196. Toilet training an adult dog that lies on her own pee

E-MAIL TO DR SING DATE SEP 14, 2010


On Tue, Sep 14, 2010 at 3:04 PM, Eian T wrote:

Hi Dr Sing,

I was desperately surfing the website for help when I chanced upon your articles. Then I called your clinic and left a message.

My dog is currently not your patient and so I would like to ask if you provide any sort of advice/toilet training?

I just got a miniature poodle from the farm (I was told she was vaccinated by a vet in Toa Payoh, I need to check it out). The poor poodle must have been in the farm for the past 8 months as she is very comfortable eating, sleeping and doing her business in the same place. And she has no problem lying in her pee.

What I did was cordon her off in the kitchen with a pee tray (used by my older dog) and everytime I see her pee/poo, I carried her to the pee tray. It didnt help. She has this problem of whining til she pees when I go away. So I put the tray where she likes to stand so that if she whines and pees, it will end up in the tray. This is to keep the place clean since I have to work in the day.

Other problems - she hardly does it when I watch her but the moment I go away she will relieve herself. I take her down for long walks and she has not done it at all. When I other dog goes to the tray, the new dog doesnt learn as well.

I'm quite lost and wonder if you do provide some house visit on toilet training a dog like that?

Hope to hear from you.

Thank you.






E-MAIL FROM DR SING DATE SEP 17, 2010


1. Just read your e-mail today as I was busy attending the wake of my god-daughter who had an accident in Perth and had returned back to Singapore.

2. I do house-calls by appointment, but the best and less expensive method is to have a one-to-one discussion in the Q&A format at Toa Payoh Vets. There are many management factors affecting toilet training that cannot be written in your e-mail. This will take up around 30 minutes of discussion at Toa Payoh Vets. However, this may not be practical advice for you. In the meantime, I have written some guidelines for you and for other readers in your situation:

3. The following is my guideline for you as your dog is now an adult dog much conditioned to its environment in which she has lost her natural instinct to be clean. So she keeps lying on her pee. She does not want to eliminate on your other dog's tray or environment.

3.1 Buy a new big crate with a grated flooring and a pee pan below.
3.2 Confine this dog inside this crate when you work.
3.3 On half the floor area of this, put non-slip rubber mats for her as a sleeping and eating area.
3.4 On the other half is the grated floor. Below the grated floor, in the pee pan, there are newspapers lined on the pee pan. On the half that is below the grated floor, put this dog's urine onto the newspapers. The other half below the non-slip mats, you should not soil it with the dog's urine.
3.5 Try this method to restore the dog's natural instinct to be clean. Let me know. It will take 2-4 weeks. Pl make an appointment if you wish to discuss further with me as it takes a book just to discuss about toilet-training an adult dog! Each dog and owner have their own personality and that is why it is important to meet at Toa Payoh Vets (for economic reasons). The best way to contact me is to phone me directly and my receptionist will give you my phone number.

Let my receptionist know if you wish to make appointment to discuss further as there are 3 vets and many of my ordinary cases are handled by Dr Vanessa Lin.

195. Horse banged car in Brisbane

Sep 14, 2010
9 pm

"As I drove round the bend, a horse trotted across the road," Dr J said as he started eating the nuts and melon seeds. We were attending the wake of my god-daughter who had a car accident on Sep 3, 2010. He wanted to attend the wake and phoned me. My god-daughter had worked in his veterinary surgery for around one year before embarking on a second degree to become a veterinarian. She had worked as an intern in his practice around 2 months ago. She was 5 weeks before graduation and a car accident happened.

"What happened to the horse?" I asked. Kangaroos and deer do cross the road suddenly in Australia causing car accidents. I recalled an incident when a deer crossed the road suddenly in Scotland where I had studied veterinary medicine but the vet braked in time. This was the first time I heard about a horse.

"The horse slid up my car bonnet and smashed the wind screen," Dr J said. "You know that the bonnet usually has a curved front. After the accident, the bonnet was as flat as a pancake. The bonnet then sprung upwards."

"So what happened to the horse?" I was glad he lived to tell the tale. A draught horse would weigh over 600 kg. I imagined that the huge body of the horse would have killed Dr J if he had driven the usual small car.

"The horse had to be put down later," Dr J said. "My face was pock-marked with glass shards. The doctor had to extract the pieces. When Nellie (a vet student in the 3rd year while Dr J was in the 5th year in Queensland University in the 1960s) saw my face, she burst out laughing."

"What make of car were you driviing?" I was surprised that he did not suffer more serious injuries.

"A Holden" Dr J said. "A big solid car which is common in Australia but too expensive to be sold in Singapore". This explained why he was not killed in the accident as it seemed that the impact sent the horse's side body shooting towards him crashing into the windscreen. In Australia, the minimum speed for expressway is said to be 100 km/hr unlike lower speed in Singapore. So, drink-driving daccidents are common every weekend such that the trauma nurses in the Perth's hospital know exactly what to do when the helicopter flies in the accident victims.

"These trauma nurses would literally run towards the helipad when the announcement was made of the arrival of the helicopter," my god-daughter's mum told me when I visited her yesterday to comfort her. She had been hospitalised in Perth's major trauma hospital before her return to Singapore. "Is it like the TV show 'ER'" I had asked her. "Yes, very much like that."

As for Dr J, he was fortunate to be alive today as he had driven a big car. The car was around 8 years old but it protected him as it had a longer bonnet than the usual Japanese car.

"Did you get compensation?" I asked Dr J. "The laws said that in this accident, nobody is at fault. Nobody gets compensation. It was around 3 months before the final year examination. I had to go to various farms to do internship. So, I rushed to buy another car."

"Why would a horse be wandering around at 9 pm?" I asked Dr J.

"The farmer said that his horse had escaped." This was plausible. "When you are young, you tend to take risks. I was driving a motorcycle everywhere in Brisbane and up and down the expressways as a student."

"A young man thinks that he is invincible." I remarked. The testosterone surge in young men in their early 20s had led to a large number of fatal accidents in Singapore and all over the world. When I was a young man, I tested my Mini-Clubman on the Malaysian expressways, overtaking big lorries as much as possible driving from Singapore to Kuala Lumpur at night. I sped till the Clubman rattled at 120 mph and I thought it would split open. Fortunately the Clubman returned to normal status when I slowed down or I would not have lived to write this story.

As for Dr J, he went to Brisbane recently. "I looked at the GPS navigation system as I drove," he said to me. I had to hold the handset close to see the map and to drive as well. There is no need to check the map anymore."

Fortunately he lived again as this is a very risky way of driving in Australia. The country side roads are full of gravel and some expressways have pot-holes. "Drink-drivers are common," Dr J said to me. "You may need to be alert as they may hit you even though you are careful. As the expressway is long, you can fall asleep while driving."

194. Sunday case: Thousands of baby ticks & other interesting cases

Sunday Sep 12, 2010 6.15 pm recording of cases seen today.

VEXING CASE

"My Jack Russell went to the vet last week for nail clipping," the young couple said. "He peed on the grass. Now he has lots of ticks on the body and inside the ears. I used Frontline yesterday and today a tick wash sold by the groomer."

Examination & de-ticking.
1. Clipped bald. Hundreds of ticks paralysed and stuck on the body
2. Forceps to pick up ticks but then many smaller ticks still alive.
3. "I need to use the tacktic wash," my groomer said. "Otherwise the owner will not be happy when he sees more ticks after de-ticking. The owner did NOT use sufficient dosage of the insecticide (2 caps to 1 litre of water, unknown drug) and therefore the baby ticks are still alive.

Examination after de-ticking.
The owner complained one tick was seen in the left ear and one on the face (left side). He bites when the owner tried to pull out the hanging ticks.

"The procedure is incorrect in this case," my groomer said. "Should have given tick wash first at correct dose, then shave and the ticks will fall off."

We picked up all the very small baby ticks that were still alive. The dog bit the owner and so it was a time-consuming case to brush out all baby ticks. Took almost one hour.

Owner advised to use Frontline Spot on tomorrow as the apartment is full of ticks. Advantix from Bayer repels the tick but the owner was not keen and wanted to buy Frontline from the pet shop as this could be cheaper. "Repels" means preventing ticks from the surrounding kitchen and bathroom to attach onto the dog but the owner could not understand the difference.

CAESAREAN
Water bag burst this morning, some 6 hours ago, but the Westie home-breeder wanted me to examine and see what I can do. I was about to close at 5p.m. After waiting for over 40 minutes, I phoned. She said she could not find a taxi but this was not credible as Singapore's taxis are many nowadays. She wanted us to wait. Such cases were not genuine. She agreed that she would not be coming.

Advice: If no puppy is born within 1 hour of the water bag rupture, an emergency Caesarean is needed. Not wait and see as the pup would have had died and the mother could be in danger of possessing a smelly dead pup (if delays over 12 hours).

DENTAL SCALING
Cavalier King Charles had dental scaling and pro-heart injection. No problem.

CAT CONSTIPATED FOR ONE WEEK. It could be that he was made to wear an e-collar to prevent scratching of his left eye. He had a cat flu and was sneezing. Somehow his left eye was itchy. When the e-collar was taken off, he scratched his left eye again. What's the cause of the conjuncitivits? I had the cat under general anaesthesia and flushed off any foreign body from under the 3rd eyelid. "He was OK," the young lady said. "When I took off the e-collar, he started to rub his left eye." I checked the left ear. It was clean unless the horizontal canal had some debris. Ears were both clean.

I palpated. Constipated stools felt. Enema given. Cat passed out some stools within 5 minutes. I asked: "Has he been wearing the e-collar 7 days ago? He did not poop as he had to wear an e-collar."

"Most likely he disliked the e-collar as he could not clean himself after pooping," the lady diagnosed. Boarded one day to observe. Should go home tomorrow.

LATERAL EAR CANAL RESECTION. The parents and daughter came to visit him. "The wounds are still wet and bleeding 4 days after surgery," I said. "The surgical area looks very bad after surgery but will look good some 14 days later." I showed the owner where the horizontal canal opening was by putting a cotton bud inside the canal on the left ear. The Miniature Schnazuer with hairy ears did not bite me. He shook his head and the cotton bud got stuck outside his horizontal canal opening and I had to take it out. He was still on NSAID pain-killers and did not bite. But not ready to go home yet as the owner will not know how to clean the ear surgical area. Another 2 days.

9 kg. Male. Not neutered. 5 years.

--- INTERESTING HISTORY FROM MY FILES

26 Jul 2007 Right head tilt. Right ear. brown pus and ear powder. Otitis externa. Dog tranquilised and ear hairs plucked. Panalog for ear cleaning.

3 Jan 2010 Excessive ear hairs and otitis externa. Tranquilised and ear irrigation. Panalog.


25 May 2010 Wanted panalog and antibiotics.


8 Sep 2010. Lateral ear canal resection together with Dr Vanessa Lin.


STRAY CAT WITH ORAL ULCERS RECOVERING AFTER PREDNISOLONE
The expatriate couple said they would pick up the cat 3 days ago but did not turn
up. Ulcers will recur again. No permanent cue. Will e-mail the couple again.


RIGHT HIP JOINT DISLOCATION IN A CHOW CHOW X. 10 days after car accident. X-ray confirmed dislocation. Surgery advised by Vet 1. "Not likely to be successful in popping the bone into the joint now," I said.

193. Dry itchy skin in a veterinarian

Saturday Sep 11, 2010

I was surprised to meet an ex-colleague near Centrepoint Shopping Centre yesterday afternoon. He was graduating from Glasgow University while I had just entered first year. That was in 1969. I was assigned to the Veterinary Diagnositic Labaoratory at Kampong Java Road while he was in the Vaccine Production Unit. Now, the whole area is the Kandang Kerbau Hospital. As a new vet, I knew nothing about poultry and swine virology and I learnt much from him and another vet.

The striking memory of him was that he was always scratching his hands and neck daily and many times. Then he would scratch his back. He was allergic to horses and so could not be near them when he was in the final year at Glasgow University. I wondered how he passed his horse examination.

I remembered more vividly the one day when we went to the poultry farm to collect blood as from vaccinated and unvaccinated chickens. The blood would be tested for antibodies called HI (haem-agglutination) titres which I was lectured about in my vet school.

The presence of HI titres and clinical signs of egg production drop and poor egg quality in non-vaccinated chickens indicated that the farm had this EDS (Egg Drop Syndrome). Actually this disease was present for the past 5 years in Europe but the veterinary authorities wanted to confirm its presence in Singapore's chickens before permitting import. Obviously this would take a long time and clever poultry farmers could not wait that long. However, this particular farm was more law-abiding and so we did the test with half of the poultry house not vaccinated and half vaccinated with the commercial EDS vaccine.

The trial confirmed the efficacy of the vaccine which was then approved for import into Singapore. This evidence-based veterinary medicine had cost the farmers much losses as EDS' 76 was a well known disease for the past 5 years in Europe. Yet the authorities had this ruling for this new "disease" in Singapore. I think the trial was done in 1980 and brought veterinary medicine and virology alive to a young vet. I was 30 years old then.

Time had flown by. But I had vividly remembered this vet who once thanked me for saving his life. How did I do it? It was a fine morning at Jalan Lekar. He inserted the needles into the chicken's wings and collected the blood in the blood collection tubes. The farmer's young daughter held the chicken while I assisted him by recording. We needed many chicken blood to get statistically significant results. I noticed that this vet started to have runny noses. After some time, he had difficulty breathing and his back hunched. He persevered in collecting blood. His eyes teared and reddened. He wiped off his runny nose. This was a shock to a young vet like me.

I had never encountered such a situation but I knew he was allergic to the chicken feathers and atmosphere as he was OK when he drove me to the farm. I had no car and he drove. "Stop blood collection, stop blood collection" I said to my senior. "Let's go back to the Vet Lab!". He had forgotten to bring his nebuliser on that day he told me later and thanked me for saving his life.

On this Saturday, he was fine and his hands were no longer itchy. "I don't have psoriasis," he corrected me. "It was dry skin." The following is the knowledge he imparted to me and which I hope will be of use to vets who suffer from dry skin in the whole body.

1. Aqueous cream BP must be applied to all the affected area daily, without fail. There are many types of aqueous cream which is a mixture of oil, water, emulsifier + a little preservative. If the person is allergic to preservative, then use ones without prservative.

2. Avoid aqueous cream with fragrance or preservative if possible.

3. In countries with low relative humidity, apply the cream more than 3 times. In Singapore, one time may be sufficient.

4. Sweat out at the club so that the skin pores open. A sauna bath perhaps?

5. Sources: Pharmacy. The cheapest source is in Johor Bahru at Jenski in Taman Sentosa. A big jar costs $18.00.

6. Alternative. The safest is vaseline which is petroleum jelly. But it is sticky in Singapore.

Conclusion: The aqueous cream is for "dry skin". That includes "dandruff" in the scalp which appears every 2 to 3 days despite anti-dandruff shampoos.

I know the water massage spa machine used daily as a 10-minute bath might be an easier solution for this vet as the heat opens the skin pores and the water currents massage the whole body. Do it every day for 10-15 minutes. De-stress at the same time. I did not mention this to him as he seems to be doing OK with his aqueous cream routine and I don't have evidence-based medicine to convince him to give it a trial!

I record this for a young veterinary undergraduate who is allergic to horses. You may suffer from dry skin itchiness as part of the syndrome later in life. Always carry a nebuliser all the time if you want to live past 60 years of age as your immune system reacts violently and fatally to allergens in the atmosphere.

192. Collect urine from a dwarf hamster?

I could see the look in her eyes. Eyes are windows to the soul and these eyes flashed a message. I don't claim to possess telepathy but these eyes texted "Is your mind going to pot? You ask me to do a mission impossible."

I have had done several hamster tumour removals and treatment, thanks to the internet group of hamster lovers. But to collect urine from a hamster for urinalysis? I have not personally done it. Now I challenge and command Dr Vanessa Lin to get it done.

How to do it? Think. As a mentor, I must be able to do it. Vanessa's silence was golden. I offered advices like:

"Put the hamster in a cage with a grated flooring. Put a plastic sheet below the grate. The hamster's urine will pee down onto the plastic sheet. Tilt the cage slightly so that the urine will flow downwards to one end. Then, you can collect the urine and put in a container to be sent to the lab for urinalysis. It should be a small cage."

Theory is great. Can this be done? Where do we find such a small cage? When will the hamster pee? How much pee can be collected. If the hamster pees 0.2 ml, the heat of the environment will just evaporate the pee.

I believe that many vet schools do not teach the students how to do it. So many animals to teach. Hamsters are low on the teaching totem pole.

The ability to perform is important for any new vet in private practice. Vanessa told me that the top graduate in her class was fired for non-performance. Impressive academic credentials don't mean a thing in the real world where a veterinary practice's profitability must be sustainable.

Collecting urine from a dwarf hamster? I must be joking. But this is a serious matter as the hamster owner had consulted a vet who had produced an excellent X-ray and from my examination of the real hamster (after telling her that a phone call diagnosis would not be possible), I knew I needed at least one urine test. To check for urine protein and the possibility of kidney disorders. "Blood tests are impossible in a live dwarf hamster unlike in dogs and cats," I said to the owner. "A urine test can be done."

So the owner left the hamster at the Surgery. And now, I asked Vanessa to get it done. Veterinary medicine throws up many situations and challenges. If Vanessa could not be successful in this task, could I show her how to do it? I asked her to do it. This was to make her think how to do it. Well, there was not much time. The owner would be back in 30 minutes as she was reluctant to leave the hamster in the Surgery in the first place. She had specifically made an appointment to see me through the Surgery phone but I was not given the message. I apologised to inconveniencing her for a second visit and asked why she did not phone me personally as she had done when she wanted a telephone diagnosis.

How to collect urine from a dwarf hamster? Read widely and take a leaf from practices from other animal species. Metabolism tests on sheep. What do they do at the science lab which conducted drug trials and which I have never visited.

20 minutes left before the expected arrival of the lady hamster owner. I had a brainwave. The urine was collected and shown to the owner. She was satisfied that she did not waste her time to seek a second opinion.

I have the pictures of the urine collection process for readers and veterinary undergraduates who may be tested during their fourth and fifth-year vivas (oral tests).






Details are at: www.toapayohvets.com

191. Telephone diagnosis

"My dwarf hamster has a bloated stomach since last week," the lady owner phoned me. "He has not been eating or pooping much. What can I do?"

It is hard to give a telephone diagnosis. Bring down for a check-up.

Vet 1 gave a laxative oil and oral antibiotics for 5 days as well as produce a beaufiful X-ray of the backide. Constipation?

"Looks like he has stones," my assistant saw big lumps on x-rays

New vet at Toa Payoh Vets - Dr Vanessa Lin Hui Jun

On Sep 3, 2010, Dr Vanessa Lin Hui Jun joins Toa Payoh Vet as an associate vet. She has around two years of experience. I have confidence that she will make a good veterinarian and will be her mentor.

I briefed Vanessa on the values of honesty and responsibility of a vet by giving her various real-life examples where the pursuit of making more money erodes such values. These examples can make interesting reading.

It is important that the leadership walk the talk and impart the values to young ones and reject vets who don't agree to the values of Toa Payoh Vets.

"There are many things you will learn in a small practice and these lessons will be very useful when you start your own practice," I said to Vanessa. "In your previous practice, you have many assistants to do things. Here, you may need to think how to do things efficiently and economically." One advantage for Vanessa is that she has me as a mentor.

"I know you have intention of opening your own practice. That is OK with me. You have your future to think of. You can see that Mr Saw has been with me for over two years and I have given my blessings for him to join other practices with better pay and prospects."

Being of the same age as the younger generation, Dr Vanessa Lin will be more their type of vet.

189. Sep 3, 2010

Sep 9, 2010

I welcome Dr Vanessa Lin Hui Jun to my team at Toa Payoh Vets on Sep 3, 2010. This was a very happy occasion for me and my clients as I am getting on in years, being 60 years old now.

Meanwhile, in Perth, something unforeseen and very sad happened.

My god-daughter, Ms Celina Chua who was only 5 weeks before graduation as a veterinarian from Murdoch University was killed in a car accident in Perth, Australia. Her friends will be holding a memorial at the University on Friday Sep 10, 2010.

188. The Chinatown coffeeshop lady said: "Call the police!"

"Call the police! Call the police!" the lady stated loudly as Mr Lim answered the phone. Somebody representing me had demanded that he pay his debt of $2,000 to me. Mr Lim had stopped payment of his $2,000-cheque to me and would not return my calls for the past 1 year. He had asked me for a $5,000 temporary loan as he had cash-flow problems and promised to return the money in one month's time with interest.

"I don't want your interest," I don't want to make money out of a businessman in dire financial straits. I only prayed that I would recover my loan as I have had bad experiences.

However, if I could help this businessman who had made millions before but now needed cash, I would as I had been acquainted with him for the past 20 years. He took the $5,000 and I was out of sight, out of mind.

That was one and a half years ago. After many phone calls for half a year, he gave me a cheque of $5,000. The next 2 days, he wanted the cheque back and gave me a cheque of $3,000 and a few days later, another one for $2,000 cheque which he stopped payment soon. He just ignored my calls for another year. I told a friend about him and he offered to help me by phoning me. He was no bill collector or loan shark as I don't get involved with the shady underworld. Mr Lim promised to phone me the next day and he did. He paid $500 and that was OK with me. He still was in the dumps but I could not help him. It is the disadvantage of of being self-employed. A self-employed can make millions and can crash and burn and he was burnt by a project which did not pay him.

Honesty is important in business and he should know better. I invited him for breakfast at Chinatown on Sep 7, 2010 to see if I could advise him or be of help to him in his business, but not in another loan.

"Who was the lady who asked you to call the police?" I asked Mr Lim at the Chinatown coffeeshop. A bright sunshine morning and I took a photograph for readers to appreciate the street where I had coffee with him.

I knew Mr Lim for the past 30 years and his lady assistant. From what I know of the character and personality of his lady assistant from a well brought up family in Indonesia, I would say she was not the instigator to call the police. But I had to know whether my judgment of character was up to par.

I asked Mr Lim: "Who was the lady who asked you to call the police? Her husband must be some big gun in the Singapore Police Force."

"The lady eaves-dropped my conversation. Your friend was speaking in a loud voice and was quite rough. The lady is a coffeeshop operator in Keong Siak Street."

I said: "The famous previous red-light district of Singapore's Chinatown. Where is she now? I would like to see how she looks like."

Mr Lim said: "She is not working so early. I told her at that time not to interfere with my business."

I said: "Call the police. Call the police. Why didn't you call the police?"

I was surprised when Mr Lim admitted: "I am in the wrong."

I said: "The coffeeshop lady must have police connections as she was rather aggressive shouting over your head such that my friend could hear her.

"Is her husband the Commissioner of Police?" I asked Mr Lim. "My friend who phoned you asked you to call the police or he would call the police in your presence."

"No, no," Mr Lim said. "The husband is a training instructor in the police force."

So there was this police connection which embolden the wife. The police do not interfere in civil matters. Otherwise they don't have time for real police investigation work.

I listened to Mr Lim's bad luck in the project in which he was owed $100,000. He had been advised to take legal action but he did not want to. I said: "Lawyers want deposits and then more deposits with no guarantee of success. Whoever advised you might pay on your behalf first. It is wise of you not to proceed with litigation. Let me talk to the other party if the party is interested. If not, just move positively in new projects and learn from the bad experience."

Giving a cheque to secure a loan is a big risk for the lender. Sometimes it is better not to help others in need as it is usually money down the drain and some threats to "call the police." Honesty is the best policy in business. Do not ignore a problem. If Mr Lim had paid even $50.00 per month, he would have had paid up after some months. But when a man is in dire financial straits, the aim is to get loans without any intention of return usually. Some of them behaved aggressively as if the lender owes the borrower money!

187. Vets being referred to

E-MAIL TO DR SING
Sep 5, 2010

Hi Dr Sing,

Just a quick line to let you know that I have finally returned to Singapore and just started work at (Name given). I am returning to Perth from 16th to 19th for my graduation. If you want me to carry anything for (Name given), I will be glad to. The other reason for this email is Dr. (Name given) heard that (Name given) might have been badly injured in a car accident in Perth on Friday night/ Saturday... is this true? If so, I hope all is ok with her... we are concerned about her welfare.

E-MAIL FROM DR SING
Sep 6, 2010 4.15 am.

Thank you for email. (Name given) is actually my god-daughter. She passed away on Sep 3, 2010 due to an accident as the other driver of an on-coming car overtook a car and smashed into her car.

In your new job, I hope you will present a kindness towards "smaller practices" as I have had nasty experiences of three vets from your practice when cases were referred to them. I gave you 3 examples in the hope that you would be kinder now that you have had started practice with them.

1. One vet demanded over the phone that I should call him first but I told him that his receptionist said he was busy and it was my client who wanted the case to be sent to him. So I extended the courtesy to phone him.

2. Another vet said I should fill up a form if I wanted to refer any animal to him.

3. The 3rd vet refused to give the X-ray of the bladder stone to a small animal practice vet. I shall name him as Vet X. His practice had fed your new employer with numerous cases over the last 20 years. Vet X's receptionist had a dog with haematuria. The dog was referred to your employer for an X-ray.

Vet X's mother had asked me to mentor her son in surgery. This was his first case of urinary stone removal from the bladder. I asked him to get the X-ray. It would be good to have an X-ray but since the vet did not want to release it, he could do nothing.

I said it was OK since I could palpate the bladder stone and in fact X-rays are not necessary if one is confident of the diagnosis based on clinical signs and history. Vet X operated under my supervision and the dog is still much alive and well when I saw the receptionist recently.

Best wishes to your new career.

P.S As for me, if any vet wants to refer to me their cases, they are welcome.