Thursday, November 14, 2013

1168. A dog, a cat and a guinea pig on Thursday evening Nov 14, 2013

Thursday, Nov 14, 2013

Closing at 8 pm is too early as most urban clients work past 6 pm and have no time to see the vet who closes at 8 pm.  Closing at 10 pm would be too long a day as I start at 9 am and a vet can burn out working long hours 7 days a week. This Thursday evening, Dr Daniel went to the gym with his mum  at 6.15 pm and so I took over and expected a quiet evening.

Case 1. The Guinea Pig
The first case to come in was a young 6-month old grey golden-haired streaked guinea pig with thick wax and scales on the left ear canals and scales on the right ear, plus a circular patch of hair loss further behind.. "The pet shop operator who sold me the my guinea pig has fungal infections," the young lady said. My assistant Naing checked the computer and brought out an incorrect case card after browsing the data of The Yishun address was incorrect as regards the unit number. It was #4-48, the 4th floor and the pet was a stray cat.
"Search for unit '11-48'  and he got the correct case card. I had no time to check why did not provide this unit as I find it to be quite versatile. I asked permission for isoflurane + oxygen gas anaesthesia of the guinea pig, got the ear hairs clipped, ears cleaned up and irrigated. I injected the anti-mite and prescribed the anti-fungal wash as microscopic examination of the left ear hairs showed ringworm.  The guinea pig went home with reviews 2 weeks later but most owners don't return if the guinea pig is OK.

Case 2. The Golden Retriever Dog
"Vomiting and diarrhoea" for the past few days, the man in his late 40s had paid $3,000 for this Australian-imported 6-month-old that was never let out of the house and fed only dry dog food. The dog was thin too although he ate ravenously. "You may be under-feeding," I palpated the abdomen "Can you hear the sounds of gas? Place your ear closer to the dog's abdomen."
I palpated the abdomen.  Loud gushy gurgling sounds were heard distinctly.
"You see, this dog's intestines are bloated with lots of gas! I need a blood test and stool test and stabilise the dog with IV drip and medication first."
The owner was surprised to hear the loud sound. The dog was hospitalised for observation.

Case 3. The British Shorthair
The young couple in their early 30s brought a thin grey spayed 5-year-old cat for examination. "Keeps vomiting for the past weeks but not every day. The cat ate but lost weight and peed a lot. She behaved active. We saw another vet who prescribed probiotics some weeks ago."
I checked the gums. The gums were pale but capillary refill time was normal at <2 a="" abdomen="" and="" are="" barely="" bladder="" blood="" br="" cat="" check="" clot="" could="" down="" feel="" feels="" full="" had="" half="" he="" i="" is="" kidney.="" kidneys="" left="" lips="" nbsp="" normal.="" not="" on="" palpated="" seconds.="" shrunk="" the="" thickened.="" to="" turned="" upside="" vulva.="" vulval="" wall="" which="">
"Can you collect a urine sample?" I asked whether the cat peed a lot of times per day.
"We work and so don't know whether he pees a lot. It is not possible to collect as the cat goes to the litter
 to pee and the litter absorbs the urine. Can you collect it?
"I suspect kidney disease or diabetes with urinary tract infection and so need a blood test and X-ray if I can't get the urine. Otherwise, it is hard to diagnose what's wrong."
"Is it possible that the cat has inherited some genetic kidney disease?" the young man asked. Nowadays, the young generation does a lot of research and knows a lot of medical knowledge.
They will bring in the cat tomorrow morning for the blood test which can only be taken under anaesthesia as the cat was quite fed up with my palpations. He hissed a bit now and then to warn me.

It was a strange evening for me in the sense that I got 3 different animals. The guinea pig was an old client with a rabbit earlier for treatment. The other two were new clients. Performance counts and I need to give the correct diagnosis using evidence-based medicine.

Was the cat having kidney disease or diabetes with UTI? Was the dog having parvoviral infection or just allergy to existing dog food since he was thin and was brought recently. Usually Golden Retrievers are sold by 3-4 months of age, not at 6 months. Would the guinea pig recover fast? I think so.

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