Aug 26, 2014
The two ladies came with a female, not spayed, 13-year-old Miniature Schnauzer.
The dog had passed blood around 2 months ago, as part of her heat cycle.
"But she still has (vaginal) discharge on and off in the last 2 months," the older lady said. "Today, she is dry."
I examined the vulva. Swollen and congested mucosa. The belly was hyperpigmented and the nipples were all black. No milk was expressed from the nipples.
"This is a case of open pyometra," I said. "Is the dog drinking a lot of water? Many dog owners think this polydipsia is normal!"
"Yes, yes, we thought this was normal in the lst month after her heat. But she is still thirsty after the second month."
"Does she pee a lot of times?" I asked
"Yes, yes," the older lady said.
"Why didn't you get her spayed when she was younger?" I asked. "She would not have suffered from pyometra (an infection of the womb)."
"Dogs die young when they are spayed," the older woman said. "My friends' spayed female dogs are dead. One died at 5 years of age!"
Her dog is now 13 years old and much alive and plump.
"How many dogs of your friends have had died?" I asked.
"3 dogs, all spayed and much younger than our dog."
I did not argue that this sample of 3 spayed female dogs dying young was too small to come to a scientific conclusion that spayed female dogs die young.
"I don't believe that spayed dogs do die young," I said. "I have not read any scientific reports regarding this issue."
"I guess it could be genetics. Our dog has longevity genes," the older lady said."What should we do now?"
"A 13-year-old dog has a much higher risk of death from anaethesia," I said. "We will take a blood test to screen the health of the kidneys, liver and blood cells. She has a heart murmur and heart disease will increase the risk."
A blood test is taken. The dog goes home with antibiotics for 7 days. The owners will have to decide whether to risk spaying the companion or not. Some old dogs do die on the operating table and so the owners must give informed consent for the spay surgery. The 13-year-old plump Miniature Schnauzer is considered aged, but she looks younger and is active.
------------------------------------------------
IMAGES OF OPEN PYOMETRA X 10
IMAGES OF CLOSED PYOMETRA X 10
Definition of pyometra. - open and closed pyometra
Differential Diagnosis
Diagnosis
Treatment
Goto:
https://www.google.com/cse/tools/create_onthefly
Key in "www.toapayohvets.com"
Search "pyometra"
.
Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Wednesday, August 27, 2014
Tuesday, August 26, 2014
1474. About Dr Thein Tun Aung, Veterinary Surgeon
HOOK
On August 22, 2014, as I walked towards the Grand Hyatt, Singapore (Video) to celebrate the 60th birthday of a friend, I recalled happy memories of a house-call in this hotel.
A FEARLESS VET - Case of a cat that has a needle in his mouth.
It was in July 20, 2010. The cat of an expatriate manager living in the Grand Hyatt had swallowed a needle. The thread hung out from the mouth. The cat pawed the manager every time he tried to open the mouth. So he phoned Toa Payoh Vets.
I requested Dr Aung to help me and Dr Saw. I knew he was good at handling cats. Fearless. The cat hid between the WC and wall of the master bedroom bathroom. Dr Aung grabbed the cat by the scruff of the neck before I could say "hello". The cat clawed him and escaped to hide behind the curtains.
"Prepare the sedative injection first," I said to Dr Aung. Then he approached the cat behind the curtains and gripped his scruff. I injected the backside muscle.
.
Suddenly, another cart pounced onto Dr Aung in a suicide attack. This was unexpected. The expatriate removed this cat. We wrapped the patient in a towel and pulled out the needle (Images x 2). The cat was back to normal. A happy ending.
------------------------------------------------------------------------------------
A DEDICATED VET - Case of a chicken bone 3/4 in the gullet and 1/4 in the stomach of a Maltese.
Dr Aung would watch me performing this uncommon surgery on his day off from his employer.
In this case of the continuously vomiting dog, X-ray showed the chicken humerus bone stuck between the gullet and the stomach. IMAGES X 1 X-RAY
"What will you do?" I asked him. This is part of my coaching method to elicit ideas from Dr Aung. "Should I cut it into two halves?"
He shook his head.
I had given an anti-spasmodic earlier. I pulled the bone out from the gullet and stomach easily. The dog recovered.
IMAGES X 3
PRESENTLY IN 2014
Now, it is 2014. Dr Aung has a busy practice in Yangon. Royal Asia Veterinary Surgery (video). He started his practice in 2010 and every day is a busy day. His medical and surgical skills acquired from his 20 years of working for vets in .....clinics in Singapore were a result of his sacrifices of being overseas.
Belief, Passion, Drive, Perseverance and Focus
20 years in Singapore working as an employee for vets in 5 vet clinics.
Acquired knowledge, skill and expertise.
SPENDING SPARE TIME TO ACQUIRE SURGICAL KNOWLEDGE
INSTEAD OF WATCHING MOVIES AND ONLINE GAMING
He was never my employee
On August 22, 2014, as I walked towards the Grand Hyatt, Singapore (Video) to celebrate the 60th birthday of a friend, I recalled happy memories of a house-call in this hotel.
A FEARLESS VET - Case of a cat that has a needle in his mouth.
It was in July 20, 2010. The cat of an expatriate manager living in the Grand Hyatt had swallowed a needle. The thread hung out from the mouth. The cat pawed the manager every time he tried to open the mouth. So he phoned Toa Payoh Vets.
I requested Dr Aung to help me and Dr Saw. I knew he was good at handling cats. Fearless. The cat hid between the WC and wall of the master bedroom bathroom. Dr Aung grabbed the cat by the scruff of the neck before I could say "hello". The cat clawed him and escaped to hide behind the curtains.
"Prepare the sedative injection first," I said to Dr Aung. Then he approached the cat behind the curtains and gripped his scruff. I injected the backside muscle.
.
Suddenly, another cart pounced onto Dr Aung in a suicide attack. This was unexpected. The expatriate removed this cat. We wrapped the patient in a towel and pulled out the needle (Images x 2). The cat was back to normal. A happy ending.
------------------------------------------------------------------------------------
A DEDICATED VET - Case of a chicken bone 3/4 in the gullet and 1/4 in the stomach of a Maltese.
Dr Aung would watch me performing this uncommon surgery on his day off from his employer.
In this case of the continuously vomiting dog, X-ray showed the chicken humerus bone stuck between the gullet and the stomach. IMAGES X 1 X-RAY
"What will you do?" I asked him. This is part of my coaching method to elicit ideas from Dr Aung. "Should I cut it into two halves?"
He shook his head.
I had given an anti-spasmodic earlier. I pulled the bone out from the gullet and stomach easily. The dog recovered.
IMAGES X 3
PRESENTLY IN 2014
Now, it is 2014. Dr Aung has a busy practice in Yangon. Royal Asia Veterinary Surgery (video). He started his practice in 2010 and every day is a busy day. His medical and surgical skills acquired from his 20 years of working for vets in .....clinics in Singapore were a result of his sacrifices of being overseas.
Belief, Passion, Drive, Perseverance and Focus
20 years in Singapore working as an employee for vets in 5 vet clinics.
Acquired knowledge, skill and expertise.
SPENDING SPARE TIME TO ACQUIRE SURGICAL KNOWLEDGE
INSTEAD OF WATCHING MOVIES AND ONLINE GAMING
He was never my employee
Monday, August 25, 2014
1473. A lady googled "deticking services Singapore"
Monday Aug 25, 2014
I am still at the clinic at 8 pm as all had gone home by 6.30 pm.
A Tampenis lady phoned to book de-ticking for her Miniature Schnauzer. She had called pest control to clear her apartment of ticks.
"How do you know Toa Payoh Vets provide de-ticking services?" I asked. She could come only at 4 pm tomorrow
"I googled 'deticking services locally and found your website and a video possibly,'" she said.
The video is at:
http://www.youtube.com/watch?v=eYP57ikgYtE
I googled "deticking services Singapore" and found the following:
---------------------------------------------------------------------------------------------------------------------------
I am still at the clinic at 8 pm as all had gone home by 6.30 pm.
A Tampenis lady phoned to book de-ticking for her Miniature Schnauzer. She had called pest control to clear her apartment of ticks.
"How do you know Toa Payoh Vets provide de-ticking services?" I asked. She could come only at 4 pm tomorrow
"I googled 'deticking services locally and found your website and a video possibly,'" she said.
The video is at:
http://www.youtube.com/watch?v=eYP57ikgYtE
I googled "deticking services Singapore" and found the following:
---------------------------------------------------------------------------------------------------------------------------
About 5,3 results (0.37 seconds)
Search Results
1472. Generalised pustular dermatitis - flaky and itchy dog
Saturday Aug 23, 2014
A very interesting case. The dog had "dandruff" from head to toe. Little or no hair loss.
Ear edges were flaky and appeared to have some crumbs.
Now the other vet had prescribed a "shampoo with steroid" given for 6 months. The owner did not have the shampoo ingredients. "Is the skin disease it due to the shampoo?" the lady asked me.
"Hard to say," I presumed this shampoo had some insecticide and therefore I could not find the typical crusty ear edge. Muzzle was rough and hard with allergy. "Plastic bowl contact or biting?" I asked.
"It could be plastic toys or treats," the wife said.
I had the dog clipped bald and bathed. Red dots all over the body were seen. Hence this was a case of generalized pustular dermatitis..
A very interesting case. The dog had "dandruff" from head to toe. Little or no hair loss.
Ear edges were flaky and appeared to have some crumbs.
Now the other vet had prescribed a "shampoo with steroid" given for 6 months. The owner did not have the shampoo ingredients. "Is the skin disease it due to the shampoo?" the lady asked me.
"Hard to say," I presumed this shampoo had some insecticide and therefore I could not find the typical crusty ear edge. Muzzle was rough and hard with allergy. "Plastic bowl contact or biting?" I asked.
"It could be plastic toys or treats," the wife said.
I had the dog clipped bald and bathed. Red dots all over the body were seen. Hence this was a case of generalized pustular dermatitis..
Sunday, August 24, 2014
Sunday's interesting case. A 15-year-old Cross-bred has a "tumour" below the right eye
Sunday Aug 14, 2014
The vet excised a skin lump and did dental scaling when the dog was 11 years old, when persuaded to do so. He did not want anymore anaesthesia and just prescribed antibiotics and steroids when the old dog of 15 years of age had a large "tumour" below the right eye.
"It is true that it is very risky to anaesthesize an old dog," I said as the vet kept telling the owner not to do any more anaesthesia. "It looks very much like a carnaissal tooth abscess, based on location, " teeth. Periodontitis Grade 4. "
"Chances of survival are 50:50 in healthy old dogs," I can't give higher % as the dog has a muffled heart sound after my heart auscultation. "If the surgery is less than 15 minutes, chances are better."
"Is the dog coughing lately?" I asked the lady.
"When he lies down on one side, he coughs some white phlegm," she said. "But he is OK when standing."
Best advices
1. Blood test
2. Heart medication of 3 types
3. Antibiotics
Better chances of survival when operated on Day 5.
"The dog is likely to have no more coughing when lying down," I said. "That is the time to go under general anaesthesia and not today.
This dog looks very fit, having been given daily exercise and much love.
The vet excised a skin lump and did dental scaling when the dog was 11 years old, when persuaded to do so. He did not want anymore anaesthesia and just prescribed antibiotics and steroids when the old dog of 15 years of age had a large "tumour" below the right eye.
"It is true that it is very risky to anaesthesize an old dog," I said as the vet kept telling the owner not to do any more anaesthesia. "It looks very much like a carnaissal tooth abscess, based on location, " teeth. Periodontitis Grade 4. "
"Chances of survival are 50:50 in healthy old dogs," I can't give higher % as the dog has a muffled heart sound after my heart auscultation. "If the surgery is less than 15 minutes, chances are better."
"Is the dog coughing lately?" I asked the lady.
"When he lies down on one side, he coughs some white phlegm," she said. "But he is OK when standing."
Best advices
1. Blood test
2. Heart medication of 3 types
3. Antibiotics
Better chances of survival when operated on Day 5.
"The dog is likely to have no more coughing when lying down," I said. "That is the time to go under general anaesthesia and not today.
This dog looks very fit, having been given daily exercise and much love.
1470. About Dr Thein Tun Aung, RAVS
HOOK
Grand Hyatt Singapore in 2014
Happy Memories of a Dedicated Vet with passion and drive
VETERINARY SURGEON
Dr Thein Tun Aung, James
I certify the following: Dr Aung graduated from the University of Veterinary Science, Yesin, Myanmar as a veterinary surgeon in 1987. He worked as a veterinarian in Kachin State mainly with large animals and poultry and small animals until 1991. He worked in several veterinary clinics and surgeries in Singapore from 1992 to 2012.In Singapore, he gained vast experiences in the diagnosis and treatment of small animal medicine and surgery over the last 10 years before he started his own practice, Royal Asia Veterinary Surgery in Yangon.
The Singapore veterinary practices he worked included AMK Veterinary Surgery under Dr Thiruchelvam, The Animal Clinic, James Tan Veterinary Centre and AMK Veterinary Surgery which was sold to Mount Pleasant Veterinary Centre in 2010. In February 2012, he resigned to set up his present practice, Royal Asia Veterinary Surgery in Yangon. Working the long hours with the various practices in Singapore enabled him to learn much about the best practices and treatments offered by the different management and veterinary surgeons.
Yezin Univ graduated 1987
Kachin State vet
Singapore 1992 - 2012
Yangon 2012-
Own practice
Variety of medical and surgical cases
Blood test
X-rays
Communications
Giving back to the community
Monastery school building and library
MVA - Yezin Final Year Student lecture
Teaching his younger vets on-the-job training in a busy clinic.
Helpful volunteer in his free time - Grand Hyatt Hotel case cat. URL
- Bone in stomach and oesophagus. URL
- Caesarean section by motor bike URL
Bright future with 20 years of experience in small animal practice. acquiring the knowledge, skill and expertise the best practices of each Singapore vet clinic. Many of his peers from Myanmar do not stay long in the small animal practice in Singapore.
Rabies
Distemper
Parvovirus
Caesarean
Pyometra and stump pyometra URL
Fractures
Heart Diseases
Puppy diseases
Urethra obstruction in cats
A role model for younger vets in Yangon -
Belief, Passion, Drive, Perseverance, Focus - URL
Art market
Sight-seeing
MYANMAR LANGUAGE
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Veterinary Surgeon
Toa Payoh Vets, Singapore
www.toapayohvets.com
CASES
2. Bone in oesophagus/stomach
3. Caesarean section on a scooter
1. A needle and thread inside a cat's mouth at the Grand Hyatt Singapore
http://2010vets.blogspot.sg/2010/07/needle-and-thread-inside-cats-mouth.html
Tuesday, July 6, 2010
A needle and thread inside a cat's mouth
Going to an apartment to treat a ferocious cat with a needle and thread
inside his mouth can send shivers down a vet's spine. It is like going
to a lion's den. But Mr Hall said he could not put his cat inside a crate
and bring him to the Surgery and so I had to make a house-call on a fine
weekday evening. I drove to the Grand Hyatt in less than 15 minutes and
such prompt attendance impressed Mr Hall. I parked outside the hotel
after being given permission to do so as I told the valet I was treating
Mr Hall's cat.
In the semi-darkened glowing lights of the lobby, I met my two assistants, Mr Thein Tun Aung and Mr Saw Htet at the lobby. The receptionist in smart black jackets and well groomed ushered us into a lift and took us up to Mr Hall's apartment.
I knew what to do as I am an old vet and would finish the job in 20 minutes. But it would be best for my two assistants to get hands-on experience as they wanted to open their own practice in Myanmar next year. They are veterinarians if they practise in Myanmar but they are veterinary assistants when they work in Singapore.
PREPARATION FOR THE BATTLE
"What will you bring to this case?" I had phoned Mr Aung earlier. "Domitor and swabs to stop bleeding," he said. I packed my bag with Domitor, Antisedan, Xylazine, Ketamine, antibitoics, swabs, a pair of forceps, needles 21G and one-ml syringes. I forgot to pack 23G needles for use in the femoral vein injection as the cat has fine veins which bled in front of the Mrs Hall when Antisedan was injected IV using the bigger 21G needle. Experience is usually gathered after a case handled.
AT THE SCENE
Mr Aung is a hands-on man and he went for the cat. This cat was crouched tightly inside the master bathroom between the water closet and the wall. Mr Aung grabbed the scruff and got him out and placed him on the cat's white towel on the bed in the master bedroom. I had not briefed my assistants and was therefore surprised.
"It is best to prepare the sedative before catching the cat," I said to Mr Aung. "Look at the cat to estimate his weight and prepare the correct dose."
The cat was displeased and pawed Mr Aung vigorously. Mr Aung released him. The cat bounced off the bed and went under the master bed, exactly in the middle of the sanctuary. There was a moment of indecision as Mr and Mrs Hall and I did not know what to do.
"Maybe Mrs Hall should go under the bed to get the cat out," I said like a General who barked orders from the safety of the army headquarters far away from the front line. Nobody moved.
"Let's lift up the bed," Mr Hall suggested intelligently. Mr Hall and my two assistants lifted up one end. I helped. It was surprisingly a very light bed but there were four of us. Mrs Hall looked on.
Being exposed, the cat sprang to hide behind the day curtains. The room has two sets of curtains. The day curtains are the translucent type. Mr Aung walked quickly towards the curtains to make friends with the cat. What he does normally is to talk to the cat and slowly let the cat (or dog) get used to the smell of his hand. The cat was ready to scratch him as he had scratched Mr Hall's hand a few times when Mr Hall tried to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare the sedative first," I said to Mr Aung. That would be what I would do before touching the cat. I estimated the cat to weigh 3 kg. Though he was adopted as a local cat, he certainly was bigger and fatter than the stray cats we see around the neighbourhood. Mr Aung got 0.1 ml Domitor and 0.1 ml Ketamine in one syringe and gave it to me. He realised that this cat would never accept an IV injection. IV injections at the Surgery could be done because the cat would be in foreign territory and would not be so ferocious usually. Here, the cat was on home ground.
FRONTLINE
Being a hands-on man, Mr Aung walked swiftly to the curtains and in one speedy grab, the cat's scruff was lifted up. He placed the cat on the white blanket on the master bed. I was ready and in less than one second, I had injected the cat's backside muscle with 0.2 ml IM of the combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It is always safe to under-dose a frightened cat. I knew the dose was insufficient. For the next 5 minutes, the cat ambled out of the master bedroom, dashed across the living cum dining room with the open concept kitchen and disappeared into Bedroom 2 at the other end of this apartment. Another 5 minutes passed. The cat was as fresh as a daisy.
REINFORCEMENTS
In a losing battle, the commander must call for reinforcements. "Give the cat Domitor IV," Mr Aung proposed catching the cat as he was one never afraid of getting cat scratches. "All three of us are veterans with cat scars on our hands" I had said to assure Mr Hall who must be wondering what was going on. The sedative seemed to be dud. A dud missile that fell and did not explode.
CAUTION
Soldiers could shock and awe in battle with more bombings to kill the enemies. But this is a cat that must be alive at the end of the house-call. "Better not to give another sedative," I advised Mr Aung. "The cat may react and die. Just wrap the cat inside a towel with his head sticking out. That would be safer. The cat would be sedated slightly by now. 15 minutes had passed." I asked Mr Saw to take the white towel and he went to the bedroom to get the cat for me. I could do everything myself but my assistants would never learn.
SUICIDE BOMBER ATTACK
Mr Aung went inside Bedroom 2 to risk his hands and got the cat by the scruff of the neck. Mr Hall and Mr Saw and possibly Mrs Hall were inside Bedroom 2. As the room was small, I stood outside the door to supervise. Like those consultants who talk but no action.
While Mr Aung was holding the cat for Mr Saw to wrap the towel around, the second cat, white with grey patches suddenly leapt up to claw either Mr Aung or the cat. I just could not believe this suicide bomber attack from the friendly troop. This attacking cat hissed and swung his paws widely. He leapt up and gravity pulled him down. From my point of view, he was attacking Mr Aung.
In cat attacks, it is wise not to interfere. Water hosing would be ideal but not inside the apartment. Mr Hall managed to get the attacker out of the room. He slinked outside the room and would not go away. He was just so furious. Was it the attention the other cat was getting? Mr Hall said to me: "This cat is very protective and was protecting me." Well, next time, no other cats should be present.
The next day, I noted that Mr Saw's left hand had two cat scratches too when we were taking blood from a dog. So, Mr Saw had suffered.
ACTION
After wrapping the cat in the towel, the cat seemed quiet. I said to Mr Saw: "Put the cat on this kitchen counter." I gave Mr Aung the forceps from my bag. He opened the cat's mouth. "There's the needle stuck in the hard palate!" he showed the culprit. I took some pictures with a zoom lens inappropriately. The zoom would not work at first until I stepped back further. Mr Aung took the needle out. A black thread with slimy saliva was attached to the end of the needle. I should have put the needle onto the tissue paper as Mr Hall seemed not too pleased when I placed it directly onto the kitchen counter. Mrs Hall took away the needle. I opened the cat's mouth to give a final check. "No injuries or ulcers," I said to Mr Hall.
ANTIDOTE
"Should give Antisedan," Mr Aung advised me. "Antisedan is an antidote," I said to Mr Hall. "The cat will wake up immediately. If Antisedan is not given, he would wake up fully over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr Hall said.
"There is a small risk that the cat may not wake up. A very small risk. Antisedan injection ensures that the cat's heart and lung systems are back to normal promptly."
The cat inside the towel hissed and hissed. Mr Hall agreed to the Antisedan injection. This was given via the cat's femoral vein at 0.1 ml IV. "Take the cat out of the towel and put him on the floor," I said to Mr Saw rather urgently. Mr Saw could not understand what I mean. In any case, he had no time to think. The cat looked up, assessed his situation well. The cat crawled out of the loosened towel, stood on the counter and in one spring, he leapt onto the floor and disappeared into the sanctuary of the master bedroom.
HAPPY ENDING
Everybody was happy that this cat was back to normal. Mr Hall asked me for my namecard as he was surprised that I was prompt in answering his house call. Mrs Hall would be more careful with her sewing needles and threads from now on.
CONCLUSION
Never give the frightened cat a second dose of sedatives as the cat may just die. This case took three times as long but the cat was alive and that was what every owner wants. It is best to treat such cases at the Surgery. Normally I don't even want to do it at the house as there are so many complications and surprises. Besides, it takes a longer time.
REVIEW
https://www.blogger.com/blogger.g?blogID=1070401363111682595#editor/target=post;postID=3906350252552625037;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=46;src=postname
In the semi-darkened glowing lights of the lobby, I met my two assistants, Mr Thein Tun Aung and Mr Saw Htet at the lobby. The receptionist in smart black jackets and well groomed ushered us into a lift and took us up to Mr Hall's apartment.
I knew what to do as I am an old vet and would finish the job in 20 minutes. But it would be best for my two assistants to get hands-on experience as they wanted to open their own practice in Myanmar next year. They are veterinarians if they practise in Myanmar but they are veterinary assistants when they work in Singapore.
PREPARATION FOR THE BATTLE
"What will you bring to this case?" I had phoned Mr Aung earlier. "Domitor and swabs to stop bleeding," he said. I packed my bag with Domitor, Antisedan, Xylazine, Ketamine, antibitoics, swabs, a pair of forceps, needles 21G and one-ml syringes. I forgot to pack 23G needles for use in the femoral vein injection as the cat has fine veins which bled in front of the Mrs Hall when Antisedan was injected IV using the bigger 21G needle. Experience is usually gathered after a case handled.
AT THE SCENE
Mr Aung is a hands-on man and he went for the cat. This cat was crouched tightly inside the master bathroom between the water closet and the wall. Mr Aung grabbed the scruff and got him out and placed him on the cat's white towel on the bed in the master bedroom. I had not briefed my assistants and was therefore surprised.
"It is best to prepare the sedative before catching the cat," I said to Mr Aung. "Look at the cat to estimate his weight and prepare the correct dose."
The cat was displeased and pawed Mr Aung vigorously. Mr Aung released him. The cat bounced off the bed and went under the master bed, exactly in the middle of the sanctuary. There was a moment of indecision as Mr and Mrs Hall and I did not know what to do.
"Maybe Mrs Hall should go under the bed to get the cat out," I said like a General who barked orders from the safety of the army headquarters far away from the front line. Nobody moved.
"Let's lift up the bed," Mr Hall suggested intelligently. Mr Hall and my two assistants lifted up one end. I helped. It was surprisingly a very light bed but there were four of us. Mrs Hall looked on.
Being exposed, the cat sprang to hide behind the day curtains. The room has two sets of curtains. The day curtains are the translucent type. Mr Aung walked quickly towards the curtains to make friends with the cat. What he does normally is to talk to the cat and slowly let the cat (or dog) get used to the smell of his hand. The cat was ready to scratch him as he had scratched Mr Hall's hand a few times when Mr Hall tried to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare the sedative first," I said to Mr Aung. That would be what I would do before touching the cat. I estimated the cat to weigh 3 kg. Though he was adopted as a local cat, he certainly was bigger and fatter than the stray cats we see around the neighbourhood. Mr Aung got 0.1 ml Domitor and 0.1 ml Ketamine in one syringe and gave it to me. He realised that this cat would never accept an IV injection. IV injections at the Surgery could be done because the cat would be in foreign territory and would not be so ferocious usually. Here, the cat was on home ground.
FRONTLINE
Being a hands-on man, Mr Aung walked swiftly to the curtains and in one speedy grab, the cat's scruff was lifted up. He placed the cat on the white blanket on the master bed. I was ready and in less than one second, I had injected the cat's backside muscle with 0.2 ml IM of the combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It is always safe to under-dose a frightened cat. I knew the dose was insufficient. For the next 5 minutes, the cat ambled out of the master bedroom, dashed across the living cum dining room with the open concept kitchen and disappeared into Bedroom 2 at the other end of this apartment. Another 5 minutes passed. The cat was as fresh as a daisy.
REINFORCEMENTS
In a losing battle, the commander must call for reinforcements. "Give the cat Domitor IV," Mr Aung proposed catching the cat as he was one never afraid of getting cat scratches. "All three of us are veterans with cat scars on our hands" I had said to assure Mr Hall who must be wondering what was going on. The sedative seemed to be dud. A dud missile that fell and did not explode.
CAUTION
Soldiers could shock and awe in battle with more bombings to kill the enemies. But this is a cat that must be alive at the end of the house-call. "Better not to give another sedative," I advised Mr Aung. "The cat may react and die. Just wrap the cat inside a towel with his head sticking out. That would be safer. The cat would be sedated slightly by now. 15 minutes had passed." I asked Mr Saw to take the white towel and he went to the bedroom to get the cat for me. I could do everything myself but my assistants would never learn.
SUICIDE BOMBER ATTACK
Mr Aung went inside Bedroom 2 to risk his hands and got the cat by the scruff of the neck. Mr Hall and Mr Saw and possibly Mrs Hall were inside Bedroom 2. As the room was small, I stood outside the door to supervise. Like those consultants who talk but no action.
While Mr Aung was holding the cat for Mr Saw to wrap the towel around, the second cat, white with grey patches suddenly leapt up to claw either Mr Aung or the cat. I just could not believe this suicide bomber attack from the friendly troop. This attacking cat hissed and swung his paws widely. He leapt up and gravity pulled him down. From my point of view, he was attacking Mr Aung.
In cat attacks, it is wise not to interfere. Water hosing would be ideal but not inside the apartment. Mr Hall managed to get the attacker out of the room. He slinked outside the room and would not go away. He was just so furious. Was it the attention the other cat was getting? Mr Hall said to me: "This cat is very protective and was protecting me." Well, next time, no other cats should be present.
The next day, I noted that Mr Saw's left hand had two cat scratches too when we were taking blood from a dog. So, Mr Saw had suffered.
ACTION
After wrapping the cat in the towel, the cat seemed quiet. I said to Mr Saw: "Put the cat on this kitchen counter." I gave Mr Aung the forceps from my bag. He opened the cat's mouth. "There's the needle stuck in the hard palate!" he showed the culprit. I took some pictures with a zoom lens inappropriately. The zoom would not work at first until I stepped back further. Mr Aung took the needle out. A black thread with slimy saliva was attached to the end of the needle. I should have put the needle onto the tissue paper as Mr Hall seemed not too pleased when I placed it directly onto the kitchen counter. Mrs Hall took away the needle. I opened the cat's mouth to give a final check. "No injuries or ulcers," I said to Mr Hall.
ANTIDOTE
"Should give Antisedan," Mr Aung advised me. "Antisedan is an antidote," I said to Mr Hall. "The cat will wake up immediately. If Antisedan is not given, he would wake up fully over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr Hall said.
"There is a small risk that the cat may not wake up. A very small risk. Antisedan injection ensures that the cat's heart and lung systems are back to normal promptly."
The cat inside the towel hissed and hissed. Mr Hall agreed to the Antisedan injection. This was given via the cat's femoral vein at 0.1 ml IV. "Take the cat out of the towel and put him on the floor," I said to Mr Saw rather urgently. Mr Saw could not understand what I mean. In any case, he had no time to think. The cat looked up, assessed his situation well. The cat crawled out of the loosened towel, stood on the counter and in one spring, he leapt onto the floor and disappeared into the sanctuary of the master bedroom.
HAPPY ENDING
Everybody was happy that this cat was back to normal. Mr Hall asked me for my namecard as he was surprised that I was prompt in answering his house call. Mrs Hall would be more careful with her sewing needles and threads from now on.
CONCLUSION
Never give the frightened cat a second dose of sedatives as the cat may just die. This case took three times as long but the cat was alive and that was what every owner wants. It is best to treat such cases at the Surgery. Normally I don't even want to do it at the house as there are so many complications and surprises. Besides, it takes a longer time.
REVIEW
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Friday, August 22, 2014
1469. A cat in Myanmar has pyometra - script
FINAL VIDEOS
Video in the English language
Video in the Myanmar language
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A proposed script for the "A Cat in Myanmar Has Pyometra" is as follows:
Scene of Yangon's downtown flats, traffic jam and sprawling suburban area.
Much more suburban areas in Yangon with farms and houses. 2 minutes of VIDEOS
Video of Singapore's apartments and apartments 2 minutes of VIDEOS
Pyometra - pus in the womb
cystic endometrial hyperplasia
bacterial infections
vaginal discharge - pus
SOLUTIONS TO CATERWAULING IN YANGON COMPARED TO SINGAPORE
Caterwauling noise nuisance urbanised Singapore
bigger area in Yangon
INCIDENCE OF PYOMETRA IN YANGON COMPARED TO SINGAPORE
Rare in Singapore cats as cat owners spay their home cats. No vets give the birth control injections as a solution to caterwauling.
Common in Yangon cats
Birth control Synthetic progesterone injections for caterwauling
Side effects of the use of such injections
Synthetic progesterone injections - Not given by Singapore vets and requested by cat owners.
The solution is to spay the caterwauling cats. In my over 30 years of practice in Toa Payoh Vets in Singapore, I have not seen a case of cat pyometra.
So I was quite excited in seeing such cases in Royal Asia Veterinary Surgery on visits in July 2014. I followed up this case and communicated with the cat owner.
SUBTITLES IN VIDEO
spay by Dr Aung
Dr Sing talks to owner during consultation and post-op VIDEOS SUBTITLES
LOBULATED WOMB of present case study. Show one image
Image of another cat with pyometra seen during Dr Sing's visit in June 2014
TIPS AND ADVICES
1. Be careful not to incise the full bladder when you incise the skin. Palpate for full bladder first but some vets may not do this and therefore incise the bladder accidentally.
.
Illustration of "RUB".
Dr Aung expressed the bladder to access the uterus.
2. Make a long skin incision. In my experience, a spay hook is a waste of time as a larger incision enables the vet to take out the swollen womb without the need of a hook.
VIDEO OF HOOKING
CONCLUSION
1. From a management point of view, the cheapest, convenient and most effective solution to a challenge is the best. In Myanmar cats, a birth-control injection appears to is the cheapest, convenient and most effective solution to stop the cat caterwauling. Usually it is given 3-4 monthly. In this case, the owner was happy to get an annual injection.
2. Culture of the Myanmar people. Most of them are Buddhists.
VIDEO OF UPPASANTHA PAGODA IN NAYPYITAW
Ovariohysterectomy (spaying) involves surgery to remove the ovaries and womb. This surgery may be against the Buddhist belief of causing harm to the cat. So cats are not spayed since there are anti-caterwauling injections.
HOOK - AUDIO OF CATERWAULING CATS in some HDB apartment areas.
3. Spaying leads to death. Some vets in rural areas may not advocate spays. Deaths may be due to lack of sepsis or experience and skills. So antibiotics are prescribed when there is pyometra.
FINAL VIDEOS
Video in the English language
UPDATE AS AT 13 SEP 2020.
There are many new small animal practices set up over the past 10 years. Spaying of the female cat is acceptable and the use of synthetic progesterone as birth control is not so common nowadays. Hence, there are less incidence of pyometra in the female cat as compared to 2014 when I visited Dr Thein Tun Aung at Royal Asia Veterinary Surgery.
Dr Thein Tun Aung (left),
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