Mar 24, 2015
The pair of guinea pigs gave birth to 1 male and 1 female on before the sire was neutered.
Parents about 1 year old.
Sep 3, 2014 dam gave birth to a male and a female. F1 generation
Oct 7, 2014 sire was neutered by Dr Daniel
Feb 13, 2015 dam gave birth to 2 males. F2 generation.
Was the neutered sire the father? The Korean lady asked me. Dr Daniel said that the neutered sire should be separated from the dam for 3 months after neuter.
Guinea pigs mature at 3 months of age.
Gestation period 59 - 73 days or 2 months.
Dec 3, 2014 F1 male will mature from 3 months and will mate with the mother.
Feb 13, 2015 (2 months' gestation, mating on Dec 13, 2014 by F1 son).
So the neutered father was NOT responsible.
Tuesday, March 24, 2015
1146. Pug with folliculitis
Mar 24, 2015
Review of the pug. 9 days. Still has inflamed skin. Appeared spreading.
Ringworm +ve some hairs
Skin scrapings 3 areas - no mites seen.
Allergy? Plastic biting of handles of mum's bedframe - allergic on chin and face.
Review of the pug. 9 days. Still has inflamed skin. Appeared spreading.
Ringworm +ve some hairs
Skin scrapings 3 areas - no mites seen.
Allergy? Plastic biting of handles of mum's bedframe - allergic on chin and face.
Sunday, March 22, 2015
1145. Sunday morning smiles on Mar 22, 2015 at 7.30 am
Sunday Mar 22, 2015
I went to the public fitness park at 6 am and at 7.30 am to exercise. I usually discipline myself to do it once, to exercise to keep fit this year. Bright cloudy morning.
As I walked out, the slim Myanmar maid, around late 20s, in bright red T-shirt, longer blue floral white shorts with two ties at the lower side and pony-tail was washing the bright red Porsche. She smiled nowadays when I said good morning or hello to her. This bright red Porsche alone would cost around $300,000 and her salary, assuming $500/month would mean 50 years of being a domestic worker to earn this amount. I hope she would save up and buy land in her village to better her life. Maids work to support their aging parents and siblings in Myanmar.
At the fitness park, I was surprised to meet this lady who walks her 11-year-old Golden Retriever every day. I met her some weeks ago when I walked to the subway to catch a train to work on a Saturday morning. Her dog was trying to sniff me out and she restrained him. "Are you from Grand Spring condo?" I asked. "No, I am from Rose Flower Gardens," she replied. "I was wearing long pants to work when we met some months ago," I said. "So, you will not recognise me. You walk to this neighbourhood too?"
"My dog gets bored walking the same route," the Golden Retriever was dragging her away.
"More likely you will get bored," I could not imagine a dog being bored when taken out in the morning to exercise. "How do you prevent tick infestations of your dog?"
"I spray an organic repellant on his body and paws and so this dog does not have ticks," she said.
"Do you use spot-on insecticide between the shoulders, e.g. Frontline?" I asked.
"Yes, I use it once a month."
"Be careful that you do not get poisoned with the daily spray as you will have inhaled it," I advised. "Even if it is organic, it is still poison!". Many Singaporeans do not bother to look into the medical side effects of multiple pills popped into their mouths including glucosamine and DMSO, anti-perspirant sprays and monthly hair dyes to look younger.
Assuming that a spray is organic, it will be safe for the health of the person and the dog. But long-term use will cause poisoinng of the body system.
The lady smiled and her dog dragged her off. Walking every day seemed to have reduced her weight since I saw her more than 2 months ago and she looked happier. She smiled as she left.
There was another older lady who walked her Golden Retriever along the roads. She also carried pieces of newspapers to scoop up the poo. The dog stopped suddenly as if he wanted to poop and so she got the newspapers ready to place. I stopped walking so as not to distract the dog. Alas, the dog did not do it. She appeared embarassed and I asked: "How many times does he poo a day?"
"Twice," she replied as the dog dragged her off.
In my neighbourhood, I saw a light brown with black soft top, probably an Audi 2-door with a bicycle attached behind the boot, driving out. An older woman walked the road to exercise. A young couple put the golf sets in their car to golf. A Caucasian expatriate with helmet cycling. One man was jogging. An older man with knees bandaged walked past me, avoiding eye contact.
On this Sunday morning in a peaceful country, most of my neighbours are sleeping late and miss the beauty of dawn breaking, the birds chirping and the coolness of the early morning. For the past years, I did not exercise, as is typical of most Singaporeans. Work and raising a family took precedence. There must be time to smell the roses in Singapore when there is peace.
I went to the public fitness park at 6 am and at 7.30 am to exercise. I usually discipline myself to do it once, to exercise to keep fit this year. Bright cloudy morning.
As I walked out, the slim Myanmar maid, around late 20s, in bright red T-shirt, longer blue floral white shorts with two ties at the lower side and pony-tail was washing the bright red Porsche. She smiled nowadays when I said good morning or hello to her. This bright red Porsche alone would cost around $300,000 and her salary, assuming $500/month would mean 50 years of being a domestic worker to earn this amount. I hope she would save up and buy land in her village to better her life. Maids work to support their aging parents and siblings in Myanmar.
At the fitness park, I was surprised to meet this lady who walks her 11-year-old Golden Retriever every day. I met her some weeks ago when I walked to the subway to catch a train to work on a Saturday morning. Her dog was trying to sniff me out and she restrained him. "Are you from Grand Spring condo?" I asked. "No, I am from Rose Flower Gardens," she replied. "I was wearing long pants to work when we met some months ago," I said. "So, you will not recognise me. You walk to this neighbourhood too?"
"My dog gets bored walking the same route," the Golden Retriever was dragging her away.
"More likely you will get bored," I could not imagine a dog being bored when taken out in the morning to exercise. "How do you prevent tick infestations of your dog?"
"I spray an organic repellant on his body and paws and so this dog does not have ticks," she said.
"Do you use spot-on insecticide between the shoulders, e.g. Frontline?" I asked.
"Yes, I use it once a month."
"Be careful that you do not get poisoned with the daily spray as you will have inhaled it," I advised. "Even if it is organic, it is still poison!". Many Singaporeans do not bother to look into the medical side effects of multiple pills popped into their mouths including glucosamine and DMSO, anti-perspirant sprays and monthly hair dyes to look younger.
Assuming that a spray is organic, it will be safe for the health of the person and the dog. But long-term use will cause poisoinng of the body system.
The lady smiled and her dog dragged her off. Walking every day seemed to have reduced her weight since I saw her more than 2 months ago and she looked happier. She smiled as she left.
There was another older lady who walked her Golden Retriever along the roads. She also carried pieces of newspapers to scoop up the poo. The dog stopped suddenly as if he wanted to poop and so she got the newspapers ready to place. I stopped walking so as not to distract the dog. Alas, the dog did not do it. She appeared embarassed and I asked: "How many times does he poo a day?"
"Twice," she replied as the dog dragged her off.
In my neighbourhood, I saw a light brown with black soft top, probably an Audi 2-door with a bicycle attached behind the boot, driving out. An older woman walked the road to exercise. A young couple put the golf sets in their car to golf. A Caucasian expatriate with helmet cycling. One man was jogging. An older man with knees bandaged walked past me, avoiding eye contact.
On this Sunday morning in a peaceful country, most of my neighbours are sleeping late and miss the beauty of dawn breaking, the birds chirping and the coolness of the early morning. For the past years, I did not exercise, as is typical of most Singaporeans. Work and raising a family took precedence. There must be time to smell the roses in Singapore when there is peace.
Friday, March 20, 2015
Myanmar Stories: A Myanmar maid learns the basic of computers
Mar 18, 2015
At Khin Khin's employment agency, I met a Myanmarese maid from Pathein. Her employer had asked her to go home since the replacement maid will arrive soon. After 4 years bringing up a child and looking after the household, she did not want to renew her contract. Yet she had not completed her computer course yet and this course would start in 2 weeks' time.
Finding a new employer may be difficult. Her pay was $480. "I have an employer willing to pay $550," the agent said. Her old employer had permitted her 2 Sundays off and she enrolled for this computer course. Her English is much better. Will she be able to find a new employer?
At Khin Khin's employment agency, I met a Myanmarese maid from Pathein. Her employer had asked her to go home since the replacement maid will arrive soon. After 4 years bringing up a child and looking after the household, she did not want to renew her contract. Yet she had not completed her computer course yet and this course would start in 2 weeks' time.
Finding a new employer may be difficult. Her pay was $480. "I have an employer willing to pay $550," the agent said. Her old employer had permitted her 2 Sundays off and she enrolled for this computer course. Her English is much better. Will she be able to find a new employer?
Paper training a new puppy (video)
An elderly couple bought a 3-month-old Chihuahua for a 3rd vaccination.
They have an old Silkie who is paper-trained. I enquired how they would train this new puppy. The Silkie may pee anywhere if the new puppy can do it and so it is important to confine the puppy early.
Video is produced.
1. No confinement.
2. Sometimes the new puppy will pee on the newspapers, meant for the Silkie in the kitchen. Most times anywhere in the apartment.
3. The Silkie is paper trained by beating by the son, many years ago. Negative reinforcement training.
The couple did not want the 4 fences as they are too big. Buying a crate and paper training inside the crate is my proposal. See video.
------------------------------------------
CONFINEMENT 2-8 WEEKS.
1. Crate + newspapers
2. Playpen + newspapers
3. Playpen + grate
4. Crate
Urine smell
2-4 months best. Older rebellious.
Indoor and outdoor.
Patience, Perseverance and Regression.
They have an old Silkie who is paper-trained. I enquired how they would train this new puppy. The Silkie may pee anywhere if the new puppy can do it and so it is important to confine the puppy early.
Video is produced.
1. No confinement.
2. Sometimes the new puppy will pee on the newspapers, meant for the Silkie in the kitchen. Most times anywhere in the apartment.
3. The Silkie is paper trained by beating by the son, many years ago. Negative reinforcement training.
The couple did not want the 4 fences as they are too big. Buying a crate and paper training inside the crate is my proposal. See video.
------------------------------------------
CONFINEMENT 2-8 WEEKS.
1. Crate + newspapers
2. Playpen + newspapers
3. Playpen + grate
4. Crate
Urine smell
2-4 months best. Older rebellious.
Indoor and outdoor.
Patience, Perseverance and Regression.
1142. How to stay healthy? Do your research.
Mar 20, 2015
My neighbouring tenant who sells parts to plumbers, electricians is 66 years old. I saw him cutting out tablets (3 types) and putting them into pill containers for 7 days. Every 5 months, the government doctor will prescribe him the same medicine
SIMvastatin 20 mg 2 tablets at night
ENALApril 20 mg 1 tab 2x/day
Sunvasc Amlodipine besylate 7 mg
Hypernol Atenolol 100 mg
"I don't see the same polyclinic doctor," he told me. "Each doctor will have his or her differing opinions. In the end, they prescribe me 5 months' supply of these pills! I go back every 5 months for a check up and get the same medication."
4 years ago, he went to a private specialist at Mount Elizabeth as somebody referred him to the doctor.
"4 nights in a single room, looking out of the window, here and there," he recounted. "I was not even sick.I asked to be discharged. Every visit from the doctor cost me $300. One month's drugs cost me $3,000. The total hospitalisation bill came to $21,000. "
The nurse told him to ask for half a month's supply. "That was $1,500 and later, she advised me to get $750 supply. I just cannot afford the fees and went to a private general practitioner who charged me around $200 for the drugs."
Now the polyclinic doctor charges him around $30.
Does he really need the drugs? "My blood pressure is only 140," he said. "Yet the doctors prescribe me drugs to control my high blood pressure."
His blood pressure and cholesterol levels needed to be checked every 5 months. Too many years of various types of medication may harm the kidneys and livers leading to kidney or liver failure. It is best that he gets the medical reports and get the reports interpreted from a family doctor. The polyclinic doctor comes and goes and he never has a family doctor who can follow up with his "chronic diseases."
My neighbouring tenant who sells parts to plumbers, electricians is 66 years old. I saw him cutting out tablets (3 types) and putting them into pill containers for 7 days. Every 5 months, the government doctor will prescribe him the same medicine
SIMvastatin 20 mg 2 tablets at night
ENALApril 20 mg 1 tab 2x/day
Sunvasc Amlodipine besylate 7 mg
Hypernol Atenolol 100 mg
"I don't see the same polyclinic doctor," he told me. "Each doctor will have his or her differing opinions. In the end, they prescribe me 5 months' supply of these pills! I go back every 5 months for a check up and get the same medication."
4 years ago, he went to a private specialist at Mount Elizabeth as somebody referred him to the doctor.
"4 nights in a single room, looking out of the window, here and there," he recounted. "I was not even sick.I asked to be discharged. Every visit from the doctor cost me $300. One month's drugs cost me $3,000. The total hospitalisation bill came to $21,000. "
The nurse told him to ask for half a month's supply. "That was $1,500 and later, she advised me to get $750 supply. I just cannot afford the fees and went to a private general practitioner who charged me around $200 for the drugs."
Now the polyclinic doctor charges him around $30.
Does he really need the drugs? "My blood pressure is only 140," he said. "Yet the doctors prescribe me drugs to control my high blood pressure."
His blood pressure and cholesterol levels needed to be checked every 5 months. Too many years of various types of medication may harm the kidneys and livers leading to kidney or liver failure. It is best that he gets the medical reports and get the reports interpreted from a family doctor. The polyclinic doctor comes and goes and he never has a family doctor who can follow up with his "chronic diseases."
Thursday, March 19, 2015
1141. Two cases. 1. Pyometra - vomit and "bloody" diarrhoea. 2. Hyperestrogenism - Swollen vulval area
A young lady's 10-year-old Cocker Spaniel had vomiting and bloody diarrhoea for around one week.
"There is a smell of blood," I said. "The blood test showed low red cell count and haemoglobin. The white cells increased showing bacterial infection. The platelets are low, showing septicaermia. The signs are not good."
I advised inpatient for 2 days with IV drips. Tests for Giardia, coronavirus and parvovirus were negative.
The lady wanted her dog back on the same day. At home, the dog continued vomiting and passing bloody stools. "She is having her heat period now," she said. The next day, the dog passed away at home when I called.
This could be a case of closed pyometra with "heat" being observed by the lady on the day before the dog died.
The dog reacted wanting to bite me when I palpated her lower abdomen. She was overweight and so I could not feel the distended uterus. Septicaemia would result in vomiting and diarrhoea. However, the lady did not want the dog to be warded and this is the owner's wish.
This death could be prevented if the dog had been spayed at a young age. But many owners prefer not to spay their female dogs. The illness and death stressed this young lady considerably. It affected me too as I would like all pyometra dogs to live.
However, I could not operate as this dog was unfit for surgery. Blood transfusion would be costly and there was some financial concerns in this case. Prevention by spaying the dog would have been much cheaper but many owners do not expect their female dogs to suffer from pyometra.
--------------------------------------------------------------------------------------------------
Mar 19, 2015.
Another case of suspected pyometra today. The 4-year-old Shih Tzu licked her vulval area till it became 10X larger than normal (video). Some female dogs are very clean and would lick off every small drop of vaginal discharge till the vulval area became much swollen, as in this dog. Another possibility is hyper-estrogenism.
The owner confirmed that this dog was very clean. She had fuzzy memory of the onset of the last heat. "Maybe November," she said.
"When was the earlier heat?" I asked.
"May," she said.
"So it is March now," I replied. "However, not all dogs come on heat exactly 6 monthly."
Antibiotics now. Spaying 2 months later is advised.
BLOOD TEST
2 abnormal results
Blood glucose 12.1 (3.9-6.0)
Monocytes 18.3% (3-10), Absolute 1.94 (0.15 - 1.35)
"There is a smell of blood," I said. "The blood test showed low red cell count and haemoglobin. The white cells increased showing bacterial infection. The platelets are low, showing septicaermia. The signs are not good."
I advised inpatient for 2 days with IV drips. Tests for Giardia, coronavirus and parvovirus were negative.
The lady wanted her dog back on the same day. At home, the dog continued vomiting and passing bloody stools. "She is having her heat period now," she said. The next day, the dog passed away at home when I called.
This could be a case of closed pyometra with "heat" being observed by the lady on the day before the dog died.
The dog reacted wanting to bite me when I palpated her lower abdomen. She was overweight and so I could not feel the distended uterus. Septicaemia would result in vomiting and diarrhoea. However, the lady did not want the dog to be warded and this is the owner's wish.
This death could be prevented if the dog had been spayed at a young age. But many owners prefer not to spay their female dogs. The illness and death stressed this young lady considerably. It affected me too as I would like all pyometra dogs to live.
However, I could not operate as this dog was unfit for surgery. Blood transfusion would be costly and there was some financial concerns in this case. Prevention by spaying the dog would have been much cheaper but many owners do not expect their female dogs to suffer from pyometra.
--------------------------------------------------------------------------------------------------
Mar 19, 2015.
Another case of suspected pyometra today. The 4-year-old Shih Tzu licked her vulval area till it became 10X larger than normal (video). Some female dogs are very clean and would lick off every small drop of vaginal discharge till the vulval area became much swollen, as in this dog. Another possibility is hyper-estrogenism.
The owner confirmed that this dog was very clean. She had fuzzy memory of the onset of the last heat. "Maybe November," she said.
"When was the earlier heat?" I asked.
"May," she said.
"So it is March now," I replied. "However, not all dogs come on heat exactly 6 monthly."
Antibiotics now. Spaying 2 months later is advised.
BLOOD TEST
2 abnormal results
Blood glucose 12.1 (3.9-6.0)
Monocytes 18.3% (3-10), Absolute 1.94 (0.15 - 1.35)
1140. Pyometra in a Miniature Schnauzer
Thursday, March 19, 2015
The 6-year-old Miniature Schnauzer just could not stand up during the last 2 days before pyometra surgery.
"He could stand up when I carried him," the owner came on the 2nd day. The dog was recumbent and not active.
Blood test showed blood bacterial infection
Two days of IV drips and antibiotics. No immediate operation as survival rate will be very low. Owners expect miracles.
On Mar 18, 2015, he was operated by Dr Daniel. Thick dark brown pus (video).
Today, Mar 19, 2015, 11.15am, he was back to normal self (sitting up) see video and should have a good chance of survival. (Video).
The 6-year-old Miniature Schnauzer just could not stand up during the last 2 days before pyometra surgery.
"He could stand up when I carried him," the owner came on the 2nd day. The dog was recumbent and not active.
Blood test showed blood bacterial infection
Two days of IV drips and antibiotics. No immediate operation as survival rate will be very low. Owners expect miracles.
On Mar 18, 2015, he was operated by Dr Daniel. Thick dark brown pus (video).
Today, Mar 19, 2015, 11.15am, he was back to normal self (sitting up) see video and should have a good chance of survival. (Video).
Tuesday, March 17, 2015
** 1138. A 1.5-year-old cat has kidney failuare - nephritis & proteinuria. Had FLUTD 10 days ago.
10 days ago, the 1.5-year-old male, not neutered cat had obstructed bladder. A vet had relieved the blocked bladder after hospitalising the cat for 5 days. Now, the cat "cannot walk" and has throat pain.
The other vet's history showed the cat had septicaemia and kidney disorder (high creatinine). The cat is very thin, at 4.1 kg now and hypothermic. The cat had dropped around 1 kg of bodyweight since 10 days ago. The cat still peed blood but had no blocked bladder.
X-rays showed enlarged kidneys. .
The first vet had prescribed resistant antibiotics. When the cat was lame 4 days ago, the vet prescribed Tramadol 50 mg (1/6 twice a day for one week.).
But the cat was peeing blood.
Urine tests showed protein 3+, bacteria, blood, and white cells, spermatozoa + (cat is not neutered).
The vet had discharged the cat after 5 days of inpatient treatment. He prescribed clavamox 62.5 mg 1 table two times per day and Danzen once a day. The clavamox is usually given orally to cats by most vets in Singapore. In this case, it was ineffective based on the antibiotic sensitivity test (see below).
Hence the cat still passed blood in the urine for the last 10 days, became weaker and the inflamed penile area was really painful. So, the cat could not walk properly. The penile area was still inflamed and enlarged (see x-rays). The kidneys became more inflamed and hence palpable as 3X enlarged. The kidneys were damaged as protein is found in the urine test.
No blood test was done again to reduce medical costs. The first vet had done blood test showing septicaemia and kidney disorders.
BACTERIAL CULTURE AND SENSITIVITY TEST
At this stage, I did a bacterial culture and sensitivity test. Sometimes, there is the cost considerations and the test is not routinely done.
Bacterial culture of urine - showed Enterobacter aerogenes bacteria resistant to amoxycillin+clavulanic acid (clavulox, clavamox), cefuroxime, nitrofurantoin, ampicillin + sulbactam and ampicillin.
It was sensitive to ciprofloxacin, gentamicin, cotrimoxazole, fosfomycin.
KIDNEY FAILURE means that the kidneys is unable to remove waste products from the blood. The kidneys have not stopped working and making urine. Early clinical signs are increased thirst and urination. Advanced kidney failure cause uraemia and signs include loss of appetite,vomiting, diarrhoea, very bad breath and ulcers in the mouth.
A high blood urea nitrogen (BUN) and creatinine levels mean kidney failure.
TREATMENT
Thin lethargic, dehydrated.
In patient 2 days.
1. Diuresis. At least 200 ml of sucutaneous fluids twic a day are given to "flush out" the kidneys. The flushing process is called diuresis is used to stimulate the kidney cells to function again. If enough kidney cells are functional, diuresis "restart" the kidneys. Replacement of various electrolytes esp. potassium must be done. Proper low protein nutrition and drugs to control vomiting and diarrhoa.
2. A low protein diet to decrese the work load on the kidneys.
3. A phosphate binder to prevent phosphorous accumulating in the blood.
4. Fluids subcutaeously given at home. Not done in this case..
5. A drug to regulate the parathyroid gland and calcium levels.
6. A drug to stimulate the bone marrow to produce new red blood cells if the cat is anaemic.
Baytril and drips.
MAR 24, 2015 FOLLOW UP - (7 DAYS AFTER CONSULTATION AT TOA PAYOH VETS).
1. No more blood in the urine since my treatment on Mar 17, 2015 (10 days after treatment by first vet).
2. Cat needs to be hand fed.
3. Cat does not poop.
Admitted: Wt 3.5 kg. Lost 600g since 7 days ago as the cat did not eat.
Temp 35.1 C compared to 36.7C 7 days ago. Severe dehydration. R lip commissure abscess, R gum ulcers behind R U canine tooth, central tongue ulcer. Rehydrate. Check FIV, FeLV but these were negative. Poor prognosis.
Need to order only Royal Canin Dry Food for kidneys (no pork). The Royal Canin canned food and the Science diet K/D can and dry has pork.
4 cats in the household. This cat was the new introduction but had been with the other 3 cats for 15 months.
CAUSE OF FLUTD
The vet had diagnosed FLUTD (Feline Lower Urinary Tract Infection). However, the vet's blood tests showed septicaemia and kidney infections. This means that this cat has a much more serious illness than the ordinary FLUTD cases where, after relieving the bladder obstruction through catherisation, the cat bounces back and starts eating.
The owner had changed Fancy Feast to Pro Nature dry food 3-4 days before the bladder obstruction. There was no Fancy Feast available. A change of diet suddenly may cause FLUTD leading to bladder obstruction. The other 3 cats were not affected. The husband could not recall till I asked him to recall and he confirmed that there was a change of brand of dry cat food. The vet had recorded this in his case sheet.
With kidney pain, the cat cannot walk normally. I felt an enlarged kidney but no pain. This is because the vet had prescribed oral Tramadol for the last 2 days.
The owner confined him at home, away from the other 3 cats and hand feed 6X/day, mixing Fancy Feast with prescribed Royal Canin Renal diet. Water is available freely.
FOLLOW UP ON APRIL 23, 2015
The cat is back to normal health and eating Royal Canine Renal Diet. The Science Diet K/D contains pork and so cannot be given on religious grounds.
The other vet's history showed the cat had septicaemia and kidney disorder (high creatinine). The cat is very thin, at 4.1 kg now and hypothermic. The cat had dropped around 1 kg of bodyweight since 10 days ago. The cat still peed blood but had no blocked bladder.
X-rays showed enlarged kidneys. .
The first vet had prescribed resistant antibiotics. When the cat was lame 4 days ago, the vet prescribed Tramadol 50 mg (1/6 twice a day for one week.).
But the cat was peeing blood.
Urine tests showed protein 3+, bacteria, blood, and white cells, spermatozoa + (cat is not neutered).
The vet had discharged the cat after 5 days of inpatient treatment. He prescribed clavamox 62.5 mg 1 table two times per day and Danzen once a day. The clavamox is usually given orally to cats by most vets in Singapore. In this case, it was ineffective based on the antibiotic sensitivity test (see below).
Hence the cat still passed blood in the urine for the last 10 days, became weaker and the inflamed penile area was really painful. So, the cat could not walk properly. The penile area was still inflamed and enlarged (see x-rays). The kidneys became more inflamed and hence palpable as 3X enlarged. The kidneys were damaged as protein is found in the urine test.
No blood test was done again to reduce medical costs. The first vet had done blood test showing septicaemia and kidney disorders.
BACTERIAL CULTURE AND SENSITIVITY TEST
At this stage, I did a bacterial culture and sensitivity test. Sometimes, there is the cost considerations and the test is not routinely done.
Bacterial culture of urine - showed Enterobacter aerogenes bacteria resistant to amoxycillin+clavulanic acid (clavulox, clavamox), cefuroxime, nitrofurantoin, ampicillin + sulbactam and ampicillin.
It was sensitive to ciprofloxacin, gentamicin, cotrimoxazole, fosfomycin.
KIDNEY FAILURE means that the kidneys is unable to remove waste products from the blood. The kidneys have not stopped working and making urine. Early clinical signs are increased thirst and urination. Advanced kidney failure cause uraemia and signs include loss of appetite,vomiting, diarrhoea, very bad breath and ulcers in the mouth.
A high blood urea nitrogen (BUN) and creatinine levels mean kidney failure.
TREATMENT
Thin lethargic, dehydrated.
In patient 2 days.
1. Diuresis. At least 200 ml of sucutaneous fluids twic a day are given to "flush out" the kidneys. The flushing process is called diuresis is used to stimulate the kidney cells to function again. If enough kidney cells are functional, diuresis "restart" the kidneys. Replacement of various electrolytes esp. potassium must be done. Proper low protein nutrition and drugs to control vomiting and diarrhoa.
2. A low protein diet to decrese the work load on the kidneys.
3. A phosphate binder to prevent phosphorous accumulating in the blood.
4. Fluids subcutaeously given at home. Not done in this case..
5. A drug to regulate the parathyroid gland and calcium levels.
6. A drug to stimulate the bone marrow to produce new red blood cells if the cat is anaemic.
Baytril and drips.
MAR 24, 2015 FOLLOW UP - (7 DAYS AFTER CONSULTATION AT TOA PAYOH VETS).
1. No more blood in the urine since my treatment on Mar 17, 2015 (10 days after treatment by first vet).
2. Cat needs to be hand fed.
3. Cat does not poop.
Admitted: Wt 3.5 kg. Lost 600g since 7 days ago as the cat did not eat.
Temp 35.1 C compared to 36.7C 7 days ago. Severe dehydration. R lip commissure abscess, R gum ulcers behind R U canine tooth, central tongue ulcer. Rehydrate. Check FIV, FeLV but these were negative. Poor prognosis.
Need to order only Royal Canin Dry Food for kidneys (no pork). The Royal Canin canned food and the Science diet K/D can and dry has pork.
4 cats in the household. This cat was the new introduction but had been with the other 3 cats for 15 months.
CAUSE OF FLUTD
The vet had diagnosed FLUTD (Feline Lower Urinary Tract Infection). However, the vet's blood tests showed septicaemia and kidney infections. This means that this cat has a much more serious illness than the ordinary FLUTD cases where, after relieving the bladder obstruction through catherisation, the cat bounces back and starts eating.
The owner had changed Fancy Feast to Pro Nature dry food 3-4 days before the bladder obstruction. There was no Fancy Feast available. A change of diet suddenly may cause FLUTD leading to bladder obstruction. The other 3 cats were not affected. The husband could not recall till I asked him to recall and he confirmed that there was a change of brand of dry cat food. The vet had recorded this in his case sheet.
With kidney pain, the cat cannot walk normally. I felt an enlarged kidney but no pain. This is because the vet had prescribed oral Tramadol for the last 2 days.
Urine test showed bacterial infection of the bladder. After 2 days of inpatient treatment with drips and medication, the kidneys have reduced in size by 50%. The cat can sit up and ate a bit of the other vet's prescribed diet for struvites. He could sit up and meowed.
The owner confined him at home, away from the other 3 cats and hand feed 6X/day, mixing Fancy Feast with prescribed Royal Canin Renal diet. Water is available freely.
FOLLOW UP ON APRIL 23, 2015
The cat is back to normal health and eating Royal Canine Renal Diet. The Science Diet K/D contains pork and so cannot be given on religious grounds.
FOLLOW UP ON MAY 12, 2015
The cat was back to normal. The daughter brought him in for neutering. "I thought your father likes him as a non-neutered cat as he responds to his attention," I said. She wanted him neutered to prevent any pregancies. So, he was neutered. His kidneys were no longer painful. I presumed he had recovered. No blood or urine tests were done to save on medical costs.
The cat was back to normal. The daughter brought him in for neutering. "I thought your father likes him as a non-neutered cat as he responds to his attention," I said. She wanted him neutered to prevent any pregancies. So, he was neutered. His kidneys were no longer painful. I presumed he had recovered. No blood or urine tests were done to save on medical costs.
Tuesday, March 10, 2015
1137. The dwarf hamster led an active life after surgery
March 10, 2015.
An early phone call from the worried lady. "There is a big hole under my hamster's right armpit," she announced. "Should I see you at the Clinic?"
The dwarf hamster had a big SC lump excised by Dr Daniel 5 days ago. The hamster climbed up and down 4 levels, a luxurious type of housing. The stitch broke down and now, I advised secondary healing. No point re-stitching.
An early phone call from the worried lady. "There is a big hole under my hamster's right armpit," she announced. "Should I see you at the Clinic?"
The dwarf hamster had a big SC lump excised by Dr Daniel 5 days ago. The hamster climbed up and down 4 levels, a luxurious type of housing. The stitch broke down and now, I advised secondary healing. No point re-stitching.
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