Tuesday, June 30, 2015

2480. Professionalism in veterinary surgery - video - rat mastectomy

June 30, 2015

Today, I spent much time discussing "Professionalism in veterinary surgeon" with Intern Ms Poh, intern who is  in her first year of animal health studies in Melbourne University. The veterinary degree is a second degree in this University.

PROFESSIONALISM IN VETERINARY SURGERY.
To prepare a video. She had to do her research and produced a report. Finally, I gave her a flow chart with the main subheadings as follows:




1. Hook  - An old rat with large breast tumours. To operate or not?

2. Theme.  BKTP - Professionalism in Veterinary Surgery

3. Pre-op
Correct diagnosis
Client education - Financial costs of op
Health screening costs  (blood tests, x-rays, urine tests, ultrasound)
Informed consent form signed. Old rat - high risks



4. Op
Correct treatment - surgical excision rather than drugs and painkillers
Referral to other experienced vets
Aseptic surgery
Ligation of the caudal superficial epigastric artery and vein. Less than 3 mm across in the rat unlike in the dog. Bleeding continuously if cut off without ligation.

No major nerves resected in this location

SAC  
Speed  - Knowledge of vet anatomy, skills and experience. Focus - no cracking of jokes.
Accuracy - Ensure correct tissues removed, blood vessels ligated
Completeness - all the tumours excised. 1-inch margin around tumour ideal but no practical in the rat.

No distractions during anaesthesia and surgery by cracking jokes.


5. Post op.
Painkillers and antibiotics
Histology report advised
Post-op complications - bleeding, infection, stitch breakdown, pain


6. Impact - financial costs, social costs, worries about anaesthetic deaths

7. Conclusion - What happens to this rat?

Credits

Produced by:
Videography by:
Veterinary surgeon operating on the rat: Dr Daniel Sing
For more information:

For more videos:


2479. A new puppy has a swollen belly



Post-purchase vet examination. 
Swollen belly in this beagle just purhased. Worms? Over-eating?
X-rays show fluid in the abdomen. A diagnosis of ascites.

"Can it be cured?" the pre-teen daughter was reluctant to return the puppy to the seller.
"It depends on the cause," Dr Daniel said. "It could be a liver or heart problem."
"You are not fated to keep a puppy," the mother said to her as one of her previous 2 dogs died and the other had to be given away owing to excessive barking.
 

FIC in a female cat?

Jun 30, 2015

One month ago, this cat, FS, 7 years old vomited and was not eating. She  had dysuria and frequent urination.  two strips of hair loss along her flanks and several patches of hair loss around her anal area. This was caused by anal sac abscess. 

Today, she had the same problem of dysuria and frequently going to the litter box to urinate.
Abdominal palpation - no enlarged or painful kidneys. No full or painful bladder. Large cylindrical column of stools in the colon felt.


1. Since young, the cat would drink for 5 minutes when the owner came back from work and switched on the running tap water.  Water bowl water seldom drank. Buy water fountain.

2. Single house-hold cat. No stress from other cats.

3. Litter box changed every 3-4 days. I advised daily picking up of the stools.
4. Litter box fine sand to be changed to paper.

5. Will eat only dry food. Feed feline C/D and observe for 1-3 months. With water fountain, may encourage more water drinking.

6. Foams when given oral medication. Disliked antibiotics.

TREATMENT
1. No urine for urinalysis.
2. Baytril inj.
3. Depo-medro 0.3 ml IM  (50mg/ml)

Will observe for next 1 month.

VIDEO

Saturday, June 27, 2015

2477. Travel pics. Milan Airport going home

Jun 27, 2015

Back to Singapore. Felt the humidity here. Jet lag. Went to the tour leader's office to give her a tip. She was not in. Her business depended on referrals not on NATAS expo and advert.


Some memorable incidents are captured in the images.



Getting cash tax refund at the Milan Airport  for buying a Burberry bag in Milan.





A group of Hokkien and Mandarin speaking tourists enjoy picture taking and selfies.





Thursday, June 25, 2015

2476. Travel pics. Milan

Jul 25, 2015  
Hotel Piacenza Fiera, Italy, Rm 111
facing open patio
At 7 am, will leave for airport for Singapore


Much drama, joy and laughter in this trip


Hokkien and Mandarin speaking group
Vocal minority
Tour leader ticked off for not "waiting" for all
Pregnant local tour guide abandoned us
Italian coach driver fainted from altitude sickness for 5 minutes flat on the grounds of Mt Blanc
One member had nose bleeding and puffy eyes
One member felt nauseous up mountain drive
Sunblock every 2 hours keeps a fair lady fair









Wednesday, June 24, 2015

2475. Travel pics. Foxtown Mall. "WhatsApp stops working" solution

Jun 24, 2015
Arrived MH Hotel Piaxenza Fiera  Rm 111
Big patio outside window. Some worries about security.
Free Wireless needed 10-digit code whereas other hotels needed just email address.
Singles complained that the room was too small - one bed lined against the wall on one side.
"You are all right as the room is bigger for your size," the slim fair lady said to a bigger sized lady friend. Then she hugged her and apologised.

Yesterday, WhatsApp had a message saying "WhatsApp has stopped working" on my Samsung. Fortunately, I googled and there was a solution.

www.fixedbyvonnie.com

How to Fix that stupid “Unfortunately (your app) has stopped.” error on your Galaxy S4
Inside settings, touch the More tab and flip open the Application Manager

Tap it open and touch the Clear data and Clear cache buttons.  This essentially resets the app to its initial state and should resolve the problem for you.

Swipe three screens to the right to open the section that displays ALL apps.  Now scroll down the list until you find your unruly app.

The solution worked for me. I had to confirm from a phone call from Colorado giving me a code. 


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Best to take pic without "objects" growing out of the head or the right ear. 3rd image was photoshopped to remove the driver of the truck. A waste of time. Plan ahead.


 





Foxtown Mall has a big Burberry presence. Yesterday, we had a woman who wore a Burberry scarf at lunch time at the train station in Chamonix. PK warned her that she could be arrested or jailed for wearing fakes in Europe. PK looked at the scarf and I thought she could differentiate the real from the fake. The woman's 23-year-old daughter had presented her this scarf. Was it the original or not? She did not wear it today at Foxtown Mall.    






Tuesday, June 23, 2015

2474. Travel pics. Chamonix snow mountain and train

Jun 22, 2015
Hotel Mercure Chaominx Les Bossons  Room 332. Good mountain view. 80 rooms. Tap unusual as you cannot see water flowing out of faucet. Excellent choice of breakfast with good bacon. Scrambled eggs watery. May be what the French like.

72-year-old man bled in nose yesterday due to exertion, helping the driver to pull out the luggages from the coach on arrival at hotel. Then he lugged his own luggage. Wheel broke. He bent down and nose bled. Giddy.








Guide said eyelid swelling and other arm and facial swelling normal. Take one tablet of pannadol and lots of sugar in coffee, the tour leader advised.

As the local guide Mary was sick owing to spotting from 5 months' pregnancy, there was a spare ticket. The Italian coach driver went up the mountains with us. He was rushing taking pictures and soon he staggered and fainted. A caucasian put his legs up and after a while he was conscious. Insufficent oxygen at 3000 m. high can kill a person. I stopped going out to the cold when I found myself breathless.

 








Monday, June 22, 2015

2473. Annecy and Chamonix

Jun 22, 2015

At Hotel Gap, local guide had to take medical leave - 5 months pregnant and spotting blood.
Motion sickness up mountains - one lady
Nose bleeding - a senior citizen



Base of Mount Blanc.








Sunday, June 21, 2015

2472. Travel Picture Tips - Lavender farms, Valensole, France

Jun 21, 2015
Best Western Hotel Gap, France
Rm 206

A 3-star hotel with clean modern furnishings and good food and beverage services. No swimming pool but there is a public one some distance away. A veterinary clinic opposite. 4 years old and with 4 vets. An interesting wall mural of Noah's Ark with anaimals advertises the practice. Cats form majority of patients with horses at 20%. A weighing machine is on level with the waiting room floor.

I had to open the window to let the cold air in as this hotel has no air-conditioning and the bedroom became stuffy. A house-fly visited me at 4.30 am.

Visited Valensole where the lavender farms are as far as the eye can see.

TIPS
Travel pics must be taken speedily as the people get restless.  I used zoom lens mainly, except for the group photo. The others use handphones.




BEST PIC.
I was across the road.
Suddenly, this sports car appeared and stopped for a few seconds. So this presence of the drivers and red sports car add vibrance and variety to the image of blue, lavender and red. The driver waved and soon zoomed away. 



From inside the coach window. This is the best father who raised the bar very high for boyfriends. I hope the daughters can find husbands that meet the care and love of their father who is more a friend than an authoritarian.  








I commented on the coincidence of two ladies wearing zebra stripes on this lavender farm visit day




 Very restless group. The vocal lady said it is too hot to pose and so the camera people must be speedy. I used macro lens. Blue skies, lavender flowers, brown sand and this triangular angle makes an unusual pic.  The tour leader to the right was using her handphone which is handy. DSLR cameras provide sharp close ups and are used by 3 people. Handphone cameras are the trend. 


Dogs on holidays make great travel pic but you need to be very speedy and use a zooms lens on the dog's or owner's eyes to focus.