Case 1: The hot dog farted on abdominal palpation again!
The two young ladies came with the hot dog for a review and blood
test.
"The Miniature Schnauzer bites," one young lady held the dog's head
with both hands as I palpated the abdomen with my left hand. "No more
vomiting. Normal now." Suddenly the dog farted as I palpated the back
half of the abdomen. This was a loud cracking sound. It was a
reproduction of the same incident when I saw him on April 8, 2012.
Scientific experiments are valid if others can reproduce the outcome
and in this case, I was able to do it again. It is not a common
occurrence and so I was much surprised with this loud puffing crack
from his backside.
"Something wrong with the intestines producing too much gas," I said.
The dog was on LD prescription diet and some dog treats, but he still
farted. I asked the owners to wait 4 weeks from the first blood test
to take blood to check whether the liver has recovered. I gave the
young lady a bottle to collect the dog's urine in the morning as he
pees a lot and then dribbles with difficulty (I suspect urine marking
as some male non-neutered dogs will try their best even to pee
nothing!). In any case, the first urine test show struvite + and
spermatozoa 2+ and so we need to review again. The male dog had no
more urine and so I did not bother to catherise to collect the urine.
Case 2: Two shrivelled front teeth in a 5-year-old Maltese. The
marketing books say "Give what the owner wants." Well, the wife did
not want the teeth to be extracted and had been to Vet 1 who did
recommend that. "It is not good for the dog," I showed that the gum
had receded considerably. "The dog does feel the pain and bacteria
will continue to grow after antibiotics. The teeth may then crack."
After much discussion, the wife agreed one bent front tooth to be
extracted. Giving what the customer wants is good marketing. I asked
the couple to think about it as the dog would need another anaesthesia
if the other tooth fracture due to shrivelled root and instability.
"It is not stable anymore," I said. "Like tree with rotten roots.
During thunderstorms, the tree topples. This root will break and part
remains in."
Much time was spent in discussion. It was up to the wife. Much time
would have been saved and more fees earned if the vet just do what the
customer wants as there will be two anaesthesias involved. The first
to do dental scaling of the two front teeth. The later one to extract.
However, this cost the owner money and the dog more pain in the delay.
Finally, the wife agreed to extraction of the two front teeth and
dental scaling. During anaesthesia, another right upper molar tooth
was loose after tartar removal. I did not extract it, knowing the
wife's preference to have teeth present in this 5-year-old Maltese. It
was loose but not that unstable. Yet all the other teeth were quite
strong and relatively clean. The two loose front teeth were a
surprising revelation as the other teeth were solid. Veterinary
dentistry can be full of surprises. Domitor + Ketamine 50% and
isoflurane was safe and fast. Owner wanted a blood test which was
done.
Case 3. Phone review of the Maltese with acute bacterial meningitis 10 days ago.
I phoned the owner. She said the Maltese was OK and
she would come for a blood test later. Case is written in:
http://www.sinpets.com/F5/20120414acute-meningitis-dog-singapore-ToaPayohVets.htm
Significant blood test results at time of stiff neck is
as follows:
April 12, 2012
Maltese, 5 years, Male
Glucose **. Specimen grossly haemolsed. Query glycolysis, suggest to
repeat. Plasma glucoes = <20mg/dL
Liver Profile. ALT/SGPT normal. AST/SGOt 95 (normal = <81)
Total WCC 19.3 (6-17)
<b>Neutrophils 94% 18.16
</b>Lymphocytes 5.4% 1.04
Monocytes 0.4% 0.08
Eosinophils 0% 0
Basophils 0% 0
Based on sudden onset clinicla signs and the total tal WCC and very
high Neutrophils, this would be a case of acute bacterial meningitis.
Case 4. The spayed cat caterwauling loudly for the past
4
weeks, starting from first month after being spayed by Vet 1. The
young couple showed me their phone video of the cat rolling over, tail
up, backside up as if ready for mating. However, no audio. "Most
likely, there is a bit of ovarian tissue left behind by Vet 1," I
said. "It will be very difficult to find this tissue even if there is
a repeat spay." What to do?
Case 5.
A 2.5-year-old dwarf hamster had a much swollen right eye. The lower
eyelid was as round as a ball, around 4 mm X 4 mm. Squeezing out the
pus with fingers had been done by Vet 1 but the swelling remains as
solid as ever. A small hole released the pus if you press the lower
eyelid. "The best way is to cut a big cut and release the pus," I said
to the mother who said this was her favourite "Small White" hamster
and was concerned that the hamster would die under anaesthesia.
"The hamster is at the end of his lifespan," she said. "If he dies on
the operating table, there is no more."
"He will die if he does not eat or drink. Within 2 weeks," I
predicted."No antibiotics and eyedrops will help. This is a large
conjuntival abscess that needs to be cut around 3 mm to let the thick
pus out. Anaesthesia is needed. The hamster may just die during
surgery."
So, the 40-year-old mother with a small boy did not know what to do.
The older man who could be her father was more aware of the no chance
with eye drop and antibiotic treatment.
Finally, she decided. I got it done. A big cut. The hamster survived
with a much normal sized lower eyelid and went home. Something like a
piece of sharp grain shell, must have had pricked the lower
conjunctiva, lodged inside and caused bacteria to multiply and form
the big abscess. The only treatment is to open a big incision into the
conjunctiva to release the sticky pus and the foreign body. I expect
this hamster to recover fully now. |
TOA
PAYOH VETS
