eyeball prolapse in a dog with itchy eyes

http://www.kongyuensing.com/laws/20130188eyeball_prolapse_dog_itchy_eyes_toapayohvets.jpg

1258. Follow-up hamster eyeball enucelation & eye salvage alternatives

TOA PAYOH VETS toapayohvets.com Date:   24 January, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits The hamster has a popped out eyeball  Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS First written: 22 January, 2013 Date:   24 January, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 1256. Hamster with a popped out eyeball. Follow-up update and surgical procedures info.   Jan 22, 2013 "She is going to die," the young lady wiped her tears as her 2-year-old female dwarf hamster was sleepy unlike others. The hamster just would not move when held on the palm of her hands. She took her out several times and this would stress out the sleepy hamster which had not eaten and drunk water in the past 2 days and was in great pain. "Two days ago, the right eyeball just popped out," she said. "Before that there was a white spot in her right eye. I thought it was a cataract." The hamster's shoulder skin stood up when pulled indicating severe dehydration. The protruded eyeball must be very painful as the hamster can't talk. She just sat still most of the time. The owner was quoted $400 by another vet to do surgery. "I don't have that much money," the student said. "Normally I charge $100-$250" for hamster surgery depending on how complicated it is and the time it takes.   Eyeball prolapse   After eyeball removal PRE-OP DEXTROSE SALINE "What are you injecting?" Dr Daniel saw me preparing a small injection of 0.05 ml in a 1-ml syringe and thought I was overdosing this hamster. "It is dextrose saline as he is so lethargic and weak." ANAESTHESIA "This is a very sick hamster," I said to Dr Daniel when we discussed anaesthesia. He proposed 1 drop of Zoletil IM. "The safest is just isoflurane gas," I said. "The vet needs to be very observant as it is hard to tell when the hamster is fully anaesthesized. We put the hamster inside a plastic container infused with 5% isoflurane gas. "Count up to 10 and take out. Repeat," I said. Dr Daniel did say 1,2,3...10!" once. The dosage was not enough. He tried again. "Use the mask," I said. But the mask was not effective as it was too big. OK for the baby rabbit. SURGERY Basically enucleation of the eyeball is similar to that for the dog. I incise 4 mm on the lateral canthus. Then I clamp the base of the eyeball with forceps. The normal eyeball suddenly popped out and the hamster squeaked. I ceased the procedure and gave the hamster more case. I scrutinised the hamster inside the plastic container. Once he could not move, I quickly took him out within a second. Clamped the eyeball, excised the base with scalpel. Unlike the dog, it was not possible to ligate the optic stalk and blood vessels. Profuse bleeding. I swabbed. Then I cut off the upper and lower eyelids to create two wounds which I sutured with 6/0. The hamster wriggled and I stitched fast 3 interrupted sutures. "Hold on to his front paws, the scruff of his neck," I said to him. The dwarf hamster is so small that there is no space for both of us. Finally, I sutured the eyelids. It was too cramped for the intern to take a video of the surgery. However she videoed 30 minutes post op and the hamster was busy cleaning himself. Surprisingly, the hamster became much more energetic after removal of the eyeball. It would be attribute to removal of pain and the dextrose saline. So, the owner was glad to see him as she took him home in the afternoon. 1 DAY AFTER SURGERY On Tuesday, Jan 22, 2013,  I phoned the young lady. She was most happy. "The hamster drinks a lot," she said. "She is much more alive." It was good news. 2 DAYS AFTER SURGERY Yesterday, Wednesday, Jan 23, 2013, the owner phoned me to say that there is a big hole. "Is it normal for hamster in such operations to have a big hole in the eye? What should I do? Can I send you the images of the eye by iPhone?" I said it was difficult to know what she meant and it is best to examine it as she thought there was a stitch breakdown exposing the eye wound. She brought the hamster to the surgery in the afternoon. I was out and some driver had suddenly swerved into my parked car opposite the church and public library, damaging the right fore lamp area. So Dr Daniel examined this hamster. "What happened?" I asked Dr Daniel. "The swelling was due to the bleeding after removal of the eyeball. It has become a clot. The owner did not give the pain killer and the hamster scratches the eye area. But the hamster is normal, very active, eating and running. Is it possible that you did not snip off the eyelids but had just stitched up the eyelids?" Dr Daniel was assisting me in this surgery to remove the eyeball but he was on the other side of the op table holding on to the hamster while I stitched up the "eyelids". As the hamster was a dwarf, he could not see me using a pair of scissors to snip off the upper and lower eyelids, as per standard operating procedure in eyeball removal surgery. In fact, it would be professionally incompetent not to do. SNIPPING OFF THE UPPER AND LOWER EYELIDS His palm is 4X in area compared to this dwarf and unlike the surgery in the dog or cat, he could not see much. He saw me using the scissors to cut off the 6/0 sutures after stitching the "eyelids". Actually, I had trimmed off the eyelids before putting in 3 stitches to close the eye. "I had cut off the eyelids, otherwise the eye would not seal off when the stitches dissolve," I said to him patiently.   EYEBALL REMOVAL SURGERY COMPARED TO THE DOG AND CATG The surgery to remove the eyeball in the hamster can be completed in less than 5 minutes unlike in the dog or cat owing to the small size of the eyeball. The same principles of surgery apply to the hamster as to the dog and cat, only that the operation is on a miniature scale and the anaesthetic risk of death from isoflurane gas is 10x higher as it is difficult to monitor the depths of anaesthesia.    SAVING THE EYE This hamster had a "white spot" in the right eye earlier. The owner thought it was a cataract. This would be a corneal ulcer. The hamster would have scratched so hard that her right eyeball popped out permanently and caused great pain. In the dog and cat, it is possible to "save the eye" if it is not badly damaged or infect. This is done by doing lateral canthotomy (which I did in this hamster) to enlarge the ocular space, push back the eyeball, give antibiotics and anti-inflammatory, stitch up the upper and lower eyelids (tarsorrhaphy) and in 14-21 days review the eyeball and remove the stitches. In this case, the eyelids are not snipped off. An e-collar is then worn. All these are not possible for the hamster esp. the post-op care as the hamster hates the e-collar and will get rid of it in no time. The hamster may not eat after such a drastic surgery. So, removing the popped out eyeball is the practical option.     Eye Injuries Are Emergencies in Hamsters. Consult Your Vet Immediately       3785 - 3791. Enucleation of the eye in a Syrian hamster at Toa Payoh Vets performed by me. The 3rd eyelid is not so prominent in the hamster unlike in the dog. This webpage is: http://kongyuensing.com/folder7/201301123hamster_eyeball_enucleation_toapayohvets.htm     More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: January 24, 2013 Toa Payoh Vets

1257. Amputation of leg saved the rabbit's life, prevents septicaemia in a guinea pig.

Why amputate if fractures are multiple fragments?  Not possible to pin or screw. Economics.

Two case studies will give you the answers.

1. Recent fracture. GP. Big swollen swelling at fractured region.
Reasons:     

    1. Pain. Guinea pig feels the pain and licks the region to alleviate its pain
    2, Pressure sores due to dragging of foot, friction from floor, continual licking of area    
  3. Infection of the inner tissues including muscles over time - localized infection - generalized infection = septicaemia  ---> multiple organ failure ---> shock ---> death.

 4. Emaciation. Not eating much owing to daily pain of fractured area.  

Case 1. Amputation of the leg prevents septicaemia in the guinea pig in later months
Narrate slides. Include how it is anaesthesized and surgery briefly

Post op complications - infection- stitch abscess.

Include some video footage. Overall video should be around 5 minutes. Ask owner to send video footage of latest updae in Mar 18, 2020 to close the case. 

-------------------------------

What happens if you don't operate but seek TCM? 

Case 2.  Amputation of the leg saved the rabbit from dying of septicaemia

narrate text

Amputation of leg saved the rabbit's life, prevents septicaemia in a guinea pig.

------------------------------------------------------

Old images. Do not use for video production.

1256. Hamster with a popped out eyeball

TOA PAYOH VETS toapayohvets.com Date:   23 January, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
The hamster has a popped out eyeball  Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   23 January, 2013	toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129
1256. Hamster with a popped out eyeball Jan 22, 2013 "She is going to die," the young lady wiped her tears as her 2-year-old female dwarf hamster was sleepy unlike others. The hamster just would not move when held on the palm of her hands. She took her out several times and this would stress out the sleepy hamster which had not eaten and drunk water in the past 2 days and was in great pain. "Two days ago, the right eyeball just popped out," she said. "Before that there was a white spot in her right eye. I thought it was a cataract." The hamster's shoulder skin stood up when pulled indicating severe dehydration. The protruded eyeball must be very painful as the hamster can't talk. She just sat still most of the time. The owner was quoted $400 by another vet to do surgery. "I don't have that much money," the student said. "Normally I charge $100-$250" for hamster surgery depending on how complicated it is and the time it takes.   Eyeball prolapse After eyeball removal PRE-OP DEXTROSE SALINE "What are you injecting?" Dr Daniel saw me preparing a small injection of 0.05 ml in a 1-ml syringe and thought I was overdosing this hamster. "It is dextrose saline as he is so lethargic and weak." ANAESTHESIA "This is a very sick hamster," I said to Dr Daniel when we discussed anaesthesia. He proposed 1 drop of Zoletil IM. "The safest is just isoflurane gas," I said. "The vet needs to be very observant as it is hard to tell when the hamster is fully anaesthesized. We put the hamster inside a plastic container infused with 5% isoflurane gas. "Count up to 10 and take out. Repeat," I said. Dr Daniel did say 1,2,3...10!" once. The dosage was not enough. He tried again. "Use the mask," I said. But the mask was not effective as it was too big. OK for the baby rabbit. SURGERY Basically enucleation of the eyeball is similar to that for the dog. I incise 4 mm on the lateral canthus. Then I clamp the base of the eyeball with forceps. The normal eyeball suddenly popped out and the hamster squeaked. I ceased the procedure and gave the hamster more case. I scrutinised the hamster inside the plastic container. Once he could not move, I quickly took him out within a second. Clamped the eyeball, excised the base with scalpel. Unlike the dog, it was not possible to ligate the optic stalk and blood vessels. Profuse bleeding. I swabbed. Then I cut off the upper and lower eyelids to create two wounds which I sutured with 6/0. The hamster wriggled and I stitched fast 3 interrupted sutures. "Hold on to his front paws, the scruff of his neck," I said to him. The dwarf hamster is so small that there is no space for both of us. Finally, I sutured the eyelids. It was too cramped for the intern to take a video of the surgery. However she videoed 30 minutes post op and the hamster was busy cleaning himself. Surprisingly, the hamster became much more energetic after removal of the eyeball. It would be attribute to removal of pain and the dextrose saline. So, the owner was glad to see him as she took him home in the afternoon. 24 HOURS AFTER SURGERY Today Tuesday, Jan 22, 2013,  I phoned the young lady. She was most happy. "The hamster drinks a lot," she said. "She is much more alive." It was good news.

1 day after surgery follow up. Hamster was OK.
3 days after surgery, no complaints from the owner. No news is good news in such cases.

1255. Toilet training a puppy who eliminates outside his den

 

On Fri, Jan 18, 2013 at 3:14 PM, Anna <,etrics.com> wrote:

Hi Judy

I am a first puppy owner, I am a mother of two. My kids are 9 and 16. I have tried putting him in one big cage to do all his business (eat, drink, sleep and play) but he seem not want to poop after food, yet he do it in the kitchen when I finally let him out to exercise.

I have read a lot from online but you are right that we are living in a HDB so we don’t have a garden for his eliminates.

I have read your article DR SING'S DRAFT REFERENCES & RESEARCH INTERVIEWS FROM 2005 - 2009
TOILET-TRAINING OF SINGAPORE PUPPIES

I am planning to try this

1. Small cage for sleeping with a pillow or blanket at night and when I think he need to sleep.
2. Bigger cage for eliminate. Keep him inside until he eliminate
3. Playing and Eating and drink in the kitchen

Not sure will it works? Please advise, thank you very much for your help. I wish to love my puppy and not to beat or short at him.

Regards,

Anna

 

EMAIL REPLY FROM DR SING DATED JAN 19, 2013
1255. Toilet training a puppy who eliminates outside his den

As each puppy is different in intelligence and behaviour, it is hard to give advices. Based on the fact that your puppy wants a clean sleeping and eating area but eliminates outside these areas,

I will propose that you continue as putting him in a crate (sleeping and eating area. Buy those panels of fences (used for playpen) to enclose this crate so that the puppy has an external "patio" to pee and poop. On this patio, put a pee tray with newspapers and his urine smell. This will be his toilet area. Slowly increase his patio and you may know he eliminates in his playpen and in 4-8 weeks' time, he will just use the pee tray and the fences can be removed..

I don't know whether you understand what I am writing about. Email me 2 images of existing cage and his surroundings if you want me to elaborate. Best wishes.
 

1254. Two young terrapins of 3.5 cm shell width Jan 17, 2013

Yesterday evening Jan 17, 2013, Dr Daniel had to go to a concert and so I was on duty from 7 pm to 8 pm. I was surprised to see two young terrapins coming for consultation as they were of around the same age and the probability of two terrapin patients in sequence  is very rare at Toa Payoh Vets. I have taken a video of them for readers.

CASE 1. "Puffing" terrapin
"She avoids water," the father said. "She seldom moves. She will raise her head, burp and a swelling appears below her neck."
Sure enough, the terrapin displayed this behaviour. As if this terrapin had difficulty breathing. She did not move at all.

As a monitor lizard would puff up to increase his size to frighten predators.
"Did you feed something causing throat obstruction?" I asked as another "balloon" below the neck swells up.
"I did feed shrimps," the father said. Most likely dyspnea. Inhalation pneumonia from swallowing too large a piece of shrimp?

I hospitalised her and gave her multivitamins in water. The next day, she was more active. Her head is still raised upwards and I have not seen her head on level horizontal. What is the solution? In cats and dogs, X-rays and sedation to check out the throat would be done. But this is a baby terrapin. I would observe. In any case, she was moving this morning when I took her out to sun and video at 10 am.

CASE 2.
"Right eye closed, so he is not eating," the father said. "Is it infection?"
I noticed a white plug covering the eyelids of the right eye. I hospitalised it and give multivitamins in the water. Changed water and bathed it. The next morning, the right eye was opened and the terrapin was overactive. See video. I put him in a shallow bowl and monitor. Once I turned my back, I saw him upside down as he had attempted to climb up the shallow bowl. I put him back on his side. He could go home and the young lady owner was most pleased.

 

Video: Oral tumours in older dogs in Singapore

http://www.youtube.com/watch?v=BKuotAsSRAA

Oral tumours in old dogs in Singapore
video to educate dog owners