SUNDAY CASE - May 16, 2010
Miniature Schnauzer, Male, 6 years
Annual vaccination + proheart vacc
Examination:
Bladder palpated. Body shivered when lower abdomen is palpated. The 17-year-old daughter saw the vibrations. "He has some abdominal pain" I said. "Maybe a bladder infection."
"Can smell his urine from far away," the father said.
"Does the dog urine-mark?" I asked.
"Yes. He would pee a lot first and then urine-mark every spot even if he has nothing to pee."
"Does he drink a lot?"
"No," the father and daughter replied. "How to make him drink more and how much he should be drinking a day?"
"Exercise will make him thirsty. Some dogs love iced water. Put ice cubes into the water," I said.
Advice:
Dogs over 2 years need a preventive programme, not just annual vaccination.
1. Complete Blood test
2. Urine test to check for struvite stones and bacteria.
Permission:
Much depends on the parents.
Urine test agreed. Urine catheter, collect dark yellow cloudy urine to be sent to the Lab.
3. Read about prevention of urinary struvite stones.
4. 3-monthly or 3-6 monthly urine test will be best but no owners will do it.
Questions:
How long after neutering will my dog stop urine marking?
"Now, 6 years old. It will take many weeks to a year."
1. Probably 1 year
2. Schedule. lst month - urine mark same area. Change to another location
Sunday, May 16, 2010
Friday, May 14, 2010
65. Dwarf Hamster, Male, 6 months. Wet penile area
"Wet Tail," the young lady said that her dwarf hamster of 6 months was very inactive and not eating or drinking since yesterday evening. It was 1 pm now.
"Wet Tail means that the hamster passes watery stools," I noted that the hamster's penile area was very wet, with yellow urine stains.
"He passes a lot of stools, hard ones," the young lady said. "What's wrong with him? He has this continuous sniffling sound, as if he has asthma." I held the hamster near my ears. Yes, he was emitting a "sit, sit, sit" sound.
INFECTION
"The hamster has an infection and so he was not moving or eating," I said. "Does he pee in a corner normally?"
"He pees everywhere," the young lady said. "Yesterday and today."
COMPETITION FOR FOOD
The hamster lives with the sibling who is bigger size in the same cage. "They have company. They never fight," the young lady was at home all day and had observed them. "Many pairs of male dwarf hamsters are OK when they are less than 3 months old," I said. "When they grow up, one will bite or attack the other."
The lady would not believe me as she was a first-time hamster owner. "Do they compete for food?" I asked. "Each would stuff as many sunflower seeds into their pouches as they can?"
"Yes," the lady confirmed. "Sometimes they stuff until their cheek pouches are very big. They only eat sunflower seeds. They don't like the other type of food."
The mouths of the two hamsters were smelly as the cheek pouches were infected due to impaction of the sunflower seeds. The seeds were also smelly as I took two seeds out of the pouch. Finally, after 5 minutes, the patient poured out 30 seeds.
HYPOTHESIS
1. Cheek pouch impaction. Bacterial infection from the pouches to the whole body system. Hamster had fever and stopped moving.
2. Urinary stain. Incontinent due to urinary tract infection or bites at this area causing painful urination. Bitten by the bigger-sized hamster. "Not as big as Hamstaro," the lady said. "But bigger than this one."
Then her friend spoke to her in Malay with some words "gig" and laughed. The bigger sibling does bite the ears and other parts of this subordinate hamster. "Whenever the squeaking became too loud," I separate them," the lady said.
ADVICE
Separate the two males or use a fencing between them. Or one upstairs and one downstairs in the crate. "They don't fight," the lady said. "Separate means they have no company for each other." I could not convince her and said: "OK, wait for the Battle of the Hamsters first."
"Wet Tail means that the hamster passes watery stools," I noted that the hamster's penile area was very wet, with yellow urine stains.
"He passes a lot of stools, hard ones," the young lady said. "What's wrong with him? He has this continuous sniffling sound, as if he has asthma." I held the hamster near my ears. Yes, he was emitting a "sit, sit, sit" sound.
INFECTION
"The hamster has an infection and so he was not moving or eating," I said. "Does he pee in a corner normally?"
"He pees everywhere," the young lady said. "Yesterday and today."
COMPETITION FOR FOOD
The hamster lives with the sibling who is bigger size in the same cage. "They have company. They never fight," the young lady was at home all day and had observed them. "Many pairs of male dwarf hamsters are OK when they are less than 3 months old," I said. "When they grow up, one will bite or attack the other."
The lady would not believe me as she was a first-time hamster owner. "Do they compete for food?" I asked. "Each would stuff as many sunflower seeds into their pouches as they can?"
"Yes," the lady confirmed. "Sometimes they stuff until their cheek pouches are very big. They only eat sunflower seeds. They don't like the other type of food."
The mouths of the two hamsters were smelly as the cheek pouches were infected due to impaction of the sunflower seeds. The seeds were also smelly as I took two seeds out of the pouch. Finally, after 5 minutes, the patient poured out 30 seeds.
HYPOTHESIS
1. Cheek pouch impaction. Bacterial infection from the pouches to the whole body system. Hamster had fever and stopped moving.
2. Urinary stain. Incontinent due to urinary tract infection or bites at this area causing painful urination. Bitten by the bigger-sized hamster. "Not as big as Hamstaro," the lady said. "But bigger than this one."
Then her friend spoke to her in Malay with some words "gig" and laughed. The bigger sibling does bite the ears and other parts of this subordinate hamster. "Whenever the squeaking became too loud," I separate them," the lady said.
ADVICE
Separate the two males or use a fencing between them. Or one upstairs and one downstairs in the crate. "They don't fight," the lady said. "Separate means they have no company for each other." I could not convince her and said: "OK, wait for the Battle of the Hamsters first."
64. Tips For Vets: Vaccinatiion of "female" puppy
The diversity of puppy development can lead to litigation or bad reputation if the vet does not adopt a certain procedure during the first vaccination.
I had a phone call from a lady owner today. She said that the puppy was a male but was listed as a female in the vaccination card by Vet 1.
In this case the pet shop said the puppy was female. He had no scrotum and a "long urethra". So Vet 1 trusted the pet shop operator who is in the business for many years.
Basically it is common sense to examine every puppy prior to vaccination so as to avoid such rare cases from happening. Never trust the pet shop operator to give you the correct info or the record the info after you sign a blank cheque (vaccination record).
I had a phone call from a lady owner today. She said that the puppy was a male but was listed as a female in the vaccination card by Vet 1.
In this case the pet shop said the puppy was female. He had no scrotum and a "long urethra". So Vet 1 trusted the pet shop operator who is in the business for many years.
Basically it is common sense to examine every puppy prior to vaccination so as to avoid such rare cases from happening. Never trust the pet shop operator to give you the correct info or the record the info after you sign a blank cheque (vaccination record).
63. What to do when one can't lower cholesterol level?
LETTER TO A CORRESPONDENT
I hope you will be able to help me find out what are the alternatives to Lipanthyl 160 which does NOT work in reducing cholesterol. The family doctor did mention taking red brewer's yeast at one's risk or nicotine. Nicotine was said not to be that effective and said that it is better to use Lipanthyl than nothing.
He said that cholesterol level would have shot higher if not for the use of Lipanthyl. I do not agree but said nothing. This drug is practically useless and causes liver damage. However, what can one advise a person who has no means of lowering the cholesterol level?
So, last month in Perth, I bought the last 2 bottles of red brewer's yeast. Apparently they were hot sellers after a TV advert, according to one retail person of a health shop.
Then I checked the internet. It was actually a statin. So, the person who takes it may die or go into a coma since she had shown severe side effects of statin use in the first place.
I ask for your help. Is there an effective drug alternative to statin?
Or another method involving change of lifestyle. I read one journal - a person claimed that he ate certain nuts and his cholesterol level went back to normal.
Please let me know if you will do research and let many readers know what to do. If you discover something, you may be able to be self employed and smell the roses, just like the sellers of red brewer's yeast.
Best wishes.
62. The boy who was late for his date
I was at the famous Takashimaya Shopping Centre on May 1, 2010, a public holiday. It was a Saturday which was my day off from work. It had been almost a year I had not been to Takashimaya and so I wanted to see how this old lady is competing with the younger malls. How did she reinvent herself? How busy were its food stalls which used to be packed like sardines some years ago? Now we have the Marina Bay Sands with all the top fashion shops.
I found a seat to order ice kachang and the oily carrot cake to eat.
There was this young tall and slim girl with long hair writing answers to mathematical problems and using her electronic calculator. She kept thumbing her mobile phone and part of her left side of her forehead was frowned with wavy lines. Eyebrows arched. I was sitting to her left and so could see only her left profile. She thumbed many times on her cell phone. She looked agitated.
Why would a young girl be doing homework on a public holiday in Takashimaya Shopping Centre's food mall? The public library at Takashimaya had closed down some years ago. In any case, the public libraries close on public holidays and this girl had no choice but to wait for her late date at this downtown shopping centre.
Who was she waiting for? Dressed up in modern fashion with zebra-striped T-shirt and coloured rectangles long pants. A touch of make up to give a natural look. At this tender age of 18 years. I could only see her profile as I sat to her left and ate the too sweet monstrous ice kachang and the extremely oily carrot cake which would up my blood cholesterol levels in a few seconds.
I guessed her date was late. Instead of wasting time, she was doing her homework on this public holiday at a public place. I was impressed with young adults who don't have time to waste and who are diligent to study for a bright future.
I was sitting to the left of the girl and she had focused on solving her 3rd maths problem. I peeked and saw words like "real numbers" in her maths worksheet. What is the meaning of "real numbers?". Are there false numbers? Fortunately for me, I did not have to do these maths problems during my A-levels in Medicine Class in Raffles Institution. There is no more "Medicine Class" nowadays in Singapore's junior colleges but there was this rare breed in the late 1960s.
After 10 minutes, a young boy-next-door suddenly banged his books on the table in front of her and greeted her with "I am here!". He appeared from nowhere and his banging attracted the others on the table.
"Ah, you are late!" I scolded him. "You must be her drinks!" The girl did not say a word, gathered her worksheet quickly, put them in her handbag. I looked at her from the side as her date helped her with her things. Was she mad? Was she embarrassed by his loud banging of the table in a public place? I don't know. Her profile showed a reddish brown face. In a few seconds she got away with her date. The young man said goodbye to me.
For young men, please let your date know if you are going to be late. There are many fishes in the ocean but treat each fish with care.
Thursday, May 13, 2010
The plump aged dwarf hamster
May 12, 2010
LUMPS AND BUMPS IN AN OLD DWARF HAMSTER
I excised a large hard fatty tumour of around 1 cm x 1 cm 12 days ago. It had pus and the owner had just discovered its presence. Zoletil IM and isoflurane gas anaesthesia were effective for this fat hamster who was 2 years old, nearly the end of her lifespan.
I stitched large skin wound with three 6/0 absorbable sutures. Hamster went home on the same day. The right eye had a thickened upper eyelid due to pus infection. I asked the owner to wait while I went to my car to get the camera to take a picture of the clean wound with little bleeding. The owner could not wait and disappeared in the waiting taxi.
12 days later, the caring young man consulted me as the hamster had a reddish lump in the operation area. "For the first 3 days, there was some bleeding under the skin. The hamster eats a lot and is very active. But what is this lump? Is it an infection?"
"This hamster is old and the hard lump could be the recurrence of his cancer," I said.
"I don't want her to be operated again," the owner said. The hamster may not survive a second anaesthesia.
"Wait and see for the next 7 days. It may be an infection," I gave him oral antibiotics. Malignant tumours do recur even in people. People can get chemotherapy and radiation but this will not be possible for the dwarf hamster.
P.S.
Aging leads to several problems in this hamster.
1. Both lip commissures are ulcerated and has pus. She still eats the seeds and has an excellent appetite, hiding the seeds inside her pouches.
2. The upper eyelid of the right eye is swollen. This could be hardened pus. I had snipped off part of it. The hamster still rubs her eyes. In one hamster with the same swollen upper eyelids, I snipped off the whole of the upper eyelid with no problems for the hamster. See webpage:
3. The skin of the elbow and other joints have flaky inflamed areas. The owner extended the legs but the hamster bit him. He has to clean off the inflamed skin.
BE KIND TO DWARF HAMSTERS
Check your hamster daily and get very small tumours excised by your vet.
LUMPS AND BUMPS IN AN OLD DWARF HAMSTER
I excised a large hard fatty tumour of around 1 cm x 1 cm 12 days ago. It had pus and the owner had just discovered its presence. Zoletil IM and isoflurane gas anaesthesia were effective for this fat hamster who was 2 years old, nearly the end of her lifespan.
I stitched large skin wound with three 6/0 absorbable sutures. Hamster went home on the same day. The right eye had a thickened upper eyelid due to pus infection. I asked the owner to wait while I went to my car to get the camera to take a picture of the clean wound with little bleeding. The owner could not wait and disappeared in the waiting taxi.
12 days later, the caring young man consulted me as the hamster had a reddish lump in the operation area. "For the first 3 days, there was some bleeding under the skin. The hamster eats a lot and is very active. But what is this lump? Is it an infection?"
"This hamster is old and the hard lump could be the recurrence of his cancer," I said.
"I don't want her to be operated again," the owner said. The hamster may not survive a second anaesthesia.
"Wait and see for the next 7 days. It may be an infection," I gave him oral antibiotics. Malignant tumours do recur even in people. People can get chemotherapy and radiation but this will not be possible for the dwarf hamster.
P.S.
Aging leads to several problems in this hamster.
1. Both lip commissures are ulcerated and has pus. She still eats the seeds and has an excellent appetite, hiding the seeds inside her pouches.
2. The upper eyelid of the right eye is swollen. This could be hardened pus. I had snipped off part of it. The hamster still rubs her eyes. In one hamster with the same swollen upper eyelids, I snipped off the whole of the upper eyelid with no problems for the hamster. See webpage:
3. The skin of the elbow and other joints have flaky inflamed areas. The owner extended the legs but the hamster bit him. He has to clean off the inflamed skin.
BE KIND TO DWARF HAMSTERS
Check your hamster daily and get very small tumours excised by your vet.
60. Educated young Singaporeans prevent oral diseases
Recently, I had two cases of owners phoning for dental scaling appointments for their dogs. I don't know about other surgeries, but few of my clients in the past bother about preventing mouth ulcers and tumours due to bad oral hygiene.
CASE 1. An 8-year-old Cavalier King Charles would not eat dry food. One of the 3 daughters complained that the dog had bad breath. So the father drove the mum and 2 daughters with the dog to get the dog dental scaling.
I had to extract 3 loose upper side teeth (PM 1 & 2 on Right Upper and PM 1 on Left Upper). Xylazine 2% 0.3 ml IM and isoflurane gas were used to anaesthesize the quiet friendly dog. "For an 8-year-old dog, his teeth are quite clean," I said to the family. "Other dogs of his age would have all teeth dropped out. What do you feed and do you brush his teeth?"
Mum said, "He eats chicken and rice. A little bit of dry food. He does not want to eat by himself and so I have to feed him."
I was surprised as most dogs eat by themselves. Is he a picky eater or because he has a painful mouth. "Do you brush his teeth?" I asked the mum. "I used a towel to clean his teeth but he is not cooperating."
"He should be able to eat dry food now that his loose teeth are extracted and therefore he should not feel any pain."
"But he has been eating chicken meat all these years," the mum said.
"Add a few pieces of dry food to his canned chicken meat for the first week," I advised. "Then increase more and more till he eats dry food. Dry food does clean his teeth. Brush his teeth 3 times a week too. Use the finger brush or the long tooth brush. I will not need to scale his teeth again."
"How long can a dog live?"
"In Singapore, the small breed can live up to 20 years, but in general, most live up to 10-15 years," I said to the happy family with 3 daughters now in their teens. Mum said the Cavalier King Charles was treated by me 8 years ago for diarrhoea. Well, he is now fully grown up and well loved.
As my intern Teresa was assisting me, I told her that the owner had prevented serious heart diseases by getting dental scaling done early. "What heart diseases?"
CASE 2
"How much do you charge for dental scaling?" a male voice asked. "$250 for general anaesthesia and dental scaling," I was answering the phone on this May 2010 Sunday. Asking for quotations is a common practice and so I did not ask whether he would like to make an appointment.
A handsome couple turned up. The lady was slim and as fair as the significant other with muscles was as dark. Both were in their early 30s. The Miniature Schnauzer had thick tartar in all his teeth and took at least 30 minutes of dental scaling unlike my Case 1. Stains and hard tartar enveloped the inside of the teeth. I wondered what the dog had been eating. Probably no teeth brushing.
"Is it not a boring job to be a cabin crew flying from one destination to another and flying back?" I asked the fair lady. She had minimal make up since she was not working and some red rashes showed on her cheeks. Those did not distract from her beauty. "No," she said. "It is an enjoyable job for me. There are hazards to this job."
"What hazards?" I asked, thinking of the air crashes.
"We get varicose veins due to long hours of standing," she showed me her some faint bluish blemish in her knee. Fortunately, the significant other did not get jealous.
CASE 1. An 8-year-old Cavalier King Charles would not eat dry food. One of the 3 daughters complained that the dog had bad breath. So the father drove the mum and 2 daughters with the dog to get the dog dental scaling.
I had to extract 3 loose upper side teeth (PM 1 & 2 on Right Upper and PM 1 on Left Upper). Xylazine 2% 0.3 ml IM and isoflurane gas were used to anaesthesize the quiet friendly dog. "For an 8-year-old dog, his teeth are quite clean," I said to the family. "Other dogs of his age would have all teeth dropped out. What do you feed and do you brush his teeth?"
Mum said, "He eats chicken and rice. A little bit of dry food. He does not want to eat by himself and so I have to feed him."
I was surprised as most dogs eat by themselves. Is he a picky eater or because he has a painful mouth. "Do you brush his teeth?" I asked the mum. "I used a towel to clean his teeth but he is not cooperating."
"He should be able to eat dry food now that his loose teeth are extracted and therefore he should not feel any pain."
"But he has been eating chicken meat all these years," the mum said.
"Add a few pieces of dry food to his canned chicken meat for the first week," I advised. "Then increase more and more till he eats dry food. Dry food does clean his teeth. Brush his teeth 3 times a week too. Use the finger brush or the long tooth brush. I will not need to scale his teeth again."
"How long can a dog live?"
"In Singapore, the small breed can live up to 20 years, but in general, most live up to 10-15 years," I said to the happy family with 3 daughters now in their teens. Mum said the Cavalier King Charles was treated by me 8 years ago for diarrhoea. Well, he is now fully grown up and well loved.
As my intern Teresa was assisting me, I told her that the owner had prevented serious heart diseases by getting dental scaling done early. "What heart diseases?"
CASE 2
"How much do you charge for dental scaling?" a male voice asked. "$250 for general anaesthesia and dental scaling," I was answering the phone on this May 2010 Sunday. Asking for quotations is a common practice and so I did not ask whether he would like to make an appointment.
A handsome couple turned up. The lady was slim and as fair as the significant other with muscles was as dark. Both were in their early 30s. The Miniature Schnauzer had thick tartar in all his teeth and took at least 30 minutes of dental scaling unlike my Case 1. Stains and hard tartar enveloped the inside of the teeth. I wondered what the dog had been eating. Probably no teeth brushing.
"Is it not a boring job to be a cabin crew flying from one destination to another and flying back?" I asked the fair lady. She had minimal make up since she was not working and some red rashes showed on her cheeks. Those did not distract from her beauty. "No," she said. "It is an enjoyable job for me. There are hazards to this job."
"What hazards?" I asked, thinking of the air crashes.
"We get varicose veins due to long hours of standing," she showed me her some faint bluish blemish in her knee. Fortunately, the significant other did not get jealous.
59. How to be successful?
May 12, 2010
To: Ms Koh
Do what you think is correct. Learn from being hands-on and making mistakes. There is no other way to be wiser and smarter.
Singapore expatriate real estate rental markets are getting hotter in 2010. I have at least 10 times more e-mails for asiahomes.com this year than last year regarding rentals esp. serviced apartments.
Some agents sms me about the Bishan Loft advert. Pl use your phone to make preliminary contact and e-mail.
Become an expert at Google Docs for real estate. I attach a picture hoping it will inspire you. I am into creating inspirational pictures for young people like you and those studying hard for their future.
The Golden Age of the internet is in your hands. Internet connects the world unlike my youthhood in the 1970s. One example I gave you was an expatriate who surfed the net, contacted www.asiahomes.com, met me and bought a $3.3 million Wing On Life condo in Singapore. My co-broking agency commission was $15,000. We would never meet if not for the world wide web.
I will not live long to enjoy this Golden Age as I was born at the wrong time. But young people like you will enjoy and prosper in this Golden Age if you know how to use the internet. Create rather than consume. This is my advice to all young adults like you. But few young adults create.
One good example is a 26-year-old man, Singaporean I met recently. He had been doing e-bay sales for the past 9 years. He did not need to work for people. He would get orders to create Star Wars "guns" etc and get them made in Singapore. Then he would mail them to customers in the U.S.A.
He was passionate in his craft as he showed me his Facebook portfolio. I was impressed with his creation of a gold ring similar to the one in the movie "Lord Of The Ring." It looked like a simple gold band but I could recognise it as the LOTR ring. He said that the movie ring had words engraved on it using CGI. He said his LOTR webpage was shut down.
But competition is nowadays much stronger and therefore his net profits have had reduced considerably. "This is a common challenge when Singapore becomes fully developed," I said to him. "Many younger vets have also set up shop to provide cheaper services than the established ones to get the business."
This young man is venturing into a "new" field "internet marketing" which also has lots of competitors and is actually an old subject. Some people even advertise in the Straits Times to conduct courses on "internet marketing." Nine years is a long time and I can understand he needs a change.
I could not believe that such young Singaporeans exist as I think they are addicted in online computer gaming and enjoyment at the age of 17 years which was when this young man started his enterprise to create and sell on e-bay. This young man showed me one other young man in Hongkong. That man created the "Iron Man" suit for sale. He lamented that this was beyond his capability. My comment is that he has lost focus and interest. It is a pity that he has no "determination" or "perseverance". He could manufacture and produce really good toys and has a forum to market his work.
In conclusion, create and read widely. One day, you will be successful even though you may not want to do real estate anymore. It is the hands-on internet experience and solving the problems of the real estate that will give you the hard edge to take on another industry later.
Best wishes
Dr Sing Kong Yuen
Best wishes.
To: Ms Koh
Do what you think is correct. Learn from being hands-on and making mistakes. There is no other way to be wiser and smarter.
Singapore expatriate real estate rental markets are getting hotter in 2010. I have at least 10 times more e-mails for asiahomes.com this year than last year regarding rentals esp. serviced apartments.
Some agents sms me about the Bishan Loft advert. Pl use your phone to make preliminary contact and e-mail.
Become an expert at Google Docs for real estate. I attach a picture hoping it will inspire you. I am into creating inspirational pictures for young people like you and those studying hard for their future.
The Golden Age of the internet is in your hands. Internet connects the world unlike my youthhood in the 1970s. One example I gave you was an expatriate who surfed the net, contacted www.asiahomes.com, met me and bought a $3.3 million Wing On Life condo in Singapore. My co-broking agency commission was $15,000. We would never meet if not for the world wide web.
I will not live long to enjoy this Golden Age as I was born at the wrong time. But young people like you will enjoy and prosper in this Golden Age if you know how to use the internet. Create rather than consume. This is my advice to all young adults like you. But few young adults create.
One good example is a 26-year-old man, Singaporean I met recently. He had been doing e-bay sales for the past 9 years. He did not need to work for people. He would get orders to create Star Wars "guns" etc and get them made in Singapore. Then he would mail them to customers in the U.S.A.
He was passionate in his craft as he showed me his Facebook portfolio. I was impressed with his creation of a gold ring similar to the one in the movie "Lord Of The Ring." It looked like a simple gold band but I could recognise it as the LOTR ring. He said that the movie ring had words engraved on it using CGI. He said his LOTR webpage was shut down.
But competition is nowadays much stronger and therefore his net profits have had reduced considerably. "This is a common challenge when Singapore becomes fully developed," I said to him. "Many younger vets have also set up shop to provide cheaper services than the established ones to get the business."
This young man is venturing into a "new" field "internet marketing" which also has lots of competitors and is actually an old subject. Some people even advertise in the Straits Times to conduct courses on "internet marketing." Nine years is a long time and I can understand he needs a change.
I could not believe that such young Singaporeans exist as I think they are addicted in online computer gaming and enjoyment at the age of 17 years which was when this young man started his enterprise to create and sell on e-bay. This young man showed me one other young man in Hongkong. That man created the "Iron Man" suit for sale. He lamented that this was beyond his capability. My comment is that he has lost focus and interest. It is a pity that he has no "determination" or "perseverance". He could manufacture and produce really good toys and has a forum to market his work.
In conclusion, create and read widely. One day, you will be successful even though you may not want to do real estate anymore. It is the hands-on internet experience and solving the problems of the real estate that will give you the hard edge to take on another industry later.
Best wishes
Dr Sing Kong Yuen
Best wishes.
Tuesday, May 11, 2010
58. Sunday's cases. Mother's Day 2010
It was Mother's Day on this Sunday, May 11, 2011. I open on Sundays but this Sunday, the Landlord of the industrial estate had switched off the electricity from 8 am to 3 pm. It was quite stuffy as the air conditioning was not functioning. "There will be no electricity," my 75-year-old receptionist informed me so that I could close the Surgery. However, I had prior appointments with Mrs Clow and her rabbit with diarrhoea. In any case, no surgery could be done, but consultation would be OK as I have bright glass windows and clear glass doors in the front desk.
After church at 11.30 am, Mrs Clow and her pre-teen daughter brought in 6 rabbits with crusty ear edges, nose and paws in one carrier with the mother rabbit and one wire cage with the father rabbit and 4 small dwarf rabbits of around 2 months old.
"My husband said that I should not be paying for the treatment as the rabbits are not mine. How much does it cost me to treat 6 rabbits for scabies?"
"Men are money-minded and practical unlike women when it comes to animals not belonging to them" I said.
"Does this include you?" she asked me. "No, no," I said. "I am generalising." I should have kept my mouth shut about the male homo sapiens.
"Should I send them to the SPCA?" Mrs Clow asked while her 11-year-old daughter was all ears.
I said: "If they are sent to the SPCA, they will be put to sleep after 3 days, as in most animal shelters in the U.S. Nobody would adopt these diseased rabbits. Their crusty infestation will take at least one week to drop off after my anti-scabies injection."
"Sometimes the scabies will recur as the surroundings still have the mites to attack the rabbits. In my experience one injection will do, but sometimes there is a need for two injections two weeks later. What will you be doing if the scabies come back?
"I can refer you to a pet shop that specialises in selling rabbits. The 4 young ones may find a home rather than be put to sleep at the SPCA." I phoned Agnes the pet shop operator. She was interested.
"In any case, you are not the owner," I cautioned. "You may get sued by the girl's parents. Why don't you talk to the owner? You are teaching your little girl the wrong values."
Mrs Clow said of her tall and slim daughter: "She is a big girl."
"How old are you," I asked the quiet girl.
"She is 11 years old," Mrs Clow replied.
Then she took out her iPhone from her handbag and thumb a message to the owner of the rabbit. Within a few seconds, Mrs Clow read the reply and said: "She wants all the 6 rabbits back."
"Why don't you talk to the girl's mother?" I advised. "You may get sued for doing what is right in your opinion." What is the right thing to do would be to sterilise the adult rabbits and to get them treated for scabies.
Bad blood between neighbours can flow fast if all these rabbits don't go home. Mrs
Clow said: "Treat the rabbits and keep them overnight. I will pay you tomorrow when I bring them home."
The four baby dwarf rabbits had thick crusts of 1cm x 0.8 cm on their noses and various big crusts on their paws and edges of the ears. They were thin. Normally I would not give them the anti-mite injection but this was now or never. So my intern Theresa restrained each rabbit while I injected the medicine under the skin at the back of the neck. One young rabbit squeaked. Another squealed and lay flat as it felt the pain. Theresa massaged the area and it recovered.
Mrs Clow went home and text-messaged me that the owner's mother would contact me. The mother paid for the treatment of the 6 rabbits the next day and brought them home. I hope the young ones would be OK and be able to eat a lot to put on weight and build up their resistance.
This was an usual Mother's Day as it involved two mothers and two daughters.
I remembered this day as a young couple came in with a cat with an injured right hind limb and the man said: "I googled 'vet open Sunday' and your practice appears on the top."
I was surprised. This cat had strayed out of the apartment and came back very lame. "She could not walk at first," the man said. "Now she could walk but her right hind leg was dragging."
I put the cat on the examination table and asked Theresa to hold it down on its left side. I flexed and extended the toes, stifle and the hip joints. There was no pain in the toes and stifle. But I heard a distinct click as the right hip ball and socket went back into the hip joint. "Did you hear the click?" I asked the man who was standing nearby. "Your cat was dragging its right hind because it had a loose hip, a subluxation of the hip joint." His wife was further back in this 80 sq. ft consultation room. "No," the man said. "I must be hard of hearing."
"No," his wife shook her head.
"Did you hear the click?" I asked my intern Theresa.
"Yes," Theresa said.
"In any case, did you see that the cat was angry when I put fix the hip as I rotated the ball into its socket?" I asked.
"Yes," the man confirmed. Then I pressed the backbone of the cat. It reacted in pain at the lower back. "Most likely, this cat had been attacked by another cat on its back and got his right hind limb skin scrapped off. Or a naughty boy had bashed him with a stick."
I was generalising on the male behaviour again. The cat was treated and warded for 3 days as the owner had no crate for him. He was as good as gold.
After church at 11.30 am, Mrs Clow and her pre-teen daughter brought in 6 rabbits with crusty ear edges, nose and paws in one carrier with the mother rabbit and one wire cage with the father rabbit and 4 small dwarf rabbits of around 2 months old.
"My husband said that I should not be paying for the treatment as the rabbits are not mine. How much does it cost me to treat 6 rabbits for scabies?"
"Men are money-minded and practical unlike women when it comes to animals not belonging to them" I said.
"Does this include you?" she asked me. "No, no," I said. "I am generalising." I should have kept my mouth shut about the male homo sapiens.
"Should I send them to the SPCA?" Mrs Clow asked while her 11-year-old daughter was all ears.
I said: "If they are sent to the SPCA, they will be put to sleep after 3 days, as in most animal shelters in the U.S. Nobody would adopt these diseased rabbits. Their crusty infestation will take at least one week to drop off after my anti-scabies injection."
"Sometimes the scabies will recur as the surroundings still have the mites to attack the rabbits. In my experience one injection will do, but sometimes there is a need for two injections two weeks later. What will you be doing if the scabies come back?
"I can refer you to a pet shop that specialises in selling rabbits. The 4 young ones may find a home rather than be put to sleep at the SPCA." I phoned Agnes the pet shop operator. She was interested.
"In any case, you are not the owner," I cautioned. "You may get sued by the girl's parents. Why don't you talk to the owner? You are teaching your little girl the wrong values."
Mrs Clow said of her tall and slim daughter: "She is a big girl."
"How old are you," I asked the quiet girl.
"She is 11 years old," Mrs Clow replied.
Then she took out her iPhone from her handbag and thumb a message to the owner of the rabbit. Within a few seconds, Mrs Clow read the reply and said: "She wants all the 6 rabbits back."
"Why don't you talk to the girl's mother?" I advised. "You may get sued for doing what is right in your opinion." What is the right thing to do would be to sterilise the adult rabbits and to get them treated for scabies.
Bad blood between neighbours can flow fast if all these rabbits don't go home. Mrs
Clow said: "Treat the rabbits and keep them overnight. I will pay you tomorrow when I bring them home."
The four baby dwarf rabbits had thick crusts of 1cm x 0.8 cm on their noses and various big crusts on their paws and edges of the ears. They were thin. Normally I would not give them the anti-mite injection but this was now or never. So my intern Theresa restrained each rabbit while I injected the medicine under the skin at the back of the neck. One young rabbit squeaked. Another squealed and lay flat as it felt the pain. Theresa massaged the area and it recovered.
Mrs Clow went home and text-messaged me that the owner's mother would contact me. The mother paid for the treatment of the 6 rabbits the next day and brought them home. I hope the young ones would be OK and be able to eat a lot to put on weight and build up their resistance.
This was an usual Mother's Day as it involved two mothers and two daughters.
I remembered this day as a young couple came in with a cat with an injured right hind limb and the man said: "I googled 'vet open Sunday' and your practice appears on the top."
I was surprised. This cat had strayed out of the apartment and came back very lame. "She could not walk at first," the man said. "Now she could walk but her right hind leg was dragging."
I put the cat on the examination table and asked Theresa to hold it down on its left side. I flexed and extended the toes, stifle and the hip joints. There was no pain in the toes and stifle. But I heard a distinct click as the right hip ball and socket went back into the hip joint. "Did you hear the click?" I asked the man who was standing nearby. "Your cat was dragging its right hind because it had a loose hip, a subluxation of the hip joint." His wife was further back in this 80 sq. ft consultation room. "No," the man said. "I must be hard of hearing."
"No," his wife shook her head.
"Did you hear the click?" I asked my intern Theresa.
"Yes," Theresa said.
"In any case, did you see that the cat was angry when I put fix the hip as I rotated the ball into its socket?" I asked.
"Yes," the man confirmed. Then I pressed the backbone of the cat. It reacted in pain at the lower back. "Most likely, this cat had been attacked by another cat on its back and got his right hind limb skin scrapped off. Or a naughty boy had bashed him with a stick."
I was generalising on the male behaviour again. The cat was treated and warded for 3 days as the owner had no crate for him. He was as good as gold.
A forgetful intern?
7. A forgetful veterinary intern?
Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.
"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.
Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."
"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.
This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.
Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?
As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."
I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).
Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.
"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.
Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."
"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.
This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.
Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?
As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."
I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).
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