47. Diabetes in the dog

VETS

1. 1 in 400 dogs.
2. more in females, middle-aged and older dogs. Females affected 2x more than males.
3. Diabetes mellitus, 4-14 years old, peak 7-9 years old.
4. Nearly all dogs with diabetes require insulin for the remainder of their lives to control their diabetes.
5. Body stops producing insulin, a hormone that regulates sugar absorption. Getting sugar (glucose) into blood cells as energy source. The body uses stored fat, not using food efficiently, so, loses weight although excellent appetite.
6. Genetically redicsposed. Keeshonds, Cairn Terriers, Miniature Pinschers, Poodles, Dachshunds, MIniature Schnauzers and Beagle and larger dogs.

7. Other causes - infectious viral diseases, steroids, progestagens, obese, unspayed female dogs.

8. Not all signs. Excessive urination (body flushes out unused glucose), thirst, hunger, lethargic, lose weight.
Some ketoacidotic - too many ketones or waste products - breaking down fat at a higher rate. Vomit, diarrhoea. Breath smells like nailpolish remover. Need emergency treatment, including insulin and iv fluids, constant monitoring. Can recover but some sufer kidney, heart failure and death. Cataracts. Urinary tract infection and skin diseases - susceptible to infection.

9. Diagnosis & Treatment. High blood sugar in blood and/or urine.
Insulin shots in morning and night, before meals.
High-salt prescription food - drink and pass a lot of water to get rid of unused glucose. Or canned food with high fiber food. Frequent reassessment of the dog in early stage of diabetes erquired. Once a week. Every 3 months check urine for infection, check eyes.

Some dogs respond poorly to insulin. New FDA-approved insulin for animals. Some dogs also get hypothryoidsism, kidney failure, pancreatitits. More difficult to manage.

Expensive and time needed.

46. PET SHOP OPERATORS. Parvovirus kills puppies

SURVIVAL SECRETS FOR PET SHOP OPERATORS

There seems to be no way of eliminating the parvovirus. The more successful the pet shop operator is, the more puppies he or she stocks. The introduction of new puppies without quarantine (not a practical idea) leads to the accumulation of parvoviruses and kennel cough infections.


The impractical suggestion is to take in puppies which have at least 2 vaccinations and wait 2 weeks after the 2nd vaccination before taking them. By then, competitors would have had made the money as Singaporeans love young puppies. The younger the better.

The successful pet shop operator loses out to the competition and becomes unsuccessful! Home breeders and other breeders would not supply him the puppies as they have others who want them.

So, as a veterinarian, I do not offer such "silly" advices. It just does not work in the real world.

PET SHOP OPERATORS. The Yorkshire refuses dry food after gastroenteritis

Within 1 week of purchase, some puppies vomit and pass watery stools.

This happens because the owner has not puppy-proofed the apartment. The puppy wanders all over the apartment and chews on objects like shoes, legs of chairs, carpets. Many times, it swallows pieces of rawhide bones and newspapers.

So, the stomach gets a lot of foreign bodies. The puppy started to vomit many times. It is best not to self treat although in mild cases of a vomiting or two, observation for the next 24 hours may be all right. Feed honey water and no dry feed for the time. In any case, the vomiting puppy should be rushed to the vet if the condition worsens.

For this Yorkshire terrier, the pet shop operator picked up the puppy and referred to me. The owner was advised not to give dry food for 24 hours. Electrolytes given were vomited out. Yet the puppy was active the next day. It just would not eat the dry dog food.

"Nobody gave him the home-cooked people food," the lady owner said. On further questioning there were treats given.

"So, the puppy might be waiting for people food," I said. "Yorkshire Terriers and Chihuahua seem to know that if they do not eat, the owner will offer them better quality more tasty food."

For the next 2 days, the Yorkshire Terrier refused to eat. He drank water and the electrolytes. Actively running about. The owner phoned me again.

"How to make him eat?"

"In this case, buy canned food, warm it and mix 10% of the dry food." I said. "Most puppies love canned food or minced meat. Slowly change to dry food later."

No more calls from the owner. The Yorkshire Terrier seems to dislike dry puppy food after suffering from vomiting and diarrhoea. I suspect there must be children who feed him people food.

"But the children are grown up," the lady owner said.

"How old is the youngest?" I asked.

"12 years old."

A 12-year-old child is not a grown up. That age is the best age to befriend this Yorkshire Terrier and share with him the joys and sorrows of growing up. Sharing of people food is one of the joys of owning the puppy too. So, this Yorkshire Terrier must be waiting or have been fed people food without the adult knowing. The child cannot tell the adult that the puppy was given people food without being scolded.

So, no adult knows. The Yorkshire was active but did not eat dry dog food. After all, there are more tasty things to eat.

The Beagle and the air conditioner filter

SURVIVAL SECRETS FOR PET SHOP OPERATORS - Air conditioner filter.

The Beagle was the ugliest, in my opinion, but the pet shop girl bought it. To me, Beagles look good if they have more patches of white colour. This one had 90% non-white colours. He had yellow diarrhoea and a few reddish spots of blood passed onto the pee tray. A change of diet and environment probably caused the diarrhoea.

Now, he was housed in the quarantine area, below the ceiling air conditioner. "Why don't you vacuum the filter?" I asked the pet shop girl. Lots of germs in this filter which was clogged with whitish stuff. The poor puppy was below. "The puppy could fall sick breathing in dust from the filter should the stuff fall off. The air conditioner had been switched off.

The pet shop girl was busy on her mobile phone. Long hours at the shop from 10 a.m to 9 p.m, 7 days a week. Pestered her. For the sake of the puppy. She took a hose and vacuumed zig zaged lines on the filter.

There was no ladder. But it was not sufficient. I offered to get her a ladder from her house. But the part-timer suggested borrowing from the neighbour. He had hair in a bun and I thought he was a girl. Waiting for national service. He took down the filter. Flushed it with water hose. Blackish water, the blackest soot you can see.

At least the filter was washed. I was glad that the puppy had a better environment and left after vaccinating 4 new puppies. Long hours can cause burn-out, ubt never ignore the hygiene of the pet shop. Puppies die easily and how can a pet shop be making money if the basic of hygiene is neglected? I don't know. In fact, there should be a check list to clean up. Part-timers must be given a schedule to do. This will make sure that the pet shop operations are kept to the highest standard of hypiene. Healthy puppies mean happy customers and hopefully, good business.

It is hard to convince the pet shop girl.

The dam had heart problems and the pup was lifeless

TIME IS OF THE ESSENCE

The long-coated chihuahua had heart problems. No other dams had breathed "har, har, har" throughout general anaesthesia. The endotracheal tube passed in the anaesthetic gas and she was not feeling any pain when I operated and took out her first pup. But she was having noisy sounds from her nose. Her lungs were not in top form. She could die anytime. The secret of success was to operate in less than 15 minutes, as short a time as possible. Long-coated Chihuahuas were extremely rare in Singapore and very valuable.

This was her first birth. She had not been able to put on weight till now, 2 years later and Mr Formicelli was worried that she might die on the operating table. He had called me personally to explain her medical background. "She has a heart problem diagnosed," he said. "Should I do the Caesarean or not? I doubt she can give birth naturally. She is panting and her rectal temperature is 37.8 deg C."

"Has she got milk?" I asked. He said yes. Well, this is a very risky elective Caesarean. If we don't operate, the pup might die and still we had to operate to save the mother from a decomposing pup. So, what was the choice?

I knew I would not be blamed if she died on the operating table. But words of death under the operating table spread fast amongst the breeding fraternity. No excuses. Death meant incompetence. Mr Formicelli nor his experienced assistant could come.

But his father, the pet shop girl and her husband were present. I put the dam under gas anaesthesia. The whites of her eyes reddened as if she had high blood pressure. I put the breathing tube into her lungs. First time lucky as I could not see her epiglottis. She was just not fully anaesthesized. But time was of the essence.

Under surgical anaesthesia, she still "har, har, har," Like a person snoring in the sleep. She had breathing difficulty too in addition to a heart murmur. Would her stressed heart now failed?

When I took out the sole pup, it was enclosed in a cloudy amniotic sac. Few clumps of white stuff, probably its stools (meconium) floated inside the water. The placenta was normal and in top condition. However, the pup was limp.

I wanted to finish the operation fast. Mr Formicelli was a top breeder and the seventy-five year old father had been active in the breeding operations. "You know what to do?" I asked as I handed him the most precious pup in the world. Maybe in Singapore for Mr Formicelli. A chocolate long-coated chihuahua. He nodded.

I could not hear any puppy cries for 2 minutes. I saw him rubbing gently its neck as the pup laid on the towel, outside the surgery room. "Swing it," I shouted. He still rubbed.

I had just inserted one stitch to close up the womb. There were 2 pups but one had broken down into a pulpy yellowish brown sticky mass from the right uterine horn. The normal pup was now life-less.

Should I continue stitching the mother? Time is of the essence for the puppy. 2 minutes had passed and I had been presumptuous. This pup needed more than rubbing its neck. Should I stop stitching? What if the mother died due to prolonging of the general anaesthesia. She was still breathing nosily and her maroon red tongue had dried up. Well, her tongue was not cyanotic and should I take the chance?

The mother is more important than the puppy to the breeder. Yet, this was a most beautiful chocolate chihuahua. A difficult to conceive. Much effort and time and expenses. All the hope. If Caesarean had taken place 6 hours earlier, it probably would be vigorous.

Now, there was a decision. To stop stitching and maybe the mother would just collapse of heart failure. To revive a puppy that might not live and sacrifice the mother? What was the best course of action. There was no time to think through. There was no plan B. It was now or never. Time was of the essence for the puppy.

I took the puppy outside the surgery. To the walk way. It was a fine August evening. I had more space there to swing it. I swung it in an arc. From the top of my head down to between my stretched out legs. 5 times I swung, 5 times yellowish white foam came out of its nostrils. The lungs must be water-logged.

I thought 5 times was sufficient. Still no life. Used the hair-dryer to warm it. Pinched its neck skin 3 times, tickled its hard palate and tongue with the tissue paper. Wiped its nose.

No life. No hope. It was past 5 minutes. I swung at least 3 times inside the consultation room. Instructed the pet shop girl what to do. She was a novice. The pups' tongue suddenly changed to a dark maroon red colour. Was this a sign of blood flowing through the body or my hard powerful swings? It was not crying. I saw the tongue moved a bit. A glimmer of life.

I just could not wait any longer. Any time, the mother might just die of heart failure. It must have been 5 minutes of attending to the pups but it seemed that time was at a standstill. Cry, puppy cry. No sounds.

There was one procedure I had to do. This was the last trick up my sleeve. It was the mouth-to-mouth resuscitation. Was it a bit too late now? Better late than never?

I extended my neck. Held the pup high above my head. Inserted its nose and mouth between my lips. Sucked hard to pull out the water from its lungs. No water was seen from its nostrils. I asked the pet shop girl to continue nursing. It was time for the mother.

I could see that the pet shop girl and the patriarch hard at work. Pinch its neck skin, I demonstrated with my fingers as I saw the pet shop girl not doing that, from the window pane separating the consultation from the surgery room. I had changed gloves and was stitching up the mother. She was normal but breathing harshly.

"Reduce to 1 percent gas (instead of the usual 2%) I told my assistant James. "You go and pinch the puppy's neck. You have strong fingers and had done successfully before." James went to help.

It seemed like an eternity. James' magic fingers worked. The pup gave one loud cry. I thought that was sufficient. It cried again and again. A voice of protest against being pinched? It was as if a dam of silence had burst. We knew it was great but we do not express our happiness like hugging each other or clapping.

The puppy was alive. The mother was well. I am sure Mr Formicelli was a satisfied customer.

Part 2. The cat with the malodorous backside wound

Cat bite abscess - malodorous, gangrenous skin. Big hole. Stitched up.
http://www.toapayohvets.com

In Singapore, a tom cat attacking home cats going out is one of the commonest complaints.

Part 1. The cat with the malodorous backside wound

"How do you know I am in the creative industry?" the broad shouldered muscular 40-year-old man put his 5-year-old cat on the operating table. The cat was tranquilised but it was not knocked out. It hissed as Nurse Ann tried to give her anaesthetic gas via a face mask.

"Creative people present trademarks," I said. "They keep beards." I did not say that many do have one ear ring on their left ear. I knew that this procedure would not be suitable for this tabby cat with light grey hairs. It was the safest method. The bearded man took the mask, cooed to the cat, "Let me try it."

The cat's eyes widened. It hissed again and put out its claws. The warning signs of danger.



"Best to postpone the operation till tomorrow when I will give an injectable anaesthetic which will not require me to use anaesthetic gas at all," I said.

"But I have no time tomorrow," the bearded man said. "I am busy at the IOC Meeting."
Singapore hosts the IOC (International Olympic Committee) Meeting and on Wednesday (2 days from now), the Committee will select Paris, London, New York, Madrid or Moscow for the venue of the 2012 Olympics Games. David Beckham and Mohammed Ali would be around pitching for London and New York respectively.

What could I say? The cat comes first or the IOC? His mum was worried.

"I could give another dose of the tranquiliser but the cat may die from fright or hear failure. So, I rather not advise it." In fact, I would not do it. "The cat's health comes first," I said. "I had given the cat a lower dose because it is older and had a severe infection."

The lump on the right side of the tail end was big and very painful, about 15 cm in size.

What should be done now?

The infected gangrenous tissues were cut off when the cat was under general anaesthesia. The hole was large. Other parts of the backside skin were snipped to join and close the big hole.


Cat bite abscess - malodorous, gangrenous skin. Big hole. Stitched up.
http://www.toapayohvets.com

In 21 days after surgery, the cat was back to normal and the mother was very happy. This was a busy son but he cared to seek treatment so that his mother's cat can live a normal life. Without treatment, the infectious bacteria would have spread to all over the body, killing this cat.

The cat had a new lease of life and hopefully, no more outside cats would attack her. If she was kept indoors all the time, she would be safe. But some cats just want to go out for a while. Danger lurks downstairs as there may be a big tom cat defending his territory.