Veterinary Pet Insurance Co (VPI), the oldest and largest pet health insurance in the USA received >1 million claims from pet owners each year. For 2009, the top 10 canine conditions are:
1. Ear infection
2. Skin allergy
3. Skin inection/hot spot
4. Gastritis/vomiting
5. Intestinal inflammation/diarrhoea
6. Bladder infection
7. Arthritis
8. Soft tissue trauma
9. Non-cancerous tumour
10. Eye infection
Most of the conditions affect all dogs, regardless of age.
Thursday, August 19, 2010
Wednesday, August 18, 2010
Swollen lump in the belly area of a Retriever
First report is at toapayohvets.com: Tumours in 3 male dogs - Sertoli cell tumour, circum-anal tumour and oral tumour
FOLLOW-UP
"The young intern has no experience in dealing with the submission of specimens for histopathology," I explained to the Laboratory girl who phoned me to tell me that the 7 testicular specimens must be correctly labelled as "right" and "left" testicle when I queried the report's findings. My histopathological samples are sent to a commercial laboratory that specialises in this subject.
How come there was a blunder? It was my policy of letting interns be more hands-on.
I had instructed my assistant, Mr Saw, to let vet interns have some hands-on experience rather than being an observer. In that way, they will learn from experience and mistakes. We all learn every day as we can't be perfect people.
Ms Lai, the intern, would be studying veterinary medicine next year and so we gave her the task of submission and filling out the forms. She had been with us for around 2 weeks and had seen submission of blood samples.
Well, the undescended testicle of this 6-year-old Retriever was enormous (half the size of a tennis ball) and would not fit into the usual container we used to submit samples for histopathology. So, I advised cutting it into 3 smaller pieces for the larger testicle (left) and 4 smaller pieces for the descended atrophied testicle (right).
I ought to have advised getting a bigger container. I did that eventually. Next time I asked my assistant to check before submission of the samples. Usually we submit one sample and it fits nicely inside the Lab-provided bottles.
Everybody learns from being hands-on. Young interns can't be spoon-fed all the time and will make some mistakes. It is part of growing up in life.
I was fortunate to have worked in the Vet Diagnostic Lab at Kampong Java Road (now the new Kandang Kerbau Hospital) as a new graduate in 1977 and so knew a bit about the work of histopathology. What had happened was that the intern put 7 pieces 1 big bottle and submitted the bottle and form without separation of the left and right testicle.
After receiving the histopathology reports, I phoned to clarify that there were two testicles submitted as the report had presumed I had submitted 7 pieces of one testicle. The report was then corrected as follows:
Specimens 1-4 are left undescended testicle. Specimen 5-7 are the atrophied descended right testicle. The histopathology results are as follows:
Takes a long time to pee. Painful enlarged prostrate when digital examined via rectum during light anaesthesia. Could this be purulent prostatitis as mentioned in: www.vet.uga.edu/vpp/clerk_anat
/sabatino/index.php.
Hyperpigmentation in the preputial area
Follow up 7 days later: Owner is happy. "No more limping now. We thought he had hip dysplasia."
I asked" Was the dog attracting other dogs during exercise outdoors?" The owner recalled that many dogs wanted to make friends with him (the effects of hyperestrogenism).
Left testis - Sertoli cell tumour (see comments below).
Right testis - Atrophy of the contra-lateral scrotal testicle resulting in aspermatogenesis.
Comments from the Histopathology Lab:
1. The left testis is extensively replaced by a tumour which is composed of closely packed tubules, trabeculae and nests of elongated spindly cells. A second interstitial (Leydig) cell tumour component cannot be excluded. Most primary testicular neoplasm in dogs are benign. The rare malignant Sertoli cell tumours have no good cytological or histological markers of malignancy. The vet needs to identify metastases in lymphatics, spermatic cord, lymph node or distant sites. Please correlate with clinical features.
Dr Sing's comments: The left testis will likely be a mixed tumour with Sertoli and interstitial cells involved). Much more details of the types of testicular tumour in the dog are in an excellent report at:
www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
2. In the right testis, the parenchyma shows closely packed seminiferous tubes composed solely of Sertoli cells without spermatogonia, spermatocytes or spermatids. This is common in cryptorchid (undescended) testis. There is no tumour involvement.
CLINICAL FEATURES OF INTEREST TO VET UNDERGRADUATES
1. As the histopathologist is an independent service provider, he or she had not seen the real dog. The right testis was assumed to be an undescended or cryptorchid testis. It was a descended testicle, much shrunken.
2. Hyperestrogenism. The reason the descended right testes was atrophied and had no sperm production was due to the excessive production of estrogen by the large left testicular tumour. Estrogen is anti-androgenic and therefore cause the atrophy of the scrotal right scrotal testes.
3. Blood test results as shown below indicated a thrombocytopenia which can be a cause of death in the dog if the tumour had not been detected early and removed.
Golden Retriever, Male, 6 years. Left undescended testicular tumour and atrophied right scrotal testicle removed 5 days ago. Greyish-white, large sized and multi-nodular suggestive of a Sertoli cell tumour.
The owner asked about post-op management. This depended on blood test results.
Blood tests:
1. No disorders of liver and kidney function. Glucose is normal.
2. Haematology: Low haemoglobin and red cell count. Low PCV. Very low platelet count. Platelet clumping noted. (This indicated bone marrow depression). Effects are well written in:
www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
Urine results
1. pH=7.0, SG 1.027.
2. Abnormal findings: Protein 2+, Glucose 1+, Blood 4+, WCC >2250/uL, RBC 900/uL, epithelial cells 1053/uL. Bacteria 3+
This indicated a severe bacterial infection of the bladder and prostate (painful and enlarged during rectal palpation). The infection is probably localised to the urinary tract as the total blood White Cell Count was OK. The dog had been given IV Vit K1 in drip earlier and appeared much more energetic the next day.
Advice to owner:
1. Had been fed meat, rice 1X/day in the past. Very thin. Increase feed to 2x/day.
2. Good quality premium dog food dry to be added. 1 egg/day for 14 days.
3. Antibiotics for next 14 - 20 days. UTI + prostatitis + bone marrow depression.
4. Review in 14 days.
4. More info of this case has been recorded at:
Tumours in 3 male dogs - Sertoli cell tumour, circum-anal tumour and oral tumour
5. An excellent veterinary report on canine testicular tumours is at: www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
I note that the "Summary" stated that "the Sertoli cell tumour is the only known testicular tumour that commonly produces hormones with clinical effects." Some vet reports I read on the internet claim that estrogen is produced by two of the 3 common testicular tumours, namely the Sertoli cell tumours and Seminomas. In the "Introduction", there was this statement that "testicular neoplasms other than Sertoli cell tumours are rarely hormonal productive. Testicular neoplasms are often mixed-origin especially in cryptorchid testes". In this case, the histopathologist indicated that the undescended testicle could be a mixed type with Sertoli cell tumour and interstitial (Leydig) cell tumour.
Cryptorchidism in the dog can be unilateral or bilateral
Note that the report said that testicular tumour in the above-mentioned dog is found as early as 6 years of age (this case) but the median age is 10 years (photo of one of my cases, left).
Testicular Tumour in an undescended testicle of a 10-year-old Spitz in my 2001 case when I was new into digital photography. This picture is acceptable by me nowadays.
In 2010, many younger dog owners do not wish to have their male dogs neutered as they perceive the surgery to be cruel. However, undescended testicles may develop testicular tumours. Weekly check up of the dog's belly will detect their presence
Testicular Tumour in the undescended testicle of an 8-year-old Jack Russell.
Check the belly of your older dog every week if you do not wish to have your male dog neutered. Testicular tumours are seldom malignant but they do cause death due to bone marrow depression and thrombocytopenia and consequent overwhelming bacterial infections.
updates and pictures at www.toapayohvets.com
FOLLOW-UP
"The young intern has no experience in dealing with the submission of specimens for histopathology," I explained to the Laboratory girl who phoned me to tell me that the 7 testicular specimens must be correctly labelled as "right" and "left" testicle when I queried the report's findings. My histopathological samples are sent to a commercial laboratory that specialises in this subject.
How come there was a blunder? It was my policy of letting interns be more hands-on.
I had instructed my assistant, Mr Saw, to let vet interns have some hands-on experience rather than being an observer. In that way, they will learn from experience and mistakes. We all learn every day as we can't be perfect people.
Ms Lai, the intern, would be studying veterinary medicine next year and so we gave her the task of submission and filling out the forms. She had been with us for around 2 weeks and had seen submission of blood samples.
Well, the undescended testicle of this 6-year-old Retriever was enormous (half the size of a tennis ball) and would not fit into the usual container we used to submit samples for histopathology. So, I advised cutting it into 3 smaller pieces for the larger testicle (left) and 4 smaller pieces for the descended atrophied testicle (right).
I ought to have advised getting a bigger container. I did that eventually. Next time I asked my assistant to check before submission of the samples. Usually we submit one sample and it fits nicely inside the Lab-provided bottles.
Everybody learns from being hands-on. Young interns can't be spoon-fed all the time and will make some mistakes. It is part of growing up in life.
I was fortunate to have worked in the Vet Diagnostic Lab at Kampong Java Road (now the new Kandang Kerbau Hospital) as a new graduate in 1977 and so knew a bit about the work of histopathology. What had happened was that the intern put 7 pieces 1 big bottle and submitted the bottle and form without separation of the left and right testicle.
After receiving the histopathology reports, I phoned to clarify that there were two testicles submitted as the report had presumed I had submitted 7 pieces of one testicle. The report was then corrected as follows:
Specimens 1-4 are left undescended testicle. Specimen 5-7 are the atrophied descended right testicle. The histopathology results are as follows:
Takes a long time to pee. Painful enlarged prostrate when digital examined via rectum during light anaesthesia. Could this be purulent prostatitis as mentioned in: www.vet.uga.edu/vpp/clerk_anat
/sabatino/index.php.
Hyperpigmentation in the preputial area
Follow up 7 days later: Owner is happy. "No more limping now. We thought he had hip dysplasia."
I asked" Was the dog attracting other dogs during exercise outdoors?" The owner recalled that many dogs wanted to make friends with him (the effects of hyperestrogenism).
Left testis - Sertoli cell tumour (see comments below).
Right testis - Atrophy of the contra-lateral scrotal testicle resulting in aspermatogenesis.
Comments from the Histopathology Lab:
1. The left testis is extensively replaced by a tumour which is composed of closely packed tubules, trabeculae and nests of elongated spindly cells. A second interstitial (Leydig) cell tumour component cannot be excluded. Most primary testicular neoplasm in dogs are benign. The rare malignant Sertoli cell tumours have no good cytological or histological markers of malignancy. The vet needs to identify metastases in lymphatics, spermatic cord, lymph node or distant sites. Please correlate with clinical features.
Dr Sing's comments: The left testis will likely be a mixed tumour with Sertoli and interstitial cells involved). Much more details of the types of testicular tumour in the dog are in an excellent report at:
www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
2. In the right testis, the parenchyma shows closely packed seminiferous tubes composed solely of Sertoli cells without spermatogonia, spermatocytes or spermatids. This is common in cryptorchid (undescended) testis. There is no tumour involvement.
CLINICAL FEATURES OF INTEREST TO VET UNDERGRADUATES
1. As the histopathologist is an independent service provider, he or she had not seen the real dog. The right testis was assumed to be an undescended or cryptorchid testis. It was a descended testicle, much shrunken.
2. Hyperestrogenism. The reason the descended right testes was atrophied and had no sperm production was due to the excessive production of estrogen by the large left testicular tumour. Estrogen is anti-androgenic and therefore cause the atrophy of the scrotal right scrotal testes.
3. Blood test results as shown below indicated a thrombocytopenia which can be a cause of death in the dog if the tumour had not been detected early and removed.
Golden Retriever, Male, 6 years. Left undescended testicular tumour and atrophied right scrotal testicle removed 5 days ago. Greyish-white, large sized and multi-nodular suggestive of a Sertoli cell tumour.
The owner asked about post-op management. This depended on blood test results.
Blood tests:
1. No disorders of liver and kidney function. Glucose is normal.
2. Haematology: Low haemoglobin and red cell count. Low PCV. Very low platelet count. Platelet clumping noted. (This indicated bone marrow depression). Effects are well written in:
www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
Urine results
1. pH=7.0, SG 1.027.
2. Abnormal findings: Protein 2+, Glucose 1+, Blood 4+, WCC >2250/uL, RBC 900/uL, epithelial cells 1053/uL. Bacteria 3+
This indicated a severe bacterial infection of the bladder and prostate (painful and enlarged during rectal palpation). The infection is probably localised to the urinary tract as the total blood White Cell Count was OK. The dog had been given IV Vit K1 in drip earlier and appeared much more energetic the next day.
Advice to owner:
1. Had been fed meat, rice 1X/day in the past. Very thin. Increase feed to 2x/day.
2. Good quality premium dog food dry to be added. 1 egg/day for 14 days.
3. Antibiotics for next 14 - 20 days. UTI + prostatitis + bone marrow depression.
4. Review in 14 days.
4. More info of this case has been recorded at:
Tumours in 3 male dogs - Sertoli cell tumour, circum-anal tumour and oral tumour
5. An excellent veterinary report on canine testicular tumours is at: www.vet.uga.edu/vpp/clerk_anat/sabatino/index.php.
I note that the "Summary" stated that "the Sertoli cell tumour is the only known testicular tumour that commonly produces hormones with clinical effects." Some vet reports I read on the internet claim that estrogen is produced by two of the 3 common testicular tumours, namely the Sertoli cell tumours and Seminomas. In the "Introduction", there was this statement that "testicular neoplasms other than Sertoli cell tumours are rarely hormonal productive. Testicular neoplasms are often mixed-origin especially in cryptorchid testes". In this case, the histopathologist indicated that the undescended testicle could be a mixed type with Sertoli cell tumour and interstitial (Leydig) cell tumour.
Cryptorchidism in the dog can be unilateral or bilateral
Note that the report said that testicular tumour in the above-mentioned dog is found as early as 6 years of age (this case) but the median age is 10 years (photo of one of my cases, left).
Testicular Tumour in an undescended testicle of a 10-year-old Spitz in my 2001 case when I was new into digital photography. This picture is acceptable by me nowadays.
In 2010, many younger dog owners do not wish to have their male dogs neutered as they perceive the surgery to be cruel. However, undescended testicles may develop testicular tumours. Weekly check up of the dog's belly will detect their presence
Testicular Tumour in the undescended testicle of an 8-year-old Jack Russell.
Check the belly of your older dog every week if you do not wish to have your male dog neutered. Testicular tumours are seldom malignant but they do cause death due to bone marrow depression and thrombocytopenia and consequent overwhelming bacterial infections.
updates and pictures at www.toapayohvets.com
169. *Common toilet-peeing-everywhere situation in Singapore's apartment
HOW A VET WILL DISCUSS ABOUT TOILET TRAINING
Date: August 18, 2010. Came for annual vaccination and heartworm vaccination. Ate at 10 am but vomited canned food during vaccination at 3.30 pm. Surprising. Dog is nervous of vets, owner said. I kept the dog in the Surgery for one hour to observe. No problem.
Dog: Pom, red, 17 months, female, not spayed
Problem: Pees everywhere inside all the rooms of the HDB apartment when let loose. Pees on newspapers when confined to the balcony when the family is not at home. Family lives with this situation of having to clean up after her peeing.
Look at the routine and my explanation:
Sleeping area - balcony by herself. So she has an incentive not to soil her "den".
Feeding - 8 am & 7 pm. Canned food. However dry dog food is left available all the time. This is a mistake. Dog should be given food for 15 minutes as a puppy and food removed.
Drinking - Water anytime. I advised no water after 8 pm so she can control her bladder. Eating dry dog food anytime may make the dog thirsty too.
Pooping - 1-2x per day.
Poops after breakfast - Yes, usually around 30 minutes after eating.
2nd pooping time variable. Sometimes overnight in the balcony.
Peeing - 4-5X/day including overnight. Is this urine spraying? "Female dogs do urine-mark to stake out their territory inside the apartment," I said to the young lady. "To let the other family members know."
As the location of peeing was all over the apartment, this seemed to be a case of urine-marking. "Spaying at a young age may stop urine-marking," I said.
I will e-mail to the owner the proposed plan and hope she will provide feedback to me in 2 months' time.
PLAN
1. Confine to balcony and adjoining living room.
2. Neutralise all urine smell inside the apartment. Put white vinegar 1 part and 3 parts water in a spray bottle and spray clean the whole apartment.
3. Close all bedroom and kitchen doors for the next 2-4 weeks.
4. Newspapers to be placed in the living area too. Preferably with urine smell (2nd piece of newspapers from the balcony.)
5. No dry food for the whole day. Give with canned food. Dog is not skinny anyway. No water after 8 pm so she can control her bladder.
6. Feed 2x/day.
7. Remove all soiled newspapers (in the balcony and living room) immediately as dogs don't like to eliminate in soiled papers.
8. Praise when the dog pees on newspapers in the living area. Dog treats if the dog is motivated by treats.
9. Same routine for 2-4 weeks and let me know by e-mail 99pups@gmail.com
I advised for the next 2 weeks, confine dog to living area and balcony. Put newspapers on tray
Date: August 18, 2010. Came for annual vaccination and heartworm vaccination. Ate at 10 am but vomited canned food during vaccination at 3.30 pm. Surprising. Dog is nervous of vets, owner said. I kept the dog in the Surgery for one hour to observe. No problem.
Dog: Pom, red, 17 months, female, not spayed
Problem: Pees everywhere inside all the rooms of the HDB apartment when let loose. Pees on newspapers when confined to the balcony when the family is not at home. Family lives with this situation of having to clean up after her peeing.
Look at the routine and my explanation:
Sleeping area - balcony by herself. So she has an incentive not to soil her "den".
Feeding - 8 am & 7 pm. Canned food. However dry dog food is left available all the time. This is a mistake. Dog should be given food for 15 minutes as a puppy and food removed.
Drinking - Water anytime. I advised no water after 8 pm so she can control her bladder. Eating dry dog food anytime may make the dog thirsty too.
Pooping - 1-2x per day.
Poops after breakfast - Yes, usually around 30 minutes after eating.
2nd pooping time variable. Sometimes overnight in the balcony.
Peeing - 4-5X/day including overnight. Is this urine spraying? "Female dogs do urine-mark to stake out their territory inside the apartment," I said to the young lady. "To let the other family members know."
As the location of peeing was all over the apartment, this seemed to be a case of urine-marking. "Spaying at a young age may stop urine-marking," I said.
I will e-mail to the owner the proposed plan and hope she will provide feedback to me in 2 months' time.
PLAN
1. Confine to balcony and adjoining living room.
2. Neutralise all urine smell inside the apartment. Put white vinegar 1 part and 3 parts water in a spray bottle and spray clean the whole apartment.
3. Close all bedroom and kitchen doors for the next 2-4 weeks.
4. Newspapers to be placed in the living area too. Preferably with urine smell (2nd piece of newspapers from the balcony.)
5. No dry food for the whole day. Give with canned food. Dog is not skinny anyway. No water after 8 pm so she can control her bladder.
6. Feed 2x/day.
7. Remove all soiled newspapers (in the balcony and living room) immediately as dogs don't like to eliminate in soiled papers.
8. Praise when the dog pees on newspapers in the living area. Dog treats if the dog is motivated by treats.
9. Same routine for 2-4 weeks and let me know by e-mail 99pups@gmail.com
I advised for the next 2 weeks, confine dog to living area and balcony. Put newspapers on tray
Tuesday, August 17, 2010
Faucitis in a stray cat
August 17, 2010
Stray cat can eat as ulcers heal 80% as evident from digital photography taken today. Midline tongue ulcer re-appears. Ulcers at base of right side of tongue seen in one of the images.
Cat was more cooperative but he got fed up after I took over 50 images. It was difficult to take his inner mouth from a table in the waiting room with outside sunlight at 11 am. I did not shine a strong light into the mouth.
HISTORY:
Tuesday, August 10, 2010
Faucitis stray cat
August 10, 2010 review of eosinophilia in a stray cat.
Salivation is the presenting sign. Ulcers in fauces and lower tongue 2 weeks ago. Treated and went home. Came back again as the cat started to salivate.
Ulcers at fauces reduced by 80% today. Cat gentle but dislikes mouth being opened. Wanted to scratch intern Ms Lai. Will the condition relapses? Is there a permanent cure? Not according to the cat experts.
Stray cat can eat as ulcers heal 80% as evident from digital photography taken today. Midline tongue ulcer re-appears. Ulcers at base of right side of tongue seen in one of the images.
Cat was more cooperative but he got fed up after I took over 50 images. It was difficult to take his inner mouth from a table in the waiting room with outside sunlight at 11 am. I did not shine a strong light into the mouth.
HISTORY:
Tuesday, August 10, 2010
Faucitis stray cat
August 10, 2010 review of eosinophilia in a stray cat.
Salivation is the presenting sign. Ulcers in fauces and lower tongue 2 weeks ago. Treated and went home. Came back again as the cat started to salivate.
Ulcers at fauces reduced by 80% today. Cat gentle but dislikes mouth being opened. Wanted to scratch intern Ms Lai. Will the condition relapses? Is there a permanent cure? Not according to the cat experts.
167. Stray cat - stomatitis
Stray cat, Male, Neutered, ginger, around 4 years old, 3.5 kg, very thin
HISTORY
Jul 18, 2010
Stray cat was picked up from the street and sent for treatment
Can't eat normally. Salivation, bad breath and mouth ulcers.
Jul 19, 2010
Blood test - Liver SGOT/AST high, Kidney Urea high, Total White Cell Count high
Neutrophils 80%, lymphocytes 10%, monocytes 4%, eosionphils 6%, basophils 0.2%
Full grooming, deflea, ear irrigation, treatment
Jul 20, 2010
1. FIV and FLV blood test - negative
Jul 21, 2010
Blood test - Liver SGOT/AST high, Kidney Urea normal, Total White Cell Count normal
Neutrophils 77%, lymphocytes 13%, monocytes 5%, eosionphils 5%, basophils 0.5%
Jul 23, 2010
Anaesthesia - xyalzine 0.1 + ketamine 0.4 ml IM + dental extraction of all loose teeth
Jul 28, 2010.
Goes home.
Aug 3, 2010.
Salivation and not eating normally Back to Toa Payoh Vets. Faucitis (ulcers at back of throat on left and right side).
Aug 4, 2010.
Pred 0.4 ml SC and antibiotics
Eats normally.
Aug 13, 2010
Mouth and tongue ulcers return
Pred 0.5 ml SC and antibiotics, omega 3 and 6 oil oral
Eats normally.
Aug 17, 2010
Eats normally. Puts on weight to 4 kg. Canned food only.
Blood test done.
Canned food only
HISTORY
Jul 18, 2010
Stray cat was picked up from the street and sent for treatment
Can't eat normally. Salivation, bad breath and mouth ulcers.
Jul 19, 2010
Blood test - Liver SGOT/AST high, Kidney Urea high, Total White Cell Count high
Neutrophils 80%, lymphocytes 10%, monocytes 4%, eosionphils 6%, basophils 0.2%
Full grooming, deflea, ear irrigation, treatment
Jul 20, 2010
1. FIV and FLV blood test - negative
Jul 21, 2010
Blood test - Liver SGOT/AST high, Kidney Urea normal, Total White Cell Count normal
Neutrophils 77%, lymphocytes 13%, monocytes 5%, eosionphils 5%, basophils 0.5%
Jul 23, 2010
Anaesthesia - xyalzine 0.1 + ketamine 0.4 ml IM + dental extraction of all loose teeth
Jul 28, 2010.
Goes home.
Aug 3, 2010.
Salivation and not eating normally Back to Toa Payoh Vets. Faucitis (ulcers at back of throat on left and right side).
Aug 4, 2010.
Pred 0.4 ml SC and antibiotics
Eats normally.
Aug 13, 2010
Mouth and tongue ulcers return
Pred 0.5 ml SC and antibiotics, omega 3 and 6 oil oral
Eats normally.
Aug 17, 2010
Eats normally. Puts on weight to 4 kg. Canned food only.
Blood test done.
Canned food only
Monday, August 16, 2010
166. Shih Tzu with urinary tract infection
"How he gets this UTI?" the mum asked. "Yesterday, I thought he was going to die." The dog just was lethargic for the past 3 days. He ate a lot after going home from neuter 7 days ago. The 8-year-old Shih Tzu had a right perineal hernia repaired by me just around 4 weeks ago.
I palpated a full bladder. There was no pain in his pre-scrotal lump which was the site of the neuter. Got a urine and blood sample taken and sent to the lab this morning.
The mum and daughter came to visit him at 5 pm. I explained to them that the dog had a severe UTI. Blood results - Total WCC was above normal, neutrophils was 97%, lymphocytes 3%. Abs neutrophils were 17 x10^9/L while lymphocytes were 0.5 x 10^9/L. "The results indicated a bacterial infection of the blood," I explained to the mum and daughter. "Luckily it is not a viral infection."
Urine results were very interesting:
pH 6.5, SG 1.039 considered normal
Abnormal:
Nitrite +, Protein 3+, Glucose +, Bilirubin +, Blood 4+, White blood cells >2250/uL and Red blood cells >2250/uL. Bacteria 3+. No crystals or cats or epithelial cells.
"How did the dog get UTI?" the mum asked.
"One reason could be the stress of surgery for perineal hernia and the neuter soon after" I said. "Is he the type of alpha dog who would urine mark every spot even when he has no urine?"
"Yes," the mum said. "I thought all male dogs do that."
"Not all male dogs," I said. "Usually only the dominant ones wanting to mark his territory."
"When a friend's female dog comes to the apartment, he will urinate over her peed area," the daughter commented.
"So, he might be withholding urine for the past 8 years to urine-mark. Urine that is kept for a long time inside the bladder would get bacterial growth," I said. The dog had an alkaline pH and this would encourage bacterial growth and possibly struvite stone formation in the theory of struvite stone formation in the dog. However, this dog ate mainly chicken, rice and carrots and therefore should not be getting struvite urinary stone formation.
After 500 ml 5% glucose saline, baytril antibiotics and spasmogesic, the dog looked active in the evening when the mum and daughter came. He would be given another treatment tomorrow and go home.
"For the past 7 years, he had never seen a vet," the mum said that the dog's veterinary cost was high.
"If you had neutered this dog at one year of age," I advised belatedly. "He would unlikely to develop perineal hernia which occurs mostly in non-neutered male dogs and therefore you need not spend money to cure him.
"In your case, it was lucky he developed only the right sided perineal hernia and so far, with all this jumping up to the daughter's bed and running around so soon after perineal repair, he had no swelling. Otherwise, he would need another repair job. The dog is to confine at home in one place for at least 4 weeks, not jumping about like a Jack Russell."
"My sister's Shih Tzu are so laid back," the mum said. "This dog even bites me." My assistant Mr Saw also warned me about his biting habit.
"After neutering, there will be less aggression and urine-marking over time," I said.
"Will his personality change?" the daughter asked.
"Yes, he will be quieter and not so obsessed with urine-marking like some men who are thinking of making money all day long. Much depends on whether your daughter will spend time playing with him.
"Let him eat more so that he would have the resistance to fight against diseases"
I said as this dog lost 1 kg after perineal hernia, neuter surgery. I could feel the spinal processes. He was now 6.5 kg.
Aug 17, 2010 4 pm
Dog reviewed for going home. No fever. Had a good appetite. Tongue was pink.
Took him out. First thing was to urine-mark a vertical surface.
I palpated a full bladder. There was no pain in his pre-scrotal lump which was the site of the neuter. Got a urine and blood sample taken and sent to the lab this morning.
The mum and daughter came to visit him at 5 pm. I explained to them that the dog had a severe UTI. Blood results - Total WCC was above normal, neutrophils was 97%, lymphocytes 3%. Abs neutrophils were 17 x10^9/L while lymphocytes were 0.5 x 10^9/L. "The results indicated a bacterial infection of the blood," I explained to the mum and daughter. "Luckily it is not a viral infection."
Urine results were very interesting:
pH 6.5, SG 1.039 considered normal
Abnormal:
Nitrite +, Protein 3+, Glucose +, Bilirubin +, Blood 4+, White blood cells >2250/uL and Red blood cells >2250/uL. Bacteria 3+. No crystals or cats or epithelial cells.
"How did the dog get UTI?" the mum asked.
"One reason could be the stress of surgery for perineal hernia and the neuter soon after" I said. "Is he the type of alpha dog who would urine mark every spot even when he has no urine?"
"Yes," the mum said. "I thought all male dogs do that."
"Not all male dogs," I said. "Usually only the dominant ones wanting to mark his territory."
"When a friend's female dog comes to the apartment, he will urinate over her peed area," the daughter commented.
"So, he might be withholding urine for the past 8 years to urine-mark. Urine that is kept for a long time inside the bladder would get bacterial growth," I said. The dog had an alkaline pH and this would encourage bacterial growth and possibly struvite stone formation in the theory of struvite stone formation in the dog. However, this dog ate mainly chicken, rice and carrots and therefore should not be getting struvite urinary stone formation.
After 500 ml 5% glucose saline, baytril antibiotics and spasmogesic, the dog looked active in the evening when the mum and daughter came. He would be given another treatment tomorrow and go home.
"For the past 7 years, he had never seen a vet," the mum said that the dog's veterinary cost was high.
"If you had neutered this dog at one year of age," I advised belatedly. "He would unlikely to develop perineal hernia which occurs mostly in non-neutered male dogs and therefore you need not spend money to cure him.
"In your case, it was lucky he developed only the right sided perineal hernia and so far, with all this jumping up to the daughter's bed and running around so soon after perineal repair, he had no swelling. Otherwise, he would need another repair job. The dog is to confine at home in one place for at least 4 weeks, not jumping about like a Jack Russell."
"My sister's Shih Tzu are so laid back," the mum said. "This dog even bites me." My assistant Mr Saw also warned me about his biting habit.
"After neutering, there will be less aggression and urine-marking over time," I said.
"Will his personality change?" the daughter asked.
"Yes, he will be quieter and not so obsessed with urine-marking like some men who are thinking of making money all day long. Much depends on whether your daughter will spend time playing with him.
"Let him eat more so that he would have the resistance to fight against diseases"
I said as this dog lost 1 kg after perineal hernia, neuter surgery. I could feel the spinal processes. He was now 6.5 kg.
Aug 17, 2010 4 pm
Dog reviewed for going home. No fever. Had a good appetite. Tongue was pink.
Took him out. First thing was to urine-mark a vertical surface.
Cheek tumour regrows in the old male dog
As the tumour recurs, the 11-year-old male dog did not eat again. He would not permit anyone to open his mouth. The lady owner had seen the tumour when the dog yawned and so was concerned. "Some white tissues," she said to me.
I used electro-surgery to cut as much of the tumour from the cheek as possible. It was 1.5 cm x 1.5 cm X 0.5 cm. Like a Singapore 10-cent coin with white plaques. Is it malignant or not?
The dog had to be under general anaesthesia to excise the lump and to get the right lower back teeth extracted too. The reason for extraction of this lower back teeth is to prevent any more irritation. I presumed it was due to the irritation of the lower tooth that caused the recurrence but this was a hypothesis. If this was correct, then the dog would not have another growth two months later and this procedure would save the young lady a lot of veterinary expenses.
"I feel the base for roughness to see if any tumour is left behind" I explained to my assistant Mr Saw. Complete excision of the lesion was done but I can't guarantee that it would be 100% as there was the cheek tissue
I sent the pieces for histopathology.
Pathology results:
Diagnosis:
Spindle and epithelioid cell proliferation.
Comments: The cells may be myofibroblastic/fibroblastic in origin. The differential diagnoses include nodular fasciitis, inflammatory myofibroblastic tumour or a low grade sarcoma, amongst others.
CONCLUSION
Dogs and people with poor oral hygiene (gum diseases,decayed teeth, bad breath) do develop oral tumours when they are old as many years of irritation leads to tumour formation. In this case, the lab report suggests a tumour which may not be malignant.
I used electro-surgery to cut as much of the tumour from the cheek as possible. It was 1.5 cm x 1.5 cm X 0.5 cm. Like a Singapore 10-cent coin with white plaques. Is it malignant or not?
The dog had to be under general anaesthesia to excise the lump and to get the right lower back teeth extracted too. The reason for extraction of this lower back teeth is to prevent any more irritation. I presumed it was due to the irritation of the lower tooth that caused the recurrence but this was a hypothesis. If this was correct, then the dog would not have another growth two months later and this procedure would save the young lady a lot of veterinary expenses.
"I feel the base for roughness to see if any tumour is left behind" I explained to my assistant Mr Saw. Complete excision of the lesion was done but I can't guarantee that it would be 100% as there was the cheek tissue
I sent the pieces for histopathology.
Pathology results:
Diagnosis:
Spindle and epithelioid cell proliferation.
Comments: The cells may be myofibroblastic/fibroblastic in origin. The differential diagnoses include nodular fasciitis, inflammatory myofibroblastic tumour or a low grade sarcoma, amongst others.
CONCLUSION
Dogs and people with poor oral hygiene (gum diseases,decayed teeth, bad breath) do develop oral tumours when they are old as many years of irritation leads to tumour formation. In this case, the lab report suggests a tumour which may not be malignant.
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