Dec 4, 2012 9.23 am
I reviewed the surgical case done on Oct 14, 2012. Not possible to talk to the busy owner for long but he said dog is OK and would check if the nylon stitches have been removed.
Golden Retriever, M, 9 years, 27kg
Blood test - Total WCC = 5.2 (6-17) which is low. N=63% OK, L=22%, M 8%, E6%, B1%. Surprisingly in June 4, 2012, the Total WCC = 3.3 which was lower. N=55%, L 28%, M 11% E4%, B2%. Platelets 110 (200-500). The dog came in for vaccination and health check and there was no complaint of ill health. This dog is very selective in eating.
PRE-OP
24 hours before surgery, IV drip and antibiotics
ANAESTHESIA
Not a fit candidate for anaesthesia as Total WCC is low and the dog is old and thin. Short surgery, the better chance of survival.
SURGERY
Electro-surgery controls bleeding better. Still time between first skin incision and last stitch took 57 minutes and isoflurane gas time = 85 minutes. Xylazine 1.3 ml + Ketamine 0.3 ml IV provides ineffective sedation. Needed isoflurane gas mask top up. Nylon 2/0 x2 packets. PDS 2/0 x 1 packet used.
HISTOPATHOLOGY. Granulation tissue either due to ulcer or wall of abscess. Had eaten chicken bones which could have pierced the cheek muscles.
CONCLUSION
Blood test is useful in health screening pre-op. Still, there is need to be speedy, accurate and completeness in surgery.
As at Dec 5, 2012, owner said dog is OK.
Wednesday, December 5, 2012
Tuesday, December 4, 2012
1202. Compliance issues in bladder stone prevention in a British Bulldog
Dec 4, 2012. I phoned the owner of the British bulldog, female, 4 years today as part of follow-up.
An interesting multi-lobed large globular bladder stone was removed by Dr Daniel on Nov 26, 2012 and the stone is being analysed.
"My dog is OK but now passes stools every 2 days, as if she is constipated," the owner said. The dog used to eat like a horse.
"How many cans of S/D do you feed/day?" I asked as this 19 kg dog should be eating 1 and 1/2 to 1 and 3/4 cans per day.
"I feed 2/3 cans/day to prevent her from being fat."
"Do you feed dog treats, bread or other food?" I asked.
"Some vegetables and fruits, but only occasionally," she said.
COMPLIANCE ISSUESOwners don't comply with strictly feeding on prescription diet. They will give some treats, bread and fruits after a while.
REVIEWS FOR URINARY TRACT INFECTIONS
Owners don't do that.
1. To prevent struvites, urinary pH = 6.2 to 6.42. To prevent calcium oxalates, urinary pH = 7.1 to 7.73-weekly urine analysis is recommended but no Singapore owners do that. Breeds like Schnauzers and Shih Tzus have a tendency to get urinary stones and reviews of UTI will have prevented costly surgeries.
STRUVITES. Use C/D after stone removal. S/D is to dissolve the stones.
CALCIUM OXALATE. Use U/D to prevent more calcium oxalate stone formation. U/D does not dissolve the stones.
Check for urinary pH
CASE STUDY OF THE BRITISH BULLDOG
Nov 19, 2012. Blood in the urine for past 2-3 days. Urine analysis and X-rays (bladder stone).
Nov 26, 2012. Cystostomy to remove the stone. Bladder wall thickened. Dr Daniel put one appositional continuous suture on submucosal layer and one inverting suture. I advised an additional layer of inverting suture as that would be what I would do. A urinary catheter could be used via urethra to pump saline into the bladder to check whether there is leakage but for 3 layers, I know that the closure is secure.
URINE ANALYSIS 2 TIMES
Nov 19, 2012. pH 8.0, SG 1.020, Pn 2+, Blood 4+, WBC 30, RBC 720, Bacteria Nil, Crystals Nil (history of haematuria for past 3 days only).
Nov 26, 2012. pH 8.0, SG 1.019, Pn 3+, Blood 4+, WBC >2250, RBC >2250, Bacteria 3+, Crystals triple phosphate occasional (history of haematuria for past 10 days). The dog was on trimax and medazole oral for 10 days and baytril injection. S/D X6 cans were fed.
Antibiotic sensistivity test not done.
POST OP
Stone analysis pending.
Oral Baytril 2 days, trimax bid x 10 days
S/D given but owner fed only 2/3 can per day instead of 1 and 1/2 or more.
OUTCOME
Dog active, no blood in the urine. Owner is happy.
Need to follow up to ensure compliance with C/D diet and check of urine for UTI and pH = 6.2 to 6.4.
It is time-consuming to follow up but owners don't comply and recurrence due to certain breed can recur again.
PHONED OWNER 10.35AM
1. Switch to dry C/D
2. Give 1 and 1/2 can of S/D per day for 20 kg bulldog till the switch to C/D.
2. No home-cooked rice or vegetables for at least next 6 months
3. Urine analysis every month.
Whether she will comply is up to her.
-----------------------------------------------------------------------------------------------------------------------------
X-rays in the previous first report: Blog No. 1186
is at:
http://2010vets.blogspot.sg/2012/11/1186-haematuria-in-british-bulldog.html and the report is reproduced below:
Monday, November 19, 2012
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
SEE ABOVE CASE REPORT FOR DEC 2012 FOLLOW UP
An interesting multi-lobed large globular bladder stone was removed by Dr Daniel on Nov 26, 2012 and the stone is being analysed.
"My dog is OK but now passes stools every 2 days, as if she is constipated," the owner said. The dog used to eat like a horse.
"How many cans of S/D do you feed/day?" I asked as this 19 kg dog should be eating 1 and 1/2 to 1 and 3/4 cans per day.
"I feed 2/3 cans/day to prevent her from being fat."
"Do you feed dog treats, bread or other food?" I asked.
"Some vegetables and fruits, but only occasionally," she said.
COMPLIANCE ISSUESOwners don't comply with strictly feeding on prescription diet. They will give some treats, bread and fruits after a while.
REVIEWS FOR URINARY TRACT INFECTIONS
Owners don't do that.
1. To prevent struvites, urinary pH = 6.2 to 6.42. To prevent calcium oxalates, urinary pH = 7.1 to 7.73-weekly urine analysis is recommended but no Singapore owners do that. Breeds like Schnauzers and Shih Tzus have a tendency to get urinary stones and reviews of UTI will have prevented costly surgeries.
STRUVITES. Use C/D after stone removal. S/D is to dissolve the stones.
CALCIUM OXALATE. Use U/D to prevent more calcium oxalate stone formation. U/D does not dissolve the stones.
Check for urinary pH
CASE STUDY OF THE BRITISH BULLDOG
Nov 19, 2012. Blood in the urine for past 2-3 days. Urine analysis and X-rays (bladder stone).
Nov 26, 2012. Cystostomy to remove the stone. Bladder wall thickened. Dr Daniel put one appositional continuous suture on submucosal layer and one inverting suture. I advised an additional layer of inverting suture as that would be what I would do. A urinary catheter could be used via urethra to pump saline into the bladder to check whether there is leakage but for 3 layers, I know that the closure is secure.
URINE ANALYSIS 2 TIMES
Nov 19, 2012. pH 8.0, SG 1.020, Pn 2+, Blood 4+, WBC 30, RBC 720, Bacteria Nil, Crystals Nil (history of haematuria for past 3 days only).
Nov 26, 2012. pH 8.0, SG 1.019, Pn 3+, Blood 4+, WBC >2250, RBC >2250, Bacteria 3+, Crystals triple phosphate occasional (history of haematuria for past 10 days). The dog was on trimax and medazole oral for 10 days and baytril injection. S/D X6 cans were fed.
Antibiotic sensistivity test not done.
POST OP
Stone analysis pending.
Oral Baytril 2 days, trimax bid x 10 days
S/D given but owner fed only 2/3 can per day instead of 1 and 1/2 or more.
OUTCOME
Dog active, no blood in the urine. Owner is happy.
Need to follow up to ensure compliance with C/D diet and check of urine for UTI and pH = 6.2 to 6.4.
It is time-consuming to follow up but owners don't comply and recurrence due to certain breed can recur again.
PHONED OWNER 10.35AM
1. Switch to dry C/D
2. Give 1 and 1/2 can of S/D per day for 20 kg bulldog till the switch to C/D.
2. No home-cooked rice or vegetables for at least next 6 months
3. Urine analysis every month.
Whether she will comply is up to her.
-----------------------------------------------------------------------------------------------------------------------------
X-rays in the previous first report: Blog No. 1186
is at:
http://2010vets.blogspot.sg/2012/11/1186-haematuria-in-british-bulldog.html and the report is reproduced below:
Monday, November 19, 2012
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
SEE ABOVE CASE REPORT FOR DEC 2012 FOLLOW UP
Monday, December 3, 2012
1201. Sunday Dec 2, 2012's interesting cases
Sunday Dec 2, 2012
A bright sunny Sunday morning. Yesterday, a hamster with a "quail-egg sized" swelling in the right pouch area was admitted by Dr Jason and referred to me. Before I left the surgery and handing over to Dr Jason, I saw a family bringing in a hamster.
I told him that tumours in hamsters should be passed to me if he does not want to operate to remove them. Giving medication would not reduce the big tumours. Some could be abscesses but they had to be lanced. This is the correct approach.
Mr Min showed me the dwarf hamster, 2 years old, male. He had the biggest ovoid lump as hard as a hard-boiled egg. "It could be an impacted food pouch on the right side," I said to Dr Daniel. "It is quite common. A broken seed could have lacerated the pouch and all the food got stuck inside."
We gave the hamster isoflurane gas inside a bottle. The hamster felt sleepy. I took a pair of forceps to evacuate the contents inside the right food pouch. Nothing came out. The hamster protested as he woke up quite easily under gas. Suddenly his eyes popped out from the sockets. "Stop every procedure," I said. "Let the hamster recover. Any handling may cause death."
After 5 minutes, Dr Daniel commenced gas anaesthesia and surgery. "Use the smallest scalpel blade and make a 0.5-cm cut on the skin," I had earlier asked Mr Min to clip off the hair and clean the area.
"It's a red tumour," I saw a bulging swelling under the skin. "Extend the incision to 1.5cm long and shell out the tumour. There is usually a large blood vessel supplying this tumour. Clamp "
A bright sunny Sunday morning. Yesterday, a hamster with a "quail-egg sized" swelling in the right pouch area was admitted by Dr Jason and referred to me. Before I left the surgery and handing over to Dr Jason, I saw a family bringing in a hamster.
I told him that tumours in hamsters should be passed to me if he does not want to operate to remove them. Giving medication would not reduce the big tumours. Some could be abscesses but they had to be lanced. This is the correct approach.
Mr Min showed me the dwarf hamster, 2 years old, male. He had the biggest ovoid lump as hard as a hard-boiled egg. "It could be an impacted food pouch on the right side," I said to Dr Daniel. "It is quite common. A broken seed could have lacerated the pouch and all the food got stuck inside."
We gave the hamster isoflurane gas inside a bottle. The hamster felt sleepy. I took a pair of forceps to evacuate the contents inside the right food pouch. Nothing came out. The hamster protested as he woke up quite easily under gas. Suddenly his eyes popped out from the sockets. "Stop every procedure," I said. "Let the hamster recover. Any handling may cause death."
After 5 minutes, Dr Daniel commenced gas anaesthesia and surgery. "Use the smallest scalpel blade and make a 0.5-cm cut on the skin," I had earlier asked Mr Min to clip off the hair and clean the area.
"It's a red tumour," I saw a bulging swelling under the skin. "Extend the incision to 1.5cm long and shell out the tumour. There is usually a large blood vessel supplying this tumour. Clamp "
1201. Follow up: The kidney-stone Schnauzer vomits again when at home.
"Unless the kidney is removed, it is not possible to prevent infections of the blood and urinary tract system," I said to the owner who had taken the dog back. The dog had a high total white cell count, blood and bacteria in the urine again. She was on intensive ciprobaby (twice) IV at 50ml/time (100 ml bottle) and had recovered during the past 3 days.
But she vomited again when she went home yesterday.She was active and Ok in the day time.
But she vomited again when she went home yesterday.She was active and Ok in the day time.
1199. Customised trained security dog services
Dec 3, 2012
Today, I met a 60-year-old retiree who accompanied her teenaged daughter to bring the 9-year-old Shih Tzu to me for general check up and vaccination.
"I have to ask my dad first as he is paying for the tests," the daughter said to me when I advised a blood and urine test for her old dog as part of health screening and this was not done before.
The dog had dental scaling done by Dr Vanessa last year and the teeth are OK, with some tartar formation. This dog does not permit his mouth to be opened and he showed his warning fangs when I attempted later. "He is a good natured dog as long as you don't touch his mouth," the girl told me. "He trembles and shakes when there is lightning and thunderstorm. A vet told us to ignore him but we hold him."
"You are fortunate that this dog does not pace and go into a frenzy during thunderstorms and lightning. He just shivers. Maybe de-sen. sitation using thunderstorm audio may help, by letting him listen regularly. But you may need to duplicate the change in temperature and humidity during thunderstorms and this cannot be done."
So, there was no solution.
However, the father has been working as a security consultant part-time, doing training programmes from his home. "Does he supply trained military guard dogs?" I asked her. "In Singapore, the system is to send staff from the police and army to Europe or USA to buy puppies and train them for narcotics and other duties by the local staff. The success rate is extremely poor. The staff has to travel far distances to see one or two puppies in various parts of Europe. I doubt the breeders really sell the good ones. Then, there is the allegation of staff corruption."
So, the girl's father could provide a niche service as his contacts in China can provide trained dogs according to the buyer's requirements. For example, if the Customs want 50 sniffler dogs, he can arrange for them to be delivered fully trained and tested by the Buyer. "This is a niche market," I said to the father.
"Not much business as Singapore and Malaysia don't buy many. A dog lasts 4 years and the Police may replace less than 10 per year."
"Well, this is a niche market to be developed by you since you have the training source and dogs in China," I said. "In the past, there is no such establishment and now you have the specialised dog training school, you can supply customised-trained dogs to anybody. Not only the army or the military. For example, a rich father may wish to get a guide dog for his blind child. This will be your niche market. You need to start your own company rather than use the present security company and build up your credibility and services."
The father could see the prospects. Whether he would be able to execute my idea, that is the million-dollar question. "It is more than 50% of the problems solved," I replied when he said that he already got the source of dog training school and the good relationship with the people there. "Very few if any Singaporean or Malaysian has this type of contact." Retirees in security business for many years have a large number of contacts if they know how to network with them to start a new business.
Today, I met a 60-year-old retiree who accompanied her teenaged daughter to bring the 9-year-old Shih Tzu to me for general check up and vaccination.
"I have to ask my dad first as he is paying for the tests," the daughter said to me when I advised a blood and urine test for her old dog as part of health screening and this was not done before.
The dog had dental scaling done by Dr Vanessa last year and the teeth are OK, with some tartar formation. This dog does not permit his mouth to be opened and he showed his warning fangs when I attempted later. "He is a good natured dog as long as you don't touch his mouth," the girl told me. "He trembles and shakes when there is lightning and thunderstorm. A vet told us to ignore him but we hold him."
"You are fortunate that this dog does not pace and go into a frenzy during thunderstorms and lightning. He just shivers. Maybe de-sen. sitation using thunderstorm audio may help, by letting him listen regularly. But you may need to duplicate the change in temperature and humidity during thunderstorms and this cannot be done."
So, there was no solution.
However, the father has been working as a security consultant part-time, doing training programmes from his home. "Does he supply trained military guard dogs?" I asked her. "In Singapore, the system is to send staff from the police and army to Europe or USA to buy puppies and train them for narcotics and other duties by the local staff. The success rate is extremely poor. The staff has to travel far distances to see one or two puppies in various parts of Europe. I doubt the breeders really sell the good ones. Then, there is the allegation of staff corruption."
So, the girl's father could provide a niche service as his contacts in China can provide trained dogs according to the buyer's requirements. For example, if the Customs want 50 sniffler dogs, he can arrange for them to be delivered fully trained and tested by the Buyer. "This is a niche market," I said to the father.
"Not much business as Singapore and Malaysia don't buy many. A dog lasts 4 years and the Police may replace less than 10 per year."
"Well, this is a niche market to be developed by you since you have the training source and dogs in China," I said. "In the past, there is no such establishment and now you have the specialised dog training school, you can supply customised-trained dogs to anybody. Not only the army or the military. For example, a rich father may wish to get a guide dog for his blind child. This will be your niche market. You need to start your own company rather than use the present security company and build up your credibility and services."
The father could see the prospects. Whether he would be able to execute my idea, that is the million-dollar question. "It is more than 50% of the problems solved," I replied when he said that he already got the source of dog training school and the good relationship with the people there. "Very few if any Singaporean or Malaysian has this type of contact." Retirees in security business for many years have a large number of contacts if they know how to network with them to start a new business.
Saturday, December 1, 2012
1198. A mother's sacrifice
Nov 30, 2012 was the last day of work for Dr Vanessa. I wished her well in her new venture as I had expected that she would be her own boss. She gave me a piece of chocolate cake to celebrate her birthday.
I had promised to send a Jack Russell with skin disease home at Lorong 8 Toa Payoh after treatment and clipping for skin itchiness. The domestic worker would wait at the first floor of the HDB block to take over the dog. I asked my intern (a young man in junior college year one) to put the dog in a crate. Min helped him. The owner had to go overseas and so I volunteered to send the dog back after grooming and bathing for the skin disease.
"It is the wrong dog," Dr Daniel phoned me. "There are 3 Jack Russells in the crates and you have got the one with the bladder stone."
Just a few days ago, the Kandang Kerbau Hospital had given the wrong babies to two mothers. One of the ankle name tags had fallen off and so the baby was given to the wrong mother. One of the two mothers discovered the mistake and there was needless worries and DNA checks. The private hospitals use RFID tags and so had no problem.
I may need to use RFID tags to identify the dogs but this would not be necessary as I don't have more than 10 dogs. Somehow, Min had given me the wrong dog. I asked the domestic worker to get permission from her employer to go back with me in the car to get the dog as the dog would bite. She got the permission via her phone and we went back to the Surgery to get the dogs.
"How long have you worked for the same employer?" I asked her.
"Twelve years," she surprised me as most workers don't stay more than 2 years.
"My employer is good," she said. "The dog is obedient too as he does not lick my face. He would look the other way. My religion does not permit me to touch dog saliva."
She walked the dog but does not feed him medication.
"Why do you work so many years?" I asked.
"To earn money for my children's education. My daughter is now grown up and is married. She will never be working as a maid like me."
Many maids made great sacrifices being away from families and going home 4 weeks every two years.so that the progeny can have a much better life.
I had promised to send a Jack Russell with skin disease home at Lorong 8 Toa Payoh after treatment and clipping for skin itchiness. The domestic worker would wait at the first floor of the HDB block to take over the dog. I asked my intern (a young man in junior college year one) to put the dog in a crate. Min helped him. The owner had to go overseas and so I volunteered to send the dog back after grooming and bathing for the skin disease.
"It is the wrong dog," Dr Daniel phoned me. "There are 3 Jack Russells in the crates and you have got the one with the bladder stone."
Just a few days ago, the Kandang Kerbau Hospital had given the wrong babies to two mothers. One of the ankle name tags had fallen off and so the baby was given to the wrong mother. One of the two mothers discovered the mistake and there was needless worries and DNA checks. The private hospitals use RFID tags and so had no problem.
I may need to use RFID tags to identify the dogs but this would not be necessary as I don't have more than 10 dogs. Somehow, Min had given me the wrong dog. I asked the domestic worker to get permission from her employer to go back with me in the car to get the dog as the dog would bite. She got the permission via her phone and we went back to the Surgery to get the dogs.
"How long have you worked for the same employer?" I asked her.
"Twelve years," she surprised me as most workers don't stay more than 2 years.
"My employer is good," she said. "The dog is obedient too as he does not lick my face. He would look the other way. My religion does not permit me to touch dog saliva."
She walked the dog but does not feed him medication.
"Why do you work so many years?" I asked.
"To earn money for my children's education. My daughter is now grown up and is married. She will never be working as a maid like me."
Many maids made great sacrifices being away from families and going home 4 weeks every two years.so that the progeny can have a much better life.
1197. Three teeth in a one-year-old dwarf hamster
Saturday Dec 1, 2012
The hamster with the swollen upper nose came back as she could not gnaw seeds. 4 days ago, Dr Daniel had incised the upper right area of the nose, draining the pus. Now, the lower right area of the nose below the right nostril had become more swollen. "The right nostril is bigger in diameter than the left," I said as the gentleman owner had complained that the hamster had sniffling sounds.
The hamster's upper right area was slightly swollen after drainage of the abscess. It took one month for the abscess to ripen and it was lanced 4 days ago on Nov 27, 2012. The lower right upper area had shown on pimple but was mainly hard as a rock. So, there was no point cutting it as it was not "ripe" meaning that the abscess had not come to a head.
The hamster squeaked when I tried to open the mouth with forceps but othewise was "sleepy" when hand-held by the girlfriend for me to take images of the inflamed area to document the condition. There would be another 4 days before this area would ripen and pus could be released. I scheduled Dec 4, 2012 to operate.
This hamster has only 3 teeth instead of 4. One right upper incisor and two lower incisor teeth with a gap between them.
"Was he born with 3 teeth?" I asked the gentlema as the hamster's front teeth grow continuously unlike human teeth. So a fractured one would grow back and the hamster wears out the teeth by gnawing and eating seeds..
"He had four teeth," he said.
"You dropped him when he was young," the girlfriend said.
Presently the hamster gained 5 g, from 40 g some 4 days ago after lancing the abscess. He would eat the bananna paste and loved the green jelly but could not chew on seeds or pellets for the past 4 days. So that was why the couple consulted me.
"He used to be 60 g," the man said.
"Once the abscess in the lower right area of the right nostril is soft and lanced, he will put on weight, befitting his name of "Ah Pui" (Fatty in the Hokkien dialect).
The hamster with the swollen upper nose came back as she could not gnaw seeds. 4 days ago, Dr Daniel had incised the upper right area of the nose, draining the pus. Now, the lower right area of the nose below the right nostril had become more swollen. "The right nostril is bigger in diameter than the left," I said as the gentleman owner had complained that the hamster had sniffling sounds.
The hamster's upper right area was slightly swollen after drainage of the abscess. It took one month for the abscess to ripen and it was lanced 4 days ago on Nov 27, 2012. The lower right upper area had shown on pimple but was mainly hard as a rock. So, there was no point cutting it as it was not "ripe" meaning that the abscess had not come to a head.
The hamster squeaked when I tried to open the mouth with forceps but othewise was "sleepy" when hand-held by the girlfriend for me to take images of the inflamed area to document the condition. There would be another 4 days before this area would ripen and pus could be released. I scheduled Dec 4, 2012 to operate.
This hamster has only 3 teeth instead of 4. One right upper incisor and two lower incisor teeth with a gap between them.
"Was he born with 3 teeth?" I asked the gentlema as the hamster's front teeth grow continuously unlike human teeth. So a fractured one would grow back and the hamster wears out the teeth by gnawing and eating seeds..
"He had four teeth," he said.
"You dropped him when he was young," the girlfriend said.
Presently the hamster gained 5 g, from 40 g some 4 days ago after lancing the abscess. He would eat the bananna paste and loved the green jelly but could not chew on seeds or pellets for the past 4 days. So that was why the couple consulted me.
"He used to be 60 g," the man said.
"Once the abscess in the lower right area of the right nostril is soft and lanced, he will put on weight, befitting his name of "Ah Pui" (Fatty in the Hokkien dialect).
1196. Spaying a dog at "6 months" of age
Saturday Dec 1, 2012
A young couple had made an appointment with me to examine their 6-month-old female dog before spaying next week. "Dr Vanessa has resigned from Toa Payoh Vets and her last day was yesterday," I said. "If you would like Dr Vanessa to spay your dog, you can contact her." Clients can have their personal preferences of the 4 vets at Toa Payoh Vets. Since it was Ok with them, I proceeded to examine the dog whose body was that of a cross between a Westie and a poodle. At 4-kg, whe could be considered suitable for spaying.
I opened the dog's mouth. Her temporary canine teeth were all white and narrow while her incisors were white and broad. "Your dog is less than 6 months of age," I said. "The permanent fangs or canine teeth will erupt at 5-6 months of age, pushing away the 4 puppy canine teeth. However, they have not yet erupted."
The couple was surprised as they were told by the sellers at Pasir Ris that the puppy - a MalteseXpoodle was 3 months old and that was 3 months ago.
"The likely explanation is that the AVA (regulatory authority) permits sale of puppies at 3 months of age. But younger puppies are more in demand and fetch a higher price. So, the puppy was sold at around 2 months of age." The vaccination certificate was not available. In any case, this puppy was less than 6 months of age.
"Can the dog be spayed at 5 months of age?" the lady asked.
"Yes," I said. "The animal welfare people sterilise them as young as 4 ,months of age. My advice is to spay her 2 months after her first heat to permit her private parts to develop fully to a msture state. But if you want to spay her before her first bleeding, 6 months of age would do." I showed the couple that this dog still had not develop the nipples. It would take time for her to mature.
"The vulval area is brownish," I said. "Is she licking her privte part? If she does, she may have a urinary tract infection."
I gave the couple a urinary bottle to collect urine for urine analysis as I could palpate a half-full bladder. "Clean the pee pan well and flush with water. When the dog pees there, collect 3 ml of the urine with this sterile syringe." The couple went home and came back soon with a bottle of yellow urine for analysis of bacteria.
"The last time she was checked by Dr Vanessa, the urine dipstick showed protein present," the young man said to me.
"A urine sample for analysis would be necessary to check for crystals, blood cells and bacteria."
Young vets must know when the permanent canine tooth erupts so as to estimate the age of young dogs. They erupt between 5-6 months, not 6-8 months, generally. In this way, they can estimate the age of the young dog.
A young couple had made an appointment with me to examine their 6-month-old female dog before spaying next week. "Dr Vanessa has resigned from Toa Payoh Vets and her last day was yesterday," I said. "If you would like Dr Vanessa to spay your dog, you can contact her." Clients can have their personal preferences of the 4 vets at Toa Payoh Vets. Since it was Ok with them, I proceeded to examine the dog whose body was that of a cross between a Westie and a poodle. At 4-kg, whe could be considered suitable for spaying.
I opened the dog's mouth. Her temporary canine teeth were all white and narrow while her incisors were white and broad. "Your dog is less than 6 months of age," I said. "The permanent fangs or canine teeth will erupt at 5-6 months of age, pushing away the 4 puppy canine teeth. However, they have not yet erupted."
The couple was surprised as they were told by the sellers at Pasir Ris that the puppy - a MalteseXpoodle was 3 months old and that was 3 months ago.
"The likely explanation is that the AVA (regulatory authority) permits sale of puppies at 3 months of age. But younger puppies are more in demand and fetch a higher price. So, the puppy was sold at around 2 months of age." The vaccination certificate was not available. In any case, this puppy was less than 6 months of age.
"Can the dog be spayed at 5 months of age?" the lady asked.
"Yes," I said. "The animal welfare people sterilise them as young as 4 ,months of age. My advice is to spay her 2 months after her first heat to permit her private parts to develop fully to a msture state. But if you want to spay her before her first bleeding, 6 months of age would do." I showed the couple that this dog still had not develop the nipples. It would take time for her to mature.
"The vulval area is brownish," I said. "Is she licking her privte part? If she does, she may have a urinary tract infection."
I gave the couple a urinary bottle to collect urine for urine analysis as I could palpate a half-full bladder. "Clean the pee pan well and flush with water. When the dog pees there, collect 3 ml of the urine with this sterile syringe." The couple went home and came back soon with a bottle of yellow urine for analysis of bacteria.
"The last time she was checked by Dr Vanessa, the urine dipstick showed protein present," the young man said to me.
"A urine sample for analysis would be necessary to check for crystals, blood cells and bacteria."
Young vets must know when the permanent canine tooth erupts so as to estimate the age of young dogs. They erupt between 5-6 months, not 6-8 months, generally. In this way, they can estimate the age of the young dog.
Tuesday, November 27, 2012
1195. British bulldog's cauliflower stone surgery
Nov 27, 2012
Yesterday morning, I mentored a bladder stone surgery on the female British bulldog, 4 years old. The dog is OK today.
Eats like a horse, the owner said. Home-cooked food and dry food. Yet, a big stone. The dog was on antibiotics and S/D diet for a week. "Can you guarantee the stone will dissolve by S/D diet?" the owner was tired of having to clean up the dribbling urine every few seconds. "My dog passes greyish urine yesterday, like ash." I said I doubt it. "So, it is better to operate. She has lost a lot of weight. Much lighter now."
I required a blood test and urine analysis on the day of surgery. This had been done before, my associate said. "It is best to monitor the latest situation."
SURGERY
Dr Daniel operated. I assisted.
I got syringe of urine direct from the bladder for urine analysis. Dark red brown urine.
Incision from apex of bladder 1.5 cm.
Thick bladder wall of 5 mm. Bloody.
Suturing. Continuous on mucosa, then 2 layers of inverting. 1 layer could be OK but I advised two layers.
BLOOD TEST RESULTS -Nov 26, 2012 on day of surgery
Total WCC 11.5 (6-19). N=89%, L=10%, M=1%, E=0, B=0
RBC and platelets normal. Urea and creatiine below normal.
URINE ANALYSIS- Nov 26, 2012 direct from the bladder
Red turbid, pH 8.0, SG 1.019, Protein 3+, Blood 4+, WBC >2250, RBC >2250
Crystals Triple phosphate occasioal, bacteria 3+
I did not request an antibiotic sensisitivity test to reduce costs.
Yesterday morning, I mentored a bladder stone surgery on the female British bulldog, 4 years old. The dog is OK today.
Eats like a horse, the owner said. Home-cooked food and dry food. Yet, a big stone. The dog was on antibiotics and S/D diet for a week. "Can you guarantee the stone will dissolve by S/D diet?" the owner was tired of having to clean up the dribbling urine every few seconds. "My dog passes greyish urine yesterday, like ash." I said I doubt it. "So, it is better to operate. She has lost a lot of weight. Much lighter now."
I required a blood test and urine analysis on the day of surgery. This had been done before, my associate said. "It is best to monitor the latest situation."
SURGERY
Dr Daniel operated. I assisted.
I got syringe of urine direct from the bladder for urine analysis. Dark red brown urine.
Incision from apex of bladder 1.5 cm.
Thick bladder wall of 5 mm. Bloody.
Suturing. Continuous on mucosa, then 2 layers of inverting. 1 layer could be OK but I advised two layers.
BLOOD TEST RESULTS -Nov 26, 2012 on day of surgery
Total WCC 11.5 (6-19). N=89%, L=10%, M=1%, E=0, B=0
RBC and platelets normal. Urea and creatiine below normal.
URINE ANALYSIS- Nov 26, 2012 direct from the bladder
Red turbid, pH 8.0, SG 1.019, Protein 3+, Blood 4+, WBC >2250, RBC >2250
Crystals Triple phosphate occasioal, bacteria 3+
I did not request an antibiotic sensisitivity test to reduce costs.
Thursday, November 22, 2012
1194. Follow up. The Schnauzer vomits again - bladder stones & kidney stones
Thur Nov 22, 2012
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
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