Wednesday, August 14, 2013

Post op care after neutering the dog

EMAIL QUERY DATED AUG 13, 2013

 Dear Judy,



Neutering a yorkie of 14 months



I wish to enquire about the above process, the fees involved and the after surgery care.

Toby is 14 months old. Make Yorkshire terrier.

When can I make appointment for the surgery if I am only able to bring him down on weekends.

Best regards
Irene


 ------------------------------------------------------------------------------------------------------------
I am Dr Sing Kong Yuen. Thank you for your email. Weekend Sunday morning at 9.30 am is preferred. No food and water at 10 pm the night before. The dog goes home around 4 pm on Sunday.

The fees will be estimated to be around $200-$250. Post op care is to clean the wound details are at:
  http://www.sinpets.com/F6/20110817dressing-stitch-removal-after-spay-neuter_ToaPayohVets.htm

Tuesday, August 13, 2013

Self-publishing on the Kindle:

8 Jul 2021  From Bridget Lum

Dr Sing,

Attached is the link for the template.
https://kdp.amazon.com/en_US/help/topic/G201834230

Monday, August 12, 2013

1072. Update: Oral mucosal mass - Mouth malignant tumour Sheltie

Sheltie, F, Spayed. 7 years old
Oral tumour recurred on Aug 4, 2013. Histology approved by owner. Dr Daniel saw 5 cauliflower growths, one being inside the throat
First cauliflower gum tumour removed on Mar 7, 2013 by Dr Daniel.
On Dec 29, 2012, a vet advised "try medication."


HISTOLOGY
Poorly differentiated malignant tumour  including carcinoma, carcinosarcoma, malignant melanoma
Need immunohistochemical work-up.


 

1071. Toy poodle puppy with skin tumour - blood test

Poodle, M, 7 months

Blood test on Aug 10, 2013
Abnormal results are:

SGOT/AST  224 (<81 br="">Uric acid  0.20  (<0 .13="" br="">
Urea  12.2  (4.2-6.3)
Creatinine 81 (89-177)
Platelets  618 (200-500)

Wait for histology results.


1070. Follow-up. Blood test - Maine Coon with white gums and back ache

Aug 10, 2013

Aug 10, 2013   Blood test
Maine Coon, F, 5 years
Fell when carried around 3 days ago. Owner observed limping left hind. Not usual self.
Pain +++    Vertebral C4-8, T/L, L/S areas. Growls when palpated.
White gums seen on first visit. Given Vit K1 injection SC

Aug 12, 2013
Gums slightly pink.
More painful on spinal areas as above.
Only left hind paw shows positive pedal reflex. Others none. But cat can walk, pee and poop.  



Abnormal results for Aug 10, 2013 blood test

Ca  3.43 (1.5-2.6)
Creatinine  178  (71-160)
Hb 7.2 (8-15)
RBC 4.6 (5-10)
Platelets 61  (300-800).

Internal bleeding from fall +/or toxic chemicals ingested. Should recover with time. To follow up.







1069. Follow up: A 7-year-old old female cat passes blood in the urine

TOA PAYOH VETS
toapayohvets.com

Date:   13 August, 2013  
 

Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Blood in the cat's urine for the 8th time - FLUTD?  
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   13 August, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
"Have you heard of FLUTD?" I asked the young couple who showed me a large pool of blood-tinged urine on the wooden floor of the room in which the 7-year-old female spayed gentle cat was locked in. The cat peed on the floor as she did not have access to the litter box.  There were two other cats in the house.
"No," the wife said. "We were informed that our cat had a urinary tract infection."
Their vet was fully booked on the 4th of August and so they consulted me. Their vet had diagnosed polycystic kidneys based on ultrasound and had been consulted 7 times for haematuria in the past 2 years. The couple had the medical records from the vet and showed them to me. A blood test showed high creatinine levels. A urine test showed struvites. The owners had been advised to go on feline C/D but did not comply.
So what is the solution to resolve the problem of the cat passing blood in the urine needing 7 consultations and no cure?
BLOOD TEST on August 5, 2013.  WhatsApp to the owner the blood and urine test report.
Glucose 7.6  (3.9 - 6.0).  I asked the owner to monitor the 24-hour water intake. Follow up on Aug 12, 2013  - no measurement but the wife said no particular increase in drinking as the amount was perceived to be similar to the other 2 cats
The creatinine level was 105 (71-160) and so the kidneys were OK.
The serum urea was 11.2 (7.2 -10.8) which was slightly high but acceptable. I would say the kidneys are normal.
URINE TEST on August 5, 2013
Red turbid urine.  pH 7, SG 1.015, Protein 3+, Blood 4+, WBC 135, RBC >2250, Bacteria 3+, Crystals Nil. (No crystals do not mean no urinary stones).
HISTOLOGY on August 5, 2013 of gingival lump
I opened the cat's mouth to check for ulcers. No ulcers. However the lower jaw right side had a fleshy mass of 0.7 cm x 0.4 cm x 0.3 cm. Was this squamous cell carcinoma?  It would be painful for the cat to eat, leading to stress. So was this the cause of the FLUTD?  FLUTD (Feline Lower Urinary Tract Disease) is due to multiple causes and so could this growth and pain be a stressful cause? The other cat likes to pounce on this gentle cat and there could be kidney trauma causing blood in the urine. However this gentle cat would miss the rough cat which I advised to be separated. So the trauma would continue.
The owner agreed to the surgical excision. The lab report was a non-malignant squamous mucosa with surface ulceration. The lump was an inflamed granulation tissue. So, it was good news. The lump was electro-excised by Dr Daniel and the hole stitched.
I had examined the vulval area during the first consultation. A reddish blood clot was present there.
"Has the cat been making lots of noises like caterwauling on heat although she is spayed?" I asked.
"No," said the wife.
"Yes, sometimes," said the husband.
"There could be remnants of ovarian tissue if the cat had been spayed with some little ovarian tissue left. Therefore the cat caterwauls."  This issue is a mystery as the couple did not give one answer.
UPDATE ON AUG 12, 2013
The wife said the cat is normal. No blood in the urine. She is mixing the prescription C/D I prescribed with the cat food to get her to eat.  It is too early to celebrate. It is extremely difficult to educate the ordinary Singaporean pet owner to comply with prescription diets and do regular urine and blood tests. Follow ups are necessary but not many vets have the time to persevere in following up many times?
This appears to be a FLUTD case. No crystals in the urine test do not mean no stones. X-rays of the bladder were not done this time.  So far, so good. It is always the same for this cat. After treatment and antibiotics, no haematuria. Then it comes. We have to wait and see whether the C/D diet would resolve the problem permanently. 
I had an older dog with similar problem of haematuria recurring after antibiotics were completed and the vet was consulted many times. This case was recorded as it was interesting. It was diagnosed as possible bladder tumour and struvites. I got an ultrasound of the bladder which showed no tumours.
After some weeks of the prescription S/D diet, the lady owner was satisfied. I have not heard from her for the past year and presumed all are well.
tpvets_logo.jpg (2726 bytes)6322. Blood in urine seen on apartment floor. Handphone image tpvets_logo.jpg (2726 bytes)6323. Gingival mass seen in lower jaw. Electro-excision tpvets_logo.jpg (2726 bytes)6324. Blood & urine tests. No urinary crystals tpvets_logo.jpg (2726 bytes)6325. Gingival mass for histology. Non-malignant
 
Updates will be on this webpage:
www.sinpets.com/F6/20130813haematuria_8th_time_cat.htm

More info at: Dogs or Cats
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: August 13, 2013

Toa Payoh Vets



Original handphone image
 
 
 

1068. Sunday's interesting cases. The Maine Coon and the Beagle have back pain

Sunday Aug 11, 2013

Two similar back ache cases.

The Maine Coon cat came back again for review as the owner felt that the cat was better but not back to normal. The cat was not as sociable as before. 

The cat had fallen when held by a girl several days ago. The cat was OK the next day. Today, the cat meowed loudly when I pressed the spinal area from C4-C8, the thoraco-lumbar area and the sacral area near the tail. He did not hiss as during the first visit. I pinched his paws between the digits. No pain response from the four paws except the right hind which was withdrawn. I used a forceps to clamp the left fore paw skin between the digits. The cat responded a bit by meowing. "Better not test more paws to irritate the cat," I said to the owner who has two pre-teen daughters with her. "The pain is more serious. Has the cat been walking all over the apartment instead of being confined to a small area?"


"No," the owner said. "The kitchen area."
"The gum is slightly pink now as compared to snow white at the first visit," I showed the owner the parted lips of this gentle cat. "That is good news."   

Now the cat will be strictly confined for 3 months. It is unrealistic to expect the owner to do it. The litter box could be a low tray instead.

Many times, I encounter a pair of similar cases.  A few days ago, another expatriate brought in a Beagle not able to stand on his hind legs. His maid had scooped up bloody urine from the newspaper and handed to me for urine examination.

"My dog had spinal disc surgery," the owner said. "Twice."
"Was he paralysed before the surgery?"
"Not for the second time in April but he had surgery done too. The first time, he could not get up to walk."

Urine tests showed blood and bacteria. Blood tests showed low platelets. I texted the owner on this Sunday morning to enquire if the dog can stand and walk? He texted back later to say the dog is OK after seeing a 24-hour vet and thanked me. In this case, the dog had jumped from the car. He had a 25-minute walk recently and after that could not stand up on his hind legs. The dog winced when I pressed the lower spinal area.  I used the pedal pain test as in the Maine Coon. No pain from all four paws. I clamp the artery forceps between the digits on all 4 paws. No pain.

So both the cat and the dog had spinal pain.

Strict confinement, no exercise, no jumping and no running will be ideal, for the next 3 months as both have a good chance of recovery. Provided they can be confined for 3 months!