741. Keratitis in pugs and people

Keratitis is an inflammation of the cornea. In people wearing soft contact lens, there are 3 types of keratitis:

1. Infective Keratitis. Cornea inflammation caused by micro-organisms like baceria, fungi and parasites. Can lose eye-sight if not treated early or by appropriate antibiotics. Cloudy scar on cornea when healed. A person can't see clearly. Same with pugs and other dogs. Big problem in pugs and shih tzus. It is called ulcerative keratitis. See one picture below:

2. Epthelial Keratitis. The top layer of the cornea is inflamed. Small holes are seen in the epithelium. It is called punctate epithelial erosions and this is also commonly seen in pugs and shih tzus. For the dogs, it is due to traumatic injury. See the green spots of one pug's eye below:

The holes may get infected by bacterial.

3. Allergic Conjunctivitis. The membrane which is below the eyelids is called conjunctiva. An allergic reaction to the contact lens or its solution leads to eyelid swelling and pain.

Chemosis - swelling of eyelids.

PUGS, SHIH TZUS AND PEKINESE
Ulcerative Keratitis is commonly seen due to injury to the protruding eyeball. Early treatment saves the eye sight.

Many Singapore owners of the pug and shih tzu and related breeds have no time to maintain the facial folds or damage the cornea during cleaning of the facial fold. Hairs get trapped inside the eyelids and as you can see from the picture below, the cornea is deprived of oxygen by the turfs of hair and get irritated and infected by bacteria found in the hairs.

My advice is to get your vet to excise both facial folds, preventing the formation of ulceratitive keratitis. But many Singapore owners do not want to accept this advice and so, as the years pass by, the cornea becomes blackened or browned by pigments (chronic irritation for many years). The dog is practicallly blind but the owner is not personally affected. It is just so sad. Keeping the eyes of pugs, shih tzus and pekineses clear and transparent to old age is a heavy responsibility. I hope the younger google generation will be more enlightened and sophisticated to prevent such problems by early treatment at the vet or by getting the facial fold excision done.

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22 Dec 2020. The lady owner of this 10-year-old male not neutered pug contacted me via text message as her pug's right eye had some "brown" thing. It was a matted cornea with ulcers and hair glued onto the cornea, on detailed examination, under sedation, in the operation room. Images are in instagram as well.

This blog:

https://2010vets.blogspot.com/2011/11/741-keratitis-in-pugs.html

www.instagram/toapayohvets

 

740. SOP Dental scaling at Toa Payoh Vets

The following is advised before an old dog (>5 years old) gets dental work done under general anaesthesia

1. General and detailed examination
2. Complete blood test for health screening
3. Oral antibiotics for 7 days before dental work
4. Dental work with low sedation and use of isoflurane + O2 gas
5. Post-op antibiotic and pain-killer injection
6. Post-op pain-killer and antibiotics 5 days
7. Teeth extracted to be shown to owner
8. Dental record
9. Dental reminder 2 years later
P.S. X-rays of lungs and heart ECG may need to be done

A big thank you to the young Singaporeans who produced the following videos to educate pet owners and bring veterinary medicine and surgery alive to the vet students studying hard for their exam.

As these google-generation people are very busy and have not charged me for services, I have not asked them to edit again to make a perfect production.

The following are the videos:


http://www.youtube.com/watch?v=tmTYP8T95V4 - Kennel Cough video the Sec 3 St Andrew boys produced. The "owner" of the pug was the student but the other characters are genuine. The video producer was another student and his teacher had kindly recommended him to me to help in this production. It turned out to be quite fun to watch this video, in my opinion.

For example, locking the door of the black Mercedes car is not done nowadays but we all had great fun in producing this video. The "owner" seemed to be smiling when he came for a second vet visit with a puppy that had worsened in coughing! I mean, the real owner would be very worried!

After hospitalisation in a crate, there was a scene of the puppy on the consultation table inside the vet consultation room! This should be cut! This is the first video production and no more other versions. That is why I explained the "deficiencies" in the production!

http://www.youtube.com/watch?v=FYeG9tUXp78 - Responsible Pet Ownership video - Nicole Pereira. Excellent summary of some of the main problems seen at Toa Payoh Vets. Great work.


http://www.youtube.com/watch?v=ExTT2a8eUCs - Oronasal Fistula Follow Up - Temasek Polytechnic Vet Tech students who do not wish to be credited

http://www.youtube.com/watch?v=9vKmXgAS_SA - FIV in stray cats 2 - Temasek Polytechnic Vet Tech students who do not wish to be credited

Overall, it took a lot of time. Too much time.

734. Educational videos produced by young Singaporeans for Toa Payoh Vets

E-MAIL FROM DR SING DATED NOV 21, 2011

Thank you very much for your help in producing the Responsible Pet video meant for the AVA Responsible Dog Ownership Road show. The KC video was also good thanks to your help. The voices of the narrators were distinct and clear, to my surprise and the narrative scenes were not boring unlike a power point presentation or a professor's lecture. I hope the vet students do learn a bit about complicated kennel cough.

I gave each party general guidelines as I want other views and presentation.
Each party brings in something new (ideas and presentation and music) in video production and that is why it is so interesting to watch them. Thanks again.

I am only worried about the microchip scanning pic and some other pic you put on the Responsible Pet Ownership video as they may be copyright. Pl confirm the source as we can get sued or get a legal warning to remove it! Pl look into this matter and it is best to remove them and put in original images.

On Sun, Nov 20, 2011 at 5:06 PM, Nicole Pereira wrote:

Hi Dr Sing, here's the links to the videos i uploaded to your 99pups account-
http://www.youtube.com/watch?v=tmTYP8T95V4 - Kennel Cough video the St Andrew boys produced
http://www.youtube.com/watch?v=FYeG9tUXp78 - Responsible Pet Ownership video
http://www.youtube.com/watch?v=ExTT2a8eUCs - Oronasal Fistula Follow Up
http://www.youtube.com/watch?v=9vKmXgAS_SA - FIV in stray cats 2

Sunday Nov 20, 2011 interesting cases

EYES
1. Pug with right eye perforated ulcer treated by me some months ago came in for annual vaccination. A young couple who remembered me as much as I remember them due to this serious eye injury drama as described in my case:


Ulcer healed very well but two very small green ulcers (fluorescein stain) seen to the 7 o'clock. Extraordinary amount of hairs clumped together on corneal surface when I cleaned it (see image). Dr Vanessa had applied the fluroescein strip and had flushed out the green dye. I took over while she checked another dog as the couple wanted to consult me.

Left eye - no ulcers but brown pigmentation covers 50$% of central area - friction from owner cleaning facial fold daily?

I advised facial fold excision as the hairs from the fold must have irritaed the corena (central area) and the pug must be rubbing the eye. "Alternative is to close the eyelids when cleaning the facial fold area," I said.

"Will the surgery affect the health of the pug?" the lady asked. "No," I said. Less itchiness and no more need to wipe the secretions off the facial fold. If irritation continues, the cornea will be seeded by brown black pigments over the years and the dog can't see clearly in front.

The owners would think about the surgery. Their other pug has no corneal ulceration problems. It is hard to foresee the future. "The facial fold is part of the pug's beauty but healthy is more important than beauty," I said.

2. CORNEAL DYSTROPHY
The miniature pinscher owner had texted to consult me yesterday to review the eye. She firmly believes that the circle of whiteness of the inside of the cornea had been reduced with the use of garasone eye drops daily with one small drop.

I will refer to the other picture I took some time ago and see. It seems that the circle has shrunk a bit and the edges are more firm. I need to review the old pic.


The left eye has some interesting developments when I view the images. The dog was fidgety and therefore no proper examination was possible. The owner did not want fluroescein eye stain test for the eyes and so I can't confirm whether the left eye still has ulcers in the upper half near the melanomas.
The pic traken toaday shows "crocodile skin" areound the eyelids. Must check previous pic soon.

CASE 3
A 13-year-old pug passed away after 11 pm yesterday. My assistant Min saw him alive and resting at 11 pm when he did his last checking.

"Why did you send a pug for grooming?" I asked the young couple who told me that the pug had never coughed once before going to the groomer two days ago (Friday). Then she coughed vigorously at home for a long time and so I was consulted on Saturday morning. The pug did not cough when I saw him. "The likely cause of coughing is due to kennel cough," I said as kennel cough is a common disease in places where dogs of various ages mix and it is a very contagious disease. The old dog had not been vaccinated forl many years. So, the primary diagnosis was kennel cough - a dry hacking cough.

I recommended to ward the old dog in a cage so she could rest. "Continuous coughing will result in blood vessel rupture in the lungs," I said to the young couple. Blood test was advised to check for infectious situation but the owners declined.

When the pug died, both her nostrils had red blood. Her tongue was cyanotic. So there was some respiratory damage and bleeding. "An independent post-mortem by the AVA will be needed to ascertain the cause of death," I said to the lady whom I phoned. "The dog is old and her immune system would be weak and she was not able to fight off the viruses and bacteria of kennel cough," I said. Cremation was arranged and the urn would be available in 2 days' time. It is one of the cases where old dogs without vaccination should not be exposed to other dogs. The pug was having her nails clipped and she panted at the pet shop. It was a sad Sunday for me as the pug had not shown any signs of impending death at the Surgery. In fact he had eaten some food after treatment with antibiotics and a drip. However, I had warned the owner of a possible death and the owners were understanding.

736. Health of Westie

The Westie Foundation of Amercia - health matters funded.

Atopic dermatitits (an allergice skin disease)
Bladder cancer
Idiopathic pulmonary fibrosis (lung scars)
Copper toxicity (hepatitis & liver failure)
Legg-Calve-Perthes disease (hip joint degenerative disease)
Luxating patellas (dislocating knee caps)
Addison's disease
Inflammatory bowel disease
Cataract
Dry eye (keratoconjunctivitis sicca)
Cranio-mandibular osteopathy (painful bone growths in the skull and jaw b ut usually OK by 12 months of age)
White shaker dog syndrome (entire body shakes or trembles - appear in other small white breeds - immune system disorder suspected - successfully treated with steroids).

735. Inspirational picture

MESSAGE TO AN ENTREPRENEUR

As regards your water project, I am reminded of this martial arts movie "Dead Or Alive" which is free online and just watched by me as I do my early morning internet work. In the movie, the antagonist mentioned 3 words about the Japanese lady not up to the mark as her brother. She needs "Skills, Timing and Strength" but she has no "strength".

Somehow, these 3 words seem apt for your project in wanting to expand your business from Singapore to China and Indonesia. I was wondering what to write in a picture of flowers I just took last Saturday at Sentosa. Now, I know and I produce a picture to encourage you.

1. The timing is right (environmental health concern for clean water), the skill is there (your brother) but the strength (of the parties doing marketing) is to be established and you have got the expatriate

and others you are networking to build up a team to increase your strength.

2. Thinking of making money all the time will not make one be successful in business, in my opinion.