Thursday, February 1, 2018

3348. A 10-year-old Golden Retriever has anal sac discharge after 2 treatments by the vet

Feb 1, 2018

"I feel very peck chek (frustrated in Chinese Hokkien dialect) as my dog passes smelly bloody anal discharge for the 3rd time. She was treated by Vet 1 twice, within 10 days, and the problem returned. The vet had told me that a biopsy (over $500) will be needed if the discharge occurred at the 3rd time!

She had paid $3000 for her dog eyeball removal and was wary of veterinary fees.
Her friend referred her to me. Dr Daniel expressed smelly black anal sac oil via digital expression.
The owner wants a cure, not going to the vet the 4th time to express oil.

This is a case of a possible anal sac necrosis with or without a tumour. Medical therapy by expression of the sacs has not worked.

Possible treatments are:
1. Catheterise the sacs and irrigate with saline and antibiotics. Sedation is needed.
Medication after antibiotic sensitivity test. Wait and see if the bleeding recurs.
2. Biopsy. The owner wanted a permanent cure and this was not a cure.
3. Anal sacculectomy as medical therapy via anal sac expression for 3rd time (rectal digital expression) still shows bloody smelly discharge at Toa Payoh Vets.
The owner would consult her husband as one complication is faecal incontinence after removal of the anal sacs.

Conclusion
Owner wanted Option 1 which is scheduled 2 weeks later as the anal sacs now are inflamed.  She is worried about faecal incontinence and will have to clean the backside if that occurs.

E-collar, R/D diet to reduce weight from 25 kg to 22 kg and provide fibre.
Blood test normal findings.







Monday, January 29, 2018

3347. A chihuahua jumps from the bed daily - r patellar luxation 2 days ago


Jan 29, 2018
Referral to Toa Payoh Vets for 2nd opinion 
Vet 1 did X-rays. Diagnosed Grade 3 patellar luxation.


8-year-old chihuahua
Jumps off bed daily - for past 8 years

Had been lame for a year
Overweight BCS 5/9

Advice
Grade 3. Dog can put RH paw on ground after putting patella in.
Heart and lungs OK. Abdomen OK. 
Apprehensive about anaesthesia.
To reduce weight for 4 weeks and see.



--------------------------better quality X-rays of another case



3346. A 16-year-old Jack Russell salivates profusely - nerve disease?





Jan 13, 2018

Jack Russell, FS, 15 years
hypersalivating only on right side of mouth. Why?

MUSCLE ATROPHY ON RIGHT SIDE MUSCLES BELOW ZYGOMATIC ARCH


EYE PUPILS
Pupillary reflex. R pupil constricts. L pupil dilates when bright light is shone.

Ulcer of 2 cm on R side of tongue, caudal edge.  R buccal mucosa ulcerations 

HISTORY
April 2018. Dental by Vet 1 .
Nov 2018. Not able to lap water from bowl. Water bottle OK
Drinks little

BLOOD TEST ON JAN 13, 2018
Urea  9.1  (4.2-6.3)
Creatinine 49  (89-177)
Platelets 595  (200-500)




Jan 13, 2018


No salivating only on right side of mouth. Some bubbles seen in right tonsillar area on GA examination.

MUSCLE ATROPHY ON RIGHT SIDE MUSCLES BELOW ZYGOMATIC ARCH


EYE PUPILS
Normal

Ulcer of 2 cm on R side of tongue, caudal edge.  R buccal mucosa ulcerations 

HISTORY
April 2018. Dental by Vet 1 .
Nov 2018. Not able to lap water from bowl. Water bottle OK
Drinks little
Treated at Toa Payoh Vets on Jan 13, 2018. Antibiotics and anti-inflam, neurobion.

BLOOD TEST ON JAN 27, 2018
Urea  13.5  (4.2-6.3)
Creatinine 87  (89-177)
Platelets  316  (200-500)


Was dental scaling done by Vet 1 the cause of the muscle atrophy?

Sunday, January 28, 2018

3345. A 9-year-old female spayed Shih Tzu passes cloudy vaginal discharge

The couple was concerned about this cloudy discharge seen "once" recently.

Lab tests done.


Also liver disorder

Thursday, January 25, 2018

3343. INTERN Femoral fractures in 2 Singapore apartment cats




High rise Singapore apartments
More than 80% of population live in apartments.
No wired netting in windows in most apartments with cats - cat jump off windows and fractures legs or dies from internal injuries





Case 1. A 4-month-old kitten fell down from the apartment










WEEK 4. Plaster of Paris removed








WEEK 10. Pin removed. Kitten can now bend knee but it is painful.


3342. Veterinary Surgery Stories: The breeder never forgets what the vet did to his dam

Jan 23, 2018


Veterinary Surgery Stories from Dr Sing Kong Yuen, Toa Payoh Vets
- The breeder never forget what the vet did to his dam


"8 puppies dead after Caesarean section," the breeder showed me his mobile phone image of a dam and 8 dead puppies. He was not going back to this vet for any surgery. He did not know what had happened but he expected no deaths of the dam and puppies in any Caesarean section. He was 85 years old and had been breeding dogs for over 40 years. Still active working hard when other breeders have retired and had knowledge of the competence of various vets performing Caesarean sections for him.  .

I had performed over 10 Caesarean sections for him without deaths of the dam and pups in the past 2 years. So he was satisfied with me though he tried to knock down my fees by saying: "I can get 3 to 4 Caesarean sections done by the other vet for the fee I pay you!"

Some 15 years ago, I was like the other vet, charging $300 for any Caesarean section of the breeder's dog at any time of the day and night. The usual vet was suspended from practice for around 10 months for selling vaccines to breeders who would do their own vaccinations. One big breeder used my services and others followed. I had performed over 200 Caesarean sections in around 3 years till a younger vet was favoured by the breeders.

I could devote more time to my private clients and had more sleep after midnight. On Jan 23, 2018, I was awake as I had been to a friend's house for dinner. The friend had an electrical blackout and it took time to locate the source in an external wall light being exposed to rain water. So, this breeder's phone call to me was received as I drove home.

"I was going to bed after delivering a second Dachshund pup naturally," he said. "I saw this Dachshund straining very hard. Her water bag had ruptured but no pups came out for more than an hour."

He had given 0.5 ml oxytocin but no pups came out. So he played safe and phoned me. I did the Caesarean section for him. The 2 pups were large. He was pleased that the spotted one was female. This Dachshund had a large single pup delivered by Caesarean section by me one year ago. Now, she could not give birth naturally and her swollen belly gave me the impression she had 4 pups or 6 pups. She had 2 large ones.








What the breeder expects is a happy outcome: "No deaths of the dam and pups."
I use solely isofluranne gas and achieve this outcome.
A good veterinary assistant monitors the anaesthesia closely.