3125. INTERN VIDEO. Digital evidence of hamster's eye stye inspires confidence in the pet owner

HOOK

Eye problems - painful, blindness unless treated early.
Small creatures like hamsters, eyes too small to be seen by the owner unlilke canine eye problems.

E.g. Pimples in the eyelid known as stye.

 



BKTP

INTRODUCTION
Why, What, How
Why need vet treatment?  Painful, rubbing eye, lose appetite, infections, eyeball rupture
What is stye?  Define eye stye

How to convince the owner that her hamster has eye stye?
Digital photography  Day 1, Day 7




How is it treated?  Eye drops may work.  Surgery - incision and drainage under gas anaesthesia in the dwarf hamster.

Hook?

"Your hamster has an eye stye," Vet 2 who was referred to this case by Vet 1 in the branch clinic announced.

The owner of this half-closed, sometimes opened right eyed dwarf hamster applied Vet 2's eyedrops for the next 7 days. The cure was not there. So, the owner sought a 3rd opinion from me.

Nowadays, the young Singaporean pet owner is knowledgeable. Just stating "eye stye" or eyelid pimple in this case is insufficient. 

 



Digital evidence is needed but this takes a lot of time and some skill to develop the evidence to inspire confidence in the young ones. It takes over an hour of digital photoshopping to develop the evidence as shown below.

DAY 1. Gas anaesthesia is necessary to examine and produce sharp photographs the hamster's eye.

Anaesthesia to get proper closed eye examination. Fluorescein eye stain test showed no corneal ulcers. The corneal areas did not show green spots which would have been evidence of eye ulcerations.  

I showed the digital evidence of eye stye and advised surgery (incision and drainage) to resolve the problem as the eye pimple is large. The pimple is on the left upper eyelid as at Day 1.

 The owner wanted the hamster home on the same day and would apply eye drops and give medication. 





DAY 7. The owner returned for the surgery (incision and drainage) after self-treatment for the past 7 days.  

 The pimples are now on the left and right upper eyelid as at Day 7.



Conclusion

This case shows how digital evidence inspired the owner to return 7 days later for the surgery of incision and drainage to resolve the eye stye problem.  The hamster was operated and hospitalised for 3 days.





To acquire digital imaging skills, I practise during my travels and usually daily taking pictures of places and friends and use Photoshop to develop better images as shown below.

Lens for close up and zoom

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Hamster hospitalised for 6 days. On Day 4 after operation, images are taken. They show the conjunctiva of the upper eyelid is inflamed due to the healing of the wound after incising the styes (see Day 7 - 2 styes).  Now Day 4 after surgery, no styes on close up image.  Show hamster video eye open more, even under operating light (video)

                                      

                                            Close up image.  Day 4 after incision of the stye.
The styes are not present. The conjunctiva is inflamed as it is early in the healing stage.

Digital photography provides evidence of the scar of the incision (arrows). The wound is healing well.

Conclusion.   Many younger Singaporean pet owners are knowledgeable as they research the internet for their pet's diseases.

Digital photography evidence inspire confidence in the owner in the vet. She knows that her pet is properly diagnosed (stye) and treated (post op.  Day 4 images).







Day 7 after consultation. The owner came to Toa Payoh Vets for surgery as advised.
This is Day 1 of surgery.


Day 4 of surgery, showing the incision scar (arrow) and the disappearance of the styes.


CREDITS

includes Dr Daniel Sing




FOR MORE INFORMATION

3124. INTERN ABEL. short videos to be subtitled and/or merged.

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1. How kittens are vaccinated and microchipped at Toa Payoh Vets, Singapore
FRAME with this text. This BKTP veterinary educational video shows how to restrain and microchip kittens in Singapore. Gentle restraint during vaccination is important. Ensure microchip does not pop out during removal of the microchip holder by pressing your thumb and forefinger onto the injection site. 

Merge the video footage into one video.  Subtitles if needed.
File     20170817guinea_pig_goes_home
MVI 3364, 3365, 3366 and 3367



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2.  Swollen eyes and not eating are common medical reasons seeking veterinary treatment. This video shows a stunted red-eared slider which is compared to a normal one of around the same age. Weight and length and width of carapace are markedly different.

 File     20170817guinea_pig_goes_home
MVI 3369

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3.  Generalised ringworm treatment requires a 2nd review one month later.  
 File     20170817guinea_pig_goes_home
MVI 3352

This video shows the importance of returning to Toa Payoh Vets for follow-up review in the case of generalised ringworm.
The owner had 3 visits to Vet 1 but the skin disease was not cured. She came to Toa Payoh Vets and was pleased that the he dog's thigh skin was less pigmented 4 weeks after treated. There were no scales. So she did not come for review despite receiving a reminder post card.

2 weeks ago, the dog started to itch and having dandruff.
Ultraviolet light and fungal culture are done. The dog is clipped bald and treated again.

Monthly reviews of the skin disease is necessary in many cases as generalised ringworm is hard to cure.
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4.  15 rotten loose teeth as the Chihuaha never had dental check up for the past 10 years.  Foul breath.
Consulted Toa Payoh Vets as the dog had difficulty eating his food as if he has oral pain.
A right facial wound discharged pus but now has closed. A right carnassial tooth abscess had been present but the tooth had dropped off when checked during dental scaling (video subtitle this footage part).


 File     20170816Funeral....

Yearly dental check up saves teeth. No check up - 15 rotten teeth extracted in a 10-year-old chihuahua.

MVI 3339 video to be before MVI  3355....etc. It is consultation. Subtitle to be done. Then merge with below footages and also subtitles. 


For dogs over 5 years, yearly dental check is especially important to prevent gum disease and tooth decay. In this case, the 15 teeth extracted could have been saved if there was yearly dental check up.
Oral tumours may form in the mouth of dogs with chronic gum diseases due to lack of dental hygiene. .


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File     20170817guinea_pig_goes_home

5.  Massive haematoma. A rare case of a massive haematoma in a guinea pig.

HOOK
Why the owner consulted the vet for the 4th time?
What is it?  A tumour inside the neck muscle area. A large blood vessel ruptured, leading to bleeding for many days after the 3rd visit. The vet incised and drained (VIDEO INSTAGRAM).
 
How to cure the guinea pig. Surgical excision. If not cancerous, The owner did not want laboratory examination of the mass removed during the 2nd visit (IMAGE INSTAGRAM). So it is not known whether the tumour is cancerous. If cancerous, it has recurred. Owner agreed to sending the tumour to the lab for histology. Video shows only Day 1-Day 3 of the GP's medical condition. Lab results are pending.

Histology is very important but some owners decline the test.  

MVI  3355, 3356, 58, 59, 61  Day 3 footages
File     20170816Funeral
MVI 3350   try not to edit as you have no time. Just merge and subtitle.

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6. Hair loss in the flanks of a spayed cat.

Cat came for annual vaccination. Complaint of balding left flank for past one year.  Right flank has slight hair loss.

Flank hair loss causes

1. Not due to old age. Causes include flea dermatitis, ear infections, skin infections and hormonal imbalance (endocrine alopecia) in spayed cats.

File: 20170816Funeral
MVI 3340

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7. An industrial park dog "Black beard" had swollen left elbow and limb.

 Much loved by funeral parlour owner. Now lethargic
Elbow abscess incised and drained.
Lower pad ulcerated
Blood test - low red cell count, haemoglobin, platelets (take image of haematology) for inclusion.

No Babesia. (take image of test kit. ask judy) Had ticks some years ago and had recovered from tick

fever.

File: 20170816Funeral
MVI 3351 on day 1


get dog out and take picture on day 3  (Aug 18, 2017) and follow up on medical 

3123. INTERN ABEL- A rare case. A guinea pig has a massive haematoma

HISTOLOGY OF TISSUE MASSES IS IMPORTANT


In 2016,  Vet 1 used a needle to aspirate the swelling.
But the swelling recurred.

In                     , Vet 2 operated and removed the mass inside the swelling. Owner given the evidence and he posted on the Instagram. The owner declined histology of the mass. So it was not known whether this was a cancerous mass.


In July 2017, Vet 2 incised the swelling to release blood. Instagram posting filtered to black and white as Instagram does not permit gore and blood.


In Aug 15, 2017, the owner consulted me as the swelling is now extensive. "The swelling returned 2 weeks after incision by Vet 2 in July 2017," the owner said.


SURGERY
Lot of blood under the skin shot out.

Zoletil 100. 0.05 ml Zoletil + 0.05 ml normal saline IM provided.effective analgesia. Top up with a few seconds of gas to effect.


Nearer to the neck, a mass of black spots embedded in the neck muscle. Excised lump. Stitch back the split muscle. Stitch skin.  To send for histology.

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Day 2

CONCLUSION
Recurrence of haematoma in this guinea pig is probably due to a rupture of a big blood vessel in the mass excised. (Image from Abel's phone). There was a reddish-black mass seen (Image in Instagram phone to Abel) some ................months ago during surgery.


However the owner did not want histology of the mass in Feb 2017. So, it is not known if the mass contains cancerous cells. If it had cancerous cells, the mass will return. If it involves a big blood vessel, the vessel will rupture and keep bleeding over the past 2 weeks. This resuslted in a massive haematoma.

In this case, the mass had been sent for histology. If there is no more bleeding or growth, the guinea pig will lead a normal life.




 


VIDEO
File:  20170817guinea_pig_goes_home. 
MVI 3368 (summarises the case post-op, Day 2 going home).
Use this file

3122. Eyelid stye in a dwarf hamster that has a very painful eye.

Vet 1 referred owner to Vet 2 who diagnosed eyelid stye and prescribed eyedrops with steroid. But dwarf hamster still rubs his eye. So, came to me.

1. Evidence to show the owner. A good digital camera and lens collaborated with Vet 2's diagnosis.
However I provided the digital evidence to show the owner. This involved photoshop to enlarge the images.

Intense eye rubbing caused 90% of the corneal surface to be red due to bleeding. This was shown to the owner. Hence the eye is very painful. Home treatment applying eye drops was not effective. The hamster was hospitalised for 3 days to be treated with eye drops and painkillers and surgery (incision and drainage) if necessay.  



2. Corneal ulcers are painful. So I used fluorescein eye drops onto eye. No green stain on the cornea indicating no corneal ulcer.

VIDEO



TREATMENT
1. Antibiotic eye drops and oral painkillers for 2 days
2. Incise and drainage of eyelid stye as soon as possible, if the stye has not reduced.



CONCLUSION
Digital photography is very useful but it takes time and patience to acquire the skills to produce close up clear images to provide evidence to the worried hamster owner. The owner used her mobile phone to snap a picture but was not able to get the details as shown here. I used a Canon EOS 70D and macro lens.   

80% of the cornea is bleeding red, due to hard rubbing of the eye.

Eyelid stye (pimple) is also known as hordeolum. It is an infection of the oil gland of the eyelid. It can be inside the eyelid or outside. In this case it is inside. If the blocked oil gland is not infected, it is known as a chalazon which is not painful.  
.

3121. Overfeeding a red-eared slider

x ray on Aug 15, 2017. No eggs seen. The red-eared slider was as large as a 5-year-old as it was overfed. 

restless. no eggs

3120. A dwarf hamster bites his broken leg - amputation stops pain and infections.

8 Sep 2020.

STEFANIE TO CREATE VIDEO based on following script as guidelines. You need to make it more interesting.


HOOK. A wired hamster cage is less expensive and is most popular for many first-time hamster owners. But it is not safe. A hamster loves to climb up the wired frame. Falls and fractures its leg.  

https://youtu.be/Xfi9cFh8IKw

WHAT TO DO WHEN THE LEG IS FRACTURED?
Almost all owners are against leg amputation when their hamster fractures the leg as in this case. But the hamster keeps licking the fractured femoral/tibial area.  The skin becomes traumatised and broken. Bacteria infects the ulcerated skin causing redness and itchiness. 



WHY SHOULD THE FRACTURED HAMSTER'S LEG BE AMPUTATED?

Bone pins and screws to repair the fracture in the dwarf hamster are not possible.

Amputation prevents further trauma and infections. The hamster is able to pee and poop without feeling the pain of broken bone ends poking into his muscles. 

Without the pain of jagged broken bones, he is able to lead a normal life with 3 legs.  He can pee and poop properly and groom himself. With a painful broken hind leg, some hamsters cannot groom properly and has a bad smell in the back area, owing to urine scalding and stool staining.

3119. A Siberian Husky has painful ears for the past 3 years

Dogs with erect ears rarely get ear problems as there is ventilation and drainage. This Husky came 3 years ago with pus and pain in his left ear. Now his right ear is painful. I suspected some foreign body or tumour stuck inside his horizontal canal. Despite ear irrigation and medication, his left ear could not be pain free. 

The left ear was very painful despite treatment. It contained pus again. Then the right ear was painful.
The old Husky's ears were operated and sent home on the same day. The owner was unable to clean his surgical wounds as the dog moved.

So on Day 15, the dog who went home after surgery, came to the Surgery for cleaning up around August 8, 2017. The owner found it difficult to clean his ear wounds. Under sedation of domitor and ketamine IV, the scabs were removed.  An image of the right ear is shown.

    Operation is successful. Note the intact drainage cartilage. In the left ear, the ear canal was
born twisted and that accounted for difficulty in drainage and ventilation. The drainage cartilage
fell off. There is some slight pain in the left ear but not the right on Day 15. Need to review after one month by phone.