Wednesday, March 13, 2013

Follow up: Nose lump in a rat - what is it?

Two images of Moo's nasal growth attached
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Kong Yuen Sing <99pups gmail.com="">
Mar 5 (8 days ago)


How is Moo now? Unable to connect to your phone when I called at 7 pm today.
Attached are 2 images.  Pl acknowledge receipt. Best wishes.
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EMAIL TO DR SING  DATED
Mar 5 (8 days ago)


Dear Dr Sing,

I have attached a picture of Moo (He keeps moving, this is the best I could get after distracting him with food), he's still eating, happy and running about but has started sneezing more than usual. Still on Clavamox 0.56ml twice a day 156.25mg/5ml liquid suspension. Today would be the 16th day of Clavamox, no runny stools so far. I would probably complete a 21 day course of Clavamox and try to see if his situation improves.

Thank you so much, both Moo and I are very lucky to have found two very experienced exotic vets :)

Have a great week ahead!

Regards,
J
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EMAIL FROM DR SING DATED MAR 13, 2013
Kong Yuen Sing <99pups gmail.com="">
3:23 AM (0 minutes ago)


It is Mar 13, 2013 now. Is the nasal swelling still present. Pl let me know.

Monday, March 11, 2013

1316. Sheltie X's large gingival lump

Sunday Mar 10, 2013

I was reviewing this Sheltie X's case, operated by Dr Daniel 3 days ago, using electro-surgery to excise the large gingival mass.

In this surgery, intubation is compulsory as it takes a longer time to excise this lump. Electro-cautery to seal the bleeders. Monosy 2/0 sutures were used to close the large wound after electro-excision. I asked Dr Daniel what was the post-op situation 3 days after op now?

"Any stitch breakdown or complaint from the owner?"
"No news," he said. He phoned the owner but the line was busy.
"You can text to her," I advised.
After 10 minutes, I phoned the owner. The mother said: "I have not checked the mouth, but the dog is OK." She asked the daughter to check the mouth but she would not want to do it.

"I will check for you," she replied. "The stitches are still there."
"Give soft food or dry food with water for the next 14 days," I advised.
"My Sheltie is eating dry food with water all the time," she said.
"How long was the gum tumour there?"
"I don't know. Four months probably."
"One month," the daughter said.
"If the tumour grows so fast and so large within one month, it is likely to be cancerous and will recur," I advised.

This is an cauliflower-type gingival lump. Could it be malignant? Since the owner did not want histology, there is no way to know its nature. \\







Some images are shown:

1315. Texting post-op info saves time - sebaceous hyperplasia

I always advise my associates to text the medical results to the owner if his or her phone is busy or unreachable. Most times, my associates do not do it.

I find it good practice as some owners will not say that nobody "phones" her about the results when her phone is engaged. Vets are very busy and I prefer phone calls to communicate one-on-one and to find out more about the post-op behaviour and wounds.

However in this case, the young lady's phone was engaged. I texted her the results saying "sebaceous hyperplasia, not cancerous." She texted to me twice and we never had one word.

She was happy to know and did her research on the internet for her 9-year-old dog whom she loved very much. The sebaceous hyperplasia is a cyst and the images are as follows:



 

1314. Liquid soap on cotton swab to remove tick on dogs?

A School Nurse has written the info below--good enough
to share--and it really works!

"I had a pediatrician tell me what she believes is the best
way to remove a tick. This is great because it works in
those places where it's sometimes difficult to get to with
tweezers: between toes, in the middle of a head full of
dark hair, etc."

"Apply a glob of liquid soap to a cotton ball. Cover the tick
with the soap-soaked cotton ball and swab it for a few
seconds (15-20); the tick will come out on its own and be
stuck to the cotton ball when you lift it away.

This technique has worked every time I've used it
(and that was frequently), and it's much less traumatic
for the patient and easier for me.."

Also, if you just pull a tick off, their heads sometimes break off
and are left under the skin so this is much safer. Be aware

also that a tick with a white speck on its back is a Deer
Tick, these can cause Tick Fever so check yourself and
your family good if you see any of these!

"Unless someone is allergic to soap, I can't see that this
would be damaging in any way.
Please pass on. Everyone needs this helpful hint

Sunday, March 10, 2013

1313. Rabbit with breast tumours. How much to operate?

Hi Doc,

Three years ago I brought my rabbit to your clinic to clear matted fur. Now I want to bring it to you for treatment again. Rabbit is diagnosed with cancerous breast tumour abt 2cm size. This vet near my house is young and inexperienced, and he quoted 800 to 1k for the surgery!!!! May i kn approximately how much for u to perform such surgery? Need your kind advise please.
Albert C

--- On Wed, 3/6/09, Kong Yuen Sing <99pups@gmail.com> wrote:

From: Kong Yuen Sing <99pups@gmail.com>
Subject: Re: Enquiry on Rabbit
To: "Albert C"
Date: Wednesday, 3 June, 2009, 6:14 PM
Thank you. Will see you tomorrow.

On Wed, Jun 3, 2009 at 4:10 PM, Albert C wrote:
I just called up your clinic to make appointment for tomorro 3pm. Thanks for your prompt reply.

Kind Regards


--- On Wed, 3/6/09, Kong Yuen Sing <99pups@gmail.com> wrote:

From: Kong Yuen Sing <99pups@gmail.com>
Subject: Re: Enquiry on Rabbit
To: "Albert Ching"
Date: Wednesday, 3 June, 2009, 3:06 PM

Estimated cost including anaesthetic, cleaning, dematting and antibiotics, bathing and exam is around $150. Staying for 2 days is $20.00 Pl tel for appointment at 6254 3326.


On Wed, Jun 3, 2009 at 2:17 PM, Albert C <@yahoo.com.sg> wrote:
---  Message ---
I have a 4 yrs old female rabbit which has thick hardened clumps of matted furs at bottom area, may i kn do you provide shave down and checkup service? What is the approx cost and earliest appointment available?
Thank you

Albert C




99pups <99pups gmail.com="">
12/27/12


to Albert
Will be back to sg n at work dec 28 2012. Will need to see rabbit tumor to quote. Pl come at 9.30am dec 28
Am in HK today
Sing K Y
Albert C
Mar 9 2013 (1 day ago)

to me
Hello Dr Sing

1) Just to update you, my rabbit passed away peacefully already, you were right, cannot go more than 3 months.

2) I have a 8 months old small breed female pup that I think should get her sterilised by you, the cost is about how much ?? when is the right time? should i wait till after her first heat???

Regards
Kong Yuen Sing <99pups gmail.com="">
8:49 AM (0 minutes ago)

to Albert, bcc: me, bcc: daniel
Thank you for email. Spay of female puppy small breed is around $$200-$250. 8 months should be OK for spaying or 2 months after first heat. 

Saturday, March 9, 2013

1412. The case of the missing Portugese vet intern

She came for 2 mornings and then one email saying she was ill. Then no news from her for the next 7 days. She volunteered for 2 weeks although I told her that she would be better seeing Singapore more as there was her "Gap Year" to see the world as a 22-year-old lady.


-----------------------------

Here are our emails to her.

MARCH 9, 2013
catarina ,,..
10:14 PM (10 hours ago)

to me
Hello,

Thank you for your preocupation. I think I ate a chicken that wasn't completly cooked and was that what made me feel sick. After a few days in bed and resting I felt better, luckly I didn't have to go to the hospital but I had a friend here that helped me =)

After a few days inside, I decided to go out on tuesday and again I had bad luck and I got a sun burn!! Now I'm in the airport flying back, it was a pitty that I had bad luck during this trip but things like this happen and I still could visit Singapore during the last couple of days (I put a lot of cream in my skin!).

How are the tortoises? I hope they are better. I was talking to a friend about it and she told me that one of her tortoise was once with its eyes swollen but never recuperated and didn't survive :/. But actually I saw improvement in the second day observing. The one that wasn't eating was always very active and I was more concerned about the one with the swollen eyes because it was very quiet, but at the second day it improved a bit, this was the picture that I took opening a bit its eyes. Let me know how that goes, it was really interesting and now I know a lot more about tortoises because I investigated =) 

Thank you so much for the opportunity and for being so nice with me, if I come back to Singapur I will do a better and longer internship, I like to do my best and I'm afraid I was a disappointment because I didn't show up again after feeling unwell. 

I wish you al the best and keep me updated =) 

kind regards,

Catarina

Date: Fri, 8 Mar 2013 03:12:28 +0800

Subject: Re: veterinary student
From: 99pups@gmail.com
To: catarina
CC: 99pups@gmail.com; singdaniel@gmail.com; jasonxll@hotmail.com
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Kong Yuen Sing <99pups gmail.com="">
8:21 AM (0 minutes ago). March 9, 2013


Thank you for your reply. I am glad you are well as I looked for you in Facebook. Some tourists do go missing. For example, a Singaporean medical student  went to Greece last year for a conference. He went touring somewhere in the Greek islands and is never seen again. Even today, nobody knows what happens to him.

As for the terrapin with the swollen eyes, both eyes opened a bit yesterday. Such cases need daily treatment, sunbathing (no sun-tan lotion for them), feeding of multivitamins, feed and eye drops. If you have a video of the one with eyes opening on day 2, do post it on you-tube for me to see. 

Recently, I watch a TV program in which the government encouraged young Portugal people to work overseas as there was no job. The young people were quite angry.

Best wishes to your future as a veterinarian. 

Friday, March 8, 2013

1411. Tearing in a rabbit - corneal ulcer.






On Mon, Mar 4, 2013 at 10:29 PM, @gmail.com> wrote:
Attn: Dr Sing KY

Hi,
 
I was recommended to your vet by a friend of yours, J. I have a 5 year old rabbit (XXX) who is currently tearing from one eye (since last year 2012). I've previously been to another vet over the course of 5 weeks, and this is a summary of how they examined my XXX:
 
15th Jan - first appointment, vet gives him duct flushing (NL Duct Flush) and prescribes Ciprofloxacin (ciloxan) eye drops, see result one week later
22nd Jan - still no improvement, vet gives same duct flushing, suggested to do xray to see if "teeth are causing the tear duct to flow"
29th Jan - went for same flushing again, AND xray, xray reveals nothing. Vet prescribes stronger drops called Acular Eyedrops for two weeks, see results
12th Feb - very slight improvement, vet says don't keep giving him drops, only give once in a while. Also gave Protexin fibreplex because XXX was having diarrhea symptoms on and off.

(Note: I am unable to obtain a report from the previous clinic as there isn't enough time to do so by the upcoming appointment. I hope the above information is detailed enough for the time being)
 
I am a little apprehensive, as I know it's tougher to diagnose rabbits due to their different anatomy structure, and I'm hoping you have a different opinion about his condition. And also, a possible breakdown of costs for the procedures that may occur.
 
I have already fixed an appointment with Dr Sing, for Wednesday 10.30am. Thank you, and let me know what you advice :)
 
Regards,
Name given
 



------------------------------

 EMAIL REPLY FROM DR SING
On 5 March 2013 07:38, Kong Yuen Sing <99pups@gmail.com> wrote:
I am Dr Sing. Got your email.Thanks.



 ---------------------------------------------------------------


On Wed, Mar 6, 2013 at 1:27 PM, @gmail.com> wrote:
Hi Dr Sing,

Thanks for the clear diagnosis for my XXX this morning. The previous vet has informed me that I can pick up the previously x-rayed image of XXX's head at the clinic itself, as they do not fax or email the image to clients... When I have the image I will try to email it to you.

One more thing I forgot to ask is, how would the ulcer in the cornea have formed? Could it be a foreign particle that triggered its growth on the cornea? I'm worried because I have another bunny at home, much younger, and I don't want my other bunny to get the same condition. Also, the vet previously told me that the eye condition would not be contagious and spread to other rabbits, but now that it's something else I'm not sure. Please advice, thanks!

Regards,
C


---------------------------

EMAIL REPLY FROM DR SING
Mar 8, 2013

It is difficult to know how the corneal ulcer was created. Whether it was due to trauma, infection or acquired entropion?

It could be due to the irritation from the ingrowing eyelids at the medial canthus (acquired entropion), foreign body penetration, hair irritation from the surrounding and constant eye rubbing. Whether there is bacteria or not, a culture need to be done but you have already used the eye drops. As for the treatment, wearing an e-collar is still advised even though the rabbit dislikes it.