I am still at the clinic at 8 pm as all had gone home by 6.30 pm.
A Tampenis lady phoned to book de-ticking for her Miniature Schnauzer. She had called pest control to clear her apartment of ticks.
"How do you know Toa Payoh Vets provide de-ticking services?" I asked. She could come only at 4 pm tomorrow
"I googled 'deticking services locally and found your website and a video possibly,'" she said.
The video is at:
http://www.youtube.com/watch?v=eYP57ikgYtE
I googled "deticking services Singapore" and found the following:
We provide de-ticking service for your pets if you find that your pet is infested with fleas/ticks. Tick removals are undertaken using safe methods, then a ...
Mar 20, 2013 - 20070406About Toa Payoh Vets Singapore veterinary clinics, ... De-ticking insecticide wash and ensuring ticks are no longer active will be an ...
A very interesting case. The dog had "dandruff" from head to toe. Little or no hair loss. Ear edges were flaky and appeared to have some crumbs.
Now the other vet had prescribed a "shampoo with steroid" given for 6 months. The owner did not have the shampoo ingredients. "Is the skin disease it due to the shampoo?" the lady asked me.
"Hard to say," I presumed this shampoo had some insecticide and therefore I could not find the typical crusty ear edge. Muzzle was rough and hard with allergy. "Plastic bowl contact or biting?" I asked.
"It could be plastic toys or treats," the wife said.
I had the dog clipped bald and bathed. Red dots all over the body were seen. Hence this was a case of generalized pustular dermatitis..
The vet excised a skin lump and did dental scaling when the dog was 11 years old, when persuaded to do so. He did not want anymore anaesthesia and just prescribed antibiotics and steroids when the old dog of 15 years of age had a large "tumour" below the right eye.
"It is true that it is very risky to anaesthesize an old dog," I said as the vet kept telling the owner not to do any more anaesthesia. "It looks very much like a carnaissal tooth abscess, based on location, " teeth. Periodontitis Grade 4. "
"Chances of survival are 50:50 in healthy old dogs," I can't give higher % as the dog has a muffled heart sound after my heart auscultation. "If the surgery is less than 15 minutes, chances are better."
"Is the dog coughing lately?" I asked the lady.
"When he lies down on one side, he coughs some white phlegm," she said. "But he is OK when standing."
Best advices
1. Blood test
2. Heart medication of 3 types
3. Antibiotics
Better chances of survival when operated on Day 5.
"The dog is likely to have no more coughing when lying down," I said. "That is the time to go under general anaesthesia and not today.
This dog looks very fit, having been given daily exercise and much love.
Grand Hyatt Singapore in 2014
Happy Memories of a Dedicated Vet with passion and drive
VETERINARY SURGEON
Dr Thein Tun Aung, James
I certify the following: Dr Aung graduated from the University of Veterinary Science, Yesin, Myanmar as a veterinary surgeon in 1987. He worked as a veterinarian in Kachin State mainly with large animals and poultry and small animals until 1991. He worked in several veterinary clinics and surgeries in Singapore from 1992 to 2012.
In Singapore, he gained vast experiences in the diagnosis and treatment of small animal medicine and surgery over the last 10 years before he started his own practice, Royal Asia Veterinary Surgery in Yangon.
The Singapore veterinary practices he worked included AMK Veterinary Surgery under Dr Thiruchelvam, The Animal Clinic, James Tan Veterinary Centre and AMK Veterinary Surgery which was sold to Mount Pleasant Veterinary Centre in 2010. In February 2012, he resigned to set up his present practice, Royal Asia Veterinary Surgery in Yangon. Working the long hours with the various practices in Singapore enabled him to learn much about the best practices and treatments offered by the different management and veterinary surgeons.
Yezin Univ graduated 1987
Kachin State vet
Singapore 1992 - 2012
Yangon 2012-
Own practice
Variety of medical and surgical cases
Blood test
X-rays
Communications
Giving back to the community
Monastery school building and library
MVA - Yezin Final Year Student lecture
Teaching his younger vets on-the-job training in a busy clinic.
Helpful volunteer in his free time - Grand Hyatt Hotel case cat. URL
- Bone in stomach and oesophagus. URL
- Caesarean section by motor bike URL
Bright future with 20 years of experience in small animal practice. acquiring the knowledge, skill and expertise the best practices of each Singapore vet clinic. Many of his peers from Myanmar do not stay long in the small animal practice in Singapore.
Rabies
Distemper
Parvovirus
Caesarean
Pyometra and stump pyometra URL
Fractures
Heart Diseases
Puppy diseases
Urethra obstruction in cats
A role model for younger vets in Yangon -
Belief, Passion, Drive, Perseverance, Focus - URL
Art market
Sight-seeing
MYANMAR LANGUAGE
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Veterinary Surgeon
Toa Payoh Vets, Singapore
www.toapayohvets.com
CASES
2. Bone in oesophagus/stomach
3. Caesarean section on a scooter
1. A needle and thread inside a cat's mouth at the Grand Hyatt Singapore
http://2010vets.blogspot.sg/2010/07/needle-and-thread-inside-cats-mouth.html
Tuesday, July 6, 2010
A needle and thread inside a cat's mouth
Going to an apartment to treat a ferocious cat with a needle and thread
inside his mouth can send shivers down a vet's spine. It is like going
to a lion's den. But Mr Hall said he could not put his cat inside a crate
and bring him to the Surgery and so I had to make a house-call on a fine
weekday evening. I drove to the Grand Hyatt in less than 15 minutes and
such prompt attendance impressed Mr Hall. I parked outside the hotel
after being given permission to do so as I told the valet I was treating
Mr Hall's cat.
In the semi-darkened glowing lights of the lobby,
I met my two assistants, Mr Thein Tun Aung and Mr Saw Htet at the lobby. The
receptionist in smart black jackets and well groomed ushered us into a
lift and took us up to Mr Hall's apartment.
I knew what to do as I
am an old vet and would finish the job in 20 minutes. But it would be
best for my two assistants to get hands-on experience as they wanted to
open their own practice in Myanmar next year. They are veterinarians if
they practise in Myanmar but they are veterinary assistants when they work in Singapore.
PREPARATION FOR THE BATTLE
"What
will you bring to this case?" I had phoned Mr Aung earlier. "Domitor
and swabs to stop bleeding," he said. I packed my bag with Domitor,
Antisedan, Xylazine, Ketamine, antibitoics, swabs, a pair of forceps,
needles 21G and one-ml syringes. I forgot to pack 23G needles for use
in the femoral vein injection as the cat has fine veins which bled in
front of the Mrs Hall when Antisedan was injected IV using the bigger
21G needle. Experience is usually gathered after a case handled.
AT THE SCENE
Mr
Aung is a hands-on man and he went for the cat. This cat was crouched
tightly inside the master bathroom between the water closet and the
wall. Mr Aung grabbed the scruff and got him out and placed him on the
cat's white towel on the bed in the master bedroom. I had not briefed my
assistants and was therefore surprised.
"It is best to prepare
the sedative before catching the cat," I said to Mr Aung. "Look at the
cat to estimate his weight and prepare the correct dose."
The cat
was displeased and pawed Mr Aung vigorously. Mr Aung released him. The
cat bounced off the bed and went under the master bed, exactly in the
middle of the sanctuary. There was a moment of indecision as Mr and Mrs
Hall and I did not know what to do.
"Maybe Mrs Hall should go under
the bed to get the cat out," I said like a General who barked orders from
the safety of the army headquarters far away from the front line. Nobody
moved.
"Let's lift up the bed," Mr Hall suggested intelligently.
Mr Hall and my two assistants lifted up one end. I helped. It was
surprisingly a very light bed but there were four of us. Mrs Hall looked
on.
Being exposed, the cat sprang to hide behind the day
curtains. The room has two sets of curtains. The day curtains are the
translucent type. Mr Aung walked quickly towards the curtains to make
friends with the cat. What he does normally is to talk to the cat and
slowly let the cat (or dog) get used to the smell of his hand. The cat
was ready to scratch him as he had scratched Mr Hall's hand a few times
when Mr Hall tried to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare
the sedative first," I said to Mr Aung. That would be what I would do
before touching the cat. I estimated the cat to weigh 3 kg. Though he
was adopted as a local cat, he certainly was bigger and fatter than the
stray cats we see around the neighbourhood. Mr Aung got 0.1 ml Domitor
and 0.1 ml Ketamine in one syringe and gave it to me. He realised that
this cat would never accept an IV injection. IV injections at the
Surgery could be done because the cat would be in foreign territory and
would not be so ferocious usually. Here, the cat was on home ground.
FRONTLINE
Being
a hands-on man, Mr Aung walked swiftly to the curtains and in one
speedy grab, the cat's scruff was lifted up. He placed the cat on the
white blanket on the master bed. I was ready and in less than one
second, I had injected the cat's backside muscle with 0.2 ml IM of the
combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It
is always safe to under-dose a frightened cat. I knew the dose was
insufficient. For the next 5 minutes, the cat ambled out of the master
bedroom, dashed across the living cum dining room with the open concept
kitchen and disappeared into Bedroom 2 at the other end of this
apartment. Another 5 minutes passed. The cat was as fresh as a daisy.
REINFORCEMENTS
In
a losing battle, the commander must call for reinforcements. "Give the
cat Domitor IV," Mr Aung proposed catching the cat as he was one never
afraid of getting cat scratches. "All three of us are veterans with cat
scars on our hands" I had said to assure Mr Hall who must be wondering
what was going on. The sedative seemed to be dud. A dud missile that
fell and did not explode.
CAUTION
Soldiers could shock and
awe in battle with more bombings to kill the enemies. But this is a cat
that must be alive at the end of the house-call. "Better not to give
another sedative," I advised Mr Aung. "The cat may react and die. Just
wrap the cat inside a towel with his head sticking out. That would be
safer. The cat would be sedated slightly by now. 15 minutes had passed."
I asked Mr Saw to take the white towel and he went to the bedroom to
get the cat for me. I could do everything myself but my assistants would
never learn.
SUICIDE BOMBER ATTACK
Mr Aung went inside
Bedroom 2 to risk his hands and got the cat by the scruff of the neck.
Mr Hall and Mr Saw and possibly Mrs Hall were inside Bedroom 2. As the
room was small, I stood outside the door to supervise. Like those
consultants who talk but no action.
While Mr Aung was holding the
cat for Mr Saw to wrap the towel around, the second cat, white with
grey patches suddenly leapt up to claw either Mr Aung or the cat. I just
could not believe this suicide bomber attack from the friendly troop.
This attacking cat hissed and swung his paws widely. He leapt up and
gravity pulled him down. From my point of view, he was attacking Mr
Aung.
In cat attacks, it is wise not to interfere. Water hosing
would be ideal but not inside the apartment. Mr Hall managed to get the
attacker out of the room. He slinked outside the room and would not go
away. He was just so furious. Was it the attention the other cat was
getting? Mr Hall said to me: "This cat is very protective and was
protecting me." Well, next time, no other cats should be present.
The
next day, I noted that Mr Saw's left hand had two cat scratches too
when we were taking blood from a dog. So, Mr Saw had suffered.
ACTION
After
wrapping the cat in the towel, the cat seemed quiet. I said to Mr Saw:
"Put the cat on this kitchen counter." I gave Mr Aung the forceps from
my bag. He opened the cat's mouth. "There's the needle stuck in the hard
palate!" he showed the culprit. I took some pictures with a zoom lens
inappropriately. The zoom would not work at first until I stepped back
further. Mr Aung took the needle out. A black thread with slimy saliva
was attached to the end of the needle. I should have put the needle onto
the tissue paper as Mr Hall seemed not too pleased when I placed it
directly onto the kitchen counter. Mrs Hall took away the needle. I
opened the cat's mouth to give a final check. "No injuries or ulcers," I
said to Mr Hall.
ANTIDOTE
"Should give Antisedan," Mr Aung
advised me. "Antisedan is an antidote," I said to Mr Hall. "The cat will
wake up immediately. If Antisedan is not given, he would wake up fully
over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr Hall said.
"There
is a small risk that the cat may not wake up. A very small risk.
Antisedan injection ensures that the cat's heart and lung systems are
back to normal promptly."
The cat inside the towel hissed and
hissed. Mr Hall agreed to the Antisedan injection. This was given via
the cat's femoral vein at 0.1 ml IV. "Take the cat out of the towel and
put him on the floor," I said to Mr Saw rather urgently. Mr Saw could
not understand what I mean. In any case, he had no time to think. The
cat looked up, assessed his situation well. The cat crawled out of the
loosened towel, stood on the counter and in one spring, he leapt onto
the floor and disappeared into the sanctuary of the master bedroom.
HAPPY ENDING
Everybody
was happy that this cat was back to normal. Mr Hall asked me for my
namecard as he was surprised that I was prompt in answering his house
call. Mrs Hall would be more careful with her sewing needles and threads
from now on.
CONCLUSION
Never give the frightened cat a
second dose of sedatives as the cat may just die. This case took three
times as long but the cat was alive and that was what every owner wants.
It is best to treat such cases at the Surgery. Normally I don't even
want to do it at the house as there are so many complications and
surprises. Besides, it takes a longer time.
Birth control injections for women used for female cats
Birth control injections
Two uterine horns filled with yellow pus
FINAL VIDEOS
Video in the English language
Video in the Myanmar language
---------------------------------------------------------------------------------------------------
A proposed script for the "A Cat in Myanmar Has Pyometra" is as follows:
Scene of Yangon's downtown flats, traffic jam and sprawling suburban area.
Much more suburban areas in Yangon with farms and houses. 2 minutes of VIDEOS
Video of Singapore's apartments and apartments 2 minutes of VIDEOS
Pyometra - pus in the womb
cystic endometrial hyperplasia
bacterial infections
vaginal discharge - pus
SOLUTIONS TO CATERWAULING IN YANGON COMPARED TO SINGAPORE
Caterwauling noise nuisance urbanised Singapore
bigger area in Yangon
INCIDENCE OF PYOMETRA IN YANGON COMPARED TO SINGAPORE
Rare in Singapore cats as cat owners spay their home cats. No vets give the birth control injections as a solution to caterwauling.
Common in Yangon cats
Birth control Synthetic progesterone injections for caterwauling
Side effects of the use of such injections
Synthetic progesterone injections - Not given by Singapore vets and requested by cat owners.
The solution is to spay the caterwauling cats. In my over 30 years of practice in Toa Payoh Vets in Singapore, I have not seen a case of cat pyometra.
So I was quite excited in seeing such cases in Royal Asia Veterinary Surgery on visits in July 2014. I followed up this case and communicated with the cat owner.
SUBTITLES IN VIDEO
spay by Dr Aung
Dr Sing talks to owner during consultation and post-op VIDEOS SUBTITLES
LOBULATED WOMB of present case study. Show one image
Image of another cat with pyometra seen during Dr Sing's visit in June 2014
TIPS AND ADVICES
1. Be careful not to incise the full bladder when you incise the skin. Palpate for full bladder first but some vets may not do this and therefore incise the bladder accidentally.
.
Illustration of "RUB".
Dr Aung expressed the bladder to access the uterus.
2. Make a long skin incision. In my experience, a spay hook is a waste of time as a larger incision enables the vet to take out the swollen womb without the need of a hook.
VIDEO OF HOOKING
CONCLUSION
1. From a management point of view, the cheapest, convenient and most effective solution to a challenge is the best. In Myanmar cats, a birth-control injection appears to is the cheapest, convenient and most effective solution to stop the cat caterwauling. Usually it is given 3-4 monthly. In this case, the owner was happy to get an annual injection.
2. Culture of the Myanmar people. Most of them are Buddhists.
VIDEO OF UPPASANTHA PAGODA IN NAYPYITAW
Ovariohysterectomy (spaying) involves surgery to remove the ovaries and womb. This surgery may be against the Buddhist belief of causing harm to the cat. So cats are not spayed since there are anti-caterwauling injections.
HOOK - AUDIO OF CATERWAULING CATS in some HDB apartment areas.
3. Spaying leads to death. Some vets in rural areas may not advocate spays. Deaths may be due to lack of sepsis or experience and skills. So antibiotics are prescribed when there is pyometra.
FINAL VIDEOS
Video in the English language
Video in the Myanmar language
UPDATE AS AT 13 SEP 2020.
There are many new small animal practices set up over the past 10 years. Spaying of the female cat is acceptable and the use of synthetic progesterone as birth control is not so common nowadays. Hence, there are less incidence of pyometra in the female cat as compared to 2014 when I visited Dr Thein Tun Aung at Royal Asia Veterinary Surgery.
I think my 15year old JRT has fistula with discharge fromcarnaissal tooth abscess on his right cheek.
Can I check whether it is advisable to do scaling at this age? GA or sedation?
How much is the cost of blood test, scaling,extraction and etc?
Look forward to your reply soonest.
many thanks
------------------------------------------
Hi
Apologies, should be 13year old.
thanks
------------------------------------------
I am Dr Sing Kong Yuen from Toa Payoh Vets.
In reply:
I like to know:
1. How to know if it's dental issues?
DENTAL DISEASES ARE PERIODONTAL DISEASE as described by you as loose and dropping teeth.
2. I did see a bruise on his tongue, dunno if he bites it or ulcer? No pain on him though
HARD TO SAY WHAT IS THE CAUSE
3. Is there any dental xray available?
YES, AT SOME CLINICS. NOT AT TOA PAYOH VETS
4. Will he die if need to go under GA for teeth extraction or scaling? He had 2 mitral valves torn so his heart is very bad.
It is highly risky to anaesthesize your old and sick dog to take out the bad teeth. If you are willing to take the risk, then please let me know. He looks very thin and the risks are much higher.