August 15, 2013
After 2 nights of hospitalisation and treatment including abdominocentesis by Dr Daniel, the Jack Russell's double chin and neck swelling has reduced in size considerably. I drove the car with my assistant Niang to return the dog to the owner.
"So small," the maid referring to the dog's swollen face and neck 2 days ago. The Jack Russell's face is sharper in outline as is normal. A bit of fluid under the neck in front of the thoracic inlet. The abdomen appeared swollen again. Overall, he feels much alive and active.
"Sometimes, the owner has no time to give medication regularly as he has his own work to do. No staff to help him as it is very difficult to find one when you are a small company" I said to Niang. "Some owners have no money to buy the medication for treatment of ascites which is not a curable condition."
Thursday, August 15, 2013
1079. Update Maine Coon - pallor again
Aug 14, 2013.
Maine Coon, MN, 5 years admitted as he was lethargic, unable to stand on hind limbs in the evening. Gums white again. Took another blood test.
12 hours after Vit K1 injection and supportive therapy, the cat's gum is slightly pink. Feline leukaemia antigen positive. FIV antibody negative may mean that the virus is not present yet or the immune system is not producing the antibodies. No fever. Not eating. Meows a bit. Can walk to hide in the corner under the table.
Maine Coon, MN, 5 years admitted as he was lethargic, unable to stand on hind limbs in the evening. Gums white again. Took another blood test.
12 hours after Vit K1 injection and supportive therapy, the cat's gum is slightly pink. Feline leukaemia antigen positive. FIV antibody negative may mean that the virus is not present yet or the immune system is not producing the antibodies. No fever. Not eating. Meows a bit. Can walk to hide in the corner under the table.
Wednesday, August 14, 2013
1078. The Ang Mo Kio Silkie Terrier ate lots of treats
I had known Cookie since he was a puppy in 2005. After the puppy vaccination, no more visits as this is a common practice. In Jul 3, 2013, blood in the urine.
July 3. Haematuria. Urine test. pH 9.0, SG 1.034, Protein +, Blood 3+, Crystals triple phosphate +, amorphous phosphate 3+ . No bladder stone palpated. I advised X-ray and S/D for 3 months.
Blood test. SGOT/AST 114 (<81 78="" 9.3="" br="" creatinine="" urea="">
July 10. Cannot pee. Owner sent the dog for X-rays at another practice. No stones seen.
Aug 13. The owner brought in the urine for test. pH 8, SG 1.020, Blood Trace, Bacteria +, amorphous phosphate 2+, Triple phosphate occasional
After July 10, no problems of urination or visible blood in the urine and so the owners were satisfied.
Dissolving of urinary crystals
My advice. S/D 3 months to dissolve the crystals. Urine test monthly. Then C/D dry.
PROBLEM
Dog will not eat the S/D.
Owner advised to feed 10% S/D and then add to become 100%. However, the owner bought S/D x 7 cans on Jul 6, 12 cans on Jul 20 and now 12 cans on Aug 13.
No dog treats given. Fed Pedigree Canned + rice in the past month.
CONCLUSION
The cat had no episodes of urination difficulty since Jul 10 todate. However, the mixture of S/D diet and other food did not dissolve the crystals as the owner needs to convert to 100% of S/D. I text the owner who says he will do it.
Aug 15, 2013. The husband phoned to see me in 20 minutes. I advised medication and review of the X-rays taken by another vet again. Many cases need monitoring and review but vets will have no "work-life" balance if they really review ever case and write case report to understand the effects of home management on S/D diet. In this case, S/D diet would have worked to eliminate the amorphous phosphate crystals in the urine if the owner had diligently converted the dog to 100% of S/D. As he did not, he still benefited in that the dog no longer had urination problem. But the latest urine test or the only one showed that blood, bacteria and crystals are coming back in the alkaline urine again. Many owners don't understand the technical use of S/D diets in dissolving the crystals by acidification of ther urine. So they don't comply since the dog will not eat it. The trick is to give 5% increasingly and consistently.
Let's hope this dog will be OK with the new motivation and participation of the owners, a couple in their late 50S
July 3. Haematuria. Urine test. pH 9.0, SG 1.034, Protein +, Blood 3+, Crystals triple phosphate +, amorphous phosphate 3+ . No bladder stone palpated. I advised X-ray and S/D for 3 months.
Blood test. SGOT/AST 114 (<81 78="" 9.3="" br="" creatinine="" urea="">
July 10. Cannot pee. Owner sent the dog for X-rays at another practice. No stones seen.
Aug 13. The owner brought in the urine for test. pH 8, SG 1.020, Blood Trace, Bacteria +, amorphous phosphate 2+, Triple phosphate occasional
After July 10, no problems of urination or visible blood in the urine and so the owners were satisfied.
Dissolving of urinary crystals
My advice. S/D 3 months to dissolve the crystals. Urine test monthly. Then C/D dry.
PROBLEM
Dog will not eat the S/D.
Owner advised to feed 10% S/D and then add to become 100%. However, the owner bought S/D x 7 cans on Jul 6, 12 cans on Jul 20 and now 12 cans on Aug 13.
No dog treats given. Fed Pedigree Canned + rice in the past month.
CONCLUSION
The cat had no episodes of urination difficulty since Jul 10 todate. However, the mixture of S/D diet and other food did not dissolve the crystals as the owner needs to convert to 100% of S/D. I text the owner who says he will do it.
Aug 15, 2013. The husband phoned to see me in 20 minutes. I advised medication and review of the X-rays taken by another vet again. Many cases need monitoring and review but vets will have no "work-life" balance if they really review ever case and write case report to understand the effects of home management on S/D diet. In this case, S/D diet would have worked to eliminate the amorphous phosphate crystals in the urine if the owner had diligently converted the dog to 100% of S/D. As he did not, he still benefited in that the dog no longer had urination problem. But the latest urine test or the only one showed that blood, bacteria and crystals are coming back in the alkaline urine again. Many owners don't understand the technical use of S/D diets in dissolving the crystals by acidification of ther urine. So they don't comply since the dog will not eat it. The trick is to give 5% increasingly and consistently.
Let's hope this dog will be OK with the new motivation and participation of the owners, a couple in their late 50S
1077. The Jack Russell with ascites
August 13, 2013
I phoned the owner to bring the dog down for abdominocentesis. He had consulted Dr Daniel who told me that the owner did not want the fluid drawn out from the abdomen, just medication. Dr Daniel informed me what he had said.
"It is best you record in writing what you advised," I told Dr Daniel. "The medication will not remove the excessive fluid which also involved the lower chin and neck (peripheral edema). There was no peripheral edema during the first consultation. The abdominocentesis must be done first or the dog will die from difficulty in breathing."
The owner said he was very busy with his work. I told him that there would be no medical costs to him. A chronic disease like ascites can be costly and need proper management, review and medication. This dog does not appear to have heart, liver or kidney problems but no X-rays or more tests could be done owing to financial constraints of the owner.
So I got the dog hospitalised. Dr Daniel put him under isoflurane gas and withdrew over 1,500 ml of abdominal exudate. The dog was feeling well and paced inside the cage. 12 hours later, his abdomen started to swell again. Abdominal neoplasia is suspected to be the cause of ascites. I sent the abdominal exudate to the lab for analysis of cancerous cells.
I phoned the owner to bring the dog down for abdominocentesis. He had consulted Dr Daniel who told me that the owner did not want the fluid drawn out from the abdomen, just medication. Dr Daniel informed me what he had said.
"It is best you record in writing what you advised," I told Dr Daniel. "The medication will not remove the excessive fluid which also involved the lower chin and neck (peripheral edema). There was no peripheral edema during the first consultation. The abdominocentesis must be done first or the dog will die from difficulty in breathing."
The owner said he was very busy with his work. I told him that there would be no medical costs to him. A chronic disease like ascites can be costly and need proper management, review and medication. This dog does not appear to have heart, liver or kidney problems but no X-rays or more tests could be done owing to financial constraints of the owner.
So I got the dog hospitalised. Dr Daniel put him under isoflurane gas and withdrew over 1,500 ml of abdominal exudate. The dog was feeling well and paced inside the cage. 12 hours later, his abdomen started to swell again. Abdominal neoplasia is suspected to be the cause of ascites. I sent the abdominal exudate to the lab for analysis of cancerous cells.
1076. Torus palatinus in a woman
August 14, 2013
I thought it was a fast-growing tumour on the hard palate as a lady, in her 50s complained of pain in the roof of her mouth (the hard palate), around 1 week after general anaesthesia. The growth was rounded and around 3 cm x 5 cm x 2 cm.
"Check you tube for 'hard palate tumour'," I asked her son. Jason did and there were similar images on the hard palate and a movie of a surgery to remove it. It is called torus palatinus. It occurs in women over 30. A bony exostosis.
Today I asked a heartlander dentist with considerable years of experience. She examined the lady's rounded growth which has an ulcer. "Very common. I have seen thousands of them. Not to worry and no need to remove it. It is a torus." She prescribed a steroid cream for the ulcer. The lady had taken 20 mg prednisolone oral last night and was in great spirits today. She asked for more. "It is not going to cure," I told her. "Consult your surgeon." She left a message with the Singapore General Hospital surgeon who is fully booked to return her call. No reply from him. So she went to this heartlander dentist whom she knows for many years.
.
A torus palatinus. I don't see it in dogs in my over 30 years of practice. I am glad it is not a malignant tumour. "However, if the ulcer persists, it may need check up at the National Dental Centre," the dentist advised. "Pain is good. If you don't feel pain in a lump, it is not a good thing as it could be a cancerous growth." Somehow I don't understand her logic.
So much worries about oral cancer had evaporated now.
I thought it was a fast-growing tumour on the hard palate as a lady, in her 50s complained of pain in the roof of her mouth (the hard palate), around 1 week after general anaesthesia. The growth was rounded and around 3 cm x 5 cm x 2 cm.
"Check you tube for 'hard palate tumour'," I asked her son. Jason did and there were similar images on the hard palate and a movie of a surgery to remove it. It is called torus palatinus. It occurs in women over 30. A bony exostosis.
Today I asked a heartlander dentist with considerable years of experience. She examined the lady's rounded growth which has an ulcer. "Very common. I have seen thousands of them. Not to worry and no need to remove it. It is a torus." She prescribed a steroid cream for the ulcer. The lady had taken 20 mg prednisolone oral last night and was in great spirits today. She asked for more. "It is not going to cure," I told her. "Consult your surgeon." She left a message with the Singapore General Hospital surgeon who is fully booked to return her call. No reply from him. So she went to this heartlander dentist whom she knows for many years.
.
A torus palatinus. I don't see it in dogs in my over 30 years of practice. I am glad it is not a malignant tumour. "However, if the ulcer persists, it may need check up at the National Dental Centre," the dentist advised. "Pain is good. If you don't feel pain in a lump, it is not a good thing as it could be a cancerous growth." Somehow I don't understand her logic.
So much worries about oral cancer had evaporated now.
Ear abscess in a terrapin
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TOA
PAYOH VETS
Post op care after neutering the dog
EMAIL QUERY DATED AUG 13, 2013
Dear Judy,
I wish to enquire about the above process, the fees involved and the after surgery care.
Toby is 14 months old. Make Yorkshire terrier.
When can I make appointment for the surgery if I am only able to bring him down on weekends.
Best regards
Irene
------------------------------------------------------------------------------------------------------------
I am Dr Sing Kong Yuen. Thank you for your email. Weekend Sunday morning at 9.30 am is preferred. No food and water at 10 pm the night before. The dog goes home around 4 pm on Sunday.
The fees will be estimated to be around $200-$250. Post op care is to clean the wound details are at:
http://www.sinpets.com/F6/20110817dressing-stitch-removal-after-spay-neuter_ToaPayohVets.htm
Dear Judy,
Neutering a yorkie of 14 months
I wish to enquire about the above process, the fees involved and the after surgery care.
Toby is 14 months old. Make Yorkshire terrier.
When can I make appointment for the surgery if I am only able to bring him down on weekends.
Best regards
Irene
------------------------------------------------------------------------------------------------------------
I am Dr Sing Kong Yuen. Thank you for your email. Weekend Sunday morning at 9.30 am is preferred. No food and water at 10 pm the night before. The dog goes home around 4 pm on Sunday.
The fees will be estimated to be around $200-$250. Post op care is to clean the wound details are at:
http://www.sinpets.com/F6/20110817dressing-stitch-removal-after-spay-neuter_ToaPayohVets.htm
Tuesday, August 13, 2013
Monday, August 12, 2013
1072. Update: Oral mucosal mass - Mouth malignant tumour Sheltie
Sheltie, F, Spayed. 7 years old
Oral tumour recurred on Aug 4, 2013. Histology approved by owner. Dr Daniel saw 5 cauliflower growths, one being inside the throat
First cauliflower gum tumour removed on Mar 7, 2013 by Dr Daniel.
On Dec 29, 2012, a vet advised "try medication."
HISTOLOGY
Poorly differentiated malignant tumour including carcinoma, carcinosarcoma, malignant melanoma
Need immunohistochemical work-up.
Oral tumour recurred on Aug 4, 2013. Histology approved by owner. Dr Daniel saw 5 cauliflower growths, one being inside the throat
First cauliflower gum tumour removed on Mar 7, 2013 by Dr Daniel.
On Dec 29, 2012, a vet advised "try medication."
HISTOLOGY
Poorly differentiated malignant tumour including carcinoma, carcinosarcoma, malignant melanoma
Need immunohistochemical work-up.
1071. Toy poodle puppy with skin tumour - blood test
Poodle, M, 7 months
Blood test on Aug 10, 2013
Abnormal results are:
SGOT/AST 224 (<81 br="">Uric acid 0.20 (<0 .13="" br="">
Urea 12.2 (4.2-6.3)
Creatinine 81 (89-177)
Platelets 618 (200-500)
Wait for histology results.
Blood test on Aug 10, 2013
Abnormal results are:
SGOT/AST 224 (<81 br="">Uric acid 0.20 (<0 .13="" br="">
Urea 12.2 (4.2-6.3)
Creatinine 81 (89-177)
Platelets 618 (200-500)
Wait for histology results.
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