1320. Update on the rat's nose lump

Dear Dr Sing,

Thank you for your email. I'm afraid I don't have better news for you. After his last course of Clavamox, the lump seems to be growing. It still feels relatively soft, but has indeed gotten larger.

Today would be his last course of steroids, would you prefer me to keep him on steroids until he sees you on Sunday?

I'm wondering if there was any signs of a tumour present when the site was cut open. I've also attached a few pictures of the lump taken recently.

Please do let me know what would be a good timing to bring Moo down for your assessment this Sunday.


Wishing you a good week ahead,

Regards,
J

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March 14, 2013

Kong Yuen Sing <99pups gmail.com="">	6:55 AM (0 minutes ago)

Thank you for your email. Lump appear to be an abscess from your digital images. Will need to open the swelling to know what it really is and to take tissue samples for histopathology. In the previous surgery, the swelling was below the muscle and no biopsy or histology was done at that time.

Steroids to be discontinued before surgery on Sunday. Pl note that there may be a big wound after surgery. 

Surgery to lance the possible encapsulated abscess/haematoma/cyst and to remove the lump is my advice but you need to decide as there is the anaesthetic risk involved. Post-op surgical complications include bleeding and infections. Other than surgery, more oral medication is unlikely to be effective. Bring him in at 9.15 am and take him back at 4 pm on Sunday. No food or water after 10 pm the night below.

Best wishes.    

1319. Treatment cost: Swollen eyes in the red-eared slider

On Wed, Mar 13, 2013 at 8:33 PM, Kelvin @yahoo.com> wrote:

Hi, Judy. May I know the cost of treating a red-eared slider whose eyes are swollen shut? My turtle has been like this for about 3 weeks and seems to be gasping from time to time. Would treatment fees be included in the consultation fees mentioned in the website? Kindly advise. Thank you.

 

 

 EMAIL REPLY FROM DR SING DATED MAR 14, 2013

 

 The costs of treatment including consultation depends on how long the slider takes to recover. Some recover within 7 days and some take a few weeks. If there is gasping, there will be respiratory tract infections.  As a guide, the costs for 7 days of hospitalisation is around $170 - $200 including nursing and medication.

1318. Update: Rectum falls out in the red-eared slider

TOA PAYOH VETS toapayohvets.com Date:   14 March, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits Rectal prolapse in terrapins and people Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   14 March, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2013-0131 Blog 1278. Rectal prolapse in terrapins and people  Recently an 82-year-old man, sound in mind and in good health brought in a terrapin with black and smelly prolapsed rectum. "No hope of repairing as the tissues are rotten and stinking," I usually push back the rectal tissues and suture up the anus for 7-14 days. If the purse-string suture is done early (within 1-2 days of rectal prolapse as for the 2011 case, image, left), the outcome is excellent. I had written that case study some years ago and the images of this 2011 case are shown below. As for this terrapin with the gangrenous rectum, euthanasia was done.   "Holding in the rectum"  - rectal prolapse where the rectum falls out of the anus. New surgical technique is providing relief. - Ventral Mesh Rectopexy. A mesh (plastic or biodegradaable material) is sutured to the pelvic floor muscles on both sides of the rectum. The top end is sutured to the spine to lift up the rectum. In women, the mesh is sutured to the top of the vaginal to prevent vaginal prolapse. At Singapore General Hospital, the fees range from $5,000 - $25,000. Recurrences are said to be low for this type of procedure as compared to other surgeries. Therapy to retrain the pelvic floor muscles in human will not apply to animals! REFERENCE:  The Straits Times Jan 17, 2013 pg 12-14 "Mind Your Body" has details of various surgeries in people. Reading what the human surgeons do and the latest advances in surgery may be of some use to veterinary surgeons as some techniques can apply to veterinary surgery. More Singaporeans are kinder towards terrapins, rabbits and hamsters in 2012 and 2013 unlike 10 years ago. The younger generation loves their companion animals much more than the baby boomer generation. There are 51 veterinary practices as at Feb 9, 2013. There were around 5 when I started practice in 1982! It is good for the pets and the pet lovers and vets should have more time to devote to the practice of veterinary medicine nowadays instead of rushing 40 cases per vet per day as in some busy practices. Successful diagnosis needs time to build up the case scientifically and to reflect and follow up. This can't be done if the vet has to attend to 40 cases per day as in hospitals. Updates will be on this webpage: http://www.bekindtopets.com/animals/20130209terrapin_rectal_prolapse_toapayohvets.htm   Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: March 14, 2013 Toa Payoh Vets

Follow up: Nose lump in a rat - what is it?

Two images of Moo's nasal growth attached

Inbox

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Kong Yuen Sing <99pups gmail.com="">	Mar 5 (8 days ago)

How is Moo now? Unable to connect to your phone when I called at 7 pm today.
Attached are 2 images.  Pl acknowledge receipt. Best wishes.

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EMAIL TO DR SING  DATED	Mar 5 (8 days ago)

Dear Dr Sing,

I have attached a picture of Moo (He keeps moving, this is the best I could get after distracting him with food), he's still eating, happy and running about but has started sneezing more than usual. Still on Clavamox 0.56ml twice a day 156.25mg/5ml liquid suspension. Today would be the 16th day of Clavamox, no runny stools so far. I would probably complete a 21 day course of Clavamox and try to see if his situation improves.

Thank you so much, both Moo and I are very lucky to have found two very experienced exotic vets :)

Have a great week ahead!

Regards,
J

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EMAIL FROM DR SING DATED MAR 13, 2013

Kong Yuen Sing <99pups gmail.com="">	3:23 AM (0 minutes ago)

It is Mar 13, 2013 now. Is the nasal swelling still present. Pl let me know.

1316. Sheltie X's large gingival lump

Sunday Mar 10, 2013

I was reviewing this Sheltie X's case, operated by Dr Daniel 3 days ago, using electro-surgery to excise the large gingival mass.

In this surgery, intubation is compulsory as it takes a longer time to excise this lump. Electro-cautery to seal the bleeders. Monosy 2/0 sutures were used to close the large wound after electro-excision. I asked Dr Daniel what was the post-op situation 3 days after op now?

"Any stitch breakdown or complaint from the owner?"
"No news," he said. He phoned the owner but the line was busy.
"You can text to her," I advised.
After 10 minutes, I phoned the owner. The mother said: "I have not checked the mouth, but the dog is OK." She asked the daughter to check the mouth but she would not want to do it.

"I will check for you," she replied. "The stitches are still there."
"Give soft food or dry food with water for the next 14 days," I advised.
"My Sheltie is eating dry food with water all the time," she said.
"How long was the gum tumour there?"
"I don't know. Four months probably."
"One month," the daughter said.
"If the tumour grows so fast and so large within one month, it is likely to be cancerous and will recur," I advised.

This is an cauliflower-type gingival lump. Could it be malignant? Since the owner did not want histology, there is no way to know its nature. \\

Some images are shown:

1315. Texting post-op info saves time - sebaceous hyperplasia

I always advise my associates to text the medical results to the owner if his or her phone is busy or unreachable. Most times, my associates do not do it.

I find it good practice as some owners will not say that nobody "phones" her about the results when her phone is engaged. Vets are very busy and I prefer phone calls to communicate one-on-one and to find out more about the post-op behaviour and wounds.

However in this case, the young lady's phone was engaged. I texted her the results saying "sebaceous hyperplasia, not cancerous." She texted to me twice and we never had one word.

She was happy to know and did her research on the internet for her 9-year-old dog whom she loved very much. The sebaceous hyperplasia is a cyst and the images are as follows: