Wednesday, August 31, 2011

573. A biting Miniature Schnauzer has vomiting and diarrhoea

Time flies. A month has passed again and this was August 31, 2011. I was on reception duty as that is the best way to know more about the customer service provided by Toa Payoh Vets.

A father and son came at 6.30 pm with his son and a broad chested Miniature Schnauzer. I took out his case card. He was from a neighbourhood where there are two vet clinics nearby just opposite his apartment.

"Why didn't you just go to the clinics nearby?" I asked the father as part of my survey on customer service. This is what most Singaporean pet owners will do. Why go far away when the time can be spent better not travelling.

There are at least 45 vet clinics in Singapore nowadays. So, there is no shortage of vets to the benefit of consumers, as in most businesses.

"My daughter prefers Toa Payoh Vets," the father said. Female members of the family may have a higher say in the choice of vets and veterinary surgery, from my preliminary survey. A daughter who studies overseas in marine biology in Australia had just instructed her family members to bring a dog to me for treatment earlier. The other daughter who phoned me to make an appointment for her father's favourite Chinese Crested dog in the story of Sedation worries of a good daughter is another example of the young ladies making decisions as to their choice of vets.

Services count and Dr Vanessa must have had provided good services as nowadays she handles most of the cases. A time to pass the baton.

What to do with this biting Schnauzer who has vomiting and diarrhoea? "He even bit me when I tried to carry him," the son showed me his left arm which was now OK. "He was bashed with a slipper at the groomer till his nose bled last time and so now he bites whenever anyone tries to muzzle him."

"Has he been neutered?" I asked.
"Yes," he said.

So what to do?
I let Dr Vanessa handle this case. The dog went to the consultation room. The two owners went in. Min had gone out for dinner as it was already 6.30 pm. I waited outside in the reception area for around 15 minutes. Soon, the two owners and dog came out and waited outside the Surgery patiently as the sun was setting. A quiet peaceful time as twilight set in.

I was doing my administrative work, looking into past case cards and checking the vaccination reminders. Why were they outside for so long, another 15 minutes? I went out to ask if they were looking for a taxi. "No," the father said. "I am waiting for your assistant to come back from dinner." Dr Vanessa came out from the consultation room to inform me too. She could not give this dog his anti-vomiting and anti-diarrhoea injection as the owners could not carry the dog onto the consultation table without being bitten and she could not cover the dog's head with a towel which I noted was on her consultation table.

This Schnauzer was a bit plump but younger and alert. He does not growl. He does not threaten. He was merely cool. Just don't mess around with covering his head or muzzling him or carrying him onto the consultation table. He would just bite.
So, Dr Vanessa advised waiting for Min. Some clients do come during certain lunch and dinner time as Dr Vanessa does consult, unlike some surgeries where certain times are closed. So, this is one period where Min had gone out for dinner and she had to wait for him.

I phoned Min and he said he was having dinner. At around 7 pm, he returned and I said to the owners: "It is sometimes better that you don't be around while they restrain the dog for injection." They agreed to wait outside the Surgery.

I let Dr Vanessa handle this case as usual. Another 15 minutes had passed. The father had come in from outside and was sitting on the chair. There was loud barking in the back of the surgery. "How many dogs do you have?" He asked. "Around 5 dogs but from the barking, it seems I have hundreds," I said. The father laughed and said: "Young doctor taking a long time to inject the dog? Is she your daughter?"

Youthfulness can be an advantage as many Singaporeans, in my perception and research, prefer young vets. It is sometimes a disadvantage in a ferocious biting dog case.

It was already more than one hour since the owners had come. So, I opened the door to enter the back of the Surgery. What was taking so long? In the room, I saw Min holding a lasso rope which came out from a long stick while another assistant was holding the leash of the Schnauzer on the other side. Dr Vanessa was holding a bigger muzzle at the right side of the dog. Her sedative of domitor and ketamine for IM injection was on the table. The Schnauzer was wary of Min whose lasso seemed to be rigid and inflexible. His lasso had one end inside a hollow tube. He held the tube and tried to lasso the Schnauzer while the other assistant Tun held onto the leash. As this lasso was inflexible, it did not work. So back and forth. It was taking a very long time.

It was an impasse. Now, I had taught Min how to use the original lasso which was of flexible plastic wrapped rope. He had used his own make as this original lasso had come out from the hollow of the pipe.

I had to intervene, being the leader. There was no choice. It was already 7.30 pm. "Give me the original lasso," I said to Min. He took it from the wall at the back gate. It had no hollow tube as that had broken. But the lasso end was still intact and so I loosen the rope to make a bigger circle to lasso the dog, without the pole. The pole was meant to protect the person holding the lasso from being bitten as it gave some distance. But the pole had broken and so I was holding the lasso end and the remaining rope.

The Schnauzer moved his head. He did not threaten. Tun held onto the leash. At the 3rd try, I manage to put the lasso over his head and pulled it tight. The dog pulled back his head in reaction. Tun held on to the blue leash which was originally with the dog.

"Get ready to inject the domitor IM," I said to Dr Vanessa as I held the dog firmly and upwards for a few seconds. She said: "Domitor is ineffective. I tried earlier on another dog. I am using domitor + ketamine combination". I said: "OK."

She quickly held the dog's back leg and injected the back muscle in the wink of an eye. "Wait 10 minutes," I said. "The owner had instructed that he wanted the whole dog clipped and groomed, including ear cleaning, anal sac and toe nail clipping. At first he just wanted a sedative to clip the backside as the dog would not permit washing of the soiled backside from the diarrhoea."

The whole process took more than one hour. I have been focusing on shortening the process of veterinary work. In this case, it can't be helped as Min is still learning how to restrain ferocious dogs. Remember he was bitten by a dwarf hamster just a few days ago?

Hands-on experiences are learnt only from handling the real cases and this take time. Workplace safety for the staff is paramount.

Still there needs to be a solution to treatment of a ferocious dog for the owner who entrusts the vet to do it. A simple thing as a lasso can still be difficult to execute in practice as in this case when the tool presented is broken. Sometimes we can't have the ideal situation and I hope Min learnt from this coaching I had just presented.

Every person is afraid of being bitten by ferocious dogs but the vet is in charge and has to know what to do, to resolve the problem satisfactorily and safely. The dog was groomed without problem. "Don't bathe the dog?" Min asked me when I phoned at 8.30 pm. I said: "You must bathe the dog in warm water. His backside is dirty from the diarrhoea stools," I said. The dog could now be muzzled and bathe.

I still remember when I was a young vet. I muzzled a dog for vaccination when a pet shop operator brought it in. Later, I got a feedback from a client that this pet shop operator was bad-mouthing me and telling others behind my back: "Dr Sing is afraid of dogs! He muzzles dogs for vaccination."

I don't muzzle every dog for vaccination and in fact, seldom does it. Biting Pomeranians are muzzled as there was no point getting my fingers bitten by sharp canine tooth as I need my fingers for surgery.

But this pet shop operator expects vets to be bite-proof and to have hidden powers to soothe all ferocious beasts! Dog bites are the risk of veterinary science but it does not mean that the staff must be bitten at any time. Workplace safety is very important and it is the responsibility of the vet to ensure that the staff is safe from bites and scratches from dogs and eats. And even from a dwarf hamster!

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