12. Corynebacterium in a dwarf hamster?

This dwarf hamster of around 2 years of age lives life to the fullest. He does not stay still for me to take a good picture. He has to be on the move, trying to escape from the cage. Even though my hospitalisation cage has no bars, but just plain glass.

This hamster personality reminded me of people with a "Type A" personality. Burning a candle at both ends and achieving performance, productivity and profitability if the person is on the right path.

Are there "Type A" hamsters in this world? If there are, I presume that his immune system has no chance to repair. So the viral warts came in and build warts in his right ear lobe. Then warts appear above his purulent swollen nose. Yet he was still active. With a swollen infected nose, he now found it painful to eat.

Could I resolve his problem and bring him back to health? You can't ask a hamster to meditate and find the path to enlightenment.

I had to hospitalise him. Gave him antibiotics daily. Got his warts cut off and stop the bleeding by cauterisation with potassium permanganate powder. The firm round abscesses in his lower body and legs popped up like solid globes. He had a bacterial infection of the blood stream and yet he was still alive. This bacteria localised under his skin and formed virulent abscesses. More than ten of them. What bacteria is it?

To reduce veterinary costs to the lowest, I did not do bacterial culture and antibiotic sensitivity tests. Many Singaporean owners don't even get their hamsters treated as they feel that vets are "expensive".



"The hamster has lost weight," a young teenaged girl commented when she came with her family on Christmas Day to bring the hamster home after 7 days of nursing and treatment. I did not reply nor felt the need to defend myself.

Sometimes, silence is golden for me. After all, the hamster had a very serious infection and the parents and 3 family members were happy to see a great difference in the health of the hamster. It was a miracle that he was still alive as most hamsters would develop a sticky wet skin-filled pus and skin rot. This hamster's bacteria would be a different type.

The various pustules and abscesses just reminded me of Corynebacterium in sheep. Some 40 years ago when I was an undergraduate in Glasgow University, I had to study sheep bacterial diseases. At the post-mortem room of the University, the lecturer showed us an ewe carcass with abscesses all over the lymph nodes, lungs, liver, kidneys and spleens. Solid abscesses like what I saw in this hamster's skin. The sheep's condition was called Caseous Lymphadenitis and the bacteria was called Corynebacterium pseudotuberculosis.

Caseous lymphadenitis was a wide spread disease in mature sheep due to shearing wounds during my time at Glasgow. At abattoirs, such infected sheep carcasses are condemned. This bacteria also causes polyarthritis in sheep involving one or more leg joints. It produces pus about the joint and in this hamster, there were some abscesses around its joints too.

I wondered whether Corynebacterium in sheep is still a prevalent disease in the UK sheep industry in 2009? Farmers were advised to shear lambs first, disinfect the shears between sheep.

Singapore has no sheep farms although Muslims do import sheep from Australia. I have not done any veterinary practice on sheep for many years. Is Corynebacterium still present in sheep in Australia where most of our Singapore students are studying? Apparently this gram-positive rod-shaped bacteria is widely distributed in nature and are mostly not harmful. C. bovis causes mastitis in cows. C. diptheriae causes diphtheria in people.

Could this hamster be suffering from Corynebacterium? I google "Corynebacterium in hamsters". There was one Japanese laboratory report of Corynebacterium kutscheri isolated from the oral cavities of aged Syrian hamsters. See: http://www.ncbi.nlm.nih.gov/pubmed/1658468.

In private practice, it is possible to get the bacterial cultures done and make the owner pay for it. But laboratory testing would increase costs 10X the price of a new hamster.

As it is, the bill for treatment and 7 days of nursing was around $200 and may be considered by some owners to be too much. An additional laboratory cost may mean that this poor hamster will cost over $300 to be treated. So, he will not get any treatment again.

The vet has to be aware of the economics of hamster veterinary practice and try not to send tumours and bacteria for laboratory analysis in an effort to reduce veterinary costs for the hamster owners.

In undergraduate life, our professors recommend laboratory tests and all tests to reach a diagnosis. In real life, hamster and many pet owners in Singapore try to look for "inexpensive" vets. They discuss about veterinary charges in internet forums. Inexpensive vets can't perform, be productive or produce profits over the years. They will just have to do something else after a couple of years. He has to survive unless he is very rich and can ride out the first few "under-cutting fee" years to build up a good clientele and sustain their business model.

With rising costs, it is extremely difficult to be a cheap vet in Singapore nowadays. New vets undercut my professional fees to get large numbers of patients. Older vets may need to retire to pasture if they can't compete on prices. Ironically, the more experienced the older vet is, the less demand for his services from many price-conscious pet owners due to under-cutting of prices by new vets. Competition is great for the consumer, no doubt about it.

Beauty and youthfulness attract but experience is valued in matters of life and death. Add "cheap services" to beauty and youthfulness and this is a powerful marketing combination for a start-up veterinary practice.

One young vet starting practice was described as "eye candy" in the internet forum. Well, that is a USP (unique selling proposition) for this practice. The picture of this vet was posted by fans. Fantasize and fantastic fans? You are young only once, enjoy the fans but don't fall to temptations and be a "Tiger". I am not talking about "Tiger" beer.








Updates and more pictures - goto www.toapayohvets.com, goto "Hamsters".

11. 3 stories of a dog, hamster and man

I have recently encountered 3 cases which seemed to be on separate topics when I recorded them in a draft form. Now, after reading them, I note that they are linked by the theme of "Sexual Performance". Do you agree with me?

STORY NO. 1. The non-performer male Cocker Spaniel.
Two Cocker Spaniels with no dog licences. "The AVA officials went to the house to check, saying somebody had complaints about his dogs." No dog licences. $200 per dog compounded fine. 2 Cocker Spaniels will be $400. Owner can appeal. If not, go to court. Maximum fine is $5,000 per dog without licence.
"Appeals are always offered in such cases. But you must have good reason," I said. "Otherwise, you will get a reply saying sorry. Can your daughter write a good letter?" I asked. The young girl who was quiet was studying Literature in the National University of Singapore.

"It is quite rare to meet a Literature undergraduate," I said to her. "Most Singapore secondary schools have dropped the "Literature" subject for "O" levels. The School Principals have to perform to get promoted. Literature is a hard subject for most students to pass. So Principals discard literature to achieve more top A grades. We will produce a generation with not much love for the craft of writing." I asked whether her course includes journalism. "I don't study journalism in the course," this young girl informed me. "Journalism is mass communication."

To apply for a dog licence, goto www.ava.gov.sg. Scan microchip form from vet. Pay $14.00 for a sterilised dog. $70 for non=sterilised. This Cocker Spaniel was
9 years old. A male 18 kg. He never produced puppies from the other female who was also overweight. "The female just sat down when he tried. Then he gave up too." I advised, "You ought to slim down the male in the early years to give him a better chance of success."

Now the female of another client was on heat. She was 3 years old, weighing 8 kg. My client had yesterday asked me if I had access to male Cocker Spaniels. Some professional dog breeder would have it. But as the HDB in which 80% of Singaporeans have this strange rule of prohibition of Cocker Spaniel in HDB apartments, there is not much production of Cocker Spaniels from the professional breeder.

So, I introduced both of them to each other as I don't have other male cockers for the client with female on heat. One professional dog breeder proposed Cavalier King Charles male stud. But my client was not too keen to produce crosses. He wanted purebred Cocker Spaniels but this 9 year-old introduction. Could he perform? In home breeding, bring female to male. Slimming down the male would have given better chances. Help the male in mating. Artificial insemination.

STORY NO. 2 - The Cougar.
Flower supplier in the wet market. "I have no money," she said as she brought in her Jack Russell for her annual vaccination.

65 years old. Trim and slim as in those slimming advertisement of famous celebrities and stars, but no photo-shopped changes unlike the advertisements. A sprightly woman who looked after her body well. Jack Russell is the constant companion. "How you get the flower supplier to sell you flowers?" I asked. Supplier started dumping poor quality flowers. She switched to other supplier but the others don't have the varieties. No supplier provide such varieties of flowers. Nice to the seller's delivery person so that the girl gave her good quality flowers.

"I was spayed," she said. "If I had died during anaesthesia, my husband would have benefited." In Singapore, buying a HDB apartment requires a family unit. In this case, she had the money but needed a husband to be eligible. So, she found one but he was older. He would do. But she definitely does not tolerate his infidelity.

I was surprised to hear the word "spay" applied for women. Faithfulness of husband who is into gambling, wine, woman and song was now in doubt. "He likes to peep and see women the "node" from behind the door. "What do you mean?" I could not understand.

"Likes to see women in the node," she reiterated. Ah, I get it finally. She meant "nude." If you pronounce "rude" as "rude" correctly, then "nude" ought to be pronounced as "node". English is a difficult language to master. I asked, "Why would a man do that with a mistress?" She said, "He can't do it." No need for explanation. Maybe Viagra was not invented then.

A husband with no income and who is a philander. Depends on wife for his daily bread. So, she took action, "I wanted him to take his name out of HDB list or get out." I asked, "Why would your husband oblige you?" I asked. "I gave him money after he took his name out." She kept her promise and he moved out. He died soon.

Is she a cougar? So what? "I have a younger man as my boyfriend. More energetic and cares for me"

A young man indeed. I was happy for this dynamic woman. Many women of her age have put on weight. She made me feel overweight too. Her personality shone through. This man was in his late forties came to pick her and her dog up in a truck. I went out of the surgery and I waved to him.
How much does this flower seller make after expenses? "$500 is my best net income," she said. "$500 per day?" I asked. "No, $500 per month". High rentals of a market stall eat up a lot of income.

"Know the trend," she said to me when I asked how she was still around despite the fact that she had difficulty getting good suppliers. "Learn how to be creative," she said. "I know how to string the flowers in a design that pleases the customers. I have a big clientele base. Some refer friends and some order on behalf of friends. So, how can I retire?" I know of Singaporeans who retire to smell the roses. Or are forced to retire at the age of 62 as what has happened to my banker.

I learnt something from a humble flower seller that day. What I learnt is that I must be aware of the trend in Singapore's small animal practice. More practices are set up by younger vets who are more in tune with the younger generation. They have more energy. More hungry and cheaper. I can't compete on price war and volume. Long hours burn out the vet as they are very stressful. The vet must have a clear mind to perform too as diagnosis is not so simple. Long hours just cloud the mind. This would be suicidal in the long term, for the vet and for the pets. So, what to do? Be creative like the flower seller. How to do it? That's the $64-million-dollar question. Basically, read widely, associate with other industry to learn their best practices, network and know what you are doing and do it well like the flower seller who created flower arrangement so well that customers flock to her.

P.S. "Cougar" is a term used to refer to an older woman befriending a younger man.

STORY NO. 3
The commando dwarf hamster.
An undergraduate male brought 2 hamsters to me on 15.11.09.

1. 4 overgrown incisor teeth diverging 45 degrees on both. This dwarf hamster, Female was just 2 months old. I clipped the teeth short. "The teeth grows normally now," the young adult said to me when he came to pick up the 2nd case.

2. 2nd case. F, 1 year. Roboroskvi. 3rd litter 3 weeks ago. "The male escaped like a commando by climbing up the roof and getting down into the lower floor of the cage," the young man explained how he got the 3rd litter out of this Roboroskvi with thick matted hairs all over her body. One breast was swollen with yellow pus. I attributed the matted hairs to the male biting her during sexual performance or rejection.



On Dec 2, 09 this female could go home with only a scab on her forehead. This scab would drop off. She had been warded for 17 days and it would cost the owner some $105 which is a large sum if you are calculating. Dwarf hamsters can be had for free. The young man took the trouble to e-mail camera pictures of the babies. Poor resolution but he took the trouble. He really loves his hamsters. He was pleased that the female had recovered.


Daily cleaning with warm water to soften the matted hair and scabs. Antibiotics oral. "Be careful," I said to my assistant Mr Saw as he placed the hamster for me to take photograph on the 17th day before she goes home. "This Roboroskvi hamster can shoot off the table in the wink of an eye." This species runs faster than a Ferrari sports car from start to 100 km. He knew about he was just not quick enough. As he placed the hamster on the towel which was on top of the table, the dwarf hamster suddenly sped off in the blink of the eye and landed on the floor. No injuries. A tall tale? Never take your eyes off the Roboroskvi for one split second. I hope Mr Saw learnt from being hands on.

To prevent mating, he housed the male on the lower floor of the 2-level cage. "So that he can't climb up the plastic walls to breed her." the young man said.

10. Feedback from the internet

E-mail Nov 6, 2009 from ...@hotmail.com

To:
judy@toapayohvets.com
I came across your site and the stories and pictures that you share.

I will try to keep this short as you are a very busy person saving animals one at a time.

I want to say you are a remarkable person that knows what to do with a good talent saving animals even when it almost looks hopeless and even close. I want to say kudos and keep up the good work and when I hope you read this that you will smile knowing another person thanking you for always doing a good job. It is quite rare to see medical cases shown with a good detailed story about it and with pictures (especially with hamsters) but I am glad you do as it is a good medical tool. As I found out what my hamster has...

i did come across this picture on your site
http://www.kongyuensing.com/pic/20090788White_Deposit_Behind_Cornea_Singapore_ToaPayohVets.jpg

I have a syrian that has that condition in both his eyes. I have always thought he gone blind. At least I know it is white deposit in his cornea.



I just hope it isnt too serious or harmful.

9. A constipated laboratory rat

Can rats be constipated?

"Singapore vets don't treat rats," the slim office lady in her late 20s showed me a 2.5-year-old white rat whose girth seems to be 10X than normal rats. The lady placed on my consultation table a piece of paper, "I print out from the internet a listings for vets in Central Singapore."


"I have to disagree with you," I replied. "Did you start from A to Z" in the veterinary surgeon listings in the internet? "Normally, a prospect will phone "A" listings first.

"There are 2 vet practices you ticked," I pointed to the blue pen marks on her paper.

"Yes, but the vets are not available.

"Is your rat in poor health?"

"My boss rescued this abandoned laboratory rat and kept him in the office. For the past few days, he had been eating and drinking less. Some 7 days ago, Vet 1 treated him for some skin infections behind and above his neck. The vet gave us a spray and we sprayed onto the sore wound. The skin problem is OK now. He just would not eat or drink as normal."

"He looks like a miniature polar bear," I recalled seeing National Geographic Magazine pictures of well fed and thick coated polar bears in winter.

"Don't worry. This rat does not bite," she said. My assistant Mr Saw took out and put on a cloth glove in his right hand, just in case. I took the owner's word and lifted the rat out of the blue plastic carrier basket. The rat looked like a gentle bear and I took my chances by handling him with my bare hand.



I palpated the rat as the owner complained that he had some swellings in his flank. They were faecal lumps. "Your rat is constipated as he has not been drinking much," I could feel many small faecal lumps inside his belly. Can you give oral medication to the rat in your office?"

The lady thought: "Just put the medication in the cage and the rat will eat it."

This would not be so simple in reality. So I asked the lady to sit down and asked Mr Saw, my Assistant to demonstrate how to give the rat medication and electrolytes by mouth using a 1-ml syringe. The office lady was not sure that she could hand-feed the rat, saying: "The care-giver usually does this but she is overseas now."

The rat was warded for two days in this case and given electrolytes, Fibreplex and antibiotics orally at least 3 times per day.

On day 2, he still had not passed faecal lumps but was more lively. No stools were passed overnight. On day 3, he passed stools and had eaten. He would go home.

What was the problem or problems?

Possibly, the insecticide spray and the medicated water must have had adversely affected the rat's health. He was not feeling well. By not drinking water, he became constipated. I could feel the faecal lumps occupying his abdomen.

8. A hamster has an inoperable tumour

--- On Sun, 9/13/09, Chen Siyin wrote:


From: ...@gmail.com
Subject: Results from Monitoring Hamster's daily activities - Hamster with inoperable tumor

Hi Dr. Sing,

Here's the PDF attached of what I've recorded so far for the past 1 week on XXX. She seems healthier now, though she still isn't the normal XXX I used to have. I've also taken a picture of her tummy for comparison. Hope it helps.

Do I still continue with the medication? Thanks.


E-MAIL REPLY FROM DR SING

Sep 14, 2009

Continue with monitoring and medication. Greyish stuff passed out fibrouds and greyish clumps of faeces - these are not normal. Most likely she ate some rubbish like grey paper bedding (if you used paper pellets) and these had caused big stomach swelling of the intestines. Your pic showed a less swollen abdominal swelling and this is good news.

Based on your report of normal appetite and water intake and activity and abnormal stool texture, your 6-month-old hamster most likely had eaten some non-food items which impacted the large intestines and are being passed out. I expect her to recover in 2 weeks. Therefor she is unlikely to have an abdominal tumour. Wait 2 weeks.

7. Is euthanasia is the only option for this "tough-cookie" old hamster?

Haggard-looking and old. Pus oozing out from both ears. Back quarters hairless. "This hamster ought to be put to sleep," my assistant Mr Aung said, as a strong stench of decaying flesh fouled the air of the operating room.

"Your wife will not be very happy with you if you suggest euthansia," I said. "Every life is precious. It will be bad 'kharma' for you if you propose death for this hamster." Mrs Aung would never kill any creature. "Let the mosquitoes bite me if they wish to," she once told me when I asked how about the government's "kill all mosquito" campaign against denque fever. Last month, she trapped a big rat hiding in my office, put it in a cage, held it by the tail and released it in a field some distance away. Another time, I saw her picking up a fat bed bug loitering in a mattress in a room she had managed for rental to some Myanmar sailors whom she claimed were the carrier. I do have a picture of this bug but not the big white rat caught by the wife.

"This old hamster can be cured," I said. "If his two large ear canal tumours can be removed, his backside alopecia would go away. He would not longer be stressed by having to scratch his ears all the time. With no stress, his backside hair will grow back."

Well you may ask, "What has the backside hair loss to do with ear infections and irritation?". They are on different ends of the hamster's body. My hypothesis is that there is a nerve connection from the ears to the backside. When the ear canals are inflamed, the nerve sends sensory impulses to the side of the body and to the backside, resulting in itchiness.






In the dog, this can be quite obvious. Many dog owners look for skin infections in the flank of the dog with ear infections, thinking that the dog bites the flank or uses the hind legs to scratch the flank because there is skin infection in this location. If the vet cures the ear problem, this flank itchiness disappears in almost all my cases treated.

OK, I agree that no dog ever had backside hair loss due to the ear infections and itchiness. In the dog, the cause is usually an infection of the anal sacs. The dog bites his backside and his anal area, resulting in alopecia and hyperpigmentation and inflammation. However, in this hamster, I doubt he has had anal sacculitis. It is just possible that his chronic ear infections lead to hair loss of his back quarters. Not everything in the dog can be attributed to another species and in this hamster, my hypothesis is that the chronic ear irritation cause him to bite his backside in an attempt to relieve the continual pain in his ears.

The only way to prove my hypothesis is to cure this hamster, not to euthanase it. Mr Aung did not know that I had deep-froze the large ear tumour and given anti-inflammatory and antibiotics for the past 4 days. The ear tumour which had abscess had softened considerably and pus of the most foul smell was oozing out from the ear canal now.

In the traditional veterinary thinking, this hamster would be considered inoperable. Why prolong his suffering. Put him to sleep and out of pain. Yet, this was not what the young lady owner wanted. It was logical for the vet.

I looked at Mr Aung waiting for his reply to my reference to bad kharma if he suggested euthanasia. According to his wife, a person suffers in his life because he had done something wrong in the previous life. Therefore he had bad kharma. So, if the person who does something bad in his present life, he would have bad kharma when he is reincarnated. All cock and bull? Well, Mr Aung did not comment.

Now, would this haggard looking oldie die during surgery? It would take a long time to operate. At least half an hour. A minute drop of Zoletil IM was insufficient as the hamster moved. Another drop was given. 1 ml of dextrose saline with baytril antibiotics had been given subcutaneously.

"Is there a vertical ear canal in the hamster?" I tested the 3rd year veterinary student from Murdoch University present at my Surgery to assist me with some Excel software application. Daniel shook his head. Did that mean "no"? I doubted his professor had ever lectured on hamster anatomy.

I asked Mr Saw to insert the artery forceps into the vertical canal of the hamster's ear. The scalpel cut the lateral wall's skin and cartilage. Lots of bleeding. Swabbed bleeding. The small bubbles of tumour inside the vertical canal were picked off and excised. This chronic ear infection had resulted in the formation of numerous round tumours as in the dog.

"Be careful not to cut the branch of the facial nerve," I explained to the student. In such a small hamster, I could glimpse a long vein at the base of the ear. To the veterinary undergraduate, it was just blood and gore. As for the parotid salivary gland, I was careful not to cut it. Not that I could see it as in the dog. I mean, this hamster was 1000 times smaller than the chihuahua. Maybe 100,000 times and any salivary gland and nerve and blood vessel would be correspondingly reduced in size.

Now you know why veterinarians in general dislike hamster surgery. There is the anaesthetic risk of the hamster dying as the surgery of these two ears took such a long time, as remarked by Daniel.

Surprisingly, this hamster survived the surgery. "Is the hamster alive the next day?" Daniel asked me when he visited in the afternoon.

"Yes," I said happily. "He looks so much better. He is a tough cookie."

6. Hamster with skin itchiness

Most likely a mite infestation although the vet could not find any mites during skin scrapings. Bacterial and fungal infections come in as opportunistic invaders. Took a skin biopsy. The hamster can't sleep well as he scratches till he is bald and the skin breaks up and get infected. Eats little. Drinks little. Just want to scratch.

Below are suggested guidelines.

1. Therefore treatment is not so simple as just using ivomectin as anti-mite treatment.
2. Skin itchiness. Need to relieve the itch.
3. Skin infections. Oral antibiotics. May need anti-fungal medication. Consult vet.
4. Skin infections. Wash with anti-fungal shampoo. Need to thoroughly rinse away the shampoo. Use separate and clean tissue to keep hamster skin dry.
5. Feeding. Good food. Hand-feeding every hour if practical for 6-10X/day.
6. Rehydration. Isotonic solution hand-feeding every hour if practical for 6-10X/day.

Preventing dehydration and boosting immunity via good and regular food intake by hand-feeding is seldom done by owners during the early stages of the disease.

5. Hamster teeth

Dental formula is 2(I1/1 M3/3) = 16
Incisor grows continuously

Cheek pouch extend to the scapulae and can be everted. When distended, it can double the width of the animal's head and shoulders. Deficient in lymphatics.