X-ray taken.
Cat with right hind leg tibial fracture
Pin was put in 6 weeks ago. The owner came to check whether pin can be removed.
Repeat x-ray 2 months later
Cat can walk normally.
Saturday, September 3, 2016
2920. Cat - tibia fracture review 6 weeks after pinning
Sep 3, 2016
X-ray taken.
Cat with right hind leg tibial fracture
Pin was put in 6 weeks ago. The owner came to check whether pin can be removed.
Not fully healed at 6 weeks.
Repeat x-ray 2 months later
Cat can walk normally.
X-ray taken.
Cat with right hind leg tibial fracture
Pin was put in 6 weeks ago. The owner came to check whether pin can be removed.
Repeat x-ray 2 months later
Cat can walk normally.
Wednesday, August 31, 2016
2919. 20 minutes to spay a caterwauling 7-month-old cat
Tuesday Aug 30, 2016
I was demonstrating spay to an RI Intern. RI sends 3 batches of Sec 4 interns to Toa Payoh Vets based on their interest in veterinary medicine.
Today, I demonstrated the pre-op and operation of a 7-month-old cat being spayed by me.
How long does it take for an experienced vet to operate a 7-month-old caterwauling cat?
Incision to end of stitching = 20 minutes.
The time is longer as the cat was moving on incision and I had to top up with 3 minutes of isolfurane + O2 gas, hence prolonging the surgery.
I tried a tested anaesthetic formula used by the other vet who sterilize at least 20 stray cats per day.
the formula is as follows:
Cat 2.6 kg
Xylazine 20 = 0.26 ml IM. Wait 5 minutes.
Ketamine = 0.16 ml IM
Surgery with top up gas if necessary.
I tried this formula but combined in one syringe xylazine and ketamine IM instead of separately in 2 syringes. Waited 15 minutes. But the cat showed signs of movement on incision but the anaesthetic gas was effective.
A video is produced by my RI intern.
I was demonstrating spay to an RI Intern. RI sends 3 batches of Sec 4 interns to Toa Payoh Vets based on their interest in veterinary medicine.
Today, I demonstrated the pre-op and operation of a 7-month-old cat being spayed by me.
How long does it take for an experienced vet to operate a 7-month-old caterwauling cat?
Incision to end of stitching = 20 minutes.
The time is longer as the cat was moving on incision and I had to top up with 3 minutes of isolfurane + O2 gas, hence prolonging the surgery.
I tried a tested anaesthetic formula used by the other vet who sterilize at least 20 stray cats per day.
the formula is as follows:
Cat 2.6 kg
Xylazine 20 = 0.26 ml IM. Wait 5 minutes.
Ketamine = 0.16 ml IM
Surgery with top up gas if necessary.
I tried this formula but combined in one syringe xylazine and ketamine IM instead of separately in 2 syringes. Waited 15 minutes. But the cat showed signs of movement on incision but the anaesthetic gas was effective.
A video is produced by my RI intern.
Tuesday, August 30, 2016
Monday, August 29, 2016
Sunday, August 21, 2016
2916. Review of 2-year-old pug with urticaria
August 21, 2016
The 10-kg pug started to itch again. Pustules and red skin between the thigh and belly area (video).
Rashes in armpits. Several rashes at left and right sides of the body. Ears no longer inflamed and painful as the owner had used a steroidal ear ointment but the hair loss and shorter hairs of the flanks tell a story of ear itchiness.
"The hind legs start to hammer at the flanks when the dog has ear pain or itchiness," I told the young couple as this hair loss area is commonly seen in other dogs with ear canal infections. (video).
"The 4 paws are also itchy now," the lady said after the end of medication with the white tablets. These were anti-fungal tablets. In reality, the pug was itchy despite the Royal Canine Hypoallergic diet soley fed..
The allergy test report from the US had arrived 1 week ago. said that the dog is allergic to chicken, corn, oatmeal, malassezia but not allergic to beef, pork, turkey, carrots , milk, eggs or two dust mites.
PLAN
1. Home-cooked pork + brown rice + carrots
2. E-collar 14 days 24 hours per day
3. Amitraz wash for the rashes
4. Review in one months
5. Medication for rashes
6. Ear ointment once a week and massage
ADVICES
1. Anal sac expression weekly before bathing (grey oil seen/expressed today)
2.Lateral ear canal resecetion and tail fold surgery advised in 6 months.
3. No treats and other food for next 3 months except the above-mentioned diet of pork + brown rick and carrots.
The 10-kg pug started to itch again. Pustules and red skin between the thigh and belly area (video).
Rashes in armpits. Several rashes at left and right sides of the body. Ears no longer inflamed and painful as the owner had used a steroidal ear ointment but the hair loss and shorter hairs of the flanks tell a story of ear itchiness.
"The hind legs start to hammer at the flanks when the dog has ear pain or itchiness," I told the young couple as this hair loss area is commonly seen in other dogs with ear canal infections. (video).
"The 4 paws are also itchy now," the lady said after the end of medication with the white tablets. These were anti-fungal tablets. In reality, the pug was itchy despite the Royal Canine Hypoallergic diet soley fed..
The allergy test report from the US had arrived 1 week ago. said that the dog is allergic to chicken, corn, oatmeal, malassezia but not allergic to beef, pork, turkey, carrots , milk, eggs or two dust mites.
PLAN
1. Home-cooked pork + brown rice + carrots
2. E-collar 14 days 24 hours per day
3. Amitraz wash for the rashes
4. Review in one months
5. Medication for rashes
6. Ear ointment once a week and massage
ADVICES
1. Anal sac expression weekly before bathing (grey oil seen/expressed today)
2.Lateral ear canal resecetion and tail fold surgery advised in 6 months.
3. No treats and other food for next 3 months except the above-mentioned diet of pork + brown rick and carrots.
Friday, August 19, 2016
2915. Throat X rays of the dog and cat - A 14-year-old Miniature Schnauzer has a large neck abscess
Aug 19, 2016
It is very important that old dogs get their dental work done and all rotten smelly loose teeth extracted. In this dog, in March 2014, I was consulted about a big lump on the dorsal part of the tail end. "It is a sebaceious gland tumour," I said. Surgery removed the tumour and no more visit from the dog.
Today, the old dog came in gasping for breath and crying. Panting a lot. "The dog cannot stand for the past 2 days. Not eating. He has a large swelling under the chin, also diarrhoea," the mum said. The daughter was working and so she brought the dog down.
A soft firm swelling across the neck below the chin. Around 3 inches x 4 inches x 3 inches. I got an X-ray done as I suspected an abscess. Lanced and reddish-brown pus flowed out. Around 100 ml collected.
No anaesthesia is given as the dog's tongue turned deep purple when restrained for examination. The dog had great difficulty breathing. Rotten teeth spread bacteria into the heart valves.
BLOOD TEST ON ADMISSION ON AUG 19, 2016
Glucose 2.6 (3.9 - 6.0). Dog was not able to stand up.
Liver enzymes ALT/SGPT 117 (less than 59)<59 p="">
AST/SGOT 133 (<81 br=""> less than 81)
Urea 15.3 (4.2-6.3) but creatinine is within normal range. Kidneys are normal in this case.
Total white cell count 39.8 (6-17)
Neutrophils 90% (60-70%), Absolute 35.8 (3-11.5%)
Lymphocytes 10% Absolute 3.98
Monocytes, eosinophils and basophils are zero.
Platelets 431 (200-500)
<59 p="">
<59 p="">
<59 p="">CONCLUSION
What the owner wants is a dog alive. Therefore, the diagnosis must be correct and X-rays are needed to provide the evidence of neck abscess. Aspiration of the neck swelling confirms pus. Incision of 2 cm drains out most pus. The next day, syringing the abscess and removal of the gelatinous pus which is formed due to the medication of baytril and a low dose of dexamethasone.
<59 p="">
<59 p="">As you can see the video, the dog is much comfortable on Day 2 after treatment and no longer pants in great pain. The outcome is good and the dog will go home on Day 3, after another IV drip today.<59 p="">Teeth scaling and check up every year for a senior dog would have had prevented such a condition of neck abscess and great pain in the neck. Owners need to spare some time to bring dogs older than 5 years old for yearly dental check up and vaccination. However, a majority do not do it.
----------------------------------------------------------------------------
<59 p="">
<59 p="">
<59 p="">
<59 p="">
<59 p="">OTHER X RAYS OF THE NECK
normal throat and neck
normal throat and neck. Normal oropharynx (No. 4) is not swollen
the cat has normal nasopharynx (throat)
cat has normal nasopharynx (throat)
M 0.1% Absolute 0.07
E 0.3% Absolute 0.21
B 0%
HISTOLOGY report from 2 biopsy punches on side of submandibular swelling.
It is very important that old dogs get their dental work done and all rotten smelly loose teeth extracted. In this dog, in March 2014, I was consulted about a big lump on the dorsal part of the tail end. "It is a sebaceious gland tumour," I said. Surgery removed the tumour and no more visit from the dog.
Today, the old dog came in gasping for breath and crying. Panting a lot. "The dog cannot stand for the past 2 days. Not eating. He has a large swelling under the chin, also diarrhoea," the mum said. The daughter was working and so she brought the dog down.
A soft firm swelling across the neck below the chin. Around 3 inches x 4 inches x 3 inches. I got an X-ray done as I suspected an abscess. Lanced and reddish-brown pus flowed out. Around 100 ml collected.
No anaesthesia is given as the dog's tongue turned deep purple when restrained for examination. The dog had great difficulty breathing. Rotten teeth spread bacteria into the heart valves.
BLOOD TEST ON ADMISSION ON AUG 19, 2016
Glucose 2.6 (3.9 - 6.0). Dog was not able to stand up.
Liver enzymes ALT/SGPT 117 (less than 59)<59 p="">
AST/SGOT 133 (<81 br=""> less than 81)
Urea 15.3 (4.2-6.3) but creatinine is within normal range. Kidneys are normal in this case.
Total white cell count 39.8 (6-17)
Neutrophils 90% (60-70%), Absolute 35.8 (3-11.5%)
Lymphocytes 10% Absolute 3.98
Monocytes, eosinophils and basophils are zero.
Platelets 431 (200-500)
<59 p="">
<59 p="">
<59 p="">CONCLUSION
What the owner wants is a dog alive. Therefore, the diagnosis must be correct and X-rays are needed to provide the evidence of neck abscess. Aspiration of the neck swelling confirms pus. Incision of 2 cm drains out most pus. The next day, syringing the abscess and removal of the gelatinous pus which is formed due to the medication of baytril and a low dose of dexamethasone.
<59 p="">
<59 p="">As you can see the video, the dog is much comfortable on Day 2 after treatment and no longer pants in great pain. The outcome is good and the dog will go home on Day 3, after another IV drip today.<59 p="">Teeth scaling and check up every year for a senior dog would have had prevented such a condition of neck abscess and great pain in the neck. Owners need to spare some time to bring dogs older than 5 years old for yearly dental check up and vaccination. However, a majority do not do it.
----------------------------------------------------------------------------
<59 p="">
<59 p="">
<59 p="">
<59 p="">
<59 p="">OTHER X RAYS OF THE NECK
looking for bone inside the throat
----------------------------------------------
-------------------------------------------------------
Submandibular Abscess causing great breathing difficulty. This 14-year-old Maltipoo had pus in the right ear for many weeks.The bacteria inside this area finally penetrated into the right neck area, forming a very painful right submandibular abscess. See lateral view of X-ray as evidence. The dog's abscess was lanced and drained under general anaesthesia. The dog is normal now. This is a case where ear canal infections can lead to right neck abscess. The owner had consulted a vet earlier for the ear infections but had not followed up when the infections had not gone away. The bacteria went into the neck via the eustachian tube and multipied, form a gigantic abscess.
BLOOD TEST
Dec 9, 2014
Abnormal
Total white cell count 68.5 (6-17)
N 98% (60-70%) N absolute 67.13 (3-11.5)
L 1.6% L Absolute 1.10M 0.1% Absolute 0.07
E 0.3% Absolute 0.21
B 0%
Platelets 142 (200-500).
Several abnormal lecuocytes seen. Occasional nucleated red blood cells seen. Large platelets present.
No malignancy
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heart disease (swelling in throat due to fluid from heart disease)
--------------------------------
GR with premolar 4 abscess
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---------------------------------
special type of equipment is needed if you want to x-ray a terrapin's throat
-----------------------------------
do not copy this image into video
normal throat (no neck abscess) with a pellet inside the gullet. For illustration.
<59 p="">
<59 p="">-------------------------------------------------------------------
In dogs, an ear abscess is not obvious. But in a terrapin you can see a swelling of the ear to know that he has an ear abscess. Treatment is similar. Incise and drain the pus.
<59 p="">
<59 p="">2914. A 2-year-old multipoo passes bloody watery stools for 2 days - X rays
Aug 19, 2016
"My multipoo was passing bloody watery stools for the last 2 days," the lady owner was worried and showed the picture of the stools in her smartphone.
No abdominal pain. X-rays show some spherical balls inside the colon and watery stools inside the descending colon. IV drip and sent home.
It was a puzzle as to what the spherical balls were.
.
"My multipoo was passing bloody watery stools for the last 2 days," the lady owner was worried and showed the picture of the stools in her smartphone.
No abdominal pain. X-rays show some spherical balls inside the colon and watery stools inside the descending colon. IV drip and sent home.
.
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