A 13-year-old Silkie has sticky right eye discharge everyday for several months.
"Dr
E prescribed eye drops and eye ointment and they were effective for
some time," the wife took out the bottles from the plastic bag and put
on my consultation table. "After a while, they don't work and I went to
the pet shop to buy the eye drops. I don't want the same eye medication
from you."
17. How to take care of your old dog's eye (Video)
Surprisingly,
the left eye cornea was as clear as a crystal but the right eye cornea
was scarred with brown dots of pigments covering 80% of the surface. The
eye white was reddish as compared to the normal white of the left eye.
"Has the dog been rubbing his right eye with his right hind leg daily?" I asked.
"Yes, yes," the husband said.
I applied fluorescein eye drops onto the cornea (video) and there was no ulcerations as there was no green stain.
"The
brown pigments on the right eye cornea are caused by long-time
scratching and now is scarred," I said. "There is no chance of reverting
to the clear cornea. Now, we need to prevent the 20% of the cornea from
becoming covered up with brown pigmentation."
"The
possible causes could be the right ear pain as the dog wanted to snap at
me when I palpated the ear. Another cause could be tooth ache as the
roots of the back upper teeth are exposed and the teeth are cemened with
thick tartar," I explained to the owners.
Sedation 5 kg, 13-year-old Silkie: Domitor + Ketamine 0.05 + 0.05 ml IV
Ear irrigation
Eye irrigation with 3rd eyelid everted to flush out debri
Optomimmune and eye drops. E-collar.
Inj. antibiotic and anti-inflam.
E-collar for 2 months.
To review in 3 weeks and dental scaling.
CONCLUSION
Allergy
to commercial ear drops, vigorous overcleaning of the right ear and
periodontal diseases can cause ear scratching with collateral damage to
the right eye in this case. Early dental scaling would have been
preferred.
Tuesday, May 19, 2015
2157. The old German Shepherd is scratching furiously
Monday, March 18, 2015
After 2 days of scratching from nose to paws, the owner phoned me for help. The 2nd sister had given this dog a piece of chicken on Mother's Day and now the dog keeps scratching her body.
She was fed only meat and rice nowadays and was all right. If fed commercial dog food, she would have diarrhoea and itchy body.
This old German Shepherd has bad hips and could not stand up if the carprofen injection under the skin is not given every 2 weekly. She got this injection from another vet every 2 weeks, not wanting to bother me. Lately she had her cataract operation on one eye first. As the surgeon had been on medical leave, after operating on 150 cases in one day, she saw her relief surgeon. She was a popular in great demand surgeon and had to take leave. So she packed the previous day's cases to the next day, totalling 150 cataract operations.
The relief surgeon read her medical notes and said: "It is lucky that you had opted for the mono-foal lens instead of the multi-focal as you have scars in your retina."
However, the surgeon had actually recommended multi-focal lens and she had accepted this advice. In multi-focal lens, you don't need reading spectacles. However, 3 days before the surgery, we went to my family optician, an experienced man in his 50s. He said: "Some of the people having multi-focal lens suffered side effects of seeing flashing lights and get depressed. There is no cure for this. Taking out the multi-focal lens and replacing a mono-focal is not that easy as in the first implant. With mono-focal, you need to have prescription lenses to read but you don't have these flashing lights."
So, this owner was very unhappy with the surgeon.
After 2 days of scratching from nose to paws, the owner phoned me for help. The 2nd sister had given this dog a piece of chicken on Mother's Day and now the dog keeps scratching her body.
She was fed only meat and rice nowadays and was all right. If fed commercial dog food, she would have diarrhoea and itchy body.
This old German Shepherd has bad hips and could not stand up if the carprofen injection under the skin is not given every 2 weekly. She got this injection from another vet every 2 weeks, not wanting to bother me. Lately she had her cataract operation on one eye first. As the surgeon had been on medical leave, after operating on 150 cases in one day, she saw her relief surgeon. She was a popular in great demand surgeon and had to take leave. So she packed the previous day's cases to the next day, totalling 150 cataract operations.
The relief surgeon read her medical notes and said: "It is lucky that you had opted for the mono-foal lens instead of the multi-focal as you have scars in your retina."
However, the surgeon had actually recommended multi-focal lens and she had accepted this advice. In multi-focal lens, you don't need reading spectacles. However, 3 days before the surgery, we went to my family optician, an experienced man in his 50s. He said: "Some of the people having multi-focal lens suffered side effects of seeing flashing lights and get depressed. There is no cure for this. Taking out the multi-focal lens and replacing a mono-focal is not that easy as in the first implant. With mono-focal, you need to have prescription lenses to read but you don't have these flashing lights."
So, this owner was very unhappy with the surgeon.
Sunday, May 17, 2015
2156. Third opinion. The stench of covered armpit wounds in a 16-year-old dog
Sunday May 17, 2015
The 16-year-old Maltese was afraid of me examining the wound, despite being given Tramadol painkiller tablets by Vet 2, 4 days ago. I was unwrapping the elastoplast and yellow wrap around self-adhering bandages covering the long left armpit wound. As I unrolled the bandage, the smell of rotting flesh permeated the consultation room.
"Vet 2 had given an antibiotic injection guaranteed to last 2 weeks," the young lady owner said. "So, he only prescribed the Tramadol, 1/2 tablet 2 times a day."
"Was Tramadol effective?" I asked.
"Yes," she confirmed that the dog was walking around when given the medication.
The dark greenish stained gauze under the bandage gave off an offensive odour of dead meat. I tried to control my breath. It is an odour of decomposed egg few Singaporeans will ever smell. It glued onto my fingers and needed several hand shampoos to get rid of the smell.
Vet 1 had prescribed some antibiotics and cleanser but this did not work. The dog's armpit got infected. So Vet 2 bandaged the leg from the wrist upward and adduct the armpit closer to the body with Elastoplast. The owner must return every 3 days to get the bandage changed. The owner sought me as the 3rd opinion.
The dog was practically screaming when I slowly unwrapped the bandage. He had a high tolerance to pain and had taken half a tablet of a 50-mg Tramadol.
"There's no choice but to sedate him to clean up the bad smelly armpit wound," I told the owners. "When a wound is covered up, it becomes smelly as a different type of bacteria thrives and grow in the flesh. It is highly risky as he may die. I will give a very low dose."
I can understand that Vet 1 and Vet 2 do not want to take risk in anaesthesizing this old dog to stitch up the wound. It is a thankless option if the dog dies. Some owners just blame the vets when the dog dies, implying negligence and incompetence.
I gave Domitor and Ketamine at 10% of the normal dosage IV. The dog slept for less than 10 minutes and the armpit wound was flushed and irrigated. The dog was shampooed. I applied KMnO4 powder, injected antibiotics and inflammatory and the dog was sent home.
The 16-year-old Maltese was afraid of me examining the wound, despite being given Tramadol painkiller tablets by Vet 2, 4 days ago. I was unwrapping the elastoplast and yellow wrap around self-adhering bandages covering the long left armpit wound. As I unrolled the bandage, the smell of rotting flesh permeated the consultation room.
"Vet 2 had given an antibiotic injection guaranteed to last 2 weeks," the young lady owner said. "So, he only prescribed the Tramadol, 1/2 tablet 2 times a day."
"Was Tramadol effective?" I asked.
"Yes," she confirmed that the dog was walking around when given the medication.
The dark greenish stained gauze under the bandage gave off an offensive odour of dead meat. I tried to control my breath. It is an odour of decomposed egg few Singaporeans will ever smell. It glued onto my fingers and needed several hand shampoos to get rid of the smell.
Vet 1 had prescribed some antibiotics and cleanser but this did not work. The dog's armpit got infected. So Vet 2 bandaged the leg from the wrist upward and adduct the armpit closer to the body with Elastoplast. The owner must return every 3 days to get the bandage changed. The owner sought me as the 3rd opinion.
The dog was practically screaming when I slowly unwrapped the bandage. He had a high tolerance to pain and had taken half a tablet of a 50-mg Tramadol.
"There's no choice but to sedate him to clean up the bad smelly armpit wound," I told the owners. "When a wound is covered up, it becomes smelly as a different type of bacteria thrives and grow in the flesh. It is highly risky as he may die. I will give a very low dose."
I can understand that Vet 1 and Vet 2 do not want to take risk in anaesthesizing this old dog to stitch up the wound. It is a thankless option if the dog dies. Some owners just blame the vets when the dog dies, implying negligence and incompetence.
I gave Domitor and Ketamine at 10% of the normal dosage IV. The dog slept for less than 10 minutes and the armpit wound was flushed and irrigated. The dog was shampooed. I applied KMnO4 powder, injected antibiotics and inflammatory and the dog was sent home.
2155. Ozone-oil treatment for all types of illnesses?
Saturday May16, 2015
I had breakfast on this sunny blue-sky Saturday morning with a senior vet. There was a Caucasian vet who came to Singapore to buy veterinary practices and I advised him to sell his practice. "The general offer is 3 times the annual revenue, subject to negotiations," I had read about this in some financial books and this Caucasian vet had also mentioned this formula to me.
This senior vet has a new product - an ozone-oil said to be very good for coughs, diarrhoea, skin wounds and many illnesses. In one case, the puppies with diarrhoea recovered after being given this product. "However, the breeder did not get the same outcome when the puppies had diarrhoea again," he laughed. His hypothesis is that antibiotics are specific for some types of bacteria like gram +positive only. But his ozone-oil, like the freshness of the air around sea waves, kills all bacteria, yeasts, viruses and other pathogens.
I had no comments. "If your product can heal wounds within 2 days, you have a big market with the construction workers," I said. "They suffer from cuts at work and coughing from hard work. Your product will say like hot cakes."
I had breakfast on this sunny blue-sky Saturday morning with a senior vet. There was a Caucasian vet who came to Singapore to buy veterinary practices and I advised him to sell his practice. "The general offer is 3 times the annual revenue, subject to negotiations," I had read about this in some financial books and this Caucasian vet had also mentioned this formula to me.
This senior vet has a new product - an ozone-oil said to be very good for coughs, diarrhoea, skin wounds and many illnesses. In one case, the puppies with diarrhoea recovered after being given this product. "However, the breeder did not get the same outcome when the puppies had diarrhoea again," he laughed. His hypothesis is that antibiotics are specific for some types of bacteria like gram +positive only. But his ozone-oil, like the freshness of the air around sea waves, kills all bacteria, yeasts, viruses and other pathogens.
I had no comments. "If your product can heal wounds within 2 days, you have a big market with the construction workers," I said. "They suffer from cuts at work and coughing from hard work. Your product will say like hot cakes."
2154. The Schnauzer's groomer is more important than the vet
Saturday Mar 16, 2015
Today was a busy Saturday. Dr Daniel had gone to Bangkok for a seminar and I was the only vet seeing cases. I was surprised to see this 10-year-old Miniature Schnauzer as the owner had not bothered to bring him for an annual vaccination and check up. The dog goes to the groomer every 2 monthly or so.
The dog was itchy and kept scratching his ears and body. So, the mistress came to see me. "He bites and will not be muzzled," she said. "He was whining in the car as I drove nearer to your clinic. Whenever he bites he paws, I will say 'Dr Sing' and he would stop. However, he would still bite his paws when I am not around."
I had seen this dog as a puppy and had seen him for the first 6 years at least once. As the mistress got promoted, she had to travel a lot for meetings in Germany and so she did not spend any time to bring the dog in for his annual check up or vaccination. The groomer's appointments were kept. Many owners doctor hop and so it was most surprising when I saw her after 4 years.
Health screening or wellness care once a year including physical examination, blood and urine tests and dental check ups will detect any diseases early so that the dog can live longer.
Case 2.
A young lady who returned home from overseas phoned to say her Cocker Spaniel had fits suddenly. She booked dog transport and came to see me. "Rotten teeth and painful ear infections can cause fits," I said to her. The dog was 12 years old and the teeth were all black. In some cases, just removing the painful decaying teeth would have improved the health of the older dog. But many owners in Singapore just do not have time or inclination to send the dog for dental check up at the vet. Some dog groomers provide such a service and so, the groomer is more important than the vet. Till the dog has serious illness and in this case, the vet is needed!
Today was a busy Saturday. Dr Daniel had gone to Bangkok for a seminar and I was the only vet seeing cases. I was surprised to see this 10-year-old Miniature Schnauzer as the owner had not bothered to bring him for an annual vaccination and check up. The dog goes to the groomer every 2 monthly or so.
The dog was itchy and kept scratching his ears and body. So, the mistress came to see me. "He bites and will not be muzzled," she said. "He was whining in the car as I drove nearer to your clinic. Whenever he bites he paws, I will say 'Dr Sing' and he would stop. However, he would still bite his paws when I am not around."
I had seen this dog as a puppy and had seen him for the first 6 years at least once. As the mistress got promoted, she had to travel a lot for meetings in Germany and so she did not spend any time to bring the dog in for his annual check up or vaccination. The groomer's appointments were kept. Many owners doctor hop and so it was most surprising when I saw her after 4 years.
Health screening or wellness care once a year including physical examination, blood and urine tests and dental check ups will detect any diseases early so that the dog can live longer.
Case 2.
A young lady who returned home from overseas phoned to say her Cocker Spaniel had fits suddenly. She booked dog transport and came to see me. "Rotten teeth and painful ear infections can cause fits," I said to her. The dog was 12 years old and the teeth were all black. In some cases, just removing the painful decaying teeth would have improved the health of the older dog. But many owners in Singapore just do not have time or inclination to send the dog for dental check up at the vet. Some dog groomers provide such a service and so, the groomer is more important than the vet. Till the dog has serious illness and in this case, the vet is needed!
2153. How your dog can live longer - Recurring kidney stones in a 12-year-old poodle
Kidney stones do occur in dogs. In this 10-year-old poodle, they were small specks of kidney stones seen in the X-rays in 2013. I had removed the bladder stones and had advised that the minor struvite kidney stones could be dissolved with prescription S/D diet over 1-3 months. Regular urine tests, blood tests and X-rays needed to be done to ensure that the stones had been completely eliminated.
However, the owners did not return for follow ups over the next two years. Nor did they come for annual check ups. They fed brown rice and minced beef mainly.
In 2015, they came as the poodle was passing blood in the urine. She had extremely painful kidneys and the left kidney stones had become gigantic as can be seen in the 2015 X-rays.
Blood test indicated kidney failure. The dog could have lived longer if she had been fed the S/D diet till the stones dissolved from 1-3 months.
This poodle was euthanased. I hope thiscase study may save lives of dogs in a similar situation with small specks of struvite kidney stones. Struvites can be dissolved by dietary management. Regular monitoring over the year is necessary.
Friday, May 15, 2015
2152. A good mother brings a child's hamster for treatment. A good father could have bought a tankful of terrapins
May 15, 2015
The storm clouds were gathering. I was teaching my intern Sue how to take care of the vertical ear canal ablation Schnauzer in-patient for 3 days. Yesterday, I had sedated the dog and Naing had cleaned up the blood clots. There was some bleeding (see video) and I made a video on how to do the nursing part.
At around 10 am, a mother came in with a dwarf hamster. He has a left swollen eyelid just like the other hamster with ear warts. She had texted me and emailed me for an appointment. This is her child's beloved pet and she took the trouble to contact me and come early.
I was also treating a terrapin that had closed and swollen eyes for over 7 weeks. "With the money I spent on vet fees," the father said. "I could have bought a tank full of terrapins!"
He was a dynamic man in his 30s sending out strong vibes as I asked him about executive condos and HDB apartments for sale. He had brought the terrapin to see Dr Daniel 3 weeks ago but was unable to medicate the terrapin.
Well, at $5.00 per hatchling, he could have bought 50 terrapins and discard this sick emaciated one weighing 16 g now. Definitely a tankful. But I don't think his son has the same point of view as the father.
ISOFLURANE + O2 ANAESTHESIA
5% for around 45 seconds. Hamster had an upper eyelid abscess of the right eye and gigantic lower eyelid abscess of the left eye (video). Quick lancing, drainage with cotton bud tip and finger expression, lavage incised wound with water within 20 seconds as the hamster wakes up.
My intern decided to adjust the operation light at the ending of the operation which made me quite mad as the video could not be completed entirely. While her hands were adjusting the operating lights, she could not film and by the time she could film, I had completed my operation.
Many young people do not comply with instructions.
A good mother brings a child's hamster for treatment without bean-counting.
A good father could have bought a tankful of terrapins if not for his son's love for the sick terrapin.
The storm clouds were gathering. I was teaching my intern Sue how to take care of the vertical ear canal ablation Schnauzer in-patient for 3 days. Yesterday, I had sedated the dog and Naing had cleaned up the blood clots. There was some bleeding (see video) and I made a video on how to do the nursing part.
At around 10 am, a mother came in with a dwarf hamster. He has a left swollen eyelid just like the other hamster with ear warts. She had texted me and emailed me for an appointment. This is her child's beloved pet and she took the trouble to contact me and come early.
I was also treating a terrapin that had closed and swollen eyes for over 7 weeks. "With the money I spent on vet fees," the father said. "I could have bought a tank full of terrapins!"
He was a dynamic man in his 30s sending out strong vibes as I asked him about executive condos and HDB apartments for sale. He had brought the terrapin to see Dr Daniel 3 weeks ago but was unable to medicate the terrapin.
Well, at $5.00 per hatchling, he could have bought 50 terrapins and discard this sick emaciated one weighing 16 g now. Definitely a tankful. But I don't think his son has the same point of view as the father.
ISOFLURANE + O2 ANAESTHESIA
5% for around 45 seconds. Hamster had an upper eyelid abscess of the right eye and gigantic lower eyelid abscess of the left eye (video). Quick lancing, drainage with cotton bud tip and finger expression, lavage incised wound with water within 20 seconds as the hamster wakes up.
My intern decided to adjust the operation light at the ending of the operation which made me quite mad as the video could not be completed entirely. While her hands were adjusting the operating lights, she could not film and by the time she could film, I had completed my operation.
Many young people do not comply with instructions.
A good mother brings a child's hamster for treatment without bean-counting.
A good father could have bought a tankful of terrapins if not for his son's love for the sick terrapin.
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