The 73-year-old flower seller and her 7-year-old Jack Russell

"My friend's dog vomited and died when sent to the vet," the 73-year-old flower seller from Geylang market limped badly yesterday (Oct 11,2012) and came by taxi at 8.30 pm. She was worried that her dog might die.

"Why are you still selling flowers?" I asked."Don't your children support you?"

1141. Blood in the stools or no?

"To be frank with you, I consulted another" vet yesterday," the lady gave me a container with mucoid stools and some tissues of blood. "atA very nice place. The vet was nice and checked the stools under the microscope. He said no blood in the stools and no parasites. But my dog still has blood in the stools."
The other vet also prescribed some liquid medication and gave assurances that there was no blood.

"To me, this pinkish tissue looks like blood. But the lady said she fed the dog beetroot.
"Could it be the colour of beetroot?" she asked.

Fortunately, I had studied in Scotland and am familiar with the purplish blue beetroot which is eaten by Westerners.

 "There will be very little blood," I said. "So, I will send this sample to the laboratory that specialises in blood and faecal tests as they will have the more sophisticated machines to detect it."

LAB RESULTS
STOOL FEME AND OB

Stool Analysis  
Appearance   Soft brownish stools
Microscopic examination (wet mount)  leucocyters, erythrocytes+ detected
Occult blood Positive    

The owner phoned at 10 am for the results. I told her. She asked me to fax a copy of the report to the other vet.   

1140. Management of practice: 2 growling big mongrels

Yesterday, I noticed that 2 mongrels (male and female) were kept in the room. As I opened the door, they growled. We don't have space to house big dogs esp. the male Great Dane Cross. In any case, the owner wanted the dogs back on the same day. We also had a Husky in for treatment of constipation for the next few days and one big dog is sufficient.

"Why are the dogs not sterilised?" I asked Dr A.
"I didn't know Min is off today."
"Don't accept big fierce dogs if you can't handle them. Phone the owner and ask her to take rthem back! The vet in charge has to take responsibility for the sedation, not Mr Min. I have two vets and must we wait for Min to do it tomorrow?"

I advised the two vets how to get the male dog sedated without being bitten.

Dr B went to the room to get the male dog out. Gently talking to them and as the dogs have leashes, he could just talk his way in and take the male dog out. I asked the clients with the Beagle to go out of the clinic first.

 "Muzzling is not possible," Dr B tried outside the clinic but the male cream dog would not accept it. "Why don't you try?"

I am no superman. Drs A and B managed to inject the sedatives IM behind the waiting room and so I did not see how they did it. I did advise blocking the chest and head with the door closed on this part of the body while Dr A injected the back muscles.

"What happens if Dr B gets bitten?" Dr A asked me during the post-op discussion.
"In the first place, Dr B should understand dog pyschology and body language and he would not be bitten in the first place. Most dogs give warning e.g. growling and if the vet ignores it, he deserves to be bitten.

It was 9.30 pm when the male dog was picked up by the owner. As the clinic manager, I have to ensure that the work processes are efficiently and effectively done. Otherwise, the practice loses money for every case handled. This accountancy is not obvious to the employee vets who still gets the salary anyway.

History of anaesthesia in dogs and cats

I just spoke to a senior vet to enquire whether he has domitor as my vets have run out of it. He does not use it. Some interesting history from this experienced small animal vet now in his 70s. He started practice some 50 years ago when Singapore had only 3 vet practices and the government Animal Infirmary. Now there are around 50.

1. Xylazine knock down. Nembutal IV to effect. "Despite the vet books claiming that Nembutal will cause drowsy puppies, I did not have any. Intubate and give halothane gas + O2 or just O2 will do." He did a few thousand dog Caesareans. Minimal dosage. Nembutal no longer available easily.

2. Now he uses xylazine + ketamine. It is better, easier to handle and cheaper. Does not need to have many nurses to assist in spay.

E.g. Shih Tzu which is bigge than a cat, xylazine 2% at 0.6 to 0.7 ml and ketamine at 0.4 to 0.5 ml IM or IV. The vet needs to experience the dosage. .

E.g. adult cat in Singapore    xylazine at 0.4 to 0.5 ml & ketamine at 0.4-0.5 ml IM.

3. His younger vet uses propofol

4. He does not use zoletil, diazepam or domitor for sedation.

This is good management as too many sedatives increase stock costs as they expire. Younger employee vets seldom know about the high overheads in a vet practice as they order various kinds of sedatives based on their likes and dislikes. When they open their practice, they may then understand.

An old wound in a hamster

On Wed, Oct 10, 2012 at 5:28 PM, ..@gmail.com> wrote:

Dear Ms Judy,

I think there is something wrong with my hamster. A few weeks ago, there seems to be some wound near the neck and shoulder area. Although it seems to be healing some days later, the wound reopened quite recently and now my hamster looks really weak and motionless. I do not know what else to do. May I please have some advice on how to make her better?

Thank you very much
 

EMAIL REPLY FROM DR SING DATED OCT 10, 2012
 You will need to send it to the vet for treatment as it seems to be long-standing wound.

1137. Email query on cost of spaying female cats at Toa Payoh Vets

On Mon, Oct 8, 2012 at 11:58 AM, ...inn@hotmail.com> wrote:
Hi Ms Judy,

I have 2 female cats, both about a year old. I would like to know what are the charges for stabilizing both of them and how soon I can get an appt with your doctors. Please advise. Thank you.

Regards,
K


E-MAIL REPLY FROM DR SING DATED OCT 10, 2012
I am Dr Sing. Pl accept my apologies for the late reply. The fees for spaying one female cat is from $120 - $180 (with painkillers and antibiotic medication and e-collar home). If the cat is pregnant, the cost is an additional $50.
Pl phone 62543326 for appointment or just come at 9.30 am on a weekday preferred. No food and water after 10 pm, the next before.

1136. Hamster food for the new Syrian hamster

On Mon, Oct 8, 2012 at 7:23 PM, J@hotmail.com> wrote:

Hi Dr Sing,

This is J... We spoke just now about the Vitakraft food for Syrian hamster. I got this ingredient info from the website. The brand originates from Germany. Is this acceptable?

Thanks!

Regards,

J

EMAIL REPLY FROM DR SING DATED OCT 9, 2012

to daniel, Joycelyn






Good research on your proposed purchase of the Vitacraft hamster food for your new Syrian hamster. The alloe vera concentrate and the "approved additives" are the parts I will not feed my hamster as I don't know what long-term effects they will produce.



It is your own preference. If I have to buy only from this Vitacraft manufacturer, I will choose





Emotion ® Nature Dinner Emotion ® Nature dinner

Artikelnummer: 24306 Item number: 24306



There is an English translation at:

http://translate.google.com.sg/translate?hl=en&sl=de&tl=en&u=http%3A%2F%2Fwww.vitakraft.de%2F



The following is copied from this website:

Mit Emotion® Nature Dinner bieten Sie Ihrem Hamster Natur pur im Futternapf! With emotion ® Nature dinner offering your hamster pure nature in the food bowl! Knackige Kürbiskerne, leckere Kolbenhirserispen, gesunder Dinkel ... Crunchy pumpkin seeds, Kolbenhirserispen tasty, healthy spelled ... Die Mischung enthält die reine Vielfalt der Natur — die Rohstoffe werden frisch geerntet und schonend verarbeitet. The blend contains pure natural diversity - the raw materials are freshly harvested and carefully processed.

Emotion® Nature Dinner ist mit vielen energiereichen Zutaten perfekt auf den natürlichen Speiseplan Ihres Nagers abgestimmt und enthält zudem wertvolle Omega-3-Fettsäuren zur Unterstützung eines gesunden Fells. Emotion ® Nature's dinner with many energy-rich ingredients perfectly adapted to the natural diet of your rodent and also contains valuable omega-3 fatty acids to support a healthy coat. Natürlich versorgt das Naturfutter Ihr Tier auch mit allen lebenswichtigen Vitaminen und Mineralstoffen — mit speziellem ACE-Komplex zum Schutz der Zellen. Of course, the natural food supplies your pet with all essential vitamins and minerals - with a special ACE complex to protect the cells. Für ein natürlich gesundes Hamsterleben! For a naturally healthy hamsters life!

Pure Nature: Mit hochwertigen Komponenten aus der Natur Pure Nature: With high quality components from nature

Vitamine : Enthält Vitamine und Mineralstoffe Vitamins : Contains vitamins and minerals

Omega 3: Essentielle Fettsäuren unterstützen eine gesunde Haut und ein gesundes Fell Omega 3: Essential fatty acids support healthy skin and a healthy coat

Cell Protect: Mit ACE-Komplex zum Schutz der Zellen Cell Protect: With ACE complex to protect the cells

Für alle Hamster For all hamsters

Von Tierärzten und Nagerexperten entwickelt Developed by veterinarians and rodent experts

Artgerecht, hochwertig, ausgewogen Arthritis, high quality, balanced

Zuckerfreie Rezeptur Sugar-free recipe

Ohne künstliche Aromastoffe No artificial flavors

Ohne künstliche Farbstoffe Free from artificial colors

Ohne künstliche Konservierungsstoffe No artificial preservatives

Inhalt: 600 g Content: 600 g





Complete food for hamster

Zusammensetzung: Composition:

Pflanzliche Nebenerzeugnisse Vegetable by-products

Getreide (Kolbenhirse 5%, Dinkel 5%) Cereals (millet 5%, 5% spelled)

Gemüse Vegetables

Saaten (Kürbiskerne 3%) Seeds (pumpkin seeds 3%)

Nüsse Nuts

Fleisch und tierische Nebenerzeugnisse Meat and other animal products

Mineralstoffe Minerals

Öle und Fette (Sonnenblumenöl 0,06%, Rapsöl 0,02%) Oils and fats (sunflower oil, 0.06%, 0.02% rapeseed oil)

Hefen Yeasts



Zusatzstoffe/kg: Additives / kg:

Ernährungsphysiologische Zusatzstoffe: Nutritional additives:

Vitamin A (E672) Vitamin A (E672) 11429 IE 11,429 IU

Vitamin D3 (E671) Vitamin D3 (E671) 875 IE 875 IU

Vitamin E Vitamin E 770 mg 770 mg

Vitamin C Vitamin C 638 mg 638 mg

Selen (E8) Selenium (E8) 010 mg 010 mg

Eisen (E1) Iron (E1) 14.215 mg 14,215 mg

Jod (E2) Iodine (E2) 406 mg 406 mg

Kupfer (E4) Copper (E4) 469 mg 469 mg

Mangan (E5) Manganese (E5) 4.334 mg 4334 mg

Zink (E6) Zinc (E6) 3.547 mg 3547 mg


Drinking and peeing a lot is not normal in your hamster. Be observant.

Updates & images will be at:
http://www.sinpets.com/hamsters/20121009hamster_food_quality_toapayohvets.htm

1135. Hamster with sticky rat glue on its body

Today I got a phone call regarding a hamster with sticky rat glue stuck on its body. "Will vegetable oil remove the glue?' the young man asked me as he had researched the internet. "I don't know," I said. "Apply a small part first and see."  

1134. A constipated star tortoise who eats only French beans

Oct 8, 2012
I was surprised that this 7-year-old star tortoise has eaten solely French beans and nothing else for the past 7 years. Now, he had not pooped for the past 2 weeks. His shell is very soft, due to poor nutritional balances.

What to do with a constipated turtle?
"Give one ml of the enema into his anus," I said to Dr Vanessa. "Put him in the blue tub with water inside."
"Is the enema contra-indicated for tortoises?" Dr Daniel asked.
Dr Vanessa gave one ml and the tortoise popped out 2 cm x 1 cm brown stools in the water.
The owner was most happy but as he had to work late, he would bring the tortoise home tomorrow.
"What to do to improve his shell?" he asked.
"You need to give a variety of food," I said. "French beans for 7 years cannot be good for the shell."

Case study of male cat's blocked bladder - struvites urolithiasis

Cat, Male, Not Neutered, Ginger, 10 months old.

"I was renting an HDB flat and living in Toa Payoh," the slim Malay woman said. "You gave me a car ride home as I was pregnant. Now her big son came with me to consult me regarding her orange male cat born on Dec 23, 2011 as her cat could not pee again after treatment by Vet 1. She had bought her apartment in North Singapore and went to the vet near her home. 

"I went to Vet 1 because the clinic is just downstairs," she said. "I can't afford the treatment again as I had already paid $240.00 on Sep 29. Vet 1 wanted around $800 but I can't afford the fees. Yesterday (Oct 1), my cat can't pee again."

"It is not cheap to treat this blocked bladder disease," I said. The owner wants an excellent outcome for one treatment. Is it possible? Yes, in some cases if the owner complies with vet instructions.

VET 1'S TREATMENT ON SEP 29, 2012
Urolithiasis with urethral obstruction
Cat has not urinated for 2 days.
Rock hard fist-sized bladder
IV catheter. valium 0.5 ml slow IV. Methone 0.08ml IM. Alfaxan 0.7 ml slow IV. Iso/O2 maintenance. Urethral obstruction unblocked. Copious saline flushed and emptied bladder.

UA.
pH 6.5  SG 1.05  Blood 3+, Protein 3+. WBC 3+, Urobilingoen 2+
Sediment:  struvites 4+, Bact +, RBC+, WCC+, yaline casts +
Advised hospitalisation and urinary catheter in the bladder for 2 days but owner was not in favour owing to budget constraints.
.
Owner was warned that bladder would be blocked in the next few days and the consequences of
cat dying. Home on clavomox for 5 days. RC urinary S/O diet for at least 6-8 weeks and re-check urine.

TOA PAYOH VET'S TREATMENT ON OCT 2, 2012
Owner agreed to the cat being hospitalised.
Case handled by Dr Daniel and his written plans were:
Cat 4.9 kg, 39.2C
1. Sedation xylazine 0.2 ml + ketamine 0.8 ml IM

Cat, Male, Not Neutered, Ginger, 10 months old.

"I was renting an HDB flat and living in Toa Payoh," the slim Malay woman said. "You gave me a car ride home as I was pregnant. Now her big son came with me to consult me regarding her orange male cat born on Dec 23, 2011 as her cat could not pee again after treatment by Vet 1. She had bought her apartment in North Singapore and went to the vet near her home.

"I went to Vet 1 because the clinic is just downstairs," she said. "I can't afford the treatment again as I had already paid $240.00 on Sep 29. Vet 1 wanted around $800 but I can't afford the fees. Yesterday (Oct 1), my cat can't pee again."

"It is not cheap to treat this blocked bladder disease," I said. The owner wants an excellent outcome for one treatment. Is it possible? Yes, in some cases if the owner complies with vet instructions.

VET 1'S TREATMENT ON SEP 29, 2012
Urolithiasis with urethral obstruction
Cat has not urinated for 2 days.
Rock hard fist-sized bladder

IV catheter. valium 0.5 ml slow IV. Methone 0.08ml IM. Alfaxan 0.7 ml slow IV. Iso/O2 maintenance. Urethral obstruction unblocked. Copious saline flushed and emptied bladder.

UA.
pH 6.5 SG 1.05 Blood 3+, Protein 3+. WBC 3+, Urobilingoen 2+
Microscopy: Struvites 4+, Bact +, RBC+, WCC+, yaline casts +

Advised hospitalisation and urinary catheter in the bladder for 2 days but owner was not in favour owing to budget constraints.
.

Owner was warned that bladder would be blocked in the next few days and the consequences of

cat dying. Home on clavomox for 5 days. RC urinary S/O diet for at least 6-8 weeks and re-check urine.

TOA PAYOH VET'S TREATMENT ON OCT 2, 2012
Owner agreed to the cat being hospitalised.
Case handled by Dr Daniel and his written surgical plans were as follows:
Cat 4.9 kg, 39.2C

1. Sedation xylazine 0.2 ml + ketamine 0.8 ml IM

2. Catherisation + lavage + indwelling
3. Baytril + tolfedine inj
4. e-collar
5. vibravet 50mg 1 tab sid x 10
6. multivit x 1 bot

Urethral obstruction
Cat has not urinated yesterday. .

UA.
pH 7.0 SG 1.015 Blood 4+, Protein 2+. , Urobilinogen Normal
Microscopy: Crystals Nil, Bact Occasional, RBC >2250, WCC 198, hyaline casts Nil, spermatozoa +

Advised hospitalisation and urinary catheter in the bladder for 2 days but owner was not in favour owing to budget constraints.
.

Owner was warned that bladder would be blocked in the next few days and the consequences of

cat dying. Home on clavomox for 5 days. RC urinary S/O diet for at least 6-8 weeks and re-check urine.


CONCLUSION
There have been a few cases of urethral obstruction in male cats seen by me recently. It is a common condition in cats. As to the cause, it is difficult to say.

In this case, struvite urolithiasis has the same conditions of alkaline pH, bacterial infection and struvite crystals. It can be prevented by the use of anti-struvite reduction diet like C/D but most owners are not educated sufficiently to get the cat to switch over to C/D for at least one month and then to maintenance C/D. For economy reasons, I advise C/D for at least one month and then canned food. No dry food at all times. This cat was fed dry food (Snappy Tom) since kittenhood as his dam is also eating the same. No urolithiasis problem for the female.

Follow up education for struvite urolithiasis is essential to ensure that the owner complies with the feeding of C/D. In this case, the cat rejected the C/D when given 100%. I had to educate the owner to give 5% of C/D + 95% of the commercial canned food and slowly increase to 100% over a period of two weeks. She was willing to listen as recurrence will involve costly vet treatment. She was able to medicate the cat with antibiotics given via the food. Many cats will not take antibiotics and many owners simply give up easily.

In strurvite cases, bacterial infection of the bladder needs to be eliminated and an acidic pH of the urine is maintained by feeding of C/D diet. It is extremely difficult to educate most Singapore cat owners and vets don't have much time to do so. Urine checks should be done monthly and 3-monthly but none will be done in most cat cases. The theory is sound but in reality, the Singapore cat owners generally are not interested in follow up urine analysis in 2012.

I noted that owners may buy one can of C/D and then no more news from them.