30. Closed pyometra in a 10-year-old Maltese

"My dog could not stand up yesterday," the son took time off to drive his mum, an woman in her late 50s and the family Maltese to consult me. He is really a good son as many grown up sons don't bother or delay. "Today, she can stand. But she is not eating."

HISTORY
This is the type of history the average Singaporean owner would tell the vet. The vet need to ask pertinent questions like vomiting (vomited 2x), polydipsia which is -drinking a lot of water (yes).

PHYSICAL EXAMINATION
Rectal temperature was 38.5C. Normal. Mucous membrane slightly cyanotic and pale.
A large distended abdomen was obvious. An old female dog not spayed. The first diagnosis was closed pyometra. Examine the vulva. A red spot of blood hung out from the vulva gave me the clue.

PALPATION OF ABDOMEN
No pain at all. Pain in the lower 1/3 of the abdomen is said to be present in closed pyometra and the swollen uterus can be palpated. The whole abdomen was just a swollen balloon and so it was difficult to palpate the two internal uterine horns. There seemed to be various swellings, some big. some small.

X-RAYS
X-rays can be done to show the swollen uterine bodies and to increase the income for the practice. A diagnosis of closed pyometra by history and clinical findings will cost the owner less. I did not milk the owner by getting X-rays done to protect myself from litigation. However, I insisted on a blood test to ensure that the dog's kidneys and liver are in good condition since the dog was vomiting. Vomiting could be due to high blood urea or liver disorder from the toxaemia.


BLOOD TEST
An increased white cell count is said to indicate a high bacteria infection. However, a normal white cell count does not mean that the dog has no pyometra as will be discussed in another case. I had blood test done in this case. There was a marked decrease in white cell count. A decrease in platelet count. Blood test is an ancillary aid to diagnosis and should never be relied upon to advise the owner on the closed pyometra case. If the owner wants to save money, I don't insist on a blood test but would advise the owner that he had been informed.
DIAGNOSIS
What is the instant diagnosis? Normal temperature and no fever. A drop of bright red bloody vaginal discharge. Just not eating much or not eating for 2 days. But there is polydipsia, polyuria and vomiting.

BE BRUTALLY FRANK ABOUT THE PROGNOSIS.
Due to the tendency of a few Singaporeans to complain and be litigious when outcomes are not to their satisfaction, I am nowadays brutally frank to dog owners when their dog's lives are in danger. Cut to the chase. I said to the son, "Your dog has a very serious womb infection. She will die within 2 days if you don't operate. If you operate she may die on the operating table as she is very old. Had you got her spayed when she was young, you would not have this worry."

"What are the chances of survival?" the son asked.
"50:50," I estimated. "If you permit her to be operated soon. Not wait till tomorrow."
"So low?"
"For most dogs in the same age group, I give less than 50%," I said. "Your dog is in good condition and not skinny. She has no fever and was sick only '2 days'. She has no heart disease but I don't know about the liver and kidneys." This dog looked well fed and could be considered a bit on the plump side. But since she collapsed yesterday and could not stand up, this was a warning sign not to give optimistic predictions. Blood test show toxaemia and yet this dog had a normal rectal temperature and looked bright. Most owners are worried about the poor chances of survival. So they delayed surgery or took their dog to another vet for another opinion and costing. This is OK if the dog is not in a toxic stage but who can tell?

TWO CHOICES?
"So, we have 2 choices," the son said. "To operate and not to operate."

PROPER COMMUNICATION IS IMPORTANT
"You have no choice," I said. "Your dog is going to die if you don't get her operated. Your mum may be seeing this dog for the last time before I operate today. It is very important I do it today as the womb is very swollen with toxic pus.

EMERGENCY SURGERY
In this case, I operated within one hour after giving her an IV drip. The dog ate the next day and is normal as at day 3 when I write this report. Soon, she would be going home. The surgery is illustrated in pictures below.




"Why you said the uterus is going to rupture soon?" the young intern asked me. It is good to ask why. The browning of the uterine walls indicated cellular necrosis and death. Within 2-4 days, the uterus would rupture leaking out pus and killing off the dog. If the owner procrastinated, don't blame the vet. The vet must give a letter of advice to protect himself or herself against frivolous complaints, should the owner want the dog discharged to seek a second opinion and the dog dies at the 2nd vet.
EARLY DETECTION, DECISIVENESS OF THE OWNER AND TRUST IN THE VET'S DIAGNOSIS AND SURGICAL COMPETENCE. A happy outcome in this case was not due to luck. When old dogs survive a toxic closed pyometra, surgery, it is not a matter of luck. It is knowing the fundamentals and the technicals of the diagnosis of closed pyometra, the anaesthesia, surgery and IV support and in excellent communications with the owner.


More pictures at www.toapayohvets.com DOGS OR
goto: http://www.bekindtopets.com/dogs/20100416closed_pyometra_old_maltese_toapayohvets.htm

29. Commodities Investment

The following is a draft report, before I forget.

An e-mail to invite me to the talk below. 2 reminder phone calls from the organisation the day below and on the day when I was late, showed that this organisation means business. In talks, it is best to take notes if you want to learn from another industry and to review. The talk was well attended as the room was almost full of older people above 30 years of age.

My impressions from this talk:
1. The Singapore's savings and fixed deposit interests are less than 1% and inflation will erode the spending power of the savings.

2. Investment in high quality funds over 5 to 30 years as part of your investment diversification should be done. Expect around 5% return per annum over the 5 years.

3. Expect around 8% return per annum when investing in funds dealing with good quality shares.

4. Do research to find out which funds are high quality and their portfolio.

5. Regular investment in a balanced fund. Invest monthly so that you need not worry when the market rises or crashes. 5% return per annum is better than fixed deposit interest rate of less than 1%. For example, monthly investment of $250. Global equiies return 7.44% and global bonds return 5.23% per annum as long term investment in the last 20 years. Much higher returns than fixed deposits. The average Singaporean retirees normally invest in fixed deposits in the POSB and do not know any other alternatives. CPF rates are 3.03%? Fixed deposit rates are 2% in Singapore. Mini-bonds are NOT bonds.

In 1939 - 2003
1. 70% you make money
2. 30% you lose money.
Any 3-year period, you make money
Any 5-year period, it is good for you.
Any 10-year period (long term), you should have better returns.

6. The Straits Times Index has shot up 100% as at April 2010 compared to Oct 2008. Oct 2008 was the economic crisis level when shares were at the bottom. Therefore many people have had missed the boat. The STI was 1,500 in Jan 2009. Now in April 2010, it is 3,000. Its peak is 3,800. When will it peak? Economic cycles are shorter nowadays. 4 years from now, it will peak at 3,800? I can't understand how the speaker comes to this conclusion or I have heard incorrectly.

May 1932 Great depression
Jul 1982 Worse recession in 25 years
Dec 1994 Most dramatic Fed tightening
Oct 2008 Economic crisis
Apr 2010 Said to be in the expansion (boom) period. Commodities will outperform. Interest rates will rise.

Australia. The following may be of interest in students studying in Australia.

1. Interest rates are record lows except in Australia.
2. Unemployment has decreased more than expectations.
3. Australia is a commodity producer.
(Implication? Invest in a country that is a commodity producer). Buy commodity shares in Australian companies?

Singapore News in Apr 15, 2010
Singapore's inflation rate will increase from 2% to 2.5% according to April 15, 2010 news I have just heard. The economy has rebounded unexpectedly.


4. The following topic was educational as the speaker said 2010

Gold prices still have not reached their peak. In Jan 1980, the lady speaker said that gold was selling at the peak of US$1,816 but two participants said it was S$800 as they bought or sold gold for their wives.

The speaker said it was US$800. The US$1,816 was the figure adjusted for inflation at 2010 rates, the lady explained. "In 1980, an HDB flat was not selling for $1 million dollars!". I can't recall HDB flats selling for $1 million in 2010.

ENERGY V. GOLD ASSESSMENT
Focus on gold as the real interest rate is low and gold is relatively cheap. To evaluate, assess how many number of barrels of oil will buy 1 oz of gold. In Jan 1980, gold prices were at its peak of US$1,816 and the number of barrels was 48.2. In Nov 2009, gold was cheap when it could buy 15.2 barrels. This is because gold supply is down. The trend is for central banks to buy gold and so demand will increase.

Silver - Smaller market. Silver outperforms gold if its price rises. Invest in 10% of your diversified portfolio.

Platinum - Still high demand despite recession as European Union regulations require cars to have catalyst to reduce toxic emissions. Auto catalyst needs platinum. Invest in 5% of your diversified portfolio.

In summary, hold commodities esp. gold and metals to hedge against inflation for a long-term portfolio. Base metals prices were high last year (2009). The last 20 years were deflationary. Now, we are in the inflationary environment and the 20% bond and 80% equities formula may not be relevant. Commodities should do better than both.

In the economic cycle
1. Slow down
2. Recession
3. Recovery - equities and properties
4. Expansion

Agriculture, metal and energy. Agriculture is the last one to rally. Metals had their best performance in 2009. In 2010, consider gold price as an alternative investment for growth.

A simple rule: Be fearful when others are greedy but be greedy when they are fearful.

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LECTURE

An International Portfolio in Commodities (lst Hour)

Because commodities are an area which have not been represented in investment portfolios, this market is relatively inefficient. Opportunities to outperform the market are much more likely to occur in an inefficient rather than a more developed market environment.” And like many asset classes, the long term is made up of a series of medium-term cycles, in which prices move up and down as supply and demand fall into and out of alignment with each other.

Looking ahead to the next few years, we see good reasons why the long-term and medium-term trends are highly encouraging for commodity investors.

· Why Commodity Futures?

· Outlook for Commodities in the 3 broad groups: Metals, Agriculture and Energy.

· How to take part of the exciting opportunities of Commodity Futures?

A Winning Investment Vehicle – Zurich (2nd Hour)

· How best to position yourself to take charge of the market rally

· What are the best periods in history to invest?

· A winning investment strategy with Zurich

Key Speakers:
1. A substitute lady speaker from Schroeders
2. Alan Tang - Chartered Financial Consultant, Certified Financial Planner, Chartered Life Underwriter , Senior Branch manager (PIAS), Money Sense Speaker (MAS)

Having done more than a thousand talks for corporations, unions, ministries and statutory boards, Alan is a revered speaker in the financial seminar circuit. He is not just effective in delivering the message, but his lessons will dramatically improve your finances.

28. Enterotomy, enterectomy, gastrostomy practical

To excel in veterinary surgery, one must have lots of practice. In human medicine, surgery is a post-graduate study and specialty but vets after 5 or 6 years of undergraduate studies are expected to be competent in veterinary surgery. There are veterinary specialists in surgery but he or she will not be able to earn a living in Singapore or in many countries.

Therefore, it is good to know that the 4th year students are given hands-on experience on intestinal surgery in the pig. 3 in a group. One would be a surgeon, one would be an anaesthestist and one would be a recorder at any one session. Anne was the one doing surgery yesterday. She had the short stick of the draw.

I did advise her to practise a lot on stitching pig intestines prior to the test. Reading notes and watching video may give the theory. But in the real McCoy, she needed to demonstrate competence if she was to get HD (High Distinction). For this high-achieving student, failure is not an option. Failure means having to repeat the test but I doubt that the University would be funding a pig for this repeat. It must be expensive and time-consuming. So, yesterday would be her trial by fire.

I discovered that she was a high-achieving student when her mother told me. It is rare to meet high-achievers doing internship in my practice and in veterinary medicine and surgery. There are around 70 graduates per year. 150 students might have started first year. The drop-out rate is high. In 70 students, only one veterinary graduate may get the University Medal for being amongst the top 7 in the whole campus. I presume the winner will be from the crop of the top 2%. It is not easy.

Veterinary medicine and surgery is a very tough subject unlike human medicine where only homo sapiens is the only species being studied to death.

A vet student has to study so many animals and each animal has its own diseases and various medicines to treat them. It is a wonder how the undergraduates can memorise and pass the examinations.

"How's the practical test on your intestinal surgery today?" I phoned Anne who was the surgeon in a group of 3. I had advised lots of practice on pig's intestines prior to the test if she wanted to get high marks. No 4th year student or even new graduates can demonstrate competence in stitching up the intestines because of the Western model of veterinary education which prohibits practices on live animals due to animal welfare concerns.

I was surprised that Anne accepted my advice and sourced for pig intestines from the butcher's shop to practise surgery. A butcher told her that pig intestines are never sold in Perth. Yet she found one selling at Northbridge. So, she practised and the vets and nurses at the vet surgery she stayed helped out.

I had many questions to ask about how she did the surgery on the pig. I don't do pigs. "Enterectomy, enterotomy and gastrostomy," she said. "How long did it take? Around one hour?" I asked optimistically. "The total surgery including stitching of the linea alba and skin stretched from 1.30pm to 4 pm."

I was just interested in one result regarding intestinal anastomosis. "Did the intestines leak after joining the two parts of the cut intestines?" Performance counts. You fail if your appositional sutures did not close the defect. The patient would suffer peritonitis and there will be a need to operate again.

"Did the intestines leak?" I asked again. This was her first intestinal surgery and she had diligently practised. "In a live pig, the intestines are mobile," Anne said. "It is not easy to stitch (unlike the dead specimens from Northbridge. The mucosa is hard to stitch up."

"So, did the intestines leak?" I asked patiently again. I could not afford to talk too long in international phone calls and this was the answer I wanted to know. You can have beautiful stitching. But the life and death issue is whether the patient's intestines, uterus, bladder, heart, blood vessel leak contents after your stitching.

"Yes," Anne explained to me that it was hard to stitch interrupted appositional sutures to join the two intestines. The sutures should not evert or invert. They should just close up tightly as in simple interrupted sutures in the skin. "Why don't you use inverting sutures on the serosa?" I asked. "Fine 4/0 absorbable sutures inverting the serosa as in gastrostomy?" Anne said, "The professors said that only one layer of appositional sutures would do as there may be intestinal blockage."

Well, I did read the lecture notes which taught what Anne just did. It also said wrapping of the omentum and tacking it to close the anastomosed area. Or a serosal patch after intestinal anastomosis.

This anastomosis of intestines is a rare surgery in a general practice. Practice on Caesarean sections would help a vet hone his skills. Unfortunately, there are not many Caesearean sections unless the vet has lots of dog breeders and provide dirt-cheap surgeries attracting them. "Why was there a leak?" I wanted to know. "Didn't you check after stitching?"

It is easy to criticise when one is not on the hot seat.
"It was closing time," Anne said. "I had to rush." Failure is really hard on high performers. Nobody wants to talk about the pains of failures. "Do you know your marks?" I asked. "No," she said. I think she would not get a HD for this surgery. And after all her hard work.

27. FAQ - Breast tumours in a 13-year-old Pomeranian

On this first Sunday after my return from Perth, I was still around at 6 pm when a couple came in with their 13-year-old Pomeranian with nodular breast tumours in the MG 4 and MG 5 glands, left side.

HIGH ANAESTHETIC RISK
"We are bringing in our dog for surgery," the couple explained to me that my associate had booked for them the appointment for surgery on Monday. "Will my dog be able to survive the anaesthesia? I hear it is very risky."

PRE-ANAESTHETIC BLOOD TEST
I checked the dog generally and the heart. "The dog's heart was OK and the general health is good," I said. "There is the gum and tooth disease as you had not done any dental work for the dog for the past 13 years. Generally, there should be no anaesthetic problem but please note that your dog is not as young as a 5-year-old female dog. There is the kidney and liver function which can be assessed by a blood test. This costs money." Owners must be advised fully the risks and a blood test will be good. But in practice, the owner may not want to pay for the blood test.

SPAY AND BREAST TUMOUOR REMOVAL
I advised separate anaesthesias to remove the breast tumours and the do the spay. "Won't the dog be having two risks in anaesthesia?" the husband asked.

"Anaesthesia in dogs older than 5 years is risky," I explained. "However, the shorter the surgery, the shorter the duration of anaesthesia. Therefore, the lower the risk of dying on the operating table. If a vet takes 1 hour to do a spay and breast tumour removal in your dog," I explained, "the higher the chance of the old dog's heart failing. If one surgery is done and this takes 15 minutes, the dog will be at much lower risk of death."

"Two surgeries in one is much cheaper," I said. "Many vets do that in the case of breast tumours plus spay. However, which owner will be happy when the dog dies on the operating table? If I charge you $5.00 and your dog passes away on the operating table after I completed two surgeries, will you be happy at all?"

I don't know whether the couple understand my explanation. I ask them to speak to my associate vet who will be handling their case. In old dog anaesthesias, the owner actually understands and takes the risk. The vet must produce a live dog at the end of the day. I mean, if there are 5 breast tumours and you remove all completely. The dog dies on the operating table or 2 days later because it is old and can't take the lengthy anaesthesia and surgery, no owner is going to refer any friends to you. Deaths do occur, but the trick of the trade is to make anaesthesia short and if surgeries need to be performed twice or thrice, inform the owner. An old dog is very much like an old family member. Every owner wants him or her alive at the end of the surgery and go home walking.

26. Large toe granuloma. Just cut it off?

As part of my training, I asked my assistant what to do in this case of the Labrador Retriever with a large lick granuloma in his 5th toe? It is good to ask for ideas although one may be deemed incompetent in asking.

"Just cut off the toe from here and stitch up from there to here," my assistant outlined the approach of "de-clawing in the cat" to cut off the large granuloma that had existed for one month. The owner finally sought veterinary advice as the dog kept licking and licking. If only he had consulted the vet early, the treatment was so simple and effective as it would just be a simple wound.

"If you cut this large granuloma, you will have a very unhappy owner," I said. "The hole will be so big as the granuloma now covers the second and third phalanx too. For cat declawing, only the first phalanx is cut off. In this dog, the area is inflammed and infected. After cutting off, the wound will not heal well. The owner is going to spend more money and the dog is going to lick."

"We can hospitalise the dog and treat for him after surgery," my assistant suggested.

"No owner will be happy if the dog's wound does not heal after hospitalisation," I explained to him. "There is the money to be spent and the worries."

"The first method is to reduce the granuloma size using drugs," I explained to him. If the granuloma disappears, there is one happy owner. "If not, the size will be reduced and surgery to cut it off will be easier and the hole will be much smaller."

Toe and other lick granulomas are common in dogs. Owners neglect early vet attention. The instinct of the vet is to cut it off. Veterinary surgery is not always the answers to inflammatory granulomas in the toes.

25. Xylazine:Ketamine IV sedation and anaesthesia in dogs

There are many methods of anaesthesizing the dogs. One of them is the use of xylazine and ketamine IV. I believe this is seldom used as each vet has his own preferences. For example, I use xylazine tranquilisation IM and halothane and nowadays isoflurane gas anaesthesia over the past 20 years of practice and I find it to be very effective and safe, with rapid recovery.

However, old dogs can learn new tricks and I always ask other vets what anaesthesia they use. There is a great variety.

My associate vet loves to use Domitor pre-anaesthetic dosage, isoflurane and then Anti-sedan reversal. Another vet loves the xylazine/ketamine combination for anaesthesia. Another one loves zoletil injectable anaesthesia. The principal vet my god-daughter is seeing practice with in Perth never uses mask anaesthesia at all and therefore he does not have anaesthetic mask.

The following is my observation of xylazine:ketamine IV anaesthesia I used in one 26-kg, 5-year-old Labrador Retriever yesterday to treat a lick granuloma of the LH D5 toe.


THE GENERAL GUIDELINE FROM ONE VET
FOR XYLAZINE:KETAMINE IV ANAESTHESIA IN DOGS

FOR ANAESTHESIA
26kg, 5-year old dog
Xylazine 2% at 2.3 ml
Ketamine 100mg/ml at 0.3 ml
In one syringe, the total is 2.6 ml, IV

FOR SEDATION, the dosage is reduced as follows:
26kg, 5-year old dog

Xylazine 2% at 1.3 ml
Ketamine 100mg/ml at 0.3 ml
In one syringe, the total is 1.6 ml. IV
This was what I gave to the dog

After 1 minute, the dog was sedated.
After 5 minutes, I injected prednisolone into his large LH 5th digit granuloma. Slick flicker of pain reaction. He was sedated well.

Recovery
He took more than half an hour to wake up and more than 1 hour to stand up. I did not given any anti-xylazine reversal as ketamine is involved.

CONCLUSION
I prefer dogs to be standing up within 2 minutes of the end of a procedure or surgery. So, I will not be using this method. It will be good for cases where there are no gas machines. This is why I am recording this case for the benefit of vets who may not have anaesthetic gas facilities.

P.S.
From this practitioner who is experienced in this method of anaesthesia, there is a general formula for xylazine:ketamine IV anaesthesia in adult dogs.

For example, 26 kg, 5-year-old dog
Xyalzine 2.3 ml + ketamine 0.3 ml = 2.6 ml in one syringe.
This is a general formula and must be reduced according to health, age and weight.

24. Be proactive to save money - Telcos' confusion

Telcos all over the world confuse clients. Below is a excellent report on the situation in Singapore in April 20910 from one lady. She should be in the consulting and research field. All the time, I had the perception that Starhub who was the first mover in providing free in-coming calls was still the best value-for-money of the 3 telcos in Singapore.

Telcos rely on the "inertia" of people. People who have subscribed to the line will usually not want to switch to the better deal and they start giving various packages to confuse comparisons. Unless one has the time to research on this.

E-MAIL FROM DR SING

On Sun, Apr 11, 2010 at 4:24 PM, Kong Yuen Sing <99pups@gmail.com> wrote:

96640404 is not available. Can you recommend me whether I should subscribe to Starhub or Singtel and what plans? I will do it on Monday and get for you the tel no

E-MAIL TO DR SING

You can subscribe to corporate SunSaver Plus plan from M1 for a 3-months subscription period without handset.

Below is the details of this plan:
Corporate SunSaver Plus
- monthly subscription $48.15
- free local outgoing mins cap at 300mins
- free local sms cap at 500sms
- M1's free incoming calls is valid till 31 Dec 2012
- Excess local outgoing mins are charged 16.05¢ flat per min. Excess local sms-es are charged 5.35¢ per sms.

I estimated that the business calls usage would range from 400mins to 500mins so the monthly phone bill incurred is likely to ranged from $64.20 to $80.25. If one day you find that the monthly phone bill consistently exceeds $82.95 for months due to the business call usage exceeding 516mins and I would suggest an upgrade to SunMax plan (scroll down for details on SunMax plan). Meanwhile, you can subscribe to SunSaver Plan plan first.

Pls: scroll down below for explanation to the choice.

Thanks.

Regards,
Ling

------

Note: Though you told me to choose the plan, I think it's still right to explain to you the choice. Below is the rather lengthy explanation if you are free to go through:

The monthly subscription pricing of the free incoming calls corporate plans of the Starhub, M1 and Singtel are essentially the same. But Starhub's and M1's free incoming calls corporate plans comes with per second billing, which is more economical than Singtel which charges by an initial block of 1min and subsequent blocks of 6secs. For the validity date of the free incoming call, M1's free incoming call is valid till Dec 31, 2012 while Starhub's and Singtel's free incoming calls are valid till Dec 31, 2010.

The minimum subscription period without purchase of handset is 3-months for all the three mobile service providers.

If you plan to subscribe for 3-months or 6-months, for which the subscription would end before Dec 21, 2010, it wouldn't make a difference whether you choose to Starhub or M1. However, if you plan to subscribe for 1-year, I would suggest that you sign under M1 as Starhub's free incoming calls are not valid after Dec 31, 2010.

I estimate that the business calls minutes can range between 400 to 500mins.

If you intend to subscribe to Starhub, you can choose
- Corporate PowerValue 300
monthly subscription $48.15
free outgoing mins cap at 300mins
free sms cap at 500sms

- Corporate PowerValue 700
monthly subscription $82.93
free outgoing mins cap at 700mins
free sms cap at 500sms

If you intend to subscribe to M1, you can choose
- Corporate SunSaver Plus
monthly subscription $48.15
free outgoing mins cap at 300mins
free sms cap at 500sms

- Corporate SunMax
monthly subscription $82.93
free outgoing mins cap at 700mins
free sms cap at 500sms

To simplify, you can subscribe the corporate SunSaver Plus plan from M1 first. If you plan to renew the subscription in the future, you can still enjoy the free incoming calls which is valid till Dec 31, 2012. If one day you were to feel that the corporate SunSaver Plus plan is insufficient for your business calls usage, you can upgrade to the corporate SunMax plan.

23. Biosecurity in poultry farms - Part 2

E-MAIL TO DR SING
2010/4/11 ...@hotmail.com>


Hi Dr Sing!

Thank you for your comments. I have re-written my essay but i'm still not very sure if i'm on the right track. Should I put it as "I am the farmer" point of view, or a general point of view? And how do i link the different farm systems? Have i done it correctly?

Poultry Assignment 2010

“It is difficult for people to catch H5N1 bird flu, but when they do, it can be deadly, (Reuters, 2010).” Bird flu is one of the main concerns of the poultry industry leading to massive economic losses in farms. For example, in December 2008, authorities found H5N1 in a chicken at a poultry farm in Hong Kong, prompting the slaughter of more than 90,000 birds (AFP, 2009). Such diseases can be prevented by implementing biosecurity measures.

WHAT IS THE DEFINITION OF BIOSECURITY? Is it just purely disease prevention?

Diseases can be introduced to poultry farms through people, poultry, contaminated premises or equipment and vectors. The type of biosecurity measures to be implemented depends on whether I am operating a free range farm, barn layer system or a conventional caged farm. Some preventive procedures can apply to all systems, while others are specifically to one or two.



For any type of the three farm systems mentioned above, the following measures must be implemented. Firstly, newly arrived or sick birds must be quarantined to prevent transmission of diseases to the healthy flock.



Secondly, routine vaccinations will be given to all chickens to prevent a particular disease by triggering the bird’s immune system to produce antibodies that in turn fight the invading causal organisms (PoultryHub, 2009). For example, vaccines such as live (V4) vaccine and in ovo Mareks Disease Vaccination are commercially used.



Thirdly, I will oversee that visitor hygiene measures are strictly abided by. Signage and gates will be put up to discourage unauthorized individuals from entering the farm (PoultryHub, 2009). Visitors and service providers must wear overalls and boots that will be provided and foot washing baths will be available at the entrance of each shed for disinfection prior to entry (PoultryHub, 2009). I will also ensure that movement of people will be scheduled such that the youngest flocks are visited first and the oldest last (PoultryHub, 2009).



Fourthly, minimizing fear and anxiety in the birds to reduce their stress level will help the birds’ natural protective mechanisms to function optimally (PoultryHub, 2009). Also, using good quality feed is particularly important as bacteria and mould may be present in poor quality feed (PoultryHub, 2009).



Fifth, I will ensure that daily inspection is done on the birds; any sick or dead birds must be removed immediately to prevent the spread of bacteria or virus.



The following are measures related to specific farm systems. If I were to operate a conventional cage or barn layer systems, thus I will ensure that a good ventilation system is installed as birds are confined to a very small area and are thus very susceptible to any air borne diseases.



If I were to operate a free range farm system, I will wire net the barns to make them bird proof (PoultryHub, 2009), discourage wild birds from visiting by removing any spilled feed immediately (deGraft-Hanson, 2002) and by sanitizing water for bird consumption (Commonwealth of Australia, 2010). I will also ensure good fencing to prevent rodents from gaining access which may contaminate poultry feed.



In conclusion, it is important to know what type of farm system is used and implement the right measure to protect the birds against potential sources of diseases.

REFERENCES



E-MAIL REPLY FROM DR SING

Excellent report. Easy to understand and I don't fall asleep reading it. I think you have a gift for research writing.

You should look at the question and you will know the answer. I believe the question was "What aspects of the biosecurity program would you put in place to protect my poultry farm against the 4 potential sources of diseases? I don't know how many poultry housing systems there are in this world as I am out of the poultry line for at least 30 years. The only birds I see recently are those common black and white ones and crows in Perth.

I believe poultry has two types of housing systems - the indoor and outdoor (free ranging systems). How to link them? You have had done it.

I remember some points which may be relevant to biosecurity too.
1. Good record keeping of biosecurity measures and writing manual of standard operating procedures for hygiene controls.
2. Review of breaches of biosecurity and learn from them, sharing knowledge with managers.
3. Regular education program for new employees and staff on biosecurity measures
4. CCTV and alarm systems for expensive breeding stock?
5. Veterinary post-mortem of sick birds, blood test to check effectiveness of vaccination, health surveillance of random samples regularly.
6. Keep up research and good writing. Be hands on. Go and visit real poultry farms! Dog farms, fish farms, alpacca farms etc and you will see biosecurity in action. Study hard. Best wishes.

22. The girl with the clicking car

Undergraduate days are frugal days and possessing a car in the 1960s was a big thing as most Singapore undergraduates then and now cannot afford ownership of a car. Not in Perth. A$3,000 will buy you a moving car and many undergraduates drive.

But this small car was clicking every time the girl shifted gears to drive. "Click," she shifted to gear 1. "Click," she shifted to gear 2 and so forth for the rest of the journey to see the principal vet.

"Are you sure your car is safe to drive?" I asked the girl. "Will it crash?"

"The mechanic says there should be no problem," she clicked again. "The mechanic needs to dismantle the gear box to solve the problem." The girl has no priority for a clickety car and was too busy.

I have my doubts about the safety of a clicking car. Must do some research. Will not the clicking cause friction. Friction causes sparks. Sparks cause the car to catch fire? I mean, if a dog is coughing, will persistent coughing lead to some serious illness? Does this not apply to a car too? Prevention is better than cure.

I did not mention this to the girl's mother in Singapore. Otherwise, the mother would worry more.

21. TRAVEL STORIES. A 79-year-old war veteran with agile mind in Perth, Australia in 2010. KINDLE STORIES

TRAVEL STORIES.
Dr Sing Kong Yuen, BVMS (Glasgow), April 2010.

This one-week in Perth, Australia, far away from my practice in Singapore, gave me time to reflect and see life and matters in a new perspective. 

Be proactive is the topic I had been thinking.

Inertia is preferred as it is troublesome and uncomfortable to start something new. The status quo is what most people wanted and therefore, the "opt-out" system of organ donation is being used by governments. If you don't "opt-out" in writing, the law states that you have agreed. Being proactive may lead to undesirable consequences.

Two days ago, I asked a young man to drive me to visit a veterinary practice at 10 am as I would like to educate myself on how vets in other countries were managing their business.

This practice was equipped with laboratory equipment to test for cortisol and thyroxine, blood pressure monitoring, ECG and a breath-rate-monitoring alarm system during anaesthesia. I sat on the bench in the waiting room.

Within 1 minute, the receptionist attended to me. "He's out," the receptionist said. So, I was surprised. He came back soon. This vet was a dynamic successful man in his 40s as he has 2 practices. I was surprised that he has no anaesthetic masks in his practice. 

"No need," he said. "I induced them with drugs." This was a new perspective to me as face masks are part and parcel of practice. For example, I used anaesthetic mask in dogs in shock in emergency Caesarean sections without giving sedation injections. However, each vet has his own successful methods of anaesthesia.

I was surprised that he was allergic to rabbits. "How about horses?" I asked. "Yes," he said. I considered myself fortunate in not being allergic to animals for the past 30 years.

I checked out the ambience of the surroundings as this was necessary for me to assess for the mother of Alice, a vet student who would be doing internship in this practice, as to whether this neighbourhood was relatively safe. It was a typical suburb but unlike my rental unit in Willeton with its manicured lawns and rose gardens and overwhelming one-storey bungalows, this suburb has apartment blocks and low rises. Willeton is said to be a middle to upper class residential area of Perth.

I visited a beautiful lake near the veterinary practice. Many children and families were present on this weekday morning. Pelicans and water fowl were abundant. This was a surprise to me as most parks were quiet.

A 79-year-old war veteran passed by. He was a strong-looking tough man in dark sunglasses, walking a medium-sized Boxer-like dog in this beautiful park. I asked him about the plant with cones of yellow, white, pink, brown and black colours, so commonly seen in parks. It appears on the logo of Murdoch University too.

 

 

"You can suck the nectar from the small flowers of this banksia plant," he said to me and asked whether I wanted to do it. "No, thanks," I said. He walked dogs every morning and boarded them for people. "Do you charge for your services?" I asked. "No," he said. "Just whisky at the end of the walk."

He was 79 years old, had both eye lens replaced, a not so strong heart. But his mind was very active and alert. Many men in their 60s become senile, but he was so mentally alert and could tell me the species of various birds in the park and the whole history of coin-collecting. 

"How do you safeguard your coins?" I asked. I presume he was living alone. "I don't put all my coins in one place," he said. "Some in the bank, some in a safe." 

I asked him, "The thieves can just cart away your safe when you are out exercising the dogs." "My alarm system is connected to the security and in 5 minutes they will come." 

 "A clever thief will deactivate the system," I said. He had the answers, "My safe is underground and it will take a long time to haul it out." 

"The thief will just clear the safe by blowing it open," I said. "Not so easy," the war veteran who is an expert in explosives for the Australian army told me. "I have a steel door to the room." This was one man who was well prepared for all contingencies. He was an expert in old coins and all his expertise is inside his brain. 

"How do you sell your coins?" I asked. "There is a Phoenix auctioneer who charges a fee on successful sale," he said. This is a 79-year-old average man on a pension, but he certainly was not "one foot in the grave." He has daily exercise by taking dogs out for people free of charge. 

On knowing that I am a vet, he said, "In Australia, vets make a lot of money." 

An immigrant who owns the Bull Creek Hawker told me the same thing. "Why do you say that?" I asked the war veteran. "See the skin lump on this miniature pinscher," he pointed to a 1-cm lump on the left chest of the dog. "The vet charges A$50 just to tell me it is a skin lump." 

The successful boss of Bull Creek Hawker told me that it cost over A$100 to consult a vet when the dog has flu while a human being paid $27.00. "So, a man with no garden don't walk a dog," the boss referred to some Cantonese idiom, meaning that a poor man should not own a dog. 

While back from the park to Willeton, my driver who was an undergraduate at Murdoch University switched lanes from the right to the centre to the left suddenly, as he was on the wrong side of the road. 

"What to do?" he asked me as a police car had flashed him to stop. "Get onto a side road," I said. "And stop the car." He was having hand tremors. He was intimidated by the Australian police as they looked physically twice as big as him. The policemen were friendly and gave him a warning not to repeat the incident.

It is 17 Nov 2022 today as I read my article. Twelve years had passed. Was I proactive in the past 12 years of life? I would say I was, but not in the materialistic sense in that I don't own two veterinary clinics. I still have the original one at Toa Payoh Vets.

 

UPDATES AT:
https://2010vets.blogspot.com/2010/04/21-79-year-old-war-veteran-with-agile.html

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BANKSIA

Banksia is an Australian genus of shrubs and small trees that occurs on a wide range of soils including those that are so infertile, wet, or dry, that other woody species do not grow.

 Banksias for the Garden

Banksias usually grow best in well drained soils in a sunny position. Most respond to light pruning, and those which form a woody rootstock (lignotuber) can be heavily pruned. Only low phosphorus fertilisers should be used.

Species native to Western Australia are prone to root-rot fungus and generally do not grow well in parts of Australia which experience high humidity and rainfall in the summer.
Banksias range from low-growing shrubs to trees up to 25 m tall. Some species, for example Banksia ericifolia and Banksia menziesii , are known for their spectacular flower heads. The flower heads produce large volumes of nectar and attract many birds and small mammals to feed on them. Banksias are excellent plants to encourage native animals to the garden.