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Monday, March 18, 2013
1327. Hamster tumours in 2013
TOA
PAYOH VETS
Sunday, March 17, 2013
1326. Facial lump was not malignant
On March 15, I went to the SGH to know the histology of my facial lump excised by Professor Foo. I expected good news. Fortunately, there was no malignancy. All these growing skin lumps in old age do pop out and it is really difficult to know which will be malignant or not and so I don't take chances.
1325. A 4-year-old Samoyed died from high fever
Monday Mar 17, 2013
Around 8 days ago, I got a phone call from the Samoyed owner asking whether the dog had a heartworm injection. I took out the case record and said there was no heartworm injection. The owner had brought the dog to Vet 3 as it was not well and Vet 3 was nearby. Vomiting and diarrhoea and fever. Ataxia and unable to stand on his hind legs and so Vet 3 was consulted.
My medical records only showed that the Samoyed came in for high fever of unknown origin around December 2012. He had brain scans done by Vet 1 but his fever did not subside despite treatment by Vet 1 for at least 2 days. The fees were rising or for some other reasons, the dog came to me.
I received this case transferred from Vet 1 as it was quite dramatic. The dog transport couple brought him in panting and recumbent. There was a traffic jam and it was worse. For the next 5 days, the fever returned after intensive treatment. Surely there was no hope for this recumbent dog as the fever recurred.
A Samoyed is as big as a child and I thought there was no hope. No evidence of tick fever parasites. So, naturally, no treatment. However, "no presence under the microscope does not mean it is not there." So I gave the immiticide treatment. The fever subsided. Was it a coincidence or not?
I documented this case because it was unusual as the dog responded to normal temperature after 5 days. The dog went home and the owner used a towel to hold her abdomen up to walk her to the toilet. The dog recovered and I did not hear from the owner till 8 days ago.
So I was surprised that the owner phoned about the heartworm vaccination. 3 days after this phone call, I saw the dog dead at Toa Payoh Vets. "There was no hope," Dr Daniel had given the IV drip and taken a blood sample.
The owner came. A mother in her late 60s and her youngest son taller than her. "How come my dog died? Was it due to the four injections given by Vet 3?" she asked me.
"A post-mortem will be needed to know the cause of death," I said to the mother. "This means the dog's body will be opened up and samples taken for testing. I don't know what are the four injections given by Vet 3 and so I can't say they cause his death."
The mother did not want the post-mortem. "The female sibling ate the duck's necks and bones once but nothing happened. She stole the 7 pieces of fishes on my table and gobbled them up. Nothing affected her health. And yet this Samoyed died after a short illness."
"It is hard to predict life and death," I said. "Vet 3 did say the liver enzymes were higher than normal, indicating a liver disorder." I spent some time talking to her. She could not wait for the cremation man to take the dog for cremation as this man came at 8.45 pm. This was a very sad case as the dog was only 4 years old. The coat had grown back luxuriously and the dog was in an excellent bodily condition, not thin and wasted like sick dogs. As to the cause of death, it remains a mystery. Could this be a resurgence of the tick fever parasites? No blood smear was done for tick fever. The dog did not have any ticks but deaths from chronic tick fever could still occur. This was one of those sadness for a young life lost.
Around 8 days ago, I got a phone call from the Samoyed owner asking whether the dog had a heartworm injection. I took out the case record and said there was no heartworm injection. The owner had brought the dog to Vet 3 as it was not well and Vet 3 was nearby. Vomiting and diarrhoea and fever. Ataxia and unable to stand on his hind legs and so Vet 3 was consulted.
My medical records only showed that the Samoyed came in for high fever of unknown origin around December 2012. He had brain scans done by Vet 1 but his fever did not subside despite treatment by Vet 1 for at least 2 days. The fees were rising or for some other reasons, the dog came to me.
I received this case transferred from Vet 1 as it was quite dramatic. The dog transport couple brought him in panting and recumbent. There was a traffic jam and it was worse. For the next 5 days, the fever returned after intensive treatment. Surely there was no hope for this recumbent dog as the fever recurred.
A Samoyed is as big as a child and I thought there was no hope. No evidence of tick fever parasites. So, naturally, no treatment. However, "no presence under the microscope does not mean it is not there." So I gave the immiticide treatment. The fever subsided. Was it a coincidence or not?
I documented this case because it was unusual as the dog responded to normal temperature after 5 days. The dog went home and the owner used a towel to hold her abdomen up to walk her to the toilet. The dog recovered and I did not hear from the owner till 8 days ago.
So I was surprised that the owner phoned about the heartworm vaccination. 3 days after this phone call, I saw the dog dead at Toa Payoh Vets. "There was no hope," Dr Daniel had given the IV drip and taken a blood sample.
The owner came. A mother in her late 60s and her youngest son taller than her. "How come my dog died? Was it due to the four injections given by Vet 3?" she asked me.
"A post-mortem will be needed to know the cause of death," I said to the mother. "This means the dog's body will be opened up and samples taken for testing. I don't know what are the four injections given by Vet 3 and so I can't say they cause his death."
The mother did not want the post-mortem. "The female sibling ate the duck's necks and bones once but nothing happened. She stole the 7 pieces of fishes on my table and gobbled them up. Nothing affected her health. And yet this Samoyed died after a short illness."
"It is hard to predict life and death," I said. "Vet 3 did say the liver enzymes were higher than normal, indicating a liver disorder." I spent some time talking to her. She could not wait for the cremation man to take the dog for cremation as this man came at 8.45 pm. This was a very sad case as the dog was only 4 years old. The coat had grown back luxuriously and the dog was in an excellent bodily condition, not thin and wasted like sick dogs. As to the cause of death, it remains a mystery. Could this be a resurgence of the tick fever parasites? No blood smear was done for tick fever. The dog did not have any ticks but deaths from chronic tick fever could still occur. This was one of those sadness for a young life lost.
1324. Cairn Terrier's health issues
Reference:
Dog World Feb 2012
Cairn Terrier Health
1. Eye diseases e.g. cataracts, ocular melanosis (a type of glaucoma), progressive retinal atrophy (degenerative eye disease).
2. As for other small breeds, Legg-Calve-Perthes diseaese (degenerative hip disease), luxating patella (slipping kneecaps), craniomandibular osteopathy (excess bone build up mainly on lower jaw, onset from 4 months of age. Flares up, painful, prevents dog opening his mouth. Usually self-limiting & disappears around 12 months of age.
3. Two liver diseases. Portosystemic vascular anomaly (portosystemic shunt). Miscrovascular dysplasia (liver shunt)
3. Renal dysplasia (kidney disease)
Dog World Feb 2012
Cairn Terrier Health
1. Eye diseases e.g. cataracts, ocular melanosis (a type of glaucoma), progressive retinal atrophy (degenerative eye disease).
2. As for other small breeds, Legg-Calve-Perthes diseaese (degenerative hip disease), luxating patella (slipping kneecaps), craniomandibular osteopathy (excess bone build up mainly on lower jaw, onset from 4 months of age. Flares up, painful, prevents dog opening his mouth. Usually self-limiting & disappears around 12 months of age.
3. Two liver diseases. Portosystemic vascular anomaly (portosystemic shunt). Miscrovascular dysplasia (liver shunt)
3. Renal dysplasia (kidney disease)
Cost of neutering rabbit, guinea pig, rat, hamster
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Friday, March 15, 2013
Sharpei with oily skin and blood in the urine
2 days ago, a friend referred a Sharpei owner to me. The dog had been passing blood for many months. With antibiotics, no blood gets passed in the urine. Then the blood comes. Vet1 had X-rayed and said no bladder stones. No further info. I asked her to get the X-rays from Vet 1. I X-rayed the dog and also could not see discrete bladder stones. However urine analysis revealed triple phosphate 2+, pH=9.0, blood 4+, and bacteria.
During the first examination, I felt a rock-hard quail-egg like lump in the bladder area. "A solid bladder stone is likely," I said. The dog was hospitalised to clip off the oily hairs. On Day 2, I palpated the bladder. There was still a similar swelling but smaller. It was painless. On Day 3, the swelling was softer due to anti-inflam and antibiotics. Only on Day 2 did the dog resent my bladder palpaton. This was a nice Sharpei and so she would not bite. I asked Dr Daniel to palpate the bladder and he did so but made no comments.
At the Surgery, the gentle dog would drink a lot of water and peed. Fresh blood would appear in the midst of peeing. So it was not just blood in the urine. It was as if the bladder was bleeding after urination. On the 3rd day, just before discharge, copious of blood appeared in her vaginal area. So, what was the cause of this bleeding?
More investigations needed to be done. E.g. air-contrast bladder X-ray.. For economic reasons, the dog was sent home for the owner to bathe her daily to get rid of the scales and oil. I advised S/D canned food and antibiotics.
Today, Mar 15, 2013, the owner phoned me regarding:
"How much of the S/D cans to feed the Sharpei? She seems to be hungry.". the mother asked.
"One or more cans depending on the dog's appetite," I replied.
"Should I warm up the remaining food in the can from the fridge when I give to her?"
"No need to unless the dog will eat only warm canned food. Dry S/D food is also available," O saod/
"No dry food for her," the mother said. "How about the bladder lump you felt?"
"It is likely to be a thick-walled inflamed bladder," I replied. "The bladder surface was irritated and infected for many months and would have had thickened considerably. It is just like a person's skin being irritated and scratched everyday. It becomes as thick as the crocodile's skin. X-rays show no stones but there may be small ones not visible on X-rays. "
During the first examination, I felt a rock-hard quail-egg like lump in the bladder area. "A solid bladder stone is likely," I said. The dog was hospitalised to clip off the oily hairs. On Day 2, I palpated the bladder. There was still a similar swelling but smaller. It was painless. On Day 3, the swelling was softer due to anti-inflam and antibiotics. Only on Day 2 did the dog resent my bladder palpaton. This was a nice Sharpei and so she would not bite. I asked Dr Daniel to palpate the bladder and he did so but made no comments.
At the Surgery, the gentle dog would drink a lot of water and peed. Fresh blood would appear in the midst of peeing. So it was not just blood in the urine. It was as if the bladder was bleeding after urination. On the 3rd day, just before discharge, copious of blood appeared in her vaginal area. So, what was the cause of this bleeding?
More investigations needed to be done. E.g. air-contrast bladder X-ray.. For economic reasons, the dog was sent home for the owner to bathe her daily to get rid of the scales and oil. I advised S/D canned food and antibiotics.
Today, Mar 15, 2013, the owner phoned me regarding:
"How much of the S/D cans to feed the Sharpei? She seems to be hungry.". the mother asked.
"One or more cans depending on the dog's appetite," I replied.
"Should I warm up the remaining food in the can from the fridge when I give to her?"
"No need to unless the dog will eat only warm canned food. Dry S/D food is also available," O saod/
"No dry food for her," the mother said. "How about the bladder lump you felt?"
"It is likely to be a thick-walled inflamed bladder," I replied. "The bladder surface was irritated and infected for many months and would have had thickened considerably. It is just like a person's skin being irritated and scratched everyday. It becomes as thick as the crocodile's skin. X-rays show no stones but there may be small ones not visible on X-rays. "
1321. Update on a rat's nose tumour
Dear Dr Sing,
Would it be possible to postpone his surgery to Monday afternoon? Approximately at 2pm.
I would like to have a second opinion sought out before proceeding the surgery as well as the X-ray that we spoke of during the previous appointment. Could I also request that only the specific lump and not the surrounding tissue be removed? Should it be that it is malicious, it will very likely reoccur and I would like to minimize the trauma that Moo might have to go through post surgery. Thus I'll like to have only the swelling drained if it is an abscess or only the specific tumor be removed to ease the pressure on his nasal passage without removal of the entire facial structure.
Do let me know if you are comfortable with the arrangement. You may also contact me at 98290503 should you have any further enquiries.
Thank you so much for everything you have done for XXX.
Regards,
.....
EMAIL FROM DR SING DATED MAR 15, 2013
Pl feel free to get a second opinion, the X-rays (including contrast X-rays) and other investigations. A biopsy can be done to check whether the lump is malignant or not without excision of the lump after drainage (if it is an abscess, haematoma or cyst).
As to whether the specific lump can be removed without the surrounding tissues, it may or may not be possible if the lump is embedded inside the muscles or tissues. All surgeons will not want to remove unnecessary tissues disfiguring the patient.
My rationale for the complete excision of the nose lump is that it is growing. If it is an abscess, haematoma or cyst, then there is no need to excise the lump after drainage. If it is a slow growing soft tissue tumour, early excision is advised by me. A biopsy can be done first if the tumour is slow growing or is benign. If it is malignant, it should be excised soon.
Would it be possible to postpone his surgery to Monday afternoon? Approximately at 2pm.
I would like to have a second opinion sought out before proceeding the surgery as well as the X-ray that we spoke of during the previous appointment. Could I also request that only the specific lump and not the surrounding tissue be removed? Should it be that it is malicious, it will very likely reoccur and I would like to minimize the trauma that Moo might have to go through post surgery. Thus I'll like to have only the swelling drained if it is an abscess or only the specific tumor be removed to ease the pressure on his nasal passage without removal of the entire facial structure.
Do let me know if you are comfortable with the arrangement. You may also contact me at 98290503 should you have any further enquiries.
Thank you so much for everything you have done for XXX.
Regards,
.....
EMAIL FROM DR SING DATED MAR 15, 2013
Pl feel free to get a second opinion, the X-rays (including contrast X-rays) and other investigations. A biopsy can be done to check whether the lump is malignant or not without excision of the lump after drainage (if it is an abscess, haematoma or cyst).
As to whether the specific lump can be removed without the surrounding tissues, it may or may not be possible if the lump is embedded inside the muscles or tissues. All surgeons will not want to remove unnecessary tissues disfiguring the patient.
My rationale for the complete excision of the nose lump is that it is growing. If it is an abscess, haematoma or cyst, then there is no need to excise the lump after drainage. If it is a slow growing soft tissue tumour, early excision is advised by me. A biopsy can be done first if the tumour is slow growing or is benign. If it is malignant, it should be excised soon.
Thursday, March 14, 2013
1320. Update on the rat's nose lump
Dear Dr Sing,
Thank you for your email. I'm afraid I don't have better news for you. After his last course of Clavamox, the lump seems to be growing. It still feels relatively soft, but has indeed gotten larger.
Today would be his last course of steroids, would you prefer me to keep him on steroids until he sees you on Sunday?
I'm wondering if there was any signs of a tumour present when the site was cut open. I've also attached a few pictures of the lump taken recently.
Please do let me know what would be a good timing to bring Moo down for your assessment this Sunday.
Wishing you a good week ahead,
Regards,
J
Thank you for your email. I'm afraid I don't have better news for you. After his last course of Clavamox, the lump seems to be growing. It still feels relatively soft, but has indeed gotten larger.
Today would be his last course of steroids, would you prefer me to keep him on steroids until he sees you on Sunday?
I'm wondering if there was any signs of a tumour present when the site was cut open. I've also attached a few pictures of the lump taken recently.
Please do let me know what would be a good timing to bring Moo down for your assessment this Sunday.
Wishing you a good week ahead,
Regards,
J
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March 14, 2013
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Steroids to be discontinued before surgery on Sunday. Pl note that there may be a big wound after surgery.
Surgery to lance the possible encapsulated abscess/haematoma/cyst and to remove the lump is my advice but you need to decide as there is the anaesthetic risk involved. Post-op surgical complications include bleeding and infections. Other than surgery, more oral medication is unlikely to be effective. Bring him in at 9.15 am and take him back at 4 pm on Sunday. No food or water after 10 pm the night below.
Best wishes.
1319. Treatment cost: Swollen eyes in the red-eared slider
On Wed, Mar 13, 2013 at 8:33 PM, Kelvin @yahoo.com> wrote:
Hi,
Judy. May I know the cost of treating a red-eared slider whose eyes are
swollen shut? My turtle has been like this for about 3 weeks and seems
to be gasping from time to time. Would treatment fees be included in the
consultation fees mentioned in the website? Kindly advise. Thank you.
EMAIL REPLY FROM DR SING DATED MAR 14, 2013
The costs of treatment including consultation depends on how long the
slider takes to recover. Some recover within 7 days and some take a few
weeks. If there is gasping, there will be respiratory tract infections.
As a guide, the costs for 7 days of hospitalisation is around $170 -
$200 including nursing and medication.
1318. Update: Rectum falls out in the red-eared slider
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