1266. Buying traditional cakes for a 92-year-old grandma

http://youtu.be/reEpbjKSp7c

A short video clip on what I did on Saturday Dec 14, 2013. I went to buy cakes for a 92-year-old grandma who would have eaten them from a young age and would therefore appreciate them.

1265. The itchy 6-year-old pomeranian has skin disease again

The itchy

Part 1
http://youtu.be/zPEi8ZIhMoo


Part 2
http://youtu.be/OmGpXpjr45A


Part 3

1264. Itchy ears in a young beagle and a poodle

Saturday Dec 14, 2013

"Floppy eared dogs like the beagle, cocker spaniel and poodle tend to have ear problems," I said to a young fair lady with a heart-shaped face. She would be in her mid 20s.

"This is because the ears are covered up, being floppy eared. So there is no ventilation. Water from the shampoo and broken hairs are trapped inside at the horizontal canal," I explained.  The dog also had anal sac infections with lots of dark brown oil expressed. 


This morning, I had another case of ear scratching using the back legs.

1263. "Judgement Day" for a closed-pyometra dog

http://youtu.be/ZykWoYi9imY

The video was produced by Intern Clara as part of her internship training to be a vet. Images are blurred for some technical reasons although most of the other interns do not have this problem..

She was not comfortable with the use of "Judgment Day" but that is the theme of the story. Judgment Day for Christians has a much different meaning but many phrases in writings have been taken from the Bible and they are not meant to denote the same interpretations.

A concise video clip. However, the 2nd and 3rd alternatives to make a judgment call by the owner were confusing and is given below.  

--------------------------------------------------    

The old female dog had a bloated abdomen. Closed pyometra was diagnosed on history, palpation x-rays and blood tests.

The options for the owner were:
1. No operation. The dog will die from septicaemia.
2. Operation on the same day after I/V drip & medication of around 3 hours. Higher anaesthetic risk as the dog is lethargic and unfit for anaesthesia. But delay of several hours may result in the swollen uterus rupturing, spilling out the bacteria and toxins into the abdomen, killing the dog.
3. Operation on the next day after I/V drip & medication. This stabilises the dog's health as the drugs have time to take effect to kill off the bacteria inside the blood stream. However, the uterus is about to burst anytime and an emergency spay is strongly advised (Option 2) with its much higher risk of anaesthetic death on the operating table .

This is a judment call for the owner and the vet. The owner bears the responsibility for the dog's death. She selected took option 2. The dog survives the operation. She comes back on Day 11 for stitch removal. Everybody has a happy ending in this case but not all closed pyometra dogs survive.  Many die as the owner delays several days seeking veterinary treatment or the vomiting dog has had been mis-diagnosed for gastro-enteritis when the owner does not permit blood testing and X-rays. Spaying your dog young would have prevented pyometra, higher medical costs and much emotional distress when closed pyometra occurs and remain neglected resulting in the dog's untimely death.

1262. Two veterinary stories for video production/e-book

Two stories are as follows:

http://bekindtopets.blogspot.sg/2008/01/dog-that-singapore-tzu-chi-fundation.html

124. The dog that the Singapore Tzu Chi Fundation volunteers saved from lethal injection. Follow up to Case 110. Edit | View | Share | Delete

kongsing

0Comment count

1449View count

1/25/

http://bekindtopets.blogspot.sg/2007/11/110-20-year-old-dog-with-breast-cancer.html

110. A gigantic breast tumour in a dog Edit | View | Share | Delete

kongsing

0Comment count

234View count

11

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http://bekindtopets.blogspot.sg/2007/07/part-2.html

http://bekindtopets.blogspot.sg/2007/07/date-of-record-jul-10-2007-saving-swamp.html


http://bekindtopets.blogspot.sg/2007/07/5.html

http://bekindtopets.blogspot.sg/2007/07/chapter-3-looters-dr-sing-kong-yuen-toa.html


http://bekindtopets.blogspot.sg/2007/07/swamp-dogs-bobby.html



http://bekindtopets.blogspot.sg/2007/07/labrador-retriever-and-maid.html

1261. Audit of case of kidney stones causing kidney failure

TOA PAYOH VETS toapayohvets.com Date:   15 November, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits The Silkie had double kidney stones Dr Sing Kong Yuen, BVMS (Glasgow), MRCVSDate:   15 November, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Silkie Terrier, F, spayed, 13 yearsFed dry food + bread since 5 years of age (adopted from another owner who migrated). 2 days ago, presented with vomiting and diarrhoea. I treated and advised blood tests and X-rays if the symptoms persisted. The dog came back yesterday, "dying" according to Dr Daniel who got the X-rays and blood tests done. A rare case of kidney stones in the 2 kidneys was diagnosed based on evidence. Dogs usually suffer from bladder stones. No urine tests done in this case.  Blood urea and creatinine are extremely high. The dog vomits dark brown fluid in the crate and has heavy abdominal breathing as at 11.14 am Nov 13, 2013 when the lady owner came to visit as I phoned her to say that the dog was suffering in pain and was on the last leg of his life. The dog vomited white froth on the reception room floor. The owner will bring home for today and had decided on euthanasia later in the day.   Two kidneys are packed with stones Vomiting and diarrhoea can be a sign of kidney failure although most cases are due to gastroenteritis. This dog was treated for gastroenteritis at the first consultation without blood test so as to reduce medical costs. As the vomiting persisted, I advised a blood test and Dr Daniel took it since I was out. This was a case of renal urolithiasis resulting in kidney failure.    Updates will be on this webpage: http://www.bekindtopets.com/dogs/20131114two_kidneys_ with_stones_Silkie_toapayohvets.htm Dec 13, 2013 I review the case medical records today to do a retrospective study. 41099 Silkie, Female, spayed, Born 2000. Aug 23, 2010. First consulted Toa Payoh Vets. 10 years old.                         Left ear tumour at base of ear and rotten teeth. Advised treatment. Just wanted antibiotic. Sep 3, 2010    Treatment done for above conditions. Nov 11, 2013  13 years old. Bloody diarrhoea. Vomited greenish stuff 2 days. Not eating and drinking. Does not want blood test (recorded in case file). Wanted I/V drip & medication.  Vet is myself (Dr Sing Kong Yuen) Nov 13, 2013 Respiratory distress. Dr Daniel Sing Blood test - severe azotemia ALT 73 (<59 br="">Urea 86  (4.2-6.3) Creatinine 1129 (89-177) Total white cell count 11.9 (6-17)  -- OK    Neutrophils 86%   Abs  10.18    Lymphocytes 6%   Abs 0.70    Monocytes  8.3%   Abs 0.99    Eosinophils 0%    Basophils 0.1% Platelets 459 ( 200-500) -- OK X-rays - calcified cores in both kidneys Owner elected euthanasia.

1260. Video: A blood-shot eyed rabbit. Practising evidence-based medicine

 http://youtu.be/YsUlZ-uqTNQ


PRACTISING EVIDENCE-BASED MEDICINE IN A RABBIT


The young rabbit's eye conjunctiva is dark red and swollen. Tears stream down the eye. In my experience, the grossly enlarged upper conjunctiva is cause by vigorous eye rubbing by the rabbit to relieve the pain and irritation. Something had fallen onto the cornea but on superficial examination, there seems to be no eye ulcer or abrasion caused by this foreign object.

The fluorescein eye stain test showed corneal ulcerations to be green. Almost 3/4 of the cornea is green with only the right sided cornea at 2-4 o'clock being clear.

Unfortunately Intern Clara edited and showed a very short clip of less than 2 seconds. She ought to show much more as this will illustrate clearly the evidence. The theme of this video is using evidence to aid in the diagnosis and the Intern must be aware of the theme and whenever possible, expands on this theme.

The raw footage of the green cornea clips is at another video. Goto:
www.toapayohvets.com/videos.htm