Wednesday, November 21, 2012

1190. Follow up on Schnauzer with kidney & bladder stones

Wed Nov 21, 2012

The Schnauzer came back on Saturday as she had been vomiting the past 2 days. Blood tests revealed a high white cell count and urine test showed amorphous urates 2+ , blood, and white cells. The dog was on IV drip and antibiotics on day 1. She did not vomit. Ate food and vomited again yesterday.

It is possible that the kidney stones had caused this urinary tract infection. What is the solution? Cut out the stones from the kidney? Presently, a lot of pain in the abdomen. Bacterial infection is treated first and let the dog stabilise. X-rays will be needed.

1189. The Schnauzer scratches all over his body. Why?

Wednesday, November 21, 2012


1189. The Schnauzer scratches all over his body. Why?



Skin diseases are most common in practice. There are many causes and one of them is a lack of grooming as Singapore pet owners are harassed by the fast-paced city life.



In this 7-year-old male Miniature Schnauzer, his whole body, limbs and backside are itchy. The Schnauzer had a good coat until recently. He had not been to the groomer for some time. "My wife used to take care of him," the man in his late 40s told me that the dog had a good coat previously. The wife was no longer around and the dog developed generalised itchiness in the body, limbs, backside and ears. Hair loss over parts of the backside and legs.



A urinary tract infection was evident from the presence of blood and bacteria. The X-ray did not show any radio-dense stones. "There could be prostatitis," Dr Daniel discussed the case with me and had spoken to the owner about neutering. "Spermatozoa +++" was present in the urine analysis. This lab finding does occur and my hypothesis is that the male dog displayed hypersexuality. Neutering would certainly resolve his behavioral problem.



I noted that the prepuce was inflamed. It was possible that this male dog had relieved his pain from an inflamed or enlarged prostate. For some male dogs, neutering would prevent much prostate problems of inflammation and infection at the older age.



The dog has an excellent appetite as you can see lots of the dry dog food in the stomach and intestines.




A follow-up one month later would be advised.



Monday, November 19, 2012

1188. Sunday's interesting case - the cat with the balding backsides

Sunday Nov 18, 2012  Bright sunshine in the morning. Heavy downpour in the afternoon.

Case 1. Four months ago, this old male neutered cat was losing hair on both backsides. Balding patches. So I was rather surprised to see him with a full bloom of coat - freckled and thick. The Indian father and his adult graduate daughter came early in the morning to get some matted hair below the armpits removed. A complaint of itchy ears.

"He is such a nice cat," Dr Daniel commented. "He did not claw or scratch when his ears are cleaned."

"He is very timid when at the vet," the father said. "At home, he is a lion."

I really admired the thick coat and asked what happened. Many years the cat had baldness in the inguinal area and the coat was in a mess. I discovered it was the management of the litter box. The cat had dirtied himself when he went in and came out of the litter box which was lined with newspapers. What is the secret of his full coat? I reviewed my medical record of 4 months ago. The cat's anal sacs were infected and expressed and medication was given. An antifungal wash.

"Now we have 2 litter boxes," the father said. I can't remember whether it was my idea or not as I do not record every advice I gave and neither did I claim credit. "The cat would go into one to pee and one to poop. He would not go into any of the two till we clean it." So, that was the secret to such a lovely coat for this 8-year-old cat. 

It was great to see this old cat having such a beautiful coat nowadays, considering that the father and daughter had so much worries over his balding backsides.

Case 2
A "gigantic" dog bigger than the Siberian Husky and more to the size of an Alaskan Malamute visited the clinic. His size was enough to send any lady or man into shivers. Like a big white wolf. He sniffed the door 



1187. The cat foster lady

"Sometimes, it is not the money but the shortage of time," I said to my associate vet who had amputated the kitten's left forelimb and had hospitalised it for 3 weeks. The wound did not heal well and the cat foster lady could not nurse the wound at home. So it was hospitalised here for some time.   

2 evenings ago, the foster lady came to visit the cat after being absent for 3 days due to her workload. My associate vet had gone to visit the ailing grandma on that Friday evening and so I spent some minutes talking  her. "Should the bandage be changed?" she asked me. "No need to change everyday," I said. The wound is healing by granulation. She usually spent time with the kitten till she had to go home. This time, the kitten peed onto her pink T-shirt. She went to the bathroom and changed to a floral one.

Today, Monday, Nov 19, 2012, the lady came. She was overjoyed when my associate vet released the cat to go home.

More Singaporeans are being kinder to stray cats and dogs now than 10 years ago. What happened to this stray kitten was that her left forelimb was paralysed. Her left eye cornea was 90% opaque and her right eye cornea had two large spherical bulges. 

1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?




"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.

"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"

"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."

"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.

"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."

"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."

I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending. 







Sunday, November 18, 2012

1185. Audit Review of skin disease: The black Mini Schnauzer still bites her legs again

Sunday Nov 18, 2012  9.58 am

Skin diseases are due to many causes and each vet has his or her own way of diagnosis and treatment. Some cases need regular reviews monthly but rarely do owners bother to do it. Some cases get cured with one or two treatments. In the following audit case, I review the case treated by my associate vet in more detail as the owner came back again some 3 months later after the first treatment at Toa Payoh Vets on Nov 15, 2012 and as she spoke in Hokkien, I took over the case from the associate vet who could not speak a word of this dialect.

I was present on Nov 15 and saw her male friend shaking his head disapprovingly. "Your husband is shaking his head," I said. "He is a friend. I am a divorcee," she informed me. So, one must not presume spouses anytime. I asked for her history from the previous vet. There were 13 pages of record.

Today Sunday, I phoned the owner at 9.50 am. Nobody answered. Too early for a Sunday morning or she had gone out. Over 50 years old lady.


Mini Sch black, female, spayed

Saturday, November 17, 2012

Social media and google docs. Can old dogs learn new tricks?

Nov 17, 2012
To: Young new graduates - marketing your expertise in the social media is hard work
From: Dr Sing Kong Yuen
Use google docs and social media to promote your expertise
The golden age of the internet is here. Yet, most young people don't know how to use the social media to promote their skills for prospective cients.

Gaming is fun and pleasure but will not create awareness of your hobbies, skills and expertise as a vet or hobbyists.

Facebook with pictures of fun and beer drinking and outrageous behaviour of the young undergraduates at school will make the their baby-boomer mothers blush, but actually such images cast the young persons involved as being lacking in self-discipline and morals and demonstrate irresponsibility to hold top management positions to prospective employers.

Use google docs to get your financial statements stored, rather than emailing attachments to the employer. The employer just click on the link with a password. This is what I mean by using social media to be more efficient, productive and smart in your profession.

With the new Samsung Notebook Lte, it is possible to write directly onto the phone-tablet. I can see this as a new way to record case studies by writing instead of typing on the keyboard and then storing the record in the cloud. Typing during consultation takes a lot of time and so this Samsung Notebook with pen will be an advance in medical recording, if you know how to apply the tools of the trade.
Read, research and apply the tools of social media to promote your expertise. It will be dull and boring compared to thumbing text messages to your friends and they thumb back trivial news to you, back and forth during your working hours. It is hard work and requires daily input on the blog, facebook or other social media. Few young ones will do it. So, this is where you distinguish yourself as a professional or hobbyists. Rarely do baby-boomer generation people do it but then they are set in their ways watching TVS or online movies and have no time to learn and apply new technologies to promote their expertise. Well, they are either established in their management positions or about to retire. Why would old dogs learn new tricks?

It is time to change your mindset if you want to distinguish yourself in this extremely competitive world where prospective clients are much more sophisticated and demanding of the highest standard of service at the lowest costs by surfing the internet.