SUNDAY'S UNUSUAL CASE
A 2.5-year-old female rat with massive
breast tumours of around 4" X 3" came in. She was eating well despite
this gigantic tumour. I found it hard to believe but she was not
emaciated and looked good.
The couple decided on surgery to remove the breast tumours despite the high anaesthetic risks. I prescribed antibiotics and pain-killers for 3 days before surgery. Surgery was done with Zoletil sedation and isoflurane gas maintenance. The rat was OK within 24 hours. Now the problem was the biting of stitches. She bit off two stitches. I advised daily cleaning and covering with a bigger plaster rather than several small strips. The wound should heal by granulation.
This is an unusual case of an older fancy rat surviving anaesthesia. Do not wait till the breast tumours become bigger or malignant before removal as anaesthetic risks are higher. Early removal saves lives.
Sunday, May 31, 2015
2176. Clinical research injectable anaesthesia in a dog
Sunday May 31, 2015
My tried formula for a deep anaesthesia and good analgesia lasting 30 minutes, enough for a spay or neuter in a dog, is as follows:
Young dog (less than 2 years, healthy on physical examination)
10kg
Domitor 0.4 ml, Ketamine 0.5 ml IV.
Today, I have Max, 7-month-old Bull Terrier X, male to be neutered.
At 16 kg, this young dog was given below the formulation dosage
Domitor 0.4 ml, Ketamine 0.5 ml IV
The dog moved his head at around the ligation of the first testicle, around 10 minutes.
I gave 5% isoflurane + oxygen gas at 3 lit/min for 2 minutes and that was sufficient anaesthesia to complete the neuter.
CONCLUSION
The under-dosage was given to reduce anaesthetic risk but this was insufficient dosage without the need to top up with isoflurane.
Surgery must be speedy, accurate and complete. Proper planning is needed to be efficient.
Two ligatures of the spermatic blood vessels were performed on each testicle. No bleeding.
Baytril and tolfedine 2ml each was given post-op.
My tried formula for a deep anaesthesia and good analgesia lasting 30 minutes, enough for a spay or neuter in a dog, is as follows:
Young dog (less than 2 years, healthy on physical examination)
10kg
Domitor 0.4 ml, Ketamine 0.5 ml IV.
Today, I have Max, 7-month-old Bull Terrier X, male to be neutered.
At 16 kg, this young dog was given below the formulation dosage
Domitor 0.4 ml, Ketamine 0.5 ml IV
The dog moved his head at around the ligation of the first testicle, around 10 minutes.
I gave 5% isoflurane + oxygen gas at 3 lit/min for 2 minutes and that was sufficient anaesthesia to complete the neuter.
CONCLUSION
The under-dosage was given to reduce anaesthetic risk but this was insufficient dosage without the need to top up with isoflurane.
Surgery must be speedy, accurate and complete. Proper planning is needed to be efficient.
Two ligatures of the spermatic blood vessels were performed on each testicle. No bleeding.
Baytril and tolfedine 2ml each was given post-op.
Saturday, May 30, 2015
2175. A spayed cat still caterwauls. Why?
May 30, 2015
A mother and her young adult daughter brought in 2 two-month-old kittens for vet examination.
They were grey Maine Coon X bought from a home-breeder, a male and female. There were so much wax that I would advise ear irrigation rather than putting ear ointment and massaging. With ear irrigation, the large chunks of black wax get syringed out.
"I have another cat spayed by a vet," the mother said. "She keeps coming on heat, meowing loudly. The vet said it was natural and prescribed some tablets which stopped the caterwauling. Could she have not done a proper spay?"
"It is hard to say, but generally, any ovarian tissues or ovary left inside during spay will cause this caterwauling!".
"What is the solution?"
"To open up the abdomen and look for the ovary near the end of the kidneys," I said. "It will be a long incision."
The owners prefer no surgery and asked about the side effects of the pills given to prevent heat given by the vet for the last 2 years.
"After prolonged use, there may be breast enlargement or pus inside the stump of the uterus, called stump pyometra."
"Other solutions?"
"Injections of hormone every 3 months as in Myanmar cats will stop the caterwauling," I said. "The side effects are stump pyometra."
A mother and her young adult daughter brought in 2 two-month-old kittens for vet examination.
They were grey Maine Coon X bought from a home-breeder, a male and female. There were so much wax that I would advise ear irrigation rather than putting ear ointment and massaging. With ear irrigation, the large chunks of black wax get syringed out.
"I have another cat spayed by a vet," the mother said. "She keeps coming on heat, meowing loudly. The vet said it was natural and prescribed some tablets which stopped the caterwauling. Could she have not done a proper spay?"
"It is hard to say, but generally, any ovarian tissues or ovary left inside during spay will cause this caterwauling!".
"What is the solution?"
"To open up the abdomen and look for the ovary near the end of the kidneys," I said. "It will be a long incision."
The owners prefer no surgery and asked about the side effects of the pills given to prevent heat given by the vet for the last 2 years.
"After prolonged use, there may be breast enlargement or pus inside the stump of the uterus, called stump pyometra."
"Other solutions?"
"Injections of hormone every 3 months as in Myanmar cats will stop the caterwauling," I said. "The side effects are stump pyometra."
2173. VIDEO. A young Shih Tzu has a bladder full of stones and an abdominal testicle
POLLIKIURIA AND HAEMATURIA IN A SHIH TZU
-----------------------------------------------------------------------
Case report
May 30, 2015
"The dog bites," the couple said as I palpated the kidneys and the bladder. The dog reacted to kidney palpation as if there is kidney pain. The bladder was empty of urine and was the size of two grapes packed with hard gritty stones.
Vet 1 had taken urine tests and X-rays.
Urine pH 8 and numerous crystals suspected to be urates??
X-rays of bladder stones were too radio-opaque to be urates.
Had advised removal of retained abdominal testicle in one surgery as bladder stone removal.
"A retained testicle can easily be seen around the neck of the bladder," I told Dr Daniel. "It can be excised promptly by ligation in less than 2 minutes."
As this dog is "obese" at 8.5 kg, any prolonged anaesthesia is risky but abdominal cryptorchidism needs to be done at the same time to save on having to open up the abdomen again. As for the descended testicle, this can be removed another day to reduce risks.
Operation will commence after lunch and the dog will go home in 3 days, providing all goes well with anaesthesia. Stones need to be analysed as the prevention depends on the composition of the stones.
In the meantime, no dry food and give the dog plenty of water to drink.
SURGERY ON MAY 30, 2015
Red swollen bleeding bladder showing inflammation and damage from sharp bladder stones stuck inside the mucosa. Every fragment had to be flushed out after picking out as many as possible with forceps. The dog's urinary bladder was catheterised but he pulled out the Elastoplast-taped catheter overnight, despite wearing an Elizabeth collar.
The stones are sharp and may be urates as suspected by Vet 1. They will be sent for analysis.
To reduce anaesthetic time, no neutering was done.
FOLLOW UP POST OP
Sunday, May 31, 2015
2178. Clinical Research on methone. Day 3 - sharp bladder stone Shih Tzu goes home
June 1, 2015
Bright sunshine blue sky day. Vesak Day. The couple is free to bring their 3-year-old Shih Tzu home today as they are a working couple. Nobody at home.
Yesterday on Day 2, this dog had ripped out his urinary catheter. I checked that he had tried to bruise his surgical wound near the flank of the penis, with his e-collar. I gave him methone inj. 10mg/ml at 0.3 ml SC. He also had Rimadyl 25 mg tablet. I checked his surgical area. There was little pain on palpation and less bruising. He ate the U/D can and was very active. I videoed him peeing normally without one leg up.
At 3 years old, he appeared "obese" but actually he was broad-chested. The first vet had provided a good detailed examination report. She had said he was obese with body score BCS 8/9. She said he could have "urate" crystals and that X-rays of the bladder stones were too radio-dense to be urate stones. Urate stones are said to be radio-opaque in some reports but it is not true.
Free catch urine dipstick. pH 8, Protein 3+, blood 4+, leucoyctyes negative, "rest wnl."
The dog was super-active today and went home with instructions
1. not to feed any more dry food as he may have a familiar tendency to develop bladder stones.
2. pee more than 2 times per day. Not practical as the couple works and nobody is at home during weekdays. So the dog holds his urine from 8 am to 8 pm waiting to go downstairs.
3. to measure volume of water drank/24 hour and record. Drink lots of water.
4. to use dipstick monthly to measure pH, blood, etc and let me know
5. to send urine for lab test 6-monthly and if there are small crystals, I can flush out the bladder.
6. stones sent for analysis
7. U/D diet can be expensive. Eat canned food exclusively. No dog treats, rice, bread. Stone analysis to confirm urates will be available in one week's time.
I don't know how many of the above-mentioned instructions the couple will comply with.
Bright sunshine blue sky day. Vesak Day. The couple is free to bring their 3-year-old Shih Tzu home today as they are a working couple. Nobody at home.
Yesterday on Day 2, this dog had ripped out his urinary catheter. I checked that he had tried to bruise his surgical wound near the flank of the penis, with his e-collar. I gave him methone inj. 10mg/ml at 0.3 ml SC. He also had Rimadyl 25 mg tablet. I checked his surgical area. There was little pain on palpation and less bruising. He ate the U/D can and was very active. I videoed him peeing normally without one leg up.
At 3 years old, he appeared "obese" but actually he was broad-chested. The first vet had provided a good detailed examination report. She had said he was obese with body score BCS 8/9. She said he could have "urate" crystals and that X-rays of the bladder stones were too radio-dense to be urate stones. Urate stones are said to be radio-opaque in some reports but it is not true.
Free catch urine dipstick. pH 8, Protein 3+, blood 4+, leucoyctyes negative, "rest wnl."
The dog was super-active today and went home with instructions
1. not to feed any more dry food as he may have a familiar tendency to develop bladder stones.
2. pee more than 2 times per day. Not practical as the couple works and nobody is at home during weekdays. So the dog holds his urine from 8 am to 8 pm waiting to go downstairs.
3. to measure volume of water drank/24 hour and record. Drink lots of water.
4. to use dipstick monthly to measure pH, blood, etc and let me know
5. to send urine for lab test 6-monthly and if there are small crystals, I can flush out the bladder.
6. stones sent for analysis
7. U/D diet can be expensive. Eat canned food exclusively. No dog treats, rice, bread. Stone analysis to confirm urates will be available in one week's time.
I don't know how many of the above-mentioned instructions the couple will comply with.
Friday, May 29, 2015
2172. Ap Alert sensor
March 29, 2015
The vet's wife wanted to buy an Ap Alert sensor as her husband considered it very useful. If the dog stops breathing, there is the warning and if it breathes regularly, there is the regular beeping sound. She contacted another vet whose receptionist told her that she must wait till the product comes in from Australia. It would cost $35.
The supplier I sourced for her quoted $250. Her husband said to buy two as his wife did not answer the phone or called me back. I confirmed two but the wife said one would do. The supplier was angry at this change of mind and despite my confirming two, he would not sell.
"Some years ago, she ordered some equipment with price agreed at $580. My girl delivered it to her office," he said." She wrote a cheque of $500. My girl accepted it as she would have wasted her taxi fare in bringing it back. "This $58 meant a lot to me as I had few customers."
In another instance, she asked him to keep the equipment for her but did not buy it. He said another vet asked him for quotations and even asked him to inform other suppliers about the new premises. In the end, this vet did not buy anything from him nor inform him of his failure to secure any business.
Some vets would ask for quotations and buy elsewhere or directly from Australia but would phone him for repairs. One even used another telephone as he did not respond to her call.
The vet's wife wanted to buy an Ap Alert sensor as her husband considered it very useful. If the dog stops breathing, there is the warning and if it breathes regularly, there is the regular beeping sound. She contacted another vet whose receptionist told her that she must wait till the product comes in from Australia. It would cost $35.
The supplier I sourced for her quoted $250. Her husband said to buy two as his wife did not answer the phone or called me back. I confirmed two but the wife said one would do. The supplier was angry at this change of mind and despite my confirming two, he would not sell.
"Some years ago, she ordered some equipment with price agreed at $580. My girl delivered it to her office," he said." She wrote a cheque of $500. My girl accepted it as she would have wasted her taxi fare in bringing it back. "This $58 meant a lot to me as I had few customers."
In another instance, she asked him to keep the equipment for her but did not buy it. He said another vet asked him for quotations and even asked him to inform other suppliers about the new premises. In the end, this vet did not buy anything from him nor inform him of his failure to secure any business.
Some vets would ask for quotations and buy elsewhere or directly from Australia but would phone him for repairs. One even used another telephone as he did not respond to her call.
2171. The guinea pig's head tilts left - review after 1 week
May 29, 2015
I did not expect to see the busy father after the treatment of the inappetant guinea pig with the left head tilt 7 days ago. The 3-year-old guinea pig was eating 50% of the food and was very thin at 700grams bodyweight.
He turned up with his two daughters today on May 29, 2015 and I was surprised as most owners do not bother or care for a review when their rabbit or guinea pig has head tilt.
"There is much improvement as she tilts her head less," he was glad that the bodyweight is now 752 grams and the guinea pig was eating. He fed Vitamin C tablet crushed in powdery form and bought wood and mineral blocks, but the guinea pig ignored them.
"No more left nostril pus after your antibiotic treatment, but the left eye is still cloudy." He cared for this guinea pig much despite his busy travelling. "After 3 days of ear drops, she would object strongly to any more ear cleaning."
"I need to irrigate the left ear under isoflurane gas anaesthesia," I advised this procedure as the guinea pig had had painful ears with black soot-like substances. "To flush out the black sticky dirt inside the ears as the guinea pig had no ear cleaning for the past 3 years. Did you give her more space to exercise?"
"This time, I extended the living space by placing her bottle at a far end of the pen. In this she's got to walk a longer distance to drink."
Under anaesthesia, I checked the molars using my fore-finger to feel for molar spurs. No sharp cheek teeth. The front teeth was trimmed 2 mm shorter.
The guinea pig's left eye cornea was cloudy but much less. She would rub her eyes whenever eye drops were applied.
As there is less head tilt, we will wait another 7-14 days after the ear irrigation and another type of ear drop dripped into the left ear to check whether the head will no more tilt to the left.
I did not expect to see the busy father after the treatment of the inappetant guinea pig with the left head tilt 7 days ago. The 3-year-old guinea pig was eating 50% of the food and was very thin at 700grams bodyweight.
He turned up with his two daughters today on May 29, 2015 and I was surprised as most owners do not bother or care for a review when their rabbit or guinea pig has head tilt.
"There is much improvement as she tilts her head less," he was glad that the bodyweight is now 752 grams and the guinea pig was eating. He fed Vitamin C tablet crushed in powdery form and bought wood and mineral blocks, but the guinea pig ignored them.
"No more left nostril pus after your antibiotic treatment, but the left eye is still cloudy." He cared for this guinea pig much despite his busy travelling. "After 3 days of ear drops, she would object strongly to any more ear cleaning."
"I need to irrigate the left ear under isoflurane gas anaesthesia," I advised this procedure as the guinea pig had had painful ears with black soot-like substances. "To flush out the black sticky dirt inside the ears as the guinea pig had no ear cleaning for the past 3 years. Did you give her more space to exercise?"
"This time, I extended the living space by placing her bottle at a far end of the pen. In this she's got to walk a longer distance to drink."
Under anaesthesia, I checked the molars using my fore-finger to feel for molar spurs. No sharp cheek teeth. The front teeth was trimmed 2 mm shorter.
The guinea pig's left eye cornea was cloudy but much less. She would rub her eyes whenever eye drops were applied.
As there is less head tilt, we will wait another 7-14 days after the ear irrigation and another type of ear drop dripped into the left ear to check whether the head will no more tilt to the left.
Thursday, May 28, 2015
2170. Video production for a FLUTD cat in Singapore
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draft for intern to produce a video |
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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 --------------------------------------------------------------------------------------------------------------------------------------------- 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. |
Saturday, May 23, 2015
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.
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..
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.
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.
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