June 18, 2014
Yesterday, I visited the Veterinary University at Yesin, Naypyidaw and the Zoo. White lions and white tigers were seen. Giraffes, hippos and Himalayan bear. A leopard or cheetah was napping. All animals in excellent bodily condition.
But the visit I like was to visit a family of my friend Shirley, living in a village near the Vet University, Yesin. The matriarch, 63 years old, brought up four sons when her husband passed away many years ago. Three went to become graduates and she is well provided and loved now.
On the 2nd floor of a building in the Veterinary University, Yesin, a notice board displayed examination marks of lst and mid-term examinations. "How's your result?" I asked the 2nd year student (right in photo, below) as her aunt said she is a very bright student. Aunts can be biased. She pointed to her name and her marks were high, showing she is focused on her studies. Lady students must book into the hostel by 6 pm. Probably 100 undergraduates per year.
Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Wednesday, June 18, 2014
Monday, June 16, 2014
Yangon Vet Talk - treatment of urethral stones - retrograde urohydropropulsion
DRAFT NOTES FOR THE SEMINAR
FELINE UROLITHIASIS
Case study. TP 45355.
Cat, Male, Neutered, 4 years old. Apartment has 2 other cats with no similar problem.
HISTORY & SIGNS: Since being neutered at 8 months of age, dysuria is seen lasting around a few days every 2-3 months. No veterinary treatment as the cat recovers the recurring dysuria. However, on Jun 19, 2014, the cat hid under the sofa and could not pee for a long time. Dr Daniel of Toa Payoh Vets treated him. Signs of postrenal uraemia not obvious (e.g anorexia and vomiting).
PHYSICAL EXAMINATION. Signs of outflow obstruction:
1. Palpation of a large painful urinary bladder palpated.
2. Detection of urocystoliths by palpation is unreliable.
2. Examination of distal penis and penile urethra showed urethral plugs. A cat catheter passage is obstructed.
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS.
1. Other causes of dysuria, haematuria and pollakiuria and outflow obstruction.
2. Analysis of uroliths or urethral plugs to differentiate struvites from other types. Tests include urinalysis, radiography, ultrasonography and cystoscopy.
3. CBC/BIOCHEMISTRY/URINALYSIS
3.1 Post-renal azotemia (high BUN, creatinine and phosphorus) for complete outflow obstruction. Not done in this case owing to financial constraints.
3.2 Urine tests.
3.2.1 Microscopic examination of the magnesium ammonium phosphate crystals. They look like colourless, coffin-like prisms with 3 to 8 sides. The lab report shows triple phosphate crystals.
3.2.2 Bacterial urine culture and antibiotic sensistivity tests. Not done due to financial constraints.
3.2.3 Chemical analysis of urethral plugs. Not done due to financial constraints.
4. IMAGING
4.1 Survey radiography. Two views of the abdomen must be taken, not just one view as is sometimes done by vets in Singapore to reduce medical costs for owners.
No struvite uroliths but some struvite urethral plugs are seen. Struvites are radio-dense on X-rays. They are most common mineral (80%) in urethral plugs in cats (The 5-minute Veterinary Consult, 3rd Edition)
4.2 Contrast urethrocystography. Not done due to financial constraints.
5. ULTRASONOGRAPHY
determines the precise location, number and size of uroliths. Not done due to financial constraints. Does not indicate the degree of radiodensity or shape of uroliths
6. CYSTOSCOPY reveals the location, number, size and shape of urethroliths and urocystoliths. Not done due to financial constraints.
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http://www.sinpets.com/20090530Canine_Uroliths_ToaPayohVets.htm
Retrograde urohydropropulsion - usually male dogs
1. X-ray
2. Health of dog
3. Technique - Best is to use a 30-ml syringe, soft or hard catheter, saline as 30-ml syringe provides excellent pressure as compared to 10-ml or 60-ml syringes. Some vets use 10-ml syringes and find it difficult to flush the urethral stones back into the bladder.
Sunday, June 15, 2014
1380. Hypothermia & anaemia
Jun 15, 2014
A 14-year-old Maltese, not spayed came in yesterday Saturday with the following:
Recently, she had "snoring" breath and howled when nobody was at home. Did not move when placed in a location as if immobile. Vomited twice on Friday. Drank and peed a lot.
The dog's gums were white and the rectal temperature was low at 36.8 C. This was a dog seriously ill.
"Normal dog's temperature is from 38.5 to 39.5 C," I said to the mother and adult son. "This is not a good sign as the dog also had pale gums, meaning loss of blood or insufficient blood."
I palpated the bloated tense abdomen. There was a swelling in the lower 1/3 of the abdomen, as if the uterus was swollen with pus. I checked the nipples. The back ones discharged reddish black fluid when expressed. So, the dog could have false pregnancy and now had closed pyometra. Blood test was taken.
However the dog passed away despite I/V drips and medication. The tongue and gums had become snow white.
It is best to get female dogs spayed when they are young as old ones may suffer from closed or open pyometra (infection of the womb) and internal bleeding from toxaemia.
A 14-year-old Maltese, not spayed came in yesterday Saturday with the following:
Recently, she had "snoring" breath and howled when nobody was at home. Did not move when placed in a location as if immobile. Vomited twice on Friday. Drank and peed a lot.
The dog's gums were white and the rectal temperature was low at 36.8 C. This was a dog seriously ill.
"Normal dog's temperature is from 38.5 to 39.5 C," I said to the mother and adult son. "This is not a good sign as the dog also had pale gums, meaning loss of blood or insufficient blood."
I palpated the bloated tense abdomen. There was a swelling in the lower 1/3 of the abdomen, as if the uterus was swollen with pus. I checked the nipples. The back ones discharged reddish black fluid when expressed. So, the dog could have false pregnancy and now had closed pyometra. Blood test was taken.
However the dog passed away despite I/V drips and medication. The tongue and gums had become snow white.
It is best to get female dogs spayed when they are young as old ones may suffer from closed or open pyometra (infection of the womb) and internal bleeding from toxaemia.
Saturday, June 14, 2014
Fits due to tooth ache not other reasons
Saturday, Jun 14, 2014
"You know, my Papillon does not have fits," the mother who had to take care of this 14-year-old emaciated dog said to me today. "After you had extracted the rotten teeth, he has no more fits and so I did not give the anti-fits medication."
That was in Jan 12, 2014 when Dr Daniel extracted 12 rotten teeth. The dog was given IV drips, antibiotics and anti-fits medication for 3 days. A blood test was done indicating kidney disorder with high blood urea and creatinine.
She really recovered as the owner said: "My dog was eating the canine K/D diet since the extraction and so I did not give the dogs anti-fits tablets. Now, she cries whenever I carry her. She did not eat for past 3 days and would not move, like being a statute. What to do? Should I put her to sleep?"
"She is in great pain," I said. "Probably kidney pain. It is up to the owner to decide on euthanasia as the dog needs much nursing and time and you would be travelling overseas. Your daughter would not want to nurse this dog. "
There was also no budget for X-rays and other tests and so this was the best I could do, from the blood test. Brain scan is out of question but was advised by the other vet. The dog was eating well when I followed up on Feb 26, 2014 when the owner came for 5 cans of K/D and antibiotics.
From March to June 14 today, no news from the owner. Probably not well cared for as now the dog is emaciated and in great pain.
How long can the Papillon live? Much longer than the 14 years if given annual check up such as dental scaling and careful nursing. But many Singaporean owners do not bother with the dog's rotten teeth which pass bacteria to the heart and other organs, causing the dog to live shorter lives.
"You know, my Papillon does not have fits," the mother who had to take care of this 14-year-old emaciated dog said to me today. "After you had extracted the rotten teeth, he has no more fits and so I did not give the anti-fits medication."
That was in Jan 12, 2014 when Dr Daniel extracted 12 rotten teeth. The dog was given IV drips, antibiotics and anti-fits medication for 3 days. A blood test was done indicating kidney disorder with high blood urea and creatinine.
She really recovered as the owner said: "My dog was eating the canine K/D diet since the extraction and so I did not give the dogs anti-fits tablets. Now, she cries whenever I carry her. She did not eat for past 3 days and would not move, like being a statute. What to do? Should I put her to sleep?"
"She is in great pain," I said. "Probably kidney pain. It is up to the owner to decide on euthanasia as the dog needs much nursing and time and you would be travelling overseas. Your daughter would not want to nurse this dog. "
There was also no budget for X-rays and other tests and so this was the best I could do, from the blood test. Brain scan is out of question but was advised by the other vet. The dog was eating well when I followed up on Feb 26, 2014 when the owner came for 5 cans of K/D and antibiotics.
From March to June 14 today, no news from the owner. Probably not well cared for as now the dog is emaciated and in great pain.
How long can the Papillon live? Much longer than the 14 years if given annual check up such as dental scaling and careful nursing. But many Singaporean owners do not bother with the dog's rotten teeth which pass bacteria to the heart and other organs, causing the dog to live shorter lives.
Yangon Vet Talk in July 5, 2014 - Treatment of pyometra video
Time is running out
Dog will die within a week if the father does not want the operation owing to poor prognosis and pragmatism. Why spend money if the vet (myself) said that the dog has 20% chances of survival?
https://www.youtube.com/watch?v=J9WJqmVPfw8
Thursday, June 12, 2014
Treatment of pyometra for valuable breeders - using uterine irrigation
Jun 12, 2014
TREATMENT OF PYOMETRA
Experiences of my associate, a senior vet aged 75 years old who did treat a few cases of pyometra in dogs.
1. Spay is the best solution. Some owners just want antibiotics. After a few cycles, the dog becomes paraplegic and it would be too late even with spay. The dog would die during surgery or not able to stand again. It is believed that the toxins from the pyometra has reached the brain or spinal cord.
2. OPEN PYOMETRA - Midline incision to view passage of the catheters into uterus via vaginal speculum. 2 cathethers via vaginal speculum to 2 uterine horns. Irrigate and flush out the pus. Use of saline and hydrogen peroxide
3. CLOSED PYOMETRA - Treatment of uterine irrigation as for open pyometra. In one case, the owner of a Pekinese wanted the treatment. The Pekinese got pregnant with one pup at the next cycle.
4. Conclusion. Spay is the cheapest. Blood test and ultrasound needed. Polydipsia is a sign.
TREATMENT OF PYOMETRA
Experiences of my associate, a senior vet aged 75 years old who did treat a few cases of pyometra in dogs.
1. Spay is the best solution. Some owners just want antibiotics. After a few cycles, the dog becomes paraplegic and it would be too late even with spay. The dog would die during surgery or not able to stand again. It is believed that the toxins from the pyometra has reached the brain or spinal cord.
2. OPEN PYOMETRA - Midline incision to view passage of the catheters into uterus via vaginal speculum. 2 cathethers via vaginal speculum to 2 uterine horns. Irrigate and flush out the pus. Use of saline and hydrogen peroxide
3. CLOSED PYOMETRA - Treatment of uterine irrigation as for open pyometra. In one case, the owner of a Pekinese wanted the treatment. The Pekinese got pregnant with one pup at the next cycle.
4. Conclusion. Spay is the cheapest. Blood test and ultrasound needed. Polydipsia is a sign.
Two urolith cases in 2 dogs. Bladder stones in 2009. Kidney stones in 2014
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