the wound. The residual pus inside the fast-healing wound regroups to form a recurrent abscess. WRITTEN POST-OP CARE INSTRUCTION TO PREVENT RECURRENT ABSCESSES To prevent misunderstanding, the vet should get the owner to sign a written instruction to the owner on the post-op care and record this in the medical record. MORE INFORMATION AT:









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TOA PAYOH VETS PTE LTD

toapayohvets.com  

Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074Tel: +65 6254-3326, 9668-6468, judy@toapayohvets.com, 99pups@gmail.com
Focus: Small animals -dogs, cats, guinea pigs, hamsters, pet rats and mice, birds and turtles      
November 06, 2020
 
 

EYELID ABSCESSES IN DWARF HAMSTERS

 

  

Two Case: Subconjunctival Abscesses in Dwarf Hamsters   
Case 1 - First written: Sep 15, 2008
Case 2 - First written: Apr 28, 2015
Updated: Nov 6, 2020


Case 1. 2008

Hamster 1.5 years old. Eyelid abscesses 3rd recurrence. Why? Toa Payoh Vets
1.5-year-old dwarf hamster. 3rd recurrence of eyelid abscess. Why?

Hamster 1.5 years old. Eyelid abscesses lanced. Thick pus. Toa Payoh Vets
Eyelid abscess is lanced 

Hamster eyelid abscesses lanced 4 days ago. Goes home. Needs proper nursing, hygiene. Toa Payo Vets
Eyelid abscess was lanced and drained 4 days ago. Goes home.
Proper nursing and hygiene in cage and feeding environment

Hamster eyelid abscesses lanced 2 days ago. Toa Payoh Vets.

Eyelid abscesses lanced and drained 2 days ago. 

The Hamster has swollen eyelids again. "Doc, I will go bankrupt if I continue consulting you," the young lady was worried. "This is the 3rd time in 2 months I have to bring my hamster to be treated."

I was amazed. The eyelids of the hamster puffed up again. Full of solid creamy pus that was drained during the past 2 visits. It is an uncommon condition. Why was this hamster having such a problem? Was it his poor immune system due to his age or something in the environment? Why did the bacteria go for the eyelids?

Abscesses in hamsters usually are cheesy in character. Usually the hamster's eyes become closed due to the stickiness nature of the pus acting as glue. But in this case, the hamster's eyes did not have pus. The pus was inside his eyelids!     

BE KIND TO OLDER HAMSTERS
Spend time to clean his water bottle, water bowl and cage regularly. A lack of hygiene in his sleeping and eating area caused this hamster to have eyelid infections. The owner saw me 3 times for the same problem.

In her case, she wanted the hamster to drink from the water bowl as the water bottle was leaking. The hamster had to dig into a high feed bowl which is commonly used by Singapore hamster owners too. I presumed the food debris from the hamster's mouth contaminated the water bowl. The water had bacteria and since the hamster drank from the high water bowl, the bacteria got into his eyes and the eyelids.

After switching to the water bottle and personally nursing the hamster using the eye drops, the lady owner did not go bankrupt as the hamster recovered.
I can imagine that the hamster had to rub his eyes after drinking water from the bowl. Some water could have splashed inside the eyes, together with the food dust, causing eye itchiness. Hence, more rubbing of the eyelids, causing infections to get inside the eyelids---forming eyelid abscesses.

 

Case 2.  2015

How to prevent a hamster's subconjunctival abscess from recurring

The owner wanted the hamster home on the same day as the treatment of the abscess some 5 weeks ago. She disputed that I had advised her how to do post-discharge care. I had told her verbally to use a cotton bud tip to rub above and below the skin wound to express out the pus, daily. In this way, any residual pus would be let out and the abscess would not recur. She only put eye drops.     

This article teaches owners how to handle this problem and to prevent the abscess from recurring. 

A small skin incision heals too fast if the owner does not express the pus on the second day. There will be pockets of pus still inside the skin. So the abscess recurs. This video shows how an abscess is treated by me at Toa Payoh Vets. Isoflurane + oxygen gas anaesthesia is used here. The whole process of lancing, curetting, irrigating and draining the abscess takes around 5 minutes. The hamster is OK and will be an in-patient for 2 days.

On Day 2, I reviewed this gentle chubby hamster. I expressed more yellow pus from the incision wound. By inching out the residual pus, the wound can heal without another abscess popping out in the next week.

The owner phoned and her male friend came to check the hamster. She asked whether the hamster could go home. I said no. Hamsters are family members and so the lady owner did not want her as an in-patient but would not want to pay for a recurrent abscess.   

POST DISCHARGE NURSING ADVICE IN WRITING.

The vet must let the owners wanting to bring the hamster home on the same day, they will have to bear the responsibility of post-discharge nursing and to pay in full should the hamster recur. This should be in writing to prevent any misunderstanding of the responsibilities of post-discharge care and much unhappiness in having to pay again for treatment. 

This hamster stayed 2 nights in-patient and was cleared of pus on Day 3. She went home and should not have any recurring abscess within the next 2 weeks.

  
 

Toa Payoh Vets

3437. Singapore Wildlife. A beautiful butterfly at The Esplanade at 1 pm 30 Oct 2020



Hot 1 pm sun. This butterfly was active at 1pm. It performed and posed for me patiently. 



Note the "green"  cape on the shoulder

MORE BUTTERFLY PHOTOS AT:


Thursday, November 5, 2020

3436. What causes a guinea pig to make loud wheezing lung sounds?

 VIDEO CREATION BY STEFANIE


HOOK
VIDEO. Show footage of around 30 seconds.


"My guinea pig was wheezing loudly yesterday evening," the young lady told me that her pet could have caught a cold as the past days were rainy days.  The young female guinea pig's nostrils were opening and closing very fast as she whistled.


   
BKTP IMAGE AND TITLE 


PHYSICAL EXAMINATION.
The guinea pig was the quiet type. She had lost some weight as she was over 800 g. She had no fever and was still eating. I checked her eyes and nose. They did not have any discharge. She also did not cough. Hence I would say she was not suffering from respiratory infections.

  
I auscultated her lungs. I heard loud harsh whistling sounds louder one the left lungs. (IMAGE OF STETHOSCOPE).

She reacted to pain when I palpated the sides of her rib cage were palpated. 


X-RAYS
TRAUMATIC INJURY TO THE LUNG AREAS. The cloudy areas in the left lung area suggested fluid. This could be blood, caused by traumatic injury. The fluid blocked the smooth flow of air in the airways. This lead to wheezes---high pitched whistles when the guinea pig breathes. 



Fluid in the left lungs block the airway passages. When the 
guinea breathes in and out, you can hear the whistling sounds. 




The male guinea pig was around 1 kg while she was around 800g. Both stayed together. 
The sudden onset harsh respiratory sounds, teeth grinding noise were due to great pain to
the chest area, likely caused by the male guinea pig or during play. 

TREATMENT
I warded the guinea pig for one night. I injected antibiotic and an anti-inflammatory. Her wheezes were much reduced in frequency. She passed around 90 pellets and hence was normal.




The owner took her home with antibiotics for 10 days. 

FOLLOW UP
5 days later, on 9 November 2020, I phoned the owner. "My guinea pig still wheezes but her sounds are softer. "She is eating and does not mount the male guinea pig."  
  

A review 2 weeks later is recommended if the wheezes are still present.








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OTHER VIDEOS TO BE EDITED TO BE INCLUDED IN ABOVE FINAL VIDEO.


Consultation. Day 1





Consultation. Day 1




After injection. Day 2. Before going home. Had passed over 80 faecal pellets
overnight as an inpatient


Video from owner. Day 5 of treatment. Guinea pig
at home. Still wheezes but not so loud.
Active. Eating normally. 

 





What does wheezy breathing sound like?
Wheezing is simply a whistling sound made when breathing. It is typically heard when a person exhales (breathes out) and sounds like a high-pitched whistle. Sometimes it is heard when inhaling — or breathing in — as well. It is not simply loud breathing or the sound of congestion or mucus when you breathe.


Wheezing happens when the airways are tightened, blocked, or inflamed, making a person's breathing sound like whistling or squeaking. Common causes include a cold, asthma, allergies, or more serious conditions, such as chronic obstructive pulmonary disease (COPD).









Image of auscultation




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Youtube and Facebook posting

5 days ago, on Thursday 5 Nov 2020, the young lady owner suspected that the loud wheezes of her guinea pig was due to the cold weather (raining for the past few days). The whistling sounds were audible even from afar.
There was no loss of appetite, but loss of weight. No fever. I palpated both sides of the chest laterally. The guinea pig moved in response to pain experienced on my finger palpation of the chest. X-rays showed fluid in the left lungs. After an antibiotic and anti-inflammatory injection and an overnight inpatient stay, the guinea pig had much lesser wheezes and was sent home. 10 November 2020. I asked the owner to WhatsApp her guinea pig wheezes. This owner's video shows that the whistling sounds are still present but less loud, according to the owner. My diagnosis of the cause in this case was traumatic injury to the lungs, likely due to the mounting and dismounting of the two guinea pigs. I based this finding on pain being felt on the side of the chest during palpation of the chest wall. Also the X-rays. The "fluid" in the lungs were likely "bleeding or inflammation" "No mounting by the male guinea pig," the owner said. "In fact this female, although 800 g in weight was proactive in trying to mount the male who is over 1 kg!" As the female guinea pig still had excellent appetite and the whistling sounds were softer, the guinea pig would be observed and to continue with the given oral antibiotic for 10 days in total to prevent lung infections.





ORIGINAL IMAGES. 












3435. Heartworms in 2 Rottweilers

 

Case recorded: Jan 29, 2008 (Chinese New Year 4th Day)
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS

"There is an emergency," my assistant interrupted my consultation. I excused myself Singapore Rottweiler sudden death heartworm disease. Toa Payoh Vetsand walked quickly to the outside of my Surgery on this bright sunny afternoon of August 27, 2008. The eyes of the other clients followed my move to see a large Rottweiler struggling to stand up.

My assistant inserted a thermometer to take the rectal temperature. It was 39.9 deg C.  The male Rottweiler shook and shivered on the floor as if he had an epileptic fit. Within a few seconds, he collapsed and stretched out motionless on the floor. He died fast. I examined his eyelids and opened his mouth. The eyelids were snow white. The mucous membranes of his mouth and tongue were cyanotic.

"Doc, what happened?" the gentleman asked. "Last week, my workers brought the dog to Vet 1 for treatment of coughing. Vet 1 said he had heartworm infection. Vet 1 gave me Proheart tablets to bring home and give them once a month to the dog. The dog did not feel well for the past few days and I bring him to you."

Ask your vet to do an annual blood test for heartworms. Singapore.Toa Payoh Vets"From the signs, the dog died due to a lot of internal bleeding," I said. "Why did you give Proheart tablets when the dog was suffering from heartworm infestation?" Proheart tablets are meant to prevent heartworm infestation. When a dog has heartworms, he should be treated by another drug but not Proheart.

"There is another Rottweiler - a female," I remembered having sourced a pair for this gentleman. The female had no signs of coughing and was eating normally.

"Get her tested for heartworm."  I advised. She was tested positive for the microfilaria, but her blood sample did not show anaemia. She still had healthy pink gums and had no fever. Therefore, her heartworm infestation was mild. At this stage, X-rays of the heart and nearby blood vessels were not taken although it would be ideal. The owner had a budget for treatment and X-rays would increase his costs.    

The owner kept the appointments to get the female injected on 2 days by a drug called Immiticide into the left back muscles on August 29 and then on the right back muscles on August 30, 2008.

Then she was rested in a cage for one month, that is, without exercise. After one month, the owner brought her for blood testing. There was negative heartworm and no anaemia. 

"You can either use Proheart tablets to give her monthly or get her a Proheart injection yearly," I advised. "As the tablets come in six tablets per package, you will need to remember to buy the tablets every 6 monthly." The owner opted for the injection.

Rottweiler. Female, 4 years. Singapore. Occult Dirofilariasis (no detectable microfilaria). Toa Payoh Vets.Did Vet 1 give him Proheart tablets after diagnosing heartworm via blood tests?  He or she would open himself or herself to a case of medical negligence.

I did not instigate the owner to commence legal action. The burden of proof of medical negligence would be on the owner. The only beneficiary would be the lawyer who would charge thousands of dollars and that would not be good for this gentleman.   

I just felt sad that this dog was one I helped the owner to buy and therefore had vaccinated him as a puppy. He did not come for vaccinations after puppyhood. The owner had high expectations of the pair producing babies but nothing happened.

After the excitement of puppyhood, many Singapore dog owners forget about the yearly vaccinations. Many bring their dogs to the groomers to beautify the dogs every 2 months. But when it comes to vaccinations, they forget about it. When they are told about heartworm prevention, they are simply not interested. With better education, the younger dog owners are more careful.

Rottweiler, Female, 4 years. First Immiticide injection IM given on left epaxial muscle. Toa Payoh VetsAs at January 29, 2009, the female Rottweiler is in good health as I write this case. The owner brought a male Rottweiler soon as Singapore does not have many Rottweilers for sale at any one time. I did not get to see the puppy. The puppy was given Proheart tablets monthly. I expect the owner would not forget the monthly medication.  In conclusion,  no heartworm prevention tablets should be given to a dog with heartworm infestation in general. As Immiticide injections are very expensive, it is hard to expect stray dogs to be treated with this drug.

NOTE:  Additional Tests:
X-rays of the heart and the blood vessels (swelling of right side of the heart and blood vessels, view of adult heartworm), blood tests for anaemia (eg. severe anaemia indicates severe infestation) and urine tests for proteinuria (marked urinary protein loss indicates severe infestation) are ideal to determine the severity of heartworm infestation and the progress of Immiticide treatment. The financial costs of so many tests need to be discussed with the owner first as the overall cost of treatment amount to over $2,000 in Singapore and gives the owner a financial shock. In this case, only blood tests before and after the Immiticide injections were carried out so as to fit the budget of the owner. 

Wednesday, November 4, 2020

3434. Contagious viral diseases kill puppies in breeding kennels and pet shops

YEAR 2005

Contagious viral diseases kill puppies in breeding kennels and pet shops

Puppies in great demand in Singapore
Supply - breeding kennels in Pasir Ris
Import from Australia and other countries

Viral diseases in breeding kennels and pet shops.
High mortality in puppies

Contagious - veterinary clinics and hospitals

Medical expenses as much as $20,000?

Loss of puppies - traumatic





Canine Distemper



Miniature Schnauzers do not shed hairs 




Coughing, runny nose, pneumonia, diarrhoea, brain infection, death



Canine Parvovirus

Vomiting and passing blood in the stools





Kennel cough

Severe cases - last few weeks. Cough like an old man. 


Chronic cough for a few weeks, not fatal




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Dog Breeders of Pasir Ris




Vaccination program


Prevention

Yearly booster

Wants antibody check before vaccination

Herd immunity

Dog Mills


2020
Rarely see distemper and parvovirus.
Leptospirosis, Canine Influenza
Babesiosis (Tick Fever)
Heartworm disease



CASES
1. A 5-month-old Yorkshire Terrier has “kennel cough” for over 2 months.

3433. Covid-19 stories. 7.6 million free face masks from the Temasek Foundation to residents in Singapore

 Straits Times 6 Oct 2020 Pg. A8

1. Sep 21, 2020 for 11 Oct 2020 (2 weeks) 
This was the 2nd nationwide distribution by the Temasek Foundation, but 4th by the Singapore government. 

7.6 million free reusable antimicrobial masks collected in 4th nationwide distribution. It received 214,000 pre-orders for mask kits, with some colours more popular than others. This is 4 times higher than in the previous round. 

2.  Jun to Jul 2020.

Temasek Foundation first nationwide distribution.

9.3 million masks distributed. No antimicrobial properties. This included 300,000 mask kits delivered to migrant workers who could not leave their dormitories. 

3. Future distribution is possible. 






 

3432. PHOTOS FOR SALE. BUILDINGS, APARTMENTS AND HOUSES IN SINGAPORE

 











PHOTOS FOR SALE

Contact:

Dr David Sing
+65 9668-6468

judy@toapayohvets.com
99pups@gmail.com
www.toapayohvets.com

 

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