3146. STEFANIE. Leg amputation in dwarf hamsters AND TWO OTHER CASE STUDIES.

1.  Use movie structure
HOOK  --- VIEWER DISCRETION Surgical procedures ---BKTP IMAGE ---TITLE

TENSION

SATISFACTION

2. Do NOT reuse the same images for Credits as you have had used for other videos before. There are many to choose from.

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1. VIDEO 1. SURGERY - LEG AMPUTATION


DIAGNOSIS

Climb wire cages. Leg got stuck or fell down from a height. Fractured
right hind leg.

Red swollen area
Limping.
Not bearing weight on fractured right hind leg.

Footages -
Video 1/6. Consultation. Owner was not in favour of proposed leg amputation. Show some footage of conversation, if possible. 

Video 2/6.  1:36 - 2;44.  Owner decided after 5 days and brought hamster down
Right hind leg being licked till it is red.  Not bearing weight on RH. Falling down.


TREATMENT


Video 3/6.  1:40 - 2:10 approximately. Clipper used to remove hairs before operation. Edit out blurred footage.

Video 4/6.  1:27 - 1:37.   Show clipped RH

Video 5/6. Use whole clip, editing out blurred images if possible. Leave my narration intact unless repetitive.

Anaesthesia - 0.01 ml of Zoletil 50 IM (2 drops).  In this case, no isoflurane gas anaesthesia is needed as the surgery was completed within the Zoletil anaesthetic effects  SHOW BOTTLE OF ZOLETIL 100.


Surgery (show the whole video footage as narrated by me. Video 6/6)

1.  Scalpel blade used.

2. Amputate two times as follows:
At the initial fractured area
Nearer to the knee joint - higher up.

If one amputation at lower tibia, there will be a dangling stump as the hamster moves. This will irritate the hamster and cause trauma and infections. Second amputation nearer the knee joint ensures no dangling stump. Also, there will be sufficient exposure to ligate the muscles and big blood vessels to prevent bleeding to death. .

3.  Control of bleeding by suturing muscle stump.

Outcome - normal life although 3-legged. No more pain and irritation from broken exposed inflamed fractured area.

What if the owner does not want to amputate?
The swollen fractured area becomes infected as the hamster continue to lick it to relieve the pain.
Bacterial infection of the broken skin due to licking for several days.
Loss of appetite and death.

REFERENCE:
https://2010vets.blogspot.com/2014/06/1371-leg-amputation-in-dwarf-hamster.htmlAnother case of fracture in a hamster FINAL VIDEO: A SYRIAN HAMSTER FRACTURES HIS RIGHT HIND LEG https://www.youtube.com/watch?v=jrMOAmLT3mo&feature=emb_logo



Stefanie.  Many interns find difficulty in creating a hook although they can create excellent videos.
A good example of a well created hamster except that the intern did NOT use the movie structure. NO HOOK.

Priapism in a Syrian hamster
https://www.youtube.com/watch?v=7kWsOXVxF1o

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HOOK. A wired hamster cage is less expensive. But it is not safe. A hamster loves to climb up the wired frame. Falls and fractures its leg.  

https://youtu.be/Xfi9cFh8IKw

1. VIDEO 1. SURGERY - LEG AMPUTATION


DIAGNOSIS

https://youtu.be/Xfi9cFh8IKw

Climb wire cages. Leg got stuck or fell down from a height. Fractured
right hind leg.

Red swollen area
Limping.
Not bearing weight on fractured right hind leg.

Footages -
Video 1/6. Consultation. Owner was not in favour of proposed leg amputation. Show some footage of conversation, if possible.

Video 2/6.  1:36 - 2;44.  Owner decided after 5 days and brought hamster down
Right hind leg being licked till it is red.  Not bearing weight on RH. Falling down when trying to stand upright.

TREATMENT


Video 3/6.  1:40 - 2:10 approximately. Clipper used to remove hairs before operation. Edit out blurred footage.

Video 4/6.  1:27 - 1:37.   Show clipped RH

Video 5/6. Use whole clip, editing out blurred images if possible. Leave my narration intact unless repetitive.

Anaesthesia - 0.01 ml of Zoletil 50 IM (2 drops).  In this case, no isoflurane gas anaesthesia is needed as the surgery was completed within the Zoletil anaesthetic effects  SHOW BOTTLE OF ZOLETIL 100.


Surgery (show the whole video footage as narrated by me. Video 6/6)








1.  Scalpel blade used.

2. Amputate two times as follows:
At the initial fractured area
Nearer to the knee joint - higher up.

If one amputation at lower tibia, there will be a dangling stump as the hamster moves. This will irritate the hamster and cause trauma and infections. Second amputation nearer the knee joint ensures no dangling stump. Also, there will be sufficient exposure to ligate the muscles and big blood vessels to prevent bleeding to death. .

3.  Control of bleeding by suturing muscle stump.

Outcome - normal life although 3-legged. No more pain and irritation from broken exposed inflamed fractured area.

What if the owner does not want to amputate?
The swollen fractured area becomes infected as the hamster continue to lick it to relieve the pain.
Bacterial infection of the broken skin due to licking for several days.
Loss of appetite and death.

One example is seen here:

https://2010vets.blogspot.com/2017/08/3120-dwarf-hamster-bites-his-broken-leg.html

REFERENCE:

https://2010vets.blogspot.com/2014/06/1371-leg-amputation-in-dwarf-hamster.html



















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2. VIDEO 2 AND 3. 
2. Create two videos based on images in 2 case studies at:

http://www.bekindtopets.com/stories/20120406old-dwarf-hamster-ear-wax-itchy-ears-singapore_ToaPayohVets.htm

3145. Tick Fever in dogs - case studies. Babesiosis tick fever in a Presa dog

TICK FEVER IN DOGS - CASES

1.  Babesiosis in a Presa in 2014

https://www.youtube.com/watch?v=SMuSbjLSBNQ


2. Tick fever in a Miniature Schnauzer
 https://2010vets.blogspot.com/2018/09/3298-tick-fever-in-dogs-and-imidox.html

3144. A stray cat has an ocular dermoid

HOOK

Video footage - show relevant footages

LIMBAL-CORNEAL DERMOID  in a cat

An OCULAR DERMOID is a fatty growth with skin parts including hairs located in the eye area.

In this case, the ocular dermoid is located at the temporal limbus, within the sclera and corneal areas.

 It is classified as a 

LIMBAL-CORNEAL DERMOID 

Ocular dermoid - limbal-corneal. (Advised but surgery was not done. Surgical excision can be done using surgical blade No. 11).
https://www.youtube.com/watch?v=5hwuWx4T83I

The cat keeps rubbing his eye as the hairs rubs onto the cornea. The cornea becomes ulcerated and painful.  Tears flow down the sides of the eyes daily, leading ro tear staining and infections.  

SURGICAL TREATMENT - COMPLETE EXCISION

For the general practitioner, the use of

1. Superficial keratectomy using scalpel blade No. 11.

1.1. In this case, pull the globe ventrally using a 5/0 nylon stay suture. To do this, put a stay suture into the dorsal bulbar conjunctiva at around 2 o'clock above the medial canthus.   

1.2  Stab and cut away the dermoid carefully from the cornea.  

2.  Start cutting from the lateral aspect of the dermoid. Undermine the dorsal bulbar conjunctiva and excise the dermoid. For the cornea, excise to a third of the corneal stroma depth and 1 mm of normal corneal tissue circumferentially. Be careful of inadvertent corneal perforation. Anti-inflam not given, if kitten or puppy.

The corneal epithelium is excised (superficial keratectomy). Third eyelid flap covers the cornea. Antibiotic eye drops. Healthy replacement cells will grow. If done well, no corneal scarring. E-collar. 

THE 2ND AND 3RD TREATMENT OPTIONS ARE: 

2. Use electro-surgery. I used the circular loop to slice out the dermoid carefully. 

For the specialist.

3. Non-penetrating lamellar keratectomy using the operating microscope and micro-surgery.

RESEARCH NOTES

What is the normal range of corneal thickness in cats?
An average cornea is between 540 µm and 560 µm. A thick cornea is 565 µm or more, with a very thick cornea being greater than 600 µm

Lamellar keratoplasty is an operation in which diseased corneal tissue is removed and replaced by lamellar corneal tissue from a donor. The procedure is performed either to improve vision (optical keratoplasty) or to provide structural support for the cornea (tectonic keratoplasty).

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A healthy cornea is important for good vision. When there is scarring or corneal disease, it can cause one not to see well. Fortunately, there are advanced corneal surgeries such as Lamellar Keratectomy, DSAEK and DALK that are available at The Eye Associates.

There are several common conditions that affect the most superficial layer of corneal cells, the epithelium. These conditions include recurrent corneal erosion (RCE), band keratopathy, Salzmann’s nodular degeneration and epithelial basement membrane dystrophy (EBMD). These conditions can interfere with vision and even cause significant pain and gritty sensation, due to a rough and irregular ocular surface.

If ocular lubricants fail to improve the pain or vision, a procedure known as Lamellar Keratectomy or LK can be beneficial. After the eye is anesthetized with drops or ointment, Dr. Foster selectively removes the diseased epithelium. A soft contact lens is placed that minimizes discomfort after the procedure. This remains in place until it is removed by Dr. Foster. In a few days, a stronger, healthier cell layer will replace that which was removed. Some scratchiness and irritation is normal for a few days after the procedure until the surface has healed.

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REFERENCE:

Dorsally located corneal dermoid in a cat

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362890/

3143. The dog had adverse drug reactions - a rare photography positioning.

Aug 20, 2020. 

 
The young lady owner had consulted two vets about the tumour near the left eye. She chose Vet 1 for the surgery. The dog had a blood test done showing low white cell count and low lymphocytes. A PCR test for Babesia was positive. So, Vet 1 prescribed a 10-day course of anti-tick medication to be followed by a 6-week course of another drug.

The dog had vomiting and diarrhoea after 3 days of the 10-day course, but Vet 1 insisted on continuation of the medication and began to hospitalise it. 

Vet 1 suspected pancreatitis. The dog was exhausted and dehydrated and had breathing difficulty. The owner's father took the dog out from Vet 1's inpatient service. The father consulted me on Aug 20, 2020. The dog was given SC drips for at least 7 days and 3 injections of baytril. No oral medications.

 

 

 

 

Aug 27, 2020, 

 

I did a house-call to see the dog.
The dog had stood up to see me. He pants when he moves and has no appetite. He is fussy about the water quality before he drinks it. The owner said that his teeth were chattering when he returned from an inpatient at Vet 1's practice (a toilet room was used to house him).

His inguinal area was inflamed with urine scalding (pampers by Vet 1) and his anal skin area was raw. The owner's father had pulled him out from Vet 1's inpatient treatment for tick-fever. 

The diagnosis of tick fever was based on positive PCR Babesia. He had vomiting and diarrhoea after 3 days of anti-tick medication but Vet 1 insisted on completion of a 10-day course. He was given IV drips and was an inpatient for some days till the owner's father pulled him out. 

I took a photo from inside my car, parked outside the house. My car was at a lower level than the house entrance.

The owner's car was parked on an elevated ground, hence it looks blurry (bokeh). The dog looks as if he had been photoshopped and pasted onto the photo in front of the car. eye contact iwht the dog. This is a rare shot. 

This dog is likely to recover, but it is hard to be sure as his immune system is not good. He had liver and kidney disorders prior to consulting Vet 1 on the eye tumour and his total white cell count and lymphocytes were low.

The blood test taken when I saw him at Toa Payoh Vets were high total white cell count and lymphocytes, with increases in liver and kidney enzymes. 

This photograph looks so unusual, as if the dog has been pasted onto the car. It was taken with a zoom lens, focused on the dog's eye. The dog was on elevated grounds while I was inside the car on the lower road surface. You can still see the skin tumour on the left eye area and the IV drip scars from Vet 1.
The urine scalded inguinal area and the anal area are no longer inflamed.

No skin tumour removal yet as the dog is still recuperating. Much less panting. The owner's father prefers to feed his own food. So I have not advised the therapeutic L/D or K/D diet for such cases with liver and kidney disorders.  

Sept 6, 2020.
Phone the owner's father. The dog is better but has not fully regained his appetite and zest to bark loudly when people come to the gate or when the squirrel jumps on the tree branches near the house.  The owner's father sent me a video of the squirrel that will hop on the branches daily. It is great to have Nature in his backyard. He has green fingers and have planted trees and small plants in his house. 

 

 

 

DETAILS OF THE DOG'S CASE OF ADVERSE DRUG REACTION ARE AT:

Part 1

https://www.youtube.com/watch?v=203zY0ssIYE

 

Part 2

https://www.youtube.com/watch?v=4ut5EeotEwg

3412. Surgical Treatment of jaw abscess in the guinea pig

An abscess in the mouth or around the jaw may be a symptom of dental disease. Your vet may need to identify and remove any problematic teeth. Skull X-rays are needed.

Find a vet who performs guinea pig surgery if there is a jaw (dental) abscess. 

There are 3 treatment options provided by Toa Payoh Vets

1.  Incision and drainage. A scalpel blade incises (cuts) the abscess.The pus is drained. The inside of the abscess is flushed with normal saline till all pus is taken out. 

2.  Enscapsulated Abscess Removal. We recommend the more detailed surgery rather than incision and drainage. It will completely remove the abscess using blunt dissection with scissors or electro-surgery.  This procedure is needed when the vet cannot fully drain the abscess or if other, underlying problems are contributing to the persistence or recurrence of the abscess.

3.  Marsupialisation. The vet makes a long surgical wound. He stitches the inside layer (mucosa) of the wound to the skin. The sutures will remain on your guinea pig for up to two weeks.  You will need to syringe saline into the wound to flush out any pus and debris daily for around 2 weeks. 

The guinea pig wears an Elizabeth collar to prevent scratching of the wound Painkillers will be prescribed. Hone nursing by daily cleaning of the wound is important.  

4. Root canal treatment is not done in guinea pigs, but is an option in human dental abscess treatment. 

 

 

  Medications are usually are delivered by mouth.

• Baytril and Bactrim are the most common antibiotics given to guinea pigs.
  
  
• If it is a fungal infection, he may be given anti-fungal medication like griseofulvin.
  
  
• Many common antibiotics, such as Amoxycillin and tetracycline, are toxic to guinea pigs when given by mouth. However, they may be injected under some circumstances, as this has less impact on your pet's gut health. 

As guinea pigs are strictly herbivorous animals, one veterinary report the recommended antibiotic treatment for odontogenic abscesses is a combination of fluoroquinolones and metronidazole.

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A guinea pig has a double chin. Part 1
https://www.youtube.com/watch?v=5fymligXmTU

2020. abscess treatment video
https://www.youtube.com/watch?v=9HKnCG-VkWI&t=104s

2020. abscess. Pt 2/3

https://www.youtube.com/watch?v=CT6cv7MnDK4&t=50s

how to check whether your guinea pig healthy

https://www.youtube.com/watch?v=8EapdMqGiUg&t=6s

3411. Photos of Myanmar

 

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