Tuesday, May 31, 2011

461. Beauty in veterinary medicine

"You didn't reply to my sms," the pet shop lady said. "So, I phoned your surgery and made an appointment for vaccination and micro-chipping."

"I was taking the real estate examination," I replied. "In any case, there is a vet available for you."

"Is she pretty?" she asked. "I did not see her as I sent my staff to your surgery. She has a sweet voice as she was the one answering my phone call."

We had known each other for years through my extension visits to her pet shops. She had agonised over competition from one Mediacorps starlet. "Don't worry," I said. "The starlet is famous but you are as good looking as her." Well, she got her man and that was what counted in love. I asked to attend her baby's first month and she invited me. Still I was much surprised by her question about whether my associate vet is eye candy or not.

"Beauty is in the eyes of the beholder," I said. "In my real estate class (my REA exams were in May 25, 26, 27, 2011), there were said to be four pretty ones according to one classmate. Another one said it was the girl with hair on her shoulders. Another said the thin one who could have been an air stewardess. Another who came to class with a different handbag every time.

Looks are still important in veterinary medicine and human medicine. We inherit our looks but we can make first impressions count. Once I went to a Development Bank of Singapore-appointed lawyer to sign some legal documents. The young lady lawyer in the HDB Hub office was wearing sandals to meet me. Was that good first impressions? I don't think so.

Once, my receptionist James and my assistant Mr Saw wore slippers while at work on a Saturday, knowing that I would not be on duty. I reprimanded them as my associate vet on duty did not think it was a big deal.

Many young adult professionals, in my observations of two young vets, seem to think that they can wear sandals to work since they are the boss in the practice. Their assistants and interns adopt similar footwear. It is time to change such mindset as "branding" of a corporation and positioning in the minds of the consumer are now much more important in this highly competitive world.

A vet may be a good one but if he or she can't be bothered to present a good first impressions, there evokes a doubt in some clients as to whether he or she can be meticulous in veterinary surgery.

Monday, May 30, 2011

460. Cryptorchidsim in a poodle - unstable isoflurane anaesthesia

"Anaesthesia for a young dog is very safe," I told the mother and young adult daughter as the mum spoke about the dog dying on the operating table. "No young normal dogs should die on the operating table unless they have some heart defects or allergies or the vet has some mistakes in his procedures. A complete blood test ought to be done but this is optional as I give the owners a choice since there will be a charge of $150 payable. Young normal dogs usually are OK without the need of a blood test."

The mother said: "My dog's blood test could not be taken by another vet. I would like to get a blood test done."

This poodle had cryptorchidism. It is a rare condition in which the testicles do not descend into the scrotum. They were present as two large lumps of 1.5 x 1.0 cm below the skin, some distance from the scrotum and to the side of the penis. These undescended testicles have a high likelihood to become cancerous and so it was wise of the owner to get them removed since the male poodle would not be used for breeding.

On May 30, 2011, the dog came in for surgery. The mum was waiting in the reception room till the dog got operated. "Please go home," I said. "I prefer to have peace of mind, without the owner sitting outside waiting for the surgery to be completed." The maid of another owner whose cat came in for removal of claws (scratched her expensive furniture and her boy's face for the last 2 years) was also sitting on the chair, waiting.

I find that it is best that owners go home first as surgeries and anaesthesia need full attention, without the owners being around to enquire the status. Distracting staff and the vet.

The poodle was sedated with xylazine 0.2 ml IM. My assistant Mr Min who replaced the experienced Mr Saw (who had worked for 3 years with me) needed much coaching as regards monitoring of anaesthesia.

This poodle seemed to have difficulty in being fully anaesthesized. At one time, his tongue was bright red and dry. I stopped the gas and let the dog stabilise to a normal pink tongue colour.

"The dog stops breathing," he commented as I was about to operate. "I get the respiratory stimulant injection."

"By the time the injection is drawn out from the bottle and given, it will be too late," I said to Mr Min. He had never encountered respiratory emergencies before in his past years of work with vets in Malaysia and Myanmar.

I just disconnected the tube, cardiac massage 3 times, blew in air into the lungs. Repeated another 5 times. The dog started to breathe. This dog had difficulty in being anaesthesized by isoflurane. The vet must know what to do.

1. Re-stabilise by giving isoflurane by mask if coughing reflexes occur and the dog is getting up. Pull out the tube and use mask to knock down the dog, at 5% isoflurane dose for around 2 minutes, to effect. Monitor eyelids, eyeball rotation and observe the breathing rate and tongue colour.
2. Intubate
3. Isoflurane at 3%.
4. Be patient. Don't use 5% if possible.

The dog was neutered. Dental scaling done after that. I syringe the wax off the ear canal esp. the left ear. Went home to a happy mother and child without problems.

Around 1% of dogs will have this anaesthetic instability problem As to the cause, it is hard to say.

Sunday, May 29, 2011

459. Z-Plasty Surgery

"More than 2 months had passed," I said. "It will take a very long time for the wound to heal using daily nursing care and bandaging," I advised a gentleman who did not want to bring the dog back to the factory as the factory space is greasy and oily.

This dog was not under my case and so I did not interfere with the management. Sometimes, the owner has given specific instructions or wishes to impose his or her own instructions on how to manage the dog bite wounds owing to economic considerations. This was not my case as I would have done a Z-plasty if the owner could permit it, at the start of the laceration injury.

Still, I am very concerned about this dog's welfare since his wound is in a high tension area and has not granulated after two months. As each vet treats a case differently according to his or her judgment and the owner's financial consideration, it is hard for the vet sometimes to derive an excellent outcome.

Two months have passed, yet the dog bite laceration wound has not closed. A Z-plasty performed at the beginning may or may not be effective and would be more costly. Still, I would strongly advise the Z-plasty at the start. Due to the high tension and mobile area of the front leg, some thoughts on how to execute the "Z" mark needs to be done.

The image above shows one approach to get the "Z" suture pattern.

Another approach is briefly as follows. Consider the wound as a vertical line. Midpoint between the vertical line as a reference guide, use the marker pen to put a "cross (X)" e.g. 5 inches horizontally to the right edge of X. Repeat the procedure horizontally to the left side of the left edge of X.

Make a skin incision from X downwards, to the bottom of the vertical line for the right side, creating a triangular flap. For the left side, make a skin incision from X upwards, creating a triangular flap. When viewed from the front, the cuts look like an "N" unlike the first approach.

Then rotate the two flaps. The final suture pattern will be a horizontal line. In theory, it is easy. In practice, it is difficult and so, daily nursing and cleaning could be the option.

Chemical cauterisation using KMnO4 now may be the most cost-effective solution. The dog can't be kept in the factory for a few months till the granulation tissue takes effect and the dog does not lick the wound.
2 months had passed. I advise that the wound by cauterised chemically as it would be relatively costly to do the Z-plasty without a guarantee that the wound will heal normally. This is because the location of the wound is in a high tension mobile skin area.

At the end of the day, much depends on the economics and the recommendation of the vet. Many older owners in the heartland practices, in my opinion, are not too keen on surgery and anaesthesia, due to the higher costs involved and a no-guarantee of successful outcome as in this case. But sometimes, it is penny wise, pound foolish. A younger sophisticated generation may have a different mindset. Still owner education as the illustration in my images will be useful. So far, no practising vet has produced veterinary medical illustrations of common surgeries or that I cannot find a handy book. The medical doctors do have some books on specific parts of the anatomy e.g. piles surgery. I guess there is no income incentive to produce such a book which could also be expensive to buy. However, the internet does help a lot to produce surgery educational videos and illustrations.

458. My White Knights In Shining Armour

Two muscled young men are hired by the King to protect The Damsel In Distress from the Park's Tulip Monster. The monster is 100 feet tall and has exploding biceps and triceps. It lurks inside the tulips of the Araluen Botanic Park in Perth, Australia

Photography Tips

1. Bright sunlight at around 10 am - 11 am always makes the picture vibrant.
2. Focus on the eyes (spectacles) on the young man on the right.
3. As the parties are moving, you need to have steady hands. Use a camera with an image stabiliser.
4. Wait till the 3 parties walk into the path illuminated by the sunlight and click.      
5. Continuous shooting mode is best but this one was captured with one click.
6. Zoom close so that there will be no distraction from cars.
7. The pectoral muscles of the young men. 

There is the DL-Timberland nature photography contest
Theme of the contest: "Outdoors: Where Relationships Are Made"

To qualify, the participants must include the idea of relationships into their photo composition and caption, whether their shot is of a landscape, wild animal or a close-up of a plant. The winner gets $1,000 cash, $1,000 in Timberland vouchers for its latest Earthkeepers line of outdoor gear plus an Olympus Pen E-PL1 camera kit.

If any of the 3 contest winners is a DL Facebook fan, the winner will receive an extra $500 in cash plus $500 in Timberland vouchers.

Check out details in www.timberland.com.sg/photo. Contest starts May 18, 2011 and ends on midnight of June 30, 2011.

This picture may fit the theme. It is outdoors. Associated with nature (Araluen Botanic Park, Perth). Relationships are made when the family bond in visiting the Araluen Botanic Park in Perth during the season when thousands of tulips bloom.

There seems to be something missing. Where are the tulips? I doubt this photo will make it to the top 3, but who knows?

Readers who love reading English Romance Novels and King Arthur may appreciate why I name the picture "My White Knights In Shining Armour"

Friday, May 27, 2011

457. Tips for passing the CEA REA examinations

May 28, 2011 4.45am

8 hours after my Paper 3 Examination - Real Estate Agency Practice and Regulations (around 30 candidates, mostly from my class). The day before, Paper 2 - Real Estate Assets and Markets (over 100 candidates). Paper 1 - Legal Famework of Real Estate (around 30 candidates).

I would like to share my REA Examination experiences which may be useful to some readers.

1. There are two examinations for almost all people wanting to be approved to work in the real estate in Singapore. One is called RES which is said to be simpler (for salesperson) and one is called REA (3 papers must be passed aone sitting).

2. The Council For Estate Agencies (CEA) has powers to impose a fine of at least $75,000 any illegal housing agent (now called 'salespersons") or agency owners (which now must have a CEA-approved KEO - Key Executive Officer).

3. Profile of the REA examination candidate. Said to be more mature persons (over 30 years of age). I had supper with 7 classmates till almost mid-night at McDonald's yesterday and I believe they are representative of the applicants.

3.1. Chinese. 5 men (4 married, 1 being a single over 35 years old), 2 women (married). I shall call them M1 (single), M2,M3,M4,M5 & W1,W2.

3.2. Working in the real estate agency for at least 3 years and has 30 transactions to qualify as a KEO - 3/7. Of the 3 people, 2/3 are given provisional REA licences till Dec 31, 2011 and are required to pass the REA exam to be licensed. These are M4, M5(myself) and W1.

M5(myself) and W1 failed to renew our annual housing agency licence issued by the IRAS because the IRAS had implemented an equivalent policy of "caveat emptor". In caveat emptor = "buyer beware" (examination question in paper 3), the buyer is responsible for what he buys. Since our faults were not due only to not renewing the licence yearly, CEA requires us to pass the REA examinations by Dec 31, 2011 or else thrown to the wolves.
1/3 is a partner in his realty firm (2 partners). His partner is CEA approved KEO. CEA demands that he sit for the REA examination. I call him M3.


lst person - M1 - Late 40s. A single man with a face full of stresses is in the sunset industry of chemical trading agent as a one-man-operation. The internet has considerably reduced his business as clients can source direct. He was advised by the lady to take the REA examination. Now he discovers that he still needs 3 years and 30 transactions even if he passes the REA exam. However, the REA qualification is valid only for 2 years. That means he can't be the KEO, in theory since he needs to work in the real estate legally managing a team of salespersons for 3 years. He can't practise as a realtor unless he sits for the CES exam to become qualified as a salesperson under the Estate Agency Act 2010. Therefore, he was given incorrect advice (his classmates tell him about vicarious liability for the owner of the training agency and sue to get back his money!).

2nd person - M2 - mid 30s, is a marketing communications consultant and lecturer who sells boats as a sideline.

3rd person - M3 - mid 50s, the partner in the realty firm given the provisional REA licence.

4th person - M4 - mid 30s, is in the fund-management industry. Extrovert with an idea of forming a consortium amongst us to do something.
5th person - M5 - myself - over the hill at 60. A director of a realty firm given the provisional REA licence practising as a veterinarian.

6th person - W1 - slim, petite, fair complexion, friendly and assured. Closely cropped hair-style. Given the provisional REA licence. Now working from home, being granted by the HDB promptly, a Home Office licence. The married woman now has his home office (approved by the HDB, address changed notified to the CEA within 14 days). "Did you install the smoke detector in the ceiling (not practical in the HDB flat) and buy the fire-extinguisher?" I asked as I had studied this topic for the exam. She did. "The smoke detector is the portable type," she said. "Some of the government the policies are rather silly. I need to buy a 2-kg fire extingisher. My office is just my study table in the living room."

7th person - W2 - confident, friendly impression, motherly. A salesperson for a realty firm with 3,000 salespersons. Manages 2 salespersons.

Thanks to the CEA, I get to know more about my classmates and their aspirations. All 7 drive, except for M1. I gave him a lift home for the past 2 nights to Tampines as it was already 10 pm after the exam and he was really stressed out. Even the office girl invigilating part-time in the school noted his demeanour and told me.


I asked my 6 classmates who had attempted the exam and what was the answer for the amount of monthly mortgage payments? My answer was $447 or some figure around $447. Two of my other classmates (not the 6 during supper) had mentioned around $800 and $1,000 respectively.

M1 said he had miscalculated as he had deducted the $30,000 CPF housing grant, forgetting that the Buyer (a couple) in the exam question was buying a new HDB BTO flat for the first time. When you buy new HDB flats, you don't get the CPF housing grant. Only when you buy a resale HDB flat in the open market and a new Executive Condo (managed by the HDB after construction by a private developer and therefore EC are not HDB flats). So many confusions. M1 had around 10 minutes to answer. I had around 15 minutes. The question was for 30 minutes and worth 20 marks. Once you deduct $30,000 from the quantum of loan, you are in deep trouble. My advice is to do at least 50 of such calculations at home for different scenarios and schemes of HDB housing loans but we never did.

The question is as follows, if I can still recall.

Couple earning $6,000
Got a new HDB BTO flat at $350,000.
Given a concessionary loan. 2.6% interest for 30 years at monthly rest
Used CPF to pay the 1.5% stamp fees and legal fees during booking.
After 2 years, they get the keys to their flat.
They have $68,000 in the CPF.

1. What is the amount of downpayment during booking?
I wrote 5% of the purchase price. This is the tricky part since HDB borrowers are given 90% of the purchase price or valuation whichever is lower and the valuation price is not stated. I did not qualify that purchase price is assumed to be valuation.

2. What is the amount of to be paid when the keys are collected.
I wrote 5% of the purchase price on collection of keys. Am I correct? I had little time to think as I had 5 minutes left. If keys are collected, sales is completed. Therefore the amount to be paid should be the balance in cash. It would be more detailed calculation. Should I state amount less $5,000 option fees, less CPF $68,000, less paid stamp and legal fees?

I had no time to think as the next parts were how much is the monthly mortgage and how much is the CPF used to service the monthly payments.

To figure out the monthly mortgage, with no past practices, I used 2.6% X HDB loan approved ($350,000 - stamp & legal fees - CPF $68,000) x 30 years divided by 360 months and arrived at around $400/month. This is the time-taking part since I had never done this calculation during my 70 hours of lectures and my lecturer had not thought of making us do such calculations too. Who would have thought that the examiner would test us on how to calculate the monthly mortgage payments?

How about the payment of the first 5% at booking and another 5% at the collection of keys? I did not include these 10% inside the above calculation to deduct from the $350,000. So, I might have got the wrong answer. What is interest at monthly rest? Is this a red herring?

So, it may be wiser not to attempt such a question. But I had no choice as this was the 5th question which I thought I had some chances of getting 10/20 marks. Now, it seems I may be getting correct answers for the 5% during booking and 5% during key collection. That may be 4/20 marks. So, never attempt such questions unless you are in active work in the HDB sales.

As for the amount of CPF the couple will pay monthly to service the loan, I did not know how to calculate. There was something I remember having read (Mr Mah Bow Tan's example of a sale of a 4-room HDB flat in the Straits Times had given the 23% but I did not recall. He did mention about the 5% for booking and key collection as under the "staggered payment scheme" - not lectured.

According to M1, it should be 23% of the couple's income of $6,000.
In conclusion, this type of question can be killers. Therefore, don't attempt it if you have a choice since you can get zero marks if you miscalculate as in the case of M1 who had deducted $30,000 as the CPF housing grant which is never given to buyers of NEW HDB flat!

Thursday, May 26, 2011

456. CPF's Minimum Sum Scheme - poorly presently to members of the public

I am studying the CPF Minimun Sum Scheme for those retiring after 55 years old for my REA examination today and looked up the CPF Board's example. Certainly it is extremely confusing as the CPF education does NOT tell how it gets the $61,500. I figure out after a long time. If the exam question comes out today, I may be able to get correct answer.

Here is my sharing of knowledge to future candidates of REA and RES. See below and go to the CPF website (Minimun Sum Scheme).

My e-mail to the CPF is as follows:

Thank you. I really need the reply to Question 1 regarding the Minimum Sum where the co-owner's CPF usage is $40,000 immediately for my exam today!

The query is reproduced as follows:

1. Minimum Sum calculation example in your website. There are 3 tables but the first table shows $61,500 pledge amount up to maximum limit. I CANNOT FIGURE how you get this figure. Please ensure that you don't waste the time of the public by not revealing how you get the figure as I took over 10 minutes and still can't figure out.
2. Can retirement account for those over 554 years old be used to pay up housing loan?

The calculation from your CPF website is as follows:

HDB Valuation $300,000
Less outstanding loan $150,000
Co-owner's CPF usage is $40,000 which is <50% of the RESIDUAL VALUE. With the other 2 tables, you use RESIDUAL VALUE - Co-owner's CPF usuage. That is easy to understand. If I use the same formula, I should get $110,000. However, you state that the owner can pledge the property up to the maximum limit of $61,500. Where you get this figure is really a mystery. As a CPF education website, you should be careful and helpful.

Assume Minimum Sum after 55 years is $123,000. Is there some figures I had not factored in? Is it 50% of $123,000? If so, please say so! That figure comes to $61,500. Don't make the reader go round in circles by showing the side calculation as we can't understand many of your CPF and HDB's complex formulas, esp. those payment or co-payment or in this case, not allowed to pay, involving 50% of some figures NOT being achieved!

IN SHORT, the answer should be as follows:

If the co-owner's CPF usuage ($40,000 in this case) is less than 50% of the RESIDUAL VALUE ($150,000/2 = $75,000), THEN HE CAN PLEDGE HIS PROPERTY up to the maximum limit of 50% of the MINIMUN SUM (stated as $123,000 IN A CPF TABLE FOR JULY 1 2010 in CPF website). This is equal to $61,500.

Therefore, for a student taking examination under high stress, he gets zero marks if he uses the formula RESIDUAL VALUE - co-owner's CPF usuage AS THIS amounts to $110,000.

However, if the co-owner's CPF usuage is $80,000 (using same $300,000 valuation price, but now the outstanding loan is $200,000. This means the RESIDUAL VALUE IS $300,000 - $200,000 = $100,000).

In this scenario, the owner can pledge his property up to the maximum limit of $20,000 (shown in CPF website, table 2 where RESIDUAL VALUE - Co-owner's CPF usage or $100,000 -$80,000 = $20,000). This is because the CPF usuage is more than 50% of the RESIDUAL VALUE.
There if you give the answer as $20,000, you can full marks. But you get zero marks if you have got the first part incorrect. That means you just pass your examination if there are 2 parts. If there is only one part and you do the first part, and give the answer as $75,000, you may even fail the question as the correct answer is $61,500 (50% of $123,000)!

How many of the readers can understand what I am writing about?

There is another Real Estate Finance and Analysis - CPF Approved Housing Scheme - called AHWL. This involves 120% of Valuation Limit, current minimun sum of $123,000 (of which the cash component is $61,500). I better not attempt even to study this topic as it is even more complex! However it is part of the syllabus.

Wednesday, May 25, 2011

455. Cats and rodents in the neighourhood. Legal remedies?

May 26, 2011. 4.30 am
10 hours after sitting for the Real Estate Agency (REA) May 2011 Examination
lst Paper Legal Framework of Real Estate

Around 20 candidates sat for this exam. I estimated that at least 10 of my classmates did not attempt. CEA had mandated that all 3 papers must be passed at one sitting. I had paid $1,400 for the course of over 70 hours and spent countless hours studying. I had to choose 5 out of 8 questions at 20 marks/question. It was more like an examination for law students rather than real estate salespersons and key executive officers.

I knew I would fail 3/8 questions as they were not fully covered during lectures. So, I had no choice. Of the 5, I had difficulty in answering at least 1 regarding noise nuisance scenarios (Question 1).

Question 1 - one section. Cats, rodents, smoke in the open-air restaurant affected the neighbourhood. What are the legal remedies? It is a real life scenario encountered in Singapore.

My answer briefly - I forgot to mention that the cats were stray cats. Legal remedies? Take out civil suit - law of tort - personal health affected. Public health. Call in the regulatory authorities to enforce regulations? What regulations I could not say. Call in the AVA (Agri-Food Veterinary Authority for rodent control - I forgot to write about the control of stray cats which is under some AVA's regulation - is rodent control under the AVA or NEA?), the NEA (National Environmental Agency - smoke pollution). Public likely to be health affected (rodents) but what is the legal remedy?

In the same question, the other section asked about legal remedies for a condo's floodlights and noise affect a resident's sleep. One resident had a nervous breakdown. Another question asked about cafe with noisy customers and music. I think I would fail this question as I could not state the laws properly. Mainly civil suit and injunction. Not good enough.

Question 2.
A sale of a condo vacated since 1 January 2009 has been concluded. I represented Seller who works in Shanghai. What are my 2 duties as her housing agent? What 2 advices to her about her tax liabilities? What 2 concessions she would get? What would I advise the Buyer?

Answer: Briefly agent's two duty of care are:
1. Ensure that the contract is valid (offer and acceptance). I would go to Shanghai or send by Fedex/UPS registered letter for Seller to sign the Sales and Purchase Agreement if she had not signed, since she was not in Singapore. I had earlier met a realtor friend who just did that for a China Buyer who had paid for the Singapore property and he flew to Guangzhou to get him to sign the Sales & Purchase Agreement and then gave back to the Singapore lawyer. But is this answer acceptable since the "sales was concluded". This is the tricky part of the question.

2. 2nd duty. To act honestly in the interest of the Seller. That meant not receiving secret commissions from the Buyer by telling the Seller that she had got a purchase price which was lower due to my being corrupted. This does not seem to be a good answer. To account for monies received? But her lawyers are handling her case and all payments. Should have mentioned Approved banks now receive the conveyance money, not lawyers. No time to think.

3. Two tax liabilities of Seller.

Property tax of 10% for non-owner occupied condo. Had she paid? Her lawyers would take care of that. IRAS would have imposed penalties or put a charge on her condo or sold it off if she had not paid property tax. I forgot to mention IRAS putting an encumbrance of a charge on property tax on the title for owners not paying property tax. This might give me some marks.

Sellers' Stamp Duty (16,12,8,4% of transaction price for the respective 1, 2, 3 and 4 years after purchase). But her SSD depended on which year she had purchased the condo. Since the condo was vacated in 1 Jan 2009, it would be 3rd-4th year assuming she bought in 1 Jan 2009 and it is May 2011 now. So, SSD should be 8%. If she bought in 1 Jan 2006 (i.e. at least 5 years earlier), I said the SSD would be the normal 3% of sales price + $5,400. Quite a tricky question. Fortunately I remember my 16, 12, 8 and 4% figures). My classmate wrote about Goods and Service Tax as being one of the tax liabilities after striking out his SSD answer. But I told him that sales of residential properties are not subject to GST. Or is it if the Seller is a GST taxable person as he assumed her to be one?

Her two concessions. I could only think of one. Get a refund of property tax since her condo was vacant for 2 years. If she had tried to get a tenant but failed to do so while asking for reasonable rentals. Lodge an application with the IRAS within 30 days of the sales and purchase agreement being completed? No. It should be after one year of vacancy.

Annual value concession? No rental for 2 years. Therefore annual value should be lower. Apply to the IRAS for review. I doubt this is the correct answer for the 2nd concession. Income tax?

Question 3. Land Acquisition Act. What was the main legal issue and had it been resolved? This was the question I had no choice but to pick it up since this was the 5th question I could answer. However I had not studied the 4 occasions (years when new amendments were introduced, according to my classmate when the government introduced measures to resolve the unhappiness of the acquired property owners being paid below market value for their properties. I could remember reading in the newspapers about the unhappiness some 20 years ago and so I said the main legal issue was being paid below market value. Was it resolved? Well, I could not specify the year (1970?) when the government agreed to pay market rates for properties acquired since I did not read the notes and my lecturer did not go show in his lecture slides this historical aspect. But all facts are in his notes and I just did not read this part!

Who were the 4 "interested persons" as regards the Land Acquisition Act? My classmate said they were the owner, landlord and tenant. Well, I wrote they were the HDB, JTC, National Heritage Board and SLA. How about NEA, AVA (fish farms)? The real person who set the question of "interested person" was not kind. I believed that my lecturer did not lecture on "interested persons".

Question 4.
Two sisters inherited a bungalow. Built a 3-storey dwelling (what is a dwelling - strata-titled apartment which I forgot to assume). Both got married. The Singapore Citizen sister died in a car accident. The other sister in the USA who had renounced her citizenship claimed that the house now belongs to her. The dead sister's husband said that his wife had said everything she owned would be his.

So, what are 2 legal claims and what are 2 legal defences? One could go crazy trying to answer this question just to pass.

Was the new dwelling registered with the Land Titles Deed? Only a registered title can be produced in court as evidence of an interest in property. Was there a will? Did the Singaporean sister died testate or intestate (you need to use such legal terms to score a mark or two)?

Would her will over-ride the joint-tenancy (assuming the two sisters are joint-tenants with the survivor taking all shares)? I said it would not as I had read somewhere.

Was the ownership of the new 3-storey dwelling a tenant-in-common with both sisters owning shares? 50:50? Or unequal shares. I had no time to ruminate on legal aspects of unequal shares.

In any case, the "foreigner" sister (she had given up Singapore citizen and recent laws made her on the same status as foreigner) would inherit her shares only. She had to dispose of her shares in 2 years (it could be 5 years) or face harsh penalties since foreigners are not allowed to own landed properties (Residential Property Act).

Question 5.
What is an "indefeasible" of title and what 2 occasions when the Registrar of Titles would not permit registration of a title as being indefeasible or some closely related question.
I could answer this question and did explain the "mirror" and "curtain" aspect. Also there is the state guarantee but forgot to mention that the plaintiff would be compensated from an insurance fund if the Registrar of Titles made an error during registration causing him losses.

What is certificate of title? More questions. It would be tough to pass this examination. I hope to get 50% but passing does not mean one gets licensed and so, much depends on Paper 2 and 3 scores.

"Did anyone take the examination question paper?" one young man asked my group of 5 candidates who were smoking. We did not. Life is getting harder and harder for housing agents who are now supposed to be giving legal advice when they are supposed to refer clients to the lawyers to do so to avoid misrepresentations and estoppels (topic of estoppels studied hard but no luck).

Tuesday, May 24, 2011

454. HDB changes the rules of the games frequently

Singapore Watch to me
show details 8:38 AM (23 hours ago)

There is a new comment on the post "How to make HDB housing affordable (Part 2)".

Author: Justina
Hi David, thanks for your feedback!

1. I totally agree with you that some families need to rent out a room should their breadwinner lose their job or should they need to supplement their income. Just to clarify, I'm only suggesting a ban on the subletting of whole unit for type B flat, and not individual rooms. That would distinguish them from current flats, where after the 5 year MOP, they can apply to sublet the entire apartment out.

2. Unless my understanding of HDB grants have changed, the $30k ($40k if near parents) grant is ONLY ELIGIBLE for RESALE flats and not new flats. This is because new flats are already subsidised from current market prices. Additional Housing Grants still exist for low income earners though.

3. As for cooling measures, I don't think the Government can undo the sudden rise in flat prices in the last couple of years ago. Even if flat prices stay at current prices and do not go up anymore, it is still quite pricey, for public housing.

(In comparison, a 2 bedroom 2 bath apartment in some parts of the US costs only about $75k. And these are not public housing, but fully private, with facilities).

Good luck with your test!

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You are correct in saying that the CPF Housing Grants of $30,000 and $40,000 are for new HDB flats as at May 25, 2011. HDB keeps changing the rules of the game and so we can't presume that new HDB flat design such as the one you propose will not be eligible for CPF Housing Grants (with the new Minister now having a fresh outlook) when new. Or even when sold as resale some 5 years later based on minimum occupation of 5 years as mandated as at present.

My point is that your title is "affordable HDB housing" or am I mistaken? You don't mean just affordable HDB housing when purchasing new HDB flats?

As for your prohibition of rental of the whole HDB flat after the minimum occupation period (which may be 10 years if the new Minister deems fit), why be-grudge a decent average Singaporean family of earning some honest income to cope with the high cost of living in the next 10 years?

HDB flat owners had so many restrictions some 10-20 years ago. They could not use the fully paid up HDB flat as security for overdraft or bank loan to finance their children's education overseas and so are already disadvantaged compared to non HDB-owners in the 1980s.

As HDB houses around 80-90% of the Singaporean population, your prohibition has a strong impact on the average person who just wants to ensure that his family has sufficient income for education of the children and one of the means is to monetise the HDB flat (by subletting the whole flat).

In my opinion, the heavily subsidised new HDB flat can still be more subsidised if the politicians want to make it affordable rather than making more rules to make it so much difficult for the average man to monetise his HDB flat. This is D-day today for me and thanks for pointing out my error, just in time, for Paper 1 of the CEA REA today.

Monday, May 23, 2011

453. Comment on affordable HDB housing for Singaporeans

My comments to the Singapore Watch website while my brain still retains my CEA REA lecture notes on Singapore Housing. The website is at:

May 23, 2011 (2 days before the CEA REA exam on May 25, 26, 27)

It is great to read about your ideas on how to make HDB housing affordable to first-timers. It must have taken you many hours to think and write about the subject. I presume you are an architect or related to the profession to give such a thorough presentation. As I am taking my CEA's approved REA exam in 2 days' time, I am perhaps able to comment on your proposal since I have to study everything about Singapore housing to pass all 3 subjects or repeat all 3.

My feedback on your Type B flat

1. Buyers cannot rent just because they buy Type B flats. This is tough as the Buyer's family may suffer deaths or loss of the job of the bread winner due to poor health or economic downturn.

Renting a room may help to provide income in times of financial difficulty which can't be predicted. Therefore, Type B flat buyers are forced to rent out illegally and risk HDB acquisition and fines. Nobody can predict the future and so for this reason alone, this prohibition on room rental should not be one of the restrictions.

2. My proposal is to make use of the concept of the CPF Housing Grants to make HDB flats affordable for first-timers depending on the pricing. Presently the CPF housing grants are extremely generous. $30,000 for a brand new HDB flat purchase and an additional $10,000 (making it $40,000) if the buyer lives within 2 km of parents/married children. This is subsidy for the first-timer and is present only in Singapore as I doubt any government will dish out such a large amount of cash. There is still the Additional CPF Housing Grant subsidy.

Taking an example. Assume a household income of $4,200/month per couple buying a 4-room flat with the CPF Housing Grants,(as illustrated by Mr Mah Bow Tan in one of his speeches in the Straits Times prior to polling day), the couple has no difficulty in paying the monthly instalments for the flat. Lower income groups have more grants including the Special Housing Grants introduced.

3. Property cooling measures of new HDB flat owners not allowed to buy private property till after 5 years of occupation and private property owners having to sell their private properties within 6 months of purchasing the HDB flat are excellent measures that should have been introduced 2 years before the General Elections.

These measures definitely will decrease speculation and property investments from the better off Singaporeans. This will make HDB prices more affordable, together with the Seller having to pay 16,12,8 and 4% of the purchase price if they sell their private properties within 1,2,3 and 4 years respectively, as the investors and speculators have been better controlled than in the past years.

Companies can now only borrow 50% from the bank also reduce speculations by non-individuals as these companies have the monies to flip properties before the introduction of the Seller's Stamp Duties of 16,12, 8 and 4% of the purchase price.

There are other property cooling measures which I think are effective. However, the increasing cost of living is the issue that the government may want to look into as it affects housing and food prices.

The cost of living continues to rise due to the government's inability to rein in costs. I believe each Ministry has to justify its existence (to pay its own civil servants amongst other things). It has to "recover cost" and make money. So the bureaucrats think of how to increase fees, introduce new regulatory fees of as much as $20,000/item to get a permit to import and sell some pharmaceutical goods. Therefore, the cost of living will increase, making it harder for the first-timer or those with financially difficulty to be afford to purchase HDB flats.

I hope my comments are OK with you. Keep up the good work.

452. Sunday May 22 2011's interesting cases

Bright sunshine blue sky Sunday

1. Case 1. 14-year-old Pom. The young lady came at 9.15 am as scheduled. "You know the high anaesthetic risk for old dogs?" I asked. "This could be the reason that the other vet did not want to operate and asked you to 'wait-and-see?".

She nodded her head: "She (the other vet) did say that it is highly risky as my dog is 14 years old."
I palpated the 3 cm x 3cm sized lump on the right chest. "There seem to be two lumps now," I said.

Case 2. Xylazine 0.1 ml IM was given at 9.20 am. I was about to commence anaesthesia when the owner of the Maltese with shivering came in to say that her dog still had a "swollen abdomen." I examined the dog. "No," I said. "But she has more back pain," I showed her the area of back pain in her dog by pressing and getting a response from the thoraco-lumbar area. "My advice is that the dog be confined inside a playpen for the next 3 months. If not, at least 1 month but very few Singaporean owners comply with my advice."

The dog was active and looked OK. What's the big deal? To prevent further damage to the spinal disc which could have prolapsed partially for now. But it is hard to make owners understand and so some vets just prescribe steroids, as in the case of the SGH Professsor's friend's Miniature Schnauzer.

"Can my dog take her daily walk and exercise?" the lady asked me. "No," I said. "Just go out to pee and poop, at least for 1 month."

Case 3. Soon another young lady with a heart-shaped fair face came. She had made an appointment for a second opinion on her 8-year-old Jack Russell, female, not spayed. "What happens to this area with bluish swelling?" she pointed to the high-energy dog's lower breast area. Two small hills from both mammary glands 4 and 5 on left and right.

"These could be due to the dog suckling her nipples here and causing the breast to swell with milk. The bluish colour is due to bruising from her suckling," I said. The young lady looked at me as if I was talking some nonsense. What did I mean?

I pressed one of the nipples in the bluish area. A missile of brownish discharge shot out onto my shirt. "Your dog has produced milk," I said. "She has false pregnancy." I showed her milk being produced by the other 2 mammary glands.

But her main purpose was to consult me about the abscess in the dog's elbows. Vet 1 had prescribed a cream. "Creams are ineffective," I said. "The dog just licks it off." She said: "I watch the dog for 2 hours. Every time she tries to lick, I will say 'no, no.'. I was impressed with her patience. "So what happens after 2 hours?" I asked. She sighed and shook her head. She could never beat time. So the dog just licked at the cream and the encapsulated abscesses on the elbow. "Surgical excision of such big abscesses is the only option," I said. She had also been advised to spay her dog to prevent pyometra (womb infection) later but she said the dog was too old.

Then she asked me about a globular growth above the carpus and the pad in the right foot. "What is this and what can be done?" I checked. "It is likely to be a tumour," I said. Again my advice was to excise it as it was now 5mm x 5 mm and would be easy to do so. The owner was not in agreement. So, I bundled some antibiotic medication and gave the injections and asked her to think about the surgery for the carpal tumour while it is still small in size. As for spay and the elbow abscesses, she had been given a second opinion. Maybe she needed a 3rd opinion?

Case 4. Just as I was going to operate on the 14-year-old Pom, another client came in with a large Samoyed said to be limping on and off in the front legs but appeared OK now. I had the Samoyed trotted outside at the side of the Surgery and told my intern Shirley to observe. Shirley wanted to study to be a vet after her graduation from the NUS and was working for the next 2 months. "Just listen, don't need to write much, " I said to her as she preoccupied herself writing the case being seen, as I wanted her to write reports to learn more, than just watching and forgetting.

After the trot which did not reveal limping, I got the dog inside the consultation room and got him on the table. Dr Vanessa had arrived and so I said she would collaborate me with this case as I would need to get operating soon. We got the dog on the table. The dog resisted being laid on her side and somehow we managed. I took the first examination and checked out the left forelimb. I extended and flexed the paws vigorously, then the carpus, the elbows, the shoulder joint. I abducted and adducted the shoulder vigorously. Not a whimper of pain from the dog. Somehow I sensed that the owners were worried about such a vigorous manipulation of the joints. However, this is necessary and normal joints, tendons and ligaments will not elicit pain. There was none.

"Now, it is your turn to check the right forelimb," I said to Dr Vanessa as we struggled to pin the dog down with her right side up. Dr Vanessa appeared to me to be gentler, picking up the paws to examine the inside for wounds. Each vet has his or her own method of limb examination. The dog could not be restrained and asserted her authority by getting up.

"So, is there lameness in the right leg or not?" the anxious wife in her 40s asked. "I can only confirm that the left front leg is OK since the dog will not permit any more examination!" I said. I left the case to Dr Vanessa as I had to operate the Chihuahua.

SURGERY. Careful and minimal isoflurane gas by endotracheal tube. It was bad news for the owner. Under the skin were a cluster of black grape-like lumps and more smaller ones spread further out, covering the subcutaneous tissue of around 6 cm x 4 cm. I tried to cut off all the grey "grapes" with the biggest being 4mmx4mm and sent them for histopathology. I suspected melanomas which have spread. I was frank with the lady owner: "It is bad news as the tumours have spread out like from the main cluster. Some are very small. It is not possible to remove 100% as some cannot be seen yet. Also, I can cut off the whole piece of affected skin as there will be a large hole on the chest."

The young lady closed her eyes and I could see that she was sad for her companion of 14 years. If only she had checked the dog daily and got the lump removed some months ago. Wait-and-see is NOT the advice of the vet for old dogs with tumours as some may be malignant. All dogs with tumours should be advised to be excised as vets are not gods and in this case, the wait-and-see advice was not good advice.

451. Hamster's everted cheek pouch e-mail

... to judy

show details 10:56 PM (3 hours ago)

Dear Doctor,
I have a hamster that has an everted cheek pouch. Since yesterday, her cheek pouch has been hanging outside her mouth. She seems to be in pain. Does she have to go to surgery? How much does it cost and how long does it take? I would also like to make an appointment on Wednesday, 25th May 2011 between 3 to 5 pm. Can you confirm if you are available? Please reply as soon as possible. Thank you.



Tuesday, May 22, 2011 2.04 am

I am Dr Sing from Toa Payoh Vets. Thank you for your email.

In reply, your hamster may need surgery if the everted cheek pouch cannot be put back inside the cheek, e.g. if it is infected and damaged badly. Cost is capped at the maximum of $150 for consultation, anaesthesia and surgery (longer duration as likely to be in your case). It takes around 10 minutes for surgery but with preparation and gas anaesthesia to effect, it will be around 25 minutes . I will only be available at 9.30 am on May 25, 26, 27 which are respectively Wed, Thu and Friday to operate as I will be studying and taking examinations for these 3 evenings.

Therefore, if we can't meet, you may consult Dr Vanessa Lin or Dr Teo by phoning 6254-3326 for appointment. Or you can leave the hamster with my assistant on Tuesday with instructions for my assistant that I will be attending to this hamster. I will operate at around 9.15 am on Wed, Thur or Friday for emergency cases such as yours. If you need to see me, it will be at 9.15 am for the above-mentioned dates or you can consult and get surgery done by the two associate vets.

Best wishes.

Sunday, May 22, 2011

450. An e-mail survey or a scam e-mail?

On Sun, May 22, 2011 at 5:22 PM, ...@gmail.com> wrote:

Dear Dr Sing

I am a student of Anglo-Chinese School (Independent) and as part of an Economics research essay, I am required to conduct interviews with veterinarians practicing in the local veterinary scene in order to successfully complete the report. Having done the necessary ground work, I am impressed with the work of Toa Payoh Vets and have therefore specially chosen to include your clinic in this research essay. However, if necessary, your business name may be kept anonymous.

I would greatly appreciate your time and effort in completing the attached. The survey would take no longer than 10 minutes to complete.

Thank you and looking forward to hearing from you soon.

Yours sincerely

Name Given


I presume you are really who you claim you are - a student of ACS (I) and not one of the hundreds of scam e-mails I receive daily. I am not able to help you in answering the economic questions you ask as the financial data is private and confidential. However, you are welcome to interview me for other questions at a time convenient to both parties.

Conducting a thorough realistic research means really being hands-on, getting outdoors, seeing the place and spending time and money to meet the person rather than sending an e-mail survey.

Usually, I discard such e-mail surveys as they need to be downloaded and uploaded as in your format. There is an error in your survey form. There is no such practice called Toa Payoh Veterinary Centre in Singapore.

Best wishes.

Saturday, May 21, 2011

449. Show, don't tell - Maltese shivers and has bloated "stomach"

On Saturday, May 21, 2011, I returned to the Surgery to discharge the shivering Maltese that had been hospitalised and treated for the past 2 days and is now OK. An earlier report is at:  The Maltese dog with a bloated abdomen keeps shivering. Why?

"Did the dog pass stools?" I asked my assistant Min. "No," he said. I expected this answer as I had given the dog an anti-spasmodic injection on day 1.

The dog had not I palpated the abdomen. It was not bloated but felt full and rounded. The concerned lady owner would be flying back from Hongkong today. Her mum and her brother came to get the dog home and to be briefed on what's the problem.


X-ray of distended bladder had been shown to the mum and e-mailed to the owner in Hong Kong with explanation of a urinary tract infection. The owner was far away and was worried.

"Since the dog was boarded with a family that has small children, it is possible that the dog had been injured on her back," I told the mother and son. I put the dog on the table and pressed the length of the spinal area from the neck to the tail. "Can you hear the 'cough sound' when I pressed this area (thoraco-lumbar)?" I asked. "That is the area of pain. Something could have been dropped onto her back but I cannot say this is the case. The dog could have fallen on her back. The pain would cause the shivering."

They did not hear anything. I repeated three times and reproduced that very soft sound reaction in that area. The son lowered his head nearer to the dog standing on the table. I repeated the procedure. He heard the sound.

I got a normal Shih Tzu and repeated the spinal area pressing. Not a single sound came from this dog. "A normal dog will not 'cough' in reaction to my pressing of the spinal area as he has no pain there," I convinced the mother and son.

The dog went home. She had a nasty neck skin infection (yellow flakes on red skin, right eyelid infection and both elbow skin inflamed). "My daughter had seen many vets - yeast infection but no cure after many visits to the vets. She researched the internet and does her own treatment," the mum said. The rest of the coat was thick and normal. A small amount of dandruff fell off the dog's body. I said: "The neck skin infection should be cured as the dog keeps scratching. I will say that the neck skin should be normal if treated properly." Unfortunately, some owners give up when their vet or vets failed to produce results for the skin infections and do self-treatment instead.

4. SHOW THE URINE RESULTS. Dipstick indicated bacterial infection of the urinary tract infection. The change of colour was shown to the mother earlier. Laboratory results are not in yet. Blood test report with no abnormal findings were given on discharge of the dog.

In conclusion, this dog's shivering could be due to more than one cause. The pain in the spinal area, the pain in the neck skin area and the pain in peeing from an infected bladder. If only dogs can talk.



Thursday, May 19, 2011

448. An ethical and moral dilemma when clients demanded an injection only

I had two cases in the last 2 days of clients instructing me to give an injection and some medication.

Case 1. The woman brought her dog that was not eating and passing smelly vaginal discharge for more than two weeks. I palpated the swollen abdomen and the female Spitz gave up being gentle and started to curl up her lips to warn me not to do it any more. "Just give an injection and some drugs," the woman whose son was my son's classmate instructed me. I suspected closed pyometra which is a life-threatening disease - an infection of the womb.

I still remembered a recent case of the "Vets Who Don't Spay Big Breeds" where the cross bred was euthanased due to poor prognosis. The owners were referred by their vet to a brand-name veterinary practice and could not afford the fees. Much time had been wasted and the dog was no longer standing. Kidneys became infected. As the prognosis was poor, around 40% of survival, the owner decided not to operate and instructed euthanasia. This case quite upset me for this was really a dog that could have been saved if the family vet had tried not to be a one-tracked mind, always referring big breeds to an expensive surgery when his clientele comes from a neighbourhood not in the upper-middle class of Singapore.

Now, this woman demanded an injection. I did not do it as I advised X-rays and blood tests first to aid in the diagnosis of pyometra. She phoned her husband first she said. The husband and I exchanged words over the phone. He then asked his wife to go to another vet.

Case 2. In this case, the 14-year old Shih Tzu had passed a lot of blood in the urine and had difficulty peeing. "This is usually urethral obstruction, with stones blocking the urine flow," I said. But the owner insisted on an injection and medicine and wait-and-see. Now, give what the customer wants? If not, the customer goes to the competitor.

This is the type of ethical or moral dilemma. One could milk the client by doing what she wants. Revenue generated. The dog would have to come back again as the drugs will not work. This is obvious to the vet but the client wants to save money. I know the medicine will not work and refused to obey her wishes. The woman wanted it to save on costs. So there was an impasse.

She left the Surgery to consult somebody, probably her family or husband carrying the dog with her. I had asked Dr Vanessa to handle this case, under my lead management. This was going to be a hot potato if not handled professionally. I mean, if the vet gives the injection and medication as requested, the dog will not recover. The other family members start to curse the vet for incompetence especially if the dog were to die from renal failure and infection when sent to the competitor and treated belatedly. The competitor would cover for himself or herself by saying that I should have had done the blood test and the X-ray and give proper treatment early and the dog would have been alive. Not just give an injection and some antibiotics. What an incompetent vet!

Well, to make a long story short, the owner agreed to the X-ray which I told her was not necessary if she wanted to save costs on veterinary surgery. She did not believe my diagosis of urethral obstruction and so she agreed to the X-ray. A surgery by opening the bladder and getting out the urinary stones and pushing back the stones in the penile urethra into the bladder would save some money for the cash-strapped owner.

"Suck out all urine," I said to Dr Vanessa. "Pump air into the bladder and the stones would be seen clearly." She said: "The cathether cannot be passed into the bladder, so there is a urethra obstruction." Later she told me that another catheter could pass into the bladder and she got around 10 ml of bloodied urine which would be sent for urine analysis.

The X-ray came back with around 5 stones below the os penis and more stones in the urinary bladder. "How you manage this case is up to you," I passed the case to Dr Vanessa as we work well together.

My diagnosis was correct without the need for the X-ray but X-rays would be better as it is part of evidence-based medicine. Now, what to do next in view of the old age of the dog (14 years old) and the financial situation of the owner.

447. A dog with a bloated abdomen shivers a lot

2:39 AM

Thank you for your email to Judy. I am Dr Sing in charge of your case.

Maltese, Female, Not Spayed, 5 years old.
Last estrus was reported by you to me from our tele-conversation from Hong Kong as to be around December. Your dog was boarded in a friend's place for the last 2 weeks. "Shivering" and not active were the complaints from your mum.

At around 10 am on May 19, 2011, your mum and brother brought XXX to consult me. Your mum complained that the dog was still shivering and not her usual self as she would normally "bite and tug at her pants" on seeing her.

The presenting sign was an acute abdomen. Your mum and I could see that your dog had a rounded "bloated" abdomen. The day before, a vet had treated the dog. I had phoned him and he had kindly told me about his clinical findings of abdominal pain and treatment. He had advised blood test and X-ray. According to your mum, he had advised surgery but she could not say what type of surgery was advised. She said that if surgery was needed, she would want it to be done by me.

The dog did not have a fever as she had been treated by Vet 1 the previous day. The pulse was normal but the dog was panting. The presenting sign was an acute abdomen. The abdomen was swollen. I could feel a large firm swelling of around 5 cm x 3 cm indicative of a swollen bladder. A swollen womb due to infection and pus (closed pyometra) could be present. The dog had a swollen inflamed vagina. She felt uncomfortable on abdominal palpation and started panting. Intestinal sounds were present on auscultation.

A complete blood test done today showed nothing abnormal. No increase in white cell count which might indicate pyometra. However Vet 1 had given antibiotic injection and so I would not eliminate the beginning of a pyometra.

Lateral view. A large distended bladder pushing all intestines to the front of the abdomen. The small and large intestines had several opaque lumps of around 1 cm and this would not be a problem if it was some foreign bodies as they would be passed out once the dog could urinate.

was given by Dr Vanessa at around 6 pm. At around 10 am, I had injected the dog with antibiotic and an anti-spasmodic to relax the bladder muscles. However, the dog did not urinate till after 6 pm (see below).

1. A dipstick showed a moderate amount of white blood cells present indicating a bacterial infection of the bladder. This would lead to painful urination and so the dog did not pee normally. More urine got retained and the bladder became distended causing pain and abdominal swelling.

2. As your mum came in the evening, I asked her whether the dog would run away if let free on the grass patch outside the surgery. She said no. So, I got the dog out under her supervision and gave her a urine collection bottle.

The dog peed at around 6 pm onto the grass outside the Surgery. Your mum kindly collected a full bottle of turbid urine which would be sent to a laboratory for urinalysis including a check for blood, bacteria and urinary crystals. Results will be known later today (Friday). The dog passed out some dark brown stools with oil from the enema.

The abdomen was normal. No more abdominal swelling. The dog started to paw your mum who was most happy. I spoke to you over the phone that the dog could go home. However, your mum was worried and so the dog would go home today on May 20, 2011.

A urinary tract infection based on dipstick results of white cells found in the urine and X-ray of urinary retention and clinical examination. The laboratory would confirm if urinary crystals were present as well and I would follow up with your brother soon as to what to do. The dog would go home on antibiotics and a follow up 7 days later is recommended.

I advise spaying of the dog around 4 weeks later as it is possible that a pyometra had started to develop.

Dog normal. No abdominal distension. Will go home on Sunday.

Wednesday, May 18, 2011

446. Urine-marking female dog?


Thank you for your email. As every puppy is unique, it will be most difficult for an outsider like me to know why the puppy's behaviour and reaction to your management is not what you expected. It is like parenting. Some parents produce scholars without bribery or threats, others suffer from dishonest and cheating offsprings. I will try to give you my point of view in your queries in CAPITAL LETTERS below.

2011/5/18 XXX <...@hotmail.com>

Dear Dr Sing,

I have been reading your blog entries and answers to many puppy owners and pretty much almost all of the available puppy training websites that are worth reading on the internet. I have also tried to use all the (positive reinforcement) methods and to look out for signs of my puppy needing to pee etc, but I still have a problem I need your help with. I really hope you can help me.

Please bear with me as my email is quite lengthy. I figured it'll be good to give you a clearer picture of what life is like for my Moomoo.

MM is 4+ months now, and is a cross between a Japanese Spitz and Papillon. We got her when she was only 1.5 months old and for the last 2+ months I have been trying to train her relentlessly, even watching her for hours straight just to catch her in the act.

For the first month that we brought her back, we put her in a 1x1 playpen and used a divider to partition off a part of her playpen such that 50% of the space was occupied with her pee tray, and 50% was her feeding/sleeping area (as per your advice to one of the shih tzu owners who wrote to you.) I used those house breaking aid spray to scent mark the newspapers inside the peetray as well. I would sit by her playpen and "accompany" her while waiting for her to pee.

Initially my puppy pooped correctly all the time, and peed outside of her pee tray. Within the first 2 weeks of bringing her back, she seemed to pee and poop on the pee tray 80% of the time. Some days, she even does it correctly 100%. Thereafter, as the weeks passed, instead of getting better, she seemed to pee wrongly all the time again.

AT THE END OF 2-4 WEEKS, YOUR PUPPY NEEDED MORE CLEAN AREAS BUT YOU DID NOT EXTEND HIS 'GROSS FLOOR AREA' (GFA). I am using a real estate term. It means that the living space in the playpen ought to have increased by 100% (by buying more fencing panels, so that the puppy can lie down on clean areas further away from its toilet area. This GFA gets increased so that by 8 WEEKS, there IS NO NEED TO CONFINE THE PUPPY 100%. A door or opened end of the playpen directs the puppy to the toilet area.

And the last straw came when one day she even pooped outside the pee tray, something that she almost never does.

I eventually realized, after reading through many many MANY websites, that the cause of her confusion and inability to learn the correct place to pee/poop is due to the fact that her playpen was situated on marble flooring in my living room. Marble, being porous, is like a hard sponge that absorbs the pee. So even though I cleaned the area with enzymatic cleansers, she still seemed to pee wrongly all the time. This was probably due to the fact that her pee has already seeped under the surface and hence her entire playpen area was filled with her urine smell, thus confusing her.

MAY NEED TO TRY WHITE VINEGAR:WATER AT 1 PART TO 3 PARTS to neutralise the urine smell of put NEWSPAPERS OR WHITE PAPERS AT THE BEGINNING. Some enzymatic cleansers don't work.

After 1 month+ of trying to train her to pee/poop on her peetray, to no avail, I decided to move her entire peetray into the kitchen, where the floor is tiled (making it easier to clean, and doesnt absorb urine smell as much as marble.) By now she had grown slightly bigger and I was worried that her pee tray might be too small for her, hence causing the misaims.

Hence, I bought a new & slightly bigger pee tray with raised sides and decided to start retraining her again from scratch, hoping that the new peetray with raised sides would help as she would have to STEP INTO the peetray to do her business. Attached is the picture of her playpen now, after moving it to the kitchen.


1) My puppy mostly poops inside the peetray now (and I always pick up the poop and wash the grate immediately after she poops). But her peeing still drives me mad. I need to understand why my puppy does not pee inside her pee tray? To be fair, she pees correctly mostly during the first 1-2 times after I change the peepad/newspapers inside the peetray. Thereafter she would pee outside of the peetray. I change her peepad/newspapers once to twice daily, as soon as it is too soiled.


2) In the first 1 month of potty training, whenever I catch her in the act of peeing outside of her pee tray, I would clap or make a loud "NO!" to startle her, before carrying her to the right place. Whenever I do not catch her in the act, I just say bad girl and clean up the mess. Somehow, I think it might have led to her thinking that she shouldnt pee infront of me. Nowadays, even though I watch her for 2 hours waiting for her to pee, she would hold it in. Sometimes she walks onto her pee tray and sniffs around, and I will say "Potty!" but she wouldnt do it. The moment I leave her for 30 secs, for a pee/coffee break or something, she would pee. And most of the time, it would be in the wrong place. *sigh* What should I do about this?



Whenever she pees correctly I will praise and treat her, make a fuss and she seems to understand, as she becomes excited and jumps around. I also let her out for about 15 minutes of supervised playtime if she pees correctly. This is aside from the 45min-1hour playtime she gets to run around in the garden.


3) From the many websites and case studies I read, dogs tend to not want to poop where they eat, and vice versa. However, I realised whenever I give Moomoo a nice treat like a bone which takes an hour to finish chewing on, she liked to bring her food/toy onto her peetray, and she will chew on it and play with it inside her pee tray. This seems to be an unlikely behavior for dogs. Why would she want to eat and play on her peetray?




Especially when its a new exciting treat/toy. She seems to like to bring it to her peetray, lie in it and explore the treat/toy slowly. It seems a little unhygenic. I try carrying her out of her peetray but she always runs back there. She can even eat on her peetray that she has just peed on (soiled). Why does she use her peetray for the wrong reasons, after so many months?

Actually I feel that she is a very smart dog because within 4 months she has already learnt: sit, down, paw, high5, spin, bang!, rollover, leave it, stay and walk. I would think that she would learn to pee correctly by now. But she hasnt.


Is there something I am doing wrongly? If so, what? How can I help Moomoo learn that she should pee in the peetray and not elsewhere within her playpen? I am confining her within the playpen except for the 45min-1hr playtime she gets daily, and her 15 min "reward" playtimes. I am waiting for the day she is 95-100% spot-on peeing on her pee tray and I can be confident that she will be able to know where to pee/poop, before I allow her to roam freely around the kitchen/living room area, unsupervised.

It has been almost three months since I brought her home. Most puppies would have been trained in 2 weeks. Whats wrong??



Please help.

Thank you, your reply and assistance is very very much appreciated. I swear. Really hope to hear from you soon.








Tuesday, May 17, 2011

445. Two old dogs can't stand on their hind legs

Case 1. The Shih Tzu has back ache
"I was told to come at 9 am if I want to consult you," the lady with a Shih Tzu was waiting on this fine Vesak Day. I do morning consultations and surgeries daily except Saturdays and usually I require appointments to be made.

It was 70 days ago and I was surprised to see the owner's mother. The owner was actually the daughter who is studying overseas and was diligently ensuring that her mother take good care of this old Shih Tzu. I guess the daughter grew up with this dog and loved her very much.

I took out the case card and there was a note saying that I had phoned the owner's mother to come to collect the medication for the dog with back ache problems. The dog was hunched and could not stand on her hind legs 70 days ago. I had given medication and injection and advised strict cage confinement for at least 3 months. Also, a follow up one month after the injury to the back.

"Why didn't you come to pick up the medicine to bring down inflammation for the dog for another 4 weeks?" I asked as Mr Min took out the bag of medicine from the cabinet. I checked the T/L spinal area by pressure using my forefinger and middle finger to press directly and firmly from the neck to the tail. At the spinal area around vertebra T10 to L3, the dog reacted with a soft "ha" and did so when I repeated the palpation. It was a quiet "cough" but the mother confirmed she could hear it. There was no painful whimpering on spinal palpation now. When I placed the dog's hind legs onto the edge of the table, the dog could not put her hind feet forward instantly. I showed the owner that the dog could do so with the front feet. So, the placing reflex was still absent in this dog and she has not fully recovered.

"I have put the dog inside the cage for the last 2 and a half months," the mother said. "She would like to run all over the apartment like a bullet train but I did not allow her to do so."

"The news is good," I said. "Strict cage confinement for the last 2 and a half months helps the injured disc area to heal." I did not dwell more on her missing out on the NSAID medication as she had already said she was busy working. I decide that I must implement a system of putting such reminder info on a notice board so as to give a second reminder in the interest of the dog.

"I have been busy working," the mum said. "What are the two lumps on the dog's back?"

"The two cauliflower lumps are warts," I said. "Older dogs do get warts and the cause is said to be a virus."

"What is your advice?" the mother asked me whether a 3rd small swelling nearer to the tail was the 3rd wart.

"I will advise clipping of the coat and see how many warts there are. Get all warts excised when they are small. Nobody knows exactly why warts appear. Warts appear in very young and old dogs. I had a case where the dog had over 50 warts because the vet advised that there was no need to do anything. The warts got infected and bleed and so I had removed all of them. Some do return but most had gone in this old dog."

Spinal disc injury cases need monthly follow-up by the owner for the first 3 months. Unfortunately many don't if they see the dog as improving.

There is a grey line crossed if vets phone up the owner to get the follow up done as the owner may ignore or mis-construe that the vet is soliciting for business.

CASE 2. The Miniature Schnauzer can stand up only when given steroids.

Recently, my specialist in the Singapore General Hospital phoned me about his friend's dog, a 9-year-old Miniature Schnauzer who could stand up and walk if he takes the steroidal drugs. Without the drug, the Schnauzer could not stand up.

The doctor said: "The Schnauzer could have 'mini-strokes' earlier as his head tilted to one side. Vet 1 gave the steroids and the dog improved. Then he could not get up to walk on his hind legs and Vet 1 gave steroids. The dog could walk only when he takes the drugs. What is your diagnosis?"

"Didn't Vet 1 provide the diagnosis?" I asked.
"She said there was nothing wrong with the dog," the specialist said.
I found this hard to believe and advised him to get the medical records as Vet 1 is an experienced battle-hardened vet. The dog owner was very distressed and so the specialist phoned me for a short consultation out of the blue.

"Is there any cure if the dog has spinal disc injury?" he asked.
"There is the surgical treatment," I said. "But in most cases, there is no permanent cure and the surgical treatment needs to be expertly done by an experienced vet."

I advised tapering off the steroid and stopping all steroids if the specialist's friend wanted me to examine the dog. Pain-killers mask pain and therefore there was no point in being consulted as I would not be able to locate the injured spinal area by palpation. X-rays may help. In any case, a telephone diagnosis is very risky and unprofessional and I tried not to give any diagnosis as things don't appear to be what they are on the ground as compared to telephone imaginations and conversations.

P.S. Dogs with head tilted to the side would appear to suffer from "mini-strokes" to the human medicine doctors as they equate hemi-paralysis of the face and body with strokes or mini-strokes. In dogs, the most common cause would be otitis media!

444. Wait-and-see Veterinary Advices

"Have you retired?" the mother and adult daughter had been consulting me regarding their dog over the past few years but now was attended to by Dr Vanessa. "No," I said. "I do consultations in the mornings by appointment but most of my cases will be handled by Dr Vanessa. It is good for my clients to have a younger vet to consult as I am 60 years old."

The mother looked at me with incredulous eyes as if she expected 60-year-olds to be half hunched and said: "It is good to retire as older people get diseases. Where's your son? Is he graduating and will he be helping you?"

"Yes," I said. "He will be graduating in December this year." Five years had flown by and my golden years have melted away.

I said to the pretty and tall Indian daughter with thick black eyebrows and a sharp face and probably in her late 20s. "Why are you so well dressed today on Vesak Day? In the finest silk sari and a red sash over your left shoulder?" I asked the daughter.

Mum said: "I am also dressed in new clothes. We are Hindus but we celebrate Vesak Day." I should have complimented the mum first. She was wearing a light grey dress, silky and shiny but the bright maroon red sash of the daughter attracted my attention.

"So, what happened to your dog?" I asked them as they had consulted Dr Vanessa without bringing the dog.

"We came for medication," the mum said. "Our dog had a lump on the rib cage area but Dr Vanessa advised us to wait and see. If the lump gets bigger, she will consider operation."

"Is the lump under the skin?" I asked.
"Well, is it a small lump?"
"It is quite big. We can bring him to you to see."
I said: "Every vet has his own opinion as regards lumps and bumps in old dogs. How old is your dog?"
"He is 14 years old."

I said: "Many vets do advise a wait-and-see. Unfortunately, many owners waited but don't see. They don't examine the lumps daily or weekly. After a few weeks, if the lump is cancerous, it will have exploded to a big size and that is when they see the vet for surgery. So, my advice to all owners with old dogs especially. Don't wait and see.

"Just get the vet to remove the lump when it is small. If it is cancerous, it could be removed with a wide margin including normal cells around it. If you wait and see, the cancerous cells have invaded the surrounding tissues, it would be very difficult to excise all and the cancerous lump recurs."

The mother and daughter were worried and they ought to be. A 14-year-old dog with a lump is likely but not guaranteed to have a cancerous tumour. There is the high risk of anaesthetic risk for dogs over 8 years of age. So, this could be the reason why some vets adopt a "wait-and-see" attitude.

The duty of care of a vet in such circumstances should be to advise surgical excision for old dogs and provide an informed consent. Not wait and see as, in my experience, most Singaporean owners of old dogs seldom "see" their dog's tumour daily till several weeks later, they discover that the tumour is much larger. By then, it is too late to save the dog as the cancerous growth has spread to the sides and will recur again after surgery.

P.S May 17, 2011 is Vesak Day and is a public holiday. A bright sunshine day when most Singaporeans would be relaxing.

I was at the reception counter, still trying to teach my new replacement vet assistant Mr Min how to work efficiently and faster and how to answer the many telephone queries.

For example, I taught him to put all the necessary stationery (ink pad, namecard of Dr Vanessa, stapler, date chop inside one plastic cup) so that he would not waste time looking for each one after Dr Vanessa signed the vaccination certificate. In a busy time, this saving of a few seconds counted as the Singapore clients dislike long waiting times. In addition, Mr Min had a habit of holding the dog while Dr Vanessa spoke to the client about the diagnosis. "Let the client hold his or her dog," I said to him. "You do the other work like preparing for the next case." This was what my old assistant Mr Saw would do. Mr Saw would weigh the dog and take the temperature of the next case for me. Here, Mr Min would be holding the little dog on the consultation table and waited. There was why the waiting times stretched.
So, I had to step in to speed the work flow.

Sometimes we would be busy on a public holiday but this Vesak Day was rather quiet. So I had time to talk to the mother and daughter and know more about their pet problems.

Friday, May 13, 2011

Referring to a brand name veterinary surgery so as not to lose clientele

"Very smelly flow of blood and pus from the below for over 2 weeks," the man in his late 30s told me. "I sent it to my vet (Vet 1) I trust, but he did not want to operate. He referred me to XXX (a brand-name vet surgery) but the vet fees would cost me more --- two thousand dollars. So, I checked out the internet and came to you."

The 9-year-old dog was no longer able to stand as there was at least 2 weeks of delay and the dog was not eating. Blood tests showed kidney disorder as well as high white cell count.

"How much is your operation fee?" the father asked me as I reviewed the dog's case with him and his son.

"$500," I do give discount to pet owners who are in need of lower vet fees for a pyometra surgery. Usually it would be nearer to $800 for the anaesthesia and surgery, excluding IV drips, medication and hospitalisation. There is no means testing in Singapore but this case appears to have been delayed considerably due to financial reasons.

"Can you reduce it?" the father asked me.
"It is as low as I can give to you," I replied. "This is not the normal cost. It would be around $800 - $1,000."

"However, you must know that the dog has around 40% chances of survival since she is very ill due to delays in seeking veterinary surgery." I had to be frank with the owners.

As I am responsible for the reputation Toa Payoh Vets, it is my duty to make sure that my associate vet handling this case do provide this risk assessment to the owner and not just to operate. If the dog dies, the owner will still be angry as he has to pay the bills when the outcome is not good. So I told my associate vet that I had given the 40% chances of survival to the owner and that the owner must be informed accordingly.

Any other options? I did not suggest euthanasia. The father said: "Since it is not 50:50, I will want the dog to be put to sleep."

If the dog had been operated 2 weeks ago by Vet 1, the chances of survival are very good. Unfortunately, the family vet did not want to operate on big dogs. I know Vet 1 always refers difficult cases to a brand-name veterinary surgery as a routine over the past century, without considering that his clients may not be able to afford the "Mount Elizabeth Hospital" type of fees. So some of his clients seek other practices.

Vets must understand their clients' financial situation and do what is good for them and their pets. A dog's life that could be saved was lost due to Vet 1's one-track mind to refer all cases to this brand-name veterinary surgery, on the erroneous assumption that he or she would not lose their clients as this brand-name surgery would not poach his clients.

In my opinion, once you refer to other vets, it is likely that you lose your client. Maybe, the client can't afford the brand-name veterinary surgery the second time and so you presume the client will return to you.

Why not find out what is the financial situation of your client, network with some vets who can perform the surgery competently but at "affordable" cost, get the quotations for your client. In this way, your service will be considered excellent. You will gain the gratitude and retain the loyalty of the client who has had used your services for many years? It is most likely your client will come back to you as he has had been doing for years.

442. Vaccination queries from a Singapore girl


To whom it may concern,

My name is ... and I am interested in keeping a dog. I understand that vaccinations against various infectious viruses and diseases are necessary for a puppy. I am also aware that the first vaccination should be administered at 6weeks old and the 2nd vaccination at least 1 week apart from the first vaccination.

I am Dr Sing from Toa Payoh Vets, www.toapayohvets.com. My reply is in CAPITAL LETTERS below.



I would like to enquire about the 8-in-one and 9-in one vaccinations. Are they suitable for puppies for their 1st and 2nd vaccination, or are they meant for yearly vaccinations ? THEY ARE THE ONLY ONES AVAILABLE AND APPROVED IN SINGAPORE. THEY HAVE BEEN USED IN lst and 2nd vaccinations with relatively very few deaths of puppies after vaccination in puppies at 6 weeks of age.

Also, would it be advisable to buy a puppy from a pet farm (say, in Pasir Ris) as compared to a normal pet shop (since the pets there would have already been vaccinated)?


I appreciate your time in reading and answering my queries.

Thank you(:

Dr Sing,
Thank you for clearing my doubts. It helped me in deciding if I should get a really young dog around 2months plus. I was pretty worried. "Cuteness" isn't a big issue as long as the puppy is healthy (:

Thanks a lot again !

Thursday, May 12, 2011

HDB flats

As the high cost of HDB flats has been a hot potato in the Singapore General Elections 2011, I will be writing some info about this category for the benefit of those taking the REA and RES examinations.

HISTORY (from the HDB Gallery at HDB Hub in Toa Payoh)

1960 Formation of HDB - builds HDB flats (public housing)
1964 Home Ownership For the People Scheme

1965 Toa Payoh Town is the first HDB development built. Known as the Chicago (gangsters were many there) of Singapore

1967 Land Acquisition Act to acquire land for public housing and infrastructure development

1968 CPF Act. Allows CPF savings to be used to buy HDB flat
1971 Resale of HDB Flats - allows HDB flats to be sold on the open market
(Only the CPF ordinary account is allowed to be used to pay for mortgage. CPF Special Account can be used if the Minimum Sum Scheme - MSS ? - is already inside the Special Account (as much as over $100,000)at the age of 55 when the person withdraws his CPF. To complicate calculations only 50% of the difference between the Excess over MSS and the MSS can be used to pay the mortgage if the 120% Valuation Limit is exceeded.....Another formula to be studied is needed!

1982 Multi-tier Family Scheme - priority for extended families to buy new HDB flat so that they can live nearby

1985 "Two bites of Cherry Concept". Singapore Citizens are allowed to buy 2 subsidized flats which they can resell in the opoen market. (In practice, they get two concessionary housing loans from the HDB. Subsidized flats are said to be 10-30% cheaper than resale flats)

1988 Town Council Act - manages and maintain public housing estates

1989 Ethic Integration Policy - EIP - prevents the formation of ethnic enclaves by ensuring a good racial mix in the HDB estates. (With effect from Mar 5, 2010, the NMPR (Non-Malaysian Permanent Resident) ethnic group is introduced as follows: Ethnic Proportion in the neighourhood is 5% subject to "above quota" and 8% in each block subject to "above quota" as elaborated below:

The Ethnic Proportion in HDB Estates are as follows:
Ethnic Group Neighbourhood Each block
Chinese 84% 87%
Malay 22% 25%
Indian & Others 12% 15%
NMPR 5% subject to 8% subject to
above quota above quota
1991 Design & Build Scheme - DBS - Allows private architects to design public housing

1992 Main Upgrading Programe - MUP - To improve the living conditons of residents in older estates and to make them on par with the new towns

1994 CPF Housing Grant Scheme - $30,000 to families buying resale flats (NOT new HDB flats) within a 2-km radius of their parents' or married children's home. (According to my REA lecture notes, the Family Grant is $30,000. The Family Grant to stay near parents is $40,000.

1995 Executive Condominium Housing Scheme - young professional couples who cannot afford the high prices of private homes. An income ceiling cap of up to $10,000. (Apparently it is $12,000 if they stay near parents). MOP 5 years. Can sell on to those eligible when MOP is 5-10 years and after 10 years, can sell on the open market. Has condo facilities. Any management corporation? I need to check on this.

Selective Enbloc Redevelopment Scheme - SERS - optimise land use by redeveloping old estates without diluting strong community ties. (Much details of the MOP 5 to 7 years etc to be memorised by the student for the exam!)

1996 Estate Renewal Strategy - ERS - systematically re-develop older estates & improving the living environment for residents

1997 Studio Apartments with elderly-friendly features as another housing option for the elderly. (Right-sizing replaces down-sizing as a term to be studied by the students!)

2000 40th Anniversary. 88% of the population live in public housing

Special Housing Assistance Program - SHAP - assist low-income household to own their homes

2001 Lift Upgrading Program - LUP - to provide lift access to every floor level in the HDB block. (In the old days, the HDB built some levels without access to lifts. You got to walk up or down two levels to get to the lifts. This is tough for the old folks.)

Build To Order Program - BTO - to match supply of HDB flats to actual demand

Rental Flat Upgrading Projects - improve the living environment for tenants

2006 Additional Housing Grant - AHG - to help the lower income to buy 2- to 3-room HDB flats

2009 Lease Buyback Scheme - LBS - low-income elderly Singaporeans who live in 3-room or smaller flats can opt to sell the tail end of the lease back to the HDB, leaving a shorter 30-year-lease for themselves. The sales proceeds will be used to buy a CPF Annuity that yields a monthly payout for life.

(Many RES and REA students will not understand what "tail end" means. The LBS starts when the person is 62 years old. As an example, at 62 years old, his remaining lease is 40 years. He keeps the last 30 years of the lease so that he can live in his own HDB flat. The difference is 10 years of lease to be sold to the HDB (40-30). This 10 years is the "tail end" of the lease.

HDB then uses the sales proceeds to purchase the CPF Annuity for him. The Annuity then pays him a monthly income till he dies. In addition, the Government gives him $5,000 cash upfront and another $5,000 to pay for the CPF Annuity too. I hope students of RES and REA can understand now.

In this example, the 62-year old would have to live to 102 years old (62+10+30) and will get a monthly income up to 102 years old!

2010 50th Anniversary


The above info is from the HDB Gallery.

Feb 18, 2011 Low-income Special Housing Grant - SHG - is paid to lower-income families that have an average household income of up to $2,500 to help them to buy 2- to 3-room HDB BTO flats. This is in addition to the AHG and the Family Grant of $30,000 and Family Grant to stay near parents of $40,000.

The Design, Build & Sell Scheme - DBSS - to permit private developers to build the flats for sale to those whose household income is capped at $10,000. The HDB owns the land and HDB and the Town Council will manage the DBSS flats after completion. No condo facilities.

There are so many facts and figures to remember. It will not be a surprise that the HDB officers can't remember each and every one of them! It will be tough to pass the REA exam if one cannot remember the various HDB schemes and eligibility!