1507. A 5-year-old Chow Chow suddenly had fits and salivation

Saturday Sep 20, 2014

A female non-spayed Chow Chow came in recumbent, shaking all over the body and salivating thick sticky saliva. "These fits happened only 15 minutes ago. What is the cause? Can you do something to stop the fits"

I checked her medical records. No fits before. I gave IM 5mg diazepam. The dog stopped shaking one hour later. She was very thin and full of scales and oily skin. Her eyes had rolled in eyelids and were sticky with lots of pus. IV drip and medication were given. Blood test done.

Today, the dog had recovered and was eating. The whole body would be clipped and a bath given. Ears irrigated, nails clipped. The owner did not want entropion surgery.

BLOOD TESTS

History:
Mar 12, 2013. Skin disease and 6-month haematuria. Demodectic mange and ringworm.
Total white cell count 19.8  (6-17)
Neutrophils 82.5%  (60-70%)    Abs  16.34  (3-12)
Platelet clumping noted but within normal range.

.
Sep 9, 2014  Fits and salivation. Recumbent. Sudden onset.

Total white cell count 28.8  (6-17)
Neutrophils 90%  (60-70%)    Abs  25.92  (3-12)
Platelet within normal range.

Glucose  0.9  (3.9 - 6.0). Query glycolysis. Suggests to repeat.

Hypoglycaemic fits likely. No complaint of polydipsia, polyphagia and polyuria.
In fact, the dog is very thin. Skin diseases generalised, with ringworm and bacteria. The dog has recovered fully now.


CONCLUSION
A Chow Chow needs much more care than a Jack Russell. Skin diseases may need monthly reviews.
Most owners have no time. So the bacteria multiplies and infect the blood stream leading to a big increase in neutrophils which are white blood cells produced in large numbers to combat the bacterial invasion.  Medical costs of treatment will be high.

Entropion is quite common in Chow Chows. The inward rolling eyelid's eye lashes irritate the cornea, causing infection and daily pus formation. The owner does not want any surgery to evert the eyelids, resolving this problem which has persisted for the last 5 years.

If the owner does not want euthanasia, the owner needs to plan and schedule regular clipping away of the long infested patchy hairy coat with the groomer and get skin reviews with the vet.

A young Shih Tzu X vomits and purges after a stay in a Pasir Ris chalet

Sunday's interesting case  Sep 21, 2014

4 days ago, the dog went to the chalet. In Singapore, Pasir Ris chalets near the sea, are rented by the family to celebrate functions and have a BBQ.
"It was only the first night and the BBQ had not started till the next day," the dog vomited 6X and had diarrhoea 10X."
The family vet treated the next day but the dog continued vomiting and purging and so was brought to her the 2nd time. Blood tests and X-rays were "normal". 3 bottles of medication were given, but now she referred the dog to the parent branch. Ultrasound showed some inflammation in the liver, gall bladder, stomach and intestines. A foreign body in the full lumen could not be ruled out.

When the dog came to me this morning, he was most aggressive. Muzzling was done but he could take the muzzle out. "Hold by the scruff of the neck while I gave the injections," I said to my assistant. Just handling the dog with hands would not do as this male dog was very strong.

Vet 1 and the referred vet had prescribed 6 types of medications and had given injections. I palpated the abdomen. Empty except for a distended bladder. Some pain felt in the rectal area as the dog winced. Could there be bone fragments inside the rectum? X-rays may not show.

Based on the sudden onset persistent vomiting and diarrhoea in the chalet, this dog could have food poisoning. The treatment varies with different vets. For such serious cases, I would give the IV drip and anti-diarrhoea medication and let the intestines rest 48 hours, with electrolytes only for the first 48 hours. The other vets fed the dog chicken pieces and advised porridge. It may be better to advise fasting for 24-48 hours.          

1505. Feedback on lateral ear canal resection surgery. A Schnauzer has very hairy ears

Sep 20, 2014

The lady asked whether Royal Canin delivers the hypoallergenic food to her house as she finds that it is better than Science Diet Z/D. Her dog had been tested for allergies which showed that the dog was allergic to grasses and even cockroaches.

."Keeping this expensive dog indoors reduces a lot of skin itchiness," she said. "Do you remember you opened up her vertical ear canals in April?"

"Some miniature schnauzers have hairy ears and so there is not much ear v. entilation or drainage. The ears become infected. Is the dog still scratching his ears and shaking his head continuously nowadays?" I asked.  

"Very much less," she said. "My friends can't believe that he is itchy to grasses"  This feedback shows that lateral ear canal resection is effective.

"There is a need to check the horizontal ear canal," I explained to her as there is some scratching of the ears. Very little .

Royal Canin does not deliver food to the house. She found it better and so she ordered it for her dog. Today another dog owner had bought 2 large bags and so there was none available. Toa Payoh Vets do not stock up such special diets as the demand is low and we have to throw away expired ones. She would phone to order the big bags. .

1504. Blood test for an old bad-breath Jack Russell X

TP 45534

Bad breath from a distance. The owner lives with the 8-year-old male dog will not be able to smell this because his nose is sensitized to the smell.

"My friend told me I must do a dental scaling," he said to me.  The dog looked like a Norwich Terrier but he said it was a Jack Russell X.

BLOOD TEST before dental work.
Surprisingly the total white cell count was 5.6 (6-17) but the neutrophils were normal at 56.4% (60-70%) and the absolute no. of neutrophils was 3.16 (0 - 3).  Overall, the values have not changed much.

Urea 6.9 (4.2 - 6.3), creatinine 81 (89-177).

4 teeth extracted. The smell was so strong that I could smell it when placed inside the plastic bag for the owner to see.
IV BAYTRIL AND DRIP.
Usually I advised 7 days of antibiotics, but the owner wanted today (Sep 18, 2014) as he was free only once a week.  So I gave the antibiotic via the IV drip direct, to kill as much of the mouth's bacteria as possible. Dog goes home with antibiotics and painkillers oral

FOLLOW UP
On Sep 19, 14, I phoned the owner.
"No bad breath?" I asked.
"No," he said happily. "Thank you.".

1503. How to make a killer presentation

Yesterday, I attended a presentation at Delifrance said to be given a lady insurance agent who told me she would be introducing her boss to me. I was asking her about insurance for a mortgage decreasing housing loan.

Instead, the boss gave the presentation on trust and leverage while she was quiet.

What she ought to do was to plan ahead, do rehearsal with her boss and give the presentation herself as she was the primary contact. The boss is a stranger. So, I sms her a Harvard Business Review article on "How to make a killer presentation."

"It is not rocket science advising a person to get a $1 million insurance cover with a 15% downpayment and recoverable yearly premiums of $6,000/month. "Just do it," I was sure she could have done a better job as she was the contact.

"Yes, Sir, Nike, Adidas" she sms me.
"Not  Adidas mdm," I replied. "Adidas is competitor. They do not do it."
"Hahahaha."


We should try to give what the customer wants. In real estate, some agents bring clients to view houses they can't afford to rent or buy. Dog groomers insist on not clipping off the tip of the tail and the face when the owner wants a complete shave.  

 

The Shih Tzu can't control his bladder for one year

Sep 18, 2014

The Shih Tzu came in for bladder stone removal as scheduled. His urine starts to smell. When the maid removed the diapers which are worn when he goes outdoors or sleeps overnight of 8 hours, I noted that the dog released a large amount of urine.

"He does urinate into the diapers," the maid showed me dark brown urine stain inside the diapers.
"What happened is that the dog will try not to pee when you put on the diapers overnight," I explained. "His bladder gets infected by stagnant urine as he keeps the urine overnight. This has been going on for one year and so now, he dribbles urine all the time."

The dog started with urine drops one year ago. He was hospitalised by a vet for one week.
"Did the vet do an X-ray or urine test?" I asked.
"I don't think he did an X-ray," the wife said. "He told me that this dog is old and old dogs cannot control their bladder. So, he must have long-term medication."

Instead, the owner got the dog to wear diapers when he is inside the apartment as his urine drops soil the whole apartment. But on Sep 11, 201, the dog was lethargic and not eating for 2 days. So he was brought to Toa Payoh Vets. X-rays showed 3 large bladder stones. Urine test show urinary tract infection with pH = 7.0, SG 1.030, positive protein, blood 4+, bacteria 2+ and no crystals. Blood tests showed total white cell count as 47.7 (normal 6 - 17), neutrophils at 96.4% (normal 60-70%) and absolute neutrophils as 46 (normal 3-11.5).  Blood urea was higher but creatinine was lower than normal.   .

Overall, this dog had a severe bacteraemia and that was why he was not eating for 2 days.

The dog was on antibiotics and today will be operated.
"Some owners will put the dog to sleep," I explained the high anaesthetic risks for old dog surgery.

In Singapore some owners do make the male dog wear diapers to prevent urine marking and soiling the apartment. This may lead to urinary tract infection as the dog withholds the urine for long time, allowing bacteria and crystals to form over several months.

SEP 18, 2014
Surgery to open the bladder. The stones had disintegrated. The testicles were swollen 5X and adhered to the scrotal sac. The testicles with pus inside the tissues and the scrotal sacs were removed.  

1502. Tail docking in 2-day-old puppies

Tail injuries happen in dogs and cats. Tail amputation or docking surgical techniques are shared in the video. It is best that your vet does the tail docking rather than use rubber bands.