1023. Diagnosis of rabbit scabies video to be produced by intern



TOA PAYOH VETS toapayohvets.com Date:   16 July, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits Does the lemon law apply to a case of rabbit scabies?    Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   16 July, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Sunday Jul 14, 2013 Intern Terence who is in National Service comes on Sundays to learn about vet medicine as he will be study vet medicine after his NS. I got him to view the process of the diagnosis and treatment of scabies in a rabbit purchased from a pet shop and asked him to co-produce a video. How good this video will be is up to the readers depends on the script to be written by Terence with my advice. I asked him to insert images of other rabbits with sarcoptic mange, from www.toapayohvets.com and not to steal other images from the website. STORY A young couple from Tampines brought in a newly purchased grey and white rabbit from a pet shop on a bright sunny Sunday July 15, 2013. "Were there any crusts on the paws when you purchased her?" I asked as the pet shop operator is responsible for selling a disease-free rabbit. The "lemon law" in Singapore which requires sellers to compensate the buyer or take back defective products may apply to the purchase of new rabbits. "A bit," the tall and slim young lady and her male friend had researched the internet and had diagnosed scabies. Vets nowadays may be redundant as owners treat scabies themselves through acquiring veterinary knowledge from the internet and buying medication online. The couple did buy an anti-mite spray from the pet shop.   "Did you take some images after purchase?" "No," she did buy some anti-mite spray. "The spray did not work as the crusts keep growing." "Your rabbit has ringworm in the ears too," I showed the circular hairless spots on the ear flap. "The pet shop operator had treated this rabbit for ringworm and scabies and therefore the lesions are not so prominent.  In fact there are no crusts on the edges of the ears and little on the nose unlike untreated rabbits. "However the paws seem to be untreated or the treatment was ineffective. So, the crusts keep enlarging as the mites keep burrowing inside the skin." I got the rabbit's paws clipped and gave the paws an anti-mite wash. Crusts on the paws were peeled off gently. I gave an anti-mite ivomectin injection. The owners would bring the rabbit home to nurse and decontaminate the environment and bedding. "Recovery with new hairs will be in 2 weeks usually," I said. "However, the rabbit may or may not need another anti-mite injection after 2 weeks depending on the recovery." P.S. A video will be much more interesting and will be produced soon. I told Terence that this case is not the classic case of scabies as the pet shop operator had treated it with partial success. The classic case will be crustful ear edges and noses as you can see in the two images of the brown and the black and white rabbits. .   Updates will be on this webpage: www.sinpets.com/F5/rabbit_scabies.htm More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: July 16, 2013 Toa Payoh Vets

Update: Success factors for a provision store and vet practice

TOA PAYOH VETS toapayohvets.com Date:   15 July, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits A successful wet market provision store    Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   15 July, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Today Thursday July 4, 2013, I decided to visit the wet market and take some video of the scene at 6 am. I attended a real estate lecture on Outdoor Advertising and was told that signboards of hawkers and market operators are exempted from payment of fees. I thought every business must pay and pay but this is good.  The bright lights were switched on and there was no crowd. The fish mongers, pork and chicken and fruit sellers and the food stalls were open. The aquarium operators were just starting up. There were some empty stalls as many operators are senior citizens and may have retired. Suddenly, a man in his late 30s called me. Vincent could recognise me although the last time I patronise his provision shop stall was 5 years ago when he was at the temporary premises in the car park. A big fire had gutted the old market place and was being built. I was surprised to see him. My domestic worker had been buying the onions and garlic and stuff from him and so I guess he remembered me but to recognise me would be not possible. His stall was packed with provisions to the gills, providing a variety of goods. This means his business must be thriving, otherwise he would not stock a variety of goods. He has some good healthy stuff like non-salty small fish from Japan for omelette, Japanese mushrooms said to be insecticide free unlike those bitter China-originated mushrooms. "The plump sausages are from Hong Kong," he told me. "The thin dried ones are from Singapore as they are mostly lean meat and Singaporeans are health conscious." "What about the sausages used for char kway teow?" I asked. "The poorest quality type is used," he said.  I asked about his business. Two stalls each of around 100 sq ft would rent around $2,000/month. His fridge to keep some items would cost $300/month in electricity. "Do you intend to expand to a 3rd stall?" I noticed one stall had red banners indicating a new business. I asked him about that stall. "Not that stall separated from my stall by a walkway," he said. The takeover of a stall is $15,000 but one stall went for $25,000 in that stall you mentioned, as the buyer wanted it to store his goods. A middle-aged woman as a helper and a sister. A red line prohibits display of goods out of the line but this extra space is not practical as it is too narrow. I bought 8 items from him, totalling $34.00. The Japanese mushrooms, the export quality brown sauce, a bottle of brown beans to steam the type of fish used for nourishing Cantonese mothers after birth, fine Vermicelli from Thailand, curry paste packet from Vietnam? highly recommended by him, the smelly bean curd bottle from Taiwan to go with porridge and a can of barley. He has special rice for the thick porridge but I did not buy it. I did not buy the open sacks of barley from other countries but the canned one as there is less smell according to him. I was eating this brand as a child but seldom sees it nowadays. He had duck sausages inside his fridge for a client who walked in. He showed me the Australian abalones. What I thought were abalones inside the plastic bag hanging out were duck gizzards. The dried prawns were of a much better quality. The ikan bilis fishes look good. Overall, he seems to be selling better quality stuff. "Service is very important," he emphasized to me as he greeted his clients, mainly women. This was what he said to me 5 years ago. We had not met since and I thought he had gone out of business. His stalls are hidden further inside away from the main entrance. On passing by, one would see a seller of joss sticks and religious paraphernalia and would miss his stalls. He was sitting outside when I came videoing the joss sticks and called me. So that was how we met again. "Do you use Facebook to market your products?" "No need to," he had to start work at 5 am and finished at 2 pm. He had to source for goods 3x/week. He does not believe in social media marketing as he believes his clients are from his good service and in the neighbourhood. That is where he is mistaken. "If you have good stuff like the Hong Kong sausages, you should use the Facebook to advertise as many people may want to buy it and the internet will show the results of your product if you know how to use the social media. Do you sell Japanese Kinman sauce?" "No," he said. "The big supermarkets like NTUC prohibit the manufacturers to permit wet market provision shops to sell."  I was surprised as I thought Singapore advocates free market enterprise. By preventing small operators from being supplied, there is in effect a monopoly and price-fixing cartel. I hope this is not the case. I bought another premium brown sauce from him instead. Small wet market provision shop operators are usually senior citizens and I am surprised that Vincent is younger. There is another one competitor. This trade will die as the big supermarkets corner the business of provisions.             In Vincent's business, the social media will help considerably if he knows how to harness it. Together with his high energy, good service and niche products of good quality and advices, he will have no lack of the health conscious younger parents from further towns other than Ang Mo Kio. But it is very hard to change a person's mindset and time-consuming to maintain a Facebook page. Especially when the operator is not interested in social media. So I expect him to just provide excellent service and get loyal clientele from the aunties and housewives living in Ang Mo Kio Wet Market 628 area and earning a decent livelihood. Till the landlord increases his rentals or the big provision shops and supermarkets slash their prices. As it is, most young consumers just go to the air-conditioned supermarkets to shop and it is more important that the wet market provision store operator make use of social media to sustain his business. The above factors for success in the provision store applies to veterinary practices too. The receptionist and the vets must provide excellent services and products wanted by clients must not be out of stock.   Updates will be on this webpage: A successful provision store More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: July 15, 2013 Toa Payoh Vets

Update:How to prevent bladder stones (struvites) in your dog

TOA PAYOH VETS toapayohvets.com Date:   13 July, 2013	Focus: Small animals - dogs, cats, hamsters, turtles, guinea pigs & rabbits
The Death Sentence for Producing Urinary Stones - How to prevent recurrences Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS First written:  1 September, 2009 Updated:  13 July, 2013   Many times, it is a death sentence when the pet dog produces urinary stones again as the average Singaporean dog owner feels that the surgical treatment, hospitalisation, nursing care and medication from around S$900 at Toa Payoh Vets to over $2,500 elsewhere are "expensive". Unfortunately, urinary stones do recur in some dogs such as the Miniature Schnauzer. Some tips to prevent recurrences of struvite stones are: 1. BREED. Breeds like the Miniature Schnauzer are prone to producing urinary stones. Urinary examination at least 3-monthly will be ideal. If not, during the yearly vaccination, ask your vet to do a urinary analysis to check for urinary crystals. 2. DIET. No dry dog food definitely. No canned foods or treats. Special low stone prescription diet or home-cooked food. 3. URINE pH, S.G,  Red and White Blood Cells measured weekly using dipsticks in collaboration with your vet. 4. WATER INTAKE. Measure diligently and scientifically 24-hourly water drunk in collaboration with your vet. Some sedentary dogs need to be encouraged to drink by more exercise or supervision. 5. ACIDIFICATION OF THE URINE if the urine pH is 7.0 and higher in collaboration with your vet. 6. BLADDER PALPATION. If stones or a crackling gassy sound are felt, it is bad news. Consult your vet promptly. 7. Early detection of blood in the urine and treatment.  Small struvite urinary stones may be dissolved using the prescription struvite diet.  Some owners ignore the blood in the urine till the dog cannot pee. The following shows two female dogs that had blood in the urine.   The Schnauzer, peeing out stones, was fed home-cooked food at the same time as another dog (Golden Retriever) was fed dry food by the maid 8 months ago after consulting me. The owner did not want surgery. She was given acidification tablets and C/D diet for 1 month and had no longer produced stones. She might have eaten some dry food given to the Golden Retriever and produced stones 8 months after my consultation. The Cocker Spaniel had been fed dry dog food for 8 years. She drank little water. Vet 1 removed bladder stones and advised feeding a fish-based diet sold by him after surgery. However blood in the urine occurred and the young lady owner consulted me. I removed 31 bladder stones in Sep 2009. UPDATE ON JUL 13, 2013 The Cocker Spaniel had no recurrences and died in December 2012 of old age. The owner saw me in July 2013 when she brought a stray kitten badly bitten on the neck by an adult stray cat in the garbage dump near her office. She told me that the Cocker Spaniel I operated had passed away of old age in December 2013. I followed up with the life of her Cocker Spaniel. The case study is at: http://2010vets.blogspot.sg/2013/07/review-of-much-loved-cocker-spaniels.html    The objective is to prevent struvite crystal formation by ensuring that the bladder is free from bacterial infections and that the urine pH is alkaline. The dog owner has to be educated in prevention and to take good care post-surgery in collaboration with their vet keeping proper records of urine test. Unfortunately, few Singapore dog owners bother about feeding a proper commercial diet or just home-cooked food as in the case of the Cocker Spaniel above.  In the Cocker Spaniel, I was surprised that the young lady owner took the trouble to cook home-cooked food of vegetables and chicken for her dog to prevent any recurrence. A recurrence means a death sentence, especially during times of recession as the owners do not want to pay for medical treatment. The above-mentioned guidelines apply to the prevention of struvite (triple phosphate) urinary stones only. P.S Here's the brief medical history of the beloved Cocker Spaniel. The Cocker Spaniel was born in Sep 1998. Spayed at an early age by Vet 1 who was the sole vet for the next 11 years, till the recurrence of bladder stones in 2009.  Bladder stones removed by Vet 1 a few months ago. Vet 1 sold a fish-based brand of food - recommended feeding it. Stones presented in the bladder again as evident by blood in the urine. 1. Aug 27, 2009.  11 years old. Bladder stone removal surgery. She brought the dog for treatment of blood in the urine. Her father had said: "Why spend on treatment when $500 can buy a new puppy?" 2. Jan 30 2010 at 12 years old. Breast tumour surgery. Breast tumours at left MG4 & 5 removed by me. 3. July 13, 2010. Lateral ear canal resection of the right ear. The right ear stank. The left ear was not smelly. The right ear was filled with pus and was inflamed and itchy. No more visits from the owner for the next 3 years. The Cocker Spaniel was weaker and weaker in 2012 and was treated by another vet. She died in Dec 2012 according to the young lady. The dog would be 14 years old. The young lady works for a famous US company unlike the childcare centre when I met her. "What do you feed after 2nd bladder stone surgery? Any recurrence?" I wanted to update myself as 3 years had passed by so fast.  "Boiled vegetable and chicken meat as advised by you." "Were you strictly disciplined on this feeding regime?" I asked. "Did you ask your mum to cook for the dog? You must have fed a lot of vegetables!" "I cook myself," she said. "Boiled cabbage and carrots are sweet when boiled. She loved it." "Is she very thin on this diet?" I asked. "She is OK," she said. "Her weight was maintained at 12-14 kg." "How you weigh her?" "I use the human weighing scales." she said. This diet did not result in bladder stone recurrence. "My dog died of old age at 14 years in December 2012," she said sadly as she recalled her management of the old companion. "She was getting weaker every day and was treated by at (a vet practice). No breast tumour recurrence. The right ear was slightly smelly and needed cleaning. Overall, the dog owner was satisfied with the clinical outcome. The dog had lived a good life, much loved, to a ripe old age. She typifies the younger generation who cares very much for the older dog. References: Bladder Stone case studies The Vet's Best Is Not Good Enough Update will be on this webpage: http://www.bekindtopets.com/animals/200905806Struvite _Urinary_Stone_Recurrence_ToaPayohVets.htm
Toa Payoh Vets Clinical Research Be Kind To Pets
Copyright Asiahomes All rights reserved. Revised: July 13, 2013 Toa Payoh Vets

1020. A much loved Cocker Spaniel's surgeries

The fair young lady in her late 20s from Bukit Batok, informed me yesterday that her Cocker Spaniel that was operated by me for ear and breast tumours had passed away in Dec 2012 when she came with her  colleague who rescused a kitten bitten in the neck by a big cat at the rubbish dump near her office yesterday. The Malay colleague will take care of the kitten when he recovers.

I reviewed the Cocker Spaniel records as she said the surgical outcome of the right ear resection operation was good.  Reviews can improve a vet's standard of care.

Here's the history

The Cocker Spaniel was born in Sep 1998. Spayed.

 

1. Aug 27, 2009.  11 years old. Bladder stone removal surgery

She brought the dog for treatment of blood in the urine. Her father had said: "Why spend on treatment when $500 can buy a new puppy?"

I counted 31 bladder stones removed!

I had recorded the case at:
http://www.bekindtopets.com/animals/200905806Struvite_Urinary_Stone_Recurrence_ToaPayohVets.htm


2. 30 Jan 2010 at 12 years old. Breast tumour surgery. Breast tumours at left MG4 &5 removed.

3. July 13, 2010. Right ear stinks. Left ear normal, not smelly. R ear with pus, itchiness and inflammation.
R ear otitis externa.  Surgery lateral ear canal resection.


No more visits from the owner. The Cocker Spaniel was weaker and weaker in 2012 and was treated by another vet. She died in Dec 2012 according to the young lady. The dog would be 14 years old. The young lady works for a famous US company unlike the childcare centre when I met her.

P.S. Retrospective review on Jul 12, 2013

Spayed at around 6 months.
All the time with Vet 1
Bladder stones removed by Vet 1.
Vet 1 sold a fish-based brand of food - recommended feeding it.
Stones came back. Lost confidence in Vet 1.
"What do you feed after 2nd bladder stone surgery? Any recurrence?" I asked.
"Boiled vegetable and chicken meat as advised by you."
"Strictly disciplined on this feeding regime?" I asked.
"You must have fed a lot of veg," I asked.
"Boiled cabbage and carrots are sweet when boiled. She loves it."
"Yes," she said. "Weight maintained at 12-14 kg."
"How you weigh her?"
"Use human scales." she said.
So, no stone recurrence. "Dog died of old age at 14 years," she said sadly.

No breast tumour recurrence. The right ear was slightly smelly and needed cleaning. Overall, the dog had lived a good life much loved, to a ripe old age. The younger generation like her cares very much for the dog.







The stray kitten with the grey black sticky neck bite wound and infection came in yesterday. It was hissing at any human being going near her. Dr Daniel treated the neck wound. I advised fluid therapy as well. The kitten looks better today.

Case Ref for further review by TP Vets: TP 40460

1018. An undescended testicle becomes a large tumour

TOA PAYOH VETS toapayohvets.com Date:   12 July, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits One undescended testicle becomes cancerous    Dr Sing Kong Yuen, BVMS (Glasgow), MRCVSDate:   12 July, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Wednesday, July 10, 2013 1018. An undescended testicle becomes a large tumour   I was happy to see the two sisters again after over 5 years. One was taller and slimmer. Their male 10-year-old terrier X had one fast-growing large lump on the left inguinal area. The other undescended testicle was smaller and normal in size. "Why didn't you get the dog neutered when he was young?" I asked. "Undescended testicles are known to become cancerous in older dogs and men, like the famous cyclist. Now it is a gigantic tumour. Since it grows so fast within a month to become bigger than a hen's egg, it is likely to be cancerous. There is a high anaesthetic risk when an old dog goes under general anaesthesia resulting in death on the operating table." "We did not think about it," the elder sister said. "Is it OK to do the surgery now?" "Take a blood test to screen his health," I advised. "In any case, you have no choice but to get the massive testicular tumour taken out because the cells will rot as they expand in size, causing much pain. The dog will lick the area till the skin becomes thin and the rotting tumour drops out. Now he is licking his penile tip which is red." The owners brought the dog in because the dog kept licking his penile tip. A blood test showed abnormally high SGOT, around 8 X higher. The dog was scheduled for surgery after one day of antibiotics and painkillers.  "How do you know it is a testicular tumour?" Dr Daniel asked me as part of a discussion on this case. He would be thinking of an inguinal hernia which is more common a condition in this belly location called "inguinal". "It is hard and firm and does not go back into the abdomen unlike an inguinal hernia," I explained my diagnosis of the undescended testicle becoming a large tumour. The dog was neutered by Dr Daniel and went home in the evening. The sisters agreed to get the large tumour analysed by the laboratory to check whether it is cancerous or not. As for the high SGOT levels, it is hard to say whether this increase in enzymes is due to the testicular tumour or that the liver is affected. A blood test one month later will be useful to check whether the cells have gone back to normal levels and this would indicate that the cause of the rise is due to the testicular tumour. An educational video is being produced.   Updates will be on this webpage: www.sinpets.com/F5/20130712testicular_tumour.htm More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: July 12, 2013 Toa Payoh Vets