4095. REYNA. A rabbit has a painful eye ulcer. Chronic ulcerative keratitis. A case of corneal lipidosis

DRAFT

20 Feb 2020. The rabbit has a painful eye ulcer. Pt 1/2. Chronic ulcerative keratitis Treatment by antibiotic eyedrops for several days at Toa Payoh Vets in December 2019. The ulcer had 'disappeared' . The owner got the rabbit home but the rabbit was furious with the Elizabeth collar and pulled it out. The owner did not make the rabbit wear the Elizabeth collar. The eye ulceration returned. The rabbit has lost weight and needs to be warded for a few days for treatment and to recuperate to regain weight. The owner opted for eyeball removal as this would stop the daily eye pain, but the rabbit had to gain weight to be fit for anaesthesia and surgery. In this consultation, the ulcer is deep and the cornea is very cloudy. The rabbit is quite old and healing may not be possible if eye surgery is performed. An option will be to remove the eyeball (enucleation) so that the rabbit does not suffer from any more eye pain and loss of appetite. There is anaesthetic risk as the rabbit is 9 years old, towards the end of life. The owner will wait another 7 days of inpatient treatment to think about it.

Dec 2019 images

20 Feb 2020 images

27 Feb 2020 images

The rabbit's routine is freedom to roam in the apartment. Dust and air irritate the ulcerated right eye, leading to more rubbing. The cornea became infected and inflamed. A cloudy cornea with a central ulcer existed.  It can be painful, leading to more rubbing to relieve the itchiness.  Eyeball removal is the treatment of choice. The owner is worried about anaesthetic risks. Wanted to wait another week. 

TIPS AND ADVICES

1. Early detection

2. Early treatment within 24 hours of injury is best

3. Diagnosis - Fluorescein eye stain test
4. E-collar

5. Review

Save eye

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Rabbit eye disease


CORNEAL DYSTROPHY OR ULCERATION?

Article from:

Corneal lipidosis - also called corneal dystrophy or lipid keratopathy - is a condition where excess lipids (usually cholesterol esters) or minerals (calcium) are deposited under the surface of the cornea. The infiltration usually starts at the edge of the cornea and can be observed in the anterior stroma, the epithelial basement membrane and the epithelium.

Corneal lipidosis is not associated to a disease; it is not breed or gender dependent.

Etiology

A lipid rich diet and/or trauma are the main causes for lipid deposits into the cornea. Congenital factors cannot be ruled out.

Clinical signs and diagnosis

It is based on a complete ophthalmic examination and a discussion with the owner about the food fed to the rabbit.

Both eyes are usually affected (bilateral) but not necessarily to the same degree. Unilateral lipidosis has rarely been reported. The fat deposits, which usually start near the third eyelid, can be opaque, raised, subtle and pale, bright white, silver or grey colored areas. Vascularization is observed in the affected part of the cornea. 

 

While the cornea is mainly affected, fat deposits have also been noted in the lens, iris and ciliary body of a Dutch rabbit. Often it is accompanied by macrophage invasion. An inflammatory process has been observed, but does not always seem to be present.

Unlike in dogs, corneal lipidosis is associated with a gradual loss of vision in rabbits. If the deposit is severe, it can lead to ulceration of the cornea.

There is no pain associated to this condition.

 

 

AN EXAMPLE OF A SEVERE CORNEAL DYSTROPHY IN A YOUNG RABBIT SEEN FROM A PET SHOP IN SEP 2017.

4094. A hamster 'loses weight',

Thursday Feb 27, 2020




Existing client. Japanese or Korean lady. The hamster came in 5 months ago as he was limping. Now he has recovered. The owner texted a WhatsApp appointment to Toa Payoh Vets at 96686468.

"Hi, I would like to bring my hamster (for a health check). He is almost 1 year old and is getting skinny. What time and day can I come with  my hamster?" 

"Our hamster is losing weight" the husband had informed the wife. "A hamster had died suddenly after showing signs of breathing difficulties."
"Is he eating and drinking normally?" I asked.
"No problem".
"Are his stools normal is size and in amounts?"
"Yes."
"She weighs 50g," I showed her the weight on the scale. "In the Sep 2019 consultation for limping, she weighed 49g as recorded in the medical files.  Your hamster is very active and is in good bodily condition. Her weight is average although 55 g will be better."

 The owner had another hamster at home. This one would be overweight at over 60g.  I checked the housing. It was a crate with grilles on the top 2/3 of the crate. 

"The hamster loves to climb the bars or grilles," I told the owner. "This is not good as many hamsters do fall down and injure themselves.
"Yes,"  the lady nodded. "He also gnaws at the grilles!"
"He was limping some 5 months ago," I referred to the records. "He could have fallen from the grille and injured his leg. Fortunately he did not fracture his leg and has had recovered!"

I asked my assistant to help me open the hamster's mouth to check the teeth. "There is no overgrown front teeth," I showed the owner. "So he has no dental problems in chewing and biting food."

A strong bad breath smile wafted up from the hamster's mouth. The cheek pouches were filled with seeds and meal worm pieces as my assistant used a pair of forceps to widen the mouth. The lady covered her nose.
Hamsters do not have bad breath normally.

"Where did you get the meal worms?" I asked the lady who feeds 2 meal worms a day. "I bought them from the Pet shop,"

4093. A red-eared slider has difficulty laying eggs - ovocentesis

Ovocentesis
https://www.youtube.com/watch?v=9-S1L3CiJCM&t=28s

ovocentesis
https://www.youtube.com/watch?v=9-S1L3CiJCM




No response to oxytocin injections
https://2010vets.blogspot.com/2017/04/3067-7-year-old-female-red-eared-slider.html





 Oxytocin injection successful
 https://2010vets.blogspot.com/2018/12/sunday-dec-30-2018-oxytocin-injection.html



Cannot lay 15 eggs
https://www.youtube.com/watch?v=fyIvOkQUjIU

4092. Syringe feeding a red-eared slider - videos

Videos

*Final Video. This video shows the process of syringe feeding the slider.
https://youtu.be/1Ja0VN9oV0I

2.

4091. An emaciated dog was not eating and standing up. Why?

In Singapore, many dogs live to a ripe old age of over 10 years. However, some become very thin or emaciated. There is a belief by some owners that weight loss is a natural progression of ageing. The

dog "does eat" but cannot put on weight. 

A TYPICAL CASE STUDY.

"My dog is unable to stand up and has head tremors," said the lady owner. "I had brought him to see you some 8 years ago."

"Your dog is emaciated," I pointed to the visible ribs of this cross-bred dog. "There is no body fat. she has lost most of her teeth and has pale gums, suggesting anaemia. This means insufficient fed blood cells and haemoglobin."
"I feed her the most expensive food purchased from the Pet Shop," she informed me. "My dog does eat it."
"If he ate the food, he ought to put on more weight. I will need a blood test to check the health of his blood system, liver and kidneys."

The owner gave consent. Blood test showed very low red blood cell numbers and disorder of the liver and kidneys. Together with the signs and symptoms, the dog is in very poor health. An IV drip perked her up as she felt stronger. A therapeutic diet of Hill's K/D was prescribed. However, the dog's health deteriorated and he passed away at home 5 days later.  

TIPS AND ADVICES

Old dogs do not lose weight if they are healthy. Consult your veterinarian for early detection of disease and treatment.

FOR MORE INFORMATION

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IMAGES

Ataxia, head tremors

Ribs are prominent

Pale gums. Most teeth had dropped out

BLOOD TEST RESULTS ON 20 Feb 2020
TP 42087

Abnormal results:
LIVER PROFILE
ALT 878 U/L  (normal is less than 59)
AST 171 U/L  (normal is less than 81)

KIDNEY PROFILE
Urea 67.4 mmol/L  (normal is 4.3 - 6.3)
Creatinine 329 umol/L (normal is 89 - 177)

HAEMATOLOGY
Haemoglobin 8.6g/dL  (normal is 12 - 18)
Red cell count 3.6x10^12/L (normal is 5.5 - 8.5)
Haematocrit (PCV) is 0.27 (normal is 0.37 - 0.55)

4090. REYNA. A rabbit has a watery eye. Epiphora.

A rabbit has a watery eye. Epiphora.

Tears overflow right eye downwards to the nose
What are the causes?
1. Usually two main causes - the corneal or obstruction of the
lacrimal drainage 

Eye irrigation of the right eye, to flush away foreign bodies like grass seeds and dirt under general anaesthesia.
In-patient for 4 days. Went home. 

"Doc, look at the eye! No green corneal ulcer, right?" my assistant said as she saw no green stain on the cornea.
.

UPDATE ON 25 FEB 2020
The owner said the rabbit had recovered from the eye ulcer.
He had passed away as he was aged at 8 years.

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NO SMOKE WITHOUT FIRE

A proverb. There's always some reason for a rumour or signs of a problem.

4089. REYNA. A dwarf hamster has two large mammary lumps

Thu 21 Feb 2020

The young lady came to Toa Payoh Vets as her first hamster passed away during surgery to remove a shoulder tumour at another vet clinic. The hamster died on the operating table. So the lady surfed the internet and made an appointment with Toa Payoh Vets today.

"There is always a risk in anaesthesia," I explained to the owner. "No vet can guarantee 100% risk-free anaesthesia and surgery."

"My hamster bites," the young lady warned me. "She has one large globular lump."
On closer examination and under restraint, I discovered she had two. They measured around 8m x 8 mm. That meant a longer time to anaesthesize, increasing the risk of death on the operating table.
We let the hamster rest for one day and gave pre-op antibiotics and painkillers.

The owner decided to take a chance on a different vet clinic. The hamster was operated by Dr Daniel Sing the next day and would go home today, Saturday. All was OK (show video post op).

OPERATION
Anaesthesia - describe
Surgery - describe
Sutures
Histology of tumours done?


  A cyst with small tumours?
A tumour? 

POST-OP VIDEO

FOLLOW UP PHONE CALL ON FEB 27, 2020 - Hamster is OK.