Monday, May 10, 2010

A forgetful intern?

7. A forgetful veterinary intern?
Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.

"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.

Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."

"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.

This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.

Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?

As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."

I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).

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