Thursday, April 4, 2013

1348. Toa Payoh Vets web page Apr 4, 2013


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com  
Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074
Tel: 6254-3326, 9668-6469, judy@toapayohvets.com  
04 April, 2013 StatCounter - Free Web Tracker and Counter
Focus: Small animals - dogs, cats, guinea pigs, hamsters, turtles & rabbits
 
INTERESTING
CASE STUDY
SURGERY HOURS 
9 am - 8 pm.  Monday to Friday
9 am to 5 pm.  Sat, Sun &
 Public Holidays.
Appointments preferred
LINKS 
 
By Appointment Only. 9.00 am - 12 noon usually daily & at other times Monday - Sunday and Public Holidays by Appointment Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS 
 
11 am - 5 pm Saturday only Dr Jason Teo E-Shen, BVSc (Queensland)
Appointments & Emergencies
Dr Jason Teo  tel 9853-1315, 9668-6469
12 noon - 8 pm 
Walk-in & house-call
Monday - Friday except Saturday Dr Daniel Sing Zongzheng, BSc, BVMS (Murdoch)
 
10 am - 5 pm
Walk-in & house-call
Sunday & Public Holidays
Our 3 vets work as a team. All enquiries, house-calls & appointments:  tel: 6254-3326, 9668-6469.

Appointments are preferred as we may be doing surgeries. 

Please let us know your choice of the 3 vets early.  
tpvets_logo.jpg (2726 bytes)6045 - 6049. Dandruff all over the puppy's body. Recovered after > 8weeks of treatment. Head & body scales overwhelm the skin surface
Lake Inle. Mandatory 3 tourists/small boat. Life vests, umbrellas.  Asiahomes.com Travels and Tours    
tpvets_logo.jpg (2726 bytes)6050. Sharpei with oily skin passes blood in the urine for months tpvets_logo.jpg (2726 bytes)6051 - 6052. Services from Toa Payoh Vets tpvets_logo.jpg (2726 bytes)6053.
Seamstresses from Myanmar
   
 
tpvets_logo.jpg (2726 bytes)6054 - 6064. >Six hours' delay resulted in two distressed pups barely alive. The vet or breeder must know how to swing the pups to save their lives (video). Dam and pups are well.
Cat, Ulcerative Keratitis, Management & Surgery, Toa Payoh Vets  
tpvets_logo.jpg (2726 bytes)6056 -6075. Script for video: My Shih Tzu has a red spot in his eye
    Ann's Restaurant by Inle Lake, Myanmar, designtravelpl.com, travel agency singapore
tpvets_logo.jpg (2726 bytes)6076. Health screening your older dog
 
    *Draft Case Studies:  2010vets Advert. Unique Singapore homes:
A heritage bungalow
Advert. Apr 2013 9D/8N for 4 pax Yangon-Bagan_Inle with high quality hotel accommodation
 
Copyright © Asiahomes
All rights reserved.  April 04, 2013
Toa Payoh Vets
 

1347. Why bother to screen your older dog's health?

TOA PAYOH VETS
toapayohvets.com
      Date:   04 April, 2013  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits.
Health Screening For the Older Dogs
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 21 September, 2011
D
ate:  04 April, 2013
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
Most dog owners in Singapore live hectic lives. There are just too many distractions and too much work or enjoyment.

After an intense period of love and care for their new puppies, the senior dogs are just left alone as there is no time for them after their puppy hood. It is usually too late for many old dogs when they are sent to the veterinarian for some chronic disease problems. Veterinary costs become high as the dog is in poor health and need more intensive care.
 

Senior dogs are:
Small and Medium-sized breeds: Over 7 years
Large and Giant-sized breeds: Over 5 years.
For those who may want their senior dogs to live longer, here are the following health screening recommendations by Toa Payoh Vets:

1. Veterinary examination every 6-12 months including examination for tumours and growths, ear infections, eye diseases and skin diseases. Skin diseases are the top 3 cases in Toa Payoh Vets. An educational video is at: Video: Microscopic exam of ringworm 

2. Blood tests to check for blood disorders, diabetes, liver and kidney diseases. Special veterinary diets can be given to prevent further health deterioration when such health screening show disorders of the liver and kidneys, prolonging the dog's life.

3. Urine tests to check on bladder and kidney infections and presence of urinary stones. Urine tests for bladder stones 3-months or periodically after operation as advised by your vet, but many Singaporean owners don't bother and bladder stones recur 3 times. 

Some owners euthanase their dogs when stones recur but others incur high veterinary costs to get them operated. Monitoring of the urine and X-rays as advised by your vet after bladder stone removal would have prevented much medical costs. 
tpvets_logo.jpg (2726 bytes)5863. Five surgeries for bladder stone problem in a Shih Tzu
4. X-rays for arthritic hip joints (can't stand up easily), spinal column, heart and lungs.
X-rays for bladder stones 3-months or periodically after operation as advised by your vet.

5. Ultra-scans of the abdomen for abnormal growths of the internal organs.

6. An MRI scan of the brain for brain tumours.

7. Dental check up and scaling every year. Prevention of oral tumours and oro-nasal fistulas (carnaissal tooth abscesses) in the old dog can be done if the owner checks his or her dog's teeth at the vet yearly.

6. Heart check for murmurs and heart diseases.

7. Stool test for blood, parasites.

8. Blood tests for allergens affecting your dog.

9. A report and discussion about the delay in senility, obesity, behavioural problems, skin problems and any questions related to each individual dog.

10. Excision of small skin, mammary, circum-anal and other tumours.  Tumours detected early can be excised saving the dog's life and reducing veterinary costs. Delaying treatment results in tumours growing and multiplying as in the circum-anal tumour. Many Singapore dog owners delay removal of their senior dog's tumours till they grown big, become smelly and bleeding, messing up the apartment. In such cases, the anaesthetic risks are very high and the dog may die on the operating table.

An example of the investigation tests and surgeries done for one older dog with heart disease and another with gum tumour is shown below

Case 2:  Get tumours excised by your vet
when they are smaller 
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Isoflurane Gas Anaesthesia. Electro-cutting removed gum tumour first. Note hard palate tumour. Toa Payoh Vets
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets
Electrosurgery stops profuse bleeding during gum & hard palate tumour removal. Toa Payoh Vets Gum and hard palate tumours in old dogs can be prevented with good dental hygiene and health. Toa Payoh Vets.
Large cancerous gum and hard palate tumou excised. Jack Russell, 10 years. Toa Payoh Vets Jack Russell, Gum & Hard Palate Tumour excised. Vet Intern. Toa Payoh Vets.
Old dogs are very high anaesthetic risks as they are seldom in the best of health unlike younger ones. Everyone is happy when the old dog does not die on the operating table after surgery. But every vet will have cases of old dogs dying on the operating table as it is impossible to get good clinical outcomes when the vets undertake high-risk anaesthetics.

16 years old fox terrier, not neutered, male, circum-anal, tail gland tumours, toapayohvets, singaporeThis is one main reason why some vets discourage or reject old dog surgeries. "The old dog will pass away before the circum-anal tumours grow much bigger," one vet said to the owner. But the dog lived longer, splattering the apartment with blood from the bleeding tumour and requiring frequent cleaning up.

 

\
5646 - 5648.  Mammary adenoma. A kind Buddhist teacher. No further news from the teacher as at April 4, 2013
When a dog dies on the operating table, it is just too emotional for everyone including the operating veterinary surgeon. Such  deaths may be bad-mouthed by the owner or the family members to friends and recorded on the internet forum. The bad news adversely affect a vet's reputation that takes so much time and effort to build.

So it is understandable if a vet does not want to operate on high-risk cases. I do avoid such cases if possible as deaths on the operating table means a beloved family member that has been growing up with the family children who have become adults is lost forever.

The average life-span of a big breed dog is 12 years. Oldest small breeds in Singapore can live up to 20 years. However, many die before they are 10 years of age due to bad health and other preventable causes such as bacterial infection of the heart valves due to severe gum diseases (preventable by regular 2-yearly dental scaling and checks), pyometra (preventable by early detection or spaying), kidney diseases, diabetes and  tumours like breast, gum and circum-anal tumours (much less occurrence in a male dog that has been neutered).

Many diseases such as circum-anal tumours rarely occur in male dogs that have been neutered. If you don't wish to neuter your dog, please check his backside monthly as small circum-anal tumours are easily removed and cost you less too.  

Tumours like breast tumours are best removed
when they are small.

 

Make an appointment with your pet shop groomer if you have a close working relationship with them and needs pet transport to the vet of your choice. Or tel 6254-3326, 9668-6469 for an appointment to discuss health screening for your senior companion. Or e-mail judy@toapayohvets.com your requirements. 

Updates will be on this webpage:
www.toapayohvets.com/surgery/20080807Senior_Dogs_Health_Checks_ToaPayohVets.htm
 
BE KIND TO OLDER DOGS & CATS --- GET TUMOURS REMOVED EARLY --- WHEN THEY ARE SMALLER.  More case studies, goto:  Cats  or  Dogs
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
 
Copyright © Asiahomes
All rights reserved. Revised: April 04, 2013

Toa Payoh Vets

Saturday, March 30, 2013

1344. A Good Friday's miracle (Mar 29, 2013)

I don't believe in miracles. This 5-year-old male neutered  Jack Russell was rushed in by the father on March 27, 2013 panting and unable to stand since 12 hours ago.

His neck was skywards. His four limbs were extended as straight as a ramrod. Panting and panting non-stop. His rectal temperature skyrocketed to 41 deg C. This scene reminded me of a dog under domitor IV anaesthesia. All muscles stiffened. Or a dog with tetanus with all 4 limbs straight but in this case, the jaws were not locked.

Was there any hope? The father gave permission for blood sample and I took a urine sample to test. Evidence-based medicine should be used as the family will want to know what is the cause of these symptoms and should the dog die, much allegations of incompetence will be insinuated if the vet does not practise evidence-based medicine.

Recently one retiree dog owner did not want the blood test or X-rays although his female dog had been lethargic for 2 days and her abdomen was bloated. His dog had fever. He came towards closing hours and the dog was given a drip and therefore needed to be warded overnight. His daughter objected to the dog being hospitalised as "none of the family's sick dogs had ever been hospitalised over the years even by the vets of a well-known big practice."  In other words, no dogs need to be hospitalised. Just give an injection and medication and the dogs go home. I discharged the dog home the next day. He phoned again to ask what was wrong with his dog and what caused the abdominal bloat as his dog was sleepy again. I asked him to seek a second opinion from another vet.

For this dog, the blood and urine test showed a bacterial infection. The bacteria would have invaded the brain and meninges causing the stiffness. It was not a stroke as the father postulated. There was an explanation for the cause of this stiffness of limbs and neck.

I gave this dog intensive treatment to prevent dehydration, reduce the stiffness and medication. On the 2nd day, he still could not stand. He started crying non-stop all the morning and afternoon. He would drink when a bowl was held to him. He would not eat. Bloody stools stained the thermometer when I took his rectal temperature. His moaning was loud and neighbours wondered why there was dog abuse. I injected sedatives but his loud crying would recur soon as the IV drip diluted the sedative effect.

So I phoned the owner's father to let him know of the poor prognosis and asked him to visit the dog. In one  experience, I had not phoned the owner to view the sick dog and it died leading to scoldings from the owner. I did not expect it to die, but some owners are quick to vent their anger. In this case, I expected the dog to die and therefore contacted the owner urgently.

A dog crying continuously, in my experience, is a sign of intense pain affecting the brain. I had seen such cases in puppies infected with distemper virus encephalitis. The crying just goes on and on.

"Nothing can be done till my son come back from overseas," the father said that euthanasia would require the son's permission. He had visited the dog and attributed the crying to his visit. But the dog had been crying for three hours before his visit. Sedatives seem to have no effect. A half-dose domitor and ketamine lasted less than an hour. The IV drip was still on. Oral sedatives. Rectal sedatives. No effect. Feeding of water temporarily stopped the crying. He did not want to eat.

Finally I decided to give another type of IV sedative to let him sleep through the night. At 8 am on Good Friday, Day 3 of the hospitalisation, there was no more crying. The dog could lift his head and stand when placed on the ground. He lapped water from the bowl. My new assistant placed a bowl of canned food in front of him. "Feed him using the spoon," I said to this young man who is under training by me in dog nursing. The dog swallowed the food. I got a video of the dog outside the clinic, standing and walking a few steps, of sitting upright on his chest. Then I placed him back to rest.

The son and his wife and father came. "What is the cause of his problem?" the father asked again although I had told him. "It is a bacterial infection of the blood and brain," I said. "What type of bacteria?" he asked.  I said I had not got the bacteria cultured. Economics played a big part in the heartlander's veterinary practice and more tests meant higher veterinary bills. If my practice was situated in a prime area where money was no problem, I would have done MRI costing a $1,000 and other tests. The overall bill would add up to at least $3,000 or more. This would not be much appreciated by the heartlander client. 

The daughter-in-law  took out her card to pay the bill. The dog was alive, eating and drinking. I advised the son that the dog would do better when nursed at home. It would also cost less. The medication and management, if complied with, would lead to his recovery. There was no blood test to show that he has recovered from the bacterial infection. This ought to be done as the father asked whether the dog had recovered. As this is heartlander practice, the minimal costs would be appreciated.

If the dog could eat and drink and was able to stand and walk for a few seconds, there was progress and recovery. MRI would be excellent in such cases to aid diagnosis. In economics, the important thing is to deliver. And this was the miracle on this Good Friday, March 29, 2013. There are miracles one can't help but believe in.


   



1343. How to produce an interesting C-section video?

 
 


tpvets_logo.jpg (2726 bytes)6054 - 6064. >Six hours' delay resulted in two distressed pups bare