Wednesday, May 1, 2019

3311. Westie with metastatic squamous cell carcinoma


Mar 1, 2019
Region of right prescapular lymph node: Metastatic, squamous cell carcinoma. 
No normal lymph node tissue architecture is recognised. Metastasis to regional lymph node is most likely. Neoplastic cells extend ot some of the margins of the tissue evaluated. Prognosis is guarded/poor with evaluation for evidence of recurrence and additonal metastatic disease advised.






May 1, 2019
Image above. Recurrence 

3310. Onychocryptosis - Ingrown toenail - Chemical Ablation Matrixectomy

May 1, 2019


The side of the toenail grows into the soft skin nearby - ingrown toe nail or onychocryptosis

This case occurred over a year. No infection in this case. Painful when the toe is stepped upon. Recently, more painful after tour in Morrocco.

Specialist says that the ingrown toe nail will recur when he cuts it away. Not permitted to use chemical ablation in Singapore SGH.

Chemical Ablation Matrixectomy

Local anaesthesia
Tourniquet rubber tubing clamped by forceps.

Size 61 scalpel cuts strip 
Strip removed
Clear debri.
Cotton bud - phenol onto nail bed
Clear debris
Irrigate
Cotton bud - isopropyl alcohol to neutralise phenol.
Clean up
Strip of cotton cover up. Padding. Dressing up.












Chemical ablation without surgery
Chemical ablation with surgery


Consent for Surgery Form. 3 risks explained.
Risks
1. Local anaesthetic - allergies
2. Phenol chemical ablation
3. 95 to 97% success. 3-5% recur. Cannot repeat surgery. Just cut softer nail.


Day 2 &3. Change bandage yourself. Pannadol for pain relief if present
Day 4. Goes to podiatrist. She used curette to scrap for pus. Very painful. Applied iodine.

6-8 wks to recover


CONSERVATIVE TREATMENT
Clip toe nail yourself. Painful.
Worried about being stepped on.


------------------------------

 Day 2. Post op

Sunday, April 28, 2019

3309. Lameness problems in dog. 4 cases. X-rays.

TP 46178  Milo

JR M 13yr   Limping  RH   Pain back



TP 46045  Cookie
Mini Schnauzer, M, 12yr
RH lame 2 days



TP 42793  Jewel

JR F 13yr
Limping LH



TP 22258 Ace
GR M 14 yr
Difficulty standing and walking



Saturday, April 27, 2019

3308. A 15-year-old male, not neutered poodle has 2 large circum-anal tumours

Fri Apr 26, 2019'


It is high risk anaesthesia as the dog is very old at 15 years. The 2 family vets advised medication for the past months, but this does not resolve the problem of the tumour growing larger and soiling the pampers and flooring. The owner surfed the internet and consulted me. 
"It is high anaesthetic risk," I told the owner. "The dog does not have heart or lung problems on physical examination but he is aged."





Friday, April 26, 2019

3307. Photography tips: Shoot perfect 'flat lay' still life images at home

Prctical photography Feb 2018

Natasha Breen. professional food, product and still life photogrpaher, shoots for stock agencies like Shutterstock, industry client.


Flat is trendy - Instagram
Camera  Canon 700D  EF 70-200mm f/4L/2.8 ens IS USM    Sigma 17-50mm lenses
Tripod no.  This is because she shoots with studio lights. The flash will freeze camera movement and gives crisp details.  Prefer handheld to make small adjustments. Live view makes composition easier.

Composition
Look for harmony for good results. Spend time arranging them. Objects, position, textures and light.

Lighting and flash gear
1. Usually a very simple one-light setup with or without a reflector depending on how much she wants to fill the shadows.
2.  Two flashes to imitate the look of sunshine or high-key, low-contrast look.
3. Important to soften the light to prevent too much contrast or distracting highlights and shadows.

Exposure settings to maximise sharpness of details and texture
1. Flat images are all about sharpness.  She aims to have enough depth of field ro keep everything in focus, from the closet details of the objects to the texture of the background.

2. Usually aperture of f/7.1 to f/14.  As she lights with flash, ISO setting is low. This provides best quality and minimal noise (which affect sharpness or hide fine details).

Tip
Objects m b the right kind for a flat lay image. Clear shapes, not too high. A lack of reflections help the overall harmony. Quality and texture of the background are important. Must complement or contrast with them.

Thursday, April 25, 2019