Thin 2.5 kg
"Every morning, the cat will meow loudly for his breakfast. My wife will kick me out from the bed to prepare his cat food," the father told me when I asked whether the cat had been eating normally. I could feel the spines of backbones sticking out onto my fingers. The cat had two big holes in her left flank. Holes of 5mm x 5 mm.
The younger daughter said: "Two years ago, you said this cat would die of liver failure as she had not been eating for one month. She is very much alive!"
"If a cat does not eat for a long time, there is liver fat breakdown and soon the cat gets jaundice and dies. There must be some reason I said about liver failure."
"Yes," the father said. "The cat stopped eating because we got a small kitten in. You said to get rid of the kitten."
"Once the kitten left the house, this cat ate. So, it was stress."
Identifying an issue from its fundamentals is not easy.
Sunday, May 16, 2010
Preventive Medicine
SUNDAY CASE - May 16, 2010
Miniature Schnauzer, Male, 6 years
Annual vaccination + proheart vacc
Examination:
Bladder palpated. Body shivered when lower abdomen is palpated. The 17-year-old daughter saw the vibrations. "He has some abdominal pain" I said. "Maybe a bladder infection."
"Can smell his urine from far away," the father said.
"Does the dog urine-mark?" I asked.
"Yes. He would pee a lot first and then urine-mark every spot even if he has nothing to pee."
"Does he drink a lot?"
"No," the father and daughter replied. "How to make him drink more and how much he should be drinking a day?"
"Exercise will make him thirsty. Some dogs love iced water. Put ice cubes into the water," I said.
Advice:
Dogs over 2 years need a preventive programme, not just annual vaccination.
1. Complete Blood test
2. Urine test to check for struvite stones and bacteria.
Permission:
Much depends on the parents.
Urine test agreed. Urine catheter, collect dark yellow cloudy urine to be sent to the Lab.
3. Read about prevention of urinary struvite stones.
4. 3-monthly or 3-6 monthly urine test will be best but no owners will do it.
Questions:
How long after neutering will my dog stop urine marking?
"Now, 6 years old. It will take many weeks to a year."
1. Probably 1 year
2. Schedule. lst month - urine mark same area. Change to another location
Miniature Schnauzer, Male, 6 years
Annual vaccination + proheart vacc
Examination:
Bladder palpated. Body shivered when lower abdomen is palpated. The 17-year-old daughter saw the vibrations. "He has some abdominal pain" I said. "Maybe a bladder infection."
"Can smell his urine from far away," the father said.
"Does the dog urine-mark?" I asked.
"Yes. He would pee a lot first and then urine-mark every spot even if he has nothing to pee."
"Does he drink a lot?"
"No," the father and daughter replied. "How to make him drink more and how much he should be drinking a day?"
"Exercise will make him thirsty. Some dogs love iced water. Put ice cubes into the water," I said.
Advice:
Dogs over 2 years need a preventive programme, not just annual vaccination.
1. Complete Blood test
2. Urine test to check for struvite stones and bacteria.
Permission:
Much depends on the parents.
Urine test agreed. Urine catheter, collect dark yellow cloudy urine to be sent to the Lab.
3. Read about prevention of urinary struvite stones.
4. 3-monthly or 3-6 monthly urine test will be best but no owners will do it.
Questions:
How long after neutering will my dog stop urine marking?
"Now, 6 years old. It will take many weeks to a year."
1. Probably 1 year
2. Schedule. lst month - urine mark same area. Change to another location
Friday, May 14, 2010
65. Dwarf Hamster, Male, 6 months. Wet penile area
"Wet Tail," the young lady said that her dwarf hamster of 6 months was very inactive and not eating or drinking since yesterday evening. It was 1 pm now.
"Wet Tail means that the hamster passes watery stools," I noted that the hamster's penile area was very wet, with yellow urine stains.
"He passes a lot of stools, hard ones," the young lady said. "What's wrong with him? He has this continuous sniffling sound, as if he has asthma." I held the hamster near my ears. Yes, he was emitting a "sit, sit, sit" sound.
INFECTION
"The hamster has an infection and so he was not moving or eating," I said. "Does he pee in a corner normally?"
"He pees everywhere," the young lady said. "Yesterday and today."
COMPETITION FOR FOOD
The hamster lives with the sibling who is bigger size in the same cage. "They have company. They never fight," the young lady was at home all day and had observed them. "Many pairs of male dwarf hamsters are OK when they are less than 3 months old," I said. "When they grow up, one will bite or attack the other."
The lady would not believe me as she was a first-time hamster owner. "Do they compete for food?" I asked. "Each would stuff as many sunflower seeds into their pouches as they can?"
"Yes," the lady confirmed. "Sometimes they stuff until their cheek pouches are very big. They only eat sunflower seeds. They don't like the other type of food."
The mouths of the two hamsters were smelly as the cheek pouches were infected due to impaction of the sunflower seeds. The seeds were also smelly as I took two seeds out of the pouch. Finally, after 5 minutes, the patient poured out 30 seeds.
HYPOTHESIS
1. Cheek pouch impaction. Bacterial infection from the pouches to the whole body system. Hamster had fever and stopped moving.
2. Urinary stain. Incontinent due to urinary tract infection or bites at this area causing painful urination. Bitten by the bigger-sized hamster. "Not as big as Hamstaro," the lady said. "But bigger than this one."
Then her friend spoke to her in Malay with some words "gig" and laughed. The bigger sibling does bite the ears and other parts of this subordinate hamster. "Whenever the squeaking became too loud," I separate them," the lady said.
ADVICE
Separate the two males or use a fencing between them. Or one upstairs and one downstairs in the crate. "They don't fight," the lady said. "Separate means they have no company for each other." I could not convince her and said: "OK, wait for the Battle of the Hamsters first."
"Wet Tail means that the hamster passes watery stools," I noted that the hamster's penile area was very wet, with yellow urine stains.
"He passes a lot of stools, hard ones," the young lady said. "What's wrong with him? He has this continuous sniffling sound, as if he has asthma." I held the hamster near my ears. Yes, he was emitting a "sit, sit, sit" sound.
INFECTION
"The hamster has an infection and so he was not moving or eating," I said. "Does he pee in a corner normally?"
"He pees everywhere," the young lady said. "Yesterday and today."
COMPETITION FOR FOOD
The hamster lives with the sibling who is bigger size in the same cage. "They have company. They never fight," the young lady was at home all day and had observed them. "Many pairs of male dwarf hamsters are OK when they are less than 3 months old," I said. "When they grow up, one will bite or attack the other."
The lady would not believe me as she was a first-time hamster owner. "Do they compete for food?" I asked. "Each would stuff as many sunflower seeds into their pouches as they can?"
"Yes," the lady confirmed. "Sometimes they stuff until their cheek pouches are very big. They only eat sunflower seeds. They don't like the other type of food."
The mouths of the two hamsters were smelly as the cheek pouches were infected due to impaction of the sunflower seeds. The seeds were also smelly as I took two seeds out of the pouch. Finally, after 5 minutes, the patient poured out 30 seeds.
HYPOTHESIS
1. Cheek pouch impaction. Bacterial infection from the pouches to the whole body system. Hamster had fever and stopped moving.
2. Urinary stain. Incontinent due to urinary tract infection or bites at this area causing painful urination. Bitten by the bigger-sized hamster. "Not as big as Hamstaro," the lady said. "But bigger than this one."
Then her friend spoke to her in Malay with some words "gig" and laughed. The bigger sibling does bite the ears and other parts of this subordinate hamster. "Whenever the squeaking became too loud," I separate them," the lady said.
ADVICE
Separate the two males or use a fencing between them. Or one upstairs and one downstairs in the crate. "They don't fight," the lady said. "Separate means they have no company for each other." I could not convince her and said: "OK, wait for the Battle of the Hamsters first."
64. Tips For Vets: Vaccinatiion of "female" puppy
The diversity of puppy development can lead to litigation or bad reputation if the vet does not adopt a certain procedure during the first vaccination.
I had a phone call from a lady owner today. She said that the puppy was a male but was listed as a female in the vaccination card by Vet 1.
In this case the pet shop said the puppy was female. He had no scrotum and a "long urethra". So Vet 1 trusted the pet shop operator who is in the business for many years.
Basically it is common sense to examine every puppy prior to vaccination so as to avoid such rare cases from happening. Never trust the pet shop operator to give you the correct info or the record the info after you sign a blank cheque (vaccination record).
I had a phone call from a lady owner today. She said that the puppy was a male but was listed as a female in the vaccination card by Vet 1.
In this case the pet shop said the puppy was female. He had no scrotum and a "long urethra". So Vet 1 trusted the pet shop operator who is in the business for many years.
Basically it is common sense to examine every puppy prior to vaccination so as to avoid such rare cases from happening. Never trust the pet shop operator to give you the correct info or the record the info after you sign a blank cheque (vaccination record).
63. What to do when one can't lower cholesterol level?
LETTER TO A CORRESPONDENT
I hope you will be able to help me find out what are the alternatives to Lipanthyl 160 which does NOT work in reducing cholesterol. The family doctor did mention taking red brewer's yeast at one's risk or nicotine. Nicotine was said not to be that effective and said that it is better to use Lipanthyl than nothing.
He said that cholesterol level would have shot higher if not for the use of Lipanthyl. I do not agree but said nothing. This drug is practically useless and causes liver damage. However, what can one advise a person who has no means of lowering the cholesterol level?
So, last month in Perth, I bought the last 2 bottles of red brewer's yeast. Apparently they were hot sellers after a TV advert, according to one retail person of a health shop.
Then I checked the internet. It was actually a statin. So, the person who takes it may die or go into a coma since she had shown severe side effects of statin use in the first place.
I ask for your help. Is there an effective drug alternative to statin?
Or another method involving change of lifestyle. I read one journal - a person claimed that he ate certain nuts and his cholesterol level went back to normal.
Please let me know if you will do research and let many readers know what to do. If you discover something, you may be able to be self employed and smell the roses, just like the sellers of red brewer's yeast.
Best wishes.
62. The boy who was late for his date
I was at the famous Takashimaya Shopping Centre on May 1, 2010, a public holiday. It was a Saturday which was my day off from work. It had been almost a year I had not been to Takashimaya and so I wanted to see how this old lady is competing with the younger malls. How did she reinvent herself? How busy were its food stalls which used to be packed like sardines some years ago? Now we have the Marina Bay Sands with all the top fashion shops.
I found a seat to order ice kachang and the oily carrot cake to eat.
There was this young tall and slim girl with long hair writing answers to mathematical problems and using her electronic calculator. She kept thumbing her mobile phone and part of her left side of her forehead was frowned with wavy lines. Eyebrows arched. I was sitting to her left and so could see only her left profile. She thumbed many times on her cell phone. She looked agitated.
Why would a young girl be doing homework on a public holiday in Takashimaya Shopping Centre's food mall? The public library at Takashimaya had closed down some years ago. In any case, the public libraries close on public holidays and this girl had no choice but to wait for her late date at this downtown shopping centre.
Who was she waiting for? Dressed up in modern fashion with zebra-striped T-shirt and coloured rectangles long pants. A touch of make up to give a natural look. At this tender age of 18 years. I could only see her profile as I sat to her left and ate the too sweet monstrous ice kachang and the extremely oily carrot cake which would up my blood cholesterol levels in a few seconds.
I guessed her date was late. Instead of wasting time, she was doing her homework on this public holiday at a public place. I was impressed with young adults who don't have time to waste and who are diligent to study for a bright future.
I was sitting to the left of the girl and she had focused on solving her 3rd maths problem. I peeked and saw words like "real numbers" in her maths worksheet. What is the meaning of "real numbers?". Are there false numbers? Fortunately for me, I did not have to do these maths problems during my A-levels in Medicine Class in Raffles Institution. There is no more "Medicine Class" nowadays in Singapore's junior colleges but there was this rare breed in the late 1960s.
After 10 minutes, a young boy-next-door suddenly banged his books on the table in front of her and greeted her with "I am here!". He appeared from nowhere and his banging attracted the others on the table.
"Ah, you are late!" I scolded him. "You must be her drinks!" The girl did not say a word, gathered her worksheet quickly, put them in her handbag. I looked at her from the side as her date helped her with her things. Was she mad? Was she embarrassed by his loud banging of the table in a public place? I don't know. Her profile showed a reddish brown face. In a few seconds she got away with her date. The young man said goodbye to me.
For young men, please let your date know if you are going to be late. There are many fishes in the ocean but treat each fish with care.
Thursday, May 13, 2010
The plump aged dwarf hamster
May 12, 2010
LUMPS AND BUMPS IN AN OLD DWARF HAMSTER
I excised a large hard fatty tumour of around 1 cm x 1 cm 12 days ago. It had pus and the owner had just discovered its presence. Zoletil IM and isoflurane gas anaesthesia were effective for this fat hamster who was 2 years old, nearly the end of her lifespan.
I stitched large skin wound with three 6/0 absorbable sutures. Hamster went home on the same day. The right eye had a thickened upper eyelid due to pus infection. I asked the owner to wait while I went to my car to get the camera to take a picture of the clean wound with little bleeding. The owner could not wait and disappeared in the waiting taxi.
12 days later, the caring young man consulted me as the hamster had a reddish lump in the operation area. "For the first 3 days, there was some bleeding under the skin. The hamster eats a lot and is very active. But what is this lump? Is it an infection?"
"This hamster is old and the hard lump could be the recurrence of his cancer," I said.
"I don't want her to be operated again," the owner said. The hamster may not survive a second anaesthesia.
"Wait and see for the next 7 days. It may be an infection," I gave him oral antibiotics. Malignant tumours do recur even in people. People can get chemotherapy and radiation but this will not be possible for the dwarf hamster.
P.S.
Aging leads to several problems in this hamster.
1. Both lip commissures are ulcerated and has pus. She still eats the seeds and has an excellent appetite, hiding the seeds inside her pouches.
2. The upper eyelid of the right eye is swollen. This could be hardened pus. I had snipped off part of it. The hamster still rubs her eyes. In one hamster with the same swollen upper eyelids, I snipped off the whole of the upper eyelid with no problems for the hamster. See webpage:
3. The skin of the elbow and other joints have flaky inflamed areas. The owner extended the legs but the hamster bit him. He has to clean off the inflamed skin.
BE KIND TO DWARF HAMSTERS
Check your hamster daily and get very small tumours excised by your vet.
LUMPS AND BUMPS IN AN OLD DWARF HAMSTER
I excised a large hard fatty tumour of around 1 cm x 1 cm 12 days ago. It had pus and the owner had just discovered its presence. Zoletil IM and isoflurane gas anaesthesia were effective for this fat hamster who was 2 years old, nearly the end of her lifespan.
I stitched large skin wound with three 6/0 absorbable sutures. Hamster went home on the same day. The right eye had a thickened upper eyelid due to pus infection. I asked the owner to wait while I went to my car to get the camera to take a picture of the clean wound with little bleeding. The owner could not wait and disappeared in the waiting taxi.
12 days later, the caring young man consulted me as the hamster had a reddish lump in the operation area. "For the first 3 days, there was some bleeding under the skin. The hamster eats a lot and is very active. But what is this lump? Is it an infection?"
"This hamster is old and the hard lump could be the recurrence of his cancer," I said.
"I don't want her to be operated again," the owner said. The hamster may not survive a second anaesthesia.
"Wait and see for the next 7 days. It may be an infection," I gave him oral antibiotics. Malignant tumours do recur even in people. People can get chemotherapy and radiation but this will not be possible for the dwarf hamster.
P.S.
Aging leads to several problems in this hamster.
1. Both lip commissures are ulcerated and has pus. She still eats the seeds and has an excellent appetite, hiding the seeds inside her pouches.
2. The upper eyelid of the right eye is swollen. This could be hardened pus. I had snipped off part of it. The hamster still rubs her eyes. In one hamster with the same swollen upper eyelids, I snipped off the whole of the upper eyelid with no problems for the hamster. See webpage:
3. The skin of the elbow and other joints have flaky inflamed areas. The owner extended the legs but the hamster bit him. He has to clean off the inflamed skin.
BE KIND TO DWARF HAMSTERS
Check your hamster daily and get very small tumours excised by your vet.
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