April 22, 2015
"Your cat has a very low platelet count and liver disorder," I showed the blood test report to the very busy bearded husband who shook my hand as he arrived at 7.25pm to take back his cat.
I know he is very busy. He works in the car parking software field which demands all his waking hours of his life as the various car parks seems to have much bugs, needing his help to resolve the problems. "Your cat has been toxic. He also has pale gums but is now pinker. Did he drink toilet water?"
I had given the cat at least 200 ml of electrolytes, amino acids and antibiotics and the cat meowed when he saw the owner.
"Some cats love to drink from the water splashed or drippinig onto the bathroom floor," I said. The man reflected and thought that this cat could have lapped toilet water.
"I have 6 cats," he said. "The other 5 have no problems."
"It all depends on how much poison the cat drinks and for how long. Why do you have 6 cats? I thought you have only one?"
"The female becomes pregnant and it is against my religion to get an abortion," the husband explained. Fortunately, my relatives have booked a kitten from my latest pregnant cat!"
"Why don't you give some of the 6 cats away?"
"No, no," he replied. "We love them."
I can't understand why he did not neuter or spay the 6 cats. Now one is pregnant again.
Thursday, April 23, 2015
Wednesday, April 22, 2015
1177. An 8-year-old Shih Tzu has an arched back
April 21, 2015
"I better have him checked as she had been having an arched back during the past 2 days," the fair tall lady in her 30s, wearing a contrasting dark blue dress showed me a video clip of her dog walking with a "camel's bump".
"He would go to the bathroom and lie down there," she noted this unusual behaviour.
"Did he have difficulty in peeing?" I asked as house-trained dogs go to the bathroom to avoid peeing onto the apartment.
"No problem."
I palpated the dog's abdomen twice. During the first time, he winced slightly when I palpated the kidneys but the spinal column palpation showed no pain. I got the dog onto the floor to walk. He was walking normally with no hunched back.
"My dog will recover whenever he is at the vet," the lady laughed. Yet there was something wrong with him.
On the second palpation after the walking, I had my assistant do a video. This time, the dog reacted when I pressed the thoracic-lumber spinal column. There was some degeneration or pain in the spinal disc and that was why the dog hunched his back the last 2 days.
"The problem is with his disc at this T/L junction," I said. "He feels the pain and so does not walk to walk much. He walked with a hunched back and went to the bathroom to lie down. In case he needed to pee, he did not need to walk far." This was my hypothesis.
VIDEO
In Singapore, many young pet owners are well educated and do research. They use the smart phone to video unusual behaviours or clinical problems. For this lady, she would not permit me to do dental scaling since I use anaesthesia. "My groomer will do the dental work," she was afraid that her dog could die from anaesthesia.
Some dog groomers now provide dental scaling without anaesthesia and this is what some owners are interested.
"I better have him checked as she had been having an arched back during the past 2 days," the fair tall lady in her 30s, wearing a contrasting dark blue dress showed me a video clip of her dog walking with a "camel's bump".
"He would go to the bathroom and lie down there," she noted this unusual behaviour.
"Did he have difficulty in peeing?" I asked as house-trained dogs go to the bathroom to avoid peeing onto the apartment.
"No problem."
I palpated the dog's abdomen twice. During the first time, he winced slightly when I palpated the kidneys but the spinal column palpation showed no pain. I got the dog onto the floor to walk. He was walking normally with no hunched back.
"My dog will recover whenever he is at the vet," the lady laughed. Yet there was something wrong with him.
On the second palpation after the walking, I had my assistant do a video. This time, the dog reacted when I pressed the thoracic-lumber spinal column. There was some degeneration or pain in the spinal disc and that was why the dog hunched his back the last 2 days.
"The problem is with his disc at this T/L junction," I said. "He feels the pain and so does not walk to walk much. He walked with a hunched back and went to the bathroom to lie down. In case he needed to pee, he did not need to walk far." This was my hypothesis.
VIDEO
In Singapore, many young pet owners are well educated and do research. They use the smart phone to video unusual behaviours or clinical problems. For this lady, she would not permit me to do dental scaling since I use anaesthesia. "My groomer will do the dental work," she was afraid that her dog could die from anaesthesia.
Some dog groomers now provide dental scaling without anaesthesia and this is what some owners are interested.
Tuesday, April 21, 2015
1176. When parents separate, what happens to the ferocious cat?
The young lady phoned me. She was worried that the nervous stray cat, now housed indoors would be thrown out and left to fend for herself. "My parents are separating next week," she said. "I would not want my cat to suffer from attacks, starvation and diseases but I can't catch the cat."
When parents separate, there is a lot of damage. I recommended her a cat trapper.
When parents separate, there is a lot of damage. I recommended her a cat trapper.
1175. A Chihuahua vomits blood after going to the park
"Heat stress" was diagnosed as the 5-year-old black and white Chihuahua vomited blood and panted after half an hour at the park.
Blood test showed elevated liver enzymes. "The dog had been panting since young," the owner said. "He is fat."
Could this case be a case of fatty liver?
Blood test showed elevated liver enzymes. "The dog had been panting since young," the owner said. "He is fat."
Could this case be a case of fatty liver?
1174. A 5-year-old Chihuahua has a ruptured uterus
This Chihuahua passes pus in the vagina. Blood test showed neutrophils at 92.8% (normal 60-70%) and platelets very low indicating toxaemia. After treating for 2 days as an in-patient, the dog had to be spayed to remove the pus-filled womb.
The ruptured womb was seen only during the surgery. There was a large inflamed spot adhered to the intestines. This was separated. The dog passed away 5 hours after recovery from anaesthesia.
The dog was a high anaesthetic risk in view of the very low platelet count. She passed away 5 hours post-op and this was very sad.
The ruptured womb was seen only during the surgery. There was a large inflamed spot adhered to the intestines. This was separated. The dog passed away 5 hours after recovery from anaesthesia.
The dog was a high anaesthetic risk in view of the very low platelet count. She passed away 5 hours post-op and this was very sad.
Sunday, April 19, 2015
*A Shih Tzu keeps having eye discharge
Sunday Apr 19, 2015
"His left eye keeps discharging thick pus daily" the lady had consulted a vet 2 weeks ago. The vet prescribed eye gel and eye drops and advised normal saline eye wash daily. "She said the dog's eye would recover soon."
"Did the vet really guarantee that?" I asked.
"If not," she replied. "I should go back to her again. But I am not doing that!"
"When was the left eye injured?"
"About 2 to 3 months ago." she was not sure of the exact date. She had been treating the eye injury with eye drops herself but the eye got worse.
"Shih Tzus have protruding eye balls," I said. "The eyes get injured easily, becomes ulcerated and scarred. Eye injuries are emergencies. Treatment by the vet should be done within 24 hours to prevent scratching of the eyes. Did the vet advise an Elizabeth collar to wear?"
"No," she said.
"The left eye cornea is dull compared to the right eye," the owner noted the scarring.
Dr Daniel sedated the dog, got the hairs around the face and ears clipped off so that the eyes do not get loose hair irritations. The eyes were irrigated with saline. The 3rd eyelid was elevated to flush out any hairs and debri. I gave a subconjuctival injection of antibiotic and anti-inflammatory. The dog went home with eye drops and a dry eye ointment as well as e-collar. He will have to stay away from the wind and sun and wear the E-collar 24 hours daily for 2 months. There was no deep corneal ulceration based on fluorescein stain test.
I cannot guarantee normal tear production as the owner had delayed seeking vet treatment for 2-3 months. It is hard to predict the outcome as to whether the eye will recover fully. To follow up in a month's time.
A Shih Tzu's eyes are most easily injured. Treatment within 24 hours by your vet is important to save the eyesight.
"His left eye keeps discharging thick pus daily" the lady had consulted a vet 2 weeks ago. The vet prescribed eye gel and eye drops and advised normal saline eye wash daily. "She said the dog's eye would recover soon."
"Did the vet really guarantee that?" I asked.
"If not," she replied. "I should go back to her again. But I am not doing that!"
"When was the left eye injured?"
"About 2 to 3 months ago." she was not sure of the exact date. She had been treating the eye injury with eye drops herself but the eye got worse.
"Shih Tzus have protruding eye balls," I said. "The eyes get injured easily, becomes ulcerated and scarred. Eye injuries are emergencies. Treatment by the vet should be done within 24 hours to prevent scratching of the eyes. Did the vet advise an Elizabeth collar to wear?"
"No," she said.
"The left eye cornea is dull compared to the right eye," the owner noted the scarring.
Dr Daniel sedated the dog, got the hairs around the face and ears clipped off so that the eyes do not get loose hair irritations. The eyes were irrigated with saline. The 3rd eyelid was elevated to flush out any hairs and debri. I gave a subconjuctival injection of antibiotic and anti-inflammatory. The dog went home with eye drops and a dry eye ointment as well as e-collar. He will have to stay away from the wind and sun and wear the E-collar 24 hours daily for 2 months. There was no deep corneal ulceration based on fluorescein stain test.
I cannot guarantee normal tear production as the owner had delayed seeking vet treatment for 2-3 months. It is hard to predict the outcome as to whether the eye will recover fully. To follow up in a month's time.
A Shih Tzu's eyes are most easily injured. Treatment within 24 hours by your vet is important to save the eyesight.
Saturday, April 18, 2015
1172. A rare case - A cat has jet black anal sac oil
Sat April 18, 2015 11 am
"The ferocious cat will never be injected or examined," I said to the mother and daughter who tried to coax the cat out of the carrier. The cat hissed warnings but they ignored her.
"Once out of the carrier," I advised. "The cat will bolt and be even angrier!."
"This is a country pumpkin cat," the adult daughter said. "She has never gone out of the apartment." Her brother who loves this cat very much was at work selling outdoor exercise equipment. The whole family loves this angry cat.
It was 2 years ago that she was spayed and I did not see her again for the annual vaccination last year. "Too busy," the working daughter said. But in the past 3 months, the cat was losing hair on both flanks.
"It is just not possible to examine her as she will scratch anyone approaching the carrier," I advised giving the cat isoflurane gas and oxygen anaesthesia. This was done and the cat was examined. Hair loss of 50% on both flanks due to licking.
A case of bilateral endocrine alopecia since she was spayed by me 2 years ago? Flea bite dermatitis earlier as there was no signs of fleas. A case of anal sacculitis which is rare in cats.
As the cat was sleeping, I pressed the anal sacs. Jet black oil oozed out in copious amounts (see video). More dried grey granular oil ssquirrelled out from one sac and the owners could see the oil.
"The normal oil is light yellow, like cooking oil," I said. "Your cat's black anal sac oil is rarely encountered. One in 1000 cats possibly. The cat could feel the itchiness in the anal sacs and alleviated her itchiness by licking the flanks.
The oil was expressed.
"Her stools may be too soft and so, the anal sac oil could not be discharged," I asked whether the owners had seen the stools.
"No," the daughter said. "The maid cleared up the stools."
This was a beloved cat who would growl and hissed at family members too. So the mum clipped her claws two at a time when the cat was sleeping.
This cat came for a check up for the hair loss early. I noted in my record that the anal sacs were OK 2 years ago. So, this problem of anal sac impaction happened in the last 2 years.
Jet black anal sac oil is very rarely seen in cats and so this will be considered a rare case.
"The ferocious cat will never be injected or examined," I said to the mother and daughter who tried to coax the cat out of the carrier. The cat hissed warnings but they ignored her.
"Once out of the carrier," I advised. "The cat will bolt and be even angrier!."
"This is a country pumpkin cat," the adult daughter said. "She has never gone out of the apartment." Her brother who loves this cat very much was at work selling outdoor exercise equipment. The whole family loves this angry cat.
It was 2 years ago that she was spayed and I did not see her again for the annual vaccination last year. "Too busy," the working daughter said. But in the past 3 months, the cat was losing hair on both flanks.
"It is just not possible to examine her as she will scratch anyone approaching the carrier," I advised giving the cat isoflurane gas and oxygen anaesthesia. This was done and the cat was examined. Hair loss of 50% on both flanks due to licking.
A case of bilateral endocrine alopecia since she was spayed by me 2 years ago? Flea bite dermatitis earlier as there was no signs of fleas. A case of anal sacculitis which is rare in cats.
As the cat was sleeping, I pressed the anal sacs. Jet black oil oozed out in copious amounts (see video). More dried grey granular oil ssquirrelled out from one sac and the owners could see the oil.
"The normal oil is light yellow, like cooking oil," I said. "Your cat's black anal sac oil is rarely encountered. One in 1000 cats possibly. The cat could feel the itchiness in the anal sacs and alleviated her itchiness by licking the flanks.
The oil was expressed.
"Her stools may be too soft and so, the anal sac oil could not be discharged," I asked whether the owners had seen the stools.
"No," the daughter said. "The maid cleared up the stools."
This was a beloved cat who would growl and hissed at family members too. So the mum clipped her claws two at a time when the cat was sleeping.
This cat came for a check up for the hair loss early. I noted in my record that the anal sacs were OK 2 years ago. So, this problem of anal sac impaction happened in the last 2 years.
Jet black anal sac oil is very rarely seen in cats and so this will be considered a rare case.
Thursday, April 16, 2015
Spondylosis L2-L3. A 12-year-old Shih Tzu has arched back
"My dog has more muscular front legs than the back," the owner said. "The back leg muscles are withered and my dog could not walk properly. The owner wondered why the dog had very weak back legs and an arched back. I noted that she made the dog wear diapers too.
"The arched back is due to pain behind the rib cage," I said. This was a case of spondylosis deformans, a chronic disease of degenerated intervertebral discs. In this disease, the joints between the vertebral bones become unstable as the intervertebral discs become abnormal and unable to act as cushions to absorb shocks when the dog jumps.
Bony spurs called osteophytes form on the sides of the vertebral bone, as can be seen in this dog's X-rays.
"Blood test showed high total white cell count and neutrophils, indicating a bacterial infection of the blood," I explained to her the blood test results. The dog had skin diseases which would have had led to such infections.
TREATMENT
1. None if there is no pain.
2. In this dog, there is some pain of arched back and wasting of the back leg muscles. Painkillers may be prescribed. Weight loss is not necessary as he is not fat. Physical therapy and exercise are not practical.
3. Surgery if the spinal cord is compressed. This will be costly.
REFERENCE: Spondylosis deformans
http://www.vcahospitals.com/main/pet-health-information/article/animal-health/spondylosis-deformans-in-dogs/2141
Wednesday, April 15, 2015
1170. Schwannoma in a 10-year-old Miniature Schnauzer
April 13, 2015
This male 11-year-old Miniature Schnauzer had a big grey skin lump, 1.3 cm x 0.8 cm x 0.7 cm on the skin of his toe. It could be a melanoma. Dr Daniel suggested excision and histology.
Histology
Benign peripheral nerve sheath tumour suggestive of schwannoma. No evidence of malignancy. Good news. Otherwise, the toe will need to be amputated.
VIDEO
MY OPINION
As the dog is old and the growth is greyish and growing "fast", the owner should be given an alternative surgery - excision of the digit (toe) in case the tumour is malignant as there is not sufficient margin to remove all tumours.
In this case, "some of the spindle cells ae seen to reach the deep resection margin focally" meaning that the whole schwannoma could not be excised fully. There is a possibility of recurrence and a need for toe amputation later. The owner was aware of this possibility.
This male 11-year-old Miniature Schnauzer had a big grey skin lump, 1.3 cm x 0.8 cm x 0.7 cm on the skin of his toe. It could be a melanoma. Dr Daniel suggested excision and histology.
Histology
Benign peripheral nerve sheath tumour suggestive of schwannoma. No evidence of malignancy. Good news. Otherwise, the toe will need to be amputated.
VIDEO
MY OPINION
As the dog is old and the growth is greyish and growing "fast", the owner should be given an alternative surgery - excision of the digit (toe) in case the tumour is malignant as there is not sufficient margin to remove all tumours.
In this case, "some of the spindle cells ae seen to reach the deep resection margin focally" meaning that the whole schwannoma could not be excised fully. There is a possibility of recurrence and a need for toe amputation later. The owner was aware of this possibility.
Tuesday, April 14, 2015
1169. Deep spreading pyoderma in a young female pug
Signs
Pustules on chin, nose and ears first --- chin acne or nasal pyoderma. Ear pustules.
Skin scraping - demodectic mites and dermatophytes ----- No demodecosis, dermatophytosis yes No bacterial culture and sensitivity done to lower costs
Spreading. Very itchy
Skin biopsy on collarettes when lesions get more - ruptured epidermal cysts --- pyogranulamatous processes
No fungal culture
No cytology
Ciprobay, ketoconizole, amitraz wash, atopica, pred at different times.
e-collar, booties for hind paws, pain relief.
Healing after more than 4 weeks of treatment
Folliculitis or impetigo?
Deep spreading pyoderma
Skin biopsy is important in this case. Report
-- ruptured epidermal cysts
VIDEO AS AT APRIL 12, 2015 MORE THAN 4 WEEKS OF TREATMENT OF THE DEEP SPREADING PYODERMA. Not fully recovered yet. Will the pustules and collarettes recur?
armpit left side - infection caused by left hind leg traumatic scraching ---foreign body material like plastic and hair keratin scratched into the dermis --- collarettes?
Still has 7 days of medication and on amitraz wash. Appears to be healing now. Owners are happy.
FLASH BACK
FIRST VISIT
PUSTULES AND COLLARETTES
APRIL 14, 2015
Always palpate and press the skin lump. It was painful as the pug reacted to palpation. I suspected an abscess. Histology report of skin lump from central sternal area - acute suppurative inflammation and abscess formation. Noevidence of malignancy.
Pustules on chin, nose and ears first --- chin acne or nasal pyoderma. Ear pustules.
Skin scraping - demodectic mites and dermatophytes ----- No demodecosis, dermatophytosis yes No bacterial culture and sensitivity done to lower costs
Spreading. Very itchy
Skin biopsy on collarettes when lesions get more - ruptured epidermal cysts --- pyogranulamatous processes
No fungal culture
No cytology
Ciprobay, ketoconizole, amitraz wash, atopica, pred at different times.
e-collar, booties for hind paws, pain relief.
Healing after more than 4 weeks of treatment
Folliculitis or impetigo?
Deep spreading pyoderma
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.
LOOKS VERY MUCH LIKE
COMPLEX DEEP PYODERMA - seborrheic conditions - follicular and sebaceous disease.
A skin biopsy showed ruptured epidermal cyst - pyogranulomatous inflammation.
A very difficult skin disease to treat with antibiotics in this pug as the pyoderma keeps spreading and the pug keeps scratching every day uncontrollably.
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.
LOOKS VERY MUCH LIKE
COMPLEX DEEP PYODERMA - seborrheic conditions - follicular and sebaceous disease.
A skin biopsy showed ruptured epidermal cyst - pyogranulomatous inflammation.
A very difficult skin disease to treat with antibiotics in this pug as the pyoderma keeps spreading and the pug keeps scratching every day uncontrollably.
Skin biopsy is important in this case. Report
-- ruptured epidermal cysts
VIDEO AS AT APRIL 12, 2015 MORE THAN 4 WEEKS OF TREATMENT OF THE DEEP SPREADING PYODERMA. Not fully recovered yet. Will the pustules and collarettes recur?
armpit left side - infection caused by left hind leg traumatic scraching ---foreign body material like plastic and hair keratin scratched into the dermis --- collarettes?
Still has 7 days of medication and on amitraz wash. Appears to be healing now. Owners are happy.
FLASH BACK
FIRST VISIT
PUSTULES AND COLLARETTES
APRIL 14, 2015
Always palpate and press the skin lump. It was painful as the pug reacted to palpation. I suspected an abscess. Histology report of skin lump from central sternal area - acute suppurative inflammation and abscess formation. Noevidence of malignancy.
Subscribe to:
Posts (Atom)