Case 1:
Danish lady in her 30s with
mum.
Purchased from the same pet shop.
Golden Retriever 3 months.
Consultation: Came for 3rd
vaccination. Puppy purchased 1
month ago.
Housing: A house with a small
garden
Feeding: 2 times per day as
advised by the seller. Wolfs down
food fast.
This case was a lot of fun for the
mum. Every time Alice, a 4th year
vet student put the puppy onto the
electronic weighing scale, he
dashed off the scales elsewhere.
Alice had to catch him again. She
placed him on the scale. Before
she could read the weight, the
puppy sprinted off making the mum
laugh. Alice and I looked serious
as such incidents happen with
other puppies too.
Toilet Training:
Newspapers 100% covering
playpen. Then reduce the
covered area as advised by
the pet shop puppy seller.
"What happened during the
first 7 days?" I asked. "Did
he poo and pee onto the
newspapers?"
"The puppy was confused and
did it everywhere inside the
playpen. After 5 days, the
puppy now eliminates onto
newspapers in a separate
half of the playpen.
"How did you train him to do
it?" I asked.
"Lots of praises. Praise him
and give treats when he
eliminates on the
newspapers."
Successful paper-training
due to hard work and
training. |
| |
Question 1: When can
the puppy go out to the
grass to eliminate? The
owner did not want the puppy
to do it in the small
garden.
The seller had advised going
out till after the 3rd
vaccination to prevent
parvoviral infections.
The puppy can go out to
places where there are no
dogs or puppies e.g.
pet shops, dog runs,
boarding houses
2
weeks after the 2nd
vaccination. However,
2 weeks after the 3rd
vaccination, the puppy can
mix with other dogs as he
has full protection against
the lethal parvoviral and
distemper viruses.
"Put the newspapers with
urine smell onto the grass
outside, so that the puppy
will commence eliminating
outdoors," I advise. "It is
a good idea," the owner
said.
Question 2: When does
my puppy get his heartworm
vaccination and does he need
one?
It is best to protect him
against heartworms which is
present in Singapore.
Vaccinate at 5 months of
age. She will make an
appointment. |
Clinical Findings:
Ears full of wax but no ear
scratching surprisingly. I advised
the puppy to go back to the pet
shop seller to get ears cleaned. I
advised deworming for intestinal
worms once a week for the next 4
weeks.
Conclusion:
This puppy will have plenty of
love and great fun exercising
outdoors since he lives in a house
and can get out without the
problem of having to bring him to
the lift and go downstairs. There
is a small garden but he will not
be permitted to go there and
destroy the plants. But he can go
outdoors easily compared to Case
2.
Case 2:
Australian gentleman in his 30s
Purchased from the same pet shop
over 2 months ago. Paper trained
on a pee pan. Now
apparently
lame.
Owner was worried about hip
dysplasia.
Golden Retriever 4.5 months. All 3
vaccinations done.
Feeding 3x/day. Poops 3-4 times
per day.
Purchased
puppy 2.5 months
ago.
Consultation: Dog has "hip
dysplasia"
Housing: Condo with smooth marble
and
wooden floors.
Playpen: Sleeps at night
with bed.
Toilet area: Pee pan + newspapers
in the balcony. Feed and water
bowl in the balcony.
HISTORY: Last 2-3 weeks, in
the morning, the puppy had been
gone on road walks for around 30 minutes
in the morning. The
puppy would stop walking after
some distance. But he had to do
it to continue walking home. In the evening, he would be
exercised. Sometimes he would be
at Sentosa to swim. Lately, he was
lame in his hind legs. great
difficulty standing up using the
back legs in the morning. Has
great difficulty moving down from the car seat.
No problem getting up the car as
he used his front legs. "He hops
when he runs," the owner said
after my general walking
examination outside the surgery.
"Could he be suffering from
hip dysplasia?" the young
man asked. "What should I do with
this puppy?"
EXAMINATION:
 1. Outside the surgery.
General visual examination of
conformation and muscle of the
back leg - cow hocks with right
hind having toe out.
Gait - The owner walked the dog up
and down concrete flooring on a
loose leash - no obvious lameness
on slow walk. Puppy was said to
"hop" on 3 legs at a run.
2. Inside the surgery.
On the examination table, put the
puppy sideways on his left and
right side to manipulate the
joints.
Abduct and adduct hips and all
other joints of the hind limbs -
no pain surprisingly.
Put puppy standing and extend 2
hind limbs - right hind limb is
shorter than left hind.
Back muscles of right hind are
smaller than left hind.
Spinal cord pressure - no
pain in general. There seemed to
be some mild pain at the
lumbo-sacral spinal area.
Could this be the cause of pain in
the morning on waking up and being
unable to get up normally as a
young puppy should?
HYPOTHESIS FOR SPLAYED
HIND LIMB AND SUBLUXATED
HIP:
"Where does the puppy spend
90% of his day?" I asked.
"Inside the apartment," the
man worked from home and
therefore knew what he said.
"Does he walk on very smooth
marble flooring when at home?"
I asked although I know the
answer since all modern
condos are marble-floored
and wooden-tiled with waxy
wood.
"Yes. The
wooden flooring
upstairs are also very
smooth, being waxed."
Based on my experiences with
the
professional dog breeders,
I would say that this puppy
had no chance to walk on
firm surfaces as they are
usually crated before sale.
Therefore, the Golden
Retriever's hind legs become
splayed slightly before
sale. The splay was not very
obvious as he did not walk
like a cowboy if you don't
observe closely.
He had also cow hocks which
would account for his "hip
dysplasia" style of walking
with the hocks lower and
right toe pointing outwards.
In addition, he was
over-exercised in the
morning going to the school
with the children for the
past 2-3 weeks. He had over
30 minutes of road walk. "He
was keen to go out in the
morning," the young man
said. "But he would
stop walking after some
distance."
"He had pain in his hip
area," I said. "So he
stopped walking".
"Sometimes, he hops," the
man said. Sparing weight
onto the hind limbs," I
said.
"The puppy could climb up
the car but would hesitate
to climb down from the car
later," the man gave
me this good clue to pain in
the hip area. Climbing up
involved the front limbs.
That was OK for the pup.
Climbing down involved the
back limbs and hip area.
There was pain. Similarly to
getting up in the morning
using the hind limbs. There
was some pain in the hip
area. But
none was elicited or shown
when I palpated, extended
and flexed the hips. Or the
knees. So, it was very
difficult to prove my
hypothesis to the young man.
There was muscle atrophy in
the right hip area would
indicate some pain in the
right hip area
for some time. This was
accepted by the young man.
I pressed the hip joint. Yet
there was no pain response
from the puppy. I extended
both hips to compare the
length of the hind limbs.
The right hind was
noticeably 3 cm shorter. But
there was no pain.
The puppy now splayed his
hind limbs out and flopped
onto my examination table.
He had enough of all these
palpations. He was a very
friendly puppy and had not
bitten me once. As I pressed
the spinal area from the
neck to the tail, there was
a very slight pain at the
lumbo-sacral area.
I don't
think the young man saw the
response as it was very
slight.
This pain and the
subluxation of the right hip
joint could account
for the difficulty in
standing up on the hind
limbs. |
"Is there a cure for the hip
dysplasia?" the man asked. "Must
he be put to sleep later?"
"I don't think he has hip
dysplasia now. He has subluxation
of his right hip. He will recover
if you let him rest for at least 4
weeks and confine him to a rough
floor area for the next 3 months.
No over-exercising. Let him walk
and run within his limits rather
than force him to do more road
walk. No morning road walk.
For hip dysplasia, he needs to be
over 6 months of age for X-rays to
confirm. His history indicated
over-exercise (probably running up
and down the 2-level condo with
the children) and just having too
much of a good time. A very active
life-style."
The puppy lies down with hind
limbs splayed out unlike other
puppies with limbs tucked under
the abdomen. This was observed and
pointed out by the owner as the
puppy flopped onto my consultation
table. "With a smooth flooring
over the past months, the puppy's
hind limbs stretched outwards and
now he just splays his hind limbs
outwards when he lies down. With a
rough flooring, his hind paws may
be able to get a grip to stand
up."
The last paragraph supported my
hypothesis that this puppy had a
lifestyle that caused splaying of
his hind limbs. As he grows older,
the splaying is not obvious.
However, his right back muscles
were not well developed compared
to his left. Both had poor
development considering that the
puppy "hops" when over-exercised.
DIAGNOSIS:
Right hip subluxation but not so
serious to cause obvious lameness.
This accounted for his occasional
hopping when he runs.
ADVICES:
1. No over-exercising for
the next 4 weeks and
preferably 3 months. He
should have no walking
exercise or running up and
down stairs for the next 7
days but confined to the
balcony-part-living room
area.
2. X-rays of the hip would
be done at over 6 months to
properly confirm hip
dysplasia. Presently he is
4.5 months.
3. Chances of him recovering
are good. 50:50 if he
continues to walk on floors
where his legs can get a
grip. A garden would be best
but this dog must live in
the apartment for the next 5
months of lease. So, what to
do?
4. "Install anti-slip mats
onto the flooring. Confine
him to a room with baby gate
or use the kitchen and
utility area for him when he
is at home," I said. This
was not practical advice as
there was no room and the
kitchen was small for such a
big breed.
"The balcony?" I asked.
"Will it be too hot when the
sun is out?" The man said,
"Yes."
"Where does he sleep
nowadays?" I asked.
"A big playpen near the
balcony." the man replied. I
asked him to draw the floor
plan. He would fence up part
of the living area next to
the balcony and connect this
area to the balcony. His
plan was good as the puppy
would be confined to and
have over 15 sq metres of
anti-slip space to walk when
staying at home.
|
CONCLUSION:
 The gentleman propose converting
the corner of the living room near
to the balcony into a fenced up
area with anti-slip mats. So, the
puppy can walk to the pee pan and
newspapers in the balcony for his
toilet and back to the living room
to see the family. No more free
roaming on slippery smooth floors
and he should recover fully. I
prescribed non-steroidal Rimadryl
tablets for 7 days.
I am quite confident that this
puppy will be fully recovered as
he was sent to the vet early. He
has an enlightened and educated
owner who has not delayed seeking
veterinary advice unlike many
Singapore puppy owners who don't
bother after the three
vaccinations and seek advices from
the groomer.
A house will be best for this
puppy but a condo has so
many facilities for the expatriate
family with young children. In any
case, by the time the lease ends,
this puppy should be normal as the
owner knows what to do and his
wife has the architectural
knowledge to execute this floor
plan for the puppy. If the
expatriate had waited for some
time, this puppy would have
dislocated his right hip and it
will be very difficult to recover.
This is a case
where clinical signs were
presented at home. At the vet, the
puppy behaved quite normally.
There are many such cases and the
owner's history and observations
count a lot more than clinical
findings. Some puppies or dogs
just behave normally at the vet as
they have a high tolerance to
pain. Showing pain is not good for
survival in the wild and this may
explain why the puppy shows no
pain readily. He may not have very
serious pain and so suppress it in
front of the vet who is a stranger
to him. Is this another
hypothesis? As for hip dysplasia,
we would have to wait and see.
|
TOA
PAYOH VETS
