At 7.45 pm, the gentleman came in while his mother waited inside the car. He was in his usual rush to buy the feline CD for next 14 days.
"How's the cat?" I asked.
"Back to his naughty self. Scratching everywhere and jumping. He has put on weight. He still has loose skin below his belly."
"It is good news." I said. "I discussed your case with Dr Daniel recently comparing with another case of a Pomeranian with right perineal hernia of 2-3 months' duration. The Pomeranian had similar very high abnormal kidney disorders based on blood test.
"Your cat had a very high Blood Urea Nitrogen (Vet 2's machine could not read values as they were excessive) and creatinine >30+ (normal 0.3 to 2.1). Phosphorus was >20+ (normal 3.4-8.5). Dr Daniel said to me yesterday that this cat could not have survived the surgery! His creatinine level was >15X the higher range of normal!"
The gentleman was the one who was most worried about the serious kidney disorder and wanted immediate surgery. I had postponed the surgery for one day and given antibiotics. The cat survived and is very naughty.
"You can buy the C/D from the other vet near your house," I said as this man complained of distance of my surgery from his home. "You don't need a prescription letter from me. I am sure he will understand as he had treated your cat before. I don't stock up C/D as they expire soon. You are an exceptional owner in that most cat owners could not be bothered with feeding the special food and get recurrence of stones again!"
"You advised feeding 3 months of C/D" he said.
"If you do regular 3-monthly urine tests," I said. "You may be able to stop C/D. If not, give C/D. The cat is thriving on C/D. Perhaps, you can mix with dry C/D which is less expensive as one can of C/D costs S$5.00."
"It is a miracle," he said. "I prayed for him before surgery."
"Yes, it was a miracle as he had a serious kidney disorder and was operated early. I intend to produce an educational video to teach other cat owners." He said he would send me the video files of the naughty cat for me to produce my video.
Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Monday, April 22, 2013
1384. Talk at Raffles Institution - Being a Vet in Singapore
|
9:42 PM (9 hours ago)
| |||
|
Dear Dr Sing,
This
is a confirmation that Dr Daniel Sing will be speaking at Raffles
Institution on 25th April 2013, Thursday, 5.30 - 6.30pm, to give a 30
minute presentation on veterinary sciences followed by a question and
answer session. A laptop with internet access will be provided as well
as a visualizer.
Dr Sing can park at the the Visitor's Carpark if he
is driving, and I will meet him at Manna Cafe (beside the pick-up point
at the carpark area) to bring him to the Lecture Theatre.
Once again, thank you very much for agreeing to come down and
we have many interested students who are looking forward to his
presentation.
Regards,
Suzanne Ou
|
7:23 AM (6 minutes ago)
| |||
|
1383. Rabbit's eye discharge.
A difficult case to follow up. One eye has discharge. Entropion was one cause but the owner did not want surgery.
EMAIL REPLY FROM DR SING DATED APRIL 22, 2013
Eye discharge is due to several causes including infections and traumatic injuries. Best to see a vet. In the meantime, an Elizabeth collar prevents scratching of the eye, but many rabbits don't like wearing it.
---------------------------------------------------------------------
On Mon, Apr 22, 2013 at 12:17 AM,@gmail.com> wrote:
Hi,
This is C, Jenny's friend, again. I'm afraid I have distressing
news. In my previous email, I asked if my rabbit Or's eye condition
would be contagious as I have another rabbit at home. And right now,
I've noticed that my other rabbit (Holland-lop breed, name's H) is
showing a bad eye as well. But H's condition is different from
Orhpi's.
I described Or's as constantly tearing and clear discharge. But
H's case is built-up crusty YELLOW discharge right around the
eyelids (top and bottom) and is causing him immense discomfort,
especially when I take a cloth and clean the bad eye; he actually
flinches in pain. His eye seems to be bleeding a bit, and I'm not sure
if it's considered an emergency because he is still eating/drinking
and pooping/peeing normally. May I know what I can do to elevate his
situation before a vet's visit? Thank you!
(With regards to Or, I would rather not risk a surgery since he
isn't fully well as you defined. If possible I'll acquire more drops
to ease his condition. Otherwise his condition is still the same as
before, not worsening and neither really improving)
~C
-------------------------------------------------------------------------------
On 8 March 2013 02:28, Kong Yuen Sing <99pups@gmail.com> wrote:
> Mar 8, 2013
>
> It is difficult to know how the corneal ulcer was created. Whether it was
> due to trauma, infection or acquired entropion?
>
> It could be due to the irritation from the ingrowing eyelids at the medial
> canthus (acquired entropion), foreign body penetration, hair irritation from
> the surrounding and constant eye rubbing. Whether there is bacteria or not,
> a culture need to be done but you have already used the eye drops. As for
> the treatment, wearing an e-collar is still advised even though the rabbit
> dislikes it.
-------------------------------------------------------------------------------
>
> On Wed, Mar 6, 2013 at 1:27 PM, @gmail.com> wrote:
>>
>> Hi Dr Sing,
>>
>> Thanks for the clear diagnosis for my Or this morning. The previous vet
>> has informed me that I can pick up the previously x-rayed image of Orhpi's
>> head at the clinic itself, as they do not fax or email the image to
>> clients... When I have the image I will try to email it to you.
>>
>> One more thing I forgot to ask is, how would the ulcer in the cornea have
>> formed? Could it be a foreign particle that triggered its growth on the
>> cornea? I'm worried because I have another bunny at home, much younger, and
>> I don't want my other bunny to get the same condition. Also, the vet
>> previously told me that the eye condition would not be contagious and spread
>> to other rabbits, but now that it's something else I'm not sure. Please
>> advice, thanks!
>>
>> Regards,
>> C >>
>>----------------------------------------------------------------------------------
>> On 5 March 2013 07:38, Kong Yuen Sing <99pups@gmail.com> wrote:
>>>
>>> I am Dr Sing. Got your email.Thanks.
>>>
>>>--------------------------------------------------------------------------
>>> On Mon, Mar 4, 2013 at 10:29 PM, @gmail.com> wrote:
>>>>
>>>> Attn: Dr Sing KY
>>>>
>>>> Hi,
>>>>
>>>> I was recommended to your vet by a friend of yours, Jenny. I
>>>> have a 5 year old rabbit (Or) who is currently tearing from one eye
>>>> (since last year 2012). I've previously been to another vet over the course
>>>> of 5 weeks, and this is a summary of how they examined my Or:
>>>>
>>>> 15th Jan - first appointment, vet gives him duct flushing (NL Duct
>>>> Flush) and prescribes Ciprofloxacin (ciloxan) eye drops, see result one week
>>>> later
>>>> 22nd Jan - still no improvement, vet gives same duct flushing, suggested
>>>> to do xray to see if "teeth are causing the tear duct to flow"
>>>> 29th Jan - went for same flushing again, AND xray, xray reveals nothing.
>>>> Vet prescribes stronger drops called Acular Eyedrops for two weeks, see
>>>> results
>>>> 12th Feb - very slight improvement, vet says don't keep giving him
>>>> drops, only give once in a while. Also gave Protexin fibreplex because Or
>>>> was having diarrhea symptoms on and off.
>>>>
>>>> (Note: I am unable to obtain a report from the previous clinic as there
>>>> isn't enough time to do so by the upcoming appointment. I hope the above
>>>> information is detailed enough for the time being)
>>>>
>>>> I am a little apprehensive, as I know it's tougher to diagnose rabbits
>>>> due to their different anatomy structure, and I'm hoping you have a
>>>> different opinion about his condition. And also, a possible breakdown of
>>>> costs for the procedures that may occur.
>>>>
>>>> I have already fixed an appointment with Dr Sing, for Wednesday 10.30am.
>>>> Thank you, and let me know what you advice :)
>>>>
>>>> Regards,
>>>> C>>>
EMAIL REPLY FROM DR SING DATED APRIL 22, 2013
Eye discharge is due to several causes including infections and traumatic injuries. Best to see a vet. In the meantime, an Elizabeth collar prevents scratching of the eye, but many rabbits don't like wearing it.
---------------------------------------------------------------------
On Mon, Apr 22, 2013 at 12:17 AM,@gmail.com> wrote:
Hi,
This is C, Jenny's friend, again. I'm afraid I have distressing
news. In my previous email, I asked if my rabbit Or's eye condition
would be contagious as I have another rabbit at home. And right now,
I've noticed that my other rabbit (Holland-lop breed, name's H) is
showing a bad eye as well. But H's condition is different from
Orhpi's.
I described Or's as constantly tearing and clear discharge. But
H's case is built-up crusty YELLOW discharge right around the
eyelids (top and bottom) and is causing him immense discomfort,
especially when I take a cloth and clean the bad eye; he actually
flinches in pain. His eye seems to be bleeding a bit, and I'm not sure
if it's considered an emergency because he is still eating/drinking
and pooping/peeing normally. May I know what I can do to elevate his
situation before a vet's visit? Thank you!
(With regards to Or, I would rather not risk a surgery since he
isn't fully well as you defined. If possible I'll acquire more drops
to ease his condition. Otherwise his condition is still the same as
before, not worsening and neither really improving)
~C
-------------------------------------------------------------------------------
On 8 March 2013 02:28, Kong Yuen Sing <99pups@gmail.com> wrote:
> Mar 8, 2013
>
> It is difficult to know how the corneal ulcer was created. Whether it was
> due to trauma, infection or acquired entropion?
>
> It could be due to the irritation from the ingrowing eyelids at the medial
> canthus (acquired entropion), foreign body penetration, hair irritation from
> the surrounding and constant eye rubbing. Whether there is bacteria or not,
> a culture need to be done but you have already used the eye drops. As for
> the treatment, wearing an e-collar is still advised even though the rabbit
> dislikes it.
-------------------------------------------------------------------------------
>
> On Wed, Mar 6, 2013 at 1:27 PM, @gmail.com> wrote:
>>
>> Hi Dr Sing,
>>
>> Thanks for the clear diagnosis for my Or this morning. The previous vet
>> has informed me that I can pick up the previously x-rayed image of Orhpi's
>> head at the clinic itself, as they do not fax or email the image to
>> clients... When I have the image I will try to email it to you.
>>
>> One more thing I forgot to ask is, how would the ulcer in the cornea have
>> formed? Could it be a foreign particle that triggered its growth on the
>> cornea? I'm worried because I have another bunny at home, much younger, and
>> I don't want my other bunny to get the same condition. Also, the vet
>> previously told me that the eye condition would not be contagious and spread
>> to other rabbits, but now that it's something else I'm not sure. Please
>> advice, thanks!
>>
>> Regards,
>> C >>
>>----------------------------------------------------------------------------------
>> On 5 March 2013 07:38, Kong Yuen Sing <99pups@gmail.com> wrote:
>>>
>>> I am Dr Sing. Got your email.Thanks.
>>>
>>>--------------------------------------------------------------------------
>>> On Mon, Mar 4, 2013 at 10:29 PM, @gmail.com> wrote:
>>>>
>>>> Attn: Dr Sing KY
>>>>
>>>> Hi,
>>>>
>>>> I was recommended to your vet by a friend of yours, Jenny. I
>>>> have a 5 year old rabbit (Or) who is currently tearing from one eye
>>>> (since last year 2012). I've previously been to another vet over the course
>>>> of 5 weeks, and this is a summary of how they examined my Or:
>>>>
>>>> 15th Jan - first appointment, vet gives him duct flushing (NL Duct
>>>> Flush) and prescribes Ciprofloxacin (ciloxan) eye drops, see result one week
>>>> later
>>>> 22nd Jan - still no improvement, vet gives same duct flushing, suggested
>>>> to do xray to see if "teeth are causing the tear duct to flow"
>>>> 29th Jan - went for same flushing again, AND xray, xray reveals nothing.
>>>> Vet prescribes stronger drops called Acular Eyedrops for two weeks, see
>>>> results
>>>> 12th Feb - very slight improvement, vet says don't keep giving him
>>>> drops, only give once in a while. Also gave Protexin fibreplex because Or
>>>> was having diarrhea symptoms on and off.
>>>>
>>>> (Note: I am unable to obtain a report from the previous clinic as there
>>>> isn't enough time to do so by the upcoming appointment. I hope the above
>>>> information is detailed enough for the time being)
>>>>
>>>> I am a little apprehensive, as I know it's tougher to diagnose rabbits
>>>> due to their different anatomy structure, and I'm hoping you have a
>>>> different opinion about his condition. And also, a possible breakdown of
>>>> costs for the procedures that may occur.
>>>>
>>>> I have already fixed an appointment with Dr Sing, for Wednesday 10.30am.
>>>> Thank you, and let me know what you advice :)
>>>>
>>>> Regards,
>>>> C>>>
Sunday, April 21, 2013
Lateral Ear Resection: Good outcome with CKC
When ear problem started?
Around one year old
Used tissues and ear drops
Has a Jack Russell now 2 years old. No ear problems
July 7, 2010 Left ear resected by me. 2 years old.
Domitor 0.1 ml, Zoletil 0.1 ml & isoflurane gas. Electro-surgery
Sep 6, 2010. Right ear resected by my associate vet.
Domitor 0.2 ml IV & isolfurane gas
INTERVIEW WITH OWNERS TODAY
1. Left ear healing well.
2. Right ear. Warded 4 days. 13 days later, came back Stitches some problem. Got to hospitalise for 3-4 days from Sep 18 to 22, 2010. Owner's mother said she remembered because of the increase in medical costs due to hospitalisation.
REVIEW MEDICAL RECORDS
Oct 18 - 20 2010 warded 2 days. R and L ear smelly. Ear scratching & shaking head.
Around one year old
Used tissues and ear drops
Has a Jack Russell now 2 years old. No ear problems
July 7, 2010 Left ear resected by me. 2 years old.
Domitor 0.1 ml, Zoletil 0.1 ml & isoflurane gas. Electro-surgery
Sep 6, 2010. Right ear resected by my associate vet.
Domitor 0.2 ml IV & isolfurane gas
INTERVIEW WITH OWNERS TODAY
1. Left ear healing well.
2. Right ear. Warded 4 days. 13 days later, came back Stitches some problem. Got to hospitalise for 3-4 days from Sep 18 to 22, 2010. Owner's mother said she remembered because of the increase in medical costs due to hospitalisation.
REVIEW MEDICAL RECORDS
Oct 18 - 20 2010 warded 2 days. R and L ear smelly. Ear scratching & shaking head.
1381. TRUST & AUDIT CASE: Trapped bladder in perineal hernia in a Pom
Sunday Apr 21, 2013
Pom M, Not Neutered, 6 years, 9.7 kg. Perineal hernia, right present for 2-3 months. His father had perineal hernia on the right, the owner told me. Dog was operated by Dr Daniel on Apr 16 and went home on Apr 18, 2013 as I advised that he would be better cared for and eating home food. He had vomited post-op, once on the next day after surgery
I have written many case studies of perineal hernias in male dogs. This report will deal with the findings of a blood test as evidence of a Pom with a long-standing perineal hernia (purplish skin and as hard as an orange).
April 16, 2013
I first saw this dog. Bruised purplish hard swelling 8c m x 8 cm x 5 cm, right. Can't poop for 2 days. Can pee. Anorexic, not neutered. T=36.5 deg C which showed a danger of dying as temp is below normal. Dr Daniel decided on same day surgery with IV drip stabilisation before surgery.
Blood test showed:
Azotemic Urea, creatinine increase, WCC increase, ALT increase
SGPT/ALT 151 (<59 p="">Urea 67 (4-6)
Creatinine 1052 (89-177)
Total WCC 20 (6-17)
N= 76%, L=5%, M=18%, E=0.1%, B=1.3%
The interesting findings are:
1. M=18%. Normal values should be 3-10%. This indicated a chronic inflammation. The hernia existed for 2-3 months and the trapped bladder and intestines must have caused a chronic inflammation. The skin of the hernia turned cyanotic and this showed cell death. Gangrene black colour would occur soon.
2. Azotemia. Bladder was trapped inside leading to obstructive flow of urine and so increase in urea and creatinine.
FOLLOW UP
The dog managed to stand on Day 3 but for short while. Sent back home by me yesterday as he would be better cared for at home. The biggest Pom at 9.7 kg although he was born as a runt, the owner told me.
Today Sunday 11.30 am, I phoned to follow up by phone.
"He has just passed away," the owner said. "At 5 am, he barked his usual time.
59>
Pom M, Not Neutered, 6 years, 9.7 kg. Perineal hernia, right present for 2-3 months. His father had perineal hernia on the right, the owner told me. Dog was operated by Dr Daniel on Apr 16 and went home on Apr 18, 2013 as I advised that he would be better cared for and eating home food. He had vomited post-op, once on the next day after surgery
I have written many case studies of perineal hernias in male dogs. This report will deal with the findings of a blood test as evidence of a Pom with a long-standing perineal hernia (purplish skin and as hard as an orange).
April 16, 2013
I first saw this dog. Bruised purplish hard swelling 8c m x 8 cm x 5 cm, right. Can't poop for 2 days. Can pee. Anorexic, not neutered. T=36.5 deg C which showed a danger of dying as temp is below normal. Dr Daniel decided on same day surgery with IV drip stabilisation before surgery.
Blood test showed:
Azotemic Urea, creatinine increase, WCC increase, ALT increase
SGPT/ALT 151 (<59 p="">Urea 67 (4-6)
Creatinine 1052 (89-177)
Total WCC 20 (6-17)
N= 76%, L=5%, M=18%, E=0.1%, B=1.3%
The interesting findings are:
1. M=18%. Normal values should be 3-10%. This indicated a chronic inflammation. The hernia existed for 2-3 months and the trapped bladder and intestines must have caused a chronic inflammation. The skin of the hernia turned cyanotic and this showed cell death. Gangrene black colour would occur soon.
2. Azotemia. Bladder was trapped inside leading to obstructive flow of urine and so increase in urea and creatinine.
FOLLOW UP
The dog managed to stand on Day 3 but for short while. Sent back home by me yesterday as he would be better cared for at home. The biggest Pom at 9.7 kg although he was born as a runt, the owner told me.
Today Sunday 11.30 am, I phoned to follow up by phone.
"He has just passed away," the owner said. "At 5 am, he barked his usual time.
59>
1380. Update: The cat with the bladder stones over 50 days after surgery
| ||||||||||||||||||||
1379. Health screening costs for the older dog
On Sun, Apr 21, 2013 at 12:17 AM, Elaine @gmail.com> wrote:
Hi Judy,
I would like to send my Jack Russell Terrier for a health checkup/screening, as he is already about 7 years old, and we have not sent for him any check up yet. Just recently we noticed a 'growth-like lump' on his left hind leg, we're not sure what it exactly is but we want to make sure that he's perfectly fine and healthy :)
Do you provide health screening or checkup? What does it include and about how much would that cost? Thanks.
Regards,
Elaine
----------------------------
April 21, 2013
Hi
Thank you for your email.
I am Dr Sing Kong Yuen from Toa Payoh Vets. A health check up/screening of the normal adult dog includes the following:
1. General examination of the dog including checking for visible tumours $65 - $100
2. Eye and ear scope examination $150 - $200
3. Blood test $150 - $250
4. Urine test $50
5. Stool test for parasites and blood $50
6. X-rays/ultrasound of chest and abdomen. $150 - $300
7. Histology of tumours $150 - $250
In the older dog, I will advise excision of any skin lump on the leg or body early when it is small in size as some may be cancerous sarcomas. The anaesthetic and surgical costs are much lower when the tumour is smaller, estimated to be from $300 - $500.
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