3267. INTERN. The male cat cannot pee again. Urethral obstruction

Sunday Sep 9, 2018. DSH, MN, 8 years old



Sole cat in household. Stressed by new litter box and litter? Also moved house in Aug 2017.
Past 2 days, dysuria and pollakiuria (abnormal frequent urination). Today, I palpated distended bladder, the size of an orange. Need urinary catherisation. Does not want X-ray and blood test today. Urine test is mandatory this time to check for crystals.

Normal saline syringed to dislodge sand in mid-urethra. Irrigated bladder with 20 ml saline 5 x.
IV drip. Baytril antibiotics.


HISTORY
Dec 14, 2017 for dysuria. Blood test - low platelet. Recovered next day.


Sep 19, 2016. Urinary catherisation. Recovered. Blood test - low platelet. Advised feline C/D but not
X-rays

                                            Urinary catheterisation to irrigate the bladder and suck out the sand


EVIDENCE
Dipstick evidence - pH 8, alkaline urine favours bacterial growth as compared to acidic urine.

Owner did not want blood test or X-ray

Explain X-ray of 2 years ago - no urinary stones
Blood test done on 2nd visit - pH alkaline





CONCLUSION
Prevent alkaline urine production. This alkalinity favours bacterial growth as compared to acidic urine. Special diet Feline C/D or feed canned food only. NO other dry pellets other than C/D.

3266. Clouds with faces - Scandinavia, Denmark, Norway. Judith, Giddeon

June 2018
Sunset. Cloud with a face seen from hotel room


Mall of Scandinavia

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3265. A dwarf hamster with the head tilted to the right had neck and leg tumour and armpit warts

An Indian mother and her small boy brought in this beloved hamster. She had come some months ago for treatment of the right head tilt which still exists but the hamster leads a normal life.

Surgery to remove the lumps were done by Dr Daniel

3264. A 13-year-old cat vomits for 3 days. She has Stage 4 chronic kidney disease (severe azotemia)

Sep 6, 2018

The 13-year-old cat had never been sick since young and so, there was no visit to the vet.
She vomited 3 days in a row and so the owner brought her to consult me.
Blood test provides evidence of Stage 4 chronic kidney disease with very high creatinine levels above 5 mg/dL.

Tongue ulcers on the right and left sides of the tongue is a sign of kidney disease in cats.

  

X-rays show severely enlarged kidneys.
Blood test on Sep 5, 2018

Haemoglobin 7  (8-15)
Red cell count 3.8  (5-10)
Total white cell count 4.5   (5.5 - 19.5)
    N = 88%  Absolute 3.95
    L=5%  Abs  0.25
   M=6.3%  Abs 0.28
   E=0.8%   Abs  0.04
   B=0.1%   Abs  0.01

 Haematocrit  0.22  (0.25-0.45)
MCV  60                 (39-55)
Platelets 185    (300-800)

 Urea 72.5  (7.2-10.8)
Creatinine  1142  (71-160) umol/L
                  =12.9mg/dL
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umol/L x 88.42 = mg/dL

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Creatinine  mg/dL   Feline

Stage 1              Stage 2                  Stage 3                           Stage 4
No azotemia      Mild                      Moderate                        Severe
Less than 1.6      1,6-2.8                 2.9-5                             More than 5

This case, creatinine level  is 12.9mg/dL,   = severe azotemia

         








Day 2. The cat has been given 2 bottles of IV drips.

3263. Respiratory problems in red-eared slider

3262. INTERN. An 18-year-old Pom X has back pain suddenly. Spondylosis deformans X rays in 2017

Many dogs live very long years as in this case. As in old people, they have difficulty getting up or walking. In this case, X-ray evidence shows spondylosis..

WHAT IS SPONDYLOSIS?

Dog is 18 years old

In 2017, after the X-rays showing spondylosis, the dog could stand up and walk. She walked a bit slow but had no pain symptoms.

However, in Sep 3, 2018, the dog screamed in pain after falling down and so consulted Dr Daniel Sing of Toa Payoh Vets. No X-ray was taken.

Blood test showed high blood urea of 25 mmol/L (4.2-6.3) and creatinine 204 umol/L (89-177).

ALT/SGPT 126 u/l (Haemogloblin 11.7 g/dL (12-18)

Red cell count 5 (.5.5 - 6.5). The dog is anaemic.

TREATMENT

Most old dogs are given painkillers. They can live a normal life with medication.

This dog was prescribed painkillers. On follow up 7 days later, the owner said the dog was walking and was not in pain. 

3261. How to stop new puppies from crying at night?

HOW TO HANDLE WHINING PUPPIES FOR FIRST 7 NIGHTS?
As there is no way to turn back the clock for Bobby, I write the following for those who adopt or buy puppies and face noisy ones for the first few nights. Apartment neighbours don't like noise disturbances.
The following bedtime tips may be useful:

1. Ignore the puppy is one way. But that has to be done by all family members. There should be nobody going to the puppy when it whines or barks. It knows that it is rewarded for attention and continues.

2. Crate the puppy and put the crate in your bedroom. Cover the crate with a blanket. Have chew toys inside the crate.

3. Switch on the radio or put a clock next to the puppy at night. Put in an old shirt of yours. Maybe a hot-water bottle in the crate.  

4. As for paragraph 4, but the old shirt is from the breeder's or kennels where you purchased the puppy.

5. Sleep beside the puppy at night for the first few nights.  Some puppies want to go to the toilet past midnight as they don't want to soil their crates. The whining happens after midnight. Pay your child to do this job for the first 3 nights. Buy the puppy over the weekend so that you have the free time to do the job. 

6. Cover up all sides of the crate so that the puppy feels safe. 

7. Continuous positive reinforcement training. Put food treats inside the crate. Say "Go crate". Food treats and praises. Do not expect results in less than 14 days of training.

8. Sleep in your bed as one option for small breeds. 

9. Exercise the puppy till it is tired and just wants to sleep. No afternoon nap. 

10. Put the puppy in a boarding kennel for 3 - 7 nights if the puppy is a noise nuisance and barks loudly in the middle of the night, upsetting neighbours. In many cases, the puppy quietens on returning home.
TIPS TO STOP PUPPIES BARKING

Best time to train is when the puppy is young. But you must know why the puppy barks. Below are the common situations:

1. Bark to ask you to wake up past midnight to change the soiled newspapers inside the crate during the first week. If you can't get up, the puppy may continue barking.

Some first-time owners get up and gave the puppy a spanking or shouting. They don't know that they have to change the soiled papers, thinking that the neighbours will be upset at this noise nuisance. Some owners change the papers and the barking stops. Do not play with the puppy. Just change and go to sleep. The tone of bark sounds different.

2. Boredom. The more he barks, the more attention he gets. So he barks more.

3. To let you know that someone or something is unusual.

4. Greeting you.

Train him not to bark when you are at home:

1. Find a situation where your dog will always bark. For example, a person knocks on the door or rings a door bell. Somebody walking past the apartment.

2. When your rushes to the door and bark loudly, go to your dog, grab his collar and give him the command “quiet” in a firm voice.