27th November 2011

There isn't a case which i followed through today, therefore there are no case studies to write about. However to note, i have partial observations on some cases; dog with haematoma on it's paws (Picture below) and also another case where the dog have some skin problem (Picture is not available).



Dog with haematoma 


Admin stuffs:
- Income card bank statement printed
- Bank statement printed
- updated database

Working hours:
9.45am-5pm

20th November 2011

Case 1

3 year old male Cocker spaniel showed pinkish inflammed paws and underside of the body. Owner mentioned that the dog visited another vet and was given some medications. The problem was resolved for a few months but it recurred again. Firstly, the vet looked at its ears and suspect that the problem may arise from it. Therefore the vet proceeds to do a few procedures to check. When vet put a cotton bud into the left ear to check by turning clockwise and anti-clockwise, the dog displayed a scratching reflex (legs shaking). The same was done to the right ear and the dog felt pain.

Vet listed three possible causes of the inflammation:

1)      Deep ear infection: Primary cure is to undergo a surgery to remove the vertical canal so as to allow aeration.

2)      Allergy: Dog maybe allergic to current food so vet suggested a change of diet to low allergen food 

3)      Skin mites: Mites maybe the factor causing the dog to itch and scratch. Best way to improve its skin condition is to shave off all the fur. An anti-mite injection was also given

Dog was also prescribed with anti-fungal medication, meanwhile owner wanted to consider about the operation and get back to the vet later.

Case 2

Pug was presented with eye problem, fluorescein strip was used to test and found that there is roughness over the cornea of both eyes. There are presence of hair in the eye socket too. Prognosis is generalized keratitis, which is the inflammation of the cornea.  Antibiotic eye drop is prescribed.

Working hours:

10-5.30pm

Admin stuffs done:

-          Keyed in client details into database

-          Keyed in bankstatements for September 2011 and December 2010 and printed and filed. File can be found on “desktop/TPV expenses/bankstatement 2011/20111001_kim_2011 TPV bankstatement

30th October 2011

Updates of case from 23th Oct ‘11

Dog was sent home and follow-up check-ups were provided. Dog seems like it is recovering from the anaemic conditions, however tick problems still persist.

Results from the blood tests from the first few days after treatment were shown below.



Pinkish gums observed means recovering from anaemic conditions



Blood test results before treatment (20^th Oct ‘11):

Liver profile= Normal

Kidney profile= Normal

Hematology=

*Hemoglobin- 7g/dL  [Normal range: 12-18]

*Red Blood Cells- 2.8 x10^12/L [Normal range: 5.5-8.5]

Total White Blood Cells- 13.2 x10^9/L [Normal range: 6-17]

Differential Count:

Neutrophils: 59.62%

Lymphocytes: 26.36%

Monocytes: 13.18%

Eosinophils: 0.08%

Basophils: 0.83%

Packed Cell Volume= 0.19 [Normal range: 0.37-0.55]

Platelets= 52 [Normal range: 200-500]

Nucleated Red Blood Cells seen [Severe demand for RBC to be release from Bone Marrow]

No platelet clump seen



H&E staining of the blood smear and observed parasites

Blood test results after 1 day of treatment (21^th Oct ‘11):

Liver profile= Enzymes increased

Kidney profile= Normal

Hematology=

*Hemoglobin- 7g/dL [Normal range: 12-18]

*Red Blood Cells- 2.9 x10^12/L [Normal range: 5.5-8.5]

White Blood Cells- 9.6 x10^9/L [Normal range: 6-17]

Differential Count:

Neutrophils: 67.40%

Lymphocytes: 15.73%

Monocytes: 14.79%

Eosinophils: 0.62%

Basophils: 1.67%

Packed Cell Volume= 0.2 [Normal range: 0.37-0.55]

Platelets= 64 [Normal range: 200-500]

No platelet clump seen but few giant platelets present

Blood test results after 4 days of treatment (24^th Oct ‘11):

Hematology=

*Hemoglobin- 5.2g/dL [Normal range: 12-18]

*Red Blood Cells- 1.9 x10^12/L [Normal range: 5.5-8.5]

White Blood Cells- 13.8 x10^9/L [Normal range: 6-17]

Differential Count:

Neutrophils: 69.49%

Lymphocytes: 14.64%

Monocytes: 12.68%

Eosinophils: 0.29%

Basophils: 2.97%

Packed Cell Volume= 0.15 [Normal range: 0.37-0.55]

Platelets= 50 [Normal range: 200-500]

Blood test results after 5 days of treatment (25^th Oct ‘11):

Hematology=

*Hemoglobin- 4.7g/dL [Normal range: 12-18]

*Red Blood Cells- 1.8 x10^12/L [Normal range: 5.5-8.5]

White Blood Cells- 12.3 x10^9/L [Normal range: 6-17]

Differential Count:

Neutrophils: 50.49%

Lymphocytes: 47.80%

Monocytes: 1.71%

Eosinophils: 0%

Basophils: 0.08%

Packed Cell Volume= 0.13 [Normal range: 0.37-0.55]

Platelets= 50 [Normal range: 200-500]

No platelet clump seen but few giant platelets present

The tests had been confirmed by repeat analysis

Blood test results from IDEXX after 5 days of treatment (25^th Oct ‘11):

Hematology=

*Hemoglobin- 5.7g/dL [Normal range: 12-18]

White Blood Cells- 6.6 x10^9/L [Normal range: 6-16.90]

Differential Count:

Neutrophils: 1.57 x10^9/L [Normal range: 2.80- 10.50]

Eosinophils: 2.33 x10^9/L [Normal range: 0.50- 1.50]

Packed Cell Volume= 19.2% [Normal range: 37-55%]

Platelets= 259K/ul [Normal range: 175-500]

Note:

Neutrophils are usually increased in acute bacterial infection

Lymphocytes are usually increased in viral disease

Monocytes are usually increased in some bacterial infections and monocytic leukaemias

Eosinophils are usually increased in allergic conditions and when intestinal parasites are present

Basophils are usually increased in association with hypersensitivity and allergic responses

Working hours:
10am- 5.00pm

Admin stuffs completed:
- Updated Client's database

- Created a soft copy of Toa Payoh Vets Surgery Record form