Friday, October 24, 2014

2015 Vets - The dog groomer and the Judge

Friday Oct 25, 2014
A couple with over 10 years of dog grooming and pet shop operation experience shared with me their grooming situation.

"Vets are making good money compared to groomers," Jim Mandalay said. "In one practice, the vet bills are not less than $200/customer. In another practice, they are over $500/customer. My grooming charges are $60 and I take at least 2 hours to groom one dog!"

"The pasture is always greener on the other side," I said. "There are vets who charge less than $100/customer," I named one practice that advised blood tests and even weekly blood tests for ill dogs. 

"With blood tests compulsory at the first clinic, at $140/blood test, the bill would be more than $200/customer," I said. "The customer can always go to another vet and there are over 60 vet clinics in Singapore nowadays!"

"The other vet also charges high fees," Jim laughed. Jim knows about vet charges as he transport pets to the clinic for treatment, charging $100/trip. His wife would do the grooming while he would answer calls and do the transport. In Singapore, competitors charge $10 for dog transport and $60 for grooming. So, Jim said that he could not increase the costs as that would drive customers to the arms of another groomer.

"Proximity and convenience are what the dog owner wants," I said.
"There is no loyalty from the customers," Jim and his wife were exhausted from so many years of grooming and the great difficulty in retaining a Singaporean receptionist.

In Singapore, the receptionist would be young ladies. They would work for a few months and change jobs or find a downtown office with lots of colleagues to work. Not content with being a receptionist in a small pet shop. So, the couple had to work by themselves. Or close shop.

"How about selling puppies?" I asked as they used to sell puppies. With puppy sales, they can retain clients as groomers.

"No, no," Jim said. "The consumer is now well protected with one year's return policy. That is the lemon law."

"Are you sure?" I asked. "In one year, the puppy can be returned to the Seller with money back? A person can buy a new car and can return it back within one year if there is a defect?"

"Yes, yes," Jim said authoritatively as regards puppy sale.
Jim related his personal experience. He sold a poodle some years ago with a sales contract between the husband buyer and himself.

"After one year, the wife phoned me to ask what compensation I would give her as the poodle had become 2 inches taller than the standards stated in breeders' books and had changed to a lighter colour."

The Buyer brought the case to the Small Claims Court and Jim had to attend the hearing.
"The judge dealt with the case although the complainant was the wife who was not the one signing the sales contract with me!" Jim said. 
"It is up to the judge as he has the power," I said. "Maybe the wife is family. Who knows what the the judge based his decision upon. Did you win the case? After all, you were not selling a pedigree dog for dog shows but a pet quality dog. The coat colour could fade or darken when the dog grows older."

"Poodles have different shades of brown," Jim said. "But the judge does not know it. Photos were submitted by the wife as evidence! She even had an expert witness to testify for her as regards the standard height of a poodle! Another pet shop owner!"

"Was the expert witness paid by her?" I asked.
"No, no," Jim said. "That poor fellow had to close his pet shop to attend the hearing! He was suppoenaed by the court to attend the hearing. No need for this woman to pay him. That was the price of him voicing his opinion on the height of what a poodle should be as an adult dog!"

This experience should teach readers not to venture any opinions in cases of disputes as the complainant can ask the Court to subpoena us for expert testimony.
"This woman would cancel the hearing and I would have to wait for another day, cancelling my grooming and transport appointments again! She knows the process of the Small Claims Court of last-minute cancellations.
"You know, she is the wife of one of those rich developers in Singapore and must have good experience of making puppy sellers pay for defective puppies. That was before the lemon law was introduced in Singapore and my case was that the puppy had been sold to her for over a year! Now, with the lemon law which states that there is a one year of guarantee, I do not sell puppies anymore!" 

"I don't agree that there is a one-year-guarantee for puppy purchase. He could have bloody diarrhoea from parvoviral infection 2 months after purchase and died. So the owner cannot claim that the puppy was bought with parvoviral infections. The incubation period for parvovirus would be around 14 days, that is, signs would appear 14 days after infection and 2 months equal 60 days. So, the Buyer cannot claim losses and medical treatment costs." 
"I am telling you it is one year," Jim insisted.
"What happened to the expert witness for the Buyer?"
"He was not even called in to testify," Jim laughed. "He had to cancel his grooming appointments to attend the hearing, making him lose income! Serves him right for being a smart aleck.

"As for me, the complainant cancelled the hearing at the last minute and so I had to close shop a second time and lose income!  The Buyer certainly knows how to make me suffer losses of income!"

I usually do not comment on competitor's treatment of a case and that would not be subpoenaed as a witness.

"So what happened? Did you lose the case?" I asked. "I think the judge would not more than you think, about dog's standard height and colour. A lighter colour could be due to bleaching shampoo and I don't think he would be fooled by the Buyer. How much did she ask for compensation?"

"The judge asked her. She wanted much more than what she paid me for the puppy. For emotional distress, you know. So much worries when the poodle became taller by two inches and losing the redness of the coat!"

"How much she paid for the puppy?" I asked..

"$1,900. She wanted much more. To be a puppy seller, you must have a good lawyer. Refer all complaints to the lawyer.

"There was this big puppy seller who had this good lawyer. One day, a very rich lady was dissatisfied with the puppy and he referred her to his lawyer. But the rich lady did not proceed with the 'see you in court' threat."

"That is why she is rich," I replied. "No point paying lawyers to sue as the legal costs would be more than the cost of the puppy! She is from the elite family of Singaporeans and she certainly can afford it but she did not do so."

But Jim could not afford to retain a lawyer as he sold only a handful of puppies from his own pets some years ago. I opened the can of drinks he offered me and it was getting dark now, closer to 7 pm when he should be sending the groomed dog home to Woodlands.
"So what was the verdict?" I reminded him that he was late for his transport.
"The rich woman lost her case."
"Why?" I asked as the government is deemed to be pro-consumer.
"She placed the photo evidence of the coat of the puppy not in chronological order, hoping to fool the judge."
"Really? How did she do it?"
"She placed the older dog's photo as the first photo. The judge said the coat colour was light and it could be due to the flash bulb!"

Thursday, October 23, 2014

1082. Just microchipping

A 7-year-old male Westie came for microchipping only as the vet authorities are more active in checking unlicensed dogs.

The previous owner had migrated. The dog had thick tartar, an undescended testicle and had no vaccination. The vet has to record that the owner does not want any dental scaling and neutering or vaccination in the record in case of misunderstanding later. The new owner said that the dog, being old, would feel the pain of neutering. 

Dogs that are fortunate have owners who would have done the dental scaling at least once in 7 years and this prevents heart valve infections (endocarditis). However, not all owners care.      

An old golden retriever has an eyelid tumour

 23, 2014 was Deepavali, was a rainy morning. I did not expect any customers. A car parked outside and a man with a young adult son brought in a 9-year-old golden retriever with an eyelid tumour.

"It looks like a cauliflower wart, " I said. "How long has he got this lower eyelid tumour?"
"I saw it this morning," the father said. "Probably 2 weeks. He has been tearing and rubbing his eyes."
"The only cure is V-shaped cut to remove it. Has he got a blood test recently?".
"OK," he said.I "He was not eating and had a blood test done by Dr Daniel, but there was no problem."
I showed him the blood test results of 2 months ago and explained: "The total red blood cell, haemoglobin and platelets were low."
"He had anaemia probably due to tick bites," I said. "Did he have a lot of ticks 2 weeks before you consulted Dr Daniel?"
"Yes, yes," the father said. "The anti-tick spot on was not effective but now he has no ticks as I have had changed to a new brand."
"Your dog is thin although his gums are not pale now and has better appetite. The low platelet count in his blood showed that he was likely to have been poisoned at that time too. It also could be due to the tick-borne disease attacking his red blood cells."
I walked him to a chart illustrating the effects of tick bites explaining that Babesia parasites could destroy the red blood cells causing anaemia.

"Yes, it was possible that he could be poisoned. We used a lot of ant poison to get rid of the ants and he might have consumed it."
The dog was anaesthesized and operated upon by Dr Daniel. He went home at around 3 pm. The father and two grown up adult sons came to bring the dog back home.

It was great to see a father who bothered to treat the old dog. Just two days ago, a lady told me that her husband refused to give the 9-year-old Schnauzer dental extraction as he would not pay for it. The Schnauzer had come for vaccination.
"How much would he pay for dental scaling and extraction?" I had quoted around $300 for anaesthesia and dental work.
"Less than a hundred dollars."
The dog had periodontitis Stage 4 with some teeth dropped. He had a hole below his right eye. A carnaissal tooth abscess opening up a hole below the right eye. 
"Maybe the carnaissal tooth had dropped off," she said.
had

Sunday, October 19, 2014

A Jack Russell has a large liver tumour

A 12-year-old Jack Russell came with a much swollen abdomen.

She was not spayed and so I thought she could have closed pyometra. This is a common problem of unspayed old female dogs. Yet the dog was active and could even walk 30 minutes to the Surgery. She had a very good appetite and drank a lot of water. She peed a lot. So, closed pyometra was ruled out.


Could there be an abdominal tumour since a vet had removed a breast tumour (MG 5 left side) some 8 months ago? Or metastasis of this breast tumour?

Could there be an ovarian tumour?

Next was ascites. On percussion of the abdomen, there was no tympany of gas or fluid thrill when I tap the right side of the abdomen and let my fingers of the other hand feel the other side.

I gave fruesemide to bring down any abdominal fluid and took an X-ray 12 hours later. There was the classical splenic neoplasia as diagnosed by Dr Daniel. This image was similar to the image in the Vet Surgery book which showed the lateral abdomen with the tail of the spleen being a globular shape.

According to an experienced older vet, an ovarian cyst would be higher up in the anterior abdomen.

So, the X-ray diagnosis is a splenic tumour. Could it have metastasized to the atrium causing an atrial tumour?











Exploratory surgery showed that the abdominal mass was a liver tumour, not a splenic tumour. Blood test showed liver hepatitis. The dog had a mammary tumour by another vet 8 months ago. No histopathology was done. It is likely that this liver tumour was a metastatic tumour from the breast. Prevention of this liver tumour might or might not be possible if the dog had been spayed at a young age. Spayed dogs seldom develop breast tumours. Primary malignant liver tumours (hepatocellular carcinoma) are rare in dogs and they are usually due to the spread from other organs with tumours. In this case, histopathology is in progress as at Oct 24, 2014.  


OCT 20, 2014. Exploratory laparotomy. Low dose of domitor + ketamine IV and isoflurane gas.

SURGERY
The large globular tumour was at one end of the lobe. The lobe was taken out. A scalpel blade cut one side of the lobe like "fracturing" the liver.  That meant that the liver was incised on one side while the assistant could hold up the liver for ligation of the parenchyma blood vessels.

Bleeding inside the parenchyma area where the one side was cut was profused. The suture needle is put inside the parenchyma and ligation was carried out..

3/0 absorbable "gullotine" ligatures were placed inside the parenchyma to ligate the blood vessels and bile ducts. Electro-coagulation was done. "Gullotine" ligatures were put on the other side of the lobe 2 cm below the tumour to control bleeding.

The liver tumour was then excised, using electro-excision needle to cut and coagulate the stump. Surprisingly, there was no bleeding after this electro-excision.

HISTOPATHOLOGY. This is in progress.  

Liver neoplasia with multiple abscesses.
One 70% size of a tennis-ball-tumour in one lobe. Abscesses have spread all over the liver.
Another ping pong ball tumour in a smaller lobe.  Histopathology in progress - whether it is simply abscesses or abscessed tumours.

24 hours post-op, the dog was eating and very active. I advised in-patient for 10 days as the other dog at home would play with this dog, causing suture breakdown.

The owner asked about prognosis.

Poor prognosis.
1. Locally advanced stage of liver neoplasia with abscesses. This is to be confirmed on histopathology of samples sent..

BLOOD TEST.
No leucocytosis. No "neutrophilia",  but neutrophils % was 92%. (60-70% normal).
Liver enzymes SGOT and SGPT were raised.

TREATMENT IN DOGS.
In people, a combination of chemotherapy or radiation therapy to down-stage the cancer to a more early stage so that surgical resection can be done to provide a long-term survival or cure.

--------------------------
NOTES

In people, liver cancer (HCC or hepatocellular carcinoma) is the 6th most,  important cancer in the world and the 3rd most important cause of cancer mortality. 80% of all HCC patients are found in the Asia Pacific region because of the high incidence of viral hepatitis. In Singapore, it is the 4th most important cancer and the second cause of cancer death after lung cancer.


Reference; Down-staging of liver cancer to allow curative surgery: An emerging paradigm. Prof Pierce Chow, Pg. 2, Salubris Issue No. 30, Jul - Sep 2014

Tuesday, October 14, 2014

A hamster in Africa



Hello,
My name is XXX and I need help with with hamster.
My girlfriend currently live in Mozambique is taking care of hamsters from a school there. Looks like one of them, L has the wet tail. I'm attaching the photos, that she send me.
She is asking for a favour - its almost impossible to get veterinarian help for small animals in Mozambique.

L (the hamster from the photos) doesn't seem to have wet tail disease, as she doesn't have diarrhoea. Also her wet back was from the spilled water. The problems with her that require treatment are :
- red mole or a tumour that is visible on the photos
- left eye irritation (infection?) - also visible on photos
- her bum is quite dirty - she doesn't seem to groom her butt area

If there is medicine or antibiotics needed to treat the problems,then I can pass it to her.
The drops for the wet tail, would be needed rather to prevent the disease, as there are multiple hamster under her care and it could be useful. 
Thanks,
XXX









---------------------------------------------------------------------------------------

Oct 16, 2014
REPLY FROM DR SING
Hamster appears to have skin infections and abscesses, possibly from bite wounds. She is unable to groom her backside. Some images are not clear.  Pl tel me for further discussion.

1078. A stray cat welfare activist

Today, an elderly lady who rescued stray cats and had 11 in her apartment brought in an old stray cat that had been vomiting yesterday. An old lady feeding this cat had asked her to help.

"I spent over a thousand dollars feeding the strays every day, twice a day," she said. "Yet the prices of canned food keep increasing!"

"Rentals have had shot up considerably as there is a grave shortfall of commercial properties," I explained to her. "So, the cost of doing business keeps going up. The Landlords keep increasing the rentals."

As to her view on stray cat activism, she said she would operate alone and not get into problems with the other activists.

There is a vet who used to charge male cat neuter at $40. Female cat spay at $50, on heat at $55 and pregnant one at $60. "The vet is a butcher," she was referring to the thicker sutures used by one vet providing cheap sterilisation, as compared to another vet who hides her sutures under the skin.

"Prices are different for the vet who used the fine sutures," I said. "Definitely she would not be charging $50 to spay a female cat."

"She charges high," the activist said. "But those cats spayed by her are my personal cats, not the strays. I have to get somebody to queue at SPCA fo.r the free spay vouchers"

She gave some cost figures:

Stray cat trapping $70
Cat transport to vet $35/cat or $30 by a lady.
Boarding after spay for 3 days and neuter for 1 day  $5.00/day

"Do you know about this person who was fined heavily for sterilising cats? I had sent over 100 stray cats to him over the past 3 years. Fortunately, none died. Well, except a pregnant one."

"Yes," I said. "I know the incident. He did not sterilise cats. He was transporting cats to a lady who sterilised them."

    

Monday, October 13, 2014

1077. What makes a wedding dinner interesting?

aSunday Oct 12, 2014

I attended a unique wedding dinner on Sunday Oct 12, 2014.

A wedding dinner can be interesting if there are some elements of entertainment and audience education. It is like a movie with a compelling story.

USUAL ROUTINE
1. A bride in white with bridegroom enters the hotel and walk in the central walkway.
2. Stage - cage cutting action
3. Couple returns to stage for champagne pouring.
4. Later, bride in red gown with groom enters the hotel and walks the central walkway
5. Family on stage to say "cheers" once or "yam sing" 3 times.
6. Walk round tables and photography of each group by couple. The photographer was not present for my table for some unknown reason. I don't get to see the couple too. There were 70 tables and I was was the bridegroom father's friend.

At the end of dinner, photos of diners were printed on the spot and handed out to the guests. This was unique service not present in other weddings.

SCREENS on the left and right showed the history of the couple. Unfortunately, the screen does not show the actions on the stage when there is "cheers" as there seem to be no projection from this top hotel in Singapore. The screens display the slides which had already been viewed.

STORY TELLING BY COUPLE AND THE BRIDE'S FRIEND. At least 5 minutes per person. Interesting anecdotes of the couple's life. Public declaration of love and thanks to parents.