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WAVES dermatology

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Perth, WA
WAVES dermatology

Dr Meng Siak is a specialist veterinary dermatologist consulting in Success, Western Australia.
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12/11/2024

Last day to register for continuing education (CE) lecture by Dr Meng for veterinarians in Perth.

This event is generously sponsored by and Dr Meng will provide the latest evidence based approach and management of canine atopic dermatitis (environmental allergy).

We hope this can guide veterinarians in their day to day management of this very common skin disease affecting dogs.

18/10/2024

Nylah visits Dr Amelia for her bee and wasp desensitisation. She has recently completed her induction phase and her owners wrote a very kind messageto Dr Amelia and the dermatology nurses.

We offer bee and wasp desensitisation for dogs or cats that developed anaphylaxis to bee or wasp venom. The induction phase involves 17 weekly in clinic injections and monitoring.

To ensure our patients have a minimally stressful stay, we request for owners to bring their favourite toys and blankets. The nurses also ensure they spend plenty of time with them during their stay with lots of treats and cuddles.

The many hats that vet nurses do!

17/10/2024

Unfortunately extensively resistant bacterial infections like Meticillin resistant Staphylococcus pseudintermedius (MRSP) and Enterococcus are becoming more common in veterinary medicine.

Like in human medicine, this is associated with repeated use of antibiotics. In dogs, this is most commonly due to recurring bacterial skin and ear infections due to allergies.

Rambo was referred to Dr Meng for an infected surgical wound that is non responsive to multiple antibiotics. A swab was collected for culture and confirmed Rambo has not one but two multidrug resistant infections.

Scarily, there was no oral antibiotics available that can treat both bacteria. Dr Meng implemented an aggressive topical antimicrobial treatment plan using wipes and ointment.

Fast forward 4 weeks, Rambo has responded very well and further surgical repair is not required!

It is important pre and post surgeries, that any skin infections need to be managed. Otherwise there will be an increased risk of post surgical soft tissue infections leading to wound break down.

In addition, these bacteria have the potential to be zoonotic and pet owners handling these dogs must be aware of potential risks and take precaution eg good hand hygiene etc.

In these cases, a referral to a vet dermatologist can be beneficial.

18/09/2024

Multidrug resistant bacterial infections causing surgical wound breakdown.

In the last few months, we had the pleasure of helping Juno. She was bitten around her neck resulting in a large wound.

Surgery to close the wound was attempted three times but failed. A swab was then collected from the wound and the cause of the failed surgeries was revealed to be a multidrug resistant bacterial infection due to Klebsiella.

Juno was then referred to WAVES Dermatology to treat the infection before further surgery. Dr Meng reviewed the culture results and started Juno on a injectable antibiotic called amikacin. This antibiotic requires close monitoring of the kidneys and this involves daily urine checks. Juno’s dedicated owner had to drop off a urine sample every morning before the decision to continue the antibiotic can be made. We also started Phovia biomodulation therapy to enhance wound healing and treat the infection.

Juno responded very well to the treatments and repeat cultures revealed resolution of the Klebsiella. Juno was then referred to WAVES Surgery for surgical closure.

We are pleased to see Juno recovered very well from the surgery and no infections were noted post surgery.

Unfortunately like in human medicine, multidrug resistant infections in dogs are becoming more common. These include methicillin resistant Staphylococcus pseudintermedius (MRSP). Thankfully vet dermatologists have extensive training in recognising and treating these resistant bacterial infections.

If you have a pet with resistant bacterial skin or ear infections. It is important you follow your vet’s advice on treatments. In complicated cases, referral to a vet dermatologist is recommended.

14/09/2024

Continued education is something WAVES Dermatology is very passionate about. We understand not every pet with skin or ear disease is able to consider referral as an option.

Dr Meng enjoys sharing the latest in management of skin and ear diseases. He has lectured internationally, nationally and most important locally within WA.

The next continued education event is sponsored by and he will lecture on how we can approach canine atopic dermatitis (environmental allergy) effectively in the primary care setting.

Thank you to for the generous sponsorship.

10/09/2024

Helping pets with their skin and ear diseases can be physically and mentally challenging.

We are thankful to receive updates from pet owners knowing how well their pets are doing. We appreciate every compliment and especially those that made the derm team laugh in unison!

10/08/2024

Anaphylaxis to bee and wasp venom. 🐝🌻

Like in humans, bee and wasp stings can result in severe allergic reactions including anaphylactic shock in dogs and cats.
Having an action plan is important for owners so they are trained on what to do if their pet develops anaphylaxis.

At WAVES Dermatology, we provide owners with this plan, which includes

1. Administration of adrenaline (such as Epipen or Anapen auto injectors)
-should be considered in every case of anaphylaxis (this is true in human medicine) especially if there is cardiovascular dysfunction such as collapse and pale mucous membranes
-this is the only effective treatment for anaphylaxis (not antihistamines nor corticosteroids) to treat clinical signs and prevent further progression
-further reading
https://pubmed.ncbi.nlm.nih.gov/37578030/
-for dogs less than 7.5kg, we draw up the desired dose/volume in individual syringes for owners

2.How to effective remove a bee sting
-reduce amount of venom injected
-look around mouth and feet (most common locations for bee stings)
-scrape using fingernail or piece of gauze
https://www.aad.org/public/everyday-care/injured-skin/bites/treat-bee-sting #:~:text=If%20the%20stinger%20remains%20in,cold%20pack%20to%20reduce%20swelling.

3.Watch for biphasic reactions
-recurrence of symptoms
-more likely in pets that had severe anaphylactic reactions.

4.Desensitisation
-highly effective in reducing risk of subsequent anaphylaxis
-further reading
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10571593/

At WAVES dermatology, we have helped many dogs and cats with desensitisation. Recently we received an email providing a positive feedback! *posted with photos of Georgie with owners’ permission*

If you have a pet that developed anaphylaxis to a bee or wasp sting, please consult with your primary care vets to discuss if a desensitisation program is an option.

01/08/2024

Happy birthday to Felicity, our latest addition to the derm family!

Felicity has joined the team after extensive experience in general practice. She has taken to derm like a fish to water!

Happy birthday again! We hope you enjoyed the cake as much as we did 😆

15/07/2024

Congratulations to Dr Amelia Ho who has successful passed her membership exams in Small Animal Medicine via the Australia and New Zealand College of Veterinary Scientists (ANZCVS).

The exams involve both rigorous written and oral components and test veterinarians on their understanding on the pathophysiology, diagnosis and treatment of diseases affecting dogs and cats. Most veterinarians take 2 years to study for the exams.

Passing the exams now allows Dr Amelia to have an all rounded knowledge to supplement her speciality training in veterinary dermatology! Only vet dermatologists that undertake the ANZCVS training program are required to pass this exams.

We are very proud of Dr Amelia for working full time, studying on veterinary dermatology AND studying for her membership exams.

02/07/2024

Perianal furunculosis can be a very debilitating autoimmune disease commonly affecting German Sherpherd Dogs and crosses.

They can present with straining to defecate, pain during defecation, blood in faeces and in severe cases, inappetance and reluctance to play/exercise.

The good news is with prompt diagnosis and treatment, this terrible disease can improve very quickly, providing immediate relief!

Dr Amelia consulted on a severe case recently and has seen dramatic improvement within 2 weeks.

If you have a pet that may have perianal furcunulosis or is not improving on treatments, please check with your primary care vet if they would benefit from a referral to a veterinary dermatologists.

02/07/2024

Happy birthday to Dr Amelia! Hip hip hooray!

Dr Amelia has been a pillar within the team and has been working very hard making a difference to pets with skin and ear diseases.

We are so thankful to have her as part of WAVES Dermatology.

Happy birthday Dr Amelia!

20/06/2024

Head arching and ear scratching in a Cavalier King Charles Spaniel.

Coco started displaying some strange behaviour recently (video 1) and her resourceful owners suspected she may have Chiari like malformation and syringomyelia.

They quickly organised an MRI which confirmed Chiari like malformation but thankfully no syringomyelia. They did however found fluid in both middle ear cavities.

Being a Cavalier King Charles Spaniel, they suspect the middle ear fluid could be Primary Secretory Otitis Media (PSOM) and got a referral to WAVES Dermatology.

Dr Meng performed myringotomy (surgical drainage of middle ear) using the video otoscope and flushed out large amounts of mucous material (video 2).

Emptying the middle ear cavities is important to prevent excessive build up and compression of adjacent inner ear and brain structures. These can lead to otogenic meningitis and development of neurological signs such as head tilt and loss of balance. More severe cases can develop central (brain) signs such as dull mentation, inappetance and seizures.

PSOM most commonly affects Cavalier King Charles Spaniels with a similar condition sterile middle ear effusion affecting brachycephalic (flat nose) breeds such as French bulldogs. If you have a pet that develops similar behaviour, it is important they are examined by your primary care vet to discuss the possible causes.

19/06/2024

Eyelids are considered skin too!

The WAVES dermatology team also sees patients with skin diseases affecting the eyelids.

Georgie developed acute swelling and masses affecting her eyelids. She was immediately seen by her primary care vet and her eyes were found to be normal. Georgie also did not respond to steroids and antibiotics . When the eyelid masses worsened, she was promptly referred to WAVES Dermatology.

Dr Meng examined Georgie and performed diagnostics. Georgie was subsequently diagnosed with an immune mediated disease called Sterile Pyogranuloma.

Georgie was started on immunomodulatory therapies and has responded very well within 3 weeks.

The prognosis for Georgie is great and her medications will be slowly reduced and hopefully withdrawn.

Eyelid diseases can be mistaken for eye issues. If your pet develops lesions around the eyes and/or eyes, it is important they get examined by your primary care vet.

They can help differentiate between eyelid/skin vs eye diseases and recommend further diagnostics that may include referral to a veterinary dermatologist.

06/06/2024

We are thankful to see dogs and cats with various skin and ear diseases.

Today we saw Droid for a 4 weeks recheck of his ulcerative skin disease, diagnosed by Dr Meng with “sterile panniculitis”. This is an autoimmune disease that attacks the fat layer of the skin, resulting in deep ulcerative lesions.

Prompt diagnosis and treatments are ideal to avoid irreversible destruction of the adnexal (hair) structures, which would result in permanently hairloss and skin scarring. These areas would then be predisposed to sun damage.

Droid is feeling much better and his owners are happy with his progress!

20/05/2024

Recently, we have been seeing a lot of “dermergencies” or dermatology emergencies 😅

Effie was referred to the WAVES emergency department for acute onset of bruising on her skin. After ruling out a bleeding disorder, she was referred to WAVES Dermatology.

Again, we collected a detailed history and suspect an autoimmune disease. We performed diagnostics and started on empirical treatment based on clinical suspicion.

10 days later, another successful response as the biopsies revealed changes consistent with deep eosinophilic and neutrophilic dermatitis. These are commonly termed “Well’s like Syndrome” and “Sweet’s like Syndrome” respectively.

We will now gradually reduce the medications and hopefully withdraw them.

Naturally Effie and her owners are very relieved to have a happier Effie again. ✌️

18/05/2024

Recently we saw a very interesting case at

Reuben was referred to Dr Meng for a non healing wound on his chest (photo 1). It started off with a pressure sore/comedonal cyst that resulted from prolonged weight bearing from Reuben lying in a sternal position.

Surgery was previously attempted to remove the comedonal cyst but the wound was unable to heal. This was further complicated by Reuben being on oral corticosteroids for his chronic stertor (snoring) resulting in delayed wound healing.

Dr Meng and his team of innovative nurses examined Reuben and formulated a plan.

This includes treating the secondary bacterial infections, withdrawing the corticosteroids, placing a doughnut (photo 2) bandage and lifestyle changes ie encouraging Reuben to lie on soft bedding vs hard flooring.

About 4 weeks later, Reuben’s wound is looking much healthier and finally healed over. Thankfully, we can avoid further surgery.

Comedonal cysts occur over dependant areas and are result of chronic irritation to hair follicles resulting in blocked follicles/comedones (“blackheads”) formation. The hair shafts subsequently ruptures and free hair fragments are irritating and incite further inflammation. These are then complicated by secondary infections leading to a cycle of inflammation and reinfections.

Early interventions such as providing cushion/padding and topical therapies to treat the comedones.

More severe cases may need surgery but care must be taken post operative to ensure optimal healing.

20/04/2024

Video otoscopy and foreign bodies in ears Part 2/2

When we examined the other ear, we found more foreign material. Can you guess what they are? See comments for more photos!

20/04/2024

Video otoscopy and foreign bodies in ears Part 1/2

One of the most common reasons for ear infections in dogs is presence of a foreign body eg grass seed. They can cause moderate to severe pain and risk perforation of the ear drum. This is why ear flushes in dogs and cats should be performed under a general anesthesia, where the lumen of the trachea is sealed by the endotrachel tube, to prevent potential aspiration of any fluid that may travel from the external ear canal through the perforation ear drum then to back of throat.

Bentley was referred to Dr Meng for persistent ear pain and head shaking. He previously had two grass seeds removed but the pain and head shaking did not resolve.

Dr Meng used a video otoscope, which allows thorough examination of the ear canals and also allows gentle yet thorough flushing and precise removal of foreign bodies.

Are you able to guess what we found from Bentley’s ears? (See comments to see what we found in one ear!)

Thankfully the ear drums are intact! Dr Meng will treat the secondary infections and a full recovery is expected!

A video otoscope is vital in all cases of recurring and chronic ear disease and reinfections. The video otoscope allows thorough examination of the ear canals and ear drums, allows flushing/removal of pus and wax plugs/foreign bodies etc. It also allows collection of material from middle ear cavity and flushing of the middle ear cavity in cases of otitis media/ middle ear disease and infection.

This means we are more likely to be able to treat the most severe and complicated chronic ear infections!

Address

1/640 Beeliar Drive
Perth, WA
6164

Opening Hours

Monday	12:30pm - 9pm
Tuesday	9am - 6pm
Thursday	8am - 6pm
Friday	8am - 6pm

Telephone

+61894125700

Website

https://wavets.com.au/departments/dermatology/

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Videos

Video otoscopy and foreign bodies in ears Part 2/2 When we examined the other ear, we found more foreign material. Can you guess what they are? See comments for more photos!

Video otoscopy and foreign bodies in ears Part 1/2 One of the most common reasons for ear infections in dogs is presence of a foreign body eg grass seed. They can cause moderate to severe pain and risk perforation of the ear drum. This is why ear flushes in dogs and cats should be performed under a general anesthesia, where the lumen of the trachea is sealed by the endotrachel tube, to prevent potential aspiration of any fluid that may travel from the external ear canal through the perforation ear drum then to back of throat. Bentley was referred to Dr Meng for persistent ear pain and head shaking. He previously had two grass seeds removed but the pain and head shaking did not resolve. Dr Meng used a video otoscope, which allows thorough examination of the ear canals and also allows gentle yet thorough flushing and precise removal of foreign bodies. Are you able to guess what we found from Bentley’s ears? (See comments to see what we found in one ear!) Thankfully the ear drums are intact! Dr Meng will treat the secondary infections and a full recovery is expected! A video otoscope is vital in all cases of recurring and chronic ear disease and reinfections. The video otoscope allows thorough examination of the ear canals and ear drums, allows flushing/removal of pus and wax plugs/foreign bodies etc. It also allows collection of material from middle ear cavity and flushing of the middle ear cavity in cases of otitis media/ middle ear disease and infection. This means we are more likely to be able to treat the most severe and complicated chronic ear infections! #videootoscopy #dogearflush #wavesdermatology #vetdermatologist

Video otoscopy to remove wax plug

Interesting case of the week. A golden retriever was presented to Dr Meng for recurrent ear infections. Using the video-otoscope, there was focal wax plugs in both ears. We managed to flush away these plugs and ensure the ear drums are intact ie not damaged. While excessive wax production in dogs is often due to underlying allergies, a clue to why this Goldie has these wax plugs can be found from the skin. The skin contains numerous large scales (“dandruff”) and the dog is not itchy at all ie not due to self trauma. Do you know what condition affecting young Golden Retrievers can result in these large scales and excessive wax production? #wavesdermatology #vetdermatologist

The adorable Zuri is welcoming the weekends with open paws/arms! Zuri had a severe anaphylactic reaction to bee sting and has been undergoing desensitisation program with WAVES Dermatology. The desensitisation can help reduce the severity of future allergic reactions, allowing both pet and owner to feel more confident enjoying the great outdoors!#beeanaphylaxis #groodles #beeallergy #wavesdermatology #veterinarydermatologist

The adorable Zuri is welcoming the weekends with open paws/arms! Zuri had a severe anaphylactic reaction to bee sting and has been undergoing desensitisation program with WAVES Dermatology. The desensitisation can help reduce the severity of future allergic reactions, allowing both pet and owner to feel more confident enjoying the great outdoors! #beeanaphylaxis #groodles #beeallergy #wavesdermatology #veterinarydermatologist

Puppy referred for itchy ears. Using our video otoscope, what can you see?

Itchy cats🐱Cats can get allergies too. Unfortunately because cats normally groom themselves, excessive grooming due to allergies can be missed or mistaken for psychogenic issues! Thankfully psychogenic over grooming is VERY rare and most cats have underlying allergies. Nicholas Angel was presented to us for constant licking and wears the cone of shame at home. Thankfully he is much better after starting his allergy medications. He is now cone free and more relaxed. If you have an itchy cat, it is important they get examined by your primary care vet. If they have been diagnosed with allergies, WAVES dermatology can help with the management plan. #itchycats #wavesdermatology #veterinarydermatologist

Happy 3yr anniversary to WAVES Dermatology! We are thankful to vets who entrust their wonderful patients into our care. We are thankful to pet owners who recommend our services to their friends. We are a small but closely knitted team who thrives to do our best in helping pets with their skin and ear issues. #wavesdermatology #happyanniversary