Nov 27, 2012
Yesterday morning, I mentored a bladder stone surgery on the female British bulldog, 4 years old. The dog is OK today.
Eats like a horse, the owner said. Home-cooked food and dry food. Yet, a big stone. The dog was on antibiotics and S/D diet for a week. "Can you guarantee the stone will dissolve by S/D diet?" the owner was tired of having to clean up the dribbling urine every few seconds. "My dog passes greyish urine yesterday, like ash." I said I doubt it. "So, it is better to operate. She has lost a lot of weight. Much lighter now."
I required a blood test and urine analysis on the day of surgery. This had been done before, my associate said. "It is best to monitor the latest situation."
SURGERY
Dr Daniel operated. I assisted.
I got syringe of urine direct from the bladder for urine analysis. Dark red brown urine.
Incision from apex of bladder 1.5 cm.
Thick bladder wall of 5 mm. Bloody.
Suturing. Continuous on mucosa, then 2 layers of inverting. 1 layer could be OK but I advised two layers.
BLOOD TEST RESULTS -Nov 26, 2012 on day of surgery
Total WCC 11.5 (6-19). N=89%, L=10%, M=1%, E=0, B=0
RBC and platelets normal. Urea and creatiine below normal.
URINE ANALYSIS- Nov 26, 2012 direct from the bladder
Red turbid, pH 8.0, SG 1.019, Protein 3+, Blood 4+, WBC >2250, RBC >2250
Crystals Triple phosphate occasioal, bacteria 3+
I did not request an antibiotic sensisitivity test to reduce costs.
Tuesday, November 27, 2012
Thursday, November 22, 2012
1194. Follow up. The Schnauzer vomits again - bladder stones & kidney stones
Thur Nov 22, 2012
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
Vomited one month ago. Had kidney and bladder stones. I removed bladder stones, analysed as struvites. No vomiting for past month. On last Sat, came in as dog vomited. Warded. Vomited several hours after eating. Why?
Blood-borne infection. Urine has bacteria. Amorphous urate 2+. What's the cause and the solution?
X-rays today.
Spoke to a vet more senior than me. He said that very rarely did he encounter kidney stones. He had operated on one. "Very painful for the dog, need to give pain-killers post-op".
"Kidney stones occur in 4% of urinary stone cases, according to one Australian specialist vet presenting the SVA 2012 seminar," I said. "This vet said that if the incision of the kidney to remove the stone is more than 50% of the kidney length, the kidney would not function normally."
The X-ray showed the kidney stones to be more distinct. The dog had been on canned S/D diet for the past month and no other food. A lot of gas in the intestines. No stones in the bladder on V/D view. Is there any stone inside the ureter? This could partially obstruct the ureter and cause pain, nausea and vomiting hours after eating. The dog still eats and appears active. IV drips and antibiotics for the past 2 days. Wait and see.
Urine analysis revealed amorphous urates 2+ in urine pH 6.0, USG 1.017, blood 3+, bacteria 2+
Were the kidney stones of the left kidney URATES instead of struvites? It is hard to tell. Very rare cases of kidney stones seen by me for the past 40 years of practice.
UPDATES & MORE IMAGES AT WEBPAGE:
http://www.sinpets.com/F5/20121108vomiting_kidney_bladder_struvites_schnauzer_toapayohvets.htm
1193. Pus in the left eye - dwarf hamster
5759. Pus in an eye for the past 2 weeks
5760. No pus in an eye after 20 days of treatment
5761. No pus in an eye after 20 days of treatment
5762. Overview
Pus oozed out from the swollen conjunctiva. The whole left eye was badly infected. How to resolve this problem? Cutting up the abscess would be a calculated risk as the hamster might get blinded. Conservative treatment with eye drops and nursing needed 23 days. The hamster went home to a delighted little girl.
Webpage at:
http://www.sinpets.com/F6/20121123hamster_purulent_conjunctivitis_toapayohvets.htm
1192. Email query on tick control collar
On Wed, Nov 21, 2012 at 3:35 PM, Nicky @gmail.com> wrote:
Hi,
I have a golden retriever who is 4 years old and weighs 23kg. He is infested by ticks currently and is using the product "certifect". I would like to ask if I can use both the "Preventick Tick Collar" and "Certifect" together or do i have to use the 2 products separately?
Thank you very much.
Best regards,
----------------------------------------------
I am Dr Sing from Toa Payoh Vets. Certifect can be used separately. I have no knowledge of what "Preventtick Tick Collar" is as I don't use it.
Wednesday, November 21, 2012
1191. Guinea pig from Chua Chu Kang made resp.noises for the past 5 days
Wed Nov 21, 2012
At 7.30 pm, by appointment, the mother and two adult daughters brought the guinea pig, female, 4 years to consult me. "She makes noises like an engine for the past 5 days," the daughter said. "Now, she would not eat the pellets but just the vegetables. She would lie on the litter and not be moving. Liked to bite her lower part."
I checked the heart and lungs. Normal. No nasal or ocular discharge. Large ovoid shaped pellets passed. The coat was badly matted. The "noises" could be an upper respiratory infection or pain as the guinea pig tries to "de-matt" her clumps of coat in her back half.
I recommended Agnes who does guinea pig grooming. "How much?" the daughters asked.
Agnes said: "$40.00" but she was not free till the weekend. She explained to me she had to take care of her children. It is school holidays and she had some programmes. She had to fit in work-life balance with a brood of five children.
As for the guinea pig, the mother said she would come on Friday as she would be working. I said I would be in Malacca on a "Peranakan heritage tour" and so the older daughter said she would bring in the guinea pig on Thursday morning. She would wait while my assistant would clip off the coat and de-matt the hair.
The family had shifted from Ang Mo Kio to Chua Choa Kang in West Singapore and had taken so much trouble to come to consult me. Veterinary medicine is a very personalised service for many pet owners. The vet must stay the course for years as many younger vets come and go or work in various clinics and so could not be available.
At 7.30 pm, by appointment, the mother and two adult daughters brought the guinea pig, female, 4 years to consult me. "She makes noises like an engine for the past 5 days," the daughter said. "Now, she would not eat the pellets but just the vegetables. She would lie on the litter and not be moving. Liked to bite her lower part."
I checked the heart and lungs. Normal. No nasal or ocular discharge. Large ovoid shaped pellets passed. The coat was badly matted. The "noises" could be an upper respiratory infection or pain as the guinea pig tries to "de-matt" her clumps of coat in her back half.
I recommended Agnes who does guinea pig grooming. "How much?" the daughters asked.
Agnes said: "$40.00" but she was not free till the weekend. She explained to me she had to take care of her children. It is school holidays and she had some programmes. She had to fit in work-life balance with a brood of five children.
As for the guinea pig, the mother said she would come on Friday as she would be working. I said I would be in Malacca on a "Peranakan heritage tour" and so the older daughter said she would bring in the guinea pig on Thursday morning. She would wait while my assistant would clip off the coat and de-matt the hair.
The family had shifted from Ang Mo Kio to Chua Choa Kang in West Singapore and had taken so much trouble to come to consult me. Veterinary medicine is a very personalised service for many pet owners. The vet must stay the course for years as many younger vets come and go or work in various clinics and so could not be available.
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.
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.
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
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.
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.
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