Yesterday Mar 16,
2012 (Friday), I saw 2 cases of guinea pigs with urinary
problems and reviewed the case with Dr Daniel as part of
my mentorship program.
We had met an interesting and friendly experienced
Australian banker who had travelled to all over the
world to work, at Liang Seah Street at 11 am today. "How
old are you?" he asked Daniel. He then told Dr Daniel
that 20% of the young men of his age and new graduates
are jobless in Ireland. He told me that my handshake was
weak, compared to Dr Daniel. "Have you been to
Timbuktu?" I asked him. "No," he said. "But I have been
to various places in Africa. I was sad to see so many
homeless children and the poverty."
P.S
I used to study English phases in primary school in the
1960s and there is a phase referring a distant place as
Timbuktu which is actually present in Africa. I doubt I
have a chance to visit it.
Case 1.
Not eating. Abdominal swelling obvious. The owner had
seen me some months ago. "No more skin infection," she
said. "My guinea pig is not eating."
Dr Daniel palpated the swollen abdomen. I did that after
him. The swelling covered almost 90% of the abdomen.
Soft distended bladder, in my opinion. I don't know what
Dr Daniel thought. Was he thinking of ascites?
Definitely, ascites present this pendulous abdomen.
Before I could speak further, the guinea pig squirted
out white cloudy urine onto the stainless steel
consultation table top. "The urine is not normal," I
said. "I would take some for urine test." I took a new
syringe to suck up some urine. The guinea pig voided
much more urine. Thick cloudy liquid. As if the bladder
had lots of white sand.
"Is it possible that my guinea pig has bladder stones?"
the lady asked. "My other guinea pig had bladder stones.
The vet removed it but then said another surgery had to
be done."
"Why was there a need for a second surgery?" I asked.
"The first one was not done well," she said. "So,
another one had to be done."
"What happened to the guinea pig after bladder surgery?"
I asked.
"She lived for a few days and then died."
"In this case, the guinea pig might have or might not
have bladder stones. We will wait for a few days and get
the urinary tract infection treated first."
A follow up the next 2 - 7 days would be needed. X-rays
would be needed to confirm bladder stones.
Case 2.
Not eating. Weight loss for 2 weeks. The owner had
phoned me about bladder stone surgery. She had consulted
Vet 2 recently and an X-ray had been taken. But two
weeks ago, she consulted Vet 1 who gave a different
diagnosis. Today she came with the X-ray as I had
advised her to get it from Vet 2 to save her cost of the
need to have another X-ray taken. Vet 2 had told her
that the medical notes would be sent to me. "It is not
the medical notes that is important," I said to the
young lady. "It is the X-ray of the bladder stones and
to see if there are other locations like kidneys and
urethra where stones are lodged."
"The vet gave antibiotics for a gastric infection," the
lady said. "But the guinea pig did not recover and was
not eating. So I went to Vet 2 who took an X-ray and
said there were bladder stones. She advised euthanasia."
"What was the original problem with your guinea pig when
you saw Vet 1 as you said that your guinea pig was
treated for stomach infection?" I asked.
"My guinea pig had passed blood in the urine."
"What did Vet 2 advise?" I asked. The lady was not so
clear about this but she said: "I don't want the guinea
pig to be put to sleep. She could not pee for the past
few days and did not poop."
Smaller than normal 1-cm long faecal pellets were passed
on the consultation table. I palpated the abdomen. "No
swollen bladder," I said. "The guinea pig had passed
urine and you might not have seen it."
"I saw a brown spot," the lady said. "Just that brown
spot on the paper. I have separated her from the other
guinea pigs"
"It is possible that you did not see the other spots if
they are not coloured," I said. "Since I can't feel a
swollen bladder despite you saying that the guinea pig
had not peed, I would say that presently, the guinea pig
had no urinary problem."
She phoned her mother regarding surgery to remove the
bladder stones (> six of them). It was the cost of
surgery quoted as $300. I advised against immediate
surgery as the guinea pig was very thin and dehydrated.
I asked her to syringe feed with the pink syrup, food
and emergency care 6 times per day, as prescribed by Vet
2 for the next 2 days.
Doing bladder surgery today would have killed this
poor-conditioned guinea pig. The antibiotics from Vet 1
and Vet 2 were working to clear the urinary tract
infection for the time being. "Let her be much stronger
to take surgery by nursing her the next 2 days," I said
to her.
"In such cases," I said to Dr Daniel. "Immediate surgery
is most likely to lead to death on the operating table."
Sometimes, the guinea pig dies the next 2 days. So, it
is better to get the pet stronger first.
A follow up 2-7 days is needed.
P.S. In Case 2, the worried owner did not say that the
guinea pig had runny nose. I saw yellow fluid from the
left nostril. "Your guinea pig has an upper respiratory
infection and anaesthesia would be very risky. The
guinea pig needs to recover from the infection." As you
can see, an immediate operation would not be in the
interest of the patient.
"Any death on the operating table is a very emotional
affair for the owner and the operating vet," I said to
Dr Daniel. "So, it is best to get the patient in the
best possible health before any operation. Unless it is
an emergency." |
TOA
PAYOH VETS
