Sunday, October 4, 2015

2322. A photographer's pictures of Daniel and Jason

1.  Picture Dec 2009.
The left diamond stud caused mum considerable emotional distress. What's next?
Will he be getting tongue and belly studs? Tattoos on his biceps and legs?

A wish from Dad in 2009.
"Create" when you have spare time
Make this world a better place

2. Picture April 2010.
Happy Birthday when Dad and Mum visited this undergraduate in Perth, Australia.
Dad is reminded of the song in his era. This song is about love,   "Smoke Gets In Your Eyes".
I doubt Dan has ever heard of it.

3. Picture June 2011
Dad picks him to go home on the last day of the Singapore Turf Club internship. He would be going back to Perth to complete his study. A candid shot. Sharp chin. Lean and muscular look.
Dad is reminded of the song in his era. The song is about love, "I can't find the words to say goodbye."

4. Picture 2012 at the cousin Vincent's wedding dinner. Vincent and his bride.

Who amongst the 3 cousins is the most handsome
For Dad, the most important value for a man is "Who is the kindest to his parents, his family members, to animals and to disadvantaged people?"

5.  Picture June 2011 of Daniel. 

In the traditional Chinese family in the 1960s, "Words of love from the Dad don't come easy". No hugs and kisses at bed-time unlike the many Caucasian families in UK and the USA. So when the Chinese children grow up, it is extremely difficult to get hugs from them.  This reminds Dad of another love song, "Words Don't Come Easy" by F R David.

6.  Picture Oct 2010.  Daniel as an undergraduate.
Visit by mum and dad in Perth.  This waiter knows how to communicate with the diners and make the dining fun.


7.  Picture of Daniel as an undergraduate.  Sep 2010.
When life was just passing examinations in Perth. No worries in this aspect.

8. Picture of Daniel's mum in Hong Kong. Aug 2011.
A bus flashed by. This image reminds Dad of a love song "Sunlight in Your Hair" by Lionel Richie

9. Picture of Daniel, his brother and mum in Perth. May 2011

This image is my favourite and probably most romantic.
Lean and muscular young men escorting their mum to a function in Perth. The one on the right looks mean. Not a gram of fat in their pectorals and abdominal muscles. Trim and solid muscles.

Mum's "knights in shining armour", protecting her against any bad people. Actually, on the way to an animal and flower fair in Perth.

Readers who love reading English Romance Novels and King Arthur may appreciate why I name the picture "My White Knights In Shining Armour". For those who don't care about romance, this image shows a mother who once takes good care for the toddlers is now towered over by two young adult sons who love her very much and are now her protectors - her "knights in shining armour". The caption should read "My Knights In Shining Armour" on 2nd thoughts.  

Mum and Dad are always aware of sibling rivalries. With both now graduates, the parental responsibilities have been fulfilled and each son has to achieve their dreams. Also to  make the world a better place. All these cannot be achieved without hard work.

10. Picture of Daniel's younger brother. Sep 2010.

Dan's younger brother as an undergraduate in Perth. A boy who once said to Dad's clients that his dad was using him as a "child labour". He was in the clinic after school and was told to sweep the clinic floors.  Many years later, the client told Dad what the Primary School Boy Daniel had complained to him.

Friday, October 2, 2015

2321. Legally threatened

Oct 2, 2015

"I will make a complaint," the dog owner threatened when I said I would not pay for the bills of another vet (Vet 2) who had hospitalised and treated her dog for paraplegia on Sep 30.

On Sep 30, 2015, at around 11 am, I had given a subcutaneous injection of antibiotic and anti-inflammatory above the neck area as the dog had multiple skin lumps. The owner attributed the lumps to a new shampoo. The dog had painful ears and I prescribed an ear ointment to be given at home. The dog was normal on leaving the clinic and at home.

In the afternoon, the owner phoned me to say that her dog was lame in the left hind leg. I advised her to wait and see as she had no time to bring the dog in for an examination. In the evening, the dog was lame in the right hind leg. She phoned and said that it must be my injection hitting a nerve, hence causing the dog to be paralysed. "I don't trust you," she declined my advice to bring the dog for an examination.    

I referred to Vet 2. She phoned me again to say that Vet 2 would charge for after-office hours. Then she suggested that I examine the dog. I did not retort that she had shouted that she did not trust me. Now she asked me to examine the dog. 

I went to the clinic to examine the dog at 9.30 pm with Dr Daniel. The dog was paralysed in the hind limbs. I palpated the spinal area. There was a pain reaction on the T10-L4 area. The husband could see the reaction. The dog's hind legs had no placing and pain reflexes.

"There must be a traumatic injury to the back," I said. "Some heavy objects had fallen on her back or she had fallen down injuring her back."

The husband recalled that the dog had struggled vigorously when ear drops were applied onto the ears.

"Was the dog on the floor when you applied the ear drops?" I asked.
"Yes," the husband demonstrated how he held the dog around the back of the rib cage area with his hands to apply the ear drops.

He accepted the referral to Vet 2 who took X rays and warded the dog overnight with a drip.
The dog tried to stand on her left hind leg the next day but not on the right hind leg.

The owner then phoned me demanding that I pay for Vet 2's fees. When I said no, as my injection was not the cause of this hind limb lameness, she threatened me legally. She said that the dog was normal before my injection and wanted to show me proof.

"No need to show me the pictures," I replied. "Your dog was normal at the clinic and when leaving the clinic walking to your car. She was normal at home till the late afternoon."

As the owner was insistent that I was the cause of the dog's lameness, it was best for me to shout up and not provoke further anger.  I had not given any injections in the hind limbs. The dog had pain in the back spinal area. Vet 2's X-rays did not show any slipped disc and he had told the owners that my injections are commonly given by vets without any injection causing paraplegia.

When an owner said "I don't trust you", I should have asked her to seek a second opinion. I did not charge for the after-hours evening examination when she did not want to consult Vet 2 so as not to pay Vet 2's fees. Now, she threatened to make a complaint.  This is one of the sad cases all vets must handle with empathy with the interest of the dog in mind.   

Wednesday, September 30, 2015

2320. A Fancy rat has a soft armpit mass

Sep 30, 2015

This rat had a gigantic breast tumour (left MG 3 to5) removed 2 months ago, but for the past month, she had a big right armpit swelling.

I could not palpate any breast nodule. Surgery showed a flat reddish soft tissue mass measuring 5 cm x2 cm which was unusual and rare. 

"This must be shown to the owner," I said. "Seeing is believing."

Even if the owner does not want to see it, the vet must show it.  The owner did not want hisopathology and this was written down, in case of complaints of incompetence and to satisfy the owner that the large mass had been excised..

The lady owner saw the mass kept inside a plastic bag.  Earlier, this specimen inside the plastic bag was discarded as Dr Daniel had said that the owner did not want to see it. I asked my assistant to retrieve it and show to the owner. I asked whether she wanted histology to check whether the tumour is cancerous or not. She declined. This advice was recorded in the case sheet.

Many young owners are internet savvy and some are suspicious of the veterinary competence.

2319. Follow up: The young neck-sxtended chihuahua develops more red spots on her shoulders.

Sep 30, 2015

The young lady in her early 30s came to buy 2 bottles of multivitamins for her Chihuahua who had presented with her nose pointing skywards some 4 weeks ago. (Another blog).

"How's the dog's neck extended posture now?" I asked.

"No more problem," she replied. "I have had stopped the heart medication for a week and she has no problem sleeping at nigh. A few soft coughs now and then."

"How about the ringworm on your wrist?" I asked.
"No more inflamed," she showed her right wrist. "I don't get ringworm now even when I held my dog. But more red spots appear on my dog's shoulder area!"

Some 2 weeks ago, the dog had generalised ringworm and she had her left wrist skin infected too.
I did not prescribe anti-ringworm medication as she was concerned about more medication since her dog was on heart drugs. I advised clipping bald to remove all contaminated hairs. She would be giving the anti-fungal wash and cream daily.
She had asked the groomer to clip the body but not the head. She clipped recently and saw more red spots.

Many owners do not bring their dog in for reviews and so what she said about the red spots could be ringworm or could be clipper burns or other reasons . A month had passed. Most of my cases of generalised ringworm had cured but this dog had more red spots.

"It is best for me to review and check on the multiple red spots, with the dog present," I explained.  

For various reasons, many Singaporean dog owners do not come for a review and in this case, she wanted to buy the multivitamins and do-it-herself treatment of the ringworm with the antifungal wash and cream.

She would bring the dog in for examination as it is not possible to confirm whether ringworm had spread or not.

2318. Ticks in Singapore dogs - email queries from one owner.

Sept 30, 2015

I've a mid sized dog (Singapore special 15kg)
Noticed she had black sesame seeds falling off her which had blood when burst on Sunday. Suspected ticks.
Searched online and apple cider vinegar wash was recommended.

Did it for 2 days. Seemed to repel the bugs. More fell off. Pet store recommended me carrington dog wash (which I diluted with more water - the instructions said 2 cap full to 1L water, I used 5 caps to 3L). I tried that, combed off some. Not all dead. Some articles mentioned dogs would salivate but she didn't.

I was told to put frontline plus 48 hours after carrington. Or should I take her in to see the vet? And is it necessary to test for tick disease?
All along she's eating well, active and alert without scratching much, only shakes body occasionally, so we didn't realize she has ticks.What do you advise?
Hope to hear from you soon.

Best Regards,



Thank you for email. I am Dr Sing K Y from Toa Payoh Vets.

My advice is to get your dog examined by your vet, get a blood test done to screen the health of your dog. Another test to check whether your dog has tick-borne diseases.

Tick infestation is the most common ectoparasitic disease in Singapore dogs.

Tuesday, September 29, 2015

2318. Coincidences A Rottweiler and a cat - tibial fractures

Sep 30, 2015

Just 2 days ago, I had breakfast with a senior vet of over 70 years old at Potong Pasir. We ate laksa which is high cholesterol. I did not drink the soup. He drank every drop, ate the clams which I gave my portion to help and would leave the egg yolk uneaten. Yet he had no high cholesterol levels due to his medication.

 He mentioned that a Malaysian vet phoned him about infections in a Rottweiler with tibial fracture and what are the options? Amputatation of the leg?  Euthanasia?  I suggested Antirobe antibiotics.

Today a cat came in with tibial fracture. The stray cat activist is a woman in her late 50s and had been feeding stray cats for the past 20 years. Her monthly feeding bill using mainly Iams cat food, is around $800.

"I have 6 cats now. This cat is around 3 years old and came flopping down in front of me. I had no intention of adopting another cat."

Her cats would watch the birds from the windows every day. She had wire-meshed all her windows except the one in the kitchen. So, this newcomer fell 8 storeys down. Vet 1 had given this cat the painkillers, antibiotics and an IV drip. He had an abdominal X-ray which showed no ruptured bladder or kidney damage. The other 2 X-rays were emailed to me.

The solution was to insert a pin of appropriate diameter to join the 2 tibial fractures together.


"I can only afford to feed the stray cats," the retiree told me that her cat food bill was a large amount. "I can't help them when they are sick."
"I do have volunteers sometimes,": she mentioned one lady who would not contribute any money to buy the cat food.

"Is she working?" I asked.
"It is hard to find volunteers and so you are fortunate," I said.
"She does not want to pay for the cat food, but she feeds a particular cat every day from my supply."

The commercial dog and cat food costs keep going up every year as Singapore faces higher labour and rental costs every year. The government also increases rentals of commercial premises every year and so these escalating costs eat into the savings of this retiree.

It is a difficult world for the stray cat feeders. This cat's fracture of the tibia was in mid-shaft. A pin was inserted and will be taken out 6 weeks later. A small 2 mm of the pin protruded

From the X-rays and observations on the 2nd day after surgery, the cat was normal. Hence, the kidneys and bladder were not affected by the cat falling 8 floors in a Singapore apartment.


"Should I join my friends on a China tour?" the retiree caregiver asked me. "My family vet says that it will take months for the fractured tibia to heal."

She had not taken holidays for many years since she started caring for 30 stray cats and her own 6 cats  every day.

I had told her that the pin needed to be taken out 6 weeks after surgery but she had another opinion from her family vet who said a few  months. Her planned travel was 7 weeks from the surgery.

She was just worried about the 30 community cats in Tampines  being deprived of food.
"Can you get the other lady volunteer to help you?" I asked. The lady volunteer would only feed a particular cat with food provided by her. She must ask her and make it convenient for her to do it.

"As for your own stray cats including the one who fell 8 storeys, can you find a pet sitter?"
"Yes," she replied. "She charges $35 per day."
"Can you find somebody who charges cheaper?"

"Looking after so many cats is like an albatross round my neck," she had done a very good job. But she is from the earlier baby boomer generation who does not know how to use social media to get donations and volunteers. So she is all alone with no interest in travelling.

I assure her that her leg fractured cat will have healed by 6 weeks as her travel would one week later.  

"Take a break," I told her as she was worried about the stray cats.

2317. A cat stills caterwauls just after spaying

Sep 27, 2015

Hello Judy,

I spoke to Dr Sing on the phone this evening regarding Greedy's active meowing at night even after sterilisation.

Attached is a voice clip of her meowing that Dr Sing has asked me to send him, would he be able to tell if this meowing comes from the remaining hormones of being on heat?

It's disturbing my sleep daily.

Thank you so much!




Meowing is due to the effects of the residual female hormones in the cat. The cat had been caterwauling for a few nights before spay. Within a week, there should be no more meowing due to the heat period. Alternatively, come for the Ovarid tablet to stop the meowing.