Jan 27, 2017 Rabbit goes home. Sling up left hind
Thursday, January 26, 2017
3012. A 3-year-old female rabbit dislocates left hip X-rays
Jan 27, 2017 Rabbit goes home. Sling up left hind
Wednesday, January 25, 2017
Jan 25, 2017
A case study of the usefulness of Rimadyl in helping the old dog to walk
TP 45772
Jane, Golden Retriever, FS, 16 years (born 2001).
Lives in North Singapore
First consultation Jan 14, 2015 Dr Sing Kong Yuen
24kg anorexia 6days vomit once, PD/PU
Thick reddish brown vaginal discharge past 4 days
Uterine horn 4 cm across palpated.
Open pyometra at 13 years of age.
.
Jun 14, 2016
Jane. 14 years old
Hip pain but can walk to bathroom.
Blood in the urine. I advised giving me a urine sample as dog is large breed
and inconvenient to come
Jun 14, 2016 Rimadyl 75 mg x 15 tab/ 1.25 tab per day for 4 days on, 4 days off. To effect.
Sep 19, 2016 Rimadyl 75 mg x 10 tab
Dec 6, 2016 x 20 tab..
Jan 23, 2016. Complaint WhatsApp A lot of difficulties walking. More painkillers, what can we do to help her? she still has a good appetite.
Jan 24, 2017. Came to buy Rimadyl and a medium bag of C/D in case the dog cannot survive.
My advice: need to increase dosage and decrease weight. What is Jane's weight? 28 kg.
Rimadyl 28 x 4.4 mg = 1.5 tab/day for 4 days to effect. To review effect of drug first. .
---------------------------------------------------------------------------------------------------
Urine test
slightly turbid, pH 9 (alkaline), SG 1.045
Protein 4+, Ketone +, Blood 4+, Triple phosphate crystals occasional, bacteria 3+
Baytril x 2.5 tab x 4 days. Trimax x 1/2 bid x 10 days
I advised acidification of the urine using prescription diet Hills' C/D.
From Jun 22, 2016 to Jan 25, 2017 - strictly on this diet. No complaint of haematuria.
CONCLUSION
2 cases of lame senior big breed dogs over 16 years old much loved by the owners.
.
In this case and another case of a X-bred 17years old, the dog is still eating but has bad hips.
So the kind owner did not elect euthanasia and has a lot of care-giving of aged dogs to execute..
A case study of the usefulness of Rimadyl in helping the old dog to walk
TP 45772
Jane, Golden Retriever, FS, 16 years (born 2001).
Lives in North Singapore
First consultation Jan 14, 2015 Dr Sing Kong Yuen
24kg anorexia 6days vomit once, PD/PU
Thick reddish brown vaginal discharge past 4 days
Uterine horn 4 cm across palpated.
Open pyometra at 13 years of age.
.
Jun 14, 2016
Jane. 14 years old
Hip pain but can walk to bathroom.
Blood in the urine. I advised giving me a urine sample as dog is large breed
and inconvenient to come
Jun 14, 2016 Rimadyl 75 mg x 15 tab/ 1.25 tab per day for 4 days on, 4 days off. To effect.
Sep 19, 2016 Rimadyl 75 mg x 10 tab
Dec 6, 2016 x 20 tab..
Jan 23, 2016. Complaint WhatsApp A lot of difficulties walking. More painkillers, what can we do to help her? she still has a good appetite.
Jan 24, 2017. Came to buy Rimadyl and a medium bag of C/D in case the dog cannot survive.
My advice: need to increase dosage and decrease weight. What is Jane's weight? 28 kg.
Rimadyl 28 x 4.4 mg = 1.5 tab/day for 4 days to effect. To review effect of drug first. .
---------------------------------------------------------------------------------------------------
Urine test
slightly turbid, pH 9 (alkaline), SG 1.045
Protein 4+, Ketone +, Blood 4+, Triple phosphate crystals occasional, bacteria 3+
Baytril x 2.5 tab x 4 days. Trimax x 1/2 bid x 10 days
I advised acidification of the urine using prescription diet Hills' C/D.
From Jun 22, 2016 to Jan 25, 2017 - strictly on this diet. No complaint of haematuria.
CONCLUSION
2 cases of lame senior big breed dogs over 16 years old much loved by the owners.
.
In this case and another case of a X-bred 17years old, the dog is still eating but has bad hips.
So the kind owner did not elect euthanasia and has a lot of care-giving of aged dogs to execute..
3010. A 17-year-old X-bred has a right hip bed sore
Jan 24, 2017
The dog was adopted from a shelter on Jan 23, 2000 and so the lady owner declared that to be his birthday. He was probably 4 months old. 17 years flew by. He had greater difficulty getting up to go to the bathroom but the owner persevered in lifting him up to walk to the bathroom.
"Lately, his front toes curled inwards," the owner told me. "He barks at night and I had to calm him down."
The 4 cm x 3 cm oval left hip sore was weeping.
The treatment was to close the wound as it appeared fresh. The caudal edges were black and the pink muscles could be seen.
"Anaesthesia using gas is the safest," I said. "No injectables."
The owner signed the anaesthesia consent form with apprehension that the dog would die on the operating table.
.
The dog was weak and did not struggle when put on the nose cone to smell the gas.
"For very old dogs," I taught my assistant who had little experience in very old dog anaesthesia
and needed to be mentored.
Do not monitor his depth of anaesthesia as a young dog," I elaborated. "A young dog needs a longer time to be anaesthesized and is unlikely to die. For this oldie, the time taken is less than half. If you monitor as if he was a young dog, he might be dead.
A Z-plasty was done to close up the hole. All was OK and the dog went home.
The challenges of barking and needing to be carried or slung to go to the bathroom are stressful.
BLOOD TEST
Total white cell count *30.5 (6-17)
N *97.6% (60-70%) Absolute 29.8
L 1.6% Absolute 0.49
M 0.8% Absolute 0.24
E and B normal
Red cell count *4.7 (5.5-8.5)
Haemoglobin *10.3 (12 - 18)
Haematocrit PCV *0.30 (0.37 - 0.55)
Platelets 409 (200-500)
ALT 79 (less than 59)<59 br="">
AST 85 (less than 81)<81 p="">
Bacteraemia and anaemia. Advised antibiotics and anaemia treatment.
The dog was adopted from a shelter on Jan 23, 2000 and so the lady owner declared that to be his birthday. He was probably 4 months old. 17 years flew by. He had greater difficulty getting up to go to the bathroom but the owner persevered in lifting him up to walk to the bathroom.
"Lately, his front toes curled inwards," the owner told me. "He barks at night and I had to calm him down."
The 4 cm x 3 cm oval left hip sore was weeping.
The treatment was to close the wound as it appeared fresh. The caudal edges were black and the pink muscles could be seen.
"Anaesthesia using gas is the safest," I said. "No injectables."
The owner signed the anaesthesia consent form with apprehension that the dog would die on the operating table.
.
The dog was weak and did not struggle when put on the nose cone to smell the gas.
"For very old dogs," I taught my assistant who had little experience in very old dog anaesthesia
and needed to be mentored.
Do not monitor his depth of anaesthesia as a young dog," I elaborated. "A young dog needs a longer time to be anaesthesized and is unlikely to die. For this oldie, the time taken is less than half. If you monitor as if he was a young dog, he might be dead.
A Z-plasty was done to close up the hole. All was OK and the dog went home.
The challenges of barking and needing to be carried or slung to go to the bathroom are stressful.
BLOOD TEST
Total white cell count *30.5 (6-17)
N *97.6% (60-70%) Absolute 29.8
L 1.6% Absolute 0.49
M 0.8% Absolute 0.24
E and B normal
Red cell count *4.7 (5.5-8.5)
Haemoglobin *10.3 (12 - 18)
Haematocrit PCV *0.30 (0.37 - 0.55)
Platelets 409 (200-500)
ALT 79 (less than 59)<59 br="">
AST 85 (less than 81)<81 p="">
Bacteraemia and anaemia. Advised antibiotics and anaemia treatment.
Sunday, January 22, 2017
3009. A 3-year-old cat has diabetes
Jan 21, 2016
Complaint of left hind limb lameness. Neuropathy or damage to the hind limb nerves can occur in feline diabetes. Cats present with hind limb paralysis or weakness.
Tel on Jan 26, 2016
Owner happy with outcome of insulin injections SC at 4IU/kg. Cat 5.3 kg
1. No limping
2. More energetic
3. Not so hungry for food as before
4. Drinks normal amounts but did not measure volume (home monitoring for diabetes). Advised to give 300 ml and see how much consumed per 24 hours.
5. Food divided into 2 portions and fed after CANINSULIN insulin injection at 7 am and 7 pm (working and therefore unable to give 2nd injection 8 hrs after first as advised by some experts.
SIGNS OF DIABETES
1. Eats a lot
2. Drinks a lot
3. Pees a lot
4. Lose weight
Blood and urine glucose high.
CAT
Blood glucose 13.5 mmol/L
(3.9 - 6.0) from Quest Lab
(5.5 - 10) from another report.
Hb 7.4 (9-15)
RBC 4.8 (5-10)
URINE
pH 7.0 (5-9)
SG 1.028 (1.005-1.030)
Glucose 3+ (normal should be 0)
Blood trace
White blood cells 5/uL
Red blood cells 4/uL
Normal glucose level (3.9 - 6.0) Quest Lab
Normal urine No glucose
CAT
Normal glucose level 100 - 180 mg/dl (5.5 - 10 mmol/L) in another report, not Quest Lab which is 3.9 to 6.0
Normal urine No glucose
DOG
Normal glucose level 80 -120 mg/dl (4.4-6.6 mmol/L)
Normal urine No glucose
Caninsulin SC 2x/day for this cat. But it lasts around 8 hours, not 12 hours.
ProZinc (protamine zinc recombinant human insulin) last 12 hours but are not available in Singapore.
The owner gives 12 hourly injection of Caninsulin as he works and has no time for 8 hourly. as recommended in cats. Caninsulin recommends around 8.30 am and 5.30 pm injections 2 x/day.
Dietary changes (low carbohydrate diet) - weight and 2 portions after insulin injection
May take a month or more to achieve good regulation
Unlike dogs, some cats may go into remission and therefore do not need insulin injections by eating a good quality low carbohydrate diet. This is because 80-95% of diabetic cats suffer from Tupe 2 (insulin resistance) diabetes and therefore dietary control will do. Type 1 diabetes is due to lack of insulin and is common in dogs.
However, initial treatment is by insulin injection and dietary control and home monitoring of blood glucose levels using blood glucose meters.
Blood glucose meters are used to accurately monitor the blood glucose level but most owners do not want to do it.
Complaint of left hind limb lameness. Neuropathy or damage to the hind limb nerves can occur in feline diabetes. Cats present with hind limb paralysis or weakness.
Tel on Jan 26, 2016
Owner happy with outcome of insulin injections SC at 4IU/kg. Cat 5.3 kg
1. No limping
2. More energetic
3. Not so hungry for food as before
4. Drinks normal amounts but did not measure volume (home monitoring for diabetes). Advised to give 300 ml and see how much consumed per 24 hours.
5. Food divided into 2 portions and fed after CANINSULIN insulin injection at 7 am and 7 pm (working and therefore unable to give 2nd injection 8 hrs after first as advised by some experts.
SIGNS OF DIABETES
1. Eats a lot
2. Drinks a lot
3. Pees a lot
4. Lose weight
Blood and urine glucose high.
CAT
Blood glucose 13.5 mmol/L
(3.9 - 6.0) from Quest Lab
(5.5 - 10) from another report.
Hb 7.4 (9-15)
RBC 4.8 (5-10)
URINE
pH 7.0 (5-9)
SG 1.028 (1.005-1.030)
Glucose 3+ (normal should be 0)
Blood trace
White blood cells 5/uL
Red blood cells 4/uL
Normal glucose level (3.9 - 6.0) Quest Lab
Normal urine No glucose
CAT
Normal glucose level 100 - 180 mg/dl (5.5 - 10 mmol/L) in another report, not Quest Lab which is 3.9 to 6.0
Normal urine No glucose
DOG
Normal glucose level 80 -120 mg/dl (4.4-6.6 mmol/L)
Normal urine No glucose
Caninsulin SC 2x/day for this cat. But it lasts around 8 hours, not 12 hours.
ProZinc (protamine zinc recombinant human insulin) last 12 hours but are not available in Singapore.
The owner gives 12 hourly injection of Caninsulin as he works and has no time for 8 hourly. as recommended in cats. Caninsulin recommends around 8.30 am and 5.30 pm injections 2 x/day.
Dietary changes (low carbohydrate diet) - weight and 2 portions after insulin injection
May take a month or more to achieve good regulation
Unlike dogs, some cats may go into remission and therefore do not need insulin injections by eating a good quality low carbohydrate diet. This is because 80-95% of diabetic cats suffer from Tupe 2 (insulin resistance) diabetes and therefore dietary control will do. Type 1 diabetes is due to lack of insulin and is common in dogs.
However, initial treatment is by insulin injection and dietary control and home monitoring of blood glucose levels using blood glucose meters.
Blood glucose meters are used to accurately monitor the blood glucose level but most owners do not want to do it.
----------------------------------
3040. A 3-year-old cat is diabetic
The complaint was a big lump in the hind leg of this 3-year-old cat that was limping. Blood test showed high blood glucose. Urine test showed glucose. The lump would be due to hind limb neuropathy which is a symptom in diabetes mellitus in cat.
On further questioning, the owner said that the cat was always looking for food, drank and peed a lot.
After insulin injections, the cat's lump disappeared and she was no longer ravenous, thirsty or urinating a lot.
On further questioning, the owner said that the cat was always looking for food, drank and peed a lot.
After insulin injections, the cat's lump disappeared and she was no longer ravenous, thirsty or urinating a lot.
Friday, January 20, 2017
2977. A 4-year-old Guinea Pig loses weight
May 8, 2016
2 guinea pigs
Admitted GP Male, Not neutered, 4 years. 740g. 38.6C
Very thin. Eating less for past 1 month.
Overgrown lower front teeth. Only recently.
Other guinea pig Pash eats more, bully him.
Lower front teeth trimmed.
Sep 2016, Nov 2016. Wanted front teeth clipped. No examination.
Jan 17, 2016 (today)
Anorexia
483 g 36.3C Diarrhoea Weak In-patient
Upper & lower front teeth overgrown (video) - trimmed.
Anaesthesia
Molar spurs (L and R upper Cheek tooth 1) - image - trimmed.
No stools passed for past 2 days
Jan 20, 2016
380g 38C one well-formed stool pellet passed. Goes home with
Critcal care - oral feeding.
CONCLUSION
Molar spurs need to be checked. Some owners may just want front teeth clipping to lower costs.
If not eating much after trimming, review with your vet for molar spurs before your pet loses more weight.
2 guinea pigs
Admitted GP Male, Not neutered, 4 years. 740g. 38.6C
Very thin. Eating less for past 1 month.
Overgrown lower front teeth. Only recently.
Other guinea pig Pash eats more, bully him.
Lower front teeth trimmed.
Sep 2016, Nov 2016. Wanted front teeth clipped. No examination.
Jan 17, 2016 (today)
Anorexia
483 g 36.3C Diarrhoea Weak In-patient
Upper & lower front teeth overgrown (video) - trimmed.
Anaesthesia
Molar spurs (L and R upper Cheek tooth 1) - image - trimmed.
No stools passed for past 2 days
Jan 20, 2016
380g 38C one well-formed stool pellet passed. Goes home with
Critcal care - oral feeding.
CONCLUSION
Molar spurs need to be checked. Some owners may just want front teeth clipping to lower costs.
If not eating much after trimming, review with your vet for molar spurs before your pet loses more weight.
3007. An 11-year-old male Samoyed had septicaemia.
Circum-anal tumour. Scheduled for surgery after 2 Tardak injections to bring down the size.
The Samoyed had haematuria and was rushed to an emergency vet surgery. X-ray taken.
Many Singaporeans find it cruel to neuter a male dog. In this case, chances of circum-anal tumour and prostatitis are unlikely in a neutered dog. This dog had very high fever for the 2 days. Vomited blood on the 3rd day and passed away despite treatment. Septicaemia is confirmed by blood test. Urine test showed bacterial prostatitis. X-ray showed enlarged prostate or tumour.
In retrospect, neutering your male dog would have prevented this situation.
--------------------
Blood test Jan 11, 2017
Haematuria. Went to emergency vet at 1 am
X-rayed. No bladder stone.
circum anal mass due for surgery 2 days later with TPV
39.9C. Abdom palp slightly uncomfortable
pantotrazole, omepazole, tramadole, metronizole, ampicillin, active cooling therapy
Came to Toa Payoh Vets at 9.30am
ALT 176 (less 59)
Total WCC 24.2 (6-17)
N 97.3% (60-70)
N Absolute 23.6 ((3-11.5)
Platelets 126 (200-500)
Septicaemia.
-------------
Urine test
pH 8, SG 1.010 Protein 4+ Blood 4+ Bacteria + No crystals
Lower urinary tract infection
--------------------
Negative Babesia, Caniv-4
----------------------
High fever next 2 days. Urine blood sometimes. ---------Vomited blood. Passed away.
-----------------
Dorsal circum-anal tumour 1.5 x 1.5 x 1 cm on Dec 23, 2016. Tardak on Dec 23 and 31. Neuter &
removal on Jan 10, 2017.
Had haematuria on Jan 10 and passed away from septicaemia on Jan 13.
The Samoyed had haematuria and was rushed to an emergency vet surgery. X-ray taken.
Many Singaporeans find it cruel to neuter a male dog. In this case, chances of circum-anal tumour and prostatitis are unlikely in a neutered dog. This dog had very high fever for the 2 days. Vomited blood on the 3rd day and passed away despite treatment. Septicaemia is confirmed by blood test. Urine test showed bacterial prostatitis. X-ray showed enlarged prostate or tumour.
In retrospect, neutering your male dog would have prevented this situation.
--------------------
Blood test Jan 11, 2017
Haematuria. Went to emergency vet at 1 am
X-rayed. No bladder stone.
circum anal mass due for surgery 2 days later with TPV
39.9C. Abdom palp slightly uncomfortable
pantotrazole, omepazole, tramadole, metronizole, ampicillin, active cooling therapy
Came to Toa Payoh Vets at 9.30am
ALT 176 (less 59)
Total WCC 24.2 (6-17)
N 97.3% (60-70)
N Absolute 23.6 ((3-11.5)
Platelets 126 (200-500)
Septicaemia.
-------------
Urine test
pH 8, SG 1.010 Protein 4+ Blood 4+ Bacteria + No crystals
Lower urinary tract infection
--------------------
Negative Babesia, Caniv-4
----------------------
High fever next 2 days. Urine blood sometimes. ---------Vomited blood. Passed away.
-----------------
Dorsal circum-anal tumour 1.5 x 1.5 x 1 cm on Dec 23, 2016. Tardak on Dec 23 and 31. Neuter &
removal on Jan 10, 2017.
Had haematuria on Jan 10 and passed away from septicaemia on Jan 13.
Wednesday, January 18, 2017
3005. Ruptured globe in a 3-year-old pug removed
The young 3-year-old pug wanted to play. She sniffed the backside of the older female dog and got a paw swipe injuring severely the left eye. Eyeball removal by Dr Daniel was done at Toa Payoh Vets.
Tuesday, January 10, 2017
3003. Eyelid tumours in old dogs
Friday, January 6, 2017
3002. A 3-year-old female pug is feeling more itchy and has frequent urination
Jan 7, 2017
X-ray No urinary stones. Urine turbid. pH 8. Bacteria 2+
Allergy test. Includes grass allergy. So home-cooked pork, carrot and rice. Allergic itch lessened recently but now increased frequency of scratching and passing urine frequently. Owner diagnosed recurrent UTI after several months of no urination problem. What to do?
X-ray No urinary stones. Urine turbid. pH 8. Bacteria 2+
Allergy test. Includes grass allergy. So home-cooked pork, carrot and rice. Allergic itch lessened recently but now increased frequency of scratching and passing urine frequently. Owner diagnosed recurrent UTI after several months of no urination problem. What to do?
Sunday, December 25, 2016
3001. A 4-month-old dwarf hamster has a "tumour".
Dec 24, 2016
Christmas Eve. Another year has passed.
The young lady's boyfriend had sent her a link to Toa Payoh Vets' hamster tumour page and she consulted me.
"Likely an abscess than a tumour," I palpated a painful lump near and below the right ear. "This is a very young dwarf hamster. Unlikely to develop tumour."
Anaesthesia by gas. Incise, drain and sent home after one hour's wait.
Christmas Eve. Another year has passed.
The young lady's boyfriend had sent her a link to Toa Payoh Vets' hamster tumour page and she consulted me.
"Likely an abscess than a tumour," I palpated a painful lump near and below the right ear. "This is a very young dwarf hamster. Unlikely to develop tumour."
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