3144. A male dog cannot pee - urethral stone. Surgery: perineal urethrostomy

May 1, 2018

The lady owner rushed rhe dog to Vet 1 some 9 days ago as the dog could not pass urine at all. Not a drop. Vet 1 "scanned" the dog and said there was no urinary stones. Yet she could not pass the urinary catheter into the bladder. The dog objected and wanted to bite her. The dog pulled out the catheter. For around 3 days, Vet 1 tried catheterisation which cost around $300 including sedation. She also asked the owner to go to the Veterinary Specialists which meant high medical expenses.   

The owner remembered me as I had treated her dog for stroke some 10 years ago and contacted me. She brought the dog over for a second opinion as Vet 1 wanted to neuter the dog on suspicion of prostate enlargement or disease causing dysuria. She also gave a Tardak injection for prostate enlargement. But the owner declined neutering. She wanted her dog to be able to pee normally.

 Dr Daniel performed a urethrostomy and removed the sole urethral stone. X-rays post surgery revealed no other stones in the bladder, kidneys or urinary tract. So, it was only one stone. .


Owner wanted the dog to be discharged since he can pee normally for the past 6 days of hospitalisation. I will not advise it as the urethral opening may close up if the owner does not do a good nursing job.

The dog bites the nurses, hence the e-collar and the need for 2 nurses to clean his urethral wound daily for the past 6 days. Today he is wanted home.

X-rays after surgery to remove one urethral stone show no urinary stones

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Urethrostomy surgery
The urethral stone is lodged inside the perineal urethra, obstructing urine flow. So the dog had great difficulty urinating. This perineal urethra is opened up. The stone is taken out. The dog can now pass urine freely. X-rays were not done by Vet 1. Vet 1 said there was no stone after "scanning." Yet the urinary catheter could not pass into the bladder, meaning that there would be a stone stopping the passage of the catheter.


At Toa Payoh Vets, the urinary catheter was similarly stopped at the perineal urethra from entering the bladder. Urethostomy (opening up the urethra) enabled Dr Daniel to extract the stone, permitting free urine flow. The urethra was left open for the dog to pee from this location. No more difficulty in urination since surgery for the past 6 days before going home.

 

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Video shows the dog can pee after perineal urethrostomy surgery and hospitalised at Day 5 after surgery.

 

3143. Truncal alopecia in a poodle due to mounting by sibling poodle, both males

April 30, 2018

The owner had a pair of male, not neutered poodles. One mounts this one daily, causing truncal alopecia (hair loss in sides of flanks), hence causing traumatic injury to the hairs, according to this owner.

3142. New mushroom has sideway stalk instead of upright stalk

12 hrs earlier at 8 am. Just a big globe

April 30,2018  8am

April 30, 2018   9am
A young mushroom on the left of the new mushroom has not bloomed yet.

Apr 30, 2018   6.30pm

May 1, 2018  4am
The mushroom with horizontal stalk has wilted by 4am
A new one has upright stalk

Original image

3141. Unusual Cat story: The 5-year-olld cat kept meowing at night in Dec 2017

Cat, Male, 5 years
TP 46603

Dec 29, 2017.

Owner complained that the cat will meow after midnight for several nights. Why?
Gingivitis. Bad breath fishy smell. Urine has vinegar smell.


 Dec 29, 2017
Blood test done

Liver normal.
Kidney failure  Urea 13.4 (7.2 to 10.8)   Creatinine 177  (71-160). Advised feline k/d

Haematology is normal. 
Total white cell count 11.1 (5.5- 19.5).
N  78%  (60-70%).  Absolute 8.7 (3-11.5)

L  8.3%   (12-30%). Absolute 0.92 (1-4.8)               

M   5%   (3-10%). Absolute 3.3 (0.15 - 1.35)             
E    16%   (2-10%). Absolute 1.11 (0.1 - 1.25)             
B    1.2%  (rare). Absolute 0.04 (rare)     
Platelets 285 (300-800). Platelet clumping noted.        

Dec 29, 2017
Urinalysis
Amber, slightly turbid.   
pH 6.5 (5-8)
SG  >1.050 (1.005 - 1.030)
Protein +  (negative)
Bacteria 2+

UTI. Urine has fishy smell

Apr 28, 2018 review
Urine not smelly. Bad breath. Fed some dry feline K/D in the morning. Steamed fish and chicken 


Blood test done
Cat came in for a blood test to review health.

Liver normal.
Kidney normal.  Urea 10.9 (7.2 to 10.8)   Creatinine 162  (71-160). Advised feline k/d

Haematology . 
Total white cell count 4.9 (5.5- 19.5).
N  51.0%  (60-70%).  Absolute 8.7 (3-11.5)

L  26.8%   (12-30%). Absolute 0.92 (1-4.8)               

M   5%   (3-10%). Absolute 3.3 (0.15 - 1.35)             
E    16%   (2-10%). Absolute 1.11 (0.1 - 1.25)             
B    1.2%  (rare). Absolute 0.04 (rare)     
Platelets 140 (300-800). Platelet clumping noted.      


No more midnight meowing.
Had been fed dry feline K/D for the past 3 months. Owner started giving fish and chicken meat to supplement the dry food. 

3140. BE KIND TO PEOPLE Stories by Dr Sing Kong Yuen. The Bangladeshi raconteur

39. April 28, 2018 Bangladeshi stories

April 28, 2018

RACONTEUR - a person who tells anecdotes in a skilful and amusing way.
- a person skilled at telling stories or anecdotes

The Bangladeshi raconteur

I met this man at a social dinner. He was a business man in his late 30s, slim built and sharp-eyed.
Here are some anecdotes from him.

1.  The mother's police.
In this farm managed by his mother, there were 7 large German Shepherd dogs. In the daytime, these dogs would go outside the farm to scavenge and roam but they would be back in the evening to patrol and protect the farm and his mother.

1.1  During one thunderstorm, the dogs barked. One of the dogs that was close to his mother barked and gripped her sleeve to get her to the door. She went out to investigate. There were some intruders who apologised and left.

1.2  When he visited his mother, the dogs would not permit him to enter the house unless his mother came out.

2. His slim mother.
2.1  "My friends always ask me which of the 2 women in my house was my wife - the slim one or the fat one since my mother looks around my age of late 30s. They would invariably get it wrong. My mother is the slim one as she has to work hard managing the workers in the farm."

2.2  "Was it an arranged marriage for your mother?" I asked as I presumed his mother was married  young. "How do I know?" he replied. "I was not born when she was married!"  He laughed heartily at his own sense of humour. The way he laughed and swung his hands caused the other diners to laugh too. Dining could be a solemn affair with family members eating together as a routine and so, his anecdotes were a breath of fresh air.

His mother had married at 12 years of age, a practice now disallowed in Bangladesh. Hence at the age of 40 - 50 years and being slim and trim, she looked as young as his fat wife.

3. The Villager who cried "Tiger"!
He related a story about a Bangladeshi man shouting "help me, help me, there is a tiger attaching me!" The villagers rushed to help him but there was no tiger. This man repeated this joke 3 times. When he shouted for help at the 4th time, no one bothered to help him. A tiger came and he was eaten.

"This was a Little Red Riding Hood story," the Bangladeshi raconteur said. Actually it was "The Boy who cried wolf". I did not correct him as it would be impolite. 

4. Fate
"Accidents can occur anytime" he said. "Life is transient and when we die is fated. So do not be afraid to do the right thing. God will help you!"

He invited us to visit his motherland to see his big farm. It had animals such as  milking cows, hens laying eggs, ducks eating snails in the padi and 3 types of fruit trees.

He had this sense of humour which make the other person regret asking him questions or doing something awkward as he would not stop laughing at him. So the other diners listened but dared not engage him in asking questions about his anecdotes, for fear of being laughed at.

3139. Second opinion. A 20-year-old red-eared slider had been lethargic and eat less for 2 months. Why?

April 27, 2018

A young man surfed the net.
The first clinic came out top and he went there. X-rays were done by Vet 1 and nothing abnormal was discovered. Treatment was given by injection in the backside of frusemide and calcium by the vet and then by him for next few days.

On the 3rd day, the slider still did not eat. He surfed the net and found Toa Payoh Vets.
The first vet had diagnosed oedema.  

The condition is serious. Swelling of the neck and 4 paws would be due to failure of one or all of the following organs - heart, liver or kidneys.

I proposed hospitalisation of 10 days to syringe feed critical care, medication electrolytes and multivitamins as the owner could not do it.

The neck swelling was aspirated and found to be clear fluid on the left neck area and bloody fluid on the right neck area.

A normal 3-year-old (left) compared to a 21-year-old red-eared slider with neck and paw edema (swelling)

3138. Mushroom in my garden April 27, 2018. A solitary white mushroom

April 27, 2018. Meeting someone at the airport at 5am


The mushroom appears to signal that the person being met is a knight in shining armour for a friend who is at the airport to meet this person.

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Mushroom 12 hours earlier

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