On last Friday, I went to the Surgery at 8 pm and phoned the owner of this cross-bred who was warded for 7 months by my colleague whom I had reminded several times to get the dog home.
A gentleman came, showed me his identity card confirming he was the registered owner and said: "Nobody phones me. So, I thought my dog has not recovered from his wound."
"I was told you were building a cage to house him in the factory," I said. "There's a man whom I met and had seen coming to visit this dog."
"I am the owner," he asserted. "My brother has not visited or seen this dog for months! Who is this person?"
I phoned my colleague as I was most surprised. I did see another man who was to be this gentleman's brother and had advised surgery and drew an illustration of Z-plasty to close the large elbow armpit laceration wound, some 3 months ago. But he did not want it. As this was not my case, I let my colleague handled it.
The gentleman paid some money and then on Saturday, another man came to take the dog home. He said: "Remember me? We spoke about the operation proposed by you. I am the brother. Now, I wish to take the dog home."
I got my assistant to take down his identity card particulars. This was such an incredible doggy story. You can't believe it is true. So, who was my colleague phoning all these months when I asked her to get the owner to take home this cross-bred? There is a mystery in this case. The wound had not healed fully but had reduced in size by 80% to a small red area. 7 months is too long to be at the vet. I need to review my system again. Vet medicine is always full of surprises now and then. I thought this dog was abandoned but he was not. Was there another phone number? I don't know as I closed this file for the time being.
Thursday, September 8, 2011
593. Follow-up on pemphigus dog
Geylang East Public Library
Thur Sep 8, 2011 7.30 pm
I phoned the lady owner about the nursing of the dog with pemphigus.
She said: "She has a very good appetite."
"How often you feed her?" I asked.
"Three times a day."
"How often you wash her mouth?" I had recommended using the garden bottle type spray to rinse the mouth and keep the open wound clean.
"Five times a day. After meals and once in the morning and before sleeping time. The mouth wound is no longer reddish. Have I got to come for review this Sunday (3 days from now)?"
I wanted to review and see if I need to stitch the left lip area which was hanging loose. I did not stitch last time because of the need to shorten the anaesthesia to avoid heart failure in this 10-year-old dog.
The painkillers and antibiotics are doing the work. So, the dog is active and hungry. Nursing is excellent. The wound is no longer inflamed. The test will be when no drugs are taken.
I asked her to come next Sunday. She thanked me.
Thur Sep 8, 2011 7.30 pm
I phoned the lady owner about the nursing of the dog with pemphigus.
She said: "She has a very good appetite."
"How often you feed her?" I asked.
"Three times a day."
"How often you wash her mouth?" I had recommended using the garden bottle type spray to rinse the mouth and keep the open wound clean.
"Five times a day. After meals and once in the morning and before sleeping time. The mouth wound is no longer reddish. Have I got to come for review this Sunday (3 days from now)?"
I wanted to review and see if I need to stitch the left lip area which was hanging loose. I did not stitch last time because of the need to shorten the anaesthesia to avoid heart failure in this 10-year-old dog.
The painkillers and antibiotics are doing the work. So, the dog is active and hungry. Nursing is excellent. The wound is no longer inflamed. The test will be when no drugs are taken.
I asked her to come next Sunday. She thanked me.
Gall bladder mucocoele. Cardiac Tamponade. Enlarged spleen.
1. Gall bladder mucocoele. Uncommon disease but there was a case. Diagnosed by ultrasound of gall bladder and blood tests. Treatment would be surgical but very high risk. The 10-year-old dog died the next day.
Vomiting was one sign.
2. Cardiac tamponade. Uncommon disease. Could be diagnosed as "fat" in the double chin as in one case in the Labrador Retriever, according to the owner who consulted Vet 1.
3. Enlarged spleens in a few dogs over the years. Reasons unknown in many cases. No parasites. Spleen removed. Some survived. Some did not.
Vomiting was one sign.
2. Cardiac tamponade. Uncommon disease. Could be diagnosed as "fat" in the double chin as in one case in the Labrador Retriever, according to the owner who consulted Vet 1.
3. Enlarged spleens in a few dogs over the years. Reasons unknown in many cases. No parasites. Spleen removed. Some survived. Some did not.
Gigantic circum-anal tumours
Successful and less costly vet treatment fi you have regular vet examinations per year and daily home check up.
I note that some old male not neutered dogs develop circum-anal tumours after the age of 10 years. One small Maltese owner took the risk to get the circum anal tumours excised by me when the dog was already 15 years old. It is best not to wait till the tumours become gigantic as there is no skin to stitch up. A lot of bleeding. Bandaging the big wound is not practical. A dog more than 10 years old is also in poor health.
I note that some old male not neutered dogs develop circum-anal tumours after the age of 10 years. One small Maltese owner took the risk to get the circum anal tumours excised by me when the dog was already 15 years old. It is best not to wait till the tumours become gigantic as there is no skin to stitch up. A lot of bleeding. Bandaging the big wound is not practical. A dog more than 10 years old is also in poor health.
590. Mammary cancer if not spayed by 6 months of age
A lady recently asked me when she should spay her dog? Whether a female spayed dog spayed at 6 months of age will never get breast cancer.
Below is the answer from an American vet, Phil Zeltzman, DVM, DACVS, website
http://www.drphilzeltzman.com/. He published his article
"Common surgeries - critical info you need to know" in Dog Fancy, Sep 2010.
1. The common surgeries are spay, neuter, lumps and bumps and bladder stones.
2. I refer to his spay information
2.1 Some vets in Europe just remove the ovaries in young, healthy female dogs (ovariectomy) - quicker an dless invasive. The uterus shrinks without complications.
2.2 He said that "despite clear scientific evidence to the contrary," some people claim that it is better for a dog to have at least one heat cycle before being spayed. He said "research shows that allowing one heat cycle before being spayed increases the risk of mammary tumours from virtually zero to 8%."
My point is: Many authors give such statistics but none actually quotes the proper research for reference. How many dogs were in the research? Who did the research?
He further stated that spaying after the 2nd heat, incidence of getting tumour is 26%. After 2 years of age, no protection. More than 25% of non-spspayed female dogs develop mammary tumours.
It will be good if Singapore vets can do a study about this 25% statistic or vets can produce proper research reports.
My advice is to spay the female dog 2 months after the first heat to let her develop her vulval area to an adult size. Spaying at 6 months is OK if the owner does not want bleeding. Any reader who knows where the proper research papers are, let me know.
Below is the answer from an American vet, Phil Zeltzman, DVM, DACVS, website
http://www.drphilzeltzman.com/. He published his article
"Common surgeries - critical info you need to know" in Dog Fancy, Sep 2010.
1. The common surgeries are spay, neuter, lumps and bumps and bladder stones.
2. I refer to his spay information
2.1 Some vets in Europe just remove the ovaries in young, healthy female dogs (ovariectomy) - quicker an dless invasive. The uterus shrinks without complications.
2.2 He said that "despite clear scientific evidence to the contrary," some people claim that it is better for a dog to have at least one heat cycle before being spayed. He said "research shows that allowing one heat cycle before being spayed increases the risk of mammary tumours from virtually zero to 8%."
My point is: Many authors give such statistics but none actually quotes the proper research for reference. How many dogs were in the research? Who did the research?
He further stated that spaying after the 2nd heat, incidence of getting tumour is 26%. After 2 years of age, no protection. More than 25% of non-spspayed female dogs develop mammary tumours.
It will be good if Singapore vets can do a study about this 25% statistic or vets can produce proper research reports.
My advice is to spay the female dog 2 months after the first heat to let her develop her vulval area to an adult size. Spaying at 6 months is OK if the owner does not want bleeding. Any reader who knows where the proper research papers are, let me know.
589. Deworming an unwilling Shih Tzu
Today, I intervened. "It is best not to force feed the deworming tablet," I said to Vet 1. "I had seen one case where this was done and the cat choked and died at a boarding house."
The practice of many vets is to give the tablet by hand-feeding. Some dogs and cats positively shifted their heads sideways and refused to open their mouths. In this case, as in above, I advised crushing the tablet into powder, mix with sugar and feed it hidden inside the food.
The practice of many vets is to give the tablet by hand-feeding. Some dogs and cats positively shifted their heads sideways and refused to open their mouths. In this case, as in above, I advised crushing the tablet into powder, mix with sugar and feed it hidden inside the food.
Wednesday, September 7, 2011
588. Cardiac tamponade follow up 13 days later after pericardiocentesis
"Let him enjoy his life," I said to the lady owner as I phoned her about the 2nd blood test done on Sep 6, 2011 and compared it to that done in Aug 25, 2011 when the dog had anaemia. Blood transfusion cost $1,200 when she asked me. I had not advised her as I did not think that this dog whose gums were pinkish would need one and in any case, it would be costly. So, I advised good food like liver, egg yolk, iron, folic acid and multivitamin tablet supplementation.
Compare the blood results
Aug 25, 2011. Can't breathe. I couldn't hear sounds. Double Chin. Both paws swollen and other parts of body. I gave 60 mg Lasix Iv and sent to Vet 2 for ultrasound, X-ray and 3rd opinion as to the cause of this "double chin" which I suspected was due to a large mediastinal mass. Cardiac Tamponade. Pericardiocentesis done and goes home. Vet 2 said possible heart tumour at base of heart and mitotic figures seen in pericardial fluid indicated neoplasia.
Aug 25, 2011
Haemoglobin 8.1 (12-18)
Red cell count 3.5 (5.5-8.5)
Sep 6, 2011. Left paw swollen slightly. Heart sounds can be heard at 30% of the normal breed size which was used as benchmark and teaching for my assistant and the lady owner. The belly looked a bit swollen when lying sideways. Lasix tablets had been given for 8 days from Aug 25, 2011 to Sep 2, 2011. Then no furosemide. I had advised to continue for the life span of the dog and so had phoned the owner to come for review.
Sep 6, 2011
Haemoglobin 10.3 (12-18)
Red cell count 4.3 (5.5-8.5). > 20% increase in red cell count due to good nutrition and supplements.
I could feel the spleen much enlarged like a child's shoe. That was not possible earlier. X-ray did show splenomegaly. Bad news.
WHITE CELL COUNT normal range. However see the composition:
Aug 25, 2011
WBC 7.8 (6-17) - normal
Neutrophils 91%
Lymphocytes 7%
Monocytes 0.5%
Eosinophils 0.9%
Basophils 0%
Platelets 191 (200-500)
PCV 0.24 (0.37-0.55)
Sep 6, 2011
WBC 8.5 (6-17) - normal
Neutrophils 57%
Lymphocytes 21%
Monocytes 8.7%
Eosinophils 11.5%
Basophils 1.5%
Platelets 316 (200-500)
PCV 0.27 (0.37-0.55)
Why the increase in monocytes and eosinophils? Is it associated with splenomegaly and endo-parasites? Heartworm blood test on 6 Sep was negative.
The Labrador now barks at passers-by outside and is more active. No long walks. Urine colour now much lighter and normal said the owner. Not so thin as there is flesh above spinal process. But weight was 35kg compared to 38 kg on Aug 25, 2011. "The water inside the skin and heart must have weighed 3 kg," the owner remarked. It was possible.
HISTORY
Jun 21, 2011. Diarrhoea and fever. 2 days. Recovered with tolfedine medication.
Aug 11, 2011. Very weak. owner gave tolfedine medication 60mg tablet 2x/day for 2 days. Recovered
Aug 16, 2011. Appetite normal but lethargic.
Aug 22, 2011. Neck swelling prominent. double chin. Went to Vet 1 who diagnosed "fat" or suspect cancer. X-ray abdomen and blood test normal.
Aug 25. 2011. Consulted me. Cardiac tamponade based on ultrasound and X-ray. Pericardiocentesis done by Vet 2. Medication for 8 days and advised review after that.
Sep 6, 2011. Reviewed. Left fore paw swollen and other signs as above.
Overall, the owner said by August 29, 2011, no more double chin or preputial and other swellings.
Compare the blood results
Aug 25, 2011. Can't breathe. I couldn't hear sounds. Double Chin. Both paws swollen and other parts of body. I gave 60 mg Lasix Iv and sent to Vet 2 for ultrasound, X-ray and 3rd opinion as to the cause of this "double chin" which I suspected was due to a large mediastinal mass. Cardiac Tamponade. Pericardiocentesis done and goes home. Vet 2 said possible heart tumour at base of heart and mitotic figures seen in pericardial fluid indicated neoplasia.
Aug 25, 2011
Haemoglobin 8.1 (12-18)
Red cell count 3.5 (5.5-8.5)
Sep 6, 2011. Left paw swollen slightly. Heart sounds can be heard at 30% of the normal breed size which was used as benchmark and teaching for my assistant and the lady owner. The belly looked a bit swollen when lying sideways. Lasix tablets had been given for 8 days from Aug 25, 2011 to Sep 2, 2011. Then no furosemide. I had advised to continue for the life span of the dog and so had phoned the owner to come for review.
Sep 6, 2011
Haemoglobin 10.3 (12-18)
Red cell count 4.3 (5.5-8.5). > 20% increase in red cell count due to good nutrition and supplements.
I could feel the spleen much enlarged like a child's shoe. That was not possible earlier. X-ray did show splenomegaly. Bad news.
WHITE CELL COUNT normal range. However see the composition:
Aug 25, 2011
WBC 7.8 (6-17) - normal
Neutrophils 91%
Lymphocytes 7%
Monocytes 0.5%
Eosinophils 0.9%
Basophils 0%
Platelets 191 (200-500)
PCV 0.24 (0.37-0.55)
Sep 6, 2011
WBC 8.5 (6-17) - normal
Neutrophils 57%
Lymphocytes 21%
Monocytes 8.7%
Eosinophils 11.5%
Basophils 1.5%
Platelets 316 (200-500)
PCV 0.27 (0.37-0.55)
Why the increase in monocytes and eosinophils? Is it associated with splenomegaly and endo-parasites? Heartworm blood test on 6 Sep was negative.
The Labrador now barks at passers-by outside and is more active. No long walks. Urine colour now much lighter and normal said the owner. Not so thin as there is flesh above spinal process. But weight was 35kg compared to 38 kg on Aug 25, 2011. "The water inside the skin and heart must have weighed 3 kg," the owner remarked. It was possible.
HISTORY
Jun 21, 2011. Diarrhoea and fever. 2 days. Recovered with tolfedine medication.
Aug 11, 2011. Very weak. owner gave tolfedine medication 60mg tablet 2x/day for 2 days. Recovered
Aug 16, 2011. Appetite normal but lethargic.
Aug 22, 2011. Neck swelling prominent. double chin. Went to Vet 1 who diagnosed "fat" or suspect cancer. X-ray abdomen and blood test normal.
Aug 25. 2011. Consulted me. Cardiac tamponade based on ultrasound and X-ray. Pericardiocentesis done by Vet 2. Medication for 8 days and advised review after that.
Sep 6, 2011. Reviewed. Left fore paw swollen and other signs as above.
Overall, the owner said by August 29, 2011, no more double chin or preputial and other swellings.
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