Monday, October 21, 2019

3305. The poodle bleeding could not be clotted - low platelets

Last time, she was spayed. Her blood could not clot. Now she had a lower eyelid wound. The owner quickly applied some baking soda powder.

No serious loss of blood.
Blood test showed lower than normal platelet count too.
An auto-immune thrombocytopenia is likely.
Elevated liver enzymes and lowered creatinine and urea than normal.

3304. INTERN. The 10-year-old Shih Tzu has an itchy dry eye for the past 11 months. What to do?

VIDEO by intern
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The objective is to educate the owner on why I (Dr Sing Kong Yuen) advised enucleation in this case

Enucleation is needed as the dog sufferred chronic eye pain and itchiness. (This is not a video about how the eyeball is removed).  So you have to plan how you will produce the script to answer the above objective to the owner.

Use edited video footages. There are 2 videos.
Use parts of owner's comments, parts of vet's comments and your conclusion.


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Hook: (Maybe 1 W and 1 H in the hook, out of 4 Ws and 1 H)

Video footage of dog and settings (e.g. dog lives in Bishan-Toa Payoh Town, Singapore) is preferred.


Shih Tzus, Pugs and Pekineses ..a breed known for prolapse of the eyeball...(Intern, do your research).

Why do such breeds ?

How it causes eye corneal ulceration?  Painful, sunlight and breezes...rub eyes....



Be Kind To Pets Veterinary Educational Video Image



Title: Eyeball removal (enucleation) to resolve the chronic pain and itchiness in a Shih Tzu's left eye.




INTRODUCTION

Many owners delay seeking veterinary treatment...itchy, painful....more ulceration...keratitis
corneal perforation (descemetocoele)....Intern to review my other cases and show images of descemetocole, chronic ulcerative keratitis etc.

Eyeball removal is an emotive issue for dog owners as for human beings.




This case, Dr Sing Kong Yuen gave his opinion. Recurring pain, loss of eyesight present already.....
In my opinion, the best solution is to remove the painful and itchy eye.


The left eyeball is very itchy as it is a dry eye












Post op








Pre-op video



POST-OP VIDEO





CONCLUSION
If the dog has lost his eye-sight as in this case and has to keep rubbing his itchy eyes against the wall daily to relieve his itchiness, the best solution for him is to remove the painful and infected eyeball. After around 14 days, he lives a normal pain-free life.



Early treatment of eye injuries may prevent enucleation if the corneal ulcerations are not serious. However, failure to get the eye treated by the vet or the treatment had not been effective may lead to recurring eye pain and dry eye. In such cases, enucleation may be best for the dog.

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ORIGINAL FILES





Saturday, October 19, 2019

3303. A 2-year-old Syrian Hamster's gigantic neck tumour

 

Oct 18, 2019

....gmail.com

12:10 AM (7 hours ago)

to judy

Hi I have a almost 2 years old Syrian Hamster about 136 gram male, having exactly the same issue in this article. 
http://www.sinpets.com/F6/20110323massive-neck-tumour-syrian-hamster-surgery-toapayohvets.htm

3 weeks ago, I notice a pea like lump on the neck and went to a Vet Clinic. They didn’t managed to extract pus but blood so asked me to monitor. Around 10 days ago I visited the vet again. The vet still couldn’t assess whether is is a lump or tumor. It has grown 5x in size. The vet only gave me antibiotics and painkillers, but now the lump today is more than 20x.


I feel this is tumor. Is it operable for my hamster age? He’s almost 2 years. He’s pretty active but lately not drinking from bottle though still eating lesser and his poo is smaller n dryer. His hair seems whiter and lesser.

Please advise if surgery can help.

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REPLY FROM TOA PAYOH VETS  dated Oct 19, 2019

I am Dr Sing Kong Yuen. Thank you for your email. 
My reply is as follows:
1.  We need to examine the tumour to confirm whether it is operable or not. From your image, it appears to be operable as it is subcutaneous.
It may be a haemangioma (benign) or a haemangiosarcoma (malignant) with large blood vessels from the neck feeding its growth. Histology is the only way to confirm its cell composition.
2. Surgical removal is the only treatment. There are large blood vessels which need to be ligated, if possible.
3. The surgery is high risk as the tumour is gigantic now - the hamster is older. He  may not survive the anaestherric stress of surgery as he is now in poorer health (not eating, less poo).
4. There may be profuse bleeding after removal, leading to death.
5. If you consent to the risks  mentioned, please bring in your hamster for surgery today, Saturday Oct 19, 2019. 
Best wishes.

OPERATION WAS PERFORMED BY DR DANIEL ON SUN OCT 20, 2019. The hamster is OK as at Oct 22, 2019 on phone call. Owner sent a photo.



IMAGES OF SURGERY






Image from the owner sent today Oct 22, 2019. Hamster was brought home on the day
of surgery. The hamster was sleeping.



UPDATE ON NOV 27, 2019
Another fast-growing neck tumour on the right side appeared. It was as large as the one excised from the left side of the neck recently. The cancerous left neck tumour had spread to the right side. No surgery was done. The hamster was given palliative care by the owner. 

Early removal of the tumour when it is 5 mm across may or may not prevent development of cancerous tumour. Hamster owners are advised to seek a hamster vet to get any small tumours excised when they are much smaller.
 

FINAL VIDEO:



THIS BLOG: 

 

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IMAGES OF PREVIOUS CASE STUDY DONE BY DR SING KONG YUEN IN 2011, as mentioned in the email



Neck tumour has been excised



Large neck tumour excised















  

Friday, October 18, 2019

3302. intern. Urethral obstruction in the cat. The 10-year-old male, not neutered cat cannot pee urine normally.




DRAFT REPORT FOR INTERN


PROCEDURES
1. Unblock the bladder. Difficult. Massage urethra. Squirt normal saline. Patience. Not to use probe.
2. Medication. Antibiotics and painkillers.
3. Prevention.  Therapeutic diet acidifying urine








 



pH = 6 (acidic) 7 days after treatment

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ORIGINAL FILES




Tuesday, October 15, 2019

3301. Writing. Create the suspense film that sells - producer, director, writer - Renee Harmon

Tue Oct 15, 2019  Esplanade




3 types of Suspense Films
ACTION FILM
HORROR FILM
SUSPENSE DRAMA






SUSPENSE DRAMA  delves deeply into a character's pyschological makeup. The suspense drama's protagonsit, antagonist and the plot's Main Question are not as clearly defined as in any other SUSPENSE film, since it is PREMISE that ties the plot together.


PREMISE has little to do with either the featured character's motives, goals and action. It does not answer the Main Question, but it deals with the question the FILMMAKER WANTS TO ASK.


IMMORTAL BELOVED - lets the vewer discover Beethoven's twisted personality, as the executor of Bethoven's will searches for Beethoven's Immortal Beloved. PREMISE QUESTION: Was Beethoven, because of his genius, above moral obligations and restrictions.   MAIN QUESTION: Will the Executor of Beethoven's will find the Immortal Beloved.


WAR OF ROSES - subjects the viewer to the apex of materialism, as fighting each other for the possession of their home, both husband and wife die. PREMISE QUESTION: Are we caught up in materialism? MAIN QUESTION: Who will keep the house?


  


Saturday, October 12, 2019

3299. Email query on red-eared slider's shell condition


Oct 10, 2019
Email to Toa Payoh Vets

Hi,


How do deal with this issue?
Sent from my iPhone






Oct 12, 2019

Thank you for image. How long is the shell in this condition? Fungal infection is one cause. Others include chemicals, friction and traumatic injury. 
The vet needs to examine and check for fungus by microscopic exam or dermatophyte culture. .
Make an appointment 6254 3326 if possible.