CASE 1. Feb 8, 2020.
This 8-year-old red-eared slider had laid batches of 3-4 eggs twice per year since the age of 5 years. But no eggs were laid today despite soil digging. She was anorexic for 7 days. The slider had loose skin folds in front of the hind limbs, indicating a severe weight loss over the years. "We feed less and once a day," the mother said. The young man's mother said: "She is ravenous after egg-laying usually."
X-rays showed 6 well formed eggs. The slider was alone in this place except for another species.
The loose skin folds in front of the back legs and the inability to turn upright within 2 minutes suggested a slider in poor condition.
Digs soil. No eggs laid. Very thin. Anorexia 7 days.
Constipation - rectal mass
I did not give the oxytocin injection as the slider was in poor health. X-rays showed some
dense material inside the rectal area. Oil laxative was prescribed. No calcium and oxytocin
injections in this case as the slider was very weak.
Follow up on 19 Feb 2020:
11 days after the consultation and treatment, the owner texted me saying that the slider laid at least 4 eggs buried deep in the soil. The owner did not dig up all the soil and so the slider could have laid all 6 eggs.
"She has an excellent appetite but was picky, " he texted. "She ate only prawns, Hikari and Reptomin pellets. She ignored the vegetables and disliked the Critical Care. I soaked the pellets in a calcium supplement and feed her." This was a happy ending.
VIDEO - Consultation. Not eating, difficulty in laying eggs
Not able to turn upright is a sign of poor health.
OUTCOME
13 days later on Feb 19, 2020. Buried at least 4 eggs deep inside the garden soil.
Appetite ravenous now. Picky. Ate prawns and pellets (video) but not vegetables. The owner is
advised to feed more as the slider is very thin.
BETTER QUALITY TURTLE FEED IS GIVEN
TIPS AND ADVICES
Poor nutrition like insufficient calcium and infections due to the extensive shell rot lead to WEAK uterine contractions. The slider must regain her health and weight if she is to lay eggs naturally. In this case, I did not give the oxytocin and calcium injections as the slider is very weak and may be infected by bacteria.
In such cases, the slider would still be unable to lay eggs after the injection.
Critical care and antibiotics are given for the next 7 days. The owner has to syringe feed 6 x per day the Critical care and observe the amount of stools and number of eggs passed. Oxytocin injections will be given when the slider is in better health if there are no eggs laid.
FINAL VIDEO: HOW TO SYRINGE FEED A RED-EARED SLIDER
As seen from the X-rays. 3 eggs had been laid nataurally
In this healthy red-eared slider, the oxytocin and calcium injections were effective to stimulate the uterus to contract. An appropriate dosage is important.
HOOK
Have you ever suffered from toothaches? You feel a very painful sensation when you drink cold water or eat food. You need a dentist. Animals can't talk and may show different signs.
In one of my unusual signs, a Miniature Bull Terrier in 2008 had frequent seizures (3 images BELOW) for a few months as he jogged with his master. Only after my extraction of the loose and decayed teeth did he live a normal life without fits! He was able to continue his daily jog and the owner was very happy. This is a rare case of seizures caused by dental disease. Your older dog or cat will have bad breath, eat lesser amount of the dry food or eat just soft food. A common sign is weight loss (image) and moving his head away to prevent you examining his mouth.
A TYPICAL CASE In Feb this year, the owner of this 14-year-old male neutered poodle would want just vaccination for his dog every year as diseases like distemper, parvovirus and leptospirosis are still present in some dogs in Singapore. He would decline dental work and blood tests. A quickie vaccination and go home.
Lethargic, scrawny and protruding spinal backbone
Weight loss and bad breath
"Your old dog is scrawnier this year," I told him. "His backbone spines are protruding. He is hunched as if he has abdominal pain. "He moves his head away when I try to open his mouth to examine his teeth and gums," I continued. "This is a sign of severe oral pain as he has been eating less every day."
Mr Tan got the news that his dog suffered from kidney and liver disorder (blood test results) after a blood test.
"When can you do the dental work so that your dog can eat without mouth pain and put on weight?" I phoned Mr Tan as he did not phone us for any advices after knowing the blood test results.
"I know he has liver and kidney disorders as shown in his blood test," he said. "Will he die under general anaesthetic during dental work?"
"No vet can guarantee there will be no anaethestic risk," I explained to him. "Your dog has a strong normal heart and lungs. From my experience, if I use only isoflurane gas anaethesia and no IV sedation and have no deaths from this method. "
Mr Tan gave his consent. The dog had 4 bad teeth extracted and was awake within 5 minutes at the end of gas anaesthesia. My assistant opened his mouth and showed Mr Tan the white teeth. The dog has no objection to his mouth being opened this time. A special therapeutic diet called Hills K/D needs to be fed as it is formulated for liver and kidney disease. The dog should now gain weight and live longer with a good quality of life. ANAESTHESIA AND DENTAL WORK (video)
CONCLUSION IT IS IMPORTANT FOR THE VET TO FOLLOW UP AS THE OLD DOG NEEDS HELP. The owner can then ask questions about the anaesthesia and be well informed of the risks. If he is assured of the chances of success, he will permit his dog to be given dental work.
Most dogs with bad teeth and gum infections will eat little as in the following case. The dog becomes very thin. He does not want his mouth to be opened, a sign of painful mouth as in this case study
Losing weight. One reason is oral pain due to dental disease.
This male neutered 14-year-old poodle came for his annual vaccination every year. I showed the protruding spinal backbone which stood out above the back. The dog washunched as if he was having abdominal pain (image).
He moved his head sideways and upwards as he objected to his mouth being opened by me - a sign of oral pain. Bad breath wafted from his mouth. The back teeth were encrusted with solid brown tartar.
BLOOD TEST
Abnormally high ALT, high urea and creatinine levels suggestive of a liver and kidney disorders.
Polydipsia (drinks a lot more) and polyuria (pees a lot more) are present, indicating liver and kidney disorders. A therapeutic diet, Hills K/D is recommended for such patients.
Lethargic, very thin and drinks a lot
Came for yearly vaccination. Now 14 years old.
Needed dental work.
Thick tartar on teeth and inflamed gums indicating chronic gingivitis
MINIMISE ANAESTHETIC RISKS
Isoflurane gas at 3%. No sedatives IM or IV. This method is safer as it reduces the risk of death due to respiratory depression. 0.5 ml of furosemide IV given as the some lung sounds were present and the dog had a history of "asthmatic" attack occasionally.
VIDEO OF TOA PAYOH VETS OPERATING ROOM
Before dental work - Thick tartar and chronic gingivitis
White" teeth. One decayed tooth extracted (arrow)
TIPS AND ADVICES
1. He should be eating healthier diet. The Hills prescription diet is formulated for patients with kidney and liver disorders.
The dog will be reviewed every 6 monthly.
2. During annual vaccinations, some owners do not want dental work to lower the veterinary costs.
Early detection of dental disease, liver and kidney orders would enable the dog to live a longer life. 3. The dog recovers fast from gas anaesthesia (video footage) and the owner is pleased with the "white" teeth. VIDEO
Overgrown front teeth (incisors) had been trimmed. No images were taken, but the video shows
the process.
Extraction of the abscessed molars would be done 7 days later if the guinea pig is fit for anaesthesia.
I had drained and lanced the left jaw abscess. It was filled with foul-smelling pus.
The owner did not return for dental work.
-------------------------------------------- In December 2015, the guinea pig had overgrown incisors and molar spurs clipped short by Dr Sing Kong Yuen one year ago and had good appetite. No dental X-rays were taken as the owner wanted the least cost.
From July - September 2016, the father and son would bring the guinea pig to cut short the overgrown front teeth only every month. This was an inexpensive procedure compared to more detailed dental X-rays. The guinea pig would eat again.
But in Nov 8, 2016, they consulted me as the 5-year-old guinea pig was emaciated, anaemic and was not eating. There was a gigantic left jaw abscess. Two treatment options are available. 1. Marsupialisation - opening up a big hole, drain the abscess and stitch the mucosa (inside layer) of the abscess to the skin, creating an open wound. The wound can be flushed daily. 2. Remove the capsule of the encapsulated abscess. This would permit the pus to be drained At Toa Payoh Vets, I incised and drain the abscess. The decayed molar tooth can be extracted when the guinea pig is in better health. The owner has to return for this dental work. The owners did not return for follow-up. In conclusion, three procedures are needed when the guinea pig has overgrown front teeth and is not eating and loses weight. 1. Physical examination for jaw abscess and dental malocclusion 2. Examination of molar spurs using the otoscope. 3. Skull X-rays, using oblique views to see the teeth.
