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Toa Payoh
Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures |
Looks can be deceiving
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:
22 April, 2010 |
 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
How to make
internship interesting and entertaining? Young
people can get bored easily. The following case
had some elements of humour for the quiet and
serious vet intern whom I tested her on her powers
of observation. A 9-year-old male black Labrador
Retriever was limping on right fore and walking on
3 legs yesterday. So the careful groomer brought
him for consultation. He was to shave this dog
bald every 2 months and was worried that if he
lifted the leg to clip, the dog would get worse.
Possibly he could be blamed for a lame dog after
grooming. So, he pre-empted blame by consulting
the vet first. This was smart of him.
EXAMINATION OF
LAMENESS
How to make internship for Tanya interesting? One
method is to ask her what the problem was and to
ensure she is hands-on. In this case, I asked the
groomer to walk the dog outside the surgery and
then trotted as I would do as a racehorse
veterinarian. The dog moved normally but
suddenly collapsed on her left fore during
running. This should make an unforgettable
impression on Tanya as the dog was OK now,
according to the groomer who had seconds thoughts
of consulting me. He was busy and had many
grooming cases and therefore he would prefer not
to come.
To save time, I got the dog to lie down on the
floor, muzzled her and palpated each digit and toe
to the shoulder of the right fore. I flexed and
extended all joints of the right fore limb, as I
did when I was a racehorse veterinarian some 20
years ago.
LOCATION OF PAIN
Palpation at right fore, 4th digit, between
phalanx 2 and 3. The dog reacted by withdrawing
and whining in pain. So this was the pain location
and the diagnosis was sprain of the ligaments in
this area. Not a serious problem.
OBSERVATION
"Is that the dog's testicle near the tail?" I
queried Tanya as the dog had a big swelling below
the tail and near the anus. "Yes," she said
immediately. The powers of observation need to be
enhanced with age and experience and so Tanya's
answer was expected.
"Are you sure?" I asked again. From general
observation, it sure looked like one to the lay
person. Tanya was sure. "It is in the wrong
position," I told Tanya. She had just passed
Junior College and so could not be expected to
know dog anatomy. On
first
impressions, this looked very much like the
scrotum. This was one of nature's tricks on
interns who will be starting first year vet. Looks
can be deceiving. A detailed hands-on examination
on the table should be done in many cases.
The vet or intern must be hands-on.
 "The
normal testicle is nowhere near the anus or tail
in the male dog," I said. "Where is the anus
actually? Please push the large spherical swelling
to reveal the anus." Tanya used her hand to move
the circum-anal tumour to the right as the dog was
trying to sit down. There it was. "Is the tumour
very near to the anal opening?" I asked. "Yes,"
she was convinced that this was no testicle.
IS THE MALE DOG
NEUTERED?
The vet must be thorough in checking. This dog has
no scrotal sacs. "This dog has been neutered," the
groomer stated. This is another trick of nature.
No scrotal
sac does not
mean that the dog is neutered. The vet has to be
hands-on..
The dog was reluctant to stand for long. However,
I had to get him standing and showed Tanya where
to locate the two undescended testicles under the
skin near the penile area. The groomer tried and
felt nothing. The testicles had swollen in size
but not excessively. These could be the start of
testicular cancer. The only signs of a feminising
testicular tumour were that this dog had put on
weight and had a very shiny coat. I did not pursue
the matter further as the owner was not
interested. Undescended testicles do become
cancerous and circum-anal tumours are best removed
when they are small. But each dog has his own
destiny. This dog had interesting teaching
material for the vet intern but I don't know she
will remember this case during her 4th year which
will be in 2015.
CONCLUSION
Neutering of the 9-year-old male dog, especially
removal of the two undescended testicles in this
dog when he was young would have prevented
testicular tumours and circum-anal tumours to
develop, in most probability. It is not a
guaranteed thing but removal of
undescended
testicles early will have been best for the
older dog as no testicular cancers will be present
in old age. Dog owners all over the world seldom
give old dogs much notice or time unlike puppies
and therefore neutering young ones may avoid much
of the hormonal or gender-related tumours in our
companion dogs. The vet's responsibility is
to inform the owner via the groomer about the
circum-anal tumour and a few black ones below the
anus. The owner did not want any surgery.
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BE
KIND TO OLDER DOGS & CATS ---
GET TUMOURS REMOVED EARLY ---
WHEN THEY ARE SMALLER. More case studies, goto:
Cats or
Dogs |
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To make
an appointment: e-mail
judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326 |
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
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 Toa
Payoh Vets
Clinical Research
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