2170. Video production for a FLUTD cat in Singapore

draft for intern to produce a video

Recurring Feline Lower Urinary Tract Disease in a Cat in Singapore Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:  28 May, 2015 HOOK Dysuria, pollakiuria and haematuria Recurrence of above signs after a vet has successfully cured him. Why? (VIDEO FOOTAGE OF CONSULTATION TO TOA PAYOH VETS) TITLE THEME Feline Lower Urinary Tract Disease in a cat in Singapore's apartment INTRODUCTION Pollakiuria, Dysuria and Haematuria can be present in the Feline Lower Urinary Tract Disease cases as follows: 1. Feline Interstitial Cystitis 2. Urethral Obstruction 3. Bladder stones 4. Other conditions such as parathryoid hormones MIDDLE Case  5-year-old male neutered cat had recovered from FLUTD after treatment by Vet 1 three months ago but now, same clinical signs of dysuria and going to the litter box many times again.  "Did you see blood in the urine?" I asked the mother and adult son. "Can't see as he goes to the litter box to urinate!" she said. Diagnosis Physical exam.  Bladder pain and enlargement, bladder pain and size, genital area for uethral plug and inflammation Urine test. pH, SG, crystals, bacteria, red and white blood cells, protein Blood test    Urea & Creatine. Phosphorus and calcium. Leucocytosis. X-ray. Kidneys, bladder to urethral opening views Ultrasound Treatment Drip Pain control Antibiotics Catherisation Surgery - cystotomy and perineal urethrostomy Prompt treatment advised. Kidney failure or infections. Prompt veterinary treatment - stabilise and pain control with Diet  - wet food, good quality protein Environment - Litter boxes, water intake, multi-cat household, change of diet or environment, male neutered cat Follow up and regular urine tests at half-yearly are rarely done by the owner. In this cat, painkiller and antibiotics were given. No urine or blood test or X-rays of the bladder and kidneys to lower medical costs this time as Vet 1 had done the first 2 tests 3 months ago and hospitalised the cat for 5 days. There was no pain or swelling in the kidneys which were not palpable. No painful or swollen bladder. No inflamed genital area or swollen purplish penis. Therefore, I would not push for the tests now. Overall, this cat could pee but frequently and with difficulty. Blood in the urine could not be ascertained as the cat peed in the litter box. FOLLOW UP ON DAY 3 The owners were happy as the cat was now "not moody".  He was affectionate again and could pee with lesser difficulty. The mum had no complaints. Two litter boxes and separated sleeping rooms at night. This cat sleeps in mum's bedroom which has a bathroom where the litter box is. As for the new C/D diet, not eating. I advised slowly add 5% and hand feed. It will be successful if the owners persevere.  Ideally, it would be best to test the urine for struvite or oxalate crystals, but in real life, the costs need to be lowered as much as possible.     CONCLUSION Recurrence Diet - struvite or calcium oxalate? Look into Environmental Factors such as Stress.  One more litter box than number of cats in the household. Privacy quiet area. Bullying. USUALLY SEEN IN Male neutered cat High rise indoor living Dry cat food Multiple cat household (bullying, shares litter box, food and water bowls) --------------------------------------------------------------------------------------------------------------------------------------------- Setting Singapore - busy hectic city living for people Other cases A 7-year-old cat has bladder stone http://2010vets.blogspot.sg/2013/02/1303-bladder-stone-in-7-year-old-cat.html A 12-year-old cat in Turkey has bladders stones sinpets.com/F6/20130819bladder_stones_cat_Turkey.htm FLUTD in a male neutered cat http://2010vets.blogspot.sg/2013/07/1029-flutd-in-young-male-neutered-cat.html Case studies 1. A bladder stone cat followed up 79 days after surgery. No recurrence on C/D diet but no time for even one monitoring. 2. Urethral obstruction in a male neutered cat recurred 50 days later bekindtopets.com/stories/20130301cat_bladder_stones_toapayohvets.htm Prompt treatment of urethral obstruction means faster recovery this time- recurring FLUTD in a 3-year-old male cat. Feeding C/D only no recurrence. kongyuensing.com/folder5/20130116Recurring_FLUTD_cat_3years_toapayohvets.htm Cairo cat has stone-packed bladder http://2010vets.blogspot.sg/2014/12/email-from-cairo-cat-with-flutd-part-2.html Urethral obstruction cases http://www.asiahomes.com/singaporetpvet/0707cat_urolithiasis.htm Perineal urethrostomy as a final resort for recurrent urethral obstruction Feline Lower Urinary Tract Disease in Cats in Singapore Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:  28 May, 2015 2015 cases May 2015  Recurring dyshagia and pollakiuria in a 5-year-old male neutered cat http://2010vets.blogspot.sg/2015/05/video-production-for-flutd-in-cats-in.html May 2015. A young cat still has haematuria after discharge by Vet 1 http://2010vets.blogspot.sg/2015/03/1157-kidney-disease-flutd-cat-passes.html Painful kidneys http://2010vets.blogspot.sg/2015/05/an-old-cat-has-painful-kidneys.html -------------------------------------------------------------------- A cat has bladder stone http://2010vets.blogspot.sg/2013/02/1303-bladder-stone-in-7-year-old-cat.html A 12-year-old cat in Turkey has bladders stones sinpets.com/F6/20130819bladder_stones_cat_Turkey.htm   FLUTD in a male neutered cat http://2010vets.blogspot.sg/2013/07/1029-flutd-in-young-male-neutered-cat.html Case studies 1. A bladder stone cat followed up 79 days after surgery. No recurrence on C/D diet but no time for even one monitoring. 2. Urethral obstruction in a male neutered cat recurred 50 days later bekindtopets.com/stories/20130301cat_bladder_stones_toapayohvets.htm Prompt treatment of urethral obstruction means faster recovery this time- recurring FLUTD in a 3-year-old male cat. Feeding C/D only no recurrence. kongyuensing.com/folder5/20130116Recurring_FLUTD_cat_3years_toapayohvets.htm Cairo cat has stone-packed bladder http://2010vets.blogspot.sg/2014/12/email-from-cairo-cat-with-flutd-part-2.html Urethral obstruction cases http://www.asiahomes.com/singaporetpvet/0707cat_urolithiasis.htm   BE KIND TO OLDER DOGS & CATS --- GET TUMOURS REMOVED EARLY --- WHEN THEY ARE SMALLER.  More case studies, go to:  Cats  or  Dogs Make an appointment with your vet. Or tel 6254-3326, 9668-6469 for an appointment to discuss health screening for your senior companion. Or e-mail judy@toapayohvets.com your requirements.  Copyright © Asiahomes All rights reserved. Revised: May 28, 2015 Toa Payoh Vets

2169. Eye trauma in a young abandoned Persian cat

May 22, 2015

After 7 days of antibiotic and painkiller treatment as an in-patient, this rescued young Persian's damaged infected eyeball was removed by Dr Daniel.

2168. VIdeo: A 16-year-old has an obnoxiously smelly armpit wound - 3rd opinion

The very old dog had an armpit wound. It is very risky to tranquilise this old dog. So Vet 1 prescribed medication. The 2nd opinion vet bandaged the left leg and anchored with Elastoplast to cover up the armpit wound. His antibiotic injection was said to last 2 weeks. The owner did not return every 3 days to change bandages.

There was a strong obnoxious smell when I removed the bandage and the swabs which contained a green discharge of rotten smell.
As this dog is very old, anaesthesia is not advised. My solution was to sedate the old dog, wash the wound thoroughly and let it heal by granulation. Potassium permanganate powder sealed up the bleeding.
Injection to bring down the swollen left limb due to tight bandaging. Antibiotics and sleeping tablet sedation to let the dog have peace and sufficient rest.

FOLLOW UP 3 DAYS LATER.
The old dog's limb was much less swollen and the wound was not smelly. "Sleeps a lot," the owner was satisfied with this open wound method to prevent stench of smelly bacterial infection.
In this old dog, the armpit wound is very difficult to stitch up as it is a mobile high tension area. In this video, I proposed 2 surgical approaches.  The Z-plasty and making another new skin incision further behind the armpit wound.

Z-plasty is used to release tension and the stitched area looks like a "Z" after stitching.
In the 2nd approach, the newly created skin incision is left open. It releases tension so that the debrided armpit wound can then be stitched. The new skin incision is not sttiched but left to heal lby 2nd intention. Antibitoic cover. These are my 2 surgical approaches if the dog is still young. Otherwise, lit takes months to heal a large armpit wound as in this case..

2167. VIDEO. The obsessive compulsive cheek pouch storage dwarf hamster

Some people hoard things till the whole house or garage is cluttered. Do hamsters hoard food inside their storage compartment, known as cheek pouches inside the mouth on the right and left sides? They pack the cheek pouches to the maximum and sometimes the cheek pouches become injured by the sharp shells from the seeds and are painful. The hamster is unable to dislodge the contents and rubs his swollen cheeks hairless.

I have a handful of such cases, but the following one is most memorable. He is the teacher's pet.

The black hamster was obsessive  in storing and packing his cheek pouch with food. The lady owner came 3 times for right cheek pouch impaction. This pouch was excised at the 3rd visit and there was no problem for the next few weeks.

Now, lthe hamster scratches his face till hair drops off the top and sides of the face, leaving his eye area still hairy.  Clearing the left cheek pouch is done. The hamster will be restricted to around 5 seeds per day. No large seeds. Sunflower seeds are shelled out before feeding to him.

FOLLOW UP ON MAY 22, 2015. Around 1 week later. "No more creamy discharge from his eyes," the owner was happy to report. "No more wet face!". She fed around 5 seeds e.g. shelled sunflower seeds and corn. The hamster would store the seeds inside his left cheek and eat them later. So his pouch is never impacted causing itchiness when large seeds are stuck inside. 

2166. The teacher's pet hamster looked like Lone Ranger

March 22, 2015
"How is your hamster now?" I asked the young lady who is a teacher.
"No more creamy discharge from her eyes," she was happy.
"That would be pus," I said. "Are the hairs growing back on her face. The areas around her eyes were all bald and so she looked like she was wearing a mask, like Lone Ranger!"
"It will take some time for the hairs to grow. Previously, her face was wet, wet, wet but now it is dry."
"Was it water from the water bottle?" I asked.
"No, I don't think so."
"It could be from the eye tears," I assumed.

Now she restricts the hamster to a strict die. Around 5 seeds like corn and peeled sunflower seeds. No coloured star pellets and others.So the hamster would not stuff her left cheek.\

I remember this black hamster very well because she had caused much distress to the teacher with the right cheek pouch impacted 3 times. The last time I had it excised and there was no more problem. Till this creamy eye discharge.

2165. A busy father spares time for the left head-tilting guinea pig

Mar 21, 2015

"No, you have not been prompt in consulting me," I said. "The head tilt has been present for 2 weeks."

What is the cause of this left head tilt in this pretty female 2-year-old guinea pig much loved by the daughter. "There is also pus from the left nostril," the father said. "And something white in the left eye."

The lungs had sounds on ausculation, more on the left side. The eye cornea did not stain green with fluorescein stain test and this white central elevated patch across the middle of the eyeball could be a scar. Everything seems to be on the left.

So, was there an injury or infection to the left side of the body? The guinea had lost 50% of the appetite and the rectal temp was 36.4 (hypothermia). The ears had never been cleaned and there was black soot in both ears. The creature squealed when I palpated her ears.

She weighed 700g. What was wrong with her?  

Most likely a middle ear infection. Will need to follow up after antibioics.

2164. Mammary adenomas in an American Cocker Spaniel

TOA PAYOH VETS toapayohvets.com   Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074   Tel: 6254-3326, 9668-6469, 9668-6468.  judy@toapayohvets.com   22 May, 2015   Focus: Small animals - dogs, cats, guinea pigs, hamsters, turtles & rabbits

Mammary adenomas in an American Cocker Spaniel Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS First written: 21 September, 2012 Update:  22 May, 2015  "Why did you  delay seeking surgery till the breast lump is gigantic in size, like two tennis balls combined?" I asked the Buddhist temple teacher who taught Buddhism and morals to over 800 children of devotees. "The breast lumps grow very fast in the last 2 weeks," she replied. "Nobody in the family wants to bring the dog for surgery. My brother said to let her die." The solution was surgical removal but the family did not want to pay the medical costs. She was kind to enough to bring in this old dog for surgery at Toa Payoh Vets. Breast adenomas grow rapidly to sizes of 4 large oranges in this American Cocker Spaniel. After mastectomy, the dog was eating and normal "Walk-in" sutures holding the skin edges tightly and the haematoma on the left MG5 was treated by opening up the area via removal of 2 stitches. Healing by granulation was uneventful.  The 8-year-old dog was not spayed.  Mammary adenoma was diagnosed. No malignancy, according to the histology report. I was surprised as it was a massive tumour. Dr Daniel and I operated. I took over the stitching to ensure that the stitches were tight. I tacked in "walk-in sutures" through the muscle layer and then the skin,  using 2/0 sutures to ensure that the large long wound would not break down.. The dog came back 4 days later. There was a swelling at one end of the tumour. " "There's seepage at the left Mammary Gland 5 area," I said to Dr Daniel who is in charge of the case. "Just cut off two stitches," I said to him. "In this way, the serum can drain out. No need to re-stitch." After that, we had no more visit from the Buddhist teacher. I was glad that this dog was not abandoned when she had the tumours. Such incidents do occur in Singapore. It is best to spay the female dog when she is young as breast tumours are less likely to develop in spayed dogs. BE KIND TO OLDER DOGS & CATS --- GET TUMOURS REMOVED EARLY --- WHEN THEY ARE SMALLER.  More case studies, go to: Cats  or  Dogs Make an appointment with your vet. Or tel 6254-3326, 9668-6469 for an appointment to discuss health screening for your senior companion. Or e-mail judy@toapayohvets.com your requirements.  Copyright © Asiahomes Internet All rights reserved. Revised: May 22, 2015 Toa Payoh Vets