2495. Angel the cat is admitted for dysuria

1. Monday, Jul 13, 2015. The cat was admitted as the owner said he had difficulty in peeing. Bladder and urethral stones were removed some 7 days ago. The cat was given IV drips on Jul 10 and 11 and I discharged him on Saturday Jul 11, 2015 since he was eating. I took out his stitched urinary catheter as it is not good for the cat to have it for more than 3 days, in my opinion, as it irritates the bladder.  However, he ate little at home, the owner said and was worried.

Dr Daniel and I discussed his treatment. Perineal urethrostomy will be the last resort.

"There is bound to be inflammation in his urethra as he had urethral stones stuck at the bend of the urethra," I said. "The bladder is not much swollen as before, not as big as an orange. Pain killers and antibiotics will be needed."
The cat was given gas anaesthesia. Dr Daniel lavaged the bladder by sucking out the bloody urine (video). An injection of painkiller and antibiotic was given.

2. Tues July 14, 2015. The cat meowed when he saw me. His bladder was not swollen. He preferred to sit inside the litter box where there is sand, than outside the box. He ate when my assistant hand- fed feline C/D with water. The owner came to visit around 6 pm and was happy to see him.

 
This is a case of the intense inflammation inside the bladder and urethra as the owner had delayed seeking treatment, base on blood test result showing kidney failure and the much swollen and red bladder (image).

HISTORY

Ju1 2, 2015    Cannot pee, blood in urine. Surgery. urethral stones and bladder stones removed.
Jul  5             Dr Daniel sent home 2 days after surgery.

Jul 8              Vomiting and dysuria. Had kidney failure based on blood test of high creatinine and urea. Given 2 days IV drips

Jul 11            I sent home as he was eating.

Jul 13          Warded. Bladder lavage. urine analysis. Catheter not stitched. 

Jul 15          Bladder swollen 1/3 size of orange. Cat eats when hand fed dry feline C/D + water. Bladder lavage. urine analysis. Catheter not stitched.  Alert.

Jul 16          Bladder small like ping pong ball, painful.

2494. The most loved cat in the block has difficulty peeing

Previously able to run down 16 floors and climb up 16 floors after going outdoors. Last 2 months, would wait for the owner to come to look for her, maybe at the 3rd floor.
"Why would a cat climb up and down 16 floors of the apartment?" I was surprised.  The slim lady owner in her late 50s do that. That was why.

Today, Jul 14, 2015, her busy son took her and the cat to me for treatment. The cat could not pee on the litter box, just squatting but could pee on the bed and blankets when lying down.

What was the problem?

1. Everybody loves this cat as he meows when fed and meows to "thank" the giver after eating. "Other cats would just eat and go silently," the woman had never stayed apart from this cat.

2. "This cat has a good memory of going to the vets," she told me. "He would avoid getting into the car."

2493. Animal Welfare. The smartest street dog in Singapore

Jun 11, 2015

"She gave birth to 2 litters," the woman who was active in trapping stray dogs and bringing them to SOSD showed me a cross-bred. "My husband and I just cannot get her! She will  run away at the first hint of suspicious activity to trap her with a collar.  Do you have the sleeping tablets? The last time you prescribed one was ineffective! "

"You did not stay long to see the effect," I said. "The effect starts 30 min to one hour after eating the tablet."
"Well, another stray dog barked. She was feeling drowsy after taking the tablet. On hearing this barking, she bolted into the dense forest!"
 
The couple wanted to catch this dog to spay her so that no litters would be born. 1/6 (a white one) of the puppies were adopted as they looked handsome, with the long nose of the bull terrier and the face of the Golden Retriever.
The wife stated that the shelter would not accept more sick dogs for medical treatment.
"There is a limit to the money any shelter will have," I said. "In any case, you sent one day at night for treatment. Heartworm was diagnosed". How much was the bill?"
"
"Your $1,250 bill from the vet could have paid for treatment of other strays." I admonished her.
 

2492. The daughter-in-law does not want the shih tzu in her HDB

Sat Jul 11, 2015

"The daughter in law does not want the shih tzu to be inside the apartment," the matronly lady brought her dog for vaccination and said that the dog demanded a lot of time to be cared for. "She does not want any dog hairs inside the apartment as she has a baby."  The son and his girlfriend bought the puppy but now leave him to mum.

"A bit fat but well cared for," I said in Hokkien as that was her dialect. "Some tartar in the back teeth. Next year, will need dental scaling." The dog was groomed regularly. Only that the groomer did not express the anal sac. Full of dark brown smelly oil.

2491. A kind family adopted a Beagle

Saturday, July 11, 2015.

As part of the adoption agreement, the family brought the neutered Beagle under the care of Voices For Dogs to Toa Payoh Vets for a check up. I showed Intern Gin the procedures involved as her 2nd semester in Melbourne Univ Animal Health course will have a module "Animal Welfare". 

If she gets straight As in the 2nd semester as in the first, she should have no problem being admitted to the Vet course.

2490. A kind cat owner with a caterwauling "spayed" cat.

Sunday Jul 7, 2015.


This lady was very kind as she did not sue the vet who spayed her cat. A few weeks after spaying, the cat caterwauled. The vet gave her a strip of Ovarid tablets to be given whenever the cat makes noises. This happened around 4 times per year and after 2 years of medication, the cat became fatter.

The lady was worried about prolonged use of hormones such as kidney failure.
"You have only one alternative to hormonal control of heat," I said. "Surgery to open and look for the ovary or ovarian tissues which are near the kidney or kidneys. When the cat is on heat, as she is now, it may be easier to spot the ovarian tissues and take them out."

"What if the cat still caterwauls?" the Sec 4 daughter asked.
"No more caterwauling, if the ovaries are removed entirely."  .

The mother signed the Informed Consent form and op will be done tomorrow

Dr Daniel advised ultrasound to see whether the ovarian tissues can be found and near which kidney. Op is delayed till next heat.


HISTORY

1.  Around Nov 2012, Vet 1 spayed this cat.  In 2013, consulted Vet 1 as caterwauling started a few months after spay. She prescribed some Ovarid tablets, to give 1/4 tablet when caterwaul on Day 1 and Day 3.


2. Cat caterwauls 4x/year and next 2 years. Given tablet. Cat puts on weight. Sometimes clear vaginal discharge.

3. Last Ovarid given some months ago. Cat on heat now, Jul 12, 2015

2489. A Rottweiler has a few thousand ticks - VIDEO FOR INTERNS

Sunday Jul 12, 2015

Unusual to see a young Rottweiler with a few thousand adult and  nymph ticks attached to the face and body.

Sedation needed. 35 kg. 4-year-old dog.
Given 1/3 formula ie. Dom + Ket at 0.4 ml + 0.5 ml IV. Able to clip bald.

The owner had applied Frontline Plus spot on. The pest control man applied a white insecticide wash yesterday. So, all ticks were dead but the mouth parts clamp to the face and body skin. Took over 2 hours to clip and remove the dead ticks. Goes home on same day. This dog had a left dislocated hip repaired by another vet (closed reduction) when he fell into a drain.  He is OK now but still, the vet must be careful in case the hip dislocates and the owner blames the vet.


DE-TICKING AT TOA PAYOH VETS.
Dog safety and staff safety.
This dog looked thin and was probably poisoned by both Frontline Plus and Pest control man's insecticide.  The owner wanted the dog's ticks extracted from  the face and body. Looked horrible. One groomer suggested that euthanasia.

SEDATION. Minimum yet sufficient. This is hard to assess in a weakened toxic dog.
Formula: I gave 30% of the calculated dosage for this 35kg Rott.   0.4 ml + 0.5 ml Dom + Ket IV.
No top up. Dog muzzle when ticks plucked from face as he tends to bite.
"Topping up may kill the dog," I explained to Naing who was not so happy with the dog trying to get up and bite him. "Just muzzle him."   



FOLLOW UP ON JUL 13, 2015
The dog ate but was not as active.
QUARANTINE FROM ANOTHER DOG (X-bred F, 7 years rescued as a puppy from the Defu Industrial Park with cement-covered body).
The lady owner said the Rott had a few small ticks seen and was told to remove them manually. I did the clipping but no further tick wash as the dog had Frontline Plus 7 days ago and the pest control had applied insecticide on his body the day before.

The Rottweiler was enclosed in a playpen of 7 fences in a circle (diagram) on the car porch.
"He could just push away the fences, being such a strong dog," I said.
"No, he dared not go near the play pen," the lady replied.  Probably he had a lasting imprint of fright as a puppy when the playpen fence collapsed on him. So he dared not go near. That was good for the owner to quarantine him.

The other dog was quarantine but had few dead ticks.

PEST CONTROL
Yesterday
1. Sprayed insecticide mist on grass, walls, floors of car porchs, play pens, perimeter of home, and not indoors as there was no ticks indoors.  Lady said about 95% effective as she saw few ticks.

2. Advised to tell the mum not to eat the papayas and pandan leaves in the garden as they will be contaminated with spray and from soil.

EPIDEMIOLOGY
Both dogs have no ticks for past 7 years.
Rott does not go outdoors except to the vet when he had right hip dislocation and surgery. On the follow up visit, the owner saw a large adult female tick which was removed.
X-bred, never visit vet since puppyhood 7 years ago. She goes out 3X/day by herself for 10 minutes. But no ticks for past 7 days. No more use of Frontline since 4 years ago for this X-bred. Rott never had any Frontline Plus. Both roam around the garden but the X-bred seemed immune. Given Frontline Plus on Jul 5 to both dogs, when Rott discovered to  have ticks from the Vet clinic. X-bred had dead ticks on inspection after Frontline Plus on
When Rott had ticks at 2nd follow up visit some 3 weeks ago, Frontline Plus given to both dogs. But Rott's face became infested with ticks. Whole body and neck area plugged with grey adult female ticks around 1 cm x 0.8 cm.

OWNER TREATMENT OF ROTT
1. Advantix 2 X at once a month after seeing ticks from Vet clinic.
2. Frontline Plus 1X
3. X-bred clear of ticks. Rott has some small ticks, now plucked off.

2488. 13-year-old cat has a recurring below right eye abscess -microbiological exam

Jul 3, 2015

Culture

Moderate growth of Lancefiled Group G Streptococcus
Susceptibility Results

Resistant to tetracycline
Sensitive to amoxycillin+clavulanic acid, erythromycine, penicillin, clinadmyain, azithromcyin, ampicillin, ofloxacin,clarithromycin.

2487. An FIV cat meowed and passed away at 6.34pm

Jul 10, 2015

The cat was diagnosed FIV +ve on Jun 23, 2015. The owner visited every evening at around 5.30 pm.Today, she panted rapidly, meowed once to the owner and passed away at 6.23pm.The lady owner said that the cat waited for her before passing away. Private individual cremation was her request so that the ashes would be the cat's.

A 14-year-old Jack Russell has canine lymphoma

Jul 10, 2015

TP 16462

Female JR, 14 years
All lymph nodes enlarged (video) but active and eating.

Blood test
Hb 12.3  (12-18)
Red cell count 5.4 (5.5-8.5)
Haematocrit  (PCV)  0.34  (0.37-0.55)
Platelets  217 (200-500)

Total WCC   11.5   (6-17)
N = 45.3 % (60-70%)     Absol 5.21
L  = 26.6%                         Absol 3.06
M  =23.5%                        Absol  2.7
E  = 2.5%                          Absol  0.29
B  = 2.1%                          Absol 0.24




Hb & RBC - lower than normal ---  anaemia coming
                      bone marrow biopsy

Tests:  lymph node biopsy or excision biopsy, bone marow biopsy, x-rays chest and abdomen


Standard chemotherapy   3 drugs + pred, 25 weeks. IV. Weekly visit to vet.   Costs more than $7,000 done by another vet practice. Advised not a cure. Remission.
Immuran + pred?