Thursday, May 18, 2017

3075. Egg binding in3 red-eared sliders - oxytocin inj

Most owners delay more than 1 week of egg-laying behavior to seek veterinary advices. In the following 2 cases, Case 1 was given oxytocin injection within 7 days of egg-laying behavior (leg digging floor, soil) and passed out 3 eggs.  Case 2 with 5 eggs - the owner wanted to wait and see and no eggs were laid when given oxytocin >4 weeks after exhibiting behavior.

CASE 1



















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Case 2. Egg binding. 5 eggs. No eggs laid as oxytocin injections were requested by the owner >4 weeks after egg-laying behavior. .





Case 3. Egg binding. 15 eggs not laid as oxytocin injections were given over 4 weeks after signs.

Wednesday, May 3, 2017

Tuesday, May 2, 2017

3073. A 19-year-old red-eared slider has swollen limbs

Written by Intern Wong Shu Yu




Synopsis:

A 19 year old female red eared slider was limp and unresponsive when brought in.  The owner mentioned that the slider had not been eating for weeks and that she was gasping for air earlier that morning. As no reflexes were detected in response to stimuli, the slider was pronounced dead. It was noted however, that the slider’s limbs and neck were swollen. This was a possible indication that the slider had been suffering from kidney, heart or liver disease prior to death. The slider’s shell was also dented inwards in the centre, which suggested a history of shell rot in the past.

The slider was considered to have lived a long life given that the natural life span of red eared sliders in captivity typically ranges between 15 to 30 years. It is highly probable that the slider had died of natural causes due to old age; however, it would not be possible to pinpoint the precise cause of death without having resort to a post-mortem. Having discussed the various options with the owner, the owner agreed to have the slider sent for cremation.

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Date: Sunday, 30 April 2017

Attending physician: Dr Sing Kong Yuen, Dr Daniel Sing

Particulars

Name: -

Age: 19 years

Weight: -

Gender: Female

Species: Terrapin

Breed: Red Eared Slider



History:

The slider had not been eating for weeks.  Patient was gasping for air and struggling for air at 2.30am that morning.  Usual diet comprises boiled chicken, prawns, vegetables and commercial pallets.
The slider was exposed to half an hour UV light every day and allowed to bask and dry
off completely.

Physical Examination:

Patient was limp and no reflexes detected
Neck, and limbs were oedematous
Shell was concave in the middle
Carapace measured 16 cm long x 15 cm across

Diagnosis:

Patient had passed away upon arrival. Cause of death is likely to be old age.
Suffered from shell rot previously, thereby affecting integrity of shell
Edema suggests that kidney, heart or liver diseases could be present

Procedures done:

None.

Treatment Plan:

1. Explained to owner that likely cause of death is old age, but that it is difficult to pinpoint the exact cause of death unless patient is sent for a post-mortem at the government vet facilities. However, some owners find the process traumatic.

2. Owner appeared to be affected by patient’s death, and asked if the patient could have been saved had he sought treatment earlier. Advised that (i) the patient was considered old given that the natural lifespan of red eared sliders in captivity is about 15 to 30 years, and that (ii) treatment options for red eared sliders were limited. Consequently, it was likely that there would be no difference in the
outcome even if earlier treatment had been sought for the patient.

3. Provided owner with option of cremation. Owner agreed and the carcass of the patient was left in the clinic and arrangements made for cremation.

Exhibits:
Fig 1: Top view of patient-  Swollen limbs

3072. An 8-year-old cat's annual health screening


Written by: Intern Ms Wong Shu Yu

Synopsis:
Tammi is an 8 year old local tabby cat who came to us for her annual checkup and vaccination. While there were no significant abnormalities detected upon physical examination, it was noted that Tammi (standing at 4.6kg) is fairly overweight for her size. This puts her at risk for fatty liver disease. An examination of Tammi’s mouth also revealed signs of gingivitis and an ulcer on the upper side of her gums.

The annual vaccine was given to Tammi and blood taken for purposes of testing for liver disease. Other procedures performed included dental scaling, ear cleaning and anal sac expression. Notably, the expression of Tammi’s anal sacs produced a black-coloured substance, which indicated that the glands have not been expressed for a prolonged period of time.

Tammi’s owner was advised to switch to a weight reduction cat food formula in order to bring down Tammi’s weight to a healthier range. The results of the anal sac expression were also shown to and its significance explained to the owner. Dr Sing highlighted that the anal sacs need to be expressed regularly in order to prevent inflammation and subsequent self-injury perpetrated by the animal on the affected area due to discomfort. 



Date:                 Sunday, 30 April 2017

Attending physician:     Dr Sing Kong Yuen

Particulars
Name:             Tammi
Age:                 8 years
Weight:             4.6kg
Gender:             Female
Species:             Feline
Breed:             Local tabby
Neutered/Spayed:         Spayed

History:
Patient is here for annual vaccination and check up
Adopted from local SPCA in October 2014
Last vaccination done in November 2016
Eating and drinking normally
Urine and stools are normal
Diet of Pronature Adult Indoor Cat Dry Food; no other food or treats given

Physical Examination:
Patient is quite overweight
Some tartar seen on teeth. One canine is longer than the other
Signs of gingivitis spotted on the gums.
Patient has an ulcer on the upper side of her gums.
No tumours detected.

Diagnosis:
Patient is overweight and therefore at risk for fatty liver disease.
Gingivitis

Procedures done:
Dental scaling: No loose teeth detected
Ear cleaning
Blood taken from jugular vein
Expression of anal sacs: black oil was expressed, indicating that the anal sacs had not been expressed for a long time.
Vaccine given.

Treatment Plan:
Explained to owner that patient is overweight and is at risk for liver disease. Advised that protein content of present diet is too high.
Explained significance of results of anal sac expression to owner. Advised that anal sacs should be expressed regularly to prevent inflammation
Recommended diet change to weight reduction formula
Drontal dewormer tablets prescribed
Blood taken will be sent to laboratory to test for liver disease

Exhibits:
                   

Fig 1: Top view of patient                Fig 2: Patient’s present diet
 

Monday, May 1, 2017

3071. A 15-year-old Miniature Schnauzer has diarrhoea when medication is completed

May 1, 2017


Dog had left sided breast tumours excised by Vet 1 last year. Right side breast tumours appear now. Also distal to left side, near vulval region, a tumour of 5 cm x 5 cm x 4 cm appeared. Main complaint is that the dog now stopped eating and had diarrhea again.

Had diarrhea episodes twice and consulted Vet 1 on March 31 and April 15, 2017. Vet 1 took X-rays and blood test. X-rays say heart and kidneys enlarged. Blood test showed high urea, anaemia and dehydration.

Diarrhoea now.





Today, given IV drip, anti-fever and anti-diarrhea and antibiotic. To stop feeding beef and rice nowadays.
Intestines may be sensitive to beef and rice and there is a high fever.
  

Saturday, April 22, 2017

3069. Golden Heart Animal Rescue, Yangon

April 16, 2017

It rained dogs and cats today. Fewer people throw water on passers-by as compared to April 13 which was the first day of Thingyan. Thingyan lasts 4 days (April 13 to 16) this year and would be 5 days in a leap year.

A good Japanese lunch in a restaurant opened by a famous actor. He had prepared a big metal basin of soup and some food to give to passers by, as this is a tradition of Buddhist donations. Giving food to the poor and needy, I can comprehend.

I wanted to visit an animal shelter in Yangon. So, Dr Thein Tun Aung drove me to the Golden Heart Animal Rescue in Yangon. I thought it would be a small one like White Heart Animal Rescue and Shelter in Magwe and was pleasantly surprised. It was around 1.2 acres in land area and 280 stray dogs of mixed breed welcomed me. One perched on top of a box which I presumed was used for the Buddha and flowers as it was near the main gate. You can see him in the video.

I predict it would house 1,000 stray dogs within 3 years and much organisation and fund raising need to be planned now.



Video at:   https://www.youtube.com/watch?v=xPManhxoQbw


Wednesday, April 12, 2017

3068. Lung tumours in the Pekinese and a cat. Prostate enlargement in a dog. Normal heart and lungs








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Cat


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Prostate enlarged



Friday, April 7, 2017

3067. A 7-year-old female red-eared slider is restless, paddling, not eating. Wants to lay eggs?

Apr 7, 2017

Behaviour for over 7 days. Paddling of legs, loss of appetite, restless,
Egg-bound?
Apartment too small to have pool and sand area.
Suggested a sand box as nesting area and access to water for feeding. 
I advised oxytocin injection 2 days but owner wanted to wait and see. 



X-ray








FOLLOW UP
April 18, 2017    1.35 kg bodyweight.  Owner agreed to oxytocin 10 IU (1 ml) SC injection today.
                            Slider stretched out hind legs but did not lay eggs. Loss of appetite but active.
                            Soil and sand box given. No digging seen.

April 19, 2017     1.3 kg.  2nd injection of oxytocin 10 IU SC today. Advised Critical Care of 1 tablespoon/kg = 6 grams daily. Divide into 4 parts/day.  1 part of CC to 2 parts of warm water.
Syringe feed.     
                           Some sliders lay eggs in water. Provide a tank of water. Some lay eggs in soil and sand. But this is apartment living and there is shortage of space for water and soil areas.

2978. Veterinary Files From Myanmar - Videos


April 12, 2017

VETERINARY EDUCATIONAL VIDEOS
FROM CASES SEEN BY DR SING KONG YUEN IN MYANMAR 2014 -2017

The following veterinary educational videos for vet students & pet owners can be viewed by going to www.youtube.com and search "veterinary files from myanmar".





VETERINARY EDUCATIONAL VIDEOS
FROM CASES SEEN BY DR SING KONG YUEN IN MYANMAR 2014 -2017

The following veterinary educational videos for vet students & pet owners can be viewed by going to www.youtube.com and search "veterinary files from myanmar".



Mar 2017
Dr T T Aung treats a coughing German Shepherd puppy in Magwe
https://www.youtube.com/edit?o=U&video_id=LZ8THY3MQtw


Mar 2017
Dr T T Aung and Dr Sing Kong Yuen visit White Heart Animal Rescue and Shelter, Magwe, Myanmar
https://www.youtube.com/watch?v=apRpziowX94




Nov 2016
Dr T T Aung and Dr Sing follows up on the Asiatic bear at Thanlyn Thabarwa Centre, 5 months after ranula operation
https://www.youtube.com/edit?o=U&video_id=za_qngLNObI


Nov 2016
Dr T T Aung treats a rabbit not eating
https://www.youtube.com/edit?o=U&video_id=_VPpdumR_MA


Oct 2016
Drs T T Aung and T T Soe donates to an old monastery; 2 case studies from RAVS
https://www.youtube.com/watch?v=Pw7wJRHsfBY

Finding a Bear Vet in Myanmar. Pt 2
Visit to Naypytidaw Zoo

Sep 2016
https://www.youtube.com/edit?o=U&video_id=-GdmeXJ5ERc

Asiatic Bear 6 months old - Day 2 after operation by Scottish Vet and Aung

Sep 2016
2nd operation on the Asiatic bear's ranula by Dr T T Aung and a Scottish vet. Pt 4
https://www.youtube.com/edit?o=U&video_id=9mx5fLM42Ho


Sep 2016
Dr Sing's Post-op review of ranula operation by marsupialisation on an Asiatic Bear. Pt 6
https://www.youtube.com/edit?o=U&video_id=_DSGqo7_2Xk

Perineal urethrostomy in a cat house-call follow up with Dr T T Aung

Sep 2016
https://www.youtube.com/edit?o=U&video_id=RhrRJjlCDR0

Dr Sing and Aung visits the Asiatic Bear 3 months after ranula operation

Sep 2016
Perineal urethrostomy surgery in a cat by Dr T T Aung - Final Video
Dr Aung shares his surgical procedure knowledge on video
https://www.youtube.com/edit?o=U&video_id=kEB_Kak9uME


Jun 2016
Bear at Thabarwa Centre Pt 4. Pre-op check up at Thabarwa Centre, Thanlyn
https://www.youtube.com/edit?o=U&video_id=yqgyKhOUAPs


Jun 2016
Sublingual mucoecoele in a bear Pt 4. Surgery by Scottish wildlife vet with T T Aung
https://www.youtube.com/edit?o=U&video_id=VEBbE4TukDk


Jun 2016. Visit bear at Thabarwa Centre, before tongue surgery Pt 3
https://www.youtube.com/edit?o=U&video_id=GiXkkaubX4g




Dec 2015
A Siberian Husky in Yangon has seizures
https://www.youtube.com/edit?o=U&video_id=0sNRhdytQ0M


Dec 2015
Visit to RAVS - layout plan
https://www.youtube.com/edit?o=U&video_id=K-hcJ4iHzd0


Oct 2015
A Yangon cat cannot give birth
https://www.youtube.com/edit?o=U&video_id=Fle5Kg3Lq-Y




Sep 2014
A testimonial for Dr T T Aung who started his own practice in Yangon. One of the rare vets who treats veterinary medicine as a calling rather than as a money-making business.
https://www.youtube.com/edit?o=U&video_id=WueLPic9Q7E


Sep 2014
Visit to Yezin Univ of Vet Science
https://www.youtube.com/edit?o=U&video_id=Um1LrWbaNQU


Aug 2014
House-call at Hyatt Hotel, Singapore with Dr T T Aung in 2010 house call cat swallowed a needle
About Dr T T Aung
https://www.youtube.com/edit?o=U&video_id=H0iuMV5vsxI

Dr Sing and T T Aung gave talk to University of Yezin final year students under MVA
visits university campus and rural areas

Aug 2014
Nystagmus and cloudy cornea in a Shih Tzu puppy
https://www.youtube.com/edit?o=U&video_id=NAenYCtlsv0


Aug 2014
Nervous signs of distemper in a Yangon English Cocker Spaniel puppy
https://www.youtube.com/edit?o=U&video_id=fhrEXAnlKEA


Aug 2014
A Myanmarese cat has pyometra. Video in Myanmar language
https://www.youtube.com/edit?o=U&video_id=55qghQhXj-s


Aug 2014.  Depo-Medo inj leads to pyometra in Yangon cats.
A Myanmarese cat has pyometra. Video in English language.
https://www.youtube.com/edit?o=U&video_id=eKheu1XulUg




Wednesday, April 5, 2017

3065. A breeder wanted to delay Caesarean section

Mar 31, 2017

"I need an urgent C-section. The water bag had ruptured!" the breeder rushed to Toa Payoh Vets.
On arrival, one puppy (Pup 1) was born naturally while inside the van.
"I want an oxytocin injection as this Dachshund had C-sections before," he said. This was a very experienced breeder. I did not want to advise that there was no time to waste as the water bag had ruptured, but then a puppy was out.

So, I gave the oxytocin 1.2 ml IM. We waited. Around 15 minutes, a very large dead pup (Pup 2) was born with a shrunkened placenta. There was no water bag. So, this could be the one with the water bag ruptured, prompting the breeder to phone me.

The Dachsund, 61st day pregnant still had swollen abdomen, indicating at least 2 puppies still inside.
C-section

Puppy 3 -  a large pup with detached placenta.
This pup was not crying  but revived and was OK.

Puppy 4 - a small pup wrapped inside the water bag as for normal puppies seen at C-section.
This pup was not moving much and breathed like gasping for breath.




















Saturday, April 1, 2017

3064. A 6-year-old female Schnauzer dripped brownish red vaginal discharge

Apr 1, 2017

Not eating much for 20 days. Vomited 1-2X in 20 days. Lethargic.
Last heat was end of February. First consult is March 31, 2017.
Closed pyometra suspected. X-ray and blood test.


Drips of sticky brownish red vaginal discharge seen during X-ray
Blood test showed septicaemia (high total WCC, neutrophils and low platelets).
Just 6 years old, female Miniature Schnauzer. Bites.









X-rays show the characteristic swollen uterine horn (sausage shaped) and in real life, the uterine horns are much swollen and wrinkled.  Heart failed during surgery but was revived.  













Blood test  Mar 31, 2017

Urea 18.7  (4.2-6.3)
Creatinine 72  (89-177)
Total white cell count 42  (12-18)
Neutrophils  97.5% (60-70%),  Abs  41  (3-11.5)
Platelets  46   (200-500)

A septic blood. 


FOLLOW UP 5 days post-op on Apr 5, 2017
Eats and drinks little
On antibiotics and NSAID Rimadyl.

CONCLUSION
Such severe sepsis may lead to death post-op as the blood is full of bacteria and toxins.
The owner had delayed 20 days of the dog having poor appetite before seeking vet advice.
It is a miracle that she survived the anaesthesia. Post-op survival is not guaranteed. If the dog eats more every day, chances of survival are good as the kidneys are not affected.