Sep 26, 2013. I am unable to contact the owner by phone. I review the surgery done by an associate vet on Aug 14, 2012.
TP 43135. Mini Schnauzer born in Jan 2003, 9 yrs old. Abdominal distension on Aug 10, 2012. 5.1 kg, 37.1 C. Associate vet recorded suspect pyo, not eating 3 days, weak, mm pale, not spayed on case sheet after talking to lady owner. Warded.
I had recorded from the father's comments on vomiting watery fluid 1 week, drank a lot, anorexic.
Blood test of interest in this pyometra:
Urea 44.7 (4.2-6.3)
Creatinine 153 (89 - 177)
Total WCC 150 (6-17)
N 92% Abs 138.45
L 0.7% Abs 1.05
M 5% Abs 7,8
E 0%
B 1.8% Abs 2.7
Platelets 458 (200-500)
"Pyometron" removal
Fluid therapy, suture x 3 packets, hospitalised 4 days and went home.
As each vet has his or her own way of writing medical records, this "pyometron" scribbling on the case sheet is written. I would write closed or open pyometra in my case records but each vet stamps his or her own individual character when it comes to veterinary recording.
Thursday, September 26, 2013
Wednesday, September 25, 2013
1158. Z-plasty is needed to close wounds of large skin tumours
Sep 25, 2013
A sudden downpour lasting less than half an hour. A 14-year-old Jack Russell with a golf-ball tumour on the left elbow came in for surgery. The dog had cataracts in both eyes and had been my patient for many years.
"Rusty trembles only in the Surgery," the maid who loves this dog like her child for over 10 years said to me as she cradled the old canine.
I scheduled the dog for surgery tomorrow while I give the IV drip and medication to strengthen this old dog. High anaestthetic risk but there is no coughing or respiratory distress in this old dog. Still, the vet must be very careful in operating on such oldies. A Z-plasty will be best.
Another Z-plasty was done by Dr Daniel in another dog with similar skin tumour as big as a fish ball. See image below:
A sudden downpour lasting less than half an hour. A 14-year-old Jack Russell with a golf-ball tumour on the left elbow came in for surgery. The dog had cataracts in both eyes and had been my patient for many years.
"Rusty trembles only in the Surgery," the maid who loves this dog like her child for over 10 years said to me as she cradled the old canine.
I scheduled the dog for surgery tomorrow while I give the IV drip and medication to strengthen this old dog. High anaestthetic risk but there is no coughing or respiratory distress in this old dog. Still, the vet must be very careful in operating on such oldies. A Z-plasty will be best.
Another Z-plasty was done by Dr Daniel in another dog with similar skin tumour as big as a fish ball. See image below:
1157. S.O.E (School of Exercise) for the senior citizen mother
Yesterday I spoke to a young man who cares and loves his mum very much. She has high cholesterol level over the years, but kept quiet regarding the results of a recent blood test which this young man had persuaded her to do it when she went to the clinic with him as he had a general headache for some time.
"Mum, what the result of the cholesterol level done by Dr Chua?" he asked at the dining table.
"269," mum had not volunteered the result.
"Less than 200 is normal," I said. "Her anti-cholesterol medication is not working. As she is allergic to the statin which would be effective, she was given an alternative which did not work or she had not cut down on her fried food. So, heart attack would be impending."
The youg man persuaded his mum to go to the gym on last Saturday morning and she had done around one hour of exercise.
"Your mum will find excuses not to go," I told the young man if he does not accompany her. "Now that your mum is a senior citizen, she becomes a child. Previously your parents sent you to pre-school and then the school when you were young. Now you send her to S.O.E as she becomes the child in her golden years."
"What is S.O.E.?" he asked.
"Like S.O.T.A, it stands not for the School of The Arts, but for the School of Exercise. So you now are grown up and need to care for the health of the aged mum who does not like exercise complaining of the heat and humidity."
"What about the other child?" he asked.
"What other child?" I replied.
"My father."
"Your father does not need to swallow pills and tablets for high cholesterol or high blood pressure and so he does not need to go to the S.O.E on an urgent basis. He does not eat fried food and is careful of his diet."
"Mum, what the result of the cholesterol level done by Dr Chua?" he asked at the dining table.
"269," mum had not volunteered the result.
"Less than 200 is normal," I said. "Her anti-cholesterol medication is not working. As she is allergic to the statin which would be effective, she was given an alternative which did not work or she had not cut down on her fried food. So, heart attack would be impending."
The youg man persuaded his mum to go to the gym on last Saturday morning and she had done around one hour of exercise.
"Your mum will find excuses not to go," I told the young man if he does not accompany her. "Now that your mum is a senior citizen, she becomes a child. Previously your parents sent you to pre-school and then the school when you were young. Now you send her to S.O.E as she becomes the child in her golden years."
"What is S.O.E.?" he asked.
"Like S.O.T.A, it stands not for the School of The Arts, but for the School of Exercise. So you now are grown up and need to care for the health of the aged mum who does not like exercise complaining of the heat and humidity."
"What about the other child?" he asked.
"What other child?" I replied.
"My father."
"Your father does not need to swallow pills and tablets for high cholesterol or high blood pressure and so he does not need to go to the S.O.E on an urgent basis. He does not eat fried food and is careful of his diet."
1156. Cerebellar ataxia in a poodle, female, 6 years
Sep 24, 2013
The lady owner phoned me to ask whether her poodle should receive more medication.
"Is the dog's head still trembling a lot?" I asked her to send me a video by email.
"Much less," she was happy that the dog was eating and putting on weight. This was the dog that was diagnosed as needing glucosamine by Vet 1 and referred for CT scan by Vet 2 as the dog was shivering and trembling fast in her body and would not eat or drink.
The husband remembered me as I had successfully operated on a bladder stone in another poodle in 2009 and asked for another opinion as the referral vet would charge CT scans from $1500 - $2000.
"I remember seeing such a case in a sheep with Scrapie in Glasgow University in my 3rd year at Glasgow University as the lecturer was demonstrating one case," I said to Dr Daniel. "The sheep was trembling in his head and body. In this dog, I would say she has cerebellar ataxia. Causes can be varied. There is no treatment for it in general."
Dr Daniel did a blood test which indicated a liver disorder or infection.
Other than preventing the dog from falling down and hurting himself as he is clumsy, there is apparently no treatment if it is an acquired cerebellar degeneration or tumour.
What is the cause of this trembling of the whole body? This condition is rarely seen in Singapore, in my experience of over 30 years and I did confirm with another vet who had 20 years of experience in small animal practice in Singapore. So Dr Daniel was fortunate to see one case.
"What is the treatment?" is what the owner wants.
"Just sending the dog home and waiting for another week to observe if the dog recover is not the solution," I said to Dr Daniel. "The dog is not eating and drinking the owner is worried."
I prescribed some anti-fits and other medication and asked the owner to call me in 7 days' time. She did it today. The dog was still clumsy but had put on some weight as she was eating. Cerebellar ataxia has varied causes including infections, degeneration and neoplasia and so it is extremely hard to cure unless the cause is known. For the time being, the dog is eating hungrily and that is what the owner is happy about. Some nervous system diseases have no cure and the intentional tremor symptoms can only be controlled by drugs. Only at necropsy or autopsy can the cause of this condition be diagnosed and euthanasia or death is not acceptable to the wife who loves this dog very much.
I will need to review again. It is such a rare case that I have not seen it for the past years of practice at Toa Payoh Vets. I doubt there are more than a handful of such cases in Singapore and so it is a big challenge to diagnose and treat
.
No cerebro-spinal fluid, CT scan and MRI scan were done owing to financial restraints and so the vet must practise within the means of the owner.
The lady owner phoned me to ask whether her poodle should receive more medication.
"Is the dog's head still trembling a lot?" I asked her to send me a video by email.
"Much less," she was happy that the dog was eating and putting on weight. This was the dog that was diagnosed as needing glucosamine by Vet 1 and referred for CT scan by Vet 2 as the dog was shivering and trembling fast in her body and would not eat or drink.
The husband remembered me as I had successfully operated on a bladder stone in another poodle in 2009 and asked for another opinion as the referral vet would charge CT scans from $1500 - $2000.
"I remember seeing such a case in a sheep with Scrapie in Glasgow University in my 3rd year at Glasgow University as the lecturer was demonstrating one case," I said to Dr Daniel. "The sheep was trembling in his head and body. In this dog, I would say she has cerebellar ataxia. Causes can be varied. There is no treatment for it in general."
Dr Daniel did a blood test which indicated a liver disorder or infection.
Other than preventing the dog from falling down and hurting himself as he is clumsy, there is apparently no treatment if it is an acquired cerebellar degeneration or tumour.
What is the cause of this trembling of the whole body? This condition is rarely seen in Singapore, in my experience of over 30 years and I did confirm with another vet who had 20 years of experience in small animal practice in Singapore. So Dr Daniel was fortunate to see one case.
"What is the treatment?" is what the owner wants.
"Just sending the dog home and waiting for another week to observe if the dog recover is not the solution," I said to Dr Daniel. "The dog is not eating and drinking the owner is worried."
I prescribed some anti-fits and other medication and asked the owner to call me in 7 days' time. She did it today. The dog was still clumsy but had put on some weight as she was eating. Cerebellar ataxia has varied causes including infections, degeneration and neoplasia and so it is extremely hard to cure unless the cause is known. For the time being, the dog is eating hungrily and that is what the owner is happy about. Some nervous system diseases have no cure and the intentional tremor symptoms can only be controlled by drugs. Only at necropsy or autopsy can the cause of this condition be diagnosed and euthanasia or death is not acceptable to the wife who loves this dog very much.
I will need to review again. It is such a rare case that I have not seen it for the past years of practice at Toa Payoh Vets. I doubt there are more than a handful of such cases in Singapore and so it is a big challenge to diagnose and treat
.
No cerebro-spinal fluid, CT scan and MRI scan were done owing to financial restraints and so the vet must practise within the means of the owner.
Tuesday, September 24, 2013
1155. Daughters who care for the 12-year-old Retriever X
The 12-year-old Retriever X panted and stopped eating. The mum had to bring the dog to consult.
"Have you continued with the heart medication?
"Have you continued with the heart medication?
1153. Daughters who adopt pets from leaving expatriates
Today the mum brought in a skinny (hairless) guinea pig for consultation of a large submandibular tumour, the size of a fish-ball, around 3 cm x 3 cm. Expat children who goes back to their country will leave their rabbits, guinea pigs to this daughter and so she has 6 GP.
"The condo management permitted two dogs per unit," mum said. "So no dogs can be housed. She is allergic to cats."
It is extremely difficult to be a mother nowadays as the younger generation will buy or adopt pets and the mother is left with the burden of caring for them when they go for holidays.
It is tough for her and I said I would find a home for this GP as she did not want surgery which is the only treatment. Medication will not work as it is a big tumour.
"The condo management permitted two dogs per unit," mum said. "So no dogs can be housed. She is allergic to cats."
It is extremely difficult to be a mother nowadays as the younger generation will buy or adopt pets and the mother is left with the burden of caring for them when they go for holidays.
It is tough for her and I said I would find a home for this GP as she did not want surgery which is the only treatment. Medication will not work as it is a big tumour.
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