Wednesday, November 20, 2013

Marketing Beyond the Basics (1555). Internet advertising

Marketing: Beyond the Basics (1555)
AAV 2011
Laurie Hess1, DVM, DABVP (Avian); Bill Schroeder2
1Veterinary Center for Birds & Exotics, Bedford Hills, NY, USA; 2InTouch Practice Communications, Schererville, IN, USA
22701292
Abstract
This master class will review marketing techniques any veterinary practice can implement to generate new business. Traditional marketing methods, including targeting pet stores, other veterinary hospitals, and existing clients will be reviewed. However, the focus of this master class will be on nontraditional, Internet-based marketing using the tools of social media and paid search engine campaigns. Emphasis will be placed on ways to "think outside the box," in terms of innovative marketing strategies not typically employed by veterinary practices.

An All-Bird/Exotic Animal Hospital
An all-bird/exotic pet practice: People think you can't do it because there are not enough patients and not enough revenue. But...you can! Done the right way, you can make it productive, progressive, and profitable.
Advertise Your Services
Veterinarians are not taught in school to market their services, and many vets do little to no marketing other than a have a sign plus or minus a website. However, offering the best medical care is not enough. 
Owners don't realize that exotic pets need care, too.
How to Advertise Your Services
Your Logo
Place your logo on stationary, business cards, etc. Incorporate exotics either with a picture or with words ("exotics," "birds," rabbits," etc.), indicating that you treat these species.

Your "Brand"
An example of a brand is "Exceptional care for extraordinary pets." Branding your practice is essential to good marketing.

Your Sign
Remember a picture is worth a thousand words, and referrals can occur just from driving by.

Marketing Your Services
Website
The Internet is where most owners look to find a veterinarian today. All vet practices should have an informative, user-friendly website. The website should contain essential key words ("bird," "rabbit," "ferret," "reptile," "exotics," etc.) so that the site comes up "high" in an Internet search for a particular species. 

Exotic pet practice is a niche industry, so key words are important: "optimize" your website with essential key words!

Search engine marketing: Develop ad campaigns on major search engines, such as Google, Bing, Facebook, etc. Each campaign should contain multiple ads targeting different key words (i.e., "rabbit vet," "bird hospital," etc.). In your ads, focus on key words that are commonly searched when owners seek exotic pet care.

Realize that each ad links back to your website, and that you are charged for "cost-per-click" advertising: you pay each time an owner clicks on your ad. Start with a limited maximum daily budget and a moderate cost per click so you don't waste money on unproductive clicks.

Monitor your search engine marketing progress weekly; Google Analytics is one useful tool. Make adjustments to key words and cost-per-click accordingly. Limit your budget on ads with infrequently searched key words; and increase your budget on ads that contain frequently searched key words where competition for the top spot in searches is high. Not surprisingly, a greater cost per click can lead to a higher spot in the search outcome.

To determine the return on your marketing investment, track the number of appointments that result from your ads. Website conversion tracking is essential, as you want to monitor whether a "click" translates into an actual appointment. Realize that it this is very difficult to track reliably. Ideas to help track conversion are to:

 Set up a phone number dedicated to a particular Internet ad to track the number of appointments an ad generates; it may be confusing if there is more than one hospital phone number.

 Set up an on-line, e-mailed-in form to make appointments, but realize that this will miss those people that just call to make an appointment.

 Seek professional advice, if possible:
 
Search ManagerTM daily e-mails recommending changes to ads

 Professional search engine marketing firm
Ensure that your website is listed on well-known, on-line directories, including Yellowpages.com, msn yellow pages, AOL yellow pages, 411.com, MapQuest yellow pages, addresses.com, and Microsoft Live Search.

Ensure a web presence on mobile networks: The Yellowpages.com mobile application comes with iPhone®, iPad®, Blackberry®, Palm®, and Android TMphones. An ad placed through ATT on Yellowpages.com enables website listing on all of these other mobile on-line directories.

List your website in Google's local business directory. To do this, visit Google's "Local Business Center" and register your business on-line with Google. Google will send a code via snail mail, which when received is used to confirm the local Google listing. Enter the code online in the "Local Business Center."

Within 6 weeks, your local listing will be posted. The listing can be updated as necessary. Clients can provide reviews on-line; but remember, reviews can be both positive and negative!

Social Media Marketing
Social media marketing is essential in this Internet age. It offers a free source of Internet marketing. While it takes some time to learn, it provides a huge return on your investment. Examples of social media are Facebook, Twitter, YouTube, LinkedIn, and Foursquare.

Facebook
Facebook has more than 500 million active users, and 50% of active users log on to Facebook in any given day. The average user has 130 "friends." In aggregate, people spend over 700 billion minutes per month on Facebook.
You don't have to be an active personal user to have an active business page. But you must have a personal page to establish a business page. 

Once a personal page is removed, so is its associated business page. So be sure to set up personal page under a permanent employee (e.g., hospital owner).
Facebook allows you to list location/directions or services; link to your website; provide contact information and hours; share hospital events and photos/video; and provide discussion boards and links to other websites.
It is easy to set up a basic page. Professional companies can customize a page with special features (i.e., a tab for hospital mission statement) and provide graphics.
Over time, people "like" your page and receive real-time notifications of new posts on your page through a continuous, real-time "news feed." People who "like" your page can "like" and "comment" on individual posts. The more "likes" your posts receive, the more likely your posts will be shared with the friends of the people who "like" your post and the more new people are likely to "like" your page, etc. This cascade leads to great business exposure.
With practice, posting new information is simple and quick.

Application to practice
It is important that your Facebook presence be as unique as your practice. A practice should use custom built graphic tabs that convey a great deal of additional information about your practice. "Stock" Facebook pages only allow for a small amount of information about the practice (i.e., hours, location, if there is a parking lot or not, and a brief description).

Private firms can create "mini websites" that rest upon your Facebook page and that "link" out to traditional websites or anywhere you want to direct your visitors. The linking out concept is important, based upon the basic design of Facebook as a "social" space.

The most valuable advertising comes from the recommendation of a current client. This trust is evident in the process of educating a viewer about your practice through social media (e.g., a non-client asking his/her Facebook friends for a recommendation of a good vet.) In this case, an existing client of yours can direct the prospective client to your Facebook page to learn more about your practice. 

This experience, if kept in Facebook, is still acceptable, because the person referred is expecting a "social" experience. Once on your Facebook page, they will be able to seamlessly click out to traditional websites without ever leaving the Facebook page. This subtle transition allows the visitor to subconsciously choose when to be marketed to and when they want to be social.

All staff can participate in Facebook, making the activity morale-boosting and team building. You can have different theme posts on different days:
 Monday: Exotics product of the week
 Tuesday: Exotics question of the week
 Wednesday: Photos/videos of patients & procedures
 Thursday: Exotic pet alert
 Friday: Answer to exotics question of the week
 Saturday/Sunday: Blogs about exotic pet topics

As with all social media, it is extremely important that you make your Facebook postings consistent and relevant. This can be the most difficult aspect of social media maintenance and the main reason why a practice would consider professional maintenance assistance.

Twitter
What is Twitter?
Twitter is a service for friends, family, and co-workers to communicate and stay connected through the exchange of quick, frequent messages ("tweets"). You write short updates ("tweets") of up to 140 characters that are posted to your profile and sent to your followers. Tweets are searchable on Twitter.com. Tweets are public and available to anyone interested in them. Twitter users ("followers") subscribe to your messages by following your page. Followers receive every one of your messages in their "timeline," a feed of all the pages to which they have subscribed.

"Do I need anything special to use it?"
All you need to use Twitter is an Internet connection or a mobile phone to establish a profile page for your business. Once your page is set up, you type your updates ("tweets") into the web box for others to follow.
Followers also may find your page if they search on Twitter search for any keyword that relates to your business. As an example, my Twitter page is "birdexoticvet" so it appears in searches for "bird," "vet," 
"veterinarian," "exotic pet," etc.).
Profile pages can be personalized with logos, photos, links to your website, information about your services, location, etc. When you combine messages that are quick to write, easy to read, public, opt-in, and accessible anywhere, you have a powerful, real-time way of communicating.

Twitter statistics
There are 370,000 new sign-ups daily; 95,000,000 tweets per day; and 175,000,000 users.

Who reads my updates ("tweets")?
Your followers read your updates, as does anyone else who comes across them in a twitter search; your Twitter profile is public by default.

How do I know who is following me?
Twitter sends you an e-mail when someone new follows your business. Followers link on your profile page or home page's sidebar will also tell you how many followers you have.

How is it useful to businesses?
As a business, you can use Twitter to share ("tweet") information, gather market intelligence and insights, and build relationships with people who care about your company. Messages from users you follow will show up on your homepage for you to read in real time. Messages your business tweets will show up on the homepage of followers of your business.

How do you develop new followers?
There is no way to ask other users to follow you on Twitter. The best way to gain followers on Twitter is to engage with others' services, follow others the content of whose tweets are meaningful to you, and be active on Twitter.

How can I sync my Twitter account to my Facebook Page, so that my Facebook Page posts automatically as Tweets are tweeted?
As a page administrator for your business Facebook page, you can go to Facebook Help and automatically link your Facebook page with your Twitter profile so that you can share status updates, links, photos, notes, and events with your followers on Twitter, directly from Facebook. When you post to Facebook on your page, your post will automatically tweet to your Twitter page.

Application to practice
As with any social media, relevance is key. With Twitter, you are "ringing" the recipient's cell phone and causing them to stop what they are doing to check out your tweet. Messages like, "I just had an awesome burger" from the vet might not be as well received as those regarding your practice and animal care.

Tip: Learn to use "hash tags" and incorporate "trending" topics into your message. For instance, during the Joplin, Missouri tornado, there was a Facebook page set up for reconnecting missing pets and their owners. I tweeted, "Neat Facebook page that reunites lost pets and their owners from #Joplin (insert Facebook address)".

YouTube
 What is YouTube?
YouTube.com is a website that allows billions of people to discover, watch, and share originally-created videos. YouTube provides a forum for people to upload original videos to connect, inform, and inspire others across the globe and acts as a distribution platform for original content creators and advertisers. YouTube enables businesses to share information about what they do in a unique and active format.

 How do I get started?
To join YouTube, go to the sign up page, choose a username and password, and enter your information.
If you already have a Google account associated with the e-mail address you entered, a YouTube/Google sign-in page will load with the e-mail field pre-populated. If you want to use a different Google Account, delete contents of the pre-populated e-mail field, and enter the e-mail address associated with the Google account to which you'd like to add YouTube. If you don't have a Google account, a YouTube/Google account creation page will load with the e-mail field pre-populated.
Choose a password, enter the verification code, and click "Create my new account".

 How do I choose a username?
Choosing the perfect username for your business is important because it should include terms that viewers might search for to find your videos (i.e., avianexoticsvet). It's easy to check availability of the username you'd like as soon as you type it in.
Go to the YouTube signup page, enter the username you'd like into the Username field, click the Check Availability link, and beside the username you entered, you'll either see "Username unavailable" or "Username available!"
Once you've found a username you like, fill in other fields to complete signup!

 Uploading videos
Once you sign up, you can upload videos:
 Click the upload link at the top of your page.
 Click the "upload video" button to browse for the video file you want to upload to YouTube.
 Select the file you want to upload, and click "open."
 As the video file is uploading, enter as much information about your video as possible in the relevant fields (including video title, description, captions [or "tags"], and what category the video best fits).
 You don't have to provide specific information, but the more information you include, the easier it is for users to find your video.
 Click the save changes button to save updates you've made to video file.

 To best promote your video
Make your description accurate and interesting, clear and specific. Determine what content it contains that will help users find it and distinguish it from other videos. Be sure to use descriptive language in complete sentences.
Remember, if people don't know the exact title or other keywords associated with your video, they might search the name of a participant or another website where it's featured. Include as much information as possible, but nothing that shouldn't be publicly displayed.

Categorize correctly: The category into which you place video is part of its description. People are more likely to rate your video highly and watch it more often if it's placed in a relevant category.

 Examples
You can post a video to demonstrate a procedure (e.g., "Dr. Laurie Hess Examines a Hummingbird"). You can also post a video to advertise a service or promotion (e.g., "Dr. Laurie Hess and Amazing Exotic Pet Videos").

 Application to practice
Using YouTube has never been easier. With the growing popularity of "flip cams" and similar products, practices have been able to take quick and simple videos for education and marketing purposes. Most "flip" cameras come loaded with easy-to-use editing software that allows editing and posting a short video in less than 10 minutes.

Most video subjects can be covered in less than 2 minutes. Most videos are not an in-depth examination of the topic but rather a quick, easy to understand clip intended to develop the viewer's interest/broad understanding of the topic. The 90-second mark is a goal for length of most Internet-published videos.

Videos should offer information where the viewer can receive additional information. Additional information could be a white paper posted on your website, a blog entry, a more detailed video, or a short post on Facebook.

LinkedIn
LinkedIn is a business-oriented social networking site. Launched in May 2003, it is used for professional networking. As of January 1, 2011, LinkedIn reports over 90 million registered users, spanning more than 200 countries and territories worldwide. The site is available in English, French, German, Italian, Portuguese, and Spanish.

LinkedIn has 21.4 million monthly unique US visitors and 47.6 million globally. More than half of LinkedIn members are outside of the US. There were nearly 2 billion people searches on LinkedIn in 2010. More than 1 million companies have LinkedIn company pages.
The site allows registered users to maintain a list of contact details of people they know and trust in business. People in the list are called "connections." Users can invite anyone (whether a site user or not) to become a connection.

The list of connections can then be used in different ways:

 A contact network is built up consisting of direct connections, connections of each of their connections (2nd-degree connections), and connections of second-degree connections (3rd-degree connections). This network can be used to gain an introduction to someone a person wishes to know through a mutual, trusted contact.

 Connections can also be used to find jobs, people, and business opportunities recommended by someone in one's contact network.
 New connections can be made between people with similar business interests to facilitate interactions between businesses in related industries.
 Employers can list jobs and search for potential candidates.
 Job seekers can review the profile of hiring managers and discover which existing contacts can introduce them.

Foursquare
Foursquare is a location-based mobile platform that makes cities easy to use and interesting to explore. Users "check in" via a smartphone app or short messaging service (SMS), also known as text messaging, and share their location with friends while collecting points and virtual "badges." Foursquare allows users to bookmark information about venues that they want to visit and to receive suggestions about nearby venues.
Local merchants leverage the Foursquare platform by utilizing a wide set of tools to obtain, engage, and retain customers and audiences.

As of December 2010, Foursquare had over 5 million users worldwide. Millions of users go to Foursquare every day to help them find their friends and explore their world. Users share activities and business loyalty with their social network to earn badges and points.
For merchants and other venue owners, Foursquare offers a free set of tools to help attract new clients and keep the best ones coming back.
Attract new clients or reward most loya
l ones by offering Foursquare specials - mobile coupons, prizes, or discounts - presented to users when they check in at or near your venue. Specials create enticement to get clients to stop and can be tailored to fit a business' needs (i.e., discount for first-time customers, rewards for the 10th visit).

Signing up for Foursquare's free merchant platform also allows a business access to the venue stats dashboard to track client foot traffic over time.

AddThis
AddThis is a popular, free sharing platform to boost traffic back to your site by making it easier for visitors to share your website content. AddThis.com places a button on your website or blog that viewers press to share content. Your audience members share your site with their friends and bring traffic back to your site.
Discover who is driving traffic back to your site. Learn which pages, services, and countries are bringing the most traffic back to your site. Learn what topics interest your audience, and use them to engage visitors and increase traffic. Compare which services perform best, and how their usage changes over time; highlight this service to get more visitors. Understand how searches and traffic from other domains result in shares and clicks back to your site. Integrate your AddThis sharing analytics data into 

Google Analytics.

Other Websites: Pet Clubs, Breeders, Pet Store
Ensure your website is listed correctly and prominently under "recommended vets" in as many of these sites as possible. Link to these other sites and have them link back to increase your site's traffic
Recommendations on one site often spawn recommendations on other sites. Be sure to check frequently to keep contact information updated.

E-Mail Marketing
E-mail marketing is faster, cheaper, and easier than direct mail, allowing you to easily target thousands of clients, referring vets, pet stores, and pet clubs with just a click.
To do this, be sure to get email addresses of all current and potential clients. Broadcast pet care reminders, promotions, discounted services, and general announcements. Base e-mails on a "call to action" targeting specific audiences:

 Microchipping - all exotic species
 Boarding - all exotic species
 Dental prophy - ferrets
 Vaccinations - ferrets

E-mail marketing is provided as a low-cost service by many veterinary software companies. Target large numbers of specific recipients (based on species, age groups, geographic locations, etc.).
E-mail marketing is labor intensive if you do it yourself, since you can only send out a limited number of e-mails simultaneously.
ePetRecords
ePetRecords is a professional e-mail service that makes mass e-mailing easy. You provide each client with a serial number card unique to their pet. Clients register their pet's serial number once on ePetRecords.com.

In future, clients can check pet's medical records (as much as you allow access) if they go to ePetRecords link on your website.
ePetRecords will confirm client appointments via email, send out mass targeted emails, reminders, newsletters, birthday cards, and post-visit client satisfaction surveys all for about $80/month.

Blogging
Blogging is a great way to tap into an audience already interested in your subject matter. Surf the Internet to search for commonly searched exotic pet topics, then use these topics as subject matter in your blog. Examples might include exotic pet boarding or vaccinations for exotic pets.
Short weekly or monthly blogs are sufficient. Take turns blogging by having different staff members contribute.

Set up a "blog site" as part of your website or as a separate site with WordPress® software (see wordpress.org): it is easy to use, downloadable, and installable for free. It can lead to many loyal followers who look forward to and recommend your blog to others. It is a potentially great source of new clients.

Client Referrals
Satisfied clients are the best source of future new business. One client satisfied client may tell:
 Other potential clients pet stores
 Pet clubs
 Pet-oriented websites (via testimonials)
 Other (cat/dog) vets (= referral sources)
However, unsatisfied clients talk, too. So, never burn bridges with clients!
Satisfied clients are a great source of testimonials on:
 Your hospital's website
 Websites commonly searched for veterinary services:

On some sites, the more reviews, the higher up your website appears in the listing.
Don't be afraid to ask a happy client to write on your behalf!
The best client referrals usually come from clients whose pets are treated most quickly and successfully, so...
 Don't accept cases you're not comfortable with

 Referring cases to a specialist ≠ failure

 Referring complicated exotics cases to a specialist (avian, companion mammal, reptile, or other discipline) may help the patient fastest and may lead to a happier, more satisfied client who ultimately returns to you with this pet and other pets.

Veterinary Referrals
When other vets hear that you treat exotics, they will likely begin to refer. Many cat and dog vets don't treat exotics because of little formal training in vet school; fear and/or no interest in exotic pets; and lack of appropriate equipment. Some will treat small mammals, but most don't treat birds or reptiles. It's easier for many to just make exotic cases "go away" than to try to treat.

Backhanded vs. Direct Referrals
Referrals may take the form of "Sorry Mrs. Smith; we don't treat birds," rather than that of a direct referral, but even backhanded referrals are still a practice builder. Be sure to follow up and thank all referring vets with a call, a written report, and regular updates as to changes in your services.

Pet Store Referrals
Pet store referrals are big, little, and very influential! They are a great source of new business as a result of care of in-store animals for sale and new pets sold to potential clients.
Generally pet stores must approach with a "herd health" perspective, and some care decisions may be based on dollars and cents, not on individual pet welfare.

Establish a Relationship with Pet Stores
 Visit and meet with the owner/manager
 Stock stores with your business cards/flyers
 Replenish cards and flyers often
 Regularly update them to changes in your services with mailings/emails
 Offer in-store consultations
 Discount your services in return for new client referrals
 Offer to participate in in-store events (i.e., pet safety day)
Remind stores that they have a vested interest:
 The healthier you are able to keep an exotic pet after it is sold, the more business (in supplies, food, boarding, etc) the store will likely get back.
 Healthier pets mean happier consumers who are more likely to return to the store for future pet purchases.
 Keeping in-store animals healthy increases likelihood that animals will be purchased.
To attract these referrals, try novel marketing strategies. Think creatively!
 "Ask the vet" sessions in stores
 Logo plastic bottle give away
 Discount coupons for a new pet first visit
 Discount coupons for multi-pet visits

Pet Club Referrals
Pet club referrals are another great source of new business and may take the form of bird clubs, house rabbit societies, reptile groups, etc. Many pet clubs are national with local chapters, which can be sources for referrals of both sick and healthy pets.

Check out the classified section of exotic pet magazines (i.e., Birdtalk, Reptiles, Critters) to see if there are species-specific pet groups near you. Check online for local listings. When you've found them:
 Stock clubs with business cards/flyers

 Regularly update them on changes in your services via mailings/emails
 Offer members-only discounts in return for client referrals
 Offer multi-pet discounts
 Offer to speak at club meetings
 Offer to do "Ask the vet" at their fundraisers
 Advertise in and write articles for their newsletter

Print Advertising
Print advertising is expensive and now somewhat obsolete in the Internet age. Sources still to consider include:
 Veterinary services section of exotic pet magazines: BirdTalk, Ferrets Magazine, Reptiles Magazine, Critters Magazine
 Veterinary journals and local veterinary society newsletters
 Local pet club newsletters
 Pet-specific promotion sections of local newspapers

In Sum...
If you treat exotic pet patients, get the word out! Market your practice! Become computer and Internet-savvy if you're going to keep up with your competition. Many software companies and websites offer services to make Internet marketing less complicated, easy, and even fun. You must spend some money on marketing to make some.

There are many exotic pets out there but few truly great exotic pet vets. If you're one of them, let the world know it!
  
Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker) Laurie Hess, DVM, DABVP (Avian)
Veterinary Center for Birds & Exotics
Bedford Hills, NY, USA

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The Sunday Times 25 Oct 20
Criteo CEO Ms Megan Clarken ,53) has a feel for Olympian challenges

Criteo is an advertising technology company that works with internet retailers to serve personalised online display advert to consumers who have visited the advertiser's website previously. HQ is Paris, 2700 employees worldwide, Revenue US$2.26 billion (S$3.1billion) in year ended last Dec and Ebitda of US$299million.

It is an advertising retargetting company, deploying proprietary AI technology to engage consumers in real time by designing, pricing and delivering highly relevant digital advert across devices and environment. 

She wants to change it to an "ad-tech company for the open Internet".

Pandemic that just won't go away. Economic situation is dismal around the world. 
1. One obvious trend is e-commerce.  accelerated by the lockdowns.
81% of consumers won't go back to the old brand and have tried a new one.
Big retailers struggle to cope. Mid-market players who learnt to adjust appear to have done well.

2.  Where search for products is being done. A change in behaviour globally. Steady increase in searches going directly to retail sites rather than google search or Amazon.  

In the Asia-Pacific, analytics suggest 55% of shoppers have downloaded at least one shopping app since Covid-19 outbreak. This region is very app-oriented marketplace.  Criteo helps retailers with apps, gathering a fee when a customer installs an app. 

3. Marketing game is changing. Eg. Branding campaigns move from product-focused advertisements to people-centred ones. 

4. Criteo has ability to get some big company clients including  those are white labelling some pieces of what the company offers as part of their own tech engines.

WHITE-LABEL PRODUCTS  are sold by retailers with their own branding and logo, even as the products are created by third parties. 

5. One challenge. Because of consumer privacy, third-party cookies are blocked by Chrome, Safari and Firefox, adversely affecting her company business. If this challenge is not resolved, so-called CONTEXTUAL ADS will not get in front of customers. Contextual ads are a form of targeted advertising for ads appearing on websites or other media.  Now we have 4 or 5 walled gardens ruling the world. 

Citreo builds its reputation as a retargeting company --- one that hits you with ads until you become a convert and buy a product or the company figures it cannot interest you more. 

6. Artificial intelligence and algorithms identify groups of people with a high degree of similarity and pitch those attributes to the highest bidder who could then focus ads on targeted audience.

The challenge in advertising is to get the right message to the right person at the right time on the most convenient device.   Digital gives you something that is contextually interesting to you.

7. Influencers matter. They make for effective amplifiers of messages. 
8. Some adverts are intrusions. Citreo wants to ensure that customers aren't annoyed and have the best experience they can possibly get.







Tuesday, November 19, 2013

1187. Blood in the urine of the guinea pig and the rabbit.

It may appear to be common sense to me but not to my assistant who collected urine from the pee pan..

However collecting urine from the guinea pig and rabbits must be on clean plastic pans (cover of plastic boxes), not the pee pan which is contaminated with stools and urine. Also the animals must be sryinged fed with 30 ml and 30 ml of water within 2 -4 hours to get urine produced. The urine was thus collected and sent for analysis.

Owners will be sms the test result.

1186. A 9-year-old male Shih Tzu peed dark brown urine

Nov 18, 2013

Today, the family rushed the 9-year-old shih tzu to me for treatment as he had passed blood in the urine and had vomited once. On the floor of the waiting room, he peed chocolate brown urine. So his bladder was now empty. This was a dog I treated as a puppy.

I palpated the abdomen. The dog gave a loud cry when I felt the anterior abdomen, towards the kidneys on the upper part.
"He may be suffering from a kidney infection as the pain is so obvious. Usually the bladder is also infected," I said. "For a definite diagnosis, I need to take blood and urine for testing as well as X-rays." There was no objection.

I asked Dr Daniel to take the blood and give the IV drip and antibiotics and anti-spasmogesic painkiller.  

"No urine, no urine," my assistant said to me in the evening. I thought it was strange as the dog had been given an I/V drip. Soon he peed lots of reddish brown urine (bottle) and this would be collected for urine analysis. The dog went home in the evening.

Tests showed high total white cell count and neutrophils indicating a bacterial infection. Surprisingly, the urea and creatinine was below normal. This would explain the kidney pain.  Urine showed bacterial infection and blood. X-rayed showed no radio-dense stones in the kidneys and bladder.

So was this case an upper and lower UTI? The dog is on antibiotics and observation.

1183. Lithotripsy to remove kidney stones

http://www.youtube.com/watch?v=BCXPXAX8bs4 in a snow leopard.

Big expensive equipment and expertise needed. The average dog owner will not be able to afford this procedure.

The leopard was on antibiotics for 8 weeks.
Weighed, blood and urine collected, physical examination, stable anaesthesia.

Endocscopy into the urinary tract to see where to place the stent.
Fluoroscopy (moving X-ray) to locate the stones
Shock waves to break down the stones into smaller pieces so that they pass out via the urine.

1182. Video: How to remove maggots efficiently

http://www.youtube.com/watch?v=t_q4qWj_scM&feature=youtu.be

There are many tasks to do in a veterinary practice. If the staff takes a much longer time to remove maggots from a wound, this time is gone and some other tasks cannot be done. This video shows how maggots are removed efficiently, starting with pain relief of the Golden Retriever.  

Monday, November 18, 2013

1183. The coach was burglarised. How did he do it?

 









Can the above pictures tell a story without text?


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The police responded to a call from the hotel in New Jersey at 9 am on a bright October 2013 morning
 



The victim was the coach which was broken into overnight. The door of the coach was still locked. Sherman unlocked the door for the police to investigate. I admired the pretty police car. "To Protect, Defend and Serve".  Why not "Protect, Defend, Serve" just like the book "Eat, Pray, Love"?




Nothing of value was inside the coach as the tour guide had advised the 35 Singaporean tourists to take all valuables and their luggage back into the hotel room last night. The stolen items were water bottles, packages of chips and the coach driver's sunglasses. A camera was not taken.   In the television, there would be the CSI taking evidence of finger prints and any other matter. But nothing was taken and so the police woman and a police man left soon after taking some notes. 
 
 
There was no suspect.  It could be a "home-less" person stealing food and water. Or was it the work of the cab driver who had been honked at by the coach driver to drive off as he was blocking the hotel entrance last night? Pure speculation. Why should the "home-less" be blamed for this petty theft? It could be the youngsters and pranksters. But why would he or they lock the coach door after burglary?  We assume he or they enter by the coach door at the side. We were not experienced in CSI (Crime Scene Investigation) and would think only of the door. The windows were not smashed. I presumed the police thought so as the burglar could have a master key.  
 





We all boarded for the Factory Outlet. The men were not thrilled to spend the whole day there. I considered it as a waste of time. So many things to see in the USA, in Washington, in New Jersey and this packaged tour catered to the retail therapy of many Singaporean women. The stereotypical Singaporean female tourist is one who would shop till she drops. I am sure many are immune to this retail therapy.  As the coach zoomed past to the happy hunting grounds or I would say, shopping outlets, a whooze and a big squarish gap appeared on the ceiling of the bus. 










 

1182, Feedback forms for tour guide - Coach broken into






Can these travel pictures tell a story without words?

At 9 am, after the hotel breakfast, in New Jersey, a group of Singaporean tourist prepared to board the bus but it had been burglared. The door was locked. How did the burglar unlock and did he lock the door?  The police was called.


 

 

 

 
 The coach drove off. The police woman took some notes. The items stolen inside of the coach were some bottles of water, chips, newspapers and the coach driver's sunglasses. A camera was not taken nor was a jacket. The luggage had been off-loaded and taken into the hotel as advised by the tour guide and so no valuables were lost.  About 10 minutes of driving to the Factory Outlet, with visions of shopping the whole day for the lady tourists, the ceiling of the coach flew off. Sunlight and a gentle breeze streamed in. I was sitting to the left of this vent and the gap was a surprise. A "Ah Ha" moment for the 36 tourists from Singapore. 35 adults and one girl of 13 years of age who must have left school after the PSLE to go on this trip with her parents. This was how the burglar came in. 
 


Sherman stopped the coach on a safe spot and inspected this gap. He had to U-turn back to the hotel to make the police report and then to re-trace his path on the expressway to look for the missing safety vent. All 36 pairs of eyes glued to the expressway for this piece, some to the right side of the coach, some to the left. The tour guide in front would scan both sides. "There's the missing vent!" somebody shouted. It was lying on the grass patch and not crushed by the large trucks wheezing past the expressway. The tour guide and Sherman went to retrieve this item.




We continued our journey. The day was bright and sunny. The skies were blue. Everybody was relieved as they have a covered coach in case of rain. The October weather was fine, but who knows whether there would be rain and without this vent, we would be soaked.