UPDATE
The supplier told me today that Feline S/D had been discontinued by Hills since 9 months ago. I told him I saw a can being given by Vet 2 recently to the cat with bladder stones I operated on.
He said that feline C/D does dissolve struvites as well and is recommended for cats with calcium oxalate too, targeting the urine pH = 6.2-6.4.
Friday, March 1, 2013
Follow up: Stone analysis results for cat with bladder stone
Report received today.
Calcium, oxalate, magnesium positive.
Preventive diet will be C/D for life
Target urinary pH to be 6.2 to 6.4
Calcium, oxalate, magnesium positive.
Preventive diet will be C/D for life
Target urinary pH to be 6.2 to 6.4
1403. SOP - Urethral obstruction in a male cat
Written: Feb 28, 2013 10.49 am reviewing this case to compare to the cat with bladder stones operated.
Feb 28, 2013
Urethral obstruction in cats may be quite common. A lady phoned me near midnight about her cat's difficulty in urination 2 days ago but she did not want to go to the emergency clinic I referred her to. So, I presumed this 13-year-old male neutered black and white cat to be the owner who came on Feb 28, 2013 as he cat could not pass urine and had blood in the urine passed.
"No, I did not phone you," the lady in her late 40s said to me as I palpated a bladder the 50% the size of a Thai mango.
"How long had he been having this problem?" I asked.
"Two days."
"Did he vomit?" I wanted to ascertain the kidney involvement as owners seldom volunteer this info.
"He vomited 3 times yesterday."
"He must be eating dry cat food since young," I predicted.
"Yes," she said. I feed dry IAMS and ikan bilis since he was young."
"He seldom drinks water," I said.
"You are correct."
This was a gentle old cat. He did not like me massaging his penile area to loosen the urethral plug and hissed.
Standard Operating Procedure (SOP). Emergency treatment usually
1. Sedate the cat. Collect blood and urine if possible. Blood collected. No urine
2. I Injected SC baytril and tolfedine. I used xylazine 0.1 and ketamine 0.4 ml IM. Sufficient.
3. Collect urine via catheter. This was not possible as the urethra was severely blocked at the bend of the penile area.
4. Put saline into syringe and flush into catheter to unblock. This was successful. Do not force catheter inwards as this tramatise the urethra as I had seen a vet doing it. Sedate first.
5. Urine flows out. Collect for urine analysis.
6. Irrigate bladder with saline and suck out any sand and blood
7. Stitch 3 areas catheter with absorbable to anchor catheter for 2 days. Blood still flows out on Day 2 (today).
8. Hospitalised overnight and goes home next day.
BLOOD TEST RESULTS
Urea 59 (7-11)
Creatinine 1003 (7-160)
Platelets 93 (300-800). Cat's mucous membranes were pale. Nose looked pale as compared to normal cat.
URINE
pH 6.5 SG 1.012 (not reliable as saline was used to unblock obstruction)
Blood 4+, Bacteria 3+, no crystals
(No crystals does not mean no bladder stone. Palpation of bladder on Day 2 - no hard stones). No urethral obstruction as catheter is in place.
X-RAYS not done to reduce cost for this first occurrence. Will do if recur.
ADVICE
Change slowly to canned food. Urine analysis 1 month later. K/D for 10 days. Seldom gets followed up as most owners don't comply.
Feb 28, 2013
Urethral obstruction in cats may be quite common. A lady phoned me near midnight about her cat's difficulty in urination 2 days ago but she did not want to go to the emergency clinic I referred her to. So, I presumed this 13-year-old male neutered black and white cat to be the owner who came on Feb 28, 2013 as he cat could not pass urine and had blood in the urine passed.
"No, I did not phone you," the lady in her late 40s said to me as I palpated a bladder the 50% the size of a Thai mango.
"How long had he been having this problem?" I asked.
"Two days."
"Did he vomit?" I wanted to ascertain the kidney involvement as owners seldom volunteer this info.
"He vomited 3 times yesterday."
"He must be eating dry cat food since young," I predicted.
"Yes," she said. I feed dry IAMS and ikan bilis since he was young."
"He seldom drinks water," I said.
"You are correct."
This was a gentle old cat. He did not like me massaging his penile area to loosen the urethral plug and hissed.
Standard Operating Procedure (SOP). Emergency treatment usually
1. Sedate the cat. Collect blood and urine if possible. Blood collected. No urine
2. I Injected SC baytril and tolfedine. I used xylazine 0.1 and ketamine 0.4 ml IM. Sufficient.
3. Collect urine via catheter. This was not possible as the urethra was severely blocked at the bend of the penile area.
4. Put saline into syringe and flush into catheter to unblock. This was successful. Do not force catheter inwards as this tramatise the urethra as I had seen a vet doing it. Sedate first.
5. Urine flows out. Collect for urine analysis.
6. Irrigate bladder with saline and suck out any sand and blood
7. Stitch 3 areas catheter with absorbable to anchor catheter for 2 days. Blood still flows out on Day 2 (today).
8. Hospitalised overnight and goes home next day.
BLOOD TEST RESULTS
Urea 59 (7-11)
Creatinine 1003 (7-160)
Platelets 93 (300-800). Cat's mucous membranes were pale. Nose looked pale as compared to normal cat.
URINE
pH 6.5 SG 1.012 (not reliable as saline was used to unblock obstruction)
Blood 4+, Bacteria 3+, no crystals
(No crystals does not mean no bladder stone. Palpation of bladder on Day 2 - no hard stones). No urethral obstruction as catheter is in place.
X-RAYS not done to reduce cost for this first occurrence. Will do if recur.
ADVICE
Change slowly to canned food. Urine analysis 1 month later. K/D for 10 days. Seldom gets followed up as most owners don't comply.
1403. Update Key Performance Indicators for spay & SOP
 TOA PAYOH VETStoapayohvets.com 01 March, 2013 Focus: Small animals - dogs, cats, hamsters, turtles, guinea pigs & rabbits | ||||
Toa Payoh Vets Clinical
Research
Standard Operating Procedures (SOP) & Key Performance Indicators (KPI) For other cases, goto: Dogs | ||||
One of the effective management
systems is to ensure consistency of process and to execute Key Performance
Indicators. To maintain the highest standards of veterinary practice and
productivity as well as sharing knowledge, the Standard Operating Procedures
(SOP) and Key Performance Indicators (KPI) are being implemented in Toa Payoh
Vets from 2011.
Good written records are a strong defence in the cases of litigation and complaints | ||||
| Standard Operating Procedures (SOP) | ||||
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| 5491 -5495. The internet connections open the doors... | ||||
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| 5417. SOP: Eye corneal ulcer & tarsorrhaphy | 5412. SOP:
Veterinary Surgery Report format |
5413. SOP: Urinary Tract Infections and struvite stones | SOP: A new puppy with blood in the stools | |
| Key Performance Indicators (KPI)
for an experienced vet E-D = Time from first skin incision to skin stitched up | ||||
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| 5991. Feb 2013. KPI spay Maltese on heat. E-D=27 min. Isoflurane gas top up needed. | ||||
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| 5448. KPI for spaying a dog with false pregnancy. E-D=19 min | 5448. KPI
for spaying a dog with pyometra. E-D=26 min |
5615. KPI: Spaying a fat dog. E-D=28 min | KPI:
Dog spay - Chihuahua. E-D=23 min |
KPI: Dog spay - Fox Terrier E-D=26 min and Shih Tzu E-D=18 min |
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| 5545. KPI for spaying a Miniature Schnauzer with closed pyometra. E-D=41 min. | KPI: Neuter E-A=18 min and tarsorrhapy | |||
| Veterinary Management: Processes, Protocols, Procedures & Best Practices | ||||
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| 5990. Best practices from a plastic surgeon | ||||
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| 5286. A vision for Toa Payoh Vets to be a top 3 veterinary surgery in Singapore | 5385. Procedure: Female dog urethral catherisation |
5111. Pet grooming business success in Singapore | 5288. Reversing
the decline in horse racing - Part 2 |
5212. Veterinary clinic inspection |
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| 5142. A neat and good spay suture pattern is important | 4980. Dressing casually at Toa Payoh Vets | 4981. Character and competence of interns and young employees | ||
| Toa Payoh
Vets Clinical Research Standard Operating Procedures (SOP) & Key Performance Indicators (KPI) For other cases, goto: Dogs This webpage is: www.bekindtopets.com/animals/20081201PG9standard-operating-procedures-vets_ToaPayohVets.htm | ||||
| Copyright © Asiahomes All rights reserved. Revised: March 01, 2013 Toa Payoh Vets | ||||
Thursday, February 28, 2013
1402. Digital images of 83g hamster now 77g after surgery
Make use of digital photography to show tumours excised, hamster recovering etc as the owner will be educated and happier to know what had happened. This hamster of 83 g was not knocked down by 3 drops of Zoelietil 50 IM today. I thought it was too little. After 5 minutes, he became drowsy. Clipped and excised the large left inguinal tumours and left ear wart. Weighed him. He was 77 g and pooped a lot. Owner was pleased.
1401. Abdominal cryptorchid in a dog
"Is the vet competent?" the owner asked me. The young male dog had been sent in for neutering. Two undescended testicles. So, just get on with the operation. Many times, there is no problem locating the two undescended testicles under the skin.
However veterinary surgery throws the vet a surprise. In this dog, one testicle was located. The only was nowhere under the skin!
Be meticulous. Make a thorough examination before any surgery. If the undescended testicle cannot be felt under the skin while the dog is standing, don't expect to find it when he is on his back! There will be a lot of doubts from the owner when the vet can't find this testicle as it is inside the abdomen.
Have an examination procedure. Verify gender. Verify presence of both undescended testicles under the skin. If not, let the dog owner know immediately and open up the abdomen. The abdominal testicle usually is located next to the bladder at the side.
Be humble if you don't know and ask your senior vet what to do.
However veterinary surgery throws the vet a surprise. In this dog, one testicle was located. The only was nowhere under the skin!
Be meticulous. Make a thorough examination before any surgery. If the undescended testicle cannot be felt under the skin while the dog is standing, don't expect to find it when he is on his back! There will be a lot of doubts from the owner when the vet can't find this testicle as it is inside the abdomen.
Have an examination procedure. Verify gender. Verify presence of both undescended testicles under the skin. If not, let the dog owner know immediately and open up the abdomen. The abdominal testicle usually is located next to the bladder at the side.
Be humble if you don't know and ask your senior vet what to do.
1401. Update on KPI spay Maltese
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