2906*****. Entropion surgery in an adopted 3-year-old Chow Chow & a Shih Tzu

Case 1.
HISTORY

2982. Searching for an entropion veterinary surgeon for a Chow Chow

Tuesday July 26, 2016

The 2-year-old Chow Chow was abandoned. He could barely open his eyelids to see and would bang into objects. Thick pus crusted his eyes. The couple who adopted him brought him to see around 6 vets. After consultation, the vets said they did not do entropion surgery.

"You phoned the vets by alphabetical order?" I asked. "Toa Payoh Vets would be at the bottom of the list."

"We googled entropion vets" the wife said. "We did consult an eye specialist but we need to wait for many weeks for our turn."

The 26-kg Chow Chow was particularly nervous and would not sit still for examination. Sedation with Domitor + Ketamine IM at 0.3 + 0.3 ml IM sedated him a bit and a blood sample was taken for health screening before the operation next week. The dog was given the first vaccination as I doubt he had been re-vaccinated since he was thrown out to the streets till adopted by this couple.   

Aug 8, 2016

Chow Chow could open his eyelids a bit after 10 days of antibiotics and is "more active" according to the happy couple.

"Why is there a red spot in his left eye?" the wife asked, after the entropion surgery. "It is a big corneal  growth of around 4 mm across, due to the past 3 years of irritation by inrolled eyelashes and was present before the surgery," I said. I got some images to prove it but these were not necessary. The dog's eyes were shut tight for the past 3 years as the upper and lower eyelids rolled into the cornea 180 degrees and the eye pain was excruciating.

Case 1.  TWO VIDEOS. An adopted 3-year-old Chow Chow has entropion.  Pre-operation examination.
A severe case of entropion in the Chow Chow. The dog has bacteria in the blood due to chronic eye infections. After 10-14 days of antibiotics, the dog can open his inward-rolling eyelids a bit more. However, this is temporary. A permanent solution is surgery to roll out the eyelids so that the dog has no eyelashes inwardly poking the cornea as in the present case of entropion.

Two pre-op videos

Post-op video one hour after surgery

UPDATE IN JULY 16, 2019

The owner is very satisfied with the outcome of the entropion surgery. I had not seen him as he goes to the vet clinic near his residence. However, he wanted a second opinion on the big swollen right hind knee of his Chow Chow who fell from the stairs. Hence I was able to find out the outcome of my entropion surgery 3 years ago and took the following image:

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DRAFTS

https://www.youtube.com/watch?v=0AuCJIDJ62g
https://www.youtube.com/watch?v=deNtDlQ3F_o

A 2.5-year-old adopted Chow Chow has severe entropion - physical examination and blood test show bacterial infections 

https://www.youtube.com/watch?v=2xPBbTDB848


POST-OP SHOWS EXCELLENT OUTCOME OF ENTROPION SURGERY
https://www.youtube.com/watch?v=bZnbIuBeo1s




Case 2.  VIDEO OF CHOW CHOW PUPPY WITH ENTROPION.
https://www.youtube.com/watch?v=h9_keIynvzY

Case 3. VIDEO. A CHOW CHOW HAS NO ENTROPION.

https://www.youtube.com/watch?v=azkeiHatXGo

Case 4. Final Video.  A Chow Chow has fits, skin disease and entropion.

https://www.youtube.com/watch?v=U1raKHDK9Bs

Case 5. A Chow Chow has ringworm infection, no entropion now

https://www.youtube.com/watch?v=J7_9Aas_KZA


Case 6. Entropion surgery in the Chinese Shar pei

http://www.bekindtopets.com/dogs/20100151Entropion_Shar_Pei_Pups_ToaPayohVets.htm

MORE IMAGES BEFORE SURGERY

VIDEOS - BEFORE SURGERY

POST OPERATION ON AUG 8, 2016
It was fortunate for the Chow Chow that the new owner got him in for surgery.

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Poster of Chow Chow at a retail shop in Tiong Bahru Plaza in Feb 2018

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A SHARPEI HAS ACQUIRED ENTROPION

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IMAGES FOR ENTROPION CHOW CHOW

F:\20180101TPVS_JAN-MAR\20180202mushrooms_solitary_bloom_today


Day2 surgery done

2905. Functional ileus in a rabbit that stopped eating suddenly

Sunday. August 7, 2016

Yesterday, a rabbit stopped eating suddenly at 9am. A few soft stools were passed. The young couple rushed to Toa Payoh Vets before 12 noon.  Abdominal distension.



X-rays taken. The X-rays show a "halo" effect which is gas inside the stomach filled with ingesta.

Ultrasound done today Aug 8, 2016 at 9.30 am. The rabbit was eating and pooping already. Ultrasound showed gas in the stomach and intestines. Lots of solid faecal lumps seen.  No neoplasia, stones seen in abdomen. Liver and kidneys appeared OK but blood test will be needed to check their health. 

Possible functional ileus.

There are many causes of ileus in rabbits. The main cause is low fibre diet. Other causes are fur balls and fibres from carpets, rugs and other objects causing obstruction.  Pain e.g. molar spurs, diseases e.g. kidney and liver infections, stress or obesity leading to inactivity.

Treatment:
Pain killer, antibiotic, SC fluids *(Hartmann's at 50ml/kg/day), oral fluids, syringe feeding high-fibre formulas and critical care. Gastrotomy to remove the dehydrated ingesta in severe cases.

Prevention:
High fibre diet. Exercise. Grooming the rabbit daily.


*Daily fluid for rabbits is 120 ml/kg/day

Video of ultrasound - Done 24 hours after treatment
Rabbit was eating and poopping normally
Gas in stomach and intestines
Faecal pellets seen

2904. Acquired entropion in a Sharpei

There are 3 Sharpei siblings now around 3 years old. Only this one has two entropion eyes

2903. INTERN RI. When to do an emergency canine Caesarean section? A 64th-day pregnant poodle has dystocia

A 64th-day pregnant poodle had dystocia. "The rectal temperature was 36 degrees in the morning," the Myanmar assistant of the breeder said to me." He has remembered my teaching to monitor the rectal temperature. Once the temperature drops below 38 deg C and will then go up again, the birth is imminent. 
 

The contractions started at 10.30 pm but no pups seen. Breeder decided to phone me at 12 midnight for an emergency Caesarean secrrion. One pup was born outside the Surgery before I arrived. Two pups were delivered by C-section. One of the two was still born. The placenta had melted to a thcik viscous greyish green material.  Any delay would mean decomposition of the dead pups and a foul stench. There was no foul smell in this case and so the .


The 2 pups in this image are the live pups. .

The dam has no milk for the next 2 days post op. The pups were nursed by another dam. After 2 days, their mother had milk production and now the pups are OK.


Dr Sing Kong Yuen's guidelines from his Scottish professors for the gestation period of the dog is 59 - 63 days.


EXAMPLES

CASE 1. 58th day pregnant. Too many puppies. elective C-section saves the pups

2902. A 15-year-old Golden Retriever from Pasir Ris vomited for 6 days and had a thick discharge for 4 days

Jan 14, 2014

13-year-old female, 24 kg Golden Retriever, not spayed, never pregnant vomited daily for 6 days. Past 4 days, passed out a thick reddish brown vaginal discharge daily.

"Loss of appetite, drank and peed a lot," the owner confirmed that her heat was 2 months ago.
"Your dog I palpated 4 cm across swollen uterine tubes suggestive of a womb infection called open pyometra."

The dog was operated and was OK.

Since the owner lived in Pasir Ris which is distant from Toa Payoh and there are several nearby clinics, I don't expect to hear from her again


On Jun 14, 2016,  her French bulldog, 8 years, female, spayed had a mast cell tumour, high grade, Grad 2, of a 50-cent coin size excised by another vet 6 months ago. Chemotherapy was not acceptable and now several lymph nodes were enlarged. Blood test 3 days ago showed an increased reticulocytes, white cells, neutreophils, monocytes and decreased platelets, ALKP. The owner wanted a second opinion. The prognosis was very poor and euthanasia was performed.

"Do you remember the Golden Retriever you did operation for pyometra?" the owner asked. I referred to my case sheet. "She is well but can still go to the toilet. She had blood in the urine."

I was happy that the Golden Retriever has survived to 15 years of age now. I prescribed pain medication for suspected hip arthritis (4 days on, 4 days off) and medication for urinary tract infection after a urine test. The owner got a urine sample. It was amber and slightly turbid urine.

Test showed pH 9, SG 1.045, protein 4+, blood +, ketones +, triple phospate crystals occasional, bacterial 3+ with red and white cells present in large numbers.  "The dog may have bladder and kidney stones," I said and did not advise X-rays since the dog was not present and to save money. "Since she is so old, I advised the Hills C/D diet to dissolve the crystals and we will wait for 2 weeks. If no more blood in the urine, then continue C/D for life." 

August 3, 2016. The owner texted to order the C/D and the pain killers for the Golden Retriever. So, the outcome was satisfactory as there was no longer blood in the urine. I am happy for the dog. She survived a major pyometra surgery and is now living a normal quality of life. The owner will submit another urine sample for testing and this should be right thing to do. A blood test will be better to check on the liver and kidneys but it may not be possible.