Recently, I had two cases of owners phoning for dental scaling appointments for their dogs. I don't know about other surgeries, but few of my clients in the past bother about preventing mouth ulcers and tumours due to bad oral hygiene.
CASE 1. An 8-year-old Cavalier King Charles would not eat dry food. One of the 3 daughters complained that the dog had bad breath. So the father drove the mum and 2 daughters with the dog to get the dog dental scaling.
I had to extract 3 loose upper side teeth (PM 1 & 2 on Right Upper and PM 1 on Left Upper). Xylazine 2% 0.3 ml IM and isoflurane gas were used to anaesthesize the quiet friendly dog. "For an 8-year-old dog, his teeth are quite clean," I said to the family. "Other dogs of his age would have all teeth dropped out. What do you feed and do you brush his teeth?"
Mum said, "He eats chicken and rice. A little bit of dry food. He does not want to eat by himself and so I have to feed him."
I was surprised as most dogs eat by themselves. Is he a picky eater or because he has a painful mouth. "Do you brush his teeth?" I asked the mum. "I used a towel to clean his teeth but he is not cooperating."
"He should be able to eat dry food now that his loose teeth are extracted and therefore he should not feel any pain."
"But he has been eating chicken meat all these years," the mum said.
"Add a few pieces of dry food to his canned chicken meat for the first week," I advised. "Then increase more and more till he eats dry food. Dry food does clean his teeth. Brush his teeth 3 times a week too. Use the finger brush or the long tooth brush. I will not need to scale his teeth again."
"How long can a dog live?"
"In Singapore, the small breed can live up to 20 years, but in general, most live up to 10-15 years," I said to the happy family with 3 daughters now in their teens. Mum said the Cavalier King Charles was treated by me 8 years ago for diarrhoea. Well, he is now fully grown up and well loved.
As my intern Teresa was assisting me, I told her that the owner had prevented serious heart diseases by getting dental scaling done early. "What heart diseases?"
CASE 2
"How much do you charge for dental scaling?" a male voice asked. "$250 for general anaesthesia and dental scaling," I was answering the phone on this May 2010 Sunday. Asking for quotations is a common practice and so I did not ask whether he would like to make an appointment.
A handsome couple turned up. The lady was slim and as fair as the significant other with muscles was as dark. Both were in their early 30s. The Miniature Schnauzer had thick tartar in all his teeth and took at least 30 minutes of dental scaling unlike my Case 1. Stains and hard tartar enveloped the inside of the teeth. I wondered what the dog had been eating. Probably no teeth brushing.
"Is it not a boring job to be a cabin crew flying from one destination to another and flying back?" I asked the fair lady. She had minimal make up since she was not working and some red rashes showed on her cheeks. Those did not distract from her beauty. "No," she said. "It is an enjoyable job for me. There are hazards to this job."
"What hazards?" I asked, thinking of the air crashes.
"We get varicose veins due to long hours of standing," she showed me her some faint bluish blemish in her knee. Fortunately, the significant other did not get jealous.
Thursday, May 13, 2010
59. How to be successful?
May 12, 2010
To: Ms Koh
Do what you think is correct. Learn from being hands-on and making mistakes. There is no other way to be wiser and smarter.
Singapore expatriate real estate rental markets are getting hotter in 2010. I have at least 10 times more e-mails for asiahomes.com this year than last year regarding rentals esp. serviced apartments.
Some agents sms me about the Bishan Loft advert. Pl use your phone to make preliminary contact and e-mail.
Become an expert at Google Docs for real estate. I attach a picture hoping it will inspire you. I am into creating inspirational pictures for young people like you and those studying hard for their future.
The Golden Age of the internet is in your hands. Internet connects the world unlike my youthhood in the 1970s. One example I gave you was an expatriate who surfed the net, contacted www.asiahomes.com, met me and bought a $3.3 million Wing On Life condo in Singapore. My co-broking agency commission was $15,000. We would never meet if not for the world wide web.
I will not live long to enjoy this Golden Age as I was born at the wrong time. But young people like you will enjoy and prosper in this Golden Age if you know how to use the internet. Create rather than consume. This is my advice to all young adults like you. But few young adults create.
One good example is a 26-year-old man, Singaporean I met recently. He had been doing e-bay sales for the past 9 years. He did not need to work for people. He would get orders to create Star Wars "guns" etc and get them made in Singapore. Then he would mail them to customers in the U.S.A.
He was passionate in his craft as he showed me his Facebook portfolio. I was impressed with his creation of a gold ring similar to the one in the movie "Lord Of The Ring." It looked like a simple gold band but I could recognise it as the LOTR ring. He said that the movie ring had words engraved on it using CGI. He said his LOTR webpage was shut down.
But competition is nowadays much stronger and therefore his net profits have had reduced considerably. "This is a common challenge when Singapore becomes fully developed," I said to him. "Many younger vets have also set up shop to provide cheaper services than the established ones to get the business."
This young man is venturing into a "new" field "internet marketing" which also has lots of competitors and is actually an old subject. Some people even advertise in the Straits Times to conduct courses on "internet marketing." Nine years is a long time and I can understand he needs a change.
I could not believe that such young Singaporeans exist as I think they are addicted in online computer gaming and enjoyment at the age of 17 years which was when this young man started his enterprise to create and sell on e-bay. This young man showed me one other young man in Hongkong. That man created the "Iron Man" suit for sale. He lamented that this was beyond his capability. My comment is that he has lost focus and interest. It is a pity that he has no "determination" or "perseverance". He could manufacture and produce really good toys and has a forum to market his work.
In conclusion, create and read widely. One day, you will be successful even though you may not want to do real estate anymore. It is the hands-on internet experience and solving the problems of the real estate that will give you the hard edge to take on another industry later.
Best wishes
Dr Sing Kong Yuen
Best wishes.
To: Ms Koh
Do what you think is correct. Learn from being hands-on and making mistakes. There is no other way to be wiser and smarter.
Singapore expatriate real estate rental markets are getting hotter in 2010. I have at least 10 times more e-mails for asiahomes.com this year than last year regarding rentals esp. serviced apartments.
Some agents sms me about the Bishan Loft advert. Pl use your phone to make preliminary contact and e-mail.
Become an expert at Google Docs for real estate. I attach a picture hoping it will inspire you. I am into creating inspirational pictures for young people like you and those studying hard for their future.
The Golden Age of the internet is in your hands. Internet connects the world unlike my youthhood in the 1970s. One example I gave you was an expatriate who surfed the net, contacted www.asiahomes.com, met me and bought a $3.3 million Wing On Life condo in Singapore. My co-broking agency commission was $15,000. We would never meet if not for the world wide web.
I will not live long to enjoy this Golden Age as I was born at the wrong time. But young people like you will enjoy and prosper in this Golden Age if you know how to use the internet. Create rather than consume. This is my advice to all young adults like you. But few young adults create.
One good example is a 26-year-old man, Singaporean I met recently. He had been doing e-bay sales for the past 9 years. He did not need to work for people. He would get orders to create Star Wars "guns" etc and get them made in Singapore. Then he would mail them to customers in the U.S.A.
He was passionate in his craft as he showed me his Facebook portfolio. I was impressed with his creation of a gold ring similar to the one in the movie "Lord Of The Ring." It looked like a simple gold band but I could recognise it as the LOTR ring. He said that the movie ring had words engraved on it using CGI. He said his LOTR webpage was shut down.
But competition is nowadays much stronger and therefore his net profits have had reduced considerably. "This is a common challenge when Singapore becomes fully developed," I said to him. "Many younger vets have also set up shop to provide cheaper services than the established ones to get the business."
This young man is venturing into a "new" field "internet marketing" which also has lots of competitors and is actually an old subject. Some people even advertise in the Straits Times to conduct courses on "internet marketing." Nine years is a long time and I can understand he needs a change.
I could not believe that such young Singaporeans exist as I think they are addicted in online computer gaming and enjoyment at the age of 17 years which was when this young man started his enterprise to create and sell on e-bay. This young man showed me one other young man in Hongkong. That man created the "Iron Man" suit for sale. He lamented that this was beyond his capability. My comment is that he has lost focus and interest. It is a pity that he has no "determination" or "perseverance". He could manufacture and produce really good toys and has a forum to market his work.
In conclusion, create and read widely. One day, you will be successful even though you may not want to do real estate anymore. It is the hands-on internet experience and solving the problems of the real estate that will give you the hard edge to take on another industry later.
Best wishes
Dr Sing Kong Yuen
Best wishes.
Tuesday, May 11, 2010
58. Sunday's cases. Mother's Day 2010
It was Mother's Day on this Sunday, May 11, 2011. I open on Sundays but this Sunday, the Landlord of the industrial estate had switched off the electricity from 8 am to 3 pm. It was quite stuffy as the air conditioning was not functioning. "There will be no electricity," my 75-year-old receptionist informed me so that I could close the Surgery. However, I had prior appointments with Mrs Clow and her rabbit with diarrhoea. In any case, no surgery could be done, but consultation would be OK as I have bright glass windows and clear glass doors in the front desk.
After church at 11.30 am, Mrs Clow and her pre-teen daughter brought in 6 rabbits with crusty ear edges, nose and paws in one carrier with the mother rabbit and one wire cage with the father rabbit and 4 small dwarf rabbits of around 2 months old.
"My husband said that I should not be paying for the treatment as the rabbits are not mine. How much does it cost me to treat 6 rabbits for scabies?"
"Men are money-minded and practical unlike women when it comes to animals not belonging to them" I said.
"Does this include you?" she asked me. "No, no," I said. "I am generalising." I should have kept my mouth shut about the male homo sapiens.
"Should I send them to the SPCA?" Mrs Clow asked while her 11-year-old daughter was all ears.
I said: "If they are sent to the SPCA, they will be put to sleep after 3 days, as in most animal shelters in the U.S. Nobody would adopt these diseased rabbits. Their crusty infestation will take at least one week to drop off after my anti-scabies injection."
"Sometimes the scabies will recur as the surroundings still have the mites to attack the rabbits. In my experience one injection will do, but sometimes there is a need for two injections two weeks later. What will you be doing if the scabies come back?
"I can refer you to a pet shop that specialises in selling rabbits. The 4 young ones may find a home rather than be put to sleep at the SPCA." I phoned Agnes the pet shop operator. She was interested.
"In any case, you are not the owner," I cautioned. "You may get sued by the girl's parents. Why don't you talk to the owner? You are teaching your little girl the wrong values."
Mrs Clow said of her tall and slim daughter: "She is a big girl."
"How old are you," I asked the quiet girl.
"She is 11 years old," Mrs Clow replied.
Then she took out her iPhone from her handbag and thumb a message to the owner of the rabbit. Within a few seconds, Mrs Clow read the reply and said: "She wants all the 6 rabbits back."
"Why don't you talk to the girl's mother?" I advised. "You may get sued for doing what is right in your opinion." What is the right thing to do would be to sterilise the adult rabbits and to get them treated for scabies.
Bad blood between neighbours can flow fast if all these rabbits don't go home. Mrs
Clow said: "Treat the rabbits and keep them overnight. I will pay you tomorrow when I bring them home."
The four baby dwarf rabbits had thick crusts of 1cm x 0.8 cm on their noses and various big crusts on their paws and edges of the ears. They were thin. Normally I would not give them the anti-mite injection but this was now or never. So my intern Theresa restrained each rabbit while I injected the medicine under the skin at the back of the neck. One young rabbit squeaked. Another squealed and lay flat as it felt the pain. Theresa massaged the area and it recovered.
Mrs Clow went home and text-messaged me that the owner's mother would contact me. The mother paid for the treatment of the 6 rabbits the next day and brought them home. I hope the young ones would be OK and be able to eat a lot to put on weight and build up their resistance.
This was an usual Mother's Day as it involved two mothers and two daughters.
I remembered this day as a young couple came in with a cat with an injured right hind limb and the man said: "I googled 'vet open Sunday' and your practice appears on the top."
I was surprised. This cat had strayed out of the apartment and came back very lame. "She could not walk at first," the man said. "Now she could walk but her right hind leg was dragging."
I put the cat on the examination table and asked Theresa to hold it down on its left side. I flexed and extended the toes, stifle and the hip joints. There was no pain in the toes and stifle. But I heard a distinct click as the right hip ball and socket went back into the hip joint. "Did you hear the click?" I asked the man who was standing nearby. "Your cat was dragging its right hind because it had a loose hip, a subluxation of the hip joint." His wife was further back in this 80 sq. ft consultation room. "No," the man said. "I must be hard of hearing."
"No," his wife shook her head.
"Did you hear the click?" I asked my intern Theresa.
"Yes," Theresa said.
"In any case, did you see that the cat was angry when I put fix the hip as I rotated the ball into its socket?" I asked.
"Yes," the man confirmed. Then I pressed the backbone of the cat. It reacted in pain at the lower back. "Most likely, this cat had been attacked by another cat on its back and got his right hind limb skin scrapped off. Or a naughty boy had bashed him with a stick."
I was generalising on the male behaviour again. The cat was treated and warded for 3 days as the owner had no crate for him. He was as good as gold.
After church at 11.30 am, Mrs Clow and her pre-teen daughter brought in 6 rabbits with crusty ear edges, nose and paws in one carrier with the mother rabbit and one wire cage with the father rabbit and 4 small dwarf rabbits of around 2 months old.
"My husband said that I should not be paying for the treatment as the rabbits are not mine. How much does it cost me to treat 6 rabbits for scabies?"
"Men are money-minded and practical unlike women when it comes to animals not belonging to them" I said.
"Does this include you?" she asked me. "No, no," I said. "I am generalising." I should have kept my mouth shut about the male homo sapiens.
"Should I send them to the SPCA?" Mrs Clow asked while her 11-year-old daughter was all ears.
I said: "If they are sent to the SPCA, they will be put to sleep after 3 days, as in most animal shelters in the U.S. Nobody would adopt these diseased rabbits. Their crusty infestation will take at least one week to drop off after my anti-scabies injection."
"Sometimes the scabies will recur as the surroundings still have the mites to attack the rabbits. In my experience one injection will do, but sometimes there is a need for two injections two weeks later. What will you be doing if the scabies come back?
"I can refer you to a pet shop that specialises in selling rabbits. The 4 young ones may find a home rather than be put to sleep at the SPCA." I phoned Agnes the pet shop operator. She was interested.
"In any case, you are not the owner," I cautioned. "You may get sued by the girl's parents. Why don't you talk to the owner? You are teaching your little girl the wrong values."
Mrs Clow said of her tall and slim daughter: "She is a big girl."
"How old are you," I asked the quiet girl.
"She is 11 years old," Mrs Clow replied.
Then she took out her iPhone from her handbag and thumb a message to the owner of the rabbit. Within a few seconds, Mrs Clow read the reply and said: "She wants all the 6 rabbits back."
"Why don't you talk to the girl's mother?" I advised. "You may get sued for doing what is right in your opinion." What is the right thing to do would be to sterilise the adult rabbits and to get them treated for scabies.
Bad blood between neighbours can flow fast if all these rabbits don't go home. Mrs
Clow said: "Treat the rabbits and keep them overnight. I will pay you tomorrow when I bring them home."
The four baby dwarf rabbits had thick crusts of 1cm x 0.8 cm on their noses and various big crusts on their paws and edges of the ears. They were thin. Normally I would not give them the anti-mite injection but this was now or never. So my intern Theresa restrained each rabbit while I injected the medicine under the skin at the back of the neck. One young rabbit squeaked. Another squealed and lay flat as it felt the pain. Theresa massaged the area and it recovered.
Mrs Clow went home and text-messaged me that the owner's mother would contact me. The mother paid for the treatment of the 6 rabbits the next day and brought them home. I hope the young ones would be OK and be able to eat a lot to put on weight and build up their resistance.
This was an usual Mother's Day as it involved two mothers and two daughters.
I remembered this day as a young couple came in with a cat with an injured right hind limb and the man said: "I googled 'vet open Sunday' and your practice appears on the top."
I was surprised. This cat had strayed out of the apartment and came back very lame. "She could not walk at first," the man said. "Now she could walk but her right hind leg was dragging."
I put the cat on the examination table and asked Theresa to hold it down on its left side. I flexed and extended the toes, stifle and the hip joints. There was no pain in the toes and stifle. But I heard a distinct click as the right hip ball and socket went back into the hip joint. "Did you hear the click?" I asked the man who was standing nearby. "Your cat was dragging its right hind because it had a loose hip, a subluxation of the hip joint." His wife was further back in this 80 sq. ft consultation room. "No," the man said. "I must be hard of hearing."
"No," his wife shook her head.
"Did you hear the click?" I asked my intern Theresa.
"Yes," Theresa said.
"In any case, did you see that the cat was angry when I put fix the hip as I rotated the ball into its socket?" I asked.
"Yes," the man confirmed. Then I pressed the backbone of the cat. It reacted in pain at the lower back. "Most likely, this cat had been attacked by another cat on its back and got his right hind limb skin scrapped off. Or a naughty boy had bashed him with a stick."
I was generalising on the male behaviour again. The cat was treated and warded for 3 days as the owner had no crate for him. He was as good as gold.
A forgetful intern?
7. A forgetful veterinary intern?
Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.
"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.
Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."
"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.
This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.
Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?
As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."
I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).
Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.
"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.
Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."
"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.
This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.
Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?
As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."
I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).
Sunday, May 9, 2010
56. Don't buy 2 sibling hamsters
Saturday, May 8, 2010
Hi doctor sing,
I'm the owner of the hamster who developed the tumour (armpit) who just pass away today. I just want to say thank Q to u. At least now my hamster passed away without the tumour.
Actually i thought of collecting her home today, but after i receive a call saying she had passed away i really feel so sad. I think if i bring her earlier to surgery she might survive. I really feel bad. Any way i just get a new hamster today. : ) take care doctor sing.
Best regards
Name of owner : )
As I was off on Saturday, May 8, 2010, I went to Marine Sands Singapore to visit the place for the first time and to visit the owner of the hamster. I was going to tell her not to buy sibling hamsters but her colleague told me she had bought two hamsters so that they have company.
The hamster's sibling had recurrence of chest tumour of a similar appearance and died on the operating table on the 3rd anaesthesia and surgery some 2 months ago.
This hamster was not eating and was in weak condition when the young lady owner brought her in to get the tumour excised. I told her firmly that the risks were very high as she had waited too long, weakening the hamster's immune system.
The hamster was warded for 2 days prior to operation so that she could regain her appetite. She did not eat. She was given hand feeding, antibiotics and electrolytes for one day. I needed to operate since time was of the essence and she was getting weaker (closed eyelids, lethargic, few pellets of stools passed).
I used isoflurane gas for a few seconds and she did survive the anaesthesia and operation. She was alive at the end of the surgery but I told Vet Intern Theresa that the chances of survival post-operation are very slim.
I asked the owner to take her back for nursing after surgery. But she asked me to care for it a few days. Her hamster passed away peacefully the next day.
She was a very high risk surgical case. She would die soon if she was not operated as she had problems drinking and eating. However, surgery would give her a chance to live longer. In this case, the post-surgical outcome was not good. Surgery gave her a chance. No surgery meant imminent death. So there was no choice but to operate with the owner's awareness of the great risk. She understood the risk but was glad that the hamster passed away without a large armpit tumour.
Hi doctor sing,
I'm the owner of the hamster who developed the tumour (armpit) who just pass away today. I just want to say thank Q to u. At least now my hamster passed away without the tumour.
Actually i thought of collecting her home today, but after i receive a call saying she had passed away i really feel so sad. I think if i bring her earlier to surgery she might survive. I really feel bad. Any way i just get a new hamster today. : ) take care doctor sing.
Best regards
Name of owner : )
As I was off on Saturday, May 8, 2010, I went to Marine Sands Singapore to visit the place for the first time and to visit the owner of the hamster. I was going to tell her not to buy sibling hamsters but her colleague told me she had bought two hamsters so that they have company.
The hamster's sibling had recurrence of chest tumour of a similar appearance and died on the operating table on the 3rd anaesthesia and surgery some 2 months ago.
This hamster was not eating and was in weak condition when the young lady owner brought her in to get the tumour excised. I told her firmly that the risks were very high as she had waited too long, weakening the hamster's immune system.
The hamster was warded for 2 days prior to operation so that she could regain her appetite. She did not eat. She was given hand feeding, antibiotics and electrolytes for one day. I needed to operate since time was of the essence and she was getting weaker (closed eyelids, lethargic, few pellets of stools passed).
I used isoflurane gas for a few seconds and she did survive the anaesthesia and operation. She was alive at the end of the surgery but I told Vet Intern Theresa that the chances of survival post-operation are very slim.
I asked the owner to take her back for nursing after surgery. But she asked me to care for it a few days. Her hamster passed away peacefully the next day.
She was a very high risk surgical case. She would die soon if she was not operated as she had problems drinking and eating. However, surgery would give her a chance to live longer. In this case, the post-surgical outcome was not good. Surgery gave her a chance. No surgery meant imminent death. So there was no choice but to operate with the owner's awareness of the great risk. She understood the risk but was glad that the hamster passed away without a large armpit tumour.
Friday, May 7, 2010
55. Sibling with same tumour
E-mail to Dr Sing dated May 4, 2010
Hi doctor Sing,
This is Ann. i bring my hamster down to surgery this morning. The Hamster who develops a tumuor at armpit. Is it successfull?? Is she ok now? i hope she do.. thanks a lot.
The young lady brought the sibling dwarf hamster with a large armpit tumour. Her other hamster had died on the operating table during the 3rd surgery to remove the recurring tumour and she was very upset some months ago. The armpit tumour was nearly 1 cm x 1 cm in size and the hamster was not eating much.
"Why don't you bring the hamster earlier for operation?" I asked her since she had the experience of belated surgery in her first hamster. "It is so much easier to remove a small tumour."
May 5, 2010
It is best not to operate immediately as the dwarf hamster, l.5 years old was not eating much. There were some stools passed.
May 6, 2010
Hamster was not eating as evidenced by no stools passed. Her two eyelids were closed. This was not a good sign of health. I put antibiotics onto the eye and my vet intern Theresa fed her orally using electrolytes 0.5 ml per time. "Likes the Biolapis electroylte but not the Fibroplex," Theresa said.
Now, should I operate or wait another day for the hamster. The hamster was not eating now and its skin stood up as a fold because it was dehydrated.
I decided on anaesthesia using isoflurane and cut off the armpit tumour. The hamster was very weak and I gave her a few seconds of isolurane gas 5%.
Surprisingly, the hamster survived. Theresa is very good at nursing and I expect the hamster to be able to survive and go home.
P.S. No Zoeletil must be given as the hamster was very weak. Surgery could not be delayed further as the hamster needed his hand to grab seeds to eat and the armpit tumour of his right fore caused pain and affected his eating.
Hi doctor Sing,
This is Ann. i bring my hamster down to surgery this morning. The Hamster who develops a tumuor at armpit. Is it successfull?? Is she ok now? i hope she do.. thanks a lot.
The young lady brought the sibling dwarf hamster with a large armpit tumour. Her other hamster had died on the operating table during the 3rd surgery to remove the recurring tumour and she was very upset some months ago. The armpit tumour was nearly 1 cm x 1 cm in size and the hamster was not eating much.
"Why don't you bring the hamster earlier for operation?" I asked her since she had the experience of belated surgery in her first hamster. "It is so much easier to remove a small tumour."
May 5, 2010
It is best not to operate immediately as the dwarf hamster, l.5 years old was not eating much. There were some stools passed.
May 6, 2010
Hamster was not eating as evidenced by no stools passed. Her two eyelids were closed. This was not a good sign of health. I put antibiotics onto the eye and my vet intern Theresa fed her orally using electrolytes 0.5 ml per time. "Likes the Biolapis electroylte but not the Fibroplex," Theresa said.
Now, should I operate or wait another day for the hamster. The hamster was not eating now and its skin stood up as a fold because it was dehydrated.
I decided on anaesthesia using isoflurane and cut off the armpit tumour. The hamster was very weak and I gave her a few seconds of isolurane gas 5%.
Surprisingly, the hamster survived. Theresa is very good at nursing and I expect the hamster to be able to survive and go home.
P.S. No Zoeletil must be given as the hamster was very weak. Surgery could not be delayed further as the hamster needed his hand to grab seeds to eat and the armpit tumour of his right fore caused pain and affected his eating.
Wednesday, May 5, 2010
54. Oral ulcers + Caudal stomatitis in a Burmese cat
Gingivostomatitis (inflammation of the gums and mouth) and Caudal Stomatitis (inflammation at the back of the mouth). I report an early case as the Danish owners are animal lovers. Burmese cat, Female, Spayed, 7 years. Fever.
Complaint: "The cat used his paws to scratch her commissure of lips one month ago," the gentleman said it was more to the right side of the mouth. The wife said it was both sides. In the last 2 days, the cat pawed on the right side of the mouth more than the left side and would not eat her dry food. What's the problem?
EXAMINATION
I suspect toothache due to decay and loose back teeth but when I examined the cat's mouth, the teeth were in excellent condition except for tartar on all the four 3rd premolars. I smelt the mouth. No bad breath or very faint.
ANAESTHESIA: 3.6kg. Xylazine 20 + Ketamine 100 0.1ml +0.4ml one syringe IM sufficient.
Ulcers back edges of tongue (white fibrous granules) both sides 3cm x 3mm. Why?
Owner says that this cat has no stress. The dominant of 3 Burmese cats.
Cause: Unknown. Virus or bacterial infections said to be involved.
More common in purebred cats like this Burmese.
Unusual report in this case: No bad breath (I smelt the mouth). No loose teeth at all. No serious gingivitis but tartar is present in all the premolars 3. Dental scaling done.
TREATMENT:
Tooth extraction is said to be most effective but this cat has no loose teeth at this stage.
ADVICE:
1. Baytril and predniosolone anti-inflammatory injections.
2. Oral baytril
3. Tolfedine for 3 days next week.
4. Medazole for 3 days.
5. Soft canned food for the time being as the ulcers are painful. But this cat is fixated on dry food for the past 7 years.
6. To check back of tongue weekly forever and let me know when small ulcers recur. I asked the husband to get the wife to come into the consultation room to see the ulcers on both sides of the back of the tongue while the cat is still under anaesthesia. I shone the torch-light for her to see. Red strips and white globular fibrous tissues lined the ulcerated areas of around 3 cm x 2 mm. Bilateral and equal in length. Is this an auto-immune disease?
A very interesting case. See picture of one similar case in a dog not vaccinated too as owners seldom vaccinate their dogs or cats after 5 years of age. Could these two be due to virus?
Complaint: "The cat used his paws to scratch her commissure of lips one month ago," the gentleman said it was more to the right side of the mouth. The wife said it was both sides. In the last 2 days, the cat pawed on the right side of the mouth more than the left side and would not eat her dry food. What's the problem?
EXAMINATION
I suspect toothache due to decay and loose back teeth but when I examined the cat's mouth, the teeth were in excellent condition except for tartar on all the four 3rd premolars. I smelt the mouth. No bad breath or very faint.
ANAESTHESIA: 3.6kg. Xylazine 20 + Ketamine 100 0.1ml +0.4ml one syringe IM sufficient.
Ulcers back edges of tongue (white fibrous granules) both sides 3cm x 3mm. Why?
Owner says that this cat has no stress. The dominant of 3 Burmese cats.
Cause: Unknown. Virus or bacterial infections said to be involved.
More common in purebred cats like this Burmese.
Unusual report in this case: No bad breath (I smelt the mouth). No loose teeth at all. No serious gingivitis but tartar is present in all the premolars 3. Dental scaling done.
TREATMENT:
Tooth extraction is said to be most effective but this cat has no loose teeth at this stage.
ADVICE:
1. Baytril and predniosolone anti-inflammatory injections.
2. Oral baytril
3. Tolfedine for 3 days next week.
4. Medazole for 3 days.
5. Soft canned food for the time being as the ulcers are painful. But this cat is fixated on dry food for the past 7 years.
6. To check back of tongue weekly forever and let me know when small ulcers recur. I asked the husband to get the wife to come into the consultation room to see the ulcers on both sides of the back of the tongue while the cat is still under anaesthesia. I shone the torch-light for her to see. Red strips and white globular fibrous tissues lined the ulcerated areas of around 3 cm x 2 mm. Bilateral and equal in length. Is this an auto-immune disease?
A very interesting case. See picture of one similar case in a dog not vaccinated too as owners seldom vaccinate their dogs or cats after 5 years of age. Could these two be due to virus?
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