Urethrostomy is a surgical procedure in which a permanent diversion of urine is created by suturing the penile mucosa to the skin subsequent to exposure of the urethral lumen. Recommended anatomic locations for the creation of an urethrostomy differ between dogs and cats; however, the complications are common to both species.
Complications associated with urethrostomy include stricture formation, hemorrhage, dehiscence, urine leakage, perineal hernia, urinary or fecal incontinence, rectal prolapse, and ascending urinary tract infection.
In male dogs, urethrostomy can be performed at prescrotal, scrotal, perineal, subpubic and prepubic locations; in female dogs, it is limited to a prepubic location. Scrotal urethrostomy is preferred because the urethra in this region is superficial, wide and has relatively less cavernous tissue, which results in less postoperative hemorrhage. A continuous suture pattern that both seals the corpus spongiosum and opposes the mucosa and skin was shown to decrease the duration of postoperative hemorrhage.
Causes of FLUTD in an indoor cat in Singapore. This cat was fed a mixture of expensive dry cat food and lived with another cat that would eat his food.
One litter box only. Soiled litter box changed daily. "When I put in the fresh litter," the mother said. "Both cats rush to the litter box!"
Urine retention for a long time causes bladder infection.
I advised two or three litter boxes and let ths cat has space to eat and sleep. He would be bullied by the other cat who puts on weight.
A 9-year old female spayed dog vomits some time after eating for more than 2 weeks. Why?
HISTORY:
9-year-old female spayed Miniature Schnauzer.
Vomiting for some 2 weeks or more. No diarrhoea. Not eating anymore.
Usually vomits some minutes after eating but now avoided eating. What is the cause?
FINDINGS:
Thin. Very painful throat. Periodontal disease Stage 4 (tartar covered teeth). I advised dental work to resolve the severe gum infections around 7 days later.
Lungs and heart sounds normal on auscultation. No abdominal pain or lumps on palpation.
BLOOD TEST:
Red cell count and haemoglobin are normal. No anaemia.
White cell count is normal. No bacteraemia.
Kidney disorder as evident by an increase in urea and creatinine.
Urea 42 mmol/L (Reference range: 4.20 - 6.30)
Creatinine 280 umol/L (Reference range: 89 - 177)
X-RAYS
No abnormal findings in the abdomen. No gastric tumours or foreign bodies visible. No stools in the intestines indicating that the dog had not eaten for some days.
INPATIENT FOR 3 DAYS. IV drips with antibiotic and painkillers for 2 days.
Day 1. No food. Vomited fluid overnight and vomited canned Hills ID in the morning of Day 2
Day 2 - 3. Ate all Hills ID food. Passed normal stools.
Day 3. Owner took the dog home for observation. Hills ID food. TIPS AND ADVICES:1. Persistent Vomiting in old dogs may be a sign of kidney disease, as in this case. 2. A blood test is needed. 3. X-rays are advised.4. IV drips to prevent dehydration and to clear toxins are standard treatments.
5. Pancreatitis will be checked if there is still vomiting. The tests add up to the medical costs.
6. Dental work to extract dead and loose teeth causing pain and bacterial infection and ulcerations in the gums is advised.
7. A misdiagnosis of gastroenteritis due to food poisoning or foreign bodies in the stomach is possible. Prescribing medication and sending the dog home after consultation will not resolve the problem of vomiting.
FOLLOW UP ON 19 Nov 2020. The dog vomits once a day, unlike before treatment. He needed to be spoon fed the Hills ID. He does not drink water and is weak. I phoned the owner to tell him to put the dog on dialysis under the skin - Hartmans and dextrose saline for the next 14 days as blood tests showed high urea and creatinine. Kidney disease can cause vomiting.
UPDATES WILL BE AT:
https://2010vets.blogspot.com/2020/11/3899-old-dog-has-been-vomiting-for.html (this webpage)
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DRAFT SCRIPT
A 9-year old female spayed dog vomits some time after eating for more than 2 weeks. Why?
HISTORY:
9-year-old female spayed Miniature Schnauzer.
Vomiting for some 2 weeks or more. No diarrhoea. Not eating anymore.
Usually vomits some minutes after eating but now avoided eating. What is the cause?
FINDINGS:
Thin. Very painful throat. Periodontal disease Stage 4 (tartar covered teeth). I advised dental work to resolve the severe gum infections around 7 days later.
Lungs and heart sounds normal on auscultation. No abdominal pain or lumps on palpation.
BLOOD TEST:
Red cell count and haemoglobin are normal. No anaemia.
White cell count is normal. No bacteraemia.
Kidney disorder as evident by an increase in urea and creatinine.
Urea 42 mmol/L (Reference range: 4.20 - 6.30)
Creatinine 280 umol/L (Reference range: 89 - 177)
X-RAYS
No abnormal findings in the abdomen. No gastric tumours or foreign bodies visible. No stools in the intestines indicating that the dog had not eaten for some days.
INPATIENT FOR 3 DAYS. IV drips with antibiotic and painkillers for 2 days.
Day 1. No food. Vomited fluid overnight and vomited canned Hills ID in the morning of Day 2
Day 2 - 3. Ate all Hills ID food. Passed normal stools.
Day 3. Owner took the dog home for observation. Hills ID food. TIPS AND ADVICES:1. Persistent Vomiting in old dogs may be a sign of kidney disease, as in this case. 2. A blood test is needed. 3. X-rays are advised.4. IV drips to prevent dehydration and to clear toxins are standard treatments.
5. Pancreatitis will be checked if there is still vomiting. The tests add up to the medical costs.
6. Dental work to extract dead and loose teeth causing pain and bacterial infection and ulcerations in the gums is advised.
7. A misdiagnosis of gastroenteritis due to food poisoning or foreign bodies in the stomach is possible. Prescribing medication and sending the dog home after consultation will not resolve the problem of vomiting.
FOLLOW UP ON 19 Nov 2020. I phoned the owner today. The dog vomits once a day, unlike before treatment. He needed to be spoon fed the Hills ID. He does not drink water and is weak. I phoned the owner to tell him to put the dog on dialysis under the skin - Hartmans and dextrose saline for the next 14 days as blood tests showed high urea and creatinine. Kidney disease can cause vomiting. Loose and dead teeth will need to be extracted once the dog no longer vomits.
UPDATES WILL BE AT:
https://2010vets.blogspot.com/2020/11/3899-old-dog-has-been-vomiting-for.html (this webpage)
-------------------------------------
PERSISTENT VOMITING IN OLD DOGS
An old dog has vomiting for more than 2 weeks. Not eating now.
My top differential diagnosis will be kidney disease and/or gastric tumours.
I took a blood test. It confirms kidney disease. X-rays appear to show a firm rounded mass in the stomach? Gastric tumour?
X-ray shows an empty stomach with no gas.
It is not possible to confirm gastric tumours in this X-ray
Consultation Day 1. Inpatient. IV drips with medication and anti-spasmodic.
Vomited food on Day 1 morning.
Day 2 - 3.
Ate all canned food (Hills ID) without vomiting. Went home on Day 3
Rotten teeth may be a cause as bacteria goes to the blood stream to the kidneys over a period of weeks.
The dog is on IV drip for the past 2 days as a form of dialysis and to prevent or treat dehydration.
This old dog had bad gum disease with thick tartar enveloping all teeth. The bacteria in the gums spread via the blood to the kidneys causing kidney disorders --- persistent vomiting. Yearly dental check up would have been best.
PODTurbo is an automated system that helps peoplecreate and publish print-on-demand products to multiple marketplaces with less effortso they can earn consistent passive income from their product sales.
Video footage. Use footage 0:00 to 1.23 approximately as hook.
"But the lump has doubled in size, " the owner consulted me today, 12 Nov 2020. "It had become harder. My hamster finds it hard to breathe normally"
"6 months ago, Dr Daniel had incised the lump," the owner recalled. "Tere was blood but no pus (Get 2 images from Hsu).
"TWO WEEKS AGO, The owner saw some pus from inside the mouth, on the lower part of the swollen left lip. (Get the footage from the ABOVE MENTIONED video - owner was narrating about using the cotton bud tip to clear the pus...)
"But the lump has increased in size," the owner brought the hamster to Toa Payoh Vets for a review. "My hamster has difficulty in breathing."
PAUSE YOUR VOICING OVER. Insert the following:
narrate text of image
A dwarf hamster has difficulty breathing
This is Part 1 of 2 Parts of the case study.`
SINGAPORE SETTING
Singapore is a city state with over 80% of the residents living in high rises. The Covid-19 pandemic caused a complete lockdown from April to June. Nowadays, air travel to most countries is still restricted - making the busy Changi Airport look like a ghost destination. A few plane, mainly transporting cargoes fly from the airport.
Mandatory face mask wearing and other restrictions apply to every one in an attempt to stop the spread of the coronavirus.
BACK TO THE DWARF HAMSTER
Dwarf hamsters are popular pets as they need little space and are good companions to youngsters like students. They are easy to maintain. But lumps and abscesses are common medical conditions.
6 months ago, a big upper lip swelling to the left of the nostrils in this 1-year-old female dwarf hamster was seen by Dr Daniel. He lanced the swelling but no pus leaked out. Red blood oozed out (Stefanie to get images from Hsu).
He sent the hamster home with baytril and pred medication.
"The hamster's lump became softer," the owner told me she had seen some pus leaking from the lower end, from inside the mouth area. "I used a cotton bud tip to clear the pus."
In this case, the size of the left upper lip lump is gigantic. It is around 7 mm x 5 mm and hardened covering at least 80% of the left upper lip and crushing the left nostril. Most likely it is a hardened abscess with or without a capsule.
See the left nostril...Its opening is narrowed...
"Is the hamster eating all his food?" I asked.
"My hamster still ate all her food in the food bowl. We feed twice a day."
"How many stool pellets she passes a day?" I asked.
"She passes many stool pellets, but they are half the normal size!"
"Is she able to drink normally?"
"She drinks a lot and pees a lot," the owner answered. "She is having difficulty breathing. That is why I got her here for examination," the mother came to Toa Payoh Vets with her two tall and slim teenagers - a boy and a girl.
TREATMENT
I warded the hamster for treatment to soften the hard lip swelling. My digital photos show AN intense inflammation in the lump as evident by the red colour. There appeared to be yellowish "pus" inside this lump.
I will soften the hard abscess with oral prednisolone and baytril daily for 7 days.
The following are options depending on the hardness of the lip lump.
1. ABSCESS INCISION AND DRAINAGE. If the abscess is soft, lancing and drainage will be done.
2. ENTIRE EXCISION. If it is hard, I don't advise excising 100% of the lump. It will be hard to heal by granulation and will become infected. The hamster will not eat and drink normally and will die from malnutrition and stress.
3. PARTIAL EXCISION. A partial removal of the swelling may be done to relieve pressure on the left nostril . I will use electrosurgery to excise a portion of the swelling nearer to the left nostril. A small wound after removal of 3 mm x 3 mm section may not cause the hamster to lose appetite.
CREDITS
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22 Nov 2020. google toa payoh vets pte ltd images on 12 Nov 2020, before treatment.
ADVICES FOR YOUNG PEOPLE - HOW TO MAKE E-GREETING CARDS.
It is good to acquire digital photography skills, as in this example.
I went to Hub Spoke Cafe on a Sunday morning. The sky was overcast. I saw around 2 butterflies in this small patch of flower plot in Terminal 2, Changi Airport. Singapore is urbanised and seeing a stationary yellow butterfly at eye level with bright 10 am sunlight on it is a rare opportunity. You must have the camera with you.
Seeing one in good health (no tattered wings, colours vibrant, not dirtied by wear and tear) and sipping nectar is a rare sighting.
The dark clouds parted and the sun rays shone on this bougainvilla flowers, directing me to this beautiful butterfly. I took 3 shots from around 15 feet away. It flew off as I approached it.
Original photo, not photoshopped. Square format
Sunlight rays shone on butterfly at around 10 am Focused on the eye, Handheld.
"P" mode, Image stabilisation, single point focus, autofocus Canon DSLR EOS 90D, 18-200 mm EFS lens
I crop photo 16:9
No photoshopping in this image as the lighting was excellent
A photo from the internet. Be aware of copyright or trademark infringement.
I used Photoshop 2021. "Select and Mask". Click "Subject". Save as .PNG file (transparent background). I use "File" --- "Place Embed" above .PNG file into the 16:9 file. See the file below:
In conclusion, the "P" Mode permits you to take most photos without the need to use the "M" mode and to set ISO, Aperture Priority, as the subject butterfly may not stay still anytime.
Focus on the eye and shoot. This is the only photo that does not need any Photoshopping as almost all photos need to adjust contrast etc.
The smartphone is not able to focus on the eyes as compared to the "single point" "high continuous speed" setting of the DSLR camera. Hence, your smartphone is unlikely to get a sharp butterfly photo.
Another tip. Use Photoshop 2021. "Filter"---"Neural filter". You can get a different image as follows:
Grass Yellow (Eurema sp.)
Found in Singapore throughout the year, Grass Yellows are small butterflies
that have lemon-yellow wings with small black spots.
