1416. Recurring cheek tumours in a dwarf hamster

Sunday Jul 20, 2014

A young couple with a daughter and son in primary school brought an overweight 14-month-old dwarf hamster, too heavy for the exercise wheel, for surgery.

"His medical bills cost more than a person," the father said. "Three times every 2 months, the cheek tumours grow. Shall we put the hamster to sleep?"

We did not say a word. We were dead serious on euthanasia.  Our answer will be "No" but the patriarch has to decide. He who pays the piped piper calls the tune.

The pretty slim tanned little girl with long hair and black eye brows in a rectangular framed face would be 10 years old and her sibling would be 7 years old.  What will the father decide?  The use of CPF monies for the treatment?


Can this fat hamster take another anaesthesia?  So heavy. He stuffed his cheek pouches with meal worms.

"He could eat 50 worms a day," the father said.
"No wonder he puts on so much weight. 65 grams bodyweight is too much. 45 grams will be ideal," I said.   

Electro-excision of the cheek tumours by Dr Daniel. Two 4/0 dissolvable stitches close the skin wound.  The father was given the tumours inside a formalin-bottle when he came for the hamster in the afternoon. A very kind father, I was surprised as some Singaporeans would request euthanasia.

"These could be fatty tumours," I advised the father to cut out the meal worms and slim the hamster to 45 g.   

1417. Follow up on ChihuahuaX with carnaissal tooth abscess

Sunday Jul 20, 2014

I was reviewing all cases and at 11.10 am,  phoned the owner of this Chihuahua who had a non-healing facial wound, sneezing, losing appetite and lethargy before treatment at Toa Payoh Vets on Jun 30, 2014.

He was one of the oldest chihuahuas with this abscess and survived the anaesthetic. Once the left upper premolar 4 was extracted, and also the premolar 3 next to it, the dog went home.

"How long it took the hole to close?" I asked the lady owner who answered my phone on this bright sunny Sunday.

"It is closed now, but it took a few days," she replied. "More energetic, eating, no more sneezing, just as normal as a dog!"

Dr Daniel did the dental scaling and the extraction, a routine job. He delivered a live dog at the end of anaesthesia and so the owner is most happy. I advised isoflurane + O2 gas anaesthesia only and he did that. A very old dog is best not given injectable anaesthestic no matter how small the dose. 

It will be best to have dental check up every year but many Singaporean owners don't bother to do so.

VIDEO -3 dogs had similar medical condition within a few days. One of them is shown in video below.  After that, no more cases.

1416. An adopted dog sneezes and coughs

July 19, 2014

"This dog is very thin," I examined the male, neutered, 5-year-old Shih Tzu adopted from a humane shelter. He had tearing eyes and runny nose. He was sneezing and coughing and had been like that for the past 7 days. He was a lethargic type, not active at all.

"Has the dog been vaccinated?" I checked his gums and they were pale. His teeth were crusted with tartar. 
"Yes," the wife said. "In June."
"It is only 3 weeks since the vaccination and the dog could have been infected with the kennel cough virus or other germs. A blood test must be done as this dog is very thin."

BLOOD TEST
Two abnormalities.
1 .Low red blood cells, haemoglobin and platelets. This is highly suspicious of tick fever.
2. High urea and low creatinine.

"A dog does not need to show fever to have tick fever," I advised checking for Babesiosis. The owner wanted to wait and see, giving the antibiotics and heart medication first. There was a Grade 3 left mitral valvular disease which may cause coughing.

1415. What to do? Fully obstructed urethra in a Yangon dog with urinary stones.

I proposed cystotomy. Make a 3-4 cm cut in the bladder,  to drain the severely distended bladder and to make a fistula (hole from bladder to the midline) to the midline. This permits time to remove the urethral stones.

1414. Bone cancer in a Jack russell

July 18, 2014

Emaciated. Fast-growing hard lump on the left upper arm. X-rays.

X-rays
Lysis or periosteal reaction of the upper 1/3 of the humeral bone indicate a likelihood of neoplasia.

1413. The old Pom keeps panting for the past 3 days, worrying the owners

I had a case of a Pom with heart disease in 2009. The article is at:
http://www.bekindtopets.com/dogs/20090923Heart_Failure_Young_Pomeranian_ToaPayohVets.htm







July 18, 2014

This 14-year-old Pom kept panting and panting. So nobody could sleep at night. The owners decided to consult me. 3 years ago, she survived closed pyometra surgery and I had not seen her. But Singapore owners do doctor hop as 3 days ago, a sister took this old Pom to see Vet 1 for a hind leg limping. I checked with Vet 1.  Vet 1 prescribed Tramadol tablets only. No record of panting.

So, this was a recent thing. "5 days of panting and whining,"the brother said.  "3 days on and off panting,"the sister said.

Old dog. Heart disease. Rotten teeth are painful and would be a cause of whining.
I did a physical examination. A Grade 1 (very soft) mitral heart valve murmur or none.

This could be a case of adverse reaction to Tramadol. The dog did drool and lost appetite.
I advised dental extractions some 2 weeks later, after antibiotics, but it is up to the owners.

As at 3rd day after treatment, the owners have no complaints. The dog had not pooped on going home after one day of in-patient treatment but is OK.  No panting.

1412. A Roborovski has a rectal prolapse

1411. A 14-year-old Pom has been panting and whining for the past 5 days

July 16, 2014

"3 days ago, my Pom had limped on her left hind leg," the man said. "My sister consulted Vet 1 and he prescribed Tramadol tablet to be eaten. But she keeps panting and whining despite medication."
"The dog is no longer lame," I saw her walking normally on the floor of the consultation room. "How long had she been panting and whining?"
"For 5 days."

Dogs in pain can't speak. This 14-year-old Pom was restlessness and had heavy panting, fast heart rate, shaking and whining. She had poor appetite but would eat if hand fed. Based on the findings, Vet 1 determined that Tramadol was a good painkiller to give.

But the dog was still having difficulty breathing.


SIDE EFFECTS OF TRAMADOL
Tramadol is an effective pain killer used as an alternative to NSAID. Mild side effects include nausea, vomiting, constipation, dizziness, drowsiness, and panting. A drop in heart rate and constricted pupils may be present.

This dog has panting and whining and X-rays shows "constipation" as food keeps lodged in the stomach filling it to the brim (image) after 2 days of Tramadol.

So was the panting due to the pain or side effect of Tramadol? I got Vet 1 's medical record. He did not mention panting during the visit.

1410. An old Jack Russell has a large tear duct swelling

3 years ago, the swelling below the lower eyelid of the left eye was smaller and soft. I incise and drain it (illustration). The owner did not want histology. The tentative diagnosis was an abscess.

Now, 3 years later, the swelling has grown much bigger in size.

I advised surgical excision of the firm and painless growth before it becomes much bigger and infected. The dog would then rub it and be in pain. The lump may be sent to the laboratory for histological examination of malignancy.

The owners said that the dog is old and would wait and see.  

1409. Intern to produce Video for Myanmar Vet Univ: Spaying a cat - 3-haemostat method by Dr Sing Kong Yuen

Saturday Jul 11, 2014

A Malay family from Chua Chu Kang brought in the 3rd female cat for spay. A beautiful white and grey cat, 1.5 years old. They don't want any vaccination.

I got an educational video made by my assistant Naing for vet students, showing how I spay this cat using the 3-haemostat method. The cat was on heat as you can see enlarged ovarian blood vessels. Incision is around 2 cm from the umbilical scar.

3.8 kg cat. Xylazine + Ketamine 0.2 + 0.8 ml IM.
First skin incision to skin stitched was 25 minutes.
Injection of induction drugs to skin stitched  49 minutes.

Spaying a caterwauling cat requires extra care and takes a  longer time.


Intern
Produce a "How to" spay a cat teaching video for a proposed Myanmar Vet University lecture

GUIDELINES
PROCESSES by Dr Sing Kong Yuen

1. History. EDUS (Eat, Drink,Urine, Stools). Vaccination or not. Caterwauling? 
2. Physical examination. Body weight, Rectal Temperature, Pulse Rate, Respiratory Rate.
3. Injectable anaesthetic. Xylazine + Ketamine IM
4. Clip abdominal hairs
5. Prepare clipped area for surgery

Each vet has his or her own way. 
6. Incise 1.5 cm from umbilical scar
7. Skin incision 1.5 cm
8. Cut away fatty tissue
9. Cut linea alba
10. Spay hook to the right
11. Hook out left ovary
12. Place ligature under lowest forceps
12. Remove lowesst forceps and tighten ligature in the grooved tissues.


ILLUSTRATION 3-FORCEP METHOD.
co-related to actual video clip.

STUMP PYOMETRA IN A YANGON CAT
GIVEN CONTRACEPTIVE DEPO-M OR CONTRACEP

CAT'S STUMP PYOMETRA REMOVED BY DR AUNG OF ROYAL ASIA VETERINARY SURGERY

YANGON CAT DEVELOPS PYOMETRA AFTER DOSES OF MEDO-M OR CONTRACEP FOR SOME WEEKS.  THE CULTURE IN THE PAST IS THAT OWNERS DO NOT WANT TO SPAY THEIR CATS BUT PREFER CONTRACEPTIVE INJECTIONS EVERY 3 MONTHS.

THE CAT GIVEN DEPO-M DEVELOPS PYOMETRA AS IN THIS YANGON CAT



ACCURACY AND COMPLETENESS IN A SPAY SURGERY MEANS COMPLETE REMOVAL OF THE OVARIAN TISSUES.  NOT LEAVING AN OVARY INSIDE THE ABDOMEN OR OVARIAN REMNANTS INSIDE AFTER SPAY.  



 

 

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