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Toa Payoh
Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures |
Perineal hernia in
dogs -
2005 case
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written:
July 5, 2005
Updated: 10 March, 2011 |
 Toa
Payoh Vets
Be Kind To Pets
Veterinary Education
Project 2010-0005 |
 Pom,
13 years old, male, irritated by big lump right side of the
anus (see photo). Keeps licking it, hence colour of skin
changed to black (see bottom right quarter of photo).
Diagnosis: Right perineal hernia.
Implications: A defect in the muscle layer means that the
"intestinal fat, intestines and bladder" falls through the
hole and cause a large swelling under the skin. What
tissues get through depends on the size of the hole. Some
cases are fatal especially if the intestines and bladders
get twisted, leading to intense pain, shock and death. Dogs do die when the hernia gets strangulated or infected.
The older boomer-generation of Singaporeans may not bother as
long as the dog eats but the younger generation is more
sophisticated and caring and so more cases are seen. Seek
prompt veterinary treatment when there are small swellings in
the perineal or anal areas. In many cases, neutering the male
dog will enable the dog to live longer and cost the owner much
less when the dog needs treatment for perineal hernia,
testicular tumours, prostate enlargement and circum-anal
tumours during old age. |
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A rabbit cannot eat
properly
- 2005 case
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
Updated: 10 March, 2011
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Toa
Payoh Vets
Be Kind To Pets
Veterinary Education
Project 2010-0005 |
 Lower front teeth
overgrowing into the
rabbit's nostril.
Malocclusion means that the
front teeth of the lower and
upper jaws do not meet.
Therefore, they do not wear
out when the rabbit eats the
carrots. They tend to
overgrow. Regular trimming
by the vet may be needed. |
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An angry English
Bulldog nearly bit off my face
- 2011 case
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
Updated: 10 March, 2011
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Toa
Payoh Vets
Be Kind To Pets
Veterinary Education
Project 2010-0005 |
On March 9, 2011, the owner made an 11am appointment to
consult me. Normally, I don't consult after 11 am as I
have another vet on duty. Sometimes I hang around to
manage the cases and supervise the staff and interns.
It is seldom possible to leave a surgery alone and
expect it to function well in terms of quality of client
services and standards of service. Empowerment of
employees and delegation is good in theory but the owner
of the Surgery has to be pro-active as life is full of
challenges and surprises as in this case of an angry
English bulldog that nearly bit off parts of my face.
The lady owner who had consulted me some 15 years ago
brought in a 4-year-old male English Bulldog that was
"limping." This was the 3rd case of lameness in a
short period of less than 7 days fulfilling a theory
that some related incidents occur in threes.
Two recent incidents were paraparesis in a Chihuahua
which puzzled the first vet and a Shih Tzu that had
weakness in the hind legs too. The cases were drafted in
my blog, Draft Case Studies:
2010vets. I really have no time to document properly for the
time being. This 3rd case had no paraparesis but is
linked by "lameness" common to all 3 dogs.
"My dog bites," the lady warned when the dog, on the
examination table, suddenly turned his head and opened
his mouth aiming for my face as I put the stethoscope on
his right chest to examine his heart. "But he does not
bite children."
Before that, I had the dog outside the surgery and asked
my assistant to trot him. The Bulldog refused to move
initially. I asked the owner to do it after the dog
walked and ran on a loose leash. I had checked his
spinal area and there was one reaction of the dog
sinking to his haunches when I pressed the lumbo-sacral
area. However, the pain could not be reproduced and so
there was no definitive proof of paraparesis.
Most owners give conflicting signs and symptoms to the
vet. Many times, the one who brings the dog to the vet
is not the caregiver. The caregiver could be the
domestic worker (maid) or the aged parents. So it was
not surprising that the first vet was puzzled by the
case of the Chihuahua "not eating and lethargic with
swollen abdomen" which I diagnosed as having paraparesis
due to spinal pain which was reproduced repeatedly.
In this English bulldog, the maid was the one caring for
the dog. After trotting 4 times up and down the outside
corridor of the Surgery at the side, the dog panted and
was quite fed up. He just went on strike and laid down
while we were all wary of him. Being bitten by a big
hunky English bulldog is no joke and so I told my
assistants to be careful and forbade my intern Michelle
from handling this breed.
After the 4th trot, I saw the dog dipping on his
left hind leg and hopping on hind legs. So, he really
had lameness, most likely the left hind. The next step
was to put the dog on the examination table. I seldom
muzzle dogs as I would be more alert. After pressing the
spinal area, checking the ears and general examination,
the dog was quite restless. I lifted up the left hind
paw. The whole lower part of the paw was reddish and
wet. I pinched the interdigital space. The dog yelped
and turned suddenly towards me. This was a warning that
he would bite if I persisted. Unfortunately, I had to
check the right hind paw which suffered similarly. The
dog was really not happy now. While the owner held on to
the leash, I checked the two front paws. Not so red. My
assistant took hair samples for microscopic examination
for ringworm as the dog had been licking the underside
of the paws raw.
I was going to check the heart and as I put the
stethoscope on the right chest, the dog suddenly turned
and opened his mouth aimed at my face. I swerved a bit
and missed being bitten. This dog ought to be muzzled.
My assistants went around looking for an appropriate
cloth muzzle. But they could not find one. "Just use a
string and tie around the muzzle," I said. Sometimes,
the assistants are so fixated on the cloth muzzle that
they forget alternatives.
I had the dog muzzled and my associate gave Domitor 0.3
ml IV. The dog was sedated for around 10 minutes while
my assistant irrigated his wax-filled ears and scrubbed
his under paws. "Take off the string," I had to tell my
assistant. "The dog may vomit." Domitor does sometimes
cause vomiting after injection, even on IV injection. If
the dog is muzzled, he can't vomit properly and may get
inhalation pneumonia.
From this report, readers can see that there are so many
risks and challenges in veterinary medicine every day.
There was recently a groomer whose face was bitten off
by a fierce dog and she was hospitalised. "It would
never happen to me" attitude creates complacency as vets
and groomers sometimes don't muzzle dogs out of
expediency and efficiency. We may not want the owner to
think we are cowards and we may be over confident of our
lion-taming skills.
But once bitten, the person is dis-figured and
traumatised. So, it is best to be alert and to muzzle. I
was fortunate this time as I got no bites on my face. It
is best to be safe than sorry. As for this English
bulldog, I advised neutering to reduce aggression and
also that he kept licking his scrotal area. He could be
suffering from dry food allergy (itchy middle ears and
paws) but the owner disputed my hypothesis as she had
changed to sea food diet which she said had no grains.
We will have to wait and see as it is not easy to just
say "dry food allergy" or "contact dermatitis" without
proof to convince the owner! |
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All rights reserved. Revised: March 10, 2011
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