2347. An inspiration digital image - Sea of Monsters Exhibition at the Science Centre

Oct 29, 2015

A surprisingly great exhibition - The Sea of Monsters at the Science Centre, Singapore. The exhibits are moving and there is the feeling of being inside the deep oceans encountering the giants of the seas.

Some are born to be employees as there is security and organisation in the corporate world. Being your own boss is very risky. But this lady has what it takes to be her own boss, with her interest in meeting people, very high Jack Russell type energy and a ton of experience and network. Will she be her own boss or keep working for others?



Some images

2346. Email diagnosis: A dwarf hamster has a gigantic ear tumour?

EMAIL TO DR SING DATED OCT 28, 2015

Hi, I texted one of your colleagues regarding a hamster which I have adopted two days back. Two days back, I adopted two 1~2 year old hamsters from a friend who is migrating overseas. One of the hamsters has a super huge growth on the head where the ear is supposed to be. It looks super painful and uncomfortable.

Also, the hamster seems to be having watery stools and appears deformed. It's fur seems to be yellowish as well. My sister said that it is old, and would probably be better to be put down, but I wanted to check if it could be saved and live a normal life if possible.

 The two hamsters have been at my place for two days. I noticed the one with the huge growth does not seem to eat or sleep much. On query, my friend told me that he had brought it to a vet before when the tumor was smaller. The doctor said it wasn't advisable to operate as it was already old and gave him some ointments which didn't seem to work. He stopped after the fourth visit as the vet seems to be just visually checking the tumor.

He claimed that the tumor continued to grow very quickly despite the ointment and the hamster seemed to be balding, so he stopped administering the ointment to it. I have attached a picture of the hamster with its tumor. Please take a look and provide some advice on what I, or we, can do to help it. I may not check my email regularly, so please so text me at 9xx.


Thank you so much. Regards, J


    


REPLY FROM DR SING

 I am Dr Sing K Y. Thank you for your email. You posted one view. It appeared to be an ear tumour. If it is purely an ear tumour and the hamster is in good health, lit can be excised. If the hamster is sick (not eating, diarrhoea), the risk of dying under anaesthesia is high and so you have to decide whether you want to take the risk.



----------------------

On Oct 31, 2015, a Myanmar lady living in Tampines brought in a 2-year-old winter white dwarf hamster with the gigantic ear tumour as seen in the above email diagnosis case. I was surprised at the coincidence of the two hamsters having the same surgical condition.  

"Why didn't you come earlier when the tumour is very small?" I asked the lady.
"It grows very big only during the last month," she replied.


Despite the high risk of death from anaesthesia, she consented to the anaesthesia and surgery. Dr Daniel operated after getting the informed consent and signing the form.

Anaesthesia was Zoletil IM and isoflurane gas. The hamster survived and went home. Post-op survival depends much on the health of the hamster.

2345. A 3-year-old female X-bred dog has an itchy smelly right armpit

Oct 27, 2015  7 pm

I was still at the office when a fair Chinese lady came into the clinic without an appointment. My assistant had gone home. She took out the previous computerised receipt of Dr Daniel's treatment for her dog's ringworm in Oct 13, 2014. She requested purchase of 2 tubes of anti-fungal cream.

The dog had been scratching her right armpit with the right hind leg and it had become smelly and she had successfully used this brand to clear the ringworm in 2014.

"Both of her armpits were losing hair and itchy," she said. "But now, it is only the right armpit."
"How did you apply the cream?" I asked as two tubes seemed to be too many as I had offered her one tube but she wanted two.

"I would entice her with some treats and speedily smear the cream onto her armpit," she said that the dog disliked being treated by her and would shy away whenever she saw the tube.

"When she ate the treats, she would dash away! That is why I had to quickly palm the ointment in the direction of the right armpit."

"You should give the reward of treats only after the treatment," I advised her to find another person to restrain the dog. "No wonder your dog quickly runs off after eating the treats. It is like paying a person before he starts work. No incentive to work hard since the person has been paid!"

"My dog is co-operative at the groomer to clip her armpit hairs. Very quiet, but she is a devil in my apartment!" the lady in her early 30s laughed. 

"If the cream is not properly applied onto the infected skin, the outcome will be poor and that is why the ringworm is still present," I said. "Email to me two images of the affected armpit."  Many owners are working and are reluctant to bring in the dog for a proper examination and prefers to get repeat medication to lower medical costs. So I understand the economics of the heartlanders.

"I was at home at 6 pm and saw the dog scratching her armpit furiously and so I came to the clinic to buy the medicine," the lady told me when I advised making an appointment. "My assistant had gone home," I explained that the younger workers prefer shorter hours at work nowadays.

I taught the happy bubbly fair complexioned lady how to treat this dog:
1. Put the dog on the table so she cannot run away. An assistant restrains the dog while she clips the infected area or ask the groomer to do it.
2. Wash and rinse the area with anti-fungal shampoo.
3. Dry and apply cream with a cotton bud. Best to wear gloves.
4. Give treats after completion of the treatment so that the dog will behave and look forward to the treatment.

P.S
I was in the office reading an article on Nuffnang, a blog advertising community of one million blogs. I do blog but has not bothered to monetise the blogs. That was why I was still in the clinic when the Chinese lady came in to buy the cream.

Netccenric was founded in 2006. It is most famous for Nuffnang. It also owns the online video advertising unit, Reelity and Churp Churp and other digital agency model business.  

2344. A full-collared Corgi from New Zealand

Oct 26, 2015 Sunday morning.

The lady in her early 30s had purchased a full-collared Corgi from a New Zealand breeder, importing into Singapore at a total cost of $3,500. She came in to spay the dog.

"Local breeders sell Corgis at $5,000!" she said. Singapore's cost of living had shot up but several of my clients and suppliers said that the market is very quiet and there is no business. An economic recession had reared its head.
The Corgi was 5 months old. I noticed that the vulval area was swollen and she kept cleaning the private parts till they were pigmented brown.

"Her heat is coming," I was told that this Corgi had championship pedigree. "If you want to breed her, do not spay her. Get the New Zealand breeder to give you the pedigree certificate. After getting it, register it with the Singapore Kennel Club so that the puppies have the certificates."

"I read in the internet that all 8 puppies of a Corgi died during birth," she was afraid that her Corgi would suffer the same fate if she breeds her.

"The deaths could be due to a failure to consult the vet before and during birth. The puppies could be stuck inside the uterus for a long time.  If a dam has too many puppies, an elective Caesarean section would have saved all puppies. A dam with 8 puppies would have a very big abdomen and would be a case for C-section."

Her friend has a champion male Corgi but is in China now. "It is better to mate at the second heat which will be around 7-8 months later. Get the dog pampers to wear when she comes on heat so as not to soil your apartment." She had a well designed white shiny floored apartment and I guess she wanted to spay the dog before the first heat."

In my opinion, it is best to spay the dog 2 months after the first heat so that she would have matured sexually. Too early a spay may lead to a very small vulval area leading to difficulty in peeing later. But it is up to the owner to decide as spaying can be done from around 5 months before the heat as in this pretty gentle Pembroke  Corgi with the golden coat. She had a very thin white strip between the eyes unlike the friend's male Corgi. But she is much loved and the owner decided not to spay her yet..  

2343. The economical vet and old non-neutered male dog diseases - tail gland diseases and circumanal tumours.

Oct 27, 2015


I recorded one case of tail gland disease in a Siberian Husky in 2009 as follows:
http://www.bekindtopets.com/dogs/20091066Tail_Gland_Disease_Male_Husky_ToaPayohVets.htm

Today, another case of a male 15-year-old X-bred came in and was  seen with Dr Daniel in the afternoon . The owners said that their vet charges only $1,000 all in to remove the much swollen tail end tumour now infested with maggots. Many months ago, the vet had proposed tail amputation plus neutering but the owners did not accept the advice. The tail growth enlarged to the size of an orange and becomes infested with maggots.

The owner could not remove all maggots as the dog was ferocious and contacted me by sms.

I suggested a Tardak injection plus antibiotics and painkillers before tail amputation 1 week later so that the tail would not be severely inflamed and infected. Amputation of an infected tail end will result in very poor wound healing. But the father wanted surgery today - tail amputation which would have done away with the need for removal of maggots on the gigantic growth.


"He is only a cross-bred," the father said. "I don't want to spend $1,000 treating this case. I am looking for an economical vet."

Since he was guaranteed by the first vet that the total cost would be only $1,000, he decided to go back to the first vet. "If he is more expensive, I will come back to you. I am looking for an economical vet."

I had quoted him $500 for amputation of an injured not infected tail but this was a much longer surgery with complications.

Last 3 days,  I was seeing more older dog health problems  from new clients.

Two recent cases of circumanal tumours in a 13-year-old Siberian Husky and in a 12-year-old English Cocker Spaniel. The former was quite inoperable with 3 large circum-anal tumours. The latter had a 1.5 cm tumour which would be easy to operate and remove but the owner cited "anaesthetic risks of dying" and so opted for the Tardak injections instead of surgery and neutering.

2342. A 14-year-old female dog has viral pneumonia after grooming - blood test for health screening

Octr 26, 2015

Maltese X, F, Not spayed, 14 years.
Not eating 2 days, lethargic, fever at 39.7C.
Watery stools and anorexia 2 days on Oct 21, 2015. Saw groomer who came with transport vehicle and had been grooming this dog for last 10 years.
"Harsh lung sounds," I had elicited coughing from this old dog much loved by the lady. "Possible viral infection at the groomer's 4 days ago. I need a blood test to be done."

Blood test on Oct 23, 2015.
Glucose 2  (3.9-6)

Total WCC  2.1  (6-17)
N = 1.7%  (60-70%)   Abso. 0.04  (3 to 11.5.)
L  29.3  (12-30%)   Abso  0.61
M 68.4%   (3-10%)  Abso 1.44  (0.15 to 1.35)
E = 0.5%
B = 0.1%


The blood test indicated viral pneumonia. The owner came early. An IV drip with antibiotic and tolfedine.

Dog recovered on Oct 25 but not 100%.  Recovery meant 80% appetite and up to her nonsense.
The other dog was lethargic for 2 days and had recovered earlier. Both went for grooming. It was great that the pneumonic dog did not deteriorate in health and had become more active after treatment.

This case shows that old dogs do get viral infection. Most Singapore owners do not bother to vaccinate their older dogs. It is surprising that this dog had a good outcome.
The dog was very thin and could have pyometra as her vulval area was swollen on Oct 23 (pus dripping, licking). Good ending.

2341. A coincidence - circum-anal tumour in a 12-year-old English Cocker Spaniel and a 13-year-old Siberian Husky

Sunday Oct 24, 2015

The active Blenheim English Cocker Spaniel looks larger than the average seen. He has the face of a Basset Hound.  Male, not neutered, 12 years old came in as he had passed red blood in the urine yesterday.

"I palpated a golf-ball sized lump in the bladder area. It could also be an enlarged prostate" I said to the husband. "It is painless and an X-ray will be advised."
"However, the more important issue is that he has one small circum anal tumour.  It measures 3 cm across below the right side of his anal area.

"No wonder he takes a long time to sit down recently," the wife said. The husband said: "We don't want to take the risk of him dying under anaesthesia. Is there an alternative treatment like medicine?"

So I gave Tardak 2.5 ml SC to bring down the size of this small tumour.Will it disappear since it is detected early?

By coincidence, yesterday, I had another case of 3 circum-anal tumours in a Siberian Husky, Male, 13 years/ The owner decided to operate it but the whole area is infected. The owner had consulted 3 vets before me. The 3rd vet did a biopsy which showed hepatoid adenoma. This test and surgery cost her $1,000. He quoted $2,000 for surgery. The owner consulted me. I told her that the tumours needed to be clean before surgery and there would be no skin to close up the anal wounds as there were 3 large tumours - two on the left and one on the right upper area of the anus, very close to the anal opening. Tardak and painkillers were effective for the past 3 days as the dog did not bite the tumours closing bleeding.

2340. The Husky has 3 circum-anal tumours

Oct 24, 2015

Husky, Male, 11 years, 17kg.

According to the owner
lst vet did not "diagnose" it. It was a small tumour.
"Inexperienced and young," the owner said.
2nd vet did not want to operate on it as the tumours had ballooned. So he refer to the 3rd vet.
3rd vet cut a portion and sent it to the histology lab for analysis. Circum-anal tumour, hepatoid adenoma. This cost $1,000. The surgery estimated to be $2,000. The biopsied tumour became inflamed and itchy. 

Before Tardak injection. Inoperable now.

That is how I became the 4th vet as the backside tumours were bleeding profusely all over the house. The owner came with the Clara, the pet transport lady to get the surgery done. The 3 tumours were infected and so the owners thought it was a simple surgery to cut them off.

"The tumours are large and very close to the anal opening," I advised operation and neutering to be 10 days later after a Tardak injection to shrink the tumours and medication for the infections. "It is not good for the dog to operate today as the bacteria will spread to the surgical wound, leading to stitch breakdown and a big skin hole hard to heal. You will have more medical costs and stress if the wound cannot close."

The owners wanted both neuter and circum-anal tumour removal today. The right undescended testicle was painful on palpation.

Tardak did reduce the bleeding. Tardak is an anti-androgen used totreat canine prostatic hypertrophy, circumanal tumours and modification of hypersexuality in the male dog. Some neutered male dogs still show hypersexuality.  It is delmadinone acetate and acts in at least 2 modes of acgtion:
1. by the inhibition of pituitary gonadotrophin release. The inhibition of ICSH (Intersittial Cell STimulating Hormone) restrains testes interstitial cell function and hence testosterone production.
2. by possibly affection the "behavioural sex centre."

Tardak given at 2 ml SC caused the tumours to shrink a bit overnight. The dog was sent home to save on medical costs. Wound cleaning and anti-fly powder need to be done at home. 10 days later, the owner will WhatsApp the image to me to see whether the dog can undergo circum anal surgery. 

2339. An owner's intuition that her dog's anorexia is not due to heart disease

Drinks a lot. Not eating for 4 days.  14-year-old male Cavalier King Charles.

"I don't think that the cause of my dog not eating for the past 4 days is due to his heart disease," the working lady had been giving her 14-year-old Cavalier King Charles Vetmedin and furosemide for the past 10 months.   "My dog's breathing rate is normal."

This dog had an unusually gigantic submandibular lymph nodes of around 5 cm across. Normal ones are not palpable. So, was there some bacterial infection of the mouth?

BLOOD TEST

Urea 68.2  (4.2-6.3)
Creatinine 511 (89-177)
suggestive of kidney failure

Haemoglobin 9.2  (12-18)
Red cell count  3.9  (5.5 - 8.5)
suggestive of anaemia


Total white cell count 35.5  (6. - 17)  leucocytosis.
N 43.7%  (60-70). Unusually low. Abs 15.5 (3-11.5)  
L 49.6%                                          Abs 17.6
PCV 0.26 (0.37-0.55)

X rays showed enlarged left heart.

So, the owner's intuition is correct. The dog has kidney failure, accounting for thirst and anaemia.

For the past months, no blood tests were done as the owner came for repeat heart disease medication and wants least medical costs.



Oct 23, 2015

The dog had vomited and had diarrhea yesterday. He was very weak and was unable to stand up.
At 9 am, the owner came as a housecall would not be of any help to the dog as he needed an IV drip. He was not able to stand up. "Your dog is very old at 14 years of age. He has heart and kidney disease and septicaemia. Hence there was vomiting and diarrhea. The chances of survival are very slim."

The owner decided to take the dog home after the IV drip. The dog was not able to stand. As she held the dog home in her arms to cross over the overhead bridge to Potong Pasir, the dog had a heart attack and passed away in her arms literally.

She thanked me and Dr Daniel for the efforts in saving her dog.

2338. A separate waiting area for cats and for dogs in a vet clinic

Oct 21, 2015

Recently I spoke to Dr Daniel about the concept of a separate waiting area for dog and cat owners. When I review the travel pics of a vet clinic in Gap, South France, it has implemented this concept.