Friday, June 4, 2010

Puppy with loose stools for a long time may get intussception

It is not normal.

Silkie was active and eating well, but passes loose stools since purchase 2 weeks ago and prior to purchase. When the puppy passes red blood, the parents and grown up childen consulted me.

Why and how to cure him?

1. It is not normal for the puppy to pass loose stools every day when fed dry food.


Causes:
1. Stress
2. Vaccination by the owner
3. Licking floors and objects
4. Given variety of puppy treats

"My puppy had diarrhoea for one month," my outspoken intern said. "He was OK after that. The breeder said it was due to vaccination."

"Loose stools is not normal," I inserted a cotton bud into the rectum to take stool sample. Fresh red blood stained the cotton bud.

"Now there is red blood. It may be parvoviral attack of the intestines. I got the parvoviral test done. It was negative. In this case, it would be professional negligent not to do the test in puppies having blood in the stools," I taught my assistant Mr Saw.

"Sometimes the vet does not think it is necessary," I said. "If the puppy dies a few days later when sen home, a complaint might be lodged with the authorities. The first question would be whether the puppy had parvoviral infection?"

As an example,I told him to test the 3 puppies sent in by the breeder. All breeders want the least veterinary cost and parvoviral tests cost money and some don't want parvoviral testing. Mr Saw did the 3 tests. One of them tested positive for puppies.


Later the intestines may telescope into each other resulting in lots of bloody stools and a need to operate. The condition is rare and is called intussception."

I had seen one case. Palpation of the abodomen can reveal a telescoped lump of small intestines. This puppy may have the start of intsussception. No X-rays are taken due to economic reasons. Puppy remained active.

Warded for 3 days.
IV drip, antibiotics and dry food.

92. Hypersexuality

Cocker Spaniel, Male, 5 years, Not neutered
Blood seen in the urine today
Eats OK, No fever
Why?

History: No previous occurrence

Urine test: Not possible as bladder is not full.

Examination: Penile tip is red and inflamed.

Traumatic injury. Does the dog hump people or objects?
"Yes" the owner said. "He has been humping pillows and the other dog frequently."

The diagnosis is traumatic injury to the penile tips due to hypersexuality.
This condition can be anti-social as visitors do not welcome their legs being gripped by the male dog.

TREATMENT

1. Neuter the male dog.
2. Anti-androgenic injections regularly has been shown to reduce the libido.

Thursday, June 3, 2010

Left perineal tumour in a male intact old Shih Tzu

Case Study 1. Circum-anal tumours and Tardak injection

Jun 1, 2009
Shih Tzu, Male, Intact, 11 years old, 7.5 kg. Can't take rectal temp. painful backside
Large left perineal tumour 10 cm x 10 cm in 5 globular lumps
IV drip + antibiotics

Jun 3, 2009
Decided to operate.
No histopathology for economic reasons.

Jun 8, 2009 Went home.


Jun 3, 2010
Facial dermatitis and eye ulcerations
Owner said the tumour did not recur after 2nd surgery and neuter.
He had not wanted neuter after the first surgery








Feb 2, 2010.
Left perineal tumour 6"x5"
Shih Tzu, Male, 12 years, 7.5 kg


Treatment
Feb 2, 2010
Pre-op IV drip + baytril 24 hours.

Feb 3, 2010
Clipped bald
Blood test
1. Liver disorder. High SGPT/ALT, SGOT/AST
2. Kidney disorder. High urea 13.3 (4.2 - 6.3). Creatinine low (29 (89 - 177)
3. Total WBC 30.8 (6 - 17)
Platelets 528 (200 - 500)




Zoletil anaesthetic 0.2 ml IV
+ Isoflurane gas > 1 hour
Surgical excision
2 packets of stitching
e-collar + rimadyrl painkillers for 7 days

Feb 4, 2010
Post-op swelling. Baytril 4 days and trimaxazole syrup

Feb 7, 2010
Neuter - 2 testicles removed.
Domitor 0.5 ml IV Antisedan 0.5 ml IV & post-op painkillers and antibiotics.

Feb 9, 2010
Parts inflamed Stitch breakdown at 8 o'clock and 12 o'clock
lst Tardak 10mg/ml inj. Bodyweight 6.8 kg. Tardak given at 14 mg or 1.4 ml SC
Another one on Feb 17, 2010 advised.
Painkillers tolfedine 60 mg x 2 tab. Pred 5mg 1/4 tab/day x 20 days
Tremethoprim, medazole,
Goes home.


The owner did not return for a 2nd Tardak injection.
"What is Tardak used for?" the JC 1 intern asked.


Jun 3, 2010
7.8 kg 39 deg C. Ringworm in body spinal area and face. To shave bald.
No tumour seen



Case Study 2. Hypersexuality and Tardak injection


Tardak (delmadinone acetate) is a potent anti-androgen 17 to 40X
the potency of progesterone. It is used for 3 indications

1. To treat hypersexuality (inhibit intersitial cedll stimulating hormone -->reduced testosterone production --> decrease libido. So it will be effective for dogs that hump cushions daily. Tardak 1.9 ml SC


2. Prostrate hypertrophy - due to chronic inflammatory process, benign hypertrophy or carcinoma. In inflammations, need to give antibiotics and corticoid.



3. Circum-anal tumours
Respond favourably so long as they are small.the larger they are at first treatment, the less encouraging is the prognosis.

90. William Somerset Maugham fan

June 3, 2010 meeting at Toa Payoh Hub

I was surprised and happy to meet a Singaporean who keeps the whole set of William Somerset Maugham books. Such men are rare as Singaporeans don't read.

"The pages are yellowed," he lamented.
"Do your books face sunlight?" I asked.
"Yes," he replied.
"Sunlight has a strong effect on books. Keep them in a dehumidifier. Do











you have book

89. Reverzine S.A (yohimbine)

Reverzine injection is an "antidote" for the reversal of xylazine-induced sedation and xylazine-ketamine anaesthesia in dogs and cats.

Active constituents: Yohimbine hydrochloride 1.25mg/ml
4-aminopyridine 2mg/ml

It must be given by IV. Not to be used for animals with cardiovascular, renal or hepatic disorders

Dogs: 1 ml/10 kg bodyweight
Cats: 0.25 ml/kg bodyweight

Parnell Laboratories (Aust) Pte Ltd

88. An independent contractor

REPLY TO AN EXPATRIATE VETERINARIAN WANTING TO WORK IN SINGAPORE

An independent contractor as a veterinarian means he does what he wants and just uses the facilities of service providers like veterinary surgeries. I hope you understand the concept and business model. It is lots of risks for you. But you cannot have the cake and eat it!

That is why I advise you (for your own good) to be an employee first if you really want to make your fortune in Singapore. There is no short cut to success as you will know by now. My real estate company, asiahomes.com started with zero income for around one year as I had to build it up. Same applies to toapayohvets.com. Vets are not supposed to advertise their presence in newspapers etc. So, it was tough, unless the vet is proactive giving seminars and doing charity.

I find employment agreements not good once the trust is gone as the employee sabotage begins since the employee cannot get out of employment. I think you need to write a business plan first. Ensure that your financial savings to last you at least one year as you will be an independent contractor.

Other things like accommodation can be found when you are here. An HDB apartment will suit your budget for at least the first year. Rental of whole 2-bedroom HDB apartment is around $1,500 - $2,000 per month. A car is essential if you want to do big house-call vet business. Taxis are not convenient. There is the car cooperative rentals. Wessex Estate houses are usually full as Caucasian expats love them.

Please note that I do NOT get involved in car purchases for independent contractors. In life, you need to do a business plan (income and expenses especially) even if you have lots of money. Otherwise the money just goes down the drain within one year. I know of rich and influential people who want to "invest" in veterinary facilities. For example, they provide land and buildings in Myanmar and I provide the rest. But I don't know them. So, I avoid them.

As for you, you need to think and think what you want to do in Singapore as you have to leave the comfort of your home to venture overseas to sell your services.

I met a young English vet who took over a practice from a German vet in Siem Reap. After 2 years, she gave up as business was not to her expectations. I visited her when during my travel to Siem Reap in January 2010. I thought there would be expatriate vets in Siem Reap and she was the only one. She was very frank with me about the business of veterinary medicine in Siem Reap. The difficulty in getting veterinary drugs and the culture of the locals. She decided to go back to England and my visit was her last day of practice. I learnt more from her failures and my other business failures. I can tell you it is very painful. Very costly and involved loss of huge amounts of monies.


So, I don't want you to suffer in Singapore if you are not into risk taking. Costs of accommodation, cars and other matters - if you earn money and have customers through referrals and excellent service and perform correct diagnoses - they are small change.

Best wishes

Dr Sing Kong Yuen

Wednesday, June 2, 2010

87. A biting dwarf hamster

At 2.5 years old, this dwarf hamster bites when touched. His lower body is deep red and he has a bare backside. So, he must be feeling painful. He scratches his ears all the time and sometimes his body. What is the cause of his itchiness?

Contact with rough pellets and water. He prefers to stay inside his feed bowl. Mum gave him tissue paper inside a yellowish bowl. He would drag the tissues out and place them on top of the pellets near the water bottle and sleeps there. The water bottle drips water. He gets wet. Being an aged hamster, his skin is no more as good as when he was young. With friction and dampness, his lower body gets irritated and inflamed. He becomes very itch.

I gave him clean paper litter and treatment for 5 days. He was much happier and his lower body became pink and not so red and itchy. He went home to the little girl who would look after him.

"How about his big lump on his right thigh area?" the mum asked. "It is better not to operate as he may just die under anaesthesia or after surgery," I said. "He is nearing the end of his life span." Hamster lives around 2.5 - 3 years.