Oct 31, 2013
TP 43110
I treated this reddish brown Persian cat, 15 years old, emaciated at 1.7 kg on Jan 24, 2012 (2nd day of Chinese New Year). Temp at 38 deg C. Severely dehydrated, cysts on both sides of the tongue, drooling, mouth ulcers, black molars. Anaemic. She had been wandering outdoors and drank pond water. This cat needed grooming too. The mother did not want blood test.
"You said my cat will not live long," the mother told me today. "We fed her a few times a day and now she is still a.live 22 months later! But she stopped eating yesterday and hides in a corner as if she is going to die. Do cats about to die behave this way? The other younger cat is now inactive too."
I asked the mother to send the cat in the afternoon instead of waiting till the evening.
Apparently the cat lost weight 2 weeks ago and is now 1.7 kg. But the rectal temp is low at 36.3C. Blood test was taken this time. No more cysts beside the tongue. Gums were pinker. The mother did not want X-rays to check for abdominal tumours
At 7.30 pm, I had a long telephone chat with her on the cat management. Actually this cat had been drinking a lot of water and had been peeing a lot (3 areas of litter instead of usual 1 time. Yet on first consultation today, the daughter said No PD/PU to Dr Daniel who had examined the cat earlier as I was out.
I discovered the son's insisted Royal Canine Fit dry food had a protein % of 32%. Too much protein for a 16 year old cat. Will this cat live? It is hard to predict. Wait for blood test results.
Thursday, October 31, 2013
1140. Follow up on Bichon with urinary stones - Oct 31, 2013
Oct 31, 2013 4.30 am
I checked on the Bichon. He was housed on the back patio with 4 steps down to access the garden. "In," I commanded him to get down the stairs to the grass to pee. He went down the stairs and looked at me. "In," I said again. He went to the grass but did not pee. After a while, he tried to poop by lowering his backside. This time, he did not have to rush to pee as when he was confined indoors as in the previous years.
Medical dissolution of triple phosphate stones using diet or acidifying medicine takes a lot of time and patience. The caregiver must know what to do. Yesterday, the caregiver went out the whole day and I had no time to go back during lunch. I had explained to her that the dog must be in the back patio whenever he is home alone. He should not be inside the living and dining area for the time being as he would dribble urine all over, owing to his urinary stone irritation of the bladder.
But the dog would sneak into the kitchen when the back kitchen door is open. The caregiver did not comply with my instructions and kept the door inside the kitchen with food and water. So the dog was home alone from 12 pm to 9 pm. When I came back, the whole kitchen floor was wet with urine. The dog had also peed vertically on the side of the fridge.
It is important to know what to do when treating such cases medically instead of doing surgery to remove the bladder stones. However caregivers and owners do ignore instructions as in this incident of urine-splattered kitchen floor.
I checked on the Bichon. He was housed on the back patio with 4 steps down to access the garden. "In," I commanded him to get down the stairs to the grass to pee. He went down the stairs and looked at me. "In," I said again. He went to the grass but did not pee. After a while, he tried to poop by lowering his backside. This time, he did not have to rush to pee as when he was confined indoors as in the previous years.
Medical dissolution of triple phosphate stones using diet or acidifying medicine takes a lot of time and patience. The caregiver must know what to do. Yesterday, the caregiver went out the whole day and I had no time to go back during lunch. I had explained to her that the dog must be in the back patio whenever he is home alone. He should not be inside the living and dining area for the time being as he would dribble urine all over, owing to his urinary stone irritation of the bladder.
But the dog would sneak into the kitchen when the back kitchen door is open. The caregiver did not comply with my instructions and kept the door inside the kitchen with food and water. So the dog was home alone from 12 pm to 9 pm. When I came back, the whole kitchen floor was wet with urine. The dog had also peed vertically on the side of the fridge.
It is important to know what to do when treating such cases medically instead of doing surgery to remove the bladder stones. However caregivers and owners do ignore instructions as in this incident of urine-splattered kitchen floor.
Wednesday, October 30, 2013
1139. Shih Tzu takes a long time to pee in the morning and passes blood at the end of peeing
Dr Daniel advised an X-ray for this 6-year-old male neutered Shih Tzu, much loved by his owner.
"He is the king in the apartment," she said. "He would bite me when I discipline my son and similarly will protect me when he thinks I am threatened by biting my son."
"He is fair and good protector," I said.
The X-rays showed stones in the bladder and at the bend of the urethra.
"What to do?" she asked. "My dog died under anaesthesia when I was a young girl and I do not want surgery."
Methods of treatment
1. Medically to acidify the urine and to dissolve the stones if they are struvites.
"How long does it take?" she asked.
"Ir the stones are small, it may take from one month onwards."
2. Surgery to remove the stones via the bladder. A syringe pumps normal saline to flush the urethral stones into the bladder.
"How long is the surgery?"
"Around 40 minutes."
URINE TEST
Alkaline pH, amorphous phosphate crystals, blood +
The owner decided on surgery 5 days later. I advised 4 days of antibiotics to clear the bladder of infections. Urine test will be done soon.
"He is the king in the apartment," she said. "He would bite me when I discipline my son and similarly will protect me when he thinks I am threatened by biting my son."
"He is fair and good protector," I said.
The X-rays showed stones in the bladder and at the bend of the urethra.
"What to do?" she asked. "My dog died under anaesthesia when I was a young girl and I do not want surgery."
Methods of treatment
1. Medically to acidify the urine and to dissolve the stones if they are struvites.
"How long does it take?" she asked.
"Ir the stones are small, it may take from one month onwards."
2. Surgery to remove the stones via the bladder. A syringe pumps normal saline to flush the urethral stones into the bladder.
"How long is the surgery?"
"Around 40 minutes."
URINE TEST
Alkaline pH, amorphous phosphate crystals, blood +
The owner decided on surgery 5 days later. I advised 4 days of antibiotics to clear the bladder of infections. Urine test will be done soon.
1138. Follow up on the 14-year-old Maltese with "7 days to live".
Yesterday Oct 29, 2013, I was much surprised to find this Maltese still alive when I predicted "7 days to live" one month ago. The Maltese had great difficulty breathing and her abdomen was tense and swollen. There was this large orange-sized tumour in the front half of the abdomen and a balloon-like swelling of the abdomen.
The young lady owner had come to me after Vet 1 had diagnosed a massive anterior abdominal tumour and the blood test had shown anaemia. She had recommended some pain killers and gave a poor prognosis. Her diagnosis was spot on as regards this massive tumour. It could be a spleen or liver tumour. However the liver enzymes in the blood test were normal. My prognosis of "7 days to live" was also grim. After treatment and drainage of the 20 ml of fresh blood from the abdomen, an iron injection and giving drips and heart disease medication, the dog went home.
Yet 30 days later, this old Maltese was alive. She no longer panted as she was on heart medication. "She would not eat by herself for the last 2 days," the young lady who came with her mother and brother said. "The gums are pink.The heart and lungs are OK.," I said after examination. "There is no abdominal swelling. The abdominal lump is as firm and as large as an orange and this may press onto the diaphragm, stomach and chest causing pain. Yet this Maltese did not feel any pain when I palpated the abdomen.The left kidney was enlarged to around 3 cm x 3 cm and there was no fluid at all. "The rectal temperature at 37.2 C is low," I said.
Under gas anaesthesia, I used a fine needle to aspirate 0.5 ml of blood from the edge of the tumour. After the drip and medication, the dog started to bark and was more active.
In this case, I did check on the IV drip which had stopped flowing for some reasons. Dr Daniel had inserted the IV catheter well with sticky elastoplast as there was still blood flowing out when he took out the blue bandage wrapping the tubing. My assistant had flushed saline to clear the blockage 3 times but I could still see blood at the one end of the catheter indicating there was no IV drip flow.
After checking, the IV drip flowed and so the dog had his glucose and salts and hence was feeling well to bark.
Surprisingly the body weight was 3.4 kg, about 0.1 kg more than 30 days ago. I advised the lady owner to hand feed the food as well as the medication and prescribed pain-killers this time. I got a blood test done. To save money for the family, I did not ask for another X-ray or ultrasound. The mother was surprised that the dog had a large abdominal tumour the size of an orange when I spoke to her as well. The daughter had not told her.
The young lady owner had come to me after Vet 1 had diagnosed a massive anterior abdominal tumour and the blood test had shown anaemia. She had recommended some pain killers and gave a poor prognosis. Her diagnosis was spot on as regards this massive tumour. It could be a spleen or liver tumour. However the liver enzymes in the blood test were normal. My prognosis of "7 days to live" was also grim. After treatment and drainage of the 20 ml of fresh blood from the abdomen, an iron injection and giving drips and heart disease medication, the dog went home.
Yet 30 days later, this old Maltese was alive. She no longer panted as she was on heart medication. "She would not eat by herself for the last 2 days," the young lady who came with her mother and brother said. "The gums are pink.The heart and lungs are OK.," I said after examination. "There is no abdominal swelling. The abdominal lump is as firm and as large as an orange and this may press onto the diaphragm, stomach and chest causing pain. Yet this Maltese did not feel any pain when I palpated the abdomen.The left kidney was enlarged to around 3 cm x 3 cm and there was no fluid at all. "The rectal temperature at 37.2 C is low," I said.
Under gas anaesthesia, I used a fine needle to aspirate 0.5 ml of blood from the edge of the tumour. After the drip and medication, the dog started to bark and was more active.
In this case, I did check on the IV drip which had stopped flowing for some reasons. Dr Daniel had inserted the IV catheter well with sticky elastoplast as there was still blood flowing out when he took out the blue bandage wrapping the tubing. My assistant had flushed saline to clear the blockage 3 times but I could still see blood at the one end of the catheter indicating there was no IV drip flow.
After checking, the IV drip flowed and so the dog had his glucose and salts and hence was feeling well to bark.
Surprisingly the body weight was 3.4 kg, about 0.1 kg more than 30 days ago. I advised the lady owner to hand feed the food as well as the medication and prescribed pain-killers this time. I got a blood test done. To save money for the family, I did not ask for another X-ray or ultrasound. The mother was surprised that the dog had a large abdominal tumour the size of an orange when I spoke to her as well. The daughter had not told her.
1137. Abandonment of a German Shepherd
For the last 3 days, the man who brought in a German Shepherd for "de-ticking" would not respond to my phone calls. In the first day, he said he would be coming. His brother said the father's car had been involved in an accident and was toured away and asked for my bank account to pay for de-ticking. I asked him to come to the Surgery and he said he would in 15 minutes. He did not turn up nor did his brother phoned up about the dog. On the 2nd day, I sms his brother to say I would report him for abandoment of the dog. He texted back to say "Busy at work. On the way." But he did not turn up. Today is the 4th day.
This seems to be an abandoment of a young German Shepherd. The brothers had told me that they want the dog but behaved differently without a concern about his well being. The father was against this dog. Dr Daniel has arranged for new homes.
This seems to be an abandoment of a young German Shepherd. The brothers had told me that they want the dog but behaved differently without a concern about his well being. The father was against this dog. Dr Daniel has arranged for new homes.
1136. Follow up on Bichon Frise Wed Oct 30, 2013
Wed Oct 30, 2013
At 5.30 am, I woke up and checked on the Bichon. This time the caregiver complied with my instructions to let him sleep in the sheltered area outside the kitchen so that he has access to the grass to pee anytime. He would be taken to the grass at other times in the day. This morning, he had no need to rush to the grass. I said "In" which is a command to move "forward" to any place I wanted him to. He has this habit of barking loudly whenever anyone comes to the front door as he positions himself in the living room. It is good but as some family members come home at 3 am, his loud barking disturbed my sleep. Whenever he barks in this way, I will get up and train him by depriving him of the privillege of being in the living room. He would have to go to the kitchen and stay there whenever he barks in this way in my presence. My family members do not adopt this method of training and so he is 70% trained. Yesterday when I came back in the afternoon, he barked again.
In medical dissolution of the struvite stones, the Bichon must also have access to the grass to pee and that is why he cannot stay indoors. We lock our front and back doors to prevent burglaries and so the dog will not pee for more than 10 hours per day till he is let l oose outdoors to the grass.
For the past 7 years, he lived indoors and would hold his bladder till it is full and go to the grass in the evenings once a day. This is quite common for dogs as they don't want to soil the inside of the house or apartment and are not paper trained. Urine stasis leads to urinary stone formation in this Bichon as he was fed mainly dry dog food and given treats by family members daily. He prefers to be indoors and so would not pee till brought to the grass outdoors. Sometimes after work past 8 pm, I would take him to the grass. His usual habit would be to raise his right leg and urine marked the lamp-post and other places. A few drops of urine here and there peed out within a second or two.
This morning at 5.30 am, after complying with my "In" command, he gave up thoughts of coming into the house and walked down the steps to the back garden grass. He stood like a while looking at me and then raised his right hind leg and stood like a statute.
I counted "1, 2, 3......." till he stopped peeing by putting down his right leg. Today, he took just 13 seconds approximately. His urinary catheter was removed by Dr Daniel yesterday evening as it is not advisable to put it in for more than 2 days to prevent bladder infection. He is still under medical treatment as an alternative to bladder stone surgery and so he must be allowed access to the grass at least 3 times per day nowadays. The caregiver is the one who must be trained to understand the rationale of ths need to access the grass to pass out any crystals dissolved by special diet. As for today's observation, it seems he can pass urine much faster than yesterday 2.30 am at around 55 seconds from raising to lowering of his right leg.
There needs to be a lot of work to get this dog to pee and the responsibility is great.
At 5.30 am, I woke up and checked on the Bichon. This time the caregiver complied with my instructions to let him sleep in the sheltered area outside the kitchen so that he has access to the grass to pee anytime. He would be taken to the grass at other times in the day. This morning, he had no need to rush to the grass. I said "In" which is a command to move "forward" to any place I wanted him to. He has this habit of barking loudly whenever anyone comes to the front door as he positions himself in the living room. It is good but as some family members come home at 3 am, his loud barking disturbed my sleep. Whenever he barks in this way, I will get up and train him by depriving him of the privillege of being in the living room. He would have to go to the kitchen and stay there whenever he barks in this way in my presence. My family members do not adopt this method of training and so he is 70% trained. Yesterday when I came back in the afternoon, he barked again.
In medical dissolution of the struvite stones, the Bichon must also have access to the grass to pee and that is why he cannot stay indoors. We lock our front and back doors to prevent burglaries and so the dog will not pee for more than 10 hours per day till he is let l oose outdoors to the grass.
For the past 7 years, he lived indoors and would hold his bladder till it is full and go to the grass in the evenings once a day. This is quite common for dogs as they don't want to soil the inside of the house or apartment and are not paper trained. Urine stasis leads to urinary stone formation in this Bichon as he was fed mainly dry dog food and given treats by family members daily. He prefers to be indoors and so would not pee till brought to the grass outdoors. Sometimes after work past 8 pm, I would take him to the grass. His usual habit would be to raise his right leg and urine marked the lamp-post and other places. A few drops of urine here and there peed out within a second or two.
This morning at 5.30 am, after complying with my "In" command, he gave up thoughts of coming into the house and walked down the steps to the back garden grass. He stood like a while looking at me and then raised his right hind leg and stood like a statute.
I counted "1, 2, 3......." till he stopped peeing by putting down his right leg. Today, he took just 13 seconds approximately. His urinary catheter was removed by Dr Daniel yesterday evening as it is not advisable to put it in for more than 2 days to prevent bladder infection. He is still under medical treatment as an alternative to bladder stone surgery and so he must be allowed access to the grass at least 3 times per day nowadays. The caregiver is the one who must be trained to understand the rationale of ths need to access the grass to pass out any crystals dissolved by special diet. As for today's observation, it seems he can pass urine much faster than yesterday 2.30 am at around 55 seconds from raising to lowering of his right leg.
There needs to be a lot of work to get this dog to pee and the responsibility is great.
Tuesday, October 29, 2013
1135. Travel story. Purchase of a How-To You Tube book in New York
On my last day at New York, I did not want to go to the top floor of Rockerfeller Centre where I can see the panaromic view of the city at "The Rock". I had only 2 hours before going to the airport to go back to Singapore. So I took off to Barnes and Nobles nearby. It is a small 2-level store with basement and does not sell veterinary books or even "The Pill Book for the Dog and Cat owner".The employee checked her computer and said that she would order from Ohio. I had bought "The Pill Book" for human beings earlier at a supermarket where the tour guide took us to. There was "Medi-Sleep" which he recommended for those who can't sleep. It contains 50 mg diphenylhydramine which is for cough mixture.
I had no time to visit another Barnes and Noble 30 blocks away which was half an hour's walk. I bought a "How to You Tube book" and went back to the tour group at 4.30 pm to go to the airport for home to Singapore. It is a pity that I did not know the Public Library of New York is at 5th Avenue too and so did not visit it. The tour group leader was giving what the Singaporean tourists want - the malls of 5th Avenue and said nothing about the book stores or libraries. So we all went on our materialistic ways to one side of 5th Avenue where the upscale shops are. The other side is where the bookstores and Public Library are and the tour guide did not mention this. He simply stated that the other side had no upscale shops. It is like Ion Shopping Centre in Singapore's Orchard Road with upscale shops. Don't go to Plaza Singapura side as the tourists will see "nothing" of interest. The National Library will be at that dull side.
Subscribe to:
Posts (Atom)