Chinese New Year Eve 4.56pm
Jan 22, 2012
PATIENT: Shih Tzu, Male, 8 years, not neutered
Around 12 months ago, Vet 1 removed many "urinary stones" but no stone analysis or other tests or follow throughs were advised. I don't know the reasons and will not speculate.
It is important to confirm the nature of the stones and a stone or calculi analysis should have been done and must be done to confirm the diagnosis. This must be recorded in the case sheet and advices of prevention of recurrence be given and recorded.
The dog recently had urethral obstruction. 13 urinary stones on X-ray were removed. Stone analysis done showed pure calcium phosphate crystals and urine tests showed bacterial infection UTI.
DIAGNOSIS: Calcium phosphate urolithiasis
CASE MANAGEMENT AT TOA PAYOH VETS
14.1.12 Calculi analysis by the NUH Dept of Lab Medicine.
Calcium stone positive, phosphate stones positive. Negative for stones of oxalate, urate, magnesium, cystine, ammonia and bicarbonate.
8.2.11 Blood test. SGPT/ALT increased, SGOT/AST increased, Urea increased 8.9 (4.2-6.3). Platelet 522 (200-500)/ Blood calcium 1.99 (1.5-3.60) is normal.
13.12.12 Urine test. ph=7, SG 1.012, Protein ++, Blood ++++, WBC 468, RBC 25, Bacteria +++. There is UTI and possibly kidney involvement. X-rays - any stones in the kidneys? Not seen. No crystals seen in the urine but this does NOT mean that the dog does not have stones when urine test is negative as in this case.
Radiography at 3-monthly intervals post-op would have picked up the stones when they were small but very rarely do Singaporean owners bother to do this. When stones are small, they can be "sucked" out using the urinary catheter and voiding urohydropropulsion. That is the reason for radiography.
X-ray in this case showed 13 radiodense uroliths. Calcium phosphate stones are radiodense.
TREATMENT
1. Medical dissolution using prescription diets. This is not possible for calcium phosphate stones.
2. Surgical removal. Done.
3. Non-surgical methods like voiding urohydropropulsion and aspiration into a urinary catheter not possible. 13 big stones with 2/13 stuck in the penile urethra.
4. Non-surgical method. Lithotripsy is not available in Singapore.
5. Metabolic disorder. Correction of hyperparathyroidism or other causes of hypercalcemia should minimise further urolith formation.
HOW TO PREVENT RECURRENCE?
1. Post-op radiography every 3 monthly is the best advice.
2. Urine test monthly to check for bacterial infection (UTI).
REFERENCE: The 5-min veterinary consult - Tiley Smith
1. PURE calcium phosphate uroliths are usually associated with metabolic disorders such as primary hyperparathyroidsim, rental tubular acidosis and excessive dietary calcium and phosphorus. This dog was fed on dry dog food.
2. A higher % of calcium phosphate uroliths are found in the kidneys than in the urinary bladder
OTHER LAB TESTS
1. Calculi analysis is necessary and was done.
2. Serum concentrations of parathyroid hormone,parathyroid hormone-related peptide
and hydroxycholecalciferol may be useful.
PREVENTION/AVOIDANCE
1. Hill's Prescription Diet U/D is formulated to reduce calcium extretion, is phosphorus-restricted and reduces formation of concentrated urine.
2. Canned diets are more effective than dry diets in preventing recurrence due to high moisture content
3. Avoid excessive acidfication or alkanisation of urine.
INTERESTING INFO
Hill's book recommends treatment of bacterial UTI and then give C/D
FOLLOW UP
1. X-ray after surgery to verify complete urolith removal is essential. This was not done as surgical removal of 13 stones were presented.
2. Abdominal radiography or ultrasonography every 3 months to detect early recurrence and prevent repeat surgery (e.g. using non-surgical methods to remove easily by voiding urohydropropulsion or catheter retrieval.
TP 16915
Op Date: Jan 12, 2012
Surgeon: Associate vet
A. Sedation injection 3.11 pm
Skin prep, Isoflurane gas
B. Skin incision 3.38pm
C. Skin stitched up 4.11 pm
B-A = 27 minutes. Dog was ferocious and therefore prep had to be done after sedation
C-B = 33 minutes. This is acceptable time taken for cystotomy for an experienced vet. All 13 stones were inside the bladder and accounted for. Therefore there was no need to do urethrostomy. The stones must have been flushed back into the bladder under anaesthesia by Vet 1 during the after midnight visit.
Blood test by Vet 1 - Significant findings, 12.40am Jan 12, 2012
MCV high 79 (60-77)
WBC high 26 (5.5 -17)
NEU high 21 (2-12)
MONO high 3 (0.3-2)
BASO high 0.16 (0-1)
PLT high 660 (175-500)
BUN high 31 (7-27)
ALKP high 233 (23-212)
K high 6.5 (3.5-5.8)
Jan 23, 2012. Chinese New Year.
I am keeping an eye on the follow through of this case. So far, the owner said she is busy and had not come down to get the CD canned diet.
Sunday, January 22, 2012
830. Sunday's Jan 22, 2012 interesting case (Chinese New Year's Eve)
Sunday, bright. sunny. Most vet practices close in the afternoon as there would be no clients. Toa Payoh Vets open till 5 pm. In the afternoon, no clients as at 3 pm when I am writing this report on a new client whose poodle, male, neutered, vomited blood yesterday and vomtied without blood today.
General exam was normal.
ABDOMINAL PALPATION
The dog arched his back when his ant aabdomen was palpated. "Hunched" said the lady owner. Mild pain in the liver, kidney, gastric area. The lady owner said: "Hunch back."
HISTORY
Since young, the dog had been vomiting every 1-2 months. Usually threw up without food. Vet 1 said nothing was wrong. I proposed X-ray or ultrasound after the Chinese New Year. For the time being, put on antibioitcs for 10 days.
TREATMENT
1. Dextrose saine 500 ml IV drip + anti-spasmogesic + antibiotic. Goes home later.
ADVICES
My hypothesis. Most likely the dog had been eating outside objects on the grass when walked by the domestic worker during the evening. Domestic workers meet their friends when they walk the dog and so it was possible that the dog gets fed some food or had gone onto the grass to eat anything . It is hard to say.
Blood test, X-ray and ultrasound can be done a few days later if vomiting continues. Cost is nto a problem with this owner. I said: "It is also possible that this dog has a small gastric foreign body that can't be vomited out nor passed through the intestines and so the dog vomits 1-2 monthly due to gastric inflammation and irritation by the movement of this foreign body and bacterial infection of the stomach (gastric mucosa)."
RIGHT EYE TEARING AND ITCHY
Swollen eyelids of the right eye due to rubbing. "Fluorescein eye stain is useful to check whether the eye cornea has ulcers or not," I put the fluroescein strip under the upper eyelid of both eyes. "Can you see the green stain on the cornea?" I shone the white light tangentially at the the right eye. "Yes," the lady owner said; "Green patches in the central cornea and at 12 o'clock and 2 o'clock. What is an ulcer?" she asked me as she could not understand. "It is a wound like the skin that has been cut, you will get a skin ulcer. A broken surface." She understood and translated it into Mandarin. I don't know how to translate ulcers in Mandarin. I must learn Mandarin as there are more Chinese Nationals nowadays and many Singaporeans speak Mandarin!
3 EMERGENCY CASES
1. One year old, female, Corgi, itchy back, wet areas. Their Vet is off, but the dog is still v. itchy. "Very good appetite after Shincort inj by Vet 1," the owner said. Wife and young son came. I advised clipping all bald just as Dr V wanted to clip just the back half. "There may be other areas and it is best to get hairs grow together." Owner said he saw "flea dirt," although Vet 1 saw a tick. A flea bite allergy not controlled by Vet 1's Shin cort injection?
2. Westie now not eating again. Wanted to see Dr Vanessa.
3. A dog with loose teeth or bad teeth. Made an appointment. Saw Dr Jason Teo yesterday.
General exam was normal.
ABDOMINAL PALPATION
The dog arched his back when his ant aabdomen was palpated. "Hunched" said the lady owner. Mild pain in the liver, kidney, gastric area. The lady owner said: "Hunch back."
HISTORY
Since young, the dog had been vomiting every 1-2 months. Usually threw up without food. Vet 1 said nothing was wrong. I proposed X-ray or ultrasound after the Chinese New Year. For the time being, put on antibioitcs for 10 days.
TREATMENT
1. Dextrose saine 500 ml IV drip + anti-spasmogesic + antibiotic. Goes home later.
ADVICES
My hypothesis. Most likely the dog had been eating outside objects on the grass when walked by the domestic worker during the evening. Domestic workers meet their friends when they walk the dog and so it was possible that the dog gets fed some food or had gone onto the grass to eat anything . It is hard to say.
Blood test, X-ray and ultrasound can be done a few days later if vomiting continues. Cost is nto a problem with this owner. I said: "It is also possible that this dog has a small gastric foreign body that can't be vomited out nor passed through the intestines and so the dog vomits 1-2 monthly due to gastric inflammation and irritation by the movement of this foreign body and bacterial infection of the stomach (gastric mucosa)."
RIGHT EYE TEARING AND ITCHY
Swollen eyelids of the right eye due to rubbing. "Fluorescein eye stain is useful to check whether the eye cornea has ulcers or not," I put the fluroescein strip under the upper eyelid of both eyes. "Can you see the green stain on the cornea?" I shone the white light tangentially at the the right eye. "Yes," the lady owner said; "Green patches in the central cornea and at 12 o'clock and 2 o'clock. What is an ulcer?" she asked me as she could not understand. "It is a wound like the skin that has been cut, you will get a skin ulcer. A broken surface." She understood and translated it into Mandarin. I don't know how to translate ulcers in Mandarin. I must learn Mandarin as there are more Chinese Nationals nowadays and many Singaporeans speak Mandarin!
3 EMERGENCY CASES
1. One year old, female, Corgi, itchy back, wet areas. Their Vet is off, but the dog is still v. itchy. "Very good appetite after Shincort inj by Vet 1," the owner said. Wife and young son came. I advised clipping all bald just as Dr V wanted to clip just the back half. "There may be other areas and it is best to get hairs grow together." Owner said he saw "flea dirt," although Vet 1 saw a tick. A flea bite allergy not controlled by Vet 1's Shin cort injection?
2. Westie now not eating again. Wanted to see Dr Vanessa.
3. A dog with loose teeth or bad teeth. Made an appointment. Saw Dr Jason Teo yesterday.
Saturday, January 21, 2012
829. The chattering chihuahua
Jan 20, 2012 Friday
The young couple came with the Chihuahua as scheduled. Death on the operating table is the main concern with the fair lady. Vet 1 had insisted that they sign the anaesthetic consent form hihglighting the risk of death in an old dog undergoing dental work. "This is the common practice," I explained. "Even the human hospitals will ask you to sign the form if you go for anaesthesia and surgery."
I had seen the couple on last Sunday and had advised antibiotics for the next few days and getting the dental work done on Friday. I told Dr Vanessa I would be handling the case myself as there was great worries for the fair lady. Sunday will be Chinese New Year's Eve. So the dog was done today. Blood test taken revealed nothing abnormal
Chihuahua, Male, 8 years, Severe stage 4 periodontal disease.
Isoflurane + oxygen anaesthesia only.
Proper sized endotracheal tube which was 6.5
Only 3 teeth left. Around 16 extracted.
The dog coughed when the owners came to pick up 2 hours later.
"It is caused by throat irritation of the endotracheal tube," I explained. "I inserted the tube into the windpipe to give the anaesthetic gas. I will give an injection."
It was one of those satisfying moments to see the young lady smile and freed of worries since her Chihuahua had not died on the op table and was as alert as if he had not been under anaesthesia. Isoflurane anaesthesia effect disappears within 5 minutes and that is why this dog was as alert as normal.
However, it takes a longer time to anesthesize the dog and there is a certain technique which I taught my assistant Min so as not to injure the dog when he is struggling before being asleep. If a sedation injection is given first, there is virtually no struggling. As I had promised the owner that I will use gas only, I kept my word.
The young couple came with the Chihuahua as scheduled. Death on the operating table is the main concern with the fair lady. Vet 1 had insisted that they sign the anaesthetic consent form hihglighting the risk of death in an old dog undergoing dental work. "This is the common practice," I explained. "Even the human hospitals will ask you to sign the form if you go for anaesthesia and surgery."
I had seen the couple on last Sunday and had advised antibiotics for the next few days and getting the dental work done on Friday. I told Dr Vanessa I would be handling the case myself as there was great worries for the fair lady. Sunday will be Chinese New Year's Eve. So the dog was done today. Blood test taken revealed nothing abnormal
Chihuahua, Male, 8 years, Severe stage 4 periodontal disease.
Isoflurane + oxygen anaesthesia only.
Proper sized endotracheal tube which was 6.5
Only 3 teeth left. Around 16 extracted.
The dog coughed when the owners came to pick up 2 hours later.
"It is caused by throat irritation of the endotracheal tube," I explained. "I inserted the tube into the windpipe to give the anaesthetic gas. I will give an injection."
It was one of those satisfying moments to see the young lady smile and freed of worries since her Chihuahua had not died on the op table and was as alert as if he had not been under anaesthesia. Isoflurane anaesthesia effect disappears within 5 minutes and that is why this dog was as alert as normal.
However, it takes a longer time to anesthesize the dog and there is a certain technique which I taught my assistant Min so as not to injure the dog when he is struggling before being asleep. If a sedation injection is given first, there is virtually no struggling. As I had promised the owner that I will use gas only, I kept my word.
Wednesday, January 18, 2012
826. Teeth scaling an 8 year old male silkie terrier
Dec 12, 2011
Nervous silkie terrier. Slight pain in larynx.
Blood test - SGPT/ALT 109 (<59) but otherwise all normal.
Urine test bacteria +++.
Surprising to find bacteria in the urine of a male dog. Licks ventral area.
Calculated dosage 10 kg young dog D=0.4 K=0.5
This is old dog, 7.4 kg. Give 50% of calculated dose
Domitor = 0.15 Ketamine = 0.18 Total 0.33 IV sufficient
Teeth still strong. So only dental scaling
Noted tip of epiglottis red but tonsils normal.
Nervous silkie terrier. Slight pain in larynx.
Blood test - SGPT/ALT 109 (<59) but otherwise all normal.
Urine test bacteria +++.
Surprising to find bacteria in the urine of a male dog. Licks ventral area.
Calculated dosage 10 kg young dog D=0.4 K=0.5
This is old dog, 7.4 kg. Give 50% of calculated dose
Domitor = 0.15 Ketamine = 0.18 Total 0.33 IV sufficient
Teeth still strong. So only dental scaling
Noted tip of epiglottis red but tonsils normal.
Tibetan Mastiff sedation
"Do you do house-calls for a very big dog with itchy ears?" an old client and friend asked me the fees to treat a very big dog at the home of her friend.
"It will be a waste of your money," I said. "Ear disease diagnosis need a microscope and other assistants to help out."
Tibetan Mastiff, Male, 7 months, 53kg. Healthy. Ear canals with black wax seen daily. Had lots of ticks recently when walked outdoors.
EAR IRRIGATION & LICK GRANULOMA INJECTION
A gentle giant but still it is best not to traumatise him. My client said: "My friend's dog was hit by a car, bit the owner's arm later."
SEDATION
Do a proper calculation as follows:
My guideline IV anaesthesia
10 kg young dog Domitor = 0.4 ml, Ketamine = 0.5 ml combined IV
53 kg young dog D= 2.12ml K=2.65ml
I gave 40%, D=0.85 K=1.06 Total = 1.85ml IV as this would be a short anaesthesia of around 10 minutes needed for me to irrigate the ears and inject the 3 lick granulomas with prednisolone intra-lesionally.
"My dog will not get up on the table," the owner said.
"No dog will climb up a veterinary table," I explained to the gentleman. "I will carry his back half and you carry his chest. Talk to your dog while we carry or he will feel he is being murdered."
The dog was carried up on the table by the owner and my assistant Min without a protest.
Now, to find that leg vein as the coat is so thick. The foreleg was thick as this was a man-sized dog. I don't clip off the hairs to see the vein as it is not acceptable.
"Tighten the tourniquet," I said to Min who had not seen large a gigantic dog. Singapore's dogs are usually small breeds and Tibetan Mastiffs are as rare as snowfall.
I pressed the swelling and drew the blood into the syringe. I injected the 1.85 ml IV.
The dog slept at this 40% of calculated dosage. I taught the owner how to check the ear canal and insert the cotton bud, smell it and then I irrigated the ear canals.
After that I injected pred into the 3 lick granulomas. The dog did twitched a little on the 3rd lick granuloma being injected but was otherwise knocked out.
4949 - 4958. Itchy ears and three interdigital cysts/lick granulomas must be treated early - Tibetan Mastiff. If itchiness of ears and paws are not treated early by your vet, the dog self-mutilates to relieve himself of the intense itchiness. Hair loss and skin infections present themselves soon
"I need to wake up the dog," I said as I injected Antisedan 1.0 ml IM on the right hip muscles. He woke up 10 minutes later and that was great.
The above 40% dosage was sufficient for a short painless ear irrigation and lick granuloma injection of less than 10 minutes.
Know how to check the ears and prevent interdigital cysts and lick granulomas in a big furry breed as it is a high maintenance breed. Brush daily and inspect daily. Clean ears. It is extremely difficult to avoid ticks. Wear booties or check paws after a walk. "I avoid the grass," the owner just walked the dog in the evenings along the road.
The following advices to the owner who had bought a very strong hair blower for Tibetan Mastiff were:
1. Daily brushing of the coat with the slicker and another brush rather than hot air blowing everyday as the dog has some skin itchiness and eczema, probably due to the earlier tick bite infestations.
2. Daily inspection of the ears
3. No rough cotton wool to dig the ears
4. There is no need to pour his ear lotion by pumping into the ears every day if the ears are clean. He use to do it every day. Daily ear dropping had resulted in brown black wax being produced.
To check the ear canals as to whether they are clean or not, I taught him how to insert the cotton bud into the ear canal. See the colour of the tip and smell it. If the colour is clear, the ear has no dirt.
5. Washing of the paws with an anti-fungal solution and rinsing.
6. A long bath tub is needed if he wants to de-tick his dog.
7. Get a big table (as long as my surgery table) and put the dog on top of the table to do his grooming. This is easier on his back.
8. Avoid tick areas. Inspect the four paws when the dog is back from outside walks. He had used Frontline sprays and spots-on insecticides but these have become ineffective over time. Wearing of booties when going out for walks is not practical as the dog needs to wear out his nails. So, daily inspection of the paws for the smallest baby tick after exercise.
This was about the biggest dog in Singapore. As big as a young man. A very gentle giant. If he bites the vet, the vet's fingers can be crushed to pieces. So it is important that he be treated gently and to use sedation if there is pain during treatment, as there is, in the intra-lesion injection of his lick granulomas.
Overall, he was good and could walk back to the car. I helped to carry him onto the boot of the friend's SUV. The owner's BMW was probably not big enough! It was great to meet up with this old client who had consulted Dr Vanessa for the past times as I was seldom around in the afternoons. I asked her to make an appointment to let me check out her dog's skin condition when she said that "old" vets are more experienced. Every vet needs to start at the beginning but young vets need to gain the experience with time. Experience is gained not only be practising but by reading a lot of veterinary literature on relevant situations and consulting other vets for how they treat certain conditions. It may sound stupid to ask other vets but much can be learned from asking.
NINE more images are at:
http://www.sinpets.com/dogs/20120119Tibetan-Mastiff-lick-granulomas-ear-itchiness-singapore_ToaPayohVets.htm
"It will be a waste of your money," I said. "Ear disease diagnosis need a microscope and other assistants to help out."
Tibetan Mastiff, Male, 7 months, 53kg. Healthy. Ear canals with black wax seen daily. Had lots of ticks recently when walked outdoors.
EAR IRRIGATION & LICK GRANULOMA INJECTION
A gentle giant but still it is best not to traumatise him. My client said: "My friend's dog was hit by a car, bit the owner's arm later."
SEDATION
Do a proper calculation as follows:
My guideline IV anaesthesia
10 kg young dog Domitor = 0.4 ml, Ketamine = 0.5 ml combined IV
53 kg young dog D= 2.12ml K=2.65ml
I gave 40%, D=0.85 K=1.06 Total = 1.85ml IV as this would be a short anaesthesia of around 10 minutes needed for me to irrigate the ears and inject the 3 lick granulomas with prednisolone intra-lesionally.
"My dog will not get up on the table," the owner said.
"No dog will climb up a veterinary table," I explained to the gentleman. "I will carry his back half and you carry his chest. Talk to your dog while we carry or he will feel he is being murdered."
The dog was carried up on the table by the owner and my assistant Min without a protest.
Now, to find that leg vein as the coat is so thick. The foreleg was thick as this was a man-sized dog. I don't clip off the hairs to see the vein as it is not acceptable.
"Tighten the tourniquet," I said to Min who had not seen large a gigantic dog. Singapore's dogs are usually small breeds and Tibetan Mastiffs are as rare as snowfall.
I pressed the swelling and drew the blood into the syringe. I injected the 1.85 ml IV.
The dog slept at this 40% of calculated dosage. I taught the owner how to check the ear canal and insert the cotton bud, smell it and then I irrigated the ear canals.
After that I injected pred into the 3 lick granulomas. The dog did twitched a little on the 3rd lick granuloma being injected but was otherwise knocked out.
4949 - 4958. Itchy ears and three interdigital cysts/lick granulomas must be treated early - Tibetan Mastiff. If itchiness of ears and paws are not treated early by your vet, the dog self-mutilates to relieve himself of the intense itchiness. Hair loss and skin infections present themselves soon
"I need to wake up the dog," I said as I injected Antisedan 1.0 ml IM on the right hip muscles. He woke up 10 minutes later and that was great.
The above 40% dosage was sufficient for a short painless ear irrigation and lick granuloma injection of less than 10 minutes.
Know how to check the ears and prevent interdigital cysts and lick granulomas in a big furry breed as it is a high maintenance breed. Brush daily and inspect daily. Clean ears. It is extremely difficult to avoid ticks. Wear booties or check paws after a walk. "I avoid the grass," the owner just walked the dog in the evenings along the road.
The following advices to the owner who had bought a very strong hair blower for Tibetan Mastiff were:
1. Daily brushing of the coat with the slicker and another brush rather than hot air blowing everyday as the dog has some skin itchiness and eczema, probably due to the earlier tick bite infestations.
2. Daily inspection of the ears
3. No rough cotton wool to dig the ears
4. There is no need to pour his ear lotion by pumping into the ears every day if the ears are clean. He use to do it every day. Daily ear dropping had resulted in brown black wax being produced.
To check the ear canals as to whether they are clean or not, I taught him how to insert the cotton bud into the ear canal. See the colour of the tip and smell it. If the colour is clear, the ear has no dirt.
5. Washing of the paws with an anti-fungal solution and rinsing.
6. A long bath tub is needed if he wants to de-tick his dog.
7. Get a big table (as long as my surgery table) and put the dog on top of the table to do his grooming. This is easier on his back.
8. Avoid tick areas. Inspect the four paws when the dog is back from outside walks. He had used Frontline sprays and spots-on insecticides but these have become ineffective over time. Wearing of booties when going out for walks is not practical as the dog needs to wear out his nails. So, daily inspection of the paws for the smallest baby tick after exercise.
This was about the biggest dog in Singapore. As big as a young man. A very gentle giant. If he bites the vet, the vet's fingers can be crushed to pieces. So it is important that he be treated gently and to use sedation if there is pain during treatment, as there is, in the intra-lesion injection of his lick granulomas.
Overall, he was good and could walk back to the car. I helped to carry him onto the boot of the friend's SUV. The owner's BMW was probably not big enough! It was great to meet up with this old client who had consulted Dr Vanessa for the past times as I was seldom around in the afternoons. I asked her to make an appointment to let me check out her dog's skin condition when she said that "old" vets are more experienced. Every vet needs to start at the beginning but young vets need to gain the experience with time. Experience is gained not only be practising but by reading a lot of veterinary literature on relevant situations and consulting other vets for how they treat certain conditions. It may sound stupid to ask other vets but much can be learned from asking.
NINE more images are at:
http://www.sinpets.com/dogs/20120119Tibetan-Mastiff-lick-granulomas-ear-itchiness-singapore_ToaPayohVets.htm
Tuesday, January 17, 2012
824. Vet surgery - productivity - cat spay
I am sharing my 30 years of experiences of a cat spay with others interested and to assess my timing as a guide for associate vets
Cat, 1 year +, Female, 2.6 kg
Sent in for spay toeday Jan 17, 2012
Surgeon: Dr Sing
Suture: 2-0 Polysorb braided lactomer C14 cutting 24 mm 3/8
Preparation: Cat was clipped bald before sedation. This saves a lot of time.
Sedation:
xylazine 0.1 ml + ketamine 0.4 ml IM
Wait 10 minutes. Still alert
Need top up isoflurane for few seconds - good analgesia
Timing
10.33am xylazine + ketamine IM
10.43 am Isoflurane 5% start reducing to 0.5%
10.52 am Skin incision started
10.54 am lst ovary (left) hooked
10.59 am 2nd overy (right) hooked
11.02 am uterine body ligated. 2 ligatures
11.08 am stitch linea alba 3 simple interrupted
11.11 am stitched skin 2 horizontal mattress
11.12 am skin stitched up
Sedation to skin stitched 10.33 - 11.12 am = 39 minutes
Tolfedine and baytril injection SC
One bandage on wound to be replaced on Day 3 with new one. I usually don't prescribe e-collar as cats hate them
Baytril x 1 tab 1/4 tab/day
Total cost of spay $150
Cat, 1 year +, Female, 2.6 kg
Sent in for spay toeday Jan 17, 2012
Surgeon: Dr Sing
Suture: 2-0 Polysorb braided lactomer C14 cutting 24 mm 3/8
Preparation: Cat was clipped bald before sedation. This saves a lot of time.
Sedation:
xylazine 0.1 ml + ketamine 0.4 ml IM
Wait 10 minutes. Still alert
Need top up isoflurane for few seconds - good analgesia
Timing
10.33am xylazine + ketamine IM
10.43 am Isoflurane 5% start reducing to 0.5%
10.52 am Skin incision started
10.54 am lst ovary (left) hooked
10.59 am 2nd overy (right) hooked
11.02 am uterine body ligated. 2 ligatures
11.08 am stitch linea alba 3 simple interrupted
11.11 am stitched skin 2 horizontal mattress
11.12 am skin stitched up
Sedation to skin stitched 10.33 - 11.12 am = 39 minutes
Tolfedine and baytril injection SC
One bandage on wound to be replaced on Day 3 with new one. I usually don't prescribe e-collar as cats hate them
Baytril x 1 tab 1/4 tab/day
Total cost of spay $150
Sunday Jan 15, 2012 interesting cases - tonsillar tumours
Bright sunshine, blue skies, white cloud.
Case 1.
A 12-year-old well cared for female, Golden Retriever, drooling on the left side only.
Vet 1 did dental scaling and extraction. Dog then started "drooling on left side."
Vet 1 then smoothened left lower PM4 since the upper PM4 and others had been extracted. Still the drooling persisted.
Vet 2 was "thorough" according to the owner. He X-rayed and ultrasound the whole body. "How about the head and neck area?" I asked. The owner did not think this was done.
According to the owner, said a big lump was present on the left back of mouth and a spherical lump on left neck below the submandibular. He recommended steroids as an alternative to euthanasia and surgery. When the dog was on steroids, she was very hungry and drank a lot. When given Tramadol, the drooling stopped. The dog had lost a lot of weight.
The dog did not want the mouth to be opened but I managed to open it and showed the owner and her sister (anaesthetist) the large tonsillar tumour (at least 3 cm x 2 cm). Pain and ulcerations there would be the cause of drooling.
CASE 2
Surprising an 8-year-old small breed came in for review after this Golden Retriever. I had done dental scaling 4 weeks ago. The dog objected strongly to the mouth being opened, but I could see the right tonsil as reddish lump 0.5 x 0.5 cm. I had told the owner of this lump seen during dental scaling. It could be a tonsillar tumour. The owner would wait and see.
If dog owners regularly check the dog's teeth and keep it cleaned or scaled yearly or two-yearly, many oral tumours would not form. This is the same with human beings too. A poor hygiene in the mouth predisposes to oral tumours and this is commonly reported.
CASE 3
"See the lump under the right eye," I had pointed it out to her at the waiting area. Later, she gave me permission to take a photo. "That is the beginning of a malar abscess - infection from the root of the back tooth into the sinus and bulging out." She had come for advice as Vet 1 wanted her to sign an indemnity form for dental work in case the dog dies under anaesthesia.
"How many deaths were under you while you did dental scaling?" the young lady was very worried about her 8-year-old chihuahua who had Stage 4 periodontal disease (the worst stage) and asked Dr Vanessa who was handling the case together with me. She did most of the talking. Many times, I would see the case together with her and most of the time, she would be doing the talking. Some owners would think I am an assistant and know nothing and so why was I giving medical advices? I usually identify myself as a vet first.
"How many?" the young lady asked again. "Ask Dr Sing," Dr Vanessa replied.
"In my over 30 years of dental scaling and I can only speak for myself, I don't have any cases of dogs doing dental work dying on the operating table," I replied. "Dental work or scaling takes a short time of less than 15 minutes unlike long surgeries and therefore, anaesthetic deaths are uncommon in many senior dogs. A very close focus on anaethesia by the vet and his assistant is very important. In old dogs, I don't give IV sedation but just isoflurane gas only."
The young lady was already red-eyed but well read about anaesthetic deaths of dogs on the operating table. I could understand her concern for the Chihuahua which was in good bodily condition unlike those skinny ones. A bit plump is better as this indicated that this dog was well cared for and had a good appetite (meaning good health too.)
"A blood test is taken to screen the dog's health first," Dr Vanessa said as she examined the heart and lungs and found them OK.
"A 10-day course of antibiotics before dental scaling is what I recommend usually to clients," I said. "The dental scaling is done around 7-10 days later and the mouth would be free of bacteria."
The boyfriend asked the young lady (in her late 20s) to wait for the blood test. So, it was quite an emotional consultation.
This Sunday was an eventful one as my assistant Min fell sick with flu. He left at 10 am to see the doctor and had the day off. Ms Ong, a junior college student with an offer from Glasgow Univ for vet studies came for her first day and so she got to see all the cases since the other three interns (Kim quitted suddenly as she found that it was too costly to study vet medicine, Mr Lim was said to have denque fever, Grace, going to 2nd year vet student from Sydney Univ would come only on Monday.
It was a bright sunshine Sunday and we managed to close at 5.30 pm. I advised Dr Vanessa to record as she communicate to the client as this is what I do, but she had her own style of writing only after everything. So there was much delay. Record what the client said e.g. history on the spot. That would be the efficient way as many clients dislike waiting too long. Some of the clients had to wait more than an hour and from my view at the reception, many prefer short consultations and getting the problem resolved. Waiting more than 15 minutes at the doctor is not a happy event for any Singaporean on a Sunday when there are so many things to do!
Case 1.
A 12-year-old well cared for female, Golden Retriever, drooling on the left side only.
Vet 1 did dental scaling and extraction. Dog then started "drooling on left side."
Vet 1 then smoothened left lower PM4 since the upper PM4 and others had been extracted. Still the drooling persisted.
Vet 2 was "thorough" according to the owner. He X-rayed and ultrasound the whole body. "How about the head and neck area?" I asked. The owner did not think this was done.
According to the owner, said a big lump was present on the left back of mouth and a spherical lump on left neck below the submandibular. He recommended steroids as an alternative to euthanasia and surgery. When the dog was on steroids, she was very hungry and drank a lot. When given Tramadol, the drooling stopped. The dog had lost a lot of weight.
The dog did not want the mouth to be opened but I managed to open it and showed the owner and her sister (anaesthetist) the large tonsillar tumour (at least 3 cm x 2 cm). Pain and ulcerations there would be the cause of drooling.
CASE 2
Surprising an 8-year-old small breed came in for review after this Golden Retriever. I had done dental scaling 4 weeks ago. The dog objected strongly to the mouth being opened, but I could see the right tonsil as reddish lump 0.5 x 0.5 cm. I had told the owner of this lump seen during dental scaling. It could be a tonsillar tumour. The owner would wait and see.
If dog owners regularly check the dog's teeth and keep it cleaned or scaled yearly or two-yearly, many oral tumours would not form. This is the same with human beings too. A poor hygiene in the mouth predisposes to oral tumours and this is commonly reported.
CASE 3
"See the lump under the right eye," I had pointed it out to her at the waiting area. Later, she gave me permission to take a photo. "That is the beginning of a malar abscess - infection from the root of the back tooth into the sinus and bulging out." She had come for advice as Vet 1 wanted her to sign an indemnity form for dental work in case the dog dies under anaesthesia.
"How many deaths were under you while you did dental scaling?" the young lady was very worried about her 8-year-old chihuahua who had Stage 4 periodontal disease (the worst stage) and asked Dr Vanessa who was handling the case together with me. She did most of the talking. Many times, I would see the case together with her and most of the time, she would be doing the talking. Some owners would think I am an assistant and know nothing and so why was I giving medical advices? I usually identify myself as a vet first.
"How many?" the young lady asked again. "Ask Dr Sing," Dr Vanessa replied.
"In my over 30 years of dental scaling and I can only speak for myself, I don't have any cases of dogs doing dental work dying on the operating table," I replied. "Dental work or scaling takes a short time of less than 15 minutes unlike long surgeries and therefore, anaesthetic deaths are uncommon in many senior dogs. A very close focus on anaethesia by the vet and his assistant is very important. In old dogs, I don't give IV sedation but just isoflurane gas only."
The young lady was already red-eyed but well read about anaesthetic deaths of dogs on the operating table. I could understand her concern for the Chihuahua which was in good bodily condition unlike those skinny ones. A bit plump is better as this indicated that this dog was well cared for and had a good appetite (meaning good health too.)
"A blood test is taken to screen the dog's health first," Dr Vanessa said as she examined the heart and lungs and found them OK.
"A 10-day course of antibiotics before dental scaling is what I recommend usually to clients," I said. "The dental scaling is done around 7-10 days later and the mouth would be free of bacteria."
The boyfriend asked the young lady (in her late 20s) to wait for the blood test. So, it was quite an emotional consultation.
This Sunday was an eventful one as my assistant Min fell sick with flu. He left at 10 am to see the doctor and had the day off. Ms Ong, a junior college student with an offer from Glasgow Univ for vet studies came for her first day and so she got to see all the cases since the other three interns (Kim quitted suddenly as she found that it was too costly to study vet medicine, Mr Lim was said to have denque fever, Grace, going to 2nd year vet student from Sydney Univ would come only on Monday.
It was a bright sunshine Sunday and we managed to close at 5.30 pm. I advised Dr Vanessa to record as she communicate to the client as this is what I do, but she had her own style of writing only after everything. So there was much delay. Record what the client said e.g. history on the spot. That would be the efficient way as many clients dislike waiting too long. Some of the clients had to wait more than an hour and from my view at the reception, many prefer short consultations and getting the problem resolved. Waiting more than 15 minutes at the doctor is not a happy event for any Singaporean on a Sunday when there are so many things to do!
Sunday, January 15, 2012
822. A twitching eye. Acquired Oculomotor Nerve Palsy in a Golden Retriever
"Is the right sunken eyeball present since puppyhood?" I asked the lady owner who showed me a bottle of eyedrops prescribed by Vet 1. No other medication was given by Vet 1 who diagnosed eye infection and advised review if the eye condition did not improve.
Case of the Golden Retriever with a twitching eye
Golden Retriever, Male, 8 years. Weight below normal.
Complaint: Fits 2 days ago. I advised bringing the dog to the Surgery rather than a house-call which would waste money as the dog needed more detailed examination.
History: Right eye is smaller than left eye. Vet 1 prescribed eye drops.
Right eye: Drooping eyelid, retracted eyeball, twitching uncontrollably as if blinking at me when reviewed. Occasional twitching (videoed by Nicole).
3rd eyelid covered the right eyeball partially since it has sunken in.
Hospitalised. Blood and urine tests are minimum tests done.
Lumbar puncture for cerebrospinal fluid analysis, MRI scan of the brain are not done at this stage to lower vet costs.
Oculomotor nerve palsy and brain involvement leading to ptosis & fits
OCULOMOTOR NERVE is the 3rd cranial nerve. It innervates the muscles co controlling eye movements, the upper eyelid muscle and the muscles controlling pupil constriction.
In this dog, the Oculomotor nerve and its branches had been damaged or inflamed causing the eyeball to sink inwards, the eyelid to droop. However, since the dog suffered from fits, the lesion is likely to be inside the brain e.g. brain tumour or aneurysm near the Oculomotor nerve or inflammation.
Blood test - high serum urea
Urine test - proteinuria
Brain scan and lumbar puncture are costly options which need to be discussed with the owner.
Other contributing causes
Trigeminal neuralgia involving only the ophthalmic nerve? The trigeminal nerve has 3 branches - ophthalmic nerve, maxillary nerve and mandibular nerve. There does not appear to be facial spasm or dropped jaw and so, the maxillary and mandibular nerves are not involved. The ophthalmic nerve may be involved.
Diagnosis
Brain scan and lumbar puncture are needed for a definitive diagnosis of acquired Oculomotor nerve palsy in this dog but it is costly.
Treatment
Anti-fits and review. The dog can eat and drink and has no more fits when on anti-fit medication. Steroids were not prescribed. To review.
Updates and more pictures at:
http://www.sinpets.com/dogs/20120115oculomotor-nerve-palsy-golden-retriever-fits-singapore_ToaPayohVets.htm
Case of the Golden Retriever with a twitching eye
Golden Retriever, Male, 8 years. Weight below normal.
Complaint: Fits 2 days ago. I advised bringing the dog to the Surgery rather than a house-call which would waste money as the dog needed more detailed examination.
History: Right eye is smaller than left eye. Vet 1 prescribed eye drops.
Right eye: Drooping eyelid, retracted eyeball, twitching uncontrollably as if blinking at me when reviewed. Occasional twitching (videoed by Nicole).
3rd eyelid covered the right eyeball partially since it has sunken in.
Hospitalised. Blood and urine tests are minimum tests done.
Lumbar puncture for cerebrospinal fluid analysis, MRI scan of the brain are not done at this stage to lower vet costs.
Oculomotor nerve palsy and brain involvement leading to ptosis & fits
OCULOMOTOR NERVE is the 3rd cranial nerve. It innervates the muscles co controlling eye movements, the upper eyelid muscle and the muscles controlling pupil constriction.
In this dog, the Oculomotor nerve and its branches had been damaged or inflamed causing the eyeball to sink inwards, the eyelid to droop. However, since the dog suffered from fits, the lesion is likely to be inside the brain e.g. brain tumour or aneurysm near the Oculomotor nerve or inflammation.
Blood test - high serum urea
Urine test - proteinuria
Brain scan and lumbar puncture are costly options which need to be discussed with the owner.
Other contributing causes
Trigeminal neuralgia involving only the ophthalmic nerve? The trigeminal nerve has 3 branches - ophthalmic nerve, maxillary nerve and mandibular nerve. There does not appear to be facial spasm or dropped jaw and so, the maxillary and mandibular nerves are not involved. The ophthalmic nerve may be involved.
Diagnosis
Brain scan and lumbar puncture are needed for a definitive diagnosis of acquired Oculomotor nerve palsy in this dog but it is costly.
Treatment
Anti-fits and review. The dog can eat and drink and has no more fits when on anti-fit medication. Steroids were not prescribed. To review.
Updates and more pictures at:
http://www.sinpets.com/dogs/20120115oculomotor-nerve-palsy-golden-retriever-fits-singapore_ToaPayohVets.htm
Saturday, January 14, 2012
Educational Video from Toa Payoh Vets - Itchy joints in a dwarf hamster
http://www.youtube.com/watch?v=D3yl4GmBBU4&feature=youtu.be
UTI = Urinary Tract Infection
UTI = Urinary Tract Infection
820. E-mail case study. Basic principles in toilet training a puppy in Singapore
E-MAIL TO DR SING JAN 12, 2012
Hi Dr Sing Kong Yuen,
I really need help toilet training my new puppy. We have tried different things from fencing to open roaming and back to fencing.
She is a Female Tibetan terrier
Presently (3.5-4)months old
Born 20/09/2012 In Brisbane
where had lots of space to play and was fenced up with siblings
Came to Singapore from breeder in Australia when 2.5-3 months old
Flew with brother to new home in Singapore
When she flew over, she was confined to a small cage with brother
for over 10 hours so had to pee/ poo there while travelling
We stay in a 2 story house with a garden.
We have 2 young kids who adore her and who keep going into her fenced area to play with her or taking her out to run.
Kids laughing just seems to excite her and so confuses her when being told off by me bur kids giggling.
We have an 8 year old male Tibetan terrier who is an angel ( very passive) and is toilet trained to pee outside in garden twice a day when we take him out.
Fencing and toilet- training:
We brought her home and fenced her with collapsible fence(1.8 by 1.8)m.
During the day, she stayed in the fenced area downstairs.
One side had sleeping box & toys & water bottle and food served on other side. Newspaper with pee smell on side wall of fence (for soilage)as in photo. At same time,also, tried taking her to shower cubicle to pee/poo with pee tray or newspaper. Failed miserably. Would sleep there or whine. We would wait and cajole for over (15-20) min but she would not do her business and then soon after that she would come out and she wiuld pee on toilet floor or room floor/mat.
At night, Slept upstairs in bedroom in smaller fenced area (0.6 by 0.6)m with sleeping box and water bottle. When we suspected she needed to pee/poo, she was taken to a different upstairs shower cubicle but same result of sleeping / whining in there and peeing later outside.
Feeding:
Being Fed 3x/day since she came.
(7am/12.30pm/7pm)
For first week, Food was left in pen till finished and sometimes hand fed as figured puppy was getting used to new environment and separation anxiety.
About 2 weeks later, once started eating fairly well, we picked up food after one hour whether eaten or not. Tried a bit of cajoling if not eaten much but figured will learn to eat faster when realises food not there all the time.
Also, had to get water bottle as she had tendency to jump into water bowl and splash and play with water and bowl.
We would let her run around for a while on & off around the house and with kids and other dog and then re- fence her but she would soil anytime & anywhere.
2-3 weeks into her arrival, we changed strategies. We made mistake of letting her loose in house all day and only putting newspaper on outside balcony near garden. We thought we had confused her earlier with where to pee/ poo (too many options for locations to pee/poo including upstairs bathroom cubicle and paper in fence and downstairs bathroom cubicle, so we changed it to one location near balcony with paper and put a (0.6 by 0.6)m fence around. So when saw her sniffing we would put her there. But she would go to sleep in there and pee/ poo once out.
A while later,we changed to not confining/ fencing peeing area as we thought she was confused with fence also being used to punish her. But without fence she kept running off the newspaper and then of course she peed/ pooed in wrong place. As a punishment, we would make her see/ smell the pee/ poo and at same time say 'no no' and then place her in fenced area (0.6 by 0.6)m Would say' bad girl'or 'no, no' after pointing to the wrong location for soiling.
A month after she arrived, we have started smacking her bum for:
biting/ barking/ nipping people/ nipping other dogs/eating wrong things(ie: poo/ shoes) /running out of gate/ eating leaves in garden.
We also tried the loud noise ( old empty drink can with coins) to teach her it's wrong but seems to scare her quite a bit.
Is this correct? What's your opinion on this?
We are frustrated as now:
•She pees/ poos whenever she eats & everywhere and house smelling
•She refuses to pee when take her to newspaper with pee trainer smell and instead will sleep on the paper and whine softly but no pee/poo there and soon after being 'released' she will pee/ poo somewhere else ( no fixed place). No matter how long you wait.
•She might then eat/ play with her poo
•She whines/barks when confined / alone in punishment fence
Plays with her poo/ Tries to eat poo
Seems confused about toilet place
Sleeps in toilet confined area/ in toilet cubicle/ on newspaper with pee- trainer smell
When realize she wants to poo/pee so take her to open area with newspaper to pee/ poo she runs away or sleeps on newspaper and soon after does it somewhere else on floor/ carpet
. Sometimes chews newspaper
As of today, after reading some of your cases, we have decided to refence her (1.8 by 1.8)m with toys on one side and newspaper at other side and food placed near toys at meal time. Also decided to feed her earlier 7am/ 12.30 & 5pm so that has time to empty bladder before sleeping.
For example today,
She ate at 5pm and at 7.30pm still just sleeping on the paper. Not peed/ pooed.
So at 7.30pm i decided i will get her out to exercise and run and instead she ran to kitchen and peed there. We brought her back to the newspaper in fence and she went to sleep on it.
At 8pm kids went into fence to play for 20min. Then she peed just next to paper on wooden floor.
At 8.30pm, not pooed yet.
At 10pm plan to take her to sleep in fenced area in bedroom. ( does not like to sleep alone and once upstairs she goes to bed).
What do I do if she keeps peeing in fenced area but not on newspaper?
Do dogs poo after every meal? How long do I wait for her to pee/poo before allowing her to go to bedroom?
Also, aiming to slowly move to 2 meals a day by 6 months. Is that ok?
Please please help and advice me about toilet training her.
About to pull my hair out.
This is becoming a battle of wills.
I'm also worried she might be stubborn enough to not pee/ poo in fenced area on paper and may end up with kidney/ urine infections.
How long do I just let her not pee/poo in the fenced area? Basically, how long do I wait?
What if she does not do it on newspaper and does it in other parts of fenced area? What do I do?
Do I need to cover entire fenced area with newspaper?
Every time she pees on floor in fence, I spray the smell repellant and disinfectant and wipe it off. Is that correct?
Should elimination area be in/ out of playpen?
At night, can she sleep in fenced area in bedroom?
At what age can we take puppy for walk on leash?
Eventually want him to pee outside the house once toilet -trained like my older dog.
Does paper-training confuse or hamper that?
I was hoping to take her for walks with older dog in hope that would copy older dog when peeing/pooing but she tries to bite leash and lies on floor & refuses to walk and hates collar so unable to do that.
Will send you photos of the fenced area and her sleeping fence too.
Really waiting eagerly for your wise words as really quite lost & frustrated!!!
Yours sincerely,
Name of Owner
E-MAIL REPLY FROM DR SING DATED JAN 14, 2012
Thank you for your email and details. My reply focuses on toilet training as you will need to read up or get a dog trainer to answer the other questions. Books are available at the National Library and the info is in the internet.
In this reply, I can only provide you the concept and principles of toilet training a puppy in Singapore based on success achieved by other Singaporeans in my survey of over 600 puppies.
1. It takes 2-8 weeks of confinement of a puppy to achieve success. Much depends on the intelligence of the puppy, the hard work and time spent by the owner, the distractions of family members and friends. For example, a couple living alone with the puppy will have a higher rate of success within 2-4 weeks than a big family with so many interferences and distractions affecting toilet training.
2. Patience and perseverance and research of the owner. Many owners are sabotaged by their family members giving various instructions and treats affecting the success in toilet training.
3. Focus on one method of confinement e.g playpen fencing confinement.
4. My case studies would have given you some ideas of the successes of various types of housing plans for puppies. Basically, strict confinement 2-8 weeks is the main part of toilet training. Positive or negative reinforcement training and others are needed.
It is not possible for me to advise you in detail in your case as each puppy has different management.
Hi Dr Sing Kong Yuen,
I really need help toilet training my new puppy. We have tried different things from fencing to open roaming and back to fencing.
She is a Female Tibetan terrier
Presently (3.5-4)months old
Born 20/09/2012 In Brisbane
where had lots of space to play and was fenced up with siblings
Came to Singapore from breeder in Australia when 2.5-3 months old
Flew with brother to new home in Singapore
When she flew over, she was confined to a small cage with brother
for over 10 hours so had to pee/ poo there while travelling
We stay in a 2 story house with a garden.
We have 2 young kids who adore her and who keep going into her fenced area to play with her or taking her out to run.
Kids laughing just seems to excite her and so confuses her when being told off by me bur kids giggling.
We have an 8 year old male Tibetan terrier who is an angel ( very passive) and is toilet trained to pee outside in garden twice a day when we take him out.
Fencing and toilet- training:
We brought her home and fenced her with collapsible fence(1.8 by 1.8)m.
During the day, she stayed in the fenced area downstairs.
One side had sleeping box & toys & water bottle and food served on other side. Newspaper with pee smell on side wall of fence (for soilage)as in photo. At same time,also, tried taking her to shower cubicle to pee/poo with pee tray or newspaper. Failed miserably. Would sleep there or whine. We would wait and cajole for over (15-20) min but she would not do her business and then soon after that she would come out and she wiuld pee on toilet floor or room floor/mat.
At night, Slept upstairs in bedroom in smaller fenced area (0.6 by 0.6)m with sleeping box and water bottle. When we suspected she needed to pee/poo, she was taken to a different upstairs shower cubicle but same result of sleeping / whining in there and peeing later outside.
Feeding:
Being Fed 3x/day since she came.
(7am/12.30pm/7pm)
For first week, Food was left in pen till finished and sometimes hand fed as figured puppy was getting used to new environment and separation anxiety.
About 2 weeks later, once started eating fairly well, we picked up food after one hour whether eaten or not. Tried a bit of cajoling if not eaten much but figured will learn to eat faster when realises food not there all the time.
Also, had to get water bottle as she had tendency to jump into water bowl and splash and play with water and bowl.
We would let her run around for a while on & off around the house and with kids and other dog and then re- fence her but she would soil anytime & anywhere.
2-3 weeks into her arrival, we changed strategies. We made mistake of letting her loose in house all day and only putting newspaper on outside balcony near garden. We thought we had confused her earlier with where to pee/ poo (too many options for locations to pee/poo including upstairs bathroom cubicle and paper in fence and downstairs bathroom cubicle, so we changed it to one location near balcony with paper and put a (0.6 by 0.6)m fence around. So when saw her sniffing we would put her there. But she would go to sleep in there and pee/ poo once out.
A while later,we changed to not confining/ fencing peeing area as we thought she was confused with fence also being used to punish her. But without fence she kept running off the newspaper and then of course she peed/ pooed in wrong place. As a punishment, we would make her see/ smell the pee/ poo and at same time say 'no no' and then place her in fenced area (0.6 by 0.6)m Would say' bad girl'or 'no, no' after pointing to the wrong location for soiling.
A month after she arrived, we have started smacking her bum for:
biting/ barking/ nipping people/ nipping other dogs/eating wrong things(ie: poo/ shoes) /running out of gate/ eating leaves in garden.
We also tried the loud noise ( old empty drink can with coins) to teach her it's wrong but seems to scare her quite a bit.
Is this correct? What's your opinion on this?
We are frustrated as now:
•She pees/ poos whenever she eats & everywhere and house smelling
•She refuses to pee when take her to newspaper with pee trainer smell and instead will sleep on the paper and whine softly but no pee/poo there and soon after being 'released' she will pee/ poo somewhere else ( no fixed place). No matter how long you wait.
•She might then eat/ play with her poo
•She whines/barks when confined / alone in punishment fence
Plays with her poo/ Tries to eat poo
Seems confused about toilet place
Sleeps in toilet confined area/ in toilet cubicle/ on newspaper with pee- trainer smell
When realize she wants to poo/pee so take her to open area with newspaper to pee/ poo she runs away or sleeps on newspaper and soon after does it somewhere else on floor/ carpet
. Sometimes chews newspaper
As of today, after reading some of your cases, we have decided to refence her (1.8 by 1.8)m with toys on one side and newspaper at other side and food placed near toys at meal time. Also decided to feed her earlier 7am/ 12.30 & 5pm so that has time to empty bladder before sleeping.
For example today,
She ate at 5pm and at 7.30pm still just sleeping on the paper. Not peed/ pooed.
So at 7.30pm i decided i will get her out to exercise and run and instead she ran to kitchen and peed there. We brought her back to the newspaper in fence and she went to sleep on it.
At 8pm kids went into fence to play for 20min. Then she peed just next to paper on wooden floor.
At 8.30pm, not pooed yet.
At 10pm plan to take her to sleep in fenced area in bedroom. ( does not like to sleep alone and once upstairs she goes to bed).
What do I do if she keeps peeing in fenced area but not on newspaper?
Do dogs poo after every meal? How long do I wait for her to pee/poo before allowing her to go to bedroom?
Also, aiming to slowly move to 2 meals a day by 6 months. Is that ok?
Please please help and advice me about toilet training her.
About to pull my hair out.
This is becoming a battle of wills.
I'm also worried she might be stubborn enough to not pee/ poo in fenced area on paper and may end up with kidney/ urine infections.
How long do I just let her not pee/poo in the fenced area? Basically, how long do I wait?
What if she does not do it on newspaper and does it in other parts of fenced area? What do I do?
Do I need to cover entire fenced area with newspaper?
Every time she pees on floor in fence, I spray the smell repellant and disinfectant and wipe it off. Is that correct?
Should elimination area be in/ out of playpen?
At night, can she sleep in fenced area in bedroom?
At what age can we take puppy for walk on leash?
Eventually want him to pee outside the house once toilet -trained like my older dog.
Does paper-training confuse or hamper that?
I was hoping to take her for walks with older dog in hope that would copy older dog when peeing/pooing but she tries to bite leash and lies on floor & refuses to walk and hates collar so unable to do that.
Will send you photos of the fenced area and her sleeping fence too.
Really waiting eagerly for your wise words as really quite lost & frustrated!!!
Yours sincerely,
Name of Owner
E-MAIL REPLY FROM DR SING DATED JAN 14, 2012
Thank you for your email and details. My reply focuses on toilet training as you will need to read up or get a dog trainer to answer the other questions. Books are available at the National Library and the info is in the internet.
In this reply, I can only provide you the concept and principles of toilet training a puppy in Singapore based on success achieved by other Singaporeans in my survey of over 600 puppies.
1. It takes 2-8 weeks of confinement of a puppy to achieve success. Much depends on the intelligence of the puppy, the hard work and time spent by the owner, the distractions of family members and friends. For example, a couple living alone with the puppy will have a higher rate of success within 2-4 weeks than a big family with so many interferences and distractions affecting toilet training.
2. Patience and perseverance and research of the owner. Many owners are sabotaged by their family members giving various instructions and treats affecting the success in toilet training.
3. Focus on one method of confinement e.g playpen fencing confinement.
4. My case studies would have given you some ideas of the successes of various types of housing plans for puppies. Basically, strict confinement 2-8 weeks is the main part of toilet training. Positive or negative reinforcement training and others are needed.
It is not possible for me to advise you in detail in your case as each puppy has different management.
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