tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   04 November, 2009
Focus: Small animals - dogs, cats, hamsters & rabbits

*10 a.m - 5 p.m (Mon - Sun, except Sat). Dr Sing Kong Yuen. By Appointment Only.

*6 p.m - 10 p.m (Mon - Fri). 10am - 5pm
Appointment preferred.
Tel: 6254-3326, 9668-6469
Fax: +65 6256 0501
Be Kind To Pets
Expatriate rentals in Singapore
Toilet training your puppy in Singapore  Dr Sing's research book to be published
Toa Payoh Vets Clinical Research
Making veterinary medicine & surgery alive
to a veterinary student studying in Australia
using real case studies and pictures


Case 1 in 2001. Interdigital Cyst in a Shih Tzu & Other Cases
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written: Nov 11, 2001
Case reviewed: Nov 4, 2009

Singapore Shih Tzu with interdigital cysts"Big swellings in his front paws" said Mr Braun. "I guess you will be clipping the hairs of the paws with a razor blade, but please be gentle with my Shih Tzu.  Mr Braun recalled that his dog was held tightly by strong hands while the veterinarian at another clinic scrapped his facial skin diseased area and he did not want this for his dog. He was widely read and knew about tranquilisers. 

It did sound very painful for the gentle Shih Tzu but veterinarians all over the world seldom use tranquilisation for minor skin scraping.  As Mr Braun saw the dog struggling, he felt the pain transmitted to himself.  He did not want this to happen to his dog again and so he went to another veterinarian.     

Singapore Shih Tzu with big interdigital cystsThe swellings called interdigital cysts were huge, as big as 1.5 cm in diameter. The cause was unknown.  Some dogs get it. Some don't. It is not a common veterinary condition in Singapore.

I tranquilised it, clipped the hairs of the paws and injected an anti-inflammatory and antibiotic drug into the cyst. The paws were bandaged. Antibiotics were given.

Four weeks later, the dog came for vaccination. It was a great surprise to see the "old dog" with hair all grown at its paws. The Shih Tzu was around 18 months old but he looked older than his age due to his serious demeanour.

Singapore Shih Tzu four weeks after injection."He took off the bandage two days after injection," said Mr Braun.  "He did not chew his paws and the hair regrows after two weeks.  Now he is biting his hip area," said Mr Braun. The area has very little hair growth. His right arm pit had a large circular patch of hair loss with some big pimples.  There was one pimple on his neck. Antibiotics and a wash were prescribed.

Tear staining (wet hairs seen inside the black circle) or epiphora was also present in his eyes. The wet hairs ought to be clipped off to prevent infection and itchiness.  It looked as if the Shih Tzu had rubbed its eyes too . Some tartar formed on his back molar teeth as he was given canned food too. He would not stay still for tooth brushing.  He did not bite but he did not stay still. Which dog will stay still to get their teeth brushed?

Singapore Shih Tzu with tear staining or epiphoraThis Shih Tzu had a sensitive skin, just like some people too.  Regular grooming and keeping the under part of the body dry and not in contact with chemical on the floor or permitting the dog to sleep on wet floors should solve most skin problems.

Interdigital cysts are best treated early. When they exists for a number of years and harden or enlarged due to continuous licking, surgical excision or medical treatment is not going to be to the owner's satisfaction.


Bull terrier. Neck stained brown from scratching.
Otitis externa.  Excessive thick brown wax inside the ears in this Bull Terrier puppy. The neck was brown with scratching.  Clearing ear mites and bacterial infection solved the problem. As for the "lazy" right ear, it may become upright once the infection is gone. The Owner must have patience to fix an ear support to get the ear upright. Calcium tablets recommended by the pet shop owners are unlikely to solve this problem.
Jack Russell matures at 6 months. Skin pimples. Pustular dermatitis.  Skin pimples in the belly skin of a 6-month old Jack Russell Terrier that is having her first heat and had been bleeding. 
Hormonal changes at maturity or "puberty" can lead to an outbreak of pimples in the female dog.
Persistent skin itch.  Brown stains indicated a persistent licking by the Shih Tzu. The cause was an anal sac impaction.
Anal sacculitis.  Itchy back and legs in a pug. The itchiness had gone on for many years resulting in a hyperpigmented black anal region and all legs. Many owners do not consult the vet and therefore the itchiness continues.
Joint eczema in a one-year old dwarf hamster. It had been nibbling its joints till they were all red.  An anti-inflammatory injection under anaesthesia was given. He recovered. But the allergies recur. Allergy in a hamster

Case 2 in 2008. Epidermal Dysplasia
in the West Highland White Terrier
Abandoned Westie. Epidermal Dysplasia. Toa Payoh VetsIn Sep 6, 2008, a man in his late 30s brought in a Westie for treatment on behalf of his brother. His brother found the Westie abandoned in the industrial park and adopted him.

"This dog is very young, judging by his white teeth. He would have an owner," I said. "The owner probably could not afford veterinary treatment and abandoned him to fend for himself. He has a microchip and it may be possible to locate his owner."

"Can you do it?" the brother asked. "The dog can then be re-united with the owner."
"You can check with the veterinary authorities with this micro-chip number," I gave the young man the number after scanning the Westie's neck. "I doubt that the original owner cares much for him. Otherwise he will not be in this terrible state. Most likely he will just abandon him again when the authorities punished him with a fine. This
Epidermal Dysplasia a young Westie, Singapore. Toa Payoh Vets abandonment is a hope that somebody will adopt him instead of sending him to the animal shelter. In the animal shelter, he would be put to sleep after 2-3 days as I doubt anybody would want to adopt him. In any case, time will be against him in the shelter as it has other  abandoned pedigree dogs and insufficient kennel space.  Most likely, the first owner abandoned him in the hope that a kind person would adopt him, instead of letting the authorities or animal shelter people killing him off with a lethal injection."       

This Westie had greasy and itchy skin in the ears, neck and inguinal area. Treatment would be long and expensive for  this inherited skin disease well documented in the West Highland White Terrier. Clipping off the infected coat is important for treatment. The new owner consented to the Westie being clipped bald so that it would be easier to shampoo and clean his diseased skin.

"The dog needs another review after one month," I advised knowing full well that this would be the one and only visit. Washes, drug, veterinary reviews and recurrence after recovery make this disease very expensive to treat. But the owner's brother wanted to try.

In a bad twist of fate, the kind brother who found this Westie was seriously injured by falling cables at his factory. Now, it would be difficult to find money to follow up on the treatment this Westie.  

Epidermal Dysplasia a young Westie, Singapore. Toa Payoh Vets Singapore does not have a charity for owners who can't afford veterinary treatment. This case would have qualified for free veterinary treatment in the U.K as there is the People's Dispensary for Small Animals.

Therefore many sick dogs of low income earners in Singapore are put to sleep or abandoned. Vets try to help as much as they can but there are just too many of such cases. If there is somebody interested in setting up a charity, let me know.  As for the Westie, the new owner did not return for follow-up, due to economic reasons. 

Case 3 in 2008. Interdigital Cysts in
a Shih Tzu X Pekinese

The wife recalled, "We had consulted several vets but there was no cure for our dog's condition over the past years. On your webpage, there was a case of an interdigital cysts and so we came to consult you." 

The educational webpage must be the Case 1 of interdigital cyst I treated in 2001. In the following 7 years, I treated a handful of cases.

"I seldom see many cases of interdigital cysts in the dog in Singapore unlike in Glasgow during my seeing practice there," I recalled my undergraduate days some 3 decades ago. British vets seem to encounter many cases at that time in the 1970s. I don't know about 2008.

"Most Singapore dogs are indoors and seldom go out to paw the soil, causing injury to the interdigital area."

Interdigital cysts. Shih Tzu X. Left fore paw. Toa Payoh VetsAt 12 years of age, the dog was in excellent condition and looked many years younger.
The big black eyes in a snow-white coat magnetised anyone passing by and they would  give this dog a second look to admire the creature. Yet there was something not right to the spectator. The left front leg had a huge swelling such that the black pad which should be hidden and below the paw was visible and made walking difficult for this dog.

On closer scrutiny, this dog had various interdigital cysts on the other paws and had been continuously licking the lower part of the paws.

Before I could ask, the man said, "The dog used to go behind the bushes and dig the grounds but he no longer does it".

"Is there a cure for this dog?" the older couple wanted to know as the dog bites his left paw leaving at least 3 red bite wounds. "It is difficult to say," I replied. "Many years have passed and the cysts are solid and hard. Surgical excision of the large cyst on the left fore paw may be one solution if it can shrink with anti-inflammatory injections."

But this dog is past middle aged and though it puts many of his peers half his age to shame as regards a healthy body, he is still considered aged and therefore a much higher anaesthetic risk. There is much more veterinary costs for following up and in this sub-prime mortgage crisis where almost every business is done to the pits, it has had been financially difficult for many pet owners in Singapore. As for this couple, this is the first time we met and so I don't know whether they are keen on follow ups.  

Interdigital cysts which do not heal after the first treatment are likely to be due to foreign body penetration of the skin. Surgical excision of the affected skin is very successful. But surgery is done within a few weeks and not after many years of swelling to be successful. Paw licking due to interdigital cysts may be more common than presented to the veterinarian in Singapore. 

tpvets_logo.jpg (2726 bytes)
Toa Payoh Vets Clinical Research

Copyright © Asiahomes Internet
All rights reserved. Revised: November 04, 2009
Toa Payoh Vets