Thursday, October 10, 2013

1184. Review of TP 40729. Maltese, 10 years old, M, kidney stones

Today Oct 10, 2013, I phoned the busy lady owner of the Maltese as she returned my call. She said the dog is OK, with no blood in the urine and is fed the special diet.

I review the medical records relevant to the case

Dec 6, 2009. 6 years old. 3 kg. Very thin. Treated for vomiting & diarrhoea
Jul 10, 2010    Dental scaling & extracted  teeth

Oct 3, 2011     Bloody urine recorded by associate vet. UTI?  Urine test - black & turbid. Blood 4+. White blood cells 1620, Red blood cells >2250. Too turbid to perform biochemical tests. Blood urea 6.5 (4.2-6.3), creatinine 85 (89-177). No increase in total WCC or other values.  X-rays

Jan 27, 2013. 10 years old. 3.3 kg. Vomiting & diarrhoea today. I palpated very painful abdomen. Blood test -  liver enzymes elevated. Urea 11.2, Creatinine 88. Advised X-ray.   

Jul 7, 2013. Blood in the urine 2 days. X-ray shows small kidney stones. X-rays given to owner.
Urine pH  8.0  SG 1.044,  Blood 4+, amorphous phosphate +,
http://www.kongyuensing.com/laws/20130725kidney_stones_Maltese_M_10years_haematuria.jpg


I recorded the following:
S/D for 1-3 months. The owner bought 12 cans of S/D and no more news from her.
urine test monthly.

As at Oct 10, 2013, the lady owner told me that there is no blood in the urine. However, she did not submit any urine for testing and said she bought  the "special diet" to feed her dog. This case study was made into a video by interns during the first episode of turbid blood in the urine. See:

http://www.youtube.com/watch?v=HvV-00dDRg4


Wednesday, October 9, 2013

1183. $46,000 fine for abetment

From what I read in the newspaper, the pet transport man was given $5.00 for every cat he brought to a lay person (a young lady) who would spay or neuter them. I met him at another vet practice recently and asked about his side of the story.

"I did not take any money," he said. "There was no mention of the $5.00 in the first police statement she made. It was in the second statement. I paid $46,000 as a fine for abetment. My lawyer is pursuing this matter. Why would I take $800 over the two years to ruin my reputation?"

Singapore has many caregivers who feed stray cats and get them sterilized and returned to their original premises. The pet transport man is paid to trap and ferry them to and from the vet who will sterilize them. The vet will claim the discounted fees from the Cat Welfare Society or some humane organisations. In this case, the Cat Welfare Society noted a discrepancy in the stamping of the claim forms - two different forms of the chop. The vet practice confirmed that there was a fraudulent stamp.

The young lady worked for a veterinary practice and had gone to Australia to study to be a vet. However, her father passed away soon and she could not continue her studies. She was arrested.

"There are still people who asked me to send the cats to her for sterilization," the transport man said. "Her surgical skills in closing the wound are excellent. Small wounds well stitched up."

"How come you got fined $46,000, an amount similar to hers? It is a large amount of money" I asked.
"For abetment. She got fined another $2,500 for other charges."
"Why did you help her if you don't profit from it?"
"After her father passed away, the Australian vet faculty gave her one month to return back and to pay the fees. She had no money and so the university terminated her place. She needed money to help her family as her father had died."

It is hard for this transport man to defend himself as the newspapers had stated he had accepted $5.00 per cat ferried for the sterilization!      

Monday, October 7, 2013

1182. Continued from 1181. Handing over inspection of maggot wound in the dog

There should be a systematic process in the treatment of maggot wounds efficiently.


There should be the final inspection for dead maggots. Although the wound is closing by >50%, there may be dead maggots inside. I advised my assistant to use the curved forceps to check. He disbelieved my suggestion that there might be maggots since the wound had closed by over 50%.

He did the 360-degree scan twice using the forceps. 4 dead maggots were extracted. The dog went home.  The wound should close uneventfully. Dead maggots would have delayed closure.




The dead maggots were black. Compare to the live ones taken out earlier in the image below.




Sunday, October 6, 2013

1181. How to remove maggots efficiently?

Each vet has his or her own way of removing maggots from the dog's anal area.
Some take a very long time as they don't have good planning. A video will be produced soon.

















How to remove maggots efficiently?
Each vet/vet assistant has his or her own way of removing maggots. I notice many tend to take a longer time to do it. Time could be spent on other work as there is a lot of administrative work to be done.

To remove them efficiently and properly without the owner needing to return for a second operation, there must be a systematic process.

PLANNING WHAT TO DO

Tools of the trade - chloroform, curved tipped forceps, cotton buds (not swabs), kidney dish, 20-ml syringe and water. Tip of cotton buds with chloroform is inserted at 12, 3, 6 and 9 o'clock for 2 minutes. Maggots will crawl out for fresh air. Pick them out with forceps and put into the kidney dish.

PAIN RELIEF

Pain relief enables safe removal of maggots as the dog may bite the staff. It is a painful process.
In this 14-year-old dog with heart disease, I used 25% of calculated dose. Not sufficient to knock out but there was pain relief.



TABLE TOP
Put dog on table top to make work easier for the staff rather than bending down

HANDING OVER CHECK
360-degree scan before handing over. Dead maggots may be there. 







Medication and anti-fly powder. Groomer to clip hairs short.

1180. Incredible Singapore story: Mum's ultimatum to the stray kitten

Sunday Oct 5, 2013 8.50 am

Bright sunshine day. An adult couple with an older woman from Tampines brought the cat for her vaccination at 8.50 am today. I was surprised as most pet owners don't come so early.
"This is the growling cat," I had recorded in my case sheet in July 12, 2009 when she was brought in for spaying. She had caterwauled 7 days ago, displeasing the neighbours. But today, this cat no longer growls. "She dares not go out of the house," the older woman said. 


"How does the cat pee and poop?" I asked. Many cat owners used litter boxes."
"She just goes to the toilet floor near the drainage hole and pee and poop there. When she came on the first day, I talked to her. Pee and poop here or you will not be adopted. The kitten went to the toilet to pee and poop."

"Really?" I asked the adult daughter whose husband was with her.
"Yes," she confirmed.
I find this story to be incredible. A stray kitten of 3 months of age, living in a car park, could understand human talk and complied to avoid being homeless.

Well, it was possible that she had been to such concrete floor in the car park as a stray kitten and so this was a coincidence. 
"In Buddhism, there is the belief in re-incarnation. Are you Buddhist?" I asked the mum.
"Yes," she said. "The previous person was bad and was reborn as a kitten!"
"How about the cat scratching the furniture?" I asked.
"Seldom, she's is afraid of me. I bought her a scratching post."
"Why didn't you tell the cat that she would be homeless if she scratched the sofa?" I asked.
"Well, scratching is not as serious as urination and passing stools in the apartment."

It was good to see this cat growing up to 4 years of age and looking very healthy. Her tongue was very pink. Her white nose was pinkish and her yellow eyes were bright. She had those leopard spots in mid-abdomen behind the chest and black long vertical stripes of the zebra. She had greyish green spots and was much loved.    

The owners lived in Tampines and as there are several vet clinics nearer to her home, I was surprised that they made an appointment and brought the cat to Toa Payoh, driving all the way. This cat was vaccinated annually in 2009, 2010, 2012 and now. 








Saturday, October 5, 2013

1179. Two grandmothers' burden



Yesterday Saturday, Oct 4, 2023, one grandmother showed me her mobile phone image of a backside wound of the 14-year-old Retriever X and requested some medicine as the wound was so smelly and she did not want to spend money on treatment. Her 2 adult daughters had wanted her to get the dog treated but she would be the caregiver.

"The maggots tunnel deep into the muscles," I said. "Antibiotics will not remove them. They need to be taken out by a person!".  I gave her the dog transport man's phone number and the dog was treated.









The other grandmother who had silver hair and is slim had her Sheltie sent in for maggot wounds which had eaten up over 10cm x 5 cm of the peri-anal skin. She had a grandson to look after as her daughter had divorced the abusive husband. "He even hit her when she was pregnant but luckily, there was no miscarriage!"   At 70 years of age, she had much responsibilities to care for her grandchildren and the dog too.    

1178. Images Perineal hernia Yorkshire and quadraparesis Pom for video production