Tuesday, May 5, 2020

4122. Red-eared slider has difficulty laying eggs. Oxytocin injection can induce egg laying if done early in dystocia


A COVID-19 PANDEMIC STORY




ON MAY 9, 2020, I FOLLOWED UP

"She is not eating even though it was a week ago that she had laid eggs after the oxytocin injection," the owner said over the phone. "Could she have another egg to lay?"

"X-ray showed 9 eggs and she laid 9," I said. "Unlikely, unless it is a soft-shelled egg that had ruptured."

MAY10, 2020.
"Still restless, not eating," the owner noted. "In the past, she ate around 3 days after injection and egg laying. Now, it is over 7 days! When would she recover her appetite?"

The slider was brought to the garden now that the Government had relaxed to rules in closing it. There had been complaints that the Government ought not have closed the condo gardens. After all, only condo residents are permitted. With closure, the argument went, the condo residents had to exercise outside the condo, increasing the crowd in public parks.

But all playgrounds in Singapore had been closed.

"Did she lay the eggs?" I aside.
"Nothing, but she lingered for one hour.

CONDO MANAGEMENT did not prohibit this slider from digging the soil?
"No, she covered up after laying the eggs."
She doesn't eat the flowers or plants, the watchful owner saw to it that dogs do not get close to her. Many children and residents including expatriates looked forward to seeing her.

FEEDING

Adopted at around 2 years of age. Ate veg for the 6 mths to 1 year. Then no interest.
Changed to prawns. Daily 2-3 light grey prawns. MUST be fresh boiled, or will not eat.
Eats only the expensive purplish leaves seen in salads

Now, mainly fresh grey prawns, not the black Tiger prawns. Must be fresh.
Tried cod fish, but not keen after first 3 times.



Very relaxed watching TV
But when need to lay eggs, will go to the main door.
Adopted at around 2 years old. Now 6 years old.

Oct 2017.   First time visited Toa Payoh Vets. For anorexia. X-rays. No eggs. Antibiotics.
Oct 2018.   X-ray  5 eggs. Laid eggs naturally.
Aug 2019.  X-ray and inj oxytocin   1.5 ml SC          10 eggs   1.9kg
Dec 2019.     "                  "                                            7 eggs
Mar 2020      "                  "                                            9 eggs
May 2, 2020      "                  "                                           9 eggs  2.2 kg. Not eating for over 1 week instead of usual 3 days. Why?

May 10, 2020. Egg laying signs. Brought downstairs. Garden.
Dig a hole, laid there for 1-2 hrs. Tried to push out, but no egg.
(Maybe expelled the remnants of soft-shelled broken eggs stuck inside for the past one week," I said. "Did you see any green discharge?"
"It was too dark, but I saw twice that she passed the unusual green discharge inside the water!"

"She is not eating," the owner had to persuade her by talking to eat 2 prawns for the past 7 days.

  




Did passed unusual greenish discharge (not brown stools) in water 2 times. Just not hungry. Why. 
Dug deep hole. Stayed there for 2 hours. Owner wanted to sleep.Brought back to condo to clean up. Bath tub. Suddenly, very hungry. "Ate 2 prawns and wanted more," the owner had to boil the prawns first. So had fed 40 shrimps. 




After digging hole and lying in the soil for around 2 hours, she was brought up, cleaned.
Very hungry...

        40 shrimps while owner boiled the grey prawns. Not the blackish Tiger Prawns as she does not like them. She also liked the purplish leaves seen in salad dishes. Prawns are boiled. But she is very fussy about the freshness. Would not eat those prawns that are not fresh.



EGG LAYING BEHAVIOUR
1. Not eating. Restless
2. Makes noises whole night. Few days. 
3. Goes to the main door wanting to go out.


Carried to the garden. Pandan trees but few flowers. Management do not mind.
But on 1 May 20, the garden was closed up during lockdown which ends in Jun 1.
Security patrols. "Why not do it quietly?" I asked.
"A lot of residents will take photos and sent to the authorities," she told me. $300 fine. So, waited till next morning and brought to Toa Payoh Vets.
  





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2/5/2020. She had come to Toa Payoh Vets as Covid-19 pandemic circuit breaker lockdown to stem the spread of the coronavirus meant that the condo management had closed the condo playground garden.

So, the slider could not go to the soft soil to dig and lay eggs that night.  All playgrounds and exercise areas in Singapore were also closed to prevent community spread of Covid-19.

GARDEN WITH LESS FLOWERS, LOOSE SOIL WHICH APPEALS TO HER. 

Not eating. Restless instead of being relaxed, tried to open the main door to go out.
She would have scouted a safe spot, dig the soil to lay eggs naturally. Around 2 hours.



X-rays showed 9 eggs. Dr Daniel Sing gave Oxytocin injection of 1.5ml SC.
The first egg was laid around 30 minutes after the injection.

The other 8 eggs were inside the car on the way home.

























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Some Singapore owners of red-eared sliders are concerned when their slider has difficulty laying eggs as in the following case study. Early oxytocin injection can induce egg laying, in our experience with our cases. Do not wait more than 24 hours.

See
CASE 1.

https://www.youtube.com/watch?v=-3zfw0oh99M


CASE 2.

This 8-year-old female Red Eared Slider has a body weight of 2.2kg.

She lays eggs once every 3 months or once every 6 months for last 2-3 years.
Nowadays, she lays eggs once a month. Sometimes she lays eggs naturally. Other times, she will need the oxytocin injection given by Toa Payoh Vets.

The following is the history:
.
14/12/2019 - x-ray (7 eggs) , gave Oxytocin inj -1.5ml SC , 1st egg lay 15 mins after inj
After that lay eggs by herself for 2 times

22/3/2020 - x-ray (9 eggs, including one big egg) ,  gave Oxytocin inj -1.5ml SC , 1st egg lay 20 mins after inj


In April, she laid eggs naturally in the garden.

2/5/2020. She had come to Toa Payoh Vets as Covid-19 pandemic lockdown has closed the playground garden sand where she would dig to lay eggs naturally.
X-rays showed 9 eggs. Dr Daniel Sing gave Oxytocin injection of 1.5ml SC.
The first egg was laid around 30 minutes after the injection.
The other 8 eggs were inside the car on the way home.

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Mar 27, 2020


Kong Yuen Sing 99pups@gmail.com

Mar 27, 2020, 7:42 PM


to jimmyme

Hi
I am Dr Sing Kong Yuen from Toa Payoh Vets,
I am doing research on your red-eared slider.
May I ask you the following:
1. Since April 2019 when I injected and Kame laid eggs, was there any other occasions she laid eggs?

2. Was she laying eggs monthly for past 12 months?

3. What diet is she fed?

4. How did you know she could not lay eggs in Mar 2020?


Many thanks to both of you.   


Dear Dr David Sing



Thank you for your interest in understudying Kate. 



My wife, R... who handles Kate daily has other households matter to settle and will get back to you after reviewing photos and collecting the data. 



Item 1. (yes other on occasions) is once every 1 month or 2 months. 



Item 2. (yes, must check the dates because some time she can lay naturally) but we do not know how many more eggs ( without X Ray ), So when she displays certain signs  ie very restless , at night can’t sleep, making a lot of noise and kicking around, and she will run to the main door signalling to go downstairs  to lay eggs which my wife feels she wants to lay eggs.  R.. will bring her downstairs to look for a suitable place, ie suitable sand.  



Item 3. Kate eats mainly cooked prawn and small dry shrimp twice a day.  She also eats vegetable and on a few occasions we feed her cooked scallops. 

Item 4. She was laying eggs monthly since Dec 19 (the last time we brought her to inject oxytocin) with Jan and Feb (lay eggs naturally) and Mar 20 (oxytocin iinjection).

DECEMBER 2019

4 eggs were laid naturally. Dystocia. Came for oxytocin injection after X rays





MARCH 2020
We let her lay eggs naturally but on Saturday, 21st March 2020, it was raining and we tried 3 times. We were not successful, so we brought her over on Sunday 22nd March. 

After x ray, Dr Daniel Sing injected her with oxytocin. She laid 8 eggs.  Dr Daniel indicated 9 eggs were inside her abdomen. One big egg seen in the X Ray was on Tuesday, 24 March 20 at about 7pm naturally (she dug the hole and laid and covered it).  My wife dug it out to take a photo of it. 















MAY 2, 2020. COVID-19 LOCKDOWN.


2/5/2020. She had come to Toa Payoh Vets as Covid-19 pandemic lockdown has closed the playground garden sand where she would dig to lay eggs

X-rays showed 9 eggs. Dr Daniel Sing gave Oxytocin injection of 1.5ml SC.
The first egg was laid around 30 minutes after the injection.


The other 8 eggs were inside the car on the way home.






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Abstract

Oxytocin dosage was determined experimentally for the red-eared slider (Trachemys scripta elegans). Five dosages including 20, 10, 5, 4, and 2 units/kg were experimentally compared in 253 female turtles in a series of experiments conducted in 1999 and 2000. The 3 highest doses were equally effective overall following a maximum of 2 injections. The 2 lower doses were equally effective overall following a maximum of 2 injections. Success rate (i.e., turtles laid all eggs or retained 2 or fewer eggs following a maximum of 2 injections) ranged from 100% (20 and 10 unit/kg doses) to an average of 88.9% for the lowest doses (4 and 2 units/kg). When reduction in oxytocin exposure is desired, the lower dosages are recommended; when turtles are being treated for egg retention, the higher dosages may be more desirable. No difference in oxytocin efficacy was found among 3 species of chelonians (red-eared slider; stinkpot, Sternotherus odoratus; and painted turtle, Chrysemys picta) when oxytocin was given at 4 units/kg. No difference in efficacy was found among 2669 red-eared sliders from 2 collecting areas in west-central Illinois induced with 4 units/kg between 2000 and 2005.



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Abstract

Nonobstructive egg retention is quite common in captive-bred turtles and may result from several different factors, including poor husbandry and poor physical condition. Oxytocin, 1 to 40 IU/kg, can be used to stimulate oviductal contraction and induce egg deposition. The purpose of this study was to investigate the efficacy of low-dose intravenous (IV) and intramuscular (IM) oxytocin for managing turtles with nonobstructive egg retention. Physical examination and radiographic and computed tomographic evaluations were performed in 39 female red-eared sliders (Trachemys scripta elegans) that were showing overt clinical signs of egg retention. After being placed for 7 days in a suitable environment without laying their eggs, a diagnosis of nonobstructive egg retention was made in 30 of the turtles. These 30 turtles were then randomly divided in 2 groups. Group OXY-IM (n = 15) received 2 IU/kg of oxytocin IM, whereas group OXY-IV (n = 15) received the same dose IV. If animals did not lay all of their eggs within 60 minutes, a second dose (2 IU/kg) was administered. Follow-up doses were given every 120 minutes until all eggs were laid. The mean time for animals on OXY-IM to start laying and complete egg deposition was 97 ± 22.4 minutes and 246.1± 27.37 minutes, respectively. All animals required a second dose, 10 turtles (66.6%) required a third dose, and 5 turtles (33.3%) required a fourth dose. The animals in OXY-IV started laying eggs on average of 61.26 ± 13.9 minutes after treatment and completed laying eggs 147.2 ± 25.5 minutes after treatment. Six animals (40%) required a second dose of oxytocin, and 4 (26.6%) required a third dose. There were significant differences (p < 0.001) in the elapsed time between the first injection and the start of egg deposition and total egg deposition between the 2 treatment groups. In conclusion, oxytocin administered IV provided faster results than IM dosing for the treatment of nonobstructive egg retention in red-eared sliders. No side effects were observed in either treatment group.





    Saturday, May 2, 2020

    4119. What to do if your rabbit has overgrown front teeth? Malocclusion

    The lower front teeth had been worn down as the rabbit tried to eat. Due to the mis-alignment of the upper and lower jaws, the upper front teeth could not wear out when the rabbit ate. So the 4 upper teeth grew sideways. The 2 bottom teeth were worn out and hence they appeared very small or "fractured." The 4 upper front teeth are overgrown.
    TREATMENT. 1. SURGERY. The best solution is to extract all the six front incisors of this rabbit. In our experience at Toa Payoh Vets, extraction of the 6 front teeth enables the rabbit to eat properly. 2. TRIMMING OF THE OVERGROWN TEETH. The owner in Singapore sometimes forget to trim the overgrown front teeth regularly. Since the teeth become overgrown, the rabbit cannot grasp the food and soon becomes very thin. OTHER DENTAL PROBLEMS - MOLAR SPURS MOLAR SPURS are present when the rabbit cannot grind the food properly since the overgrown front teeth causes difficulty in chewing. The sides of the molars get worn out abnormally. In the rabbit, the upper molars with develop sharp edges called spurs. These cut into the inside of the cheeks causing cheek ulcerations. The lower molars will have the inner sides develop sharp edges. The left side and right side of the molars develop arching spurs. These entrapment of the tongue, making it difficult for the rabbit to move his or her tongue to eat properly. Molar spurs need to be trimmed by the vet as soon as possible. CONCLUSION As a consequence of not getting the vet to treat early, the rabbit cannot wear its cheek teeth properly. Molar spurs (sharp ends) develop, causing incorrect positioning of the molars. This lead to bacteria entering the roots of the molars causing dental or jaw abscess. The rabbit dies if he is not treated as he becomes malnourished and dehydrated over time. Extraction of the overgrown front teeth will have prevented the development of molar spurs and dental abscess which are expensive treatments. ANOTHER CASE STUDY IS AT: https://2010vets.blogspot.com/2018/05/3152-rabbit-has-malocclusion-and-broke.html

    4118. Kidney Failure in a cat. Kidney stones in a dog

    Write according to the 3 D's, wrapped up in a drama, below:

    DETAILS
    DIALOGUE
    DISCOVERY

    For example:


    1.  DETAILS.  Explain kidney failure...anatomy, physiology, etc. Case study.
     


    Halithosis, a large tongue ulcer, gum inflammation
    What happened to this old cat?


    2. DIALOGUE creation based on Q andA . You need to imagine what the vet will ask based on
        Signs and symptoms:    Apppetite, Drinking, Urination, Stools.
                                              Complaint usually is vomiting, not eating>
       

    "My old cat has been vomiting a lot," the owner said. "I think she is suffering from food poisoning!"


    3. DISCOVERY.  Diagnosis, treatment and prevention. Outcome, prognosis for CKD.

    Learn how to write a concise interesting script based on the 3 D's wrapped in drama.

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    FINAL VIDEO DONE BY THE INTERN AS FOLLOWS:










    --------------------------------------------------------------------------------
    The following is the guideline for the intern to create the above video.

    COMMENTS:  THE 2 TITLES  ARE:     KIDNEY FAILURE    KIDNEY STONES

    The article can be more concise and should have veterinary medical terms as it is a veterinary educational video for Vet Students (& Pet Owners). Use the 5Ws and 1 H (how)

    FOR SCRIPT WRITING to create a video, USE TWO COLUMNS. e.g.   .


    Text  in left column                                                     Insertion in right column
                                                                                        Insert (gifs, images, video etc at appropriate                                                                                            sections of the text)  e.g. X-rays, blood test                                                                                              reports of high BUN, creatinine in a real case.

     1.  What is a kidney failure?
          Where is it?
          What does it do?
          Who (is the patient - dogs, cats in this article)
          Why does the patient get kidney failure?
          How do you diagnose and treat, outcome
          How do you prevent kidney failure?



    2 LINKS IN MY YOUTUBE. Try to edit footage and make a really fun to view vet educational video


    1.  X-rays of a 13-year-old cat with Stage 4 Chronic Kidney Disease



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    Please REVIEW MY WRITING AS IT IS A DRAFT AND IT IS UP TO YOU TO
    EDIT AND CREATE THE VIDEO BASED ON THE IMPORTANT ASPECTS. IF I DO IT FOR YOU, YOU WILL NOT LEARN MUCH. HENCE THE DRAFT.   


    X-rays of the cat's kidneys with no chronic kidney disease - Part 2

    The cat went for boarding for 5 days. Came home with strong smell of urine. Painful kidneys on palpation. X-rays show kidneys enlarged. Blood test shows very low platelets but no elevated urea and creatinine.

    The cat could have groomed himself, licking off the urine and stools on his body during boarding, leading to kidney swelling and  painful urination.

    After 2 days in-patient and IV drip to flush out the blood toxins, with antibiotics and pain medication, the cat goes home. Now he is back to normal.

    This is Stage 1 of kidney disease. There is no azotemia. Creatinine is less than 1.6 mg/dL.

    The cause of kidney failure was due to toxins. Prompt treatment in flushing out the toxins via an IV drip resulted in recovery.

    Sep 6 2018. Attached image of X-ray of a 13-year-old cat shows Stage 4 chronic kidney disease kidneys. See blog for better quality images of chronic kidney disease, at:

    https://2010vets.blogspot.com/2018/09/3234-13-year-old-cat-vomits-for-3-days.html
    https://2010vets.blogspot.com/2018/09/3234-13-year-old-cat-vomits-for-3-days.html




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    Introduction to Kidneys 

    Kidneys filter the blood, maintains a constant electrolyte balance, regulates hormones and secrete hormones such as erythropoietin that stimulates the production of red blood cells. 



    Acute vs Chronic Kidney Failure

    Kidney failure REFERS TO the failure of the kidneys to carry out their function

    The main difference between acute and chronic kidney failure is the duration of time that the kidney has stopped functioning.

    Acute renal failure.
    The kidney function suddenly declines for a few hours or days and is usually attributed to infections or toxins in dogs. Chronic renal failure refers to when the loss of function of kidneys is more gradual and may be over a few months or years.

    (The most common cause of this in dogs is geriatric decline, which often causes degeneration of the kidneys.)  QUOTE YOUR REFERENCE

    Causes of Chronic Kidney Failure

    In general, kidney failure is caused by:
    • Bacterial infections, like leptospirosis, which can be transmitted by drinking or swimming in contaminated water. This infection can lead to inflammation of the kidneys and consequent destruction of renal cells.

    • Toxicosis, or kidney poisoning which leads to damage of the kidneys’ cells. It occurs when dogs ingest drugs (like ibuprofen) or poisons (like antifreeze or grapes)

    • Congenital disease: hereditary conditions such as cysts and agenesis can lead to abnormal kidney function.

    • Geriatric degeneration: when kidneys get old, their cells will decline and die

    Diagnosis of kidney failure

    PRESENTING SIGNS ARE:
    POLYDIPSIA, POLYURIA, VOMITING, ANAEMIA.  (This is also a veterinary educational video!)


    symptoms such as vomiting, increased drinking and urination (use some

    lethargy, weight loss, and production of pale mucous membranes in the mouth and elsewhere are observed in the anima. Consult your vet early. 








    BE BRIEF
    A BLOOD TEST will show abnormally high levels of BLOOD UREA NITROGEN AND CREATININE.  EXPLAIN WHAT BUN AND CREATININE DOES.

    LEUCOCYTOSIS - POSSIBLE BACTERIAL INFECTION. 


    The vet will then perform a blood test and if levels of creatinine and blood urea nitrogen (BUN) are abnormally high, it is highly likely that the animal has sustained kidney damage.

    Oftentimes
    (WHERE IS YOUR REFERENCE?), a higher than normal white blood cell known as leukocytosis is also an indication of the cause of kidney failure which may be a possible bacteria infection.


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    VIDEO 2 - Kidney stones in a dog. Search my blog or youtube for a case study.

    Information on kidney stones

    The signs on the formation of kidney stones are:
    • Fever 
    • Abdominal discomfort
    • Kidney pain
    • Blood in the urine (hematuria)
    • Altered urine production
    • Lethargy 
    • Poor appetite
    • Vomiting
    • Weight loss

    Diagnosis of kidney stones

    If an animal is suspected to have kidney stones and obstruction in the urinary tract as it displays the above symptoms, the vet will then conduct an x-ray in order to clearly determine if there are kidney stones.

    Treatment of kidney stones

    In Singapore, kidney stones are often removed surgically. Struvite stones are often the most common type of kidney stones formed. These stones may recur and hence vets usually test the composition of the stones upon removal via surgery in order to predict and prevent future recurrence. In the case of urinary tract infections (UTIs), bacteria would be present along with the stones and thus it is important for vets to prescribe antibiotics in the long run for the animal. Regular monitoring via urine analysis and ultrasound is also necessary to diagnose future recurrences early.

    Overall Conclusion

    It is important for owners to do constant monitoring of their pets who may have a genetic predisposition for kidney stones or have previously removed kidney stones. Oftentimes, if there are issues with kidneys, the animals will have to be permanently placed on a special diet or return frequently for dialysis in the case of chronic kidney failure.