Feb 24, 2015
SEEING IS BELIEVING
The
textbooks have all their information but the hands-on practice,
recording and observation of anaesthesia hones a vet's skill and
expertise in anaesthesia and surgeries at least cost and provide a high
level of safety for the pet.
I produce two videos to
share my over 30 years of experiences on neutering a dog safely and
efficiently with my Myanmar vet assistant with injectable anaesthesia.
No isoflurane gas was used if the surgery is started and ended within 21
minutes from injection to final skin stitching
Sheltie, Male, 7 months, 5.6 kg. 38.7C
INJECTABLE ANAESTHESIA
For a young healthy dog, the formula is as follows:
10 kg, young Dom = 0.4 ml Ketamine =0.5ml in one syringe IV
Duration of analgesia (no pain, no movement) = 15 minutes
This dog was given D=0.2 ml and Ketamine 0.25 ml IV. Very good analgesia and safety.
PRE-OP
Clip surgical area first. This dog was excitable and so this was done after the injection of anaesthetic.
A: Injection of Dom + Ketamine 10.47am
D: First skin incision 10.56 am
E: Completion of skin stitching 11.08 am
E-D = 12 min (neuter took 12 min).
E-A = 21 min
Each testicle from incision to the final cut = 3-4 min
lst testicle 10.56 am - 10.59 am
2nd testicle 10.59am - 11.03 am
Antisedan given at 11.30 am. Dog stands up at 11.35 am. All OK.
SURGERY
3-forceps method
Suture Caprosyn /0 absorbable nylon type.
CONCLUSION
No isoflurane gas top up is needed if the vet knows exactly the effects of domitor and ketamine for young dogs in neutering. Many pet owners ask how long it takes to neuter a dog. In this case, the whole process will be around 30 minutes. The surgery itself is around 12 minutes in this case.
Tuesday, February 24, 2015
Sunday, February 22, 2015
1122. An old Miniature Schnauzer has a tail lump. What to do?
Feb 22, 2015. 4th day of Chinese New Year.
A tail lump in an old Miniature Schnauzer - what to do?
When faced with a skin lump, veterinary opinions differ. Some vets will advise "wait and see", prescribing some antibiotics. I will advise excision as it may or may not be cancerous. It will be up to the owner to make the final decision.
The vet should NOT advise "wait and see". Give the owner the option to excise or not to do it as the lump may be pre-cancerous or cancerous.
In this case, the old dog had a circular skin lump 8 mm x 8 mm x 3 mm. It looked very much like a ringworm. Dr Daniel said it could possibly by a result of licking or biting as the old dog had anal sacculitis, with thick brown oil expressed by me earlier.
I advise the owner to get the lump taken out by excision with a 1-cm resection margin ideally. A 1-cm skin margin would permit any present cancerous cells, if any, be removed, leaving little chance of recurrence.
This was not possible as there was insufficient skin and the tail would have to be taken out. The owner wanted to keep the tail stump. She gave informed consent to excise the lump without the margin. Histology was approved.
Dr Daniel operated. The lump was not cancerous based on histology. Dr Daniel's opinion was that this could be due to the dog's anal sacculitis itchiness and licking and that the lump could be inflammatory.
In an old dog, it is best NOT to wait and see. If the dog's lump is cancerous or turn cancerous later, there will be no good words for the vet's competence from family members.
In this case, the skin lump was not cancerous. Everybody is happy. This could be a case of tail gland tumour based on its location. I had seen one in a Siberian Husky some years ago.
A tail lump in an old Miniature Schnauzer - what to do?
When faced with a skin lump, veterinary opinions differ. Some vets will advise "wait and see", prescribing some antibiotics. I will advise excision as it may or may not be cancerous. It will be up to the owner to make the final decision.
The vet should NOT advise "wait and see". Give the owner the option to excise or not to do it as the lump may be pre-cancerous or cancerous.
In this case, the old dog had a circular skin lump 8 mm x 8 mm x 3 mm. It looked very much like a ringworm. Dr Daniel said it could possibly by a result of licking or biting as the old dog had anal sacculitis, with thick brown oil expressed by me earlier.
I advise the owner to get the lump taken out by excision with a 1-cm resection margin ideally. A 1-cm skin margin would permit any present cancerous cells, if any, be removed, leaving little chance of recurrence.
This was not possible as there was insufficient skin and the tail would have to be taken out. The owner wanted to keep the tail stump. She gave informed consent to excise the lump without the margin. Histology was approved.
Dr Daniel operated. The lump was not cancerous based on histology. Dr Daniel's opinion was that this could be due to the dog's anal sacculitis itchiness and licking and that the lump could be inflammatory.
In an old dog, it is best NOT to wait and see. If the dog's lump is cancerous or turn cancerous later, there will be no good words for the vet's competence from family members.
In this case, the skin lump was not cancerous. Everybody is happy. This could be a case of tail gland tumour based on its location. I had seen one in a Siberian Husky some years ago.
Saturday, February 21, 2015
1121. Born free
Feb 21, 2015
6.30 am exercise
Feb 21, 2015. 6.30 am
3rd day of Chinese New Year
I exercised in a public fitness area
The Bar Bender burned my upper arm muscles as I bent the two bars inwards and counted 1, 2, 3
Could do 10 now.
The Standing Push ups - could do 20
The Abdominal muscle bender - could do 100
The cycling machine - too creaky and noisy. would upset residents and so I did less cycling.
Daily workout, one at 6 am and one in the evening
Better than going to the air-conditioned gym once a while.
Self discipline needed. Fresh air.
Can see dawn breaking. Black sky to dark blue to light blue.
Today, a bird high up in the tree "tweet, tweet, tweet..." 10 times for some time. Born free. Shorter life.
Like some men. Addicted to coffee and late night online gaming to 4 am. Every night if possible.
Unable to wake up. A mean-looking grumpy face at the office.
Can never function normally or be kind to any one when deprived of coffee in the morning.
A bird in the nearby terraced house sang a melody every time. Caged. No freedom. Safety. But no worries of predators or hunger.
Like some women. Cannot survive without air-conditioning.
Unable to appreciate the wild flowers and flitting butterflies in the hot and humid countryside
Admonition on travel to undeveloped areas with no electricity and with no air conditioning
6.30 am exercise
Feb 21, 2015. 6.30 am
3rd day of Chinese New Year
I exercised in a public fitness area
The Bar Bender burned my upper arm muscles as I bent the two bars inwards and counted 1, 2, 3
Could do 10 now.
The Standing Push ups - could do 20
The Abdominal muscle bender - could do 100
The cycling machine - too creaky and noisy. would upset residents and so I did less cycling.
Daily workout, one at 6 am and one in the evening
Better than going to the air-conditioned gym once a while.
Self discipline needed. Fresh air.
Can see dawn breaking. Black sky to dark blue to light blue.
Today, a bird high up in the tree "tweet, tweet, tweet..." 10 times for some time. Born free. Shorter life.
Like some men. Addicted to coffee and late night online gaming to 4 am. Every night if possible.
Unable to wake up. A mean-looking grumpy face at the office.
Can never function normally or be kind to any one when deprived of coffee in the morning.
A bird in the nearby terraced house sang a melody every time. Caged. No freedom. Safety. But no worries of predators or hunger.
Like some women. Cannot survive without air-conditioning.
Unable to appreciate the wild flowers and flitting butterflies in the hot and humid countryside
Admonition on travel to undeveloped areas with no electricity and with no air conditioning
Thursday, February 19, 2015
1199. Three Chinese New Year inpatients.
Chinese New Year, Feb 20, 2015 is a cloudy day.
There will definitely be no cases as the owners celebrate.
I came to check on the Jack Russell that had recovered from vomiting and diarrhoea, the terrapin that swam sideways and the kitten that had diarrhoea for over a week.
1. The terrapin had been here for 2 days. Had lost 2 grams but is more active and no longer gasping as evident by the rapid throat movements of rapid panting. I noted the shell has had become greener instead of yellow green 2 days ago. He had not put on much weight as his two siblings, all originated from Florida, USA and sold by Pet Lovers' Centre. This batch looked good when I saw them some weeks ago at the pet shop. Now, the owner had a hideout which is a dome-shaped porcelain. Only 2 terrapins could hide inside as there is insufficient space now. Probably they bullied this 3rd one who is yellowish green in shell colour while the other two are dark green (see video).
Today, I tested this patient. He could swim with less frequency of right sided tilting after 2 days of inpatient treatment. He was exposed to sunlight as he never had ultraviolet light at home. The owner did phone yesterday but it takes time to recover from respiratory disease.
2. The Jack Russell had recovered from vomiting and diarrhoea some 2 days ago. The owner is very busy going all round Singapore to fix fibre-optic problems. He appeared on his bike at around 11.30 am and I saw him while I was monitoring this terrapin outside. He loves this Jack Russell and I offered to send the dog and him home in my car since he was riding his motorbike. He said he would drive his car here tomorrow. After much persuasion, he took the dog home on his motorbike (video). Some people work very hard for a living and I could see his weariness and bloodshot eyes. For the long hours he put in, he had no time to relax, let alone pick up his dog. Anyway, the dog went home today, on his bike.
4. The diarrhoeic kitten was still lethargy but still alive. Had drank water but did not want to eat. Handfeeding is done although he rejected after a few mouthfuls. Multivit, water and antibiotics are given.
There will definitely be no cases as the owners celebrate.
I came to check on the Jack Russell that had recovered from vomiting and diarrhoea, the terrapin that swam sideways and the kitten that had diarrhoea for over a week.
1. The terrapin had been here for 2 days. Had lost 2 grams but is more active and no longer gasping as evident by the rapid throat movements of rapid panting. I noted the shell has had become greener instead of yellow green 2 days ago. He had not put on much weight as his two siblings, all originated from Florida, USA and sold by Pet Lovers' Centre. This batch looked good when I saw them some weeks ago at the pet shop. Now, the owner had a hideout which is a dome-shaped porcelain. Only 2 terrapins could hide inside as there is insufficient space now. Probably they bullied this 3rd one who is yellowish green in shell colour while the other two are dark green (see video).
Today, I tested this patient. He could swim with less frequency of right sided tilting after 2 days of inpatient treatment. He was exposed to sunlight as he never had ultraviolet light at home. The owner did phone yesterday but it takes time to recover from respiratory disease.
2. The Jack Russell had recovered from vomiting and diarrhoea some 2 days ago. The owner is very busy going all round Singapore to fix fibre-optic problems. He appeared on his bike at around 11.30 am and I saw him while I was monitoring this terrapin outside. He loves this Jack Russell and I offered to send the dog and him home in my car since he was riding his motorbike. He said he would drive his car here tomorrow. After much persuasion, he took the dog home on his motorbike (video). Some people work very hard for a living and I could see his weariness and bloodshot eyes. For the long hours he put in, he had no time to relax, let alone pick up his dog. Anyway, the dog went home today, on his bike.
4. The diarrhoeic kitten was still lethargy but still alive. Had drank water but did not want to eat. Handfeeding is done although he rejected after a few mouthfuls. Multivit, water and antibiotics are given.
Tuesday, February 17, 2015
Follow Up: A 7-year-old Shih Tzu 2 months post surgery to remove bladder stones. (Video)
Today, the Shih Tzu came in as he was limping from his left fore foot. A stitch still remains from his bladder surgery done on Dec 20, 2014 and I removed it.
This dog had blood in the urine in 2012 but the owner did not want surgery. The dog started vomiting once a month. X-ray showed numerous struvite stones inside the bladder and os penis.
Now today, Feb 17, 2015, the dog is perfectly normal. Only home-cooked food.
This dog had blood in the urine in 2012 but the owner did not want surgery. The dog started vomiting once a month. X-ray showed numerous struvite stones inside the bladder and os penis.
Now today, Feb 17, 2015, the dog is perfectly normal. Only home-cooked food.
Follow Up: A 7-year-old Shih Tzu 2 months post surgery to remove bladder stones. (Video)
Today, the Shih Tzu came in as he was limping from his left fore foot. A stitch still remains from his bladder surgery done on Dec 20, 2014 and I removed it.
This dog had blood in the urine in 2012 but the owner did not want surgery. The dog started vomiting once a month. X-ray showed numerous struvite stones inside the bladder and os penis.
Now today, Feb 17, 2015, the dog is perfectly normal. Only home-cooked food.
Feb 2015 Video interview 2 months after urinary stone removal by Dr Daniel Sing
http://youtu.be/YYH6wQctLWk
This dog had blood in the urine in 2012 but the owner did not want surgery. The dog started vomiting once a month. X-ray showed numerous struvite stones inside the bladder and os penis.
Now today, Feb 17, 2015, the dog is perfectly normal. Only home-cooked food.
Feb 2015 Video interview 2 months after urinary stone removal by Dr Daniel Sing
http://youtu.be/YYH6wQctLWk
1196. An apartment cat's lifestyle -obsturction of LI or torsion as seen on X rays?
Today, Feb 17, 2015, 2 days before Chinese New Year, I phoned the owner of this 6-year-old female spayed cat that was warded for vomiting frothy yellow stuff and passing watery reddish brown stools on 3 days earlier. The cat lived on the 2nd floor and would go outdoors every day for around 15 minutes. This was her routine but on Feb 5, 2015, her owner had to bring her for treatment of acute gastroenteritis.
"She has recovered fully," the lady said. "What is the cause of her vomiting and diarrhoea? Dr Daniel did not give me the reasons."
"It is not easy to pinpoint the exact cause," I said. "The blood test was normal. The stools analysed did not show ova, cysts parasites, leucocytes and erythrocytes. The urine had some bacteria and blood.
"X-rays cannot show the cause. But I suspect large intestine obstruction as evident by the transverse colon showing lots of gas. Dr Daniel thinks it may be a torsion."
I had given the dog IV drip, baytril and spasmogesic SC and warded her overnight from Feb 4 to Feb 5, 2015. Today, I phoned the owner and received the good news that the cat had recovered within 2-3 days of going home.
As to the cause of the gastro-eneritis, it would be related to the outdoor lifestyle of this cat. Perhaps she had eaten something poisonous or had cleaned her chemical contaminated paws. "Now she is kept at home and she is not happy," the lady told me that the cat would want ro go out whenever she opened the door.
"Best to keep her inside the apartment," I advised.
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