3093. A 9-year-old cat coughs for 6 months but has excellent appetite

Vet 1.  Coughs a few times 6 months ago. Saw Vet 1.
Ausculated lungs and heart - normal. So owner did not bother with antibiotics. Gave cough drops.

Coughs more and more. Owner saws video in smartphone of coughing cat.
Consulted Toa Payoh Vets in Jan 2016. Why?

3092. A 9-year-old Miniature Schnauzer has trembling legs

Hind limb trembling

L7 spurs
Recurrent bladder stones
Urine test done



11  months ago

3091. A 13-year-old cat had sudden onset bloody diarrhoea

Fresh red blood passed with watery stools. Why?
Apartment cat loves to eat lizards.

Blood test - thrombocytopenia.
Sudden onset bleeding inside the stomach and intestines. Not clotting.
Bit own tongue inside crate - lots of bleeding.

Cause of death - owner did not want autopsy. Unable to confirm cause.

3090. A 9-month-old dwarf hamster has an itchy eye. Why? Show and tell. Corneal ulcer

3089. A Maltese has a gigantic perineal hernia - synthetic mesh

June 21, 2017

"Very rarely do we get such a gigantic hernia measuring over 10 cm across," I said to the owner who came to me as the 3rd vet. The 2nd vet had quoted some $3,000 to insert a synthetic mesh to close up the big gap of the width of 2 fingers. Ordinary apposition will not be effective.  The first vet had referred her to the 2nd vet who did not want to operate as she had no mesh but had inserted a urinary catheter as the dog could not pee.  The two vets had done X-rays and advised mesh to cover the defect in the pelvic diaphragm. So, the owner searched for a vet who was more affordable. 

"Can you guarantee 100% successful outcome?" the owner asked me.
The dog was a male not neutered dog as frisky as a young puppy despite his age of over 10 years.
"I cannot guarantee 100%," I replied. "The dog needs to be crated for at least 14 days and preferably 30 days."
"He will bark and bark," the owner said. So the dog was my inpatient for the 3 days post-op.

The dog stopped breathing at an early stage and was revived with emergency adrenallin and resuscitation.  He survived the lengthy anaesthesia as the mesh surgery took over 1 hour. The next day, he was normal and would be crated for 2 days.

Excess skin to be trimmed to prevent haematoma swelling. To neuter 14 days later.
Hernia repair took over 1 hour. Not advisable to prolong anaesthesia to neuter resulting in increased anaesthetic risk of dying on operating table.



X RAYS

 BLOOD TESTS
Normal except monocytosis


HOW TO USE THE MESH
1. Hernia reduced.  Hernial ring dissection.
2. Check muscular weakness and size of defect. Hernia is lateral to the external anal sphincter muscle. The herniated contents are between the sphincter and the levator ani muscle. Often the levator ani is atrophied, making a big opening for abdominal contents between the anal sphincter and the coccygeus muscles.
The herniated contents include intestines, bladder, prostate and rectum are pushed into the abdomen.

3. Identify pudendal arteries, veins and nerves. Also note sciatic nerves and sacrotuberous ligament.

4. (Video in Youtube). In one big dog, a vet drill 4 holes into the caudal ischial border to insert sutures to anchor mesh to internal obturator muscles. This was not done in this case.

4.1 Mesh folded diagonally and cut.

5. Cone formed from one half.
6. Place cone over the defect and size adjusted until the base of the cone covers the hernial ring.
7. Take out mesh. Suture the ends with 3 interrupted sutures.
8. Stitch horizontal mattress sutures (muscles of anal sphincter to mesh).
9. Inside the cone, stitch mesh to muscles.
10. (Video in Youtube).  Ischial border holes - stitches tied onto ventral cone via holes attaching internal obturator muscles. This was not done in this case.

11. Trim excess cone off the top.
12. Suture subcutaneous skin.
13. Suture skin.

MESH IMPLANT for Large Perineal Hernial Repair
Dr Sing Kong Yuen, BVMS (Glasgow)

1. VIDEO: MESH IMPLANT FOR Large Perineal Hernial Repair
   VIDEO CONTAINS SURGICAL PROCEDURES
   VIEWER'S DISCRETION IS ADVISED
   https://www.youtube.com/watch?v=tFxb36ANOwM

2. BLOG: MESH IMPLANT for Large Perineal Hernial Repair.
   https://2010vets.blogspot.com/2017/08/3118-mesh-implant-for-gigantic-perineal.html

MORE INFORMATION AT:
https://2010vets.blogspot.com/2022/08/4190-perineal-hernial-repair-in-male.html

 

3088. A 6-year-old cat vomits for the past 10 days

Blood test shows liver disorder and low platelet count.
Possibly the cat had stepped on something toxic and/or licked the chemicals.
So, vomiting for 10 days.
Owner was able to give antibiotics with brown sugary paste now.
Cat has recovered fully today.

I suspect some chemicals ingested by the cat had caused liver damage and low platelet count.

3087. A 13-year-old Jack Russell has a right facial swelling - carnassial tooth abscess

Facial swelling below the right eye, 5 cm x 5 cm x 3 cm
Slight pain on palpation. Black spot seen between the crown spaces of right carnassial. Bad breath. Dog disliked showing it and would bite if I continued.
   
Could it be a tumour or cyst or carnassial tooth abscess?
Dog not happy to be X-rayed another view after lateral views.
X-rays as follows shows the roots of the right carnassial tooth are black instead of white. This indicated bone loss around the roots, confirming this is a case of carnassial tooth abscess.

Treatment is by extraction of the carnassial tooth under anaesthesia. The dog recovered fully after the dental surgery.