 TOA
PAYOH VETS
toapayohvets.com
Last Updated.
30 October, 2006
Focus: Small animals - dogs, cats, hamsters, rabbits
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CHOLANGITIS IN A GOLDEN RETRIEVER PUPPY IN SINGAPORE. Should vets
remove the gall bladder of the puppy?
Dr Sing Kong
Yuen, BVMS, MRCVS
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written for a young man who is going to study veterinary medicine in
Australia. |
Today, I had some time to catch up
with my newspaper readings.
I read the Strraits Times dated October 13, 2006 about Ms Lydia Sum, a
famous Hong Kong star, nicknamed "Fei Fei" (Fatty). She was said to
be suffering from cholangitis, a bile duct infection. The cause of
this infection is gallstones. She had 36 gallstones taken out in 2002.
I do not know why her gall bladder was not removed. From what I read in
the Straits Times newspaper interview of Singapore specialists, the gall
bladder is not essential to life and would be removed so that no more gall
stones can be formed again. No more infection. This is human
medicine. How about veterinary medicine?
Should vets remove the gall bladder of puppies with cholangitis?
Cholangitis in puppies? Very rare, I think. Or rarely presented and
diagnosed?
Because of Lydia Sum's publicity, I reviewed my case. It was "puppy
cholangitis". A once-in-a-lifetime case for a vet to be able to operate on
it.
In February 2005, the petshop operator asked me to treat a Golden
Retriever puppy for not being active.
I kept him in the Surgery for observation. It had acute anterior abdominal
pain and fever. The fever went down when the puppy was given antibiotics.
The puppy would eat again. Then the fever returned.
There was no luxury to do blood tests and other investigations as the
tests exceed immensely the economic value of the puppy to the pet shop
operator.
I asked permission to do an "exploratory laparotomy" as this was the least
costly option. The gall bladder was over distended. Orange brown gall with
lots of sandy particles were drained out. The bacteria must be inside this
gall bladder. After surgery, the puppy recovered and lead a normal life. I
did not remove the gall bladder.
Why was the article in my website?
Fortunately I can google, using "gall bladder + Toa Payoh Vets."
Incredibly fast, I got the webpage instantly. See below:
Source:
http://www.toapayohvets.com/letters/tpvets_Feb2105.htm
Pictures were posted on Feb 21, 2005. Using google to search "gall
bladder + Toa Payoh Vets", I could find the webpage I had
written about the gall bladder obstruction in a puppy I operated on
many months ago. |
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The puppy
cholangits case is shown in pictures below. It is a boring case to
most veterinary students. For me, it was a rare case. Very
itneresting as I operated on him.
Ms Lydia Sum's cholangitis case, admission to hospital again, went
into intensive care unit, hongkong media frenzy upsetting her
daughter and all sorts of tabloid sensationalism make me learn
more about human cholangitis.
If only medical text books on cholangitis can be written to make
such readings interesting.
Now, ! remember. My ex-nurse had gall bladder stones and had her
gall bladder removed. Many people seem to have gall bladder
stones. So far, I am lucky.
My son will not know about Ms Lydia Sum as he is in another
generation from a far-away planet of multi-role gaming. He is very
much addicted to this and would not talk to me when he is online
fighting with virtual monsters.
It is a pity. This virtual addictiontakes away so much of
his little free time. He could have read widely all topics as
Singapore's National Library and community libraries have so much
diverse information.
I want him to gain a broad knowledge of the world. To be worldly
wise. Street wise through reading widely. To be a man of the
world.
But that may be asking too much for a young man who has been
addicted to online gaming.
He is going to study veterinary medicine in Murdoch University in
Australia in 2007. I hope he will wean himself as I will not be
around to see his late nights fixated to a computer screen.
I write this article to inspire him and all the veterinary
students who must study so hard.
There is too much to learn in veterinary medicine. So many
animals, compared to human medicine.
I hope this article with pictures would make their mugging of "cholangitis"
more interesting and easier to remember for examinations!
Should vets remove the gall bladder of puppies with cholangitis?
I have no answer to this question. I did not remove the puppy's
gall bladder in this case.
See the pictures below. |
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Be
Kind To Pets
is a community service sponsored by
asiahomes.com |
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172.
Feb 6, 2005. Salivation, thirsty, vomiting, panting a lot.
Labrador 3-month-old puppy sent to the vet. An acute localised pain in the liver area. |
173.
Feb 6, 2005. Gall bladder larger than a golf ball. Gall
bladder obstruction. Very painful.
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174.
Feb 8, 2005. Started to eat. Discharged to save on
veterinary costs. Note long incision in abdominal area. |
175.
Feb 17, 2005. The Labrador Retriever was normal and active.
Collar & stitches removed today.
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Exploratory laparotomy
is one way to find out what's wrong inside the abdomen. Very few
pet shop operators want to pay the big veterinary bills for
further tests.
This puppy had an acute anterior abdominal pain, specifically
localised to the liver area, recurring fever after antibiotics
were stopped. No signs of jaundice as the liver was not infected.
An exploratory laparotomy confirmed gall bladder or bile duct
infections. In practice, it is sometimes not possible to get
laboratory backup as the cost is prohibitive. That does not mean
that the puppy cannot be saved. Subsidised veterinary
surgery fees may be necessary to give this puppy a new lease
of life. Otherwise, he will be euthanased or die.
There is no second surgery in this case. The human medicine
recommends removal of the gall bladder to prevent recurrent bile
duct infections in gall bladder stone cases.
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