Sunday, February 3, 2013

1273. The slider can't walk normally at home but is OK at the vet!


toapayohvets.com

Date:   03 February, 2013  
 

Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
The slider can't walk normally at home but is OK at the vet
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: March 29,  2004
Date:   03 February, 2013 
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0203

 

Turtles are symbols of longevity and hard work to the Chinese. In Singapore, they are easier to keep in small apartments.  They are usually kept in tanks and don't smell bad or make a lot of noises unlike dogs. Many are much loved by the young owners but many have been abandoned into reservoirs or given up to the animal shelters. 

Red-eared sliders or terrapins are the only approved species of turtles to be kept as pets in Singapore. This is because other turtles like Star Tortoises are prohibited by the government.

They are bought as hatchlings in the wet markets and in certain pet shops for 50 cents in the 1980s and more in 2013.

I seldom have terrapins as patients since they are not favoured as pets compared to dogs and cats. I may have a handful of cases per year.  Dog patients predominate as patients in all veterinary surgeries in Singapore and in my practice and when a terrapin patient comes in, it is a challenge to cure its disease.       

One fine day in March 2004, a red-eared Slider was not walking normally and so the owner brought him in for consultation.

"It tilts its body towards the left and lifted its right leg, when it walks," the teenager put his slider on my The red-eared Slider (turtle) is popular as pets in Singaporeconsultation table. Instead of neglecting it, the busy teenager who spent a lot of time text-messaging his friends on his mobile phone spared an hour to consult me.  

"Let's see how it walks," I had a general examination of the big terrapin. "It walks straight now. I don't see any turning to the left side when it walks!"
 
At the veterinary surgery, it had behaved normally. "This is a common situation for many pet owners when the pet is at the veterinary surgery," I said. " Their pets look normal when they should be sick!"

"What is the problem with this terrapin?" the boy asked.
I lifted it up and examined every part of its body. I extended its four legs while it attempted to retract them.

"Look at just below and in front of its right armpit," I said. " Embedded under the skin is a 4 mm-long wooden splinter. This condition is diagnosed as "foreign body".

I used a pair of small curved scissors to cut off the foreign body from the skin of the armpit. "There is a little bleeding from the skin after snipping off the wooden splinter," I advised the owner. "However, it is not serious."

The turtle was bleeding a bit. It felt good and energetic wanting only to zoom away from me when placed on the consultation table. "It wants to go to the most tranquil and scenic Singapore's Pierce Reservoir," I said.

"No, no, no way!" the boy said. "It goes home to where it is a family member. Everyone is pleased with its good behaviour. It does not bark at all hours unlike the dog of my neighbour. It does not spray urine on the corridor walls unlike the cat of another neighbour. My whole family loves it."

This turtle went home and now in 2013 when I chanced upon its images of the foreign body in this slider,  taken in 2004, time had really passed by. I had not seen it for the past 9 years and I presumed it is in excellent health and will be just 16 years old.  No news is good news for the vet! 
 
Wooden splinter in the armpit of a red-eared Slider, Toa Payoh VetsBE KIND TO PETS.  The picture is captioned: "I want to swim in the Pierce Reservoir" sends a message to new pet owners to be responsible for their pets. It is  not meant to encourage turtle swimming in reservoirs. Its owners would never allow it to swim in any reservoir as it would swim far away and be lost.  It is very well cared for and never needed veterinary attention for the past 7 years. Till it had a foreign body.

DON'T abandon the Red-eared Sliders in reservoirs and ponds in the Botanic Gardens, Mount Faber, ponds and parks.  When you have a pet, BE KIND. Take care of it for as long as it lives.    
MORE INFO ABOUT THE RED-EARED SLIDER

The top of the shell (carapace) is smooth and gently curved and is olive to black with yellow stripes and bars. It is a medium -sized turtle that is best identified by a red or sometimes yellow patch that is found just behind its eye.

The Red-eared Slider is almost exclusively aquatic. It rarely ventures out of the water except to lay its eggs or to migrate to a new water body, should the need arise. As a water dweller, the adult turtle feeds primarily on aquatic plants. Young turtles are mostly carnivorous, gradually switching to vegetation as they age.

This Slider is commonly seen basking in the sun, on logs or masses of vegetation. When basking sites are in short supply, they may even pile on top of each other, up to three turtles deep. The Red-eared Slider very easily is spooked and will slide directly into the water from its sunning spot at the least provocation.
During the breeding season between March and July, the female may find herself swept away by a persistent suitor. The male Red-eared Sliders attempt to win over a female by engaging in courtship activities include swimming backwards in front of the female with their forelegs stretched out, palm side up.
Red-eared Sliders may produce up to three clutches of four to 23 eggs in a single year. With each nest, the female will go on shore and dig a shallow hole that is three to 10 inches wide. She deposits her eggs in these excavations and subsequently covers them up with soil and materials to seal in the eggs for protection from predators and the elements. The young turtles hatch 60 to 75 days later, although they may spend the winter in the nest.
Source: Texas Park and Wildlife  -  www.tpwd.state.tx.us/nature/wild/reptiles/slider.htm
The above case was seen in 2004 and I have not seen this glider since then. It is 2013 now and two interns had produced an interesting video based on my story concept related to the case of 3 terrapins with swollen eyes hospitalised at Toa Payoh Vets in 2012.

More info:
Male sliders are said to have a concave lower shell while the female has a horizontally flat lower shell. Female sliders are bigger in size. Male sliders have longer toe nails. 

More interesting turtle cases seen at Toa Payoh Vets at:
Turtles


Updates will be at this webpage:
http://www.asiahomes.com/dev/040529red_eared_slider.htm
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: February 03, 2013

Toa Payoh Vets

Saturday, February 2, 2013

1272. Interns - Making great videos

This year, in 2013, I started making educational veterinary videos for www.bekindtopets.com community education of veterinary students and pet owners as the younger readers seldom read, are more visual and impatient. Videos cannot provide the depth and breath of knowledge unlike text in books but they suit the internet generation of Singaporeans, most of them growing up in an era of abundance and wealth.  

Learning a new skill demands time and practice and that is why I did not make videos in the past as I discipline myself to writing veterinary articles almost one a day and creating digital images for www.toapayohvets.com. Such articles take up around 30-60 minutes per article. Video making will take much longer time initially and so I did not do it for the last 10 years.

I use the Canon DSLR 650 and was surprised that the camera's video operations suddenly stopped after less than 1 minute. I thought it was the settings. I spoke to a camera seller who told me that I used the slow speed SD cards to produce high definition videos and so the camera stopped recording after a few minutes. I bought the high speed cards and there is no problem. Much time is needed to learn about good video production by practising and reseraching. .  

Lately I read the last printed copy of Canon's Dec Issue 26 BUZZ magazine and the following are some tips. 

Part 1. Five tips for making great videos.
1. Know your gear
2. Learn photography
3. See the light
4. Scout for location
5. Good pre-production precedes every good video

Many interns are not familiar with good photography as they just click the phone camera here and there. Sometimes in poor lighting. Good photography includes the rules of thirds, good composition and excellent lighting.

Details of the Part 1's 5 tips are at:
http://media.canon-asia.com/local/sg/live/buzz/buzz_26.pdf

Next 5 tips  will be at:
www.canon.com.sg/BUZZ

In Be Kind To Pets video production, the ADVICES & TIPS webpage is usually very dull, with white text on black background. You can see from the "Canon's 10 tips for Making Videos" how the writer inserts the Canon video camera inside the page to advertise this product which is relevant. The table, grass and flying birds makes this webpage more attractive than just plain text on black background.

There are young people who earn a very good income, better than a veterinarian, just by being good at the skill of video making for corporations at affordable prices. There are such people offering such services if you research the internet and see their websites.

But they are not present in Singapore as most young Singaporeans are distracted with other personal matters including multi-party gaming and watching movies from the laptop when they are free or at the office. Singaporeans tend to charge very high rates for  internet matters e.g. setting up websites. Then they disappear after a few years or earlier as they do not focus on their business or want to try other businesses. Or they have too many clients and their fees shoot up, out of the reach of the small business owner.

If you are really keen on video making, read the various magazines and practise making videos a lot. There is no short cut to success in real life

Friday, February 1, 2013

1271. Update. Two very itchy dogs in Singapore


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   01 February, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Case 1. Itchy Dogs.  Demodectic mange. In search of the anti-demodectic injection 
Case 2. Itchy Dogs. Generalised ringworm
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   01 February, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0131

Case 1. Itchy Dogs.  Demodectic mange. In search of the anti-demodectic injection 

"I don't know why your vet does not give the old dog an anti-demodectic mite injection," I said to the mother who "inherited" the 15-year-old Shih Tzu from her daughter. The daughter, in her late 30s, had brought her to consult me for a second opinion on January 30, 2013 was the owner of the dog but had migrated to Australia.

The mother said: "My daughter in KL asked me to consult you. My dog had skin diseases for so many years except for one year 3 years ago. I feed salmon and other good food. Every time, the itchiness would recur after some time after my vet had given a steroid injection. I hear steroids are not good for my dog."

"I don't know why your vet has not or will not give the anti-demodectic injection," I said. "Did you ask him why? Did he do a blood test to screen the health of this old dog, esp. the liver and kidney functions? If these organs are not normal, he might not want to risk giving the injection. You can ask him to fax to me the blood test results."

"Do you vets get along well with one another?" the mother had not asked her regular vet why he did not give the anti-demodectic injection. She also did not want to upset her regular vet by asking for clinical records for me to peruse and get a bigger picture of the dog's health.

"All vets do fax or email copies of our client reports to the 2nd-opinion vets when requested by the owner to do so. There is no problem for any vet in Singapore to do that as every vet will have owners who want a 2nd or 3rd opinion for his pet that does not respond to treatment by the first vet."  As the mother was not comfortable to making the request, I did not insist and took her history of what happened to her dog from the beginning. She had brought some medication given by her previous vet. These included antibiotics, anti-mite cream and fatty acid oil supplements.  

"Some skin diseases are not easy to cure unless the cause is known," I checked that this slim Shih Tzu did not have hair loss, little scales, four black paws with big skin warts, clean ears, teeth with little tartar despite no dental check up, a broken tail end with grey skin as if it had partial gangrene and very swollen anal sacs.

"Now the paws are not so itchy," the mother showed me a "poisonous" white cream that her regular vet had given her maid who must wear gloves to apply to the paws. "After applying the cream, the mites die and so the dog does not bite his paws so much. He also does not have that red flush of the skin in the evening causing him to cry and whine now."

The cream was formulated by her vet and so I would not be able to tell whether it included a steroid, hence accounting for the cessation of inflammation.

"Listen carefully to the client," I said to my intern from 4th year the Vet University in Kuala Lumpur. "What she wanted was to get an anti-demodectic injection."  The mother had said that her vet had done skin scrapings and showed her "cigar-shaped" mites under the microscope. "These are demodectic mites," I referred to a chart drawing of demodex and her daughter took an image with her hand phone.

The consultation was nearly one hour long as the mother wavered on whether to get another blood test done or get her vet to give me his results and thereby offending this good vet. "I have a bottle of 100 tablets of Eltroxin tablets," she showed me and I have given half of the bottle. My vet said my dog has low thyroid hormones." She was reluctant to get a thyroxin blood level test done.

"A thyroxin test will show whether the medication is effective or not and on the status of the low thyroxin level," I said. "In fact, a repeat blood test is always advised to monitor the disease some 4 weeks after the first and the first blood test was 3 weeks ago."  It was hard knowing what was the situation since the mother did not want to upset her regular vet.

So, this back and forth conversation took nearly an hour. "How to cure the demodectic infection?" the mum asked again and again.

"Demodectic mites are normally present in the dog's skin," I said. "When its immune system is below normal or low as in puppies and old dogs like yours, the mites multiply and cause skin itchiness and disease. So, increasing the immune system would have helped considerably."

"How about giving my dog the anti-mite injection?" she asked me. "A blood test is necessary to screen the health of your dog before I give the injection," I am not surprised that Singapore dog owners nowadays are sophisticated to know that some vets give regular anti-mite injections to kill the demodectic mites. However, this was a very old dog and the injection might kill him.

"If the owner wants the injection, the vet ought to give it," I said. "But educating the owner is difficult. The best way is to boost the immune system of your dog. Why does your dog lick all four paws till they are black?" I had explained that the large skin warts on and above the paws irritate the dog as he tried to lick them off. "Continuous licking to get rid of the paw warts, cause the skin to break, become inflamed, infected and ulcerated. After some weeks, the melatonin skin pigments get inside the skin, causing blackness of the skin of the paws. Excising the warts would remove a stress for this old dog and hopefully the demodectic mites will not cause disease."

"But my dog is so old and will die under the general anaesthesia," she replied.
"A blood test will show whether this dog is fit for anaesthesia," I said. "The electro-surgery to excise     
the skin warts off the paws takes less than 5 minutes and I can say that the dog has a very high rate of survival since anaesthesia is so short."

The daughter seemed to know what I was talking about. The mother was pre-occupied with the possibility of recurrence of the red skin flush and loud whining in the evening, probably stressing her so much. So we were at different ends of the world. The dog was much better now due to the variety of medications, the skin cream and the fatty acid oil supplements but this skin flush and whining might recur. Her daughter would be going home to Australia in a few days' time.

It needed a lot of patience. What the mother wanted was a treatment to cure the disease once and for all as she had spent a lot of money with so many treatments by her regular vet.

What I proposed was to remove the stress factors as treatment involved steroids and anti-mite cream and/or injections which could harm this old dog. 

"I will pay for the blood tests," the daughter suddenly volunteered. Chronic skin diseases are costly to treat and in this case, it was not only the recurrence of itchiness and whining but also money matters. Unless the cause can be identified and can be easily treated, skin diseases are hard to cure in some dogs. In this dog, the ventral groin area is no long black, due to previous steroid jabs. But the paws were still black. On detailed examination, I would say the big skin warts on the four paws would be due to the spread of these viral warts by the dog licking as the body seemed free of the warts unlike other old dogs. The dog's anal sac was voluminous with dark brown thick viscous oil. I asked my intern to express the glands and she managed to get 5% out. I showed her how to do it and expressed over 3 ml of the oil while another intern videoed the procedure. The broken tail needed to be amputated. This was another advice I gave and the mother said: "Earlier the tail was black. I massaged it till the colour returned." That meant the tail had become gangrenous and is now half alive. The hairless tip and broken angle of the tip would be an irritant to this dog, decreasing the immune system and encouraging the demodectic mites to overwhelm his body causing red flush and pain of whining. If only dogs can talk.      

So, the first advice would be to remove the warts and in most cases, the dog would become much happier and no longer need to get rid of these "dangling" tumours. Simple solution if the dog was young and not an anaesthetic risk. "Warts seldom appear in young dogs," I said to the mother. "I had an old pug in which I removed 50 skin warts."

"Is the pug OK?" the mother asked.

"Yes," I said. Skin warts do irritate the older dog but many owners are oblivious to this discomfort of the old companion. 

UPDATE ON FEB 1, 2013
A blood test to screen the dog's health and thyroxin levels were permitted by the owner. The test revealed nothing abnormal and so this 15-year-old dog could take the anaesthesia with very low risk of death on the operating table.

 Therefore I asked the owner to make an appointment for removal of the paw warts and the broken tail. The anal sacs were expressed (videoed by an intern) and its voluminous greyish oil disposed. As for the anti-demodectic mite injection, this dog would be able to take this injection. This was what the mother had sought in visiting me.

Updates will be on this webpage;
http://www.asiahomes.com/petshotline/20130131demodectic_mites_old_dog_toapayohvets.htm


Case 2. Itchy Dogs. Generalised ringworm
 
A CASE OF GENERALISED RINGWORM IN A SIBERIAN HUSKY. The cure is permanent if the dog is given the correct medication for a duration of time and unless re-infected, it is usually a very satisfactory clinical outcome for the owner. No need to see the vet many times.

In this case, the owner's brother came to me seeking some injections and medication as the dog was scratching and scratching non-stop every day for the past weeks.

I checked the hairs under the microscope and showed him the ringworm on the hair strands. An intern from Melbourne University is tasked with making a video on this microscopic examination slides for the benefit of pet owners and vet students.

 
tpvets_logo.jpg (2726 bytes)5914 - 5920. An injection & some tablets will not be sufficient to cure generalised ringworm in a very itchy Siberian Husky. Intern to produce video on microscopic exam
30 days after treatment - no itchiness
The dog stopped being itchy 7 days after treatment for generalised ringworm and for the next 30 days. However the owner asked me why the ringworm lesions become black 30 days after treatment. The hairs also did not grow back. "The pigmentation would be due to the dog scratching and the application of your medication for some weeks before consulting me," I said. "The hairs should grow back but it takes a long time for some dogs."  Many small breeds grow their full coat within 1-2 months.In his case, the hairs seem not to grow at all except for some fine hairs near the upper neck!

ADVICES & TIPS
Seek veterinary advice promptly if your dog or pet keeps scratching for more than 2 days
Updates will be on this webpage;
http://www.asiahomes.com/petshotline/20130131demodectic_mites_old_dog_toapayohvets.htm
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: February 01, 2013

Toa Payoh Vets

Thursday, January 31, 2013

1270. Skin disease - why no demodex injection from her own vet?




tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   31 January, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Veterinary Surgery & Video:
Anal sacculitis & rupture in the dog and cat 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 12 December 2008
Date:   31 January, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0131

 

1270. Skin disease - why no demodex injection from her own vet?

 
"I don't know why your vet does not give the old dog an anti-demodectic mite injection," I said to the mother who "inherited" the 15-year-old Shih Tzu from her daughter. The daughter, in her late 30s, had brought her to consult me for a second opinion was the owner of the dog but had migrated to Australia.

The mother said: "My daughter in KL asked me to consult you. My dog had skin diseases for so many years except for one year 3 years ago. I feed salmon and other good food. Every time, the itchiness would recur after some time after my vet had given a steroid injection. I hear steroids are not good for my dog."

"I don't know why your vet has not or will not give the anti-demodectic injection," I said. "Did you ask him why? Did he do a blood test to screen the health of this old dog, esp. the liver and kidney functions? If these organs are not normal, he might not want to risk giving the injection. You can ask him to fax to me the blood test results."

"Do you vets get along well with one another?" the mother did not want to upset her regular vet by asking for clinical records. So, I did not insist. 

"Some skin diseases are not easy to cure unless the cause is known," I checked that this slim Shih Tzu did not have hair loss, little scales, four black paws with big skin warts, clean ears, teeth with little tartar despite no dental check up, a broken tail end with grey skin as if it had partial gangrene and very swollen anal sacs.

"Now the paws are not so itchy," the mother showed me a "poisonous" white cream that her regular vet had given her maid who must wear gloves to apply to the paws. "After applying the cream, the mites die and so the dog does not bite his paws so much. He also does not have that red flush of the skin in the evening causing him to cry and whine now."

The cream was formulated by her vet and so I would not be able to tell whether it included a steroid, hence accounting for the cessation of inflammation.

"Listen carefully to the client," I said to my intern from 4th year the Vet University in Kuala Lumpur. "What she wanted was to get an anti-demodectic injection."  The mother had said that her vet had done skin scrapings and showed her "cigar-shaped" mites under the microscope. "These are demodectic mites," I referred to a chart drawing of demodex and her daughter took an image with her hand phone.

The consultation was nearly one hour long as the mother wavered on whether to get another blood test done or get her vet to give me his results and thereby offending this good vet. "I have a bottle of 100 tablets of Eltroxin tablets," she showed me and I have given half of the bottle. My vet said my dog has low thyroid hormones." She was reluctant to get a thyroxin blood level test done.

"A thyroxin test will show whether the medication is effective or not and on the status of the low thyroxin level," I said. "In fact, a repeat blood test is always advised to monitor the disease some 4 weeks after the first and the first blood test was 3 weeks ago."  It was hard knowing what was the situation since the mother did not want to upset her regular vet.

So, this back and forth conversation took nearly an hour. "How to cure the demodectic infection?" the mum asked again and again.

"Demodectic mites are normally present in the dog's skin," I said. "When its immune system is below normal or low as in puppies and old dogs like yours, the mites multiply and cause skin itchiness and disease. So, increasing the immune system would have helped considerably."

"How about giving my dog the anti-mite injection?" she asked me. "A blood test is necessary to screen the health of your dog before I give the injection," I am not surprised that Singapore dog owners nowadays are sophisticated to know that some vets give regular anti-mite injections to kill the demodectic mites. However, this was a very old dog and the injection might kill him.

"If the owner wants the injection, the vet ought to give it," I said. "But educating the owner is difficult. The best way is to boost the immune system of your dog. Why does your dog lick all four paws till they are black?" I had explained that the large skin warts on and above the paws irritate the dog as he tried to lick them off. "Continuous licking to get rid of the paw warts, cause the skin to break, become inflamed, infected and ulcerated. After some weeks, the melatonin skin pigments get inside the skin, causing blackness of the skin of the paws. Excising the warts would remove a stress for this old dog and hopefully the demodectic mites will not cause disease."

"But my dog is so old and will die under the general anaesthesia," she replied.
"A blood test will show whether this dog is fit for anaesthesia," I said. "The electro-surgery to excise     
the skin warts off the paws takes less than 5 minutes and I can say that the dog has a very high rate of survival since anaesthesia is so short."

The daughter seemed to know what I was talking about. The mother was pre-occupied with the possibility of recurrence of the red skin flush and loud whining in the evening, probably stressing her so much. So we were at different ends of the world. The dog was much better now due to the variety of medications, the skin cream and the fatty acid oil supplements but this skin flush and whining might recur. Her daughter would be going home to Australia in a few days' time.

It needed a lot of patience. What the mother wanted was a treatment to cure the disease once and for all as she had spent a lot of money with so many treatments by her regular vet.

What I proposed was to remove the stress factors as treatment involved steroids and anti-mite cream and/or injections which could harm this old dog. 

"I will pay for the blood tests," the daughter suddenly volunteered. Chronic skin diseases are costly to treat and in this case, it was not only the recurrence of itchiness and whining but also money matters. Unless the cause can be identified and can be easily treated, skin diseases are hard to cure in some dogs. In this dog, the ventral groin area is no long black, due to previous steroid jabs. But the paws were still black. On detailed examination, I would say the big skin warts on the four paws would be due to the spread of these viral warts by the dog licking as the body seemed free of the warts unlike other old dogs. The dog's anal sac was voluminous with dark brown thick viscous oil. I asked my intern to express the glands and she managed to get 5% out. I showed her how to do it and expressed over 3 ml of the oil while another intern videoed the procedure. The broken tail needed to be amputated. This was another advice I gave and the mother said: "Earlier the tail was black. I massaged it till the colour returned." That meant the tail had become gangrenous and is now half alive. The hairless tip and broken angle of the tip would be an irritant to this dog, decreasing the immune system and encouraging the demodectic mites to overwhelm his body causing red flush and pain of whining. If only dogs can talk.      

So, the first advice would be to remove the warts and in most cases, the dog would become much happier and no longer need to get rid of these "dangling" tumours. Simple solution if the dog was young and not an anaesthetic risk. "Warts seldom appear in young dogs," I said to the mother. "I had an old pug in which I removed 50 skin warts."

"Is the pug OK?" the mother asked.
"Yes," I said. Skin warts do irritate the older dog but many owners are oblivious to this discomfort of the old companion. 

This webpage;
http://www.asiahomes.com/petshotline/20130131demodectic_mites_old_dog_toapayohvets.htm
 
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: January 31, 2013

Toa Payoh Vets


   

1269. Veterinary surgery & video: Anal abscesses in the dog and cat

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   31 January, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Veterinary Surgery & Video:
Anal sacculitis & rupture in the dog and cat 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 12 December 2008
Date:   31 January, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0131
CASE 1
Case written: Dec 12, 2008 6.57am

The left anal sac area was hard, painful and swollen on the first day of consultation. Around 10% of the infected area was soft but it was best to treat this dog with antibiotics and anti-inflammatory injection to let the abscess "point" or ripen.

On the 2nd day, the young lady owner came saying that there was a big hole. The dog was put under general anaesthesia gas and operated. The oil was expressed. Some oil shot out from the right anal sac as well.

The deep hole was irrigated and flushed to clear all dead skin debris and pus. The edge of the wound was jagged. I used scissors to undermine the skin. Then I trimmed away the jagged edges of the skin and obtain fresh skin edges with blood supply. After that, 3/0 absorbable interrupted sutures to stitch up the wound.

Fortunately, it was easy to stitch up this wound compared to the one in the cat (CASE 2) as there was more skin.  The dog went home wearing an e-collar. No complaint was heard for the next 7 days and I presumed the wound would heal well. 


CASE 2
Case written: Jun 26, 2007 3.17pm

What to do with such a large infected oval wound near the anus? The cat had licked out the fatty tissues under the skin. A big gap of 0.5 cm deep and 2 cm long was presented. She had stopped pooping. How to close such a big gap successfully?

1. Ideally, put the cat on antibiotics for a few days. Was the wound. But the wound is large.
2. The cat was fat, at 5.5 kg. Would she be able to survive the injectable general anaesthetic?
3. Anaesthesize the cat using xylazine and ketamine at 0.2 ml: 0.8 ml one syringe, IM
4. Clip the hairs, wash the areas. Syringe in 6% hydrogen peroxide.
5. Debride --- cut off dead skin edges and remove dead tissues from inside.
6. Relieve anal sacs of oil. Greyish brown oil seen from left gland. Right gland must have had ruptured resulting in a big hole.
7. Trim edges of wound --- convert to diamond shaped wound.
8. Undermine tissues to get loose skin.
9. Cut lowest end to extend the wound. Z-shaped wounds sutured.
10. Avoid anal sphincter (near the anal ring).
11. Elizabeth collar size 10.
12. Best to ward cat for 10 days but owner wants her home.
13. Warn the owner to confine the cat and if she runs around the home, she may rub stitches off.
14. In 14 days, wound will heal and stitches to be removed.  

 
Case 3:
Written in Jan 31, 2013
A Jack Russell had a ripened anal abscess
Video produced by an intern from Raffles Institution Pre-University 2nd year, in Jan 2013:
tpvets_logo.jpg (2726 bytes)5890. Video: Anal abscesses in a Jack Russell
Initially a hard lump, I gave antibiotics for 2 days. The lump softened and burst. The abscess was cleaned up by Dr Daniel Sing and stitched. The process was videoed by an intern. No further complaints from the owner. 
This webpage:
http://www.kongyuensing.com/animals/20071228Vet_Tips_Cat_anal_wound.htm
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: January 31, 2013

Toa Payoh Vets

Wednesday, January 30, 2013

1268. Two dogs with head tit.

Jan 28, 2013.

Recently I had two dogs from different owners. 

A female unspayed Maltese 6 years old, head tilted to right. She could not stand up. 

A 13-year-old Terrier X with full cataracts had a right head tilt but was able to stand. So, what were the causes?

Some lesions had affected the brain. A stroke?

For the Maltese, the male often pounced on her and I suspected trauma to one part of the brain or the ear area.

"Don't charge me too high. I come to you because the breeder refers me to you," said the lady with diamond ear rings and Mercedes.

The Maltese was hand-fed and given IV drips and medication for 3 days. She could lift up her head but was unable to stand. No spinal pain. Has strong pain reflexes from the paws. Blood tests showed nothing abnormal.

The Terrier X owner wanted the dog home 24 hours later. Blood test done showed nothing abnormal . It was hard to diagnose what caused the right head tilt as the owner did not want to pay for tests. A CT scan would cost $1,000/scan. 

These two dog owners will not want to pay for these tests.