6. Internship. Painful Squeak When passing motion in a guinea pig

video prepared by

Gina Ng and Erica Chai

5. Internship. “An Ounce of Prevention is Worth a Pound of Cure”

As the saying goes, this is applicable to all kinds of disease and especially to the ones that recur. Urolithisis or urinary calculi are the formation of mineral stones within the urinary tract especially the lower urinary tract such as the bladder and the urethra.

There are many factors that can cause urolithisis in dogs such as urinary tract infection such as cystitis or urethritis, breed disposition, diet, exercise, amount of water drank, age and sex. The formation of different types of stones depends on various factors such as pH of the urine, metabolic or anatomic abnormalities, and types of diet or genetic predisposition. Small breed dogs such as Miniature Schnauzer, Lhasa Apso, terrier, Shih Tzu and Miniature Poodle are predispose to stone formation as compare to large breed dog. Besides that, there is a high incidence of struvite uroliths in Miniature Schnauzer due to its genetic predisposition. Often diets high in certain nutrient such as calcium, protein, oxalates will also increase the risk of stones formation. Dogs fed solely on dry biscuits will make the urine concentrated which will cause the crystals to precipitate and favours the formation of stones.

There is no 100% cure to this disease as it had 30-40% chance of recurrence. This will not only pose problem on the animal but the owner as well. Animal that suffer from urolithiasis may have severe discomfort and pain and may even face death if the kidney is damage or if there is complete obstruction to the urinary tract. This will not only be inhumane but this also involves a large sum of money for the treatment as this may require emergency surgery. Surgery alone may range from $500-1500, and that will be followed by warding fees, medicine, pre-operation blood test, catheterisation, urinalysis, x-ray and many more. The total sum may reach a whooping of $1500-2000. Besides that, how many surgeries can the animal endure within few years of the episodes? Whereas prevention which consist of change of diet, exercise, monthly urinalysis which range from $30-50 and x-ray every 3 months which range from $50-70 will definitely be cheaper and more economically wise. This will not only put your pet out of misery but also save the life of your beloved ones.

Here’s a summary of treatment cost compare to its prevention:

Treatment		Prevention
Sedation	$100-150	Urine test	$50-100
Anaesthesia	$200-300	x-ray	$50-70
Cystotomy	$500-1000	Prescription diet	$30-50
Blood test	$150-200
Urine test	$50-100
Iv drip	$50-100
Suture material	$20-40
Stone analysis	$150-200
Medication	$70-100
Post-op nursing	$100-150
Total	$1390-2340	Total	130-220

In conclusion, many people may not want to follow and won’t bother to consider this regime. However from economic point of view this would be the best and not to forget other considerations like time, emotion, pain and life of your pet.

Prepared by 

Erica Chai Hui Ling

4. Internship. Enucleation of Winter White Dwarf Hamster

Surgical procedure:

1.       The hamster was gassed with Isoflurane in a small container for approximately 10 seconds until its body was limp.

2.       First we must incise 4mm of the lateral canthus so that we can have adequate exposure of the internal structure of the eye

3.       Then we can clamp the optic nerve stalk with the smallest forceps, however it is not possible to ligate the stalk because it is way too small.

4.       Next, is to incise the optic nerve stalk. Some bleeding may be expected after the incision however it will clot soon because the vessels are tiny.

5.       Then, we have to trim the upper and lower eyelids so that the skin will heal when opposed together. If these eyelids were not cut then the skin will not close even when stitched together.

6.       Lastly is to close up the wound using 6/0 absorbable suture.

7.       The whole eye enucleation procedure should take less than 1 minute because the anaesthetic effect wears off very fast in small animals especially when using gas anaesthesia.

8.       Clean the external of the wound and the surrounding fur that is stained.

9.       It is not possible to put E-collar on a hamster. So the best way to avoid self inflicted injury is to administer analgesic drug.

10.   This is because analgesic will provide comfort and the animal won’t feel irritated and pain. Thus, it will not scratch its eye.

NB: There is a simplified illustration of the procedure below.

Differences:

1.       No 360˚ paralimbal incision to remove eyeball from its socket.

2.       There is no ligation of the optic stalk below the clamp.

3.       Lots of bleeding controlled by stitching of eyelid.

4.       Excision of upper and lower eyelid to create fresh wound.

5.       Excision of extraocular muscle attachment.
6.   Removal of the third eyelid or nictitans membrane

Prepared by
Erica chai Hui Ling

-

3. Internship. A Golden Retriever With Two Big Lumps Below the Sternum

History:

Ace is a 10 year old, male, Golden Retriever that came in with subcutaneous tumour and ruptured abcess (10”x5”x5”) below the sternum. He had been inappetance and had trouble walking for 10 days. During examination, he was down with slight pyrexia (T: 40.7˚C), deep ear infection, abscess, tumour and ulcerated foot pad of the right forelimb.

Possible treatment option:

1.       The dog required surgery to remove both the abscess and subcutaneous tumour.

2.       Excise about 1cm from the margin of the tumour to ensure complete removal.

3.       Then surgically debride the affected area and remove pus by flushing the abscess.

4.       Use hydrogen peroxide followed by chlorhexidine, diluted povidone iodine and then smear mixture of antibiotic cream and dermapred on the wound.

5.       Depending on the size, the gaping wound can be stitch up or left open for second intention healing and that would need daily wound cleaning.

6.       If the wound is big, we need to stitch up and reduce the dead space to avoid fluid accumulation. We also need to insert drainage such as Penrose drain to allow daily flushing of the wound.

7.       If the wound is small then second intention healing is intended. 

8.       The animal also needed systemic antibiotic, analgesic and anti-inflammatory medicine.

9.       If there is swelling, then apply warm compression twice daily.

10.   The dog had to wear a e-collar to avoid self trauma.

  
Prepared by
Intern: Erica Chai Hui Ling

2. Internship. Swollen right fore paw in a 12 year old shih tzu cross

Swollen right fore paw in a 12 year old shih tzu cross

Shih tzu cross, Male, 12 years old, not sterilised
Active: 5.8kg, in good condition

è Heart and lungs are okay

è No history of panting/ breathing difficulty

è No medical history

è Low risk

Problem: Foreign body under paw. Right front paw is swelling. Big scab/wound about 6mm in diameter. Might have stepped on something.

Treatment: Surgery to remove foreign body (found out to be a tumour)

History: Went for grooming about 2 weeks ago

Owner worried about effects of anaesthesia

Owner does not want dog to undergo histology (old age)

1. Internship. False pregnancy in a very old dog

False pregnancy in a very old dog 

Active, in good condition

History:

è Food: Caesar can, Dog food (soaked in water) A & F dog food for old dogs, 1 egg everyday

è Drink: when asked to do so

è Pee: ??

è Poo: Once/ twice a day

Menses: Red, dark brown discharge, colour gets lighter towards the end,

Duration: 2 – 2.5 weeks (since young)

è Last menses: start of October

Has a breast tumour

Problem: False pregnancy

è Signs: Milk in breast

Problem: Itchy paw

è May be due to allergy to Dettol

Conclusion: Should have sterilised it 

- Toh Ming Hui