Tuesday, September 30, 2014

1069. Amended C-section script for video production



Hook
VIDEO FOOTAGE CLIPS. Narrate by Phyllis according to text whenever possible. Subtitles. An Action Clip.

A PUPPY IS DELIVERED BY THE VET.
NOT CRYING. NO MOVEMENT. IS HE DEAD?


The pregnant poodle came in with 64 days old fetuses, an ultrasound and radiographs results.
Image of the FIRST delivered puppy in the amniontic bag, umbilical cut, puppy not crying and moving.
Title / BKTP
Title: AN ELECTIVE CAESAREAN SECTION
1-year old poodle, first-time dam, mated 64 days ago, one mating.

IMAGE OF BKTP. See email attached link.

Image and title: “BKTP”
Intro
DEFINE C-SECTION. C-section can be emergency or elective. This is a case of elective C-section, meaning that the owner has had planned for the time of C-section.


History: The poodle was 64 days pregnant. The owner's first vet had taken X-rays which were not clear and ultrasound which showed 3 puppies. However the first vet was on compassionate leave and his receptionist phoned to postpone the elective Caesarean section. This was unacceptable to the owner who had done reseaerch and felt that the poodle was overdue. He consulted Dr Sing Kong Yuen of Toa Payoh Vets, telling him that he had monitored the rectal temperature as advised by the first vet. The temperature had dropped to below 38 deg C. (video footage of conversation bet Dr Sing and owner).
 


Physical examination: The poodle had a dropping of rectal temperature a day before consultation with Dr Sing. This indicated that birth was imminent but there were no signs of contraction.

Rectal temperature is only ONE of the signs of imminent birth. Physical examination is important.

During physical examiantion, the poodle was healthy. (VIDEO FOOTAGE OF EXAMINATION OF HEART, LUNGS, ABDOMEN ASUCULTATION FOR FOETAL HEART BEATS.

SYMMETRICAL ABDOMEN (Image) shows that the poodle was unlikely to bear an odd number of puppies. From Dr Sing's experience with around 300 C-sections in breeders' puppies, he told the owner that the dam probably would have 4 puppies.

Palpation of the nipples - no milk production. Some first-time dams produce milk after C-section and oxytocin injections. So, this would not be a problem. But the owner had bought commercial milk from the pet shop and was well prepared.
Video of the recording of the history and physical examination, with subtitles.

Defining Caesarean & explaining the poor milk production.
Middle

ANAESTHESIA & SURGERY. Show relevant video footage clips.

1. Gas used is isoflurane + oxygen
2. A MASK to sedate the poodle before intubation (breathing tube).
3. Intubated poodle.
SURGERY: Video clip of the skin, linea alba incision up t6o seeing the birfurcation of the uterine body


SITE OF UTERINE INCISION BY DR SING.
The vet text book usually instructs that the whole uterus be taken out first. This means a very long skin incision, about 4 X longer than what Dr Sing did to incise the uterus inside the abdomen. as shown in this video


The bifurcation of the uterus was exposed after the skin incision of the abdomen has been made. (video). The first puppy inside the water bag is taken out, membranes ruptured, umbilical cord clamped by 2 artery forceps. 

BUT THE PUPPY WAS PRACTICALLY "DEAD" Same for the other 3 puppies. What to do?


REVIVAL OF RESPIRATORY-DISTRESSED PUPPIES. 


STEPS ARE AS FOLLOWS:
1. SWINGING IN AN ARC
2. RUBBING NECK SKIN
PINCHING NECK SKIN
HEAD DOWN
CLEAR MUCUS FROM MOUTH AND NOSE WITH TISSUE AFTER SWINGING
STIMUATE INSIDE OF MOUTH WITH FINGER

8. BLOW AIR INTO THE PUP'S NOSE AND MOUTH ORALLY BY VET TO INFLATE THE LUNGS, AS A LAST RESORT. THIS WAS NOT DONE.


it took more than 10 minutes/pup. But finally, the puppies cry (video footage of other parts to close this action video)


Video of anesthesia, procedure and the cleaning of the puppy.
Conclusion
This was a case of uterine inertia. The use of lowering of rectal temperature as an indication of imminent birth is not a very reliable indicator. The gestation period of 64 days dated from the first day of mating is more important as an indicator of overdue pregnancy in the dog. 

In the ordinary vet surgery, there is no sophisticated equipment to monitor the foetus. So the judgment of the vet is important. From my experience, small breeds can be operated by elective C-section at the 60-62 days generally to get active moving puppies.
Video of Post-operative checkup, and slides of care after caesarean & proper care of newborn puppies.
Credits
CREDITS

Video done by:
Phyllis Wong

Producer:
Dr Sing Kong Yuen,
BVMS (Glasgow), MRCVS

Video software:
Windows Movie Maker

Toa Payoh Vets 2014

Be Kind To Pets

For more information, visit:
http://toapayohvets.com/

For other videos, visit:
http://www.toapayohvets.com/videos.htm


1068. Original C-section script by Phyllis



Hook
The pregnant poodle came in with 64 days old fetuses, an ultrasound and radiographs results.
Image of the delivered puppies and the mother dog.
Title / BKTP
Caesarean of a past due date 1 year old poodle.
Be Kind to Pets: An educational video for vet students and pet owners.
Caption: “BKTP”
Intro
History: The poodle came in with a past due date of pregnancy of 64 days.
It has a history of diarrhea and vomiting, thus it had been under drips twice in a vet clinic. The owner had the poodle arranged ultrasound and radiographs; showing the presence of only 3 fetuses.

Physical examination: The poodle had a fluctuating temperature a day before the day of visitation, which indicates the soon birth of the fetuses.
The poodle is generally healthy, but without the presence of breast milk, and also bearing a symmetrical abdomen shape.
Video of the recording of the history and physical examination, with subtitles.

Defining Caesarean & explaining the poor milk production.
Middle
Anesthetizing the poodle before the procedure starts, with an approximately 5 to 10 minutes waiting time.

Surgery: Before the procedure starts, the breathing of the dog should not be too deep or active. The bifurcation of the uterus was exposed after the incision of the abdomen has been made, and finally the incision of bifurcation, exposing the neonate in a sac.

Care of neonates after caesarean: Stimulation of its breathing was made by the rubbing of the newborn, fluids in the lungs of neonates have to be cleared by the clearing, its mouth and nose and finally releasing the fluid by swinging the newborn in a solid flowing movement. After which, newborns were made sure to be in a healthy condition of pink and are breathing well.

Tail docking can be only done at 2 days old puppies, whereby one of the 3 methods has been introduced to the puppies. The 3 methods may seem to be suitable for only 2 days old puppies, but one of the methods required the puppy to be at least 7 days old. Lastly, a solution will be applied onto the wound which had a healing effect and also prevents further bleeding.
Video of anesthesia, procedure and the cleaning of the puppy.
Conclusion
Advice for home breeders about post Caesarean care.

Post operation checkup: Questions posted by a client about the poor condition of the production of milk, color of the vulva, and the diarrhea condition of the mother's poodle. Finally, the veterinarian advised solutions to posted questions by the owner.
Video of Post-operative checkup, and slides of care after caesarean & proper care of newborn puppies.
Credits
CREDITS

Video done by:
Phyllis Wong

Producer:
Dr Sing Kong Yuen,
BVMS (Glasgow), MRCVS

Video software:
Windows Movie Maker

Toa Payoh Vets 2014

Be Kind To Pets

For more information, visit:
http://toapayohvets.com/

For other videos, visit:
http://www.toapayohvets.com/videos.htm


Monday, September 29, 2014

1067. Tips on how to; Street photography - pretty women and dogs - Spain

Too many tourists obstruct a good view of this tunnel.
In the split second when tourist traffic is less, I snapped this image.
Use Rules of Thirds, with the people in the lower 1/3 of the frame for a better composition



People adds interest to a tunnel image



This owner with yellow jacket and two black dogs was adjusting his dog leashes
A passer-by came in 




Crop out the passer by. Rule of Thirds with the subjects in middle 1/3 of frame




Original image was taken in a split second as the two sisters posed for another photographer in the early morning sunlight. A passer-by obstructed me. Croping the image would be the solution and it turns up well in the images below.


Explanation on how I process the cropped image. Bloggers or Photoshop 6.0 have some software problem in not giving me the correct position of the following images

Cropping out the passer-by was not my intention.
Yet the two sisters posing at an angle look great than from the frontal view.
In portrait photography, an angled view is advised 


Photo-shopped and sharpened image
Image has been photoshopped but looks a bit pale. The ladies are fair.


More saturation
More saturation brings out the blusher and make pic more attractive

Sunday, September 28, 2014

1066. Travel stories - How to take good street photographs without too much technical knowledge


Many photo magazines will mention that for good images, there is the need to use manual control of focus, ISO, f stops and speed.

By the time the amateur like me adjusts all these in street photography, the moment or lighting will have disappeared. I am sharing my experience of how to take good photos fast without all these technical details. 

1. Good lighting is still the most important.













Final copy




















Saturday, September 27, 2014

Travel Stories - How to produce good photographs without too much technical knowledge

Abba Garden Hotel  Rm 501, Barcelona, Spain
Sep 27, 2014

Many photo magazines will mention that for good images, there is the need to use manual control of focus, ISO, f stops and speed.

By the time the amateur like me adjusts all these in street photography, the moment or lighting will have disappeared. I am sharing my experience of how to take good photos fast without all these technical details. 















Wednesday, September 24, 2014

1064. A tea lady n a new law graduate

Yesterday I met a tea lady and spoke to the father of a new law graduate earning $15,000/ mth.  The latter earns in a month what the former earns in a year.  A top law firm will pay for top legal graduates but vets do not get half.      


1063. Update: The gasping terrapin was gasping, crying and not eating 4 days ago.

Thursday Sep 25, 2014

I phoned the wife today at 12 noon. This beloved 6-year-old terrapin came in on Sep 21, 2014, not eating and making crying sounds. The tongue had white membranes peeling off. She was gasping and so it was easy to see the inside of her mouth. She did not pass stools for a few days.What's the problem?

The terrapin had poor uneven shell quality being fed solely on a Taiwanese brand of pellets and nothing else. No sunlight for the past 6 years.  The tank was too small.

"The cause of the poor shell quality could be this particular brand of brand," I said. "It may be toxic causing tongue ulcerations and infections of the mouth. How often do you change the water in the tank?"

"Every two days," the husband said. He would give the medication including multivitamin drops.

I proposed feeding dry shrimps, little fishes and egg yolk (boiled). Today, good news from the wife. The terrapin is eating dry shrimps and this is a good sign.  Small pieces of fresh fish. If the terrapin can swim, little guppies may be interesting.