Creatures Inspired

Vaginal Hyperplasia

2010-09-02T11:50:00.001+08:00

One of my clients called me the other day and told me that his dog was on time for delivery and looked like the fetus has came out half way and stucked in the middle. I quickly rushed to his house to have a look. I was a little skeptical as he didn't mention anything about his dog being mated before. Anyway, I've promised him to have a look and there I went.

To my surprise, the dog wasn't delivering as what my client have told me. It was a case of vaginal prolapse, or more convincingly vaginal hyperplasia causing the vagina to prolapse. There wasn't any puppies in the uterus as I couldn't palpate any. It was a labrador and most of the time, a labrador might gave birth to at 7 - 8 puppies in a batch.

The occurence of vaginal hyperplasia is usualy under the influence of the hormone estrogen. Estrogen can cause the vaginal wall to become edematous and swell, thus, making it large enough to protrude outside the vulvar lips. Some people may prefer the words "vaginal edema" rather than vaginal hyperplasia because it does not involved a true organ prolapse or hyperplasia of the vagina.

Treatment depends on the stage of estrus, extend of the fold prolapse, whether it's a breeding bitch or whether the dog is pregnant. In this case, the dog was not pregnant nor was it on heat. It was a puzzle for us as to why this condition has occured in a non pregnant, non-estrus bitch. Further check on the blood revealed "band neutrophil", a condition of the white blood cell, neutrophil indicating toxic changes in the body. And, in the bitch, it is highly suggestive of "pyometra", an infective and inflammative condition of the uterus. And, true enough, ultrasound diagnosis revealed the dog was having pyometra and the possibility of cystic ovaries.

The best treatment for pyometra is to remove the entire uterus and the ovaries together so that the dog can be saved immediately. A pyometra has always being regarded as a "time bomb" as it can rupture anytime if the swelling was large enough. So, there we went, into the surgical room. The dog has 2 problems to be solved - a pyometra and vaginal hypreplasia.

Upon opening up the abdominal cavity, the first organ I saw was the enlarged uterus. We have to remove the entire uterus as it was too risky to leave it because it was so big! Look at my hand and compare it to the size of the uterus.

After we have removed the pyometral uterus, we proceeded with the removal of the prolapse vagina.

After the prolapse vagina has been removed, the remaining stump was sutured and put back in place. The dog was saved from pyometra which can cause death if not treated.

This case was very special because the vaginal hyperplasia was probably due to the hormonal effect caused by the cystic ovaries. Most literature stated that vaginal hyperplasia occurs during estrus or at the end of pregnancy. And, I treasured very much the experience of seeing a vaginal hyperplasia out of the "norm".

A Cherry In The Eye?

2010-05-07T12:12:00.000+08:00

"Cherry eye" is a common term used to indicate the prolapse or protrusion of the canine third eyelid gland which is situated at the medial aspect of the eye. The condition occurs more commonly in dogs than cats. Usually, you can see a reddish colored mass coming out from the medial aspect of the eye i.e. the term "cherry eye". It may be caused by a hereditary weakness in the connective tissues surrounding the gland. It is most common in puppies.

The main purpose of the gland is to produce tears to lubricate the eye (up to 30% of tears). And, because of that, cherry eye can expose the eye to dryness which may lead to "dry eye" (keratoconjunctivitis sicca). This is particularly true if the third eyelid glands were being removed as it was with the older treatment method. So folks, do not remove your dog's third eyelid gland if it has cherry eye as there are other treatment options which are much more better. The modern method of cherry eye treatment involves repositioning the gland to its normal position. The success rate of this treatment is up to 80% in most breeds.

An Eyeless Puppy

2010-05-07T11:41:00.000+08:00

A few years ago I got a rarely happening case where a Poodle puppy was born without eyes! Yes folks, without eyes. I have never seen one naturally although we have studied it before. I treasured very much this case as not everyone have the opportunity to witness it. So, here it is for your viewing pleasure.

I Can Swallow Whatever I Want 3 : The Durian Season.

2010-04-02T13:10:00.000+08:00

Hi folks, it's durian season again. A lot of you must be avid durian lover. Same as this dog here. He just loooove durian. He's an English Cocker Spaniel and lives with a durian crazy family. But, unfortunately it wasn't a pretty experience the last time he swallowed a durian with its seed, that's without the owner's knowledge . It happened last week. The clinical signs? Vomit, vomit and vomit whatever he took in. Otherwise, the dog looked healthy.

We did an ultrasound scanning to diagnose the problem. And, sure enough the durian seed was there, inside the small intestine.

So, we decided to carry out surgery to take out the durian seed. Mind you that we do not perform surgery in every durian swallowing case. In some cases, the dog actually vomitted out the seed after several days.

This was the small intestine where the seed got stucked in.

We put so called "stay sutures" at both ends of the intestine where the seed was for easier manipulation during surgery. The instestine was later cut to release the seed.

The seed was removed and later the intestine was sutured back by using absorbable suture. The intestine is full of actively dividing cells. It will heal very fast in fact in just 2 to 3 days time. Usually, we will use fast absorbing sutures to close the wound.

And, finally the durian seed was removed. It was about 4.5cm in length.

By the way, readers are welcome to make any comments or maybe share your cases. Thanks.

I Can Swallow Whatever I Want 2

2010-03-18T15:21:00.000+08:00

Hi folks! It's swallowing act again. But this time, it's a stapler wire!

This time, it's really hard to find such a tiny object in such a long intestine! We had to thoroughly search the entire intestine (small & large) to finally managed to find it.

Taking the stapler wire out was not a problem at all. Most of the time wasted was due to the search.

There's another case where a poodle swallowed a .....ehem.....condom which I didn't got the chance to take any photos because unluckily I forgot to bring my camera on that special day. Apparently, the owner did not throw the condom "properly" after use and the dog, I guess found it on the floor. Hmmm....I wonder what flavour it was that tempting the dog to swallow it.

I'll post more interesting swallowing act next time. Do come back for more. Thanks.

By the way, please throw used condom properly in case you have a garbage eater in your house, hihi.

I Can Swallow Whatever I Want!

2010-02-17T18:22:00.000+08:00

My oh my! If you think that only magicians can perform knife swallowing tricks, wait until you see this. It's rather amazing what dogs can do with their curiosity. Ladies and gentlemen, I present to you a "Neeeeeedle swallowing Pekingese"!

A pekingese was brought to us by a lovely couple a few weeks back. The lady owner did not actually see the dog swallowed the needle precisely. She got to know about it when one of her needles went missing after she left it on the sofa. As you can see from the x-rays above and below, the needle was right inside the stomach. And, it all happened 2 days before her wedding day!

We have no choice but to operate on the dog to remove the needle failing which might cause more harm to the dog. We were very concern about the needle going through the stomach wall and causing more injuries to other internal organs such as the liver and kidney. If it does "travels", then, it might be harder for us to find it. We have to do it and do it quickly.

The surgery was quite straight forward. We were surprised to find out that a thread was attached to the needle.

The needle was about 4cm long! Hmmm... how did a dog with a small mouth swallowed such a long needle, with a thread somemore?

Bad bad doggy!

The Year of the Tiger

2010-02-07T10:52:00.000+08:00

I wish everyone a wonderful & prosperous year of the Tiger. Sorry for not being able to post new stuff here for so long. In the new year, I'll try my best to post up interesting stuff for you. Thanks.

Veneral Tumor in Dogs?

2009-07-12T15:39:00.000+08:00

One interesting nature about dogs is that unlike human, they do not simply mate to serve their "needs". The female only allows the male to breed twice a year during heats. And, because of this, they rarely get diseases transmitted through copulation. One exception is the Transmissible Venereal Tumor or TVT. The word venereal itself described the mode of transmission of this disease, but in actual case, the disease can be transmitted through contact as some dogs might have the tumor growing on the nose (transmitted when they lick the tumor affected parts).

TVT was first described by Russian vet M.A. Novinsky (1841–1914) in 1876 when he successfully demonstrated that the tumor could be transmitted from one dog to another by infecting them with the tumor cells. In fact, it is very easy to be transmitted.

In our practice, we have successfully treated dogs (male & female) with TVT. Chemotherapy is very effective against TVT. Some people might use radiation or surgery but chances are the tumor will grows back again.

Very easy to spot the tumor which grows outward from the vagina. Most of the time, the owner will first complaint of bleeding from the hind. I have taken photos from the male dog's but forgot where did I saved them. Anyway, in males, the tumor will grow on the penis and the inner part of the prepuce. You have to actually pull the prepuce back to reveal the cauliflower like tumor in the inner penis. Normally, there will be blood dripping from the prepucial opening and owner may misunderstood this as blood in the urine.

The treatment is very simple, safe and effective if done correctly. Any chemotherapy drug is very dangerous and must be handled by trained veterinarian. In fact, some of them can cause your skin to slough if in contact with your skin. The photo above showed the same dog after the first chemotherapy. The tumor started to shrink just after one treatment but it's not enough to initiate only one treatment. It has to be a series of treatment depending on what drugs to be used.

There you have it! Complete recovery of the dog from the tumor after the third chemotherapy. Actually, this dog was given four chemotherapy session in order to complete the series of chemotherapy treatment designed for her.

In the male dogs, the tumor almost always occurs in the inner part of the penis. It can easily be seen once you pull the prepuce back until the end of the penis. The structure is something like a cauliflower usually with some bleeding. The most obvious sign to look for in a male dog with TVT is dripping of blood from the preputial opening.

A Cat With A Heart, Indeed!

2009-07-11T15:58:00.000+08:00

Have you seen a cat with its heart outside the body?!! Well, tada..... here it is. First time in the blogsphere. You can't find this anywhere else, exclusively here only. What's the chance of getting a heart shape on your skin? I can't even imagine the probability.

Corneal Ulcer In Dogs.

2009-07-10T22:56:00.000+08:00

Today, I'm going to talk about corneal ulcers, especially in dogs. Not that cats do not get corneal ulcers, but, 80% of the cases I've seen so far happened in dogs. The causes of corneal ulcers? Well, the most common one is due to scratching either during fights, or the dog's been scratching the eye due to irritations. This happens mostly in those small breed dogs with flat face and big, bulging and protruding eye balls, e.g. shih tzu, pekingese and pugs. And, we do get lots of corneal ulcer cases, at least, I mean at least 2 to 3 cases a month. Some of them involved only the corneal surface. And, some of them got worst and the corneal sometimes ruptured, releasing the membrane underneath it (what we called the descemet's membrane which was named after the French physician Jean Descemet). When this happened, you could actually see the membrane bulging out from the cornea. This is what we terms as descematocoel.

In this photo, the ulcer is right in the middle of the eye. Sometimes, we could estimate the age of the ulcer by knowing the process of ulcer formation although it is not very accurate.

This is another Shih Tzu with a corneal ulcer in the middle of the left eye. The ulcer was not too bad compared to the one above. Sometimes, we just give the owner eye ointment and send the dog home. But, in severe cases, we have to conduct a surgery to pull the third eyelid of the dog to cover the unhealing ulcer so that the ulcer will be protected and have time to recover.

This is what we call a third eyelid flap whereby the third eyelid is pulled to cover the eye and temporarily suturd to the upper eyelid. The flap may have to be in place like that for up to 2 weeks. After 2 weeks, we'll have to release the flap and check the ulcer again. If everything turns out to be fine, then, the flap is removed.

Below is the ulcer after the removal of the 3rd eyeli flap. The ulcer is healing nicely and it clearity of the cornea it becomes normal once the ulcer has completely healed in another 1 to 2 weeks' time.

The most serious problem with unhealing corneal ulcers is uninviting bacterial infections. Some bacteria can produce a type of enzyme that prevents or melt the corneal. This would leads to unhealing ulcer. A much more major surgery have to be done to correct this condition.

Keep on blogging, Dr. Kenny

2009-06-20T19:05:00.000+08:00

A friend of mine actually read my blog the other day. He was amazed with the contents as he said my blog is very informative and it's hard to get information straight from a vet coupled with real life photos. He asked me to continue blogging as my blog has a potential to attract readers, especially the pet owners. My writings might one day help somebody's pet, he said. Well, I must confess. I'm a bit lazy to write especially after busy and hectic days. Nevertheless,I'll do my best to entertain my readers.

Bladder Stone In Dog?

2008-10-17T17:47:00.000+08:00

It's amazing how dogs and cats shared some similarities with us human. Apart from the daily do's like eating, drinking and sleeping, they also have some similar diseases, or disease conditions, so to speak. Recently, we had a dog with bladder stone. The owner was quite surprised to know that dogs can have bladder stones. In the mind of the public, you'll never thought of this to be happened in a dog. Well, yes, it happened. Like they say, SHIT happens.

We had quite a number of urolithiasis (bladder stone) cases in a year. Most dogs were from the pedigree breed. Breed predisposed you might asks? Well, we're not sure but one thing for sure is that, food does have a role in urolithiasis.

O.K. back to this case. The dog's name was Lily. It's a 2 year old female Shih Tzu, weighing around 5.4kg. Lily's owner noticed blood stain in her urine. She was also getting a bit irritated each time she wanted to release the urine due to pain. Her urination was also becoming more frequent than usual. Sometimes owner may ask a funny question regarding bladder stone. The million dollar question is : "Can my dog gets bladder stone from ingesting stones?". Well, I leave that to you guys.

Anyway, upon physical examination, Lily was fine, except for the blood in the urine. Sometimes, if the bladder stone was big enough, we could actually palpate the stone if the bladder was not filled with urine. But, in Lily's case, she was quite fat and palpation of the stone was not possible.

Later, x-ray was done and surely enough, a stone was visible in the x-ray film. I'm sorry I couldn't post the x-ray here at the moment as I did not take a photo on the x-ray.

So, Lily's owner had decided to have her operated to remove the bladder stone.

Figure 1 : Lily's half fulled bladder with 2 stay sutures in placed.

Figure 2 : The bladder stone being removed from Lily's bladder.

Figure 3 : The urolith, which was removed from Lily's bladder, was later identified as struvite ( a type of urinary stone in dogs and cats ).

There, you have it. The story of Lily the Shih Tzu. Although the stone has been removed, there's always a chance of recurrence if the owner do not take care of Lily's diet and lifestyle.

Funny Cow Video

2008-10-11T17:42:00.000+08:00

Found this funny cow on Youtube. Enjoy.

http://www.youtube.com/watch?v=EMoEAfDJ8Iw

Dog bite dog.

2008-09-29T14:05:00.000+08:00

About 3 months ago, an owner came to me with her dog (Snoopy) wrapping up in her arms. Tears started to flow down her cheek while she related the incident that happened the night before. Snoopy was always kept inside her house while the other fellow, Max, a local breed, was kept outside. Somehow, on that night, Snoopy managed to slip through the glass door and when into Max territory. Now, Max was not a friendly neighborhood dog that you'll find licking your feet or wagging his tail at some strangers. Snoopy did not realised that he was about to put his feet in somebody else territory. At that time, Max was munching away his favourite dishes and that made the situation more tense. At an instance, the owner heard a loud noise coming from Snoopy asking for help. The attack was over in just a few seconds, and the only thing the owner saw was blood splatterd everywhere on the floor.

The owner panicked and tried to calm down. Snoopy was obviously hurt and scared. He immediately when under the car to hide. After several attempts, finally, the owner managed to get Snoopy out of its hiding. Further check up revealed Snoopy's right eye were popping out but the bleeding has stopped.

It was around 10:30p.m. and most vet clinics have closed for the day. The owner did not have any vet's contact number so she thought to consult the vet the next morning.

This was how Snoopy looked like when he was presented to me, of course after the hair surrounding the right eye had been shaved. Obviously, the right eye was popping out and it is caused normally by a large force created within the orbit, such as hit by car or bog bite or being kicked from the side. We managed to do a quick physical examination on Snoopy and found a few bite wounds surrounding the neck. Other than that, no other abnormalities were found on the external body.

Then, a thorough check on the right eye revealed that the eye has been damaged and because it happened the night before, a few hours have gone (which was crucial) and the corneal has became dried and damaged. It was difficult to save the cornea and the muscles surrounding the eye ball also has been torned. We have discussed with the owner about the prognosis of the right eye and the best option (we had 2 options) at that time was to remove the eye.

And, so we did removed the right eye. The surgery took about an hour and it was a successful one. Apart from that, we also put Snoopy on intravenous drips, antibiotic, anti-inflammatory drugs and good nutrition.

Snnopy stayed with us for 3 days. He is a healthy and happy one eyed dog now.

The moral of this episode? Don't mix your dog if they are not happy with each other and please send your dog to the vets as soon as possible if you encounter such a case in the future. Who knows, the vet might be able to save the popped out eye instead of removing it although sometimes, the dog can't see with the eye.

WELCOME!

2008-09-27T16:50:00.000+08:00

Hi there. Welcome to my new blog. This blog is still a virgin, so I guess there are lots of work to be done soon. Anyway, this is the first time I'm blogging. So, please bear with me as I'm not so acquainted with blogging.

The main reason for me to have this blog is to share with the world my experience in treating sick pet animals, mainly cats and dogs, and the story behind their illness. I hope, through this blog, visitors could understand that there is a need for us to help these animals the best way we possibly could because they are defenseless when facing diseases of natural or manmade. They could not speak our language and the only way for them to communicate when they are ill is through body language. Ever wonder why your dog couldn't bark for a few days and he is not interested in his favourite lamb flavored pellets anymore? Is he sick? Or, he just missed his little brother that had been separated a few days ago because you thought your auntie might need a companion at home? Or, little Max had swallowed a piece of your son's toy car's wheel 2 days ago? There are so many possibilities of why Max has lost his appetite today. Can you tell the real cause of its inappetence in just a glance?

Now, that's when the vets play their parts. Your friendly neighborhood vet will first have to ask you the reasons for your visit, the history behind all these hoo haa that happened for the past few days. It's not that simple though, but sometimes all you need is just a little bit of common sense, and your senses. Experience is very important, too.

I hope that all of you could enjoy reading my blog and here we go!

Thanks for visiting.

Dr. Kenny