Saturday, August 31, 2013

1111. Saturday Aug 31, 2013 continuing education & client communication


Dermatology Talk by Dr Gregg Takashima on Saturday, 31st August 2013

I attended this talk at 7 pm - 9 pm organised by Hills. It is good to know more about how an American vet treats skin diseases in dogs and cats as skin diseases are No. 1 cases in Toa Payoh Vets.

Clients are getting more sophisticated as they trawl the internet and diagnose their skin diseases in their pets. Some are spot on as they diagnose ringworm and scabies correctly.

In fact, in this bright clear blue-sky morning today, an Accountant came to me for a 2nd opinion as the first vet told him that his 5-year-old male cross-bred with a very black hairless inguinal area was normal.

"I have done research on the internet and I think my dog has thyroid disease," he said to me. "How long has the hyperpigmentation been present?" I asked him.
"During the last 2 years."
All the other parts of the body had hairs except this black groin area. Just jet black.
 
"Usually this groin area has hairs," I told him.
  He did not think so judging from his facial expression.
Fortunately I have another patient, a Husky with vaginal bleeding for over 4 weeks and I asked its owner to permit me to show him the dog's groin area. The thick coat of hair present convinced him.

Client education with show and tell is important.

"Your dog must have licked this area daily for many months," I said. "Licking irritates the skin which becomes black due to melanin cells being migrated to this area. Initially, the skin was in contact with some moist flooring or soil. It becomes a skin infection causing pain and inflammation, leading to itchiness. The dog keeps licking."

I expressed the anal sacs. Thick granular grey brown oil came out in copious amounts and smelled badly. The dog also had a painful left ear. Overall, his coat was good except for that unsightly black groin area. What to do?

I suggested a blood test and also a check for thyroid hormones T3, T4 and TSH since he was worried about thryoid hormones. The dog was slim and otherwise normal. I advised avoidance of contact with soil as the dog loves rolling onto soil. A rubber mat on the car porch area and confining the dog to that area. This sounded impractical.

The skin was dry and thickened due to irritation. I did not do any skin scraping, impression smears or fungal culture for today. The dog was given a wash, an anti-inflammatory and antibiotics and would be reviewed after one month. Meanwhile 5 ml of blood was taken for the thyroid hormone analysis and another set of blood was collected for basic health screening.

As for the talk by Dr Gregg, it was interesting to know about oral papillomas being common in dogs that have been sent to the dog-day-care centre in his American practice area. These dogs lick each other and develop the contagious oral tumours. "Any cases in Singapore?" he asked. None of the 20 vets present said yes.
 
As for the potentiated sulphonamides, he mentioned about the need for the dog to drink lots of water while on medication as there is the side effect of dry eyes and kidney damage. So he uses this drug as a last resort.
 
He uses the cattle or horse ivermection for demodectic mites (miniumun of 3 skin scrapings) by giving it into ice-cream. Check for mites every 2 weeks till 2 consecutive samples are negative. He advocates diagrams to illustrate areas of body affected and digital images to document skin diseases. I do use illustrations and sometimes digital images. Ivomectin affects the brain of collies and collie X as he had one case of a Collie that went comatose and took some weeks to recover. Amitraz or others would be given instead of ivomectin.

Cases of deep ear irrigation, yeasts seen on paws and ears, demodectic mange in an old dog and other interesting cases were shown. MSRA skin ulcers in vet staff, allergy tests, food elimination trials, regional formulated injections to treat skin diseases and trends were discussed.




Friday, August 30, 2013

1110. Myanmar stories - The pretty girl

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   01 September, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Myanmar stories - The pretty girl    
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   01 September, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Friday, August 30, 2013

Friday Aug 30, 2013

I visited Khin Khin Employment agency at 3 pm as I am off work during the weekday afternoons and wanted to help organise her management of this business which was not my cup of tea. I have no share in this business but it has many management lessons for my veterinary practice.
.
"No internet connections," Khin Khin complained. "Singtel pushes us to contact the modem maker who passes the buck to Singtel!"  She needed the internet to connect with the Ministry Of Manpower to submit forms for job applicant.  Owing to her persistence and aggressiveness, the Singtel girl phoned back and said they would send somebody the next day.

This was a problem as she could not wait. I had a little knowledge of modem. I advised "switch off and on" for the modem or "reset".  My advise was useless.  Her manager put a pen into the "reset" point but there was no effect. The "red" light still remained. "It should be green if the modem is working," he said to me. So, nothing could be done.

"Check the network connections," I said.
"Done. No use." the manager said. He liked to tell me he is a computer graduate from Myanmar and he does know much more about setting up websites than me.

"Try again," I said.
He clicked the various names of wireless network source. The neighbours had security password and so there was no hope of connecting to the internet without knowing their password. But there was one called "Gateway". Clicking on it connected the computers to the internet. So work could be done. As to who "Gateway" was, we don't know. Somebody who had not inserted a security password to log on or a hacker?

A second problem came as I was advising Khin Khin's manager to keep proper records. Next year, the MOM wants all accounts to be audited. More money for the auditors and economic hardship for the employment agencies as the bureaucrats demand more compliance and dictate the amounts of fees to be charged to job applicants instead of letting the free market work.

The manager did not know how to devise an Excel formula for the balance of profit and loss in the accounts. I asked him to check the internet forum. No use. Finally I asked him to subtract the "sum of column of profit from the sum of column of expenses". The formula worked.  "The loss figure is in 'brackets'" I told him as he expected a "minus" sign.

Read widely about financial statements and you will know that bracketed figures represent "minus" or loss in accountancy.

Suddenly a stocky Myanmar man in his 50s, looking like one of those cooks came with a bag of goods. "What's inside this bag?" I asked Khin Khin. "They are presents for the 'pretty girl,'" she said.

Khin Khin knows I have difficulty remembering Myanmar names and so called her the "pretty girl". She is in her mid 20s and dresses quite well whenever I met her.

I had mentioned about her in one of my previous Myanmar stories. Khin Khin and she had gone to the famous temple to thank the Gods for her getting employment successfully. She lost the job subsequently and went back to Myanmar. But she  found a better one. The employer was setting up an office in the Philippines and wanted her to go there. She found another good employer working 5 days a week. She is staying with Khin Khin sharing the house with other Myanmar people. I believe she is a draughtswoman. Her conversational English is good. I believe she is hard working as well as being good looking and so the boss likes her. Good looks are unfair advantages in the office if the employee is industrious.
 
"This man does not charge for the courier services because she is a pretty girl," Khin Khin said to me. "Yesterday, I had free dinner as the other tenant cooked for the pretty girl."

"How come you have to pay for courier charges to send things to Yangon?" I teased her as she seems to fixate on looks and condemn those Myanmar job applicants who are not in good physical shape.

"I am old and ugly," she remarked. Actually this man is a sailor and collected the goods from the mother of the pretty girl.  Unlike many Singaporean mothers, this mother wanted her to work in Singapore.

"Why?" I asked Khin Khin one day as Singapore mothers will not want their daughters to be away from Singapore if given a choice.

"So that she will not be near the man whose family quarrelled with her mother. This man is very persistent and wants to marry her. But her mum will disown her if she does that." It seems Myanmar mums are quite strong personalities. Khin Khin would take all her husband's salary when he was working in Singapore and dole him an allowance.  How many Singapore husbands  will do that I wonder. Probably none.

The pretty girl's mother was said to make several thousands of dollars on flipping properties in Myanmar as presently there is much asset appreciation in Yangon. "If it is so easy to make money," I said to Khin Khin. "Why don't you sell your apartment in Yangon and make money instead of struggling in Singapore? Now your office of 250 sq ft is reduced by 50% as you rent to another sub-tenant. The office now is so crammed that 5 people would fill up the room!"  

This Friday was memorable in that I felt dizzy at around 8 pm as I sent the two RI interns to the Bishan subway and nearby apartment. I quickly drove home thinking I would be getting a stroke. Fortunately, it was food poisoning as I had diarrhoea with lots of gas and recovered the next day. The two RI interns had produced an excellent movie on the 15-year-old closed pyometra and uterine torsion case as they enacted the true story well. It is difficult to produce the dialogue but they did it. See:
Video Part 1: Closed pyometra & uterine torsion - Part 1
Video Part 2: 
Closed pyometra & uterine torsion - Part 2
 
Updates will be on this webpage:
www.sinpets.com/F6/20130901pretty_girl.htm


More info at: Dogs or Cats
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: September 01, 2013

Toa Payoh Vets



 

1109. HOW YOUR OLD DOG CAN LIVE LONGER. Follow up: Westie with bladder stone - 26th day post op

Saturday 31 Aug 2013  9.38 am

Wife who loves this 10-year-old Westie much more than husband came to get stitches out.
"26th day after op," she said. "Stitches still there."  These absorbable PDS sutures are really lasting. Seldom dissolve early. The dog was active. Stitches taken out. A small skin haematoma at one end expressed. Video image.

The dog vomited on Day 16 to 21. The couple was much concerned and wanted antacid as he read on the internet that his dog was suffering from stomach ulcers. "It is hard to tell what he is suffering from without tests," I said. I gave him the antacid and changed antibiotic tablets to Vibravet paste.
"Stop the dry U/D diet."
No more vomiting two days later and today the stitches are taken out.

"He is still urine-marking a lot when outdoors," she said. "Every few spots, he will lift his leg. At home, he does it 3-4 times a day if he is not outdoors."

"Male dogs do that," I said. "Neutered ones may do less times or not at all. Holding back urine causes bacterial infection and then stone formation, leading to blood in the urine or difficulty in urination."
"Is it too risky to neuter him now?" she asked.
"Based on his blood test and examination, he is fit for anaesthesia. Neuter and dental scaling 3 months from now will be best. Get urine tested 3 monthly to check for infection of the bladder"

The owner wanted 24 cans of U/D and went home quite happy with this dog who keeps looking for the canned food by tapping on the feeding area. He has a voracious appetite and is now 8.1 kg making him heavy to be carried.

TIPS
Besides proper care of the older dog, get him health screening and urine tested. Prevent urinary stones by urine testing +/- X-rays regularly. In any case, urine test 3 monthly.  To prevent urine marking, neuter him when he is around 6-8 months old so that the male dog does not retain urine, causing stagnant urine favouring bacterial infection and stone formation. Some dogs don't drink much water. 


RETROSPECTIVE REVIEW OF CASE
TP 45123
Westie, M, Not neutered, Born Nov 16, 2003
Wanted 3rd opinion as Vet 1 took blood test for suspected poisoning and Vet 2 diagnosed bladder stones based on X-ray.
Blood test unremarkable
X-ray bladder stones
Urine test calcium oxalate crystals
Owner does not want stone analysis owing to financial constraints.
Bladder stones removed. Calcium oxalate.
On U/D diet.
As at 26th day after surgery, no complaint of surgical outcome.
Vomiting reported

UPDATE ON WESTIE
The wife came to buy 24 cans of U/D yesterday Sep 5, 2013 and said that the Westie is OK.

1108. Relocating from Ireland to Singapore - dog

Hello,
 
I am helping a client of mine who has just relocated to Singapore from Ireland. They are looking for a veterinarian for their 23 kg setter. I had a few questions about your office.
  • How soon are you making appointments for new dogs?
  • About how much does a general checkup with vaccinations cost?
  • Is there anything they should know about moving their dog to Singapore?
  • They are looking for dog boarding facilities as well, do you offer that service or could you recommend someplace?
I am so sorry for all of these questions. Thank you so much for your time. I look forward to hearing from you and referring your office to the family.
 
Sincerely,

Margaret Hoffman
 
  
Margaret Hoffman | Resource Specialist
Direct 314.523.7547 | Main 314.576.0010
MHoffman@vandover.com | ighr.com


EMAIL REPLY DATED AUG 31, 2013


I am Dr Sing Kong Yuen from Toa Payoh Vets

Thank you for email. My replies are respectively:
Appointments can be made 24 hours earlier in general.
General check up is around $65 - $75. Vaccinations are $40 for 9-in-1 vaccine, $70 for proheart vaccination, $40 for kennel cough vacc.
A rental house with a garden will be best for the dog. For families, a ground-floor condominum with private garden. Get copies of the dog's medical records from previous vet including health screening.

Get import licence from the Singapore Government's Agri-Food & Veterinary Authority  www.ava.gov.sg
.
We don't have boarding facilities. Phone Pet Hotel +65 6582 2222 for boarding.

Thursday, August 29, 2013

Script for intern - Kidney disease

Date: Aug 30, 2013  

TP 43996
Miniature Schnauzer
Black, F, spayed, 9 years


A vomiting and diarrhoeic dog.
8.8 kg, 38.4C.

Recent History
2 weeks no appetite
2 days of vomiting and diarrhoea
No abdominal pain


A simple case of gastro-enteritis?
Some injection and medication.

Not so fast. Review the previous history.
"Bladder stones removed 3 times", the owner said. "The first two times were in October 2010 and October 2011."
"How do you remember the dates so well?" I asked this groomer.
"October is her birthday and she missed the celebrations. I was happy to celebrate her October 2012 birthday. But she had the 3rd bladder stone surgery in January 2013!"
"Miniature Schnauzers are a breed prone to bladder stone formation," I said. "Struvite stones were analysed in Oct 2010. Did you still continue feeding the dry dog food after surgery?"
"Yes, but now I feed home cooked food, vegetables, rice and sometimes canned food"

Almost all Singapore dog owners do not follow up after bladder stone surgery as regards urine testing, X-rays and special diet for prevention of the struvite stones. So, the stones return and in this case, the dog had 3 bladder stone surgeries!

Blood test, urine test and X-ray advised.

Blood test was done in Jan 2013 and Aug 2013

INTERN TO HAVE  DISCUSSION WITH DR DANIEL SING ON KIDNEY DISEASE.

.





Wednesday, August 28, 2013

Images for closed pyometra & uterine torsion video

Images













1105. Stray cat from Hougang drain



Video movie of uterine torsion & closed pyometra

The patient bites and so the interns were frightened. However, we need to wrap up the video making today as it is 7th day post-op. I got a lady who is not afraid of dogs to bathe, dry the dog and bring it into the consultation room for last video section. 

So much time had been spent with the 2 interns to shoot this video and re-do. I hope it will turn up educational and fun.

Monday, August 26, 2013

1103. Untreated generalised scabies in a Cocker Spaniel - images







1102. Follow up: The old Maltese with uterine torsion & closed pyometra still snapped at the vet

Aug 27, 2013.

The dog is alert and is hosptialised for 7 days after her surgery.

She ate all a/d. Still she would snap at my hand should I go near her. She never forgives or forget.
At 15 years of age, her blood test results were unremarkable. Except for a decrease in creatinine and an increase in neutrophils, she has normal values. No increase in total white cell count unlike other closed pyometra cases I encountered despite such a gigantic womb and being so old.

Around 90-100 years old in human age. Still strong and alert.

1101. Stray cat activism. Soft masses inside abdomen in a stray cat

The kind teacher brought one of these stray cats that had lost weight and was not eating for the past 2 months to Dr Daniel on Aug 19, 2013.

Blood tests were unremarkable. X-rays show a circular mass in the abdomen. Exploratory laporatomy showed the lumps which are sent for histopathology.

"There seems to be a stalk," Dr Daniel said.
"They appear to be encapsulated abscesses, peritoneal tumours or some worm masses e.g. round worm larvae migrating from the mouth to the intestines causing such reactive masses."

Mine was all speculation. Histopathology may enlighten me. Stray cats eat hazardous materials as part of their life-style. Did this cat swallow fish bones and perforated her intestines. Then such masses form to wall off the holes in the intestines?


 


1100. HOW YOU OLD DOG CAN LIVE LONGER? Bladder rupture

Case study

TP 44384. Maltese, Female, Not Spayed, 12 years. Vet: Dr Daniel
The old dog was still active but had lost appetite yesterday. No vomiting or diarrhoea. Rotten teeth. First consultation on May 7, 2013. Complaint of stranguria and haematuria. Given antibiotics. Advised urine test, dental, spay and X-rays but the owner did not accept these advices.

Then on May 14, 2013, dog came in and the following tests were done.

URINE TEST
Amber, turbid, pH 7.0, SG 1.026, Nitrite +ve, Protein 2+, Blood 4+, White blood cells >2250, RBC >2250. Bacteria 3+, Crystals Amorphous phosphate 2+

BLOOD TEST
Urea  62.6 (4.2-6.3)
Creatinine 882  (89-177)
Total white cell count  44.3  (6-17)
N=98.7%, Absolute = 43.7   --- very high

X-rays not done


52 minutes of isoflurane gas anesthesia after sedation
Ruptured bladder repaired.
Dog was vomiting post-op on 2nd day.
Owner decided on euthanasia

RETROSPECTIVE REVIEW
Relevant medical advices were given as regards urination problems.


HOW YOUR OLD DOG CAN LIVE LONGER?
1. Dogs over 7 years old - yearly health screening (blood & urine test) and dental work.
2. Urine test and blood tests & X-rays to be done when there is urination problem rather than wait and see.





 








1099. Sunday's interesting case. The optometrist's 3rd daughter

TOA PAYOH VETS
toapayohvets.com

Date:   27 August, 2013  
 

Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
 
The optometrist's 3rd daughter  
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   27 August, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

 

Sunday Aug 26, 2013's interesting case

"I work very hard to raise and educate 3 daughters," the 67-year-old optometrist used to work from 9 am to 9 pm said to me. "Now, two are married and I don't get a cent from them." His 3rd daughter who is slim and good-looking, wearing dual-colour short pants laughed."Do you really expect the younger generation to give parents some money from their earnings every month?" I read of many Americans living with their parents nowadays, owing to economic downturn. "They have different values of hard work and thrift. They want work-life balance and so they don't work long hours generally. If they don't need your money as adults, you should consider yourself fortunate!"

Nowadays he closes his shop whenever he likes because his rental in downtown Orchard Road is around $4,000 while the other shop rentals in other malls were charging $8,000 - $20,000 rental per month. "I do not charge clients who are poor," he declared to me. "There was one who asked me if he could pay by installments. His family member has cancer and so I said that he could pay me when he was able to do so."

"Would you be giving free spectacles if your rental was $15,000/month?" I asked.

"Well, the clients who need free spectacles will not step into such posh shops."

His 3rd daughter in her late 20s had brought in a 13-year-old cat for me to remove an ingrown toe nail. She had phoned me at 10 am on Saturday as the cat's paw was bleeding and I suggested that she bandaged the foot and bring the cat in today, in order to save on after-hours costs which would come to over $300.
So, here she was, with her father. She would not bear to see her cat's ingrown toe nail being cut off  in her presence. So she left the op room when I did it.





"My cat claws me all the time at home," she warned me. So I expected a ferocious lion all ready to swing her claws at me. But she was very quiet and there was no need for a sedative. She just lied quietly and patiently and I got some images taken.




"Since you have worked for so many years, you must have lots of clients," I said to the father. "Is your children taking over your business?"





"No, my children are not interested," he had already given up on his 2 older daughters and this younger one was working happily in an events marketing company in publishing.

"I am interested," the 3rd daughter said she had spoken to him and would not mind attending the compulsory optometry course to be accredited.  He had not groomed the 3rd daughter.
Rentals will not stay at $4,000/month forever," he had no confidence in his children to compete and bring his goodwill and clientele business to a higher level.

"Have you got a website?" I scrutinised his name card as he said my spectacles were out-dated and old fashioned. I told him they were branded "Gap" and the thick black frames were admittedly, not modern looking.

His 3rd daughter laughed as she is from this internet generation who appreciates websites and know the leveling power of the social media. Maybe the father knows that one-man-operator optometrist practice is a dying business but I don't think so. Many such shops hire people who come and go and there is a niche for proprietors who provide personalised service and is available over the years as the family members grow up. The baby-boomer generation is ignorant in the ways of social media.


Of course, the internet generation may not be loyal clients and go for fanciful renovations and high prices. However I believe there is a place for a niche optometry personalised service with years of experience. It is very difficult to find such old veterans nowadays if you value experience over glamour.
Updates will be on this webpage:
www.sinpets.com/F6/20130826optometrist.htm


More info at: Dogs or Cats
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: August 27, 2013

Toa Payoh Vets

1099. Sunday's interesting case - The optometrist's 3rd daughter

"I work very hard to raise and educate 3 daughters," the 67-year-old optometrist used to work from 9 am to 9 pm said to me. "Now, two are married and I don't get a cent from them."

"Do you really expect the younger generation to give parents some money from their earnings every month?" I asked. "They have different values. If they don't need your money as adults, you should consider yourself fortunate!"

Nowadays he closes his shop whenever he likes because his rental in downtown Orchard Road is around $4,000 while the other shop rentals in other malls were charging $8,000 - $20,000 rental per month. "I do not charge clients who are poor," he declared to me. "There was one who asked me if he could pay by instalments. His family member has cancer and so I said that he could pay me when he was able to do so."

"Would you be giving free spectacles if your rental was $15,000/month?" I asked.
"Well, the clients who need free spectacles will not step into such posh shops."
His 3rd daughter in her late 20s had brought in a 13-year-old cat for me to remove an ingrown toe nail. She had phoned me at 10 am on Saturday as the cat's paw was bleeding and I suggested that she bandaged the foot and bring the cat in today, in order to save on after-hours costs which would come to over $300.

So, here she was, with her father. She would not bear to see her cat's ingrown toe nail being cut off.
"My cat claws me all the time at home," she warned me. So I expected a ferocious lion all ready to swing her claws at me. But she was very quiet and there was no need for a sedative. She just lied quietly and patiently and I got some images taken.

"Since you have worked for so many years, you must have lots of clients," I said to the father. "Is your children taking over your business?"

"No, my children are not interested," he had already given up on his 2 older daughters and this younger one was working happily in an events marketing company in publishing.

"I am interested," the 3rd daughter said she had spoken to him and would not mind attending the compulsory optometry course to be accredited.  He had not groomed the 3rd daughter.

"Rentals will not stay at $4,000/month forever," he had no confidence in his children to compete and bring his goodwill and clientele business to a higher level.

"Have you got a website?" I scrutinised his name card as he said my spectacles were out-dated and old fashioned. I told him they were branded "Gap" and the thick black frames were admittedly, not modern looking.

His 3rd daughter laughed as she is from this internet generation who appreciates websites and know the levelling power of the social media. Maybe the father knows that one-man-operator optometrist practice is a dying business but I don't think so. Many such shops hire people who come and go and there is a niche for proprietors who provide personalised service and is available over the years as the family members grow up.

Of course, the internet generation may not be loyal clients and go for fanciful renovations and high prices. However I believe there is a place for a niche optometry personalised service with years of experience. It is very difficult to find such old veterans nowadays if you value experience over glamour.
   

1098. Dicom software to read certain digital X-Ray images & 2 tips


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   27 August, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
 
Two tips for urinary stone X-rays of dogs  
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   27 August, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

 
Blood in the urine may be a sign of bladder stones. A urine test and X-rays of the bladder and kidneys should be advised and this was done by the other vet.

A good practice is to use air-contrast X-ray of the bladder as it is more troublesome, esp. in the female dog as she has to be catheterized. The bladder needed to be emptied via the urinary catheter.
 
tpvets_logo.jpg (2726 bytes)6339-6340. Struvites stones in a Golden Retriever. 3 X-rays were taken - 2 lateral views and one ventro-dorsal view. This lateral view (left) shows the stones inside the bladder.   

In this young Golden Retriever , urine tests show lots of struvite crystals were performed by another practice. The owner was given the CD containing 3 X-rays. The CD does not have the specific software to automatically download the images. There are two ways of sourcing this software.

Downloaded one from the internet or get it from the supplier of the machine. The software is at:
http://www.microdicom.com/

I noted that 3 X-rays were needed to be taken as the struvite bladder stones can be seen in only one of the two lateral views. 

Another good tip is to palpate the bladder before X-rays. If the bladder is full, get the dog out to the grass to pee. Or catheterise the dog to empty the bladder to get good views of bladder stones. Otherwise, there is a need to take another X-ray if the full bladder obstructs any views of smaller stones.

FOR THE BENEFIT OF OTHER VETS WHO MAY ENCOUNTER PROBLEMS DOWNLOADING DIGITAL IMAGES OF THE DICOM-TYPE , THE FOLLOWING INFO IS PROVIDED:
http://2010vets.blogspot.sg/2013/08/medical-imaging-software.html


 
Updates will be on this webpage:
www.sinpets.com/F6/20130827dicom_X_rays.htm
 


More info at: Dogs or Cats
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
Copyright © Asiahomes
All rights reserved. Revised: August 27, 2013

Toa Payoh Vets