Sleep bruxism - grinds one's teeth involuntarily during sleep. One in 3 children and some adults. Causes - stress, anger, trauma, some drugs, genes. Leads to jaw pain, tense facial muscles, head and ear aches, worn out teeth.
Does this happen in dogs and rabbits during sleep? In people, treatment of underlying conditions, pain relief and mouth guard to wear during sleep.
Monday, November 8, 2010
235. Uterine Artery Embolisation (UAE) shrinks fibroids
Reference: The Straits Times Mind Your Body, Oct 21, 2010
Fibroids are benign tumours in women and affect 40% of women aged over 40. Cause pain and heavy bleeding or prevent pregnancy if inside the fallopian tubes. It will not eliminate all fibroids unlike surgical removal but does not require surgery with its complications.
UAE is a non-surgical way using a tiny catheter to block the blood flow in the artery that supplies blood to the fibroids. It is done by radiologists but Dr Bruce McLucas, an American gynaecologist wants to train gynaecologists to do it. In SGH, Prof Tan Bien Soo, senior consultant radiologist said it is team work between different specialists that matters. He says there is "continuity of care" in SGH where the procedure is currently done by radiologists who usually don't follow up on the patient, unlike the gynecologist.
Done under sedation, UAE leaves no scars and no blood loss. Outpatient procedure, less cost and recovery time. In 9/10 women, UAE shrinks the fibroid by 60% within 6 months, sufficient to stop pain and other compications. UAE is less damaging han myomectomy (surgical removal of fibroids) or hysterectomy (entire womb with or without ovaries and fallopian tubes surgically removed).
Fibroids are benign tumours in women and affect 40% of women aged over 40. Cause pain and heavy bleeding or prevent pregnancy if inside the fallopian tubes. It will not eliminate all fibroids unlike surgical removal but does not require surgery with its complications.
UAE is a non-surgical way using a tiny catheter to block the blood flow in the artery that supplies blood to the fibroids. It is done by radiologists but Dr Bruce McLucas, an American gynaecologist wants to train gynaecologists to do it. In SGH, Prof Tan Bien Soo, senior consultant radiologist said it is team work between different specialists that matters. He says there is "continuity of care" in SGH where the procedure is currently done by radiologists who usually don't follow up on the patient, unlike the gynecologist.
Done under sedation, UAE leaves no scars and no blood loss. Outpatient procedure, less cost and recovery time. In 9/10 women, UAE shrinks the fibroid by 60% within 6 months, sufficient to stop pain and other compications. UAE is less damaging han myomectomy (surgical removal of fibroids) or hysterectomy (entire womb with or without ovaries and fallopian tubes surgically removed).
Sunday, November 7, 2010
Holiday at Philea
I had a 3-day 2-night stay at a brand new resort in Melaka and shares my experiences with readers
MARKETING INFO FOR DESIGN TRAVEL PTE LTD, www.designtravel.com.sg
1. Philea Resort & Spa, Ayer Keroh, Melaka. I arrived on Friday (Deepavali), 5 Nov 2010. There was a Bridal Fair 2010 at the Philea Ballroom which can seat a maximum of 500 people for weddings. For 200 people, the ballroom can be partitioned. There are small meeting rooms which seat around 10-20 people.
2. All info on the Philea Resort is at:
http://www.phileahotel.com/resort_melaka_malaysia/index.html
3. MARKETING SEGMENT. I believe that the type of corporate customers for this resort is:
3.1 Not those on budget like young adults who want to shop and dine till past midnight as they will need a taxi to come back to the Philea Resort & Spa which is not in the down-town location.
It will be OK for expatriates who can afford taxis and I have seen 2 older Caucasian expats in their 30s, returning by taxi at around 9pm.
3.2 Prospects with spending power including families and professional bodies. According to travel agency owner, Mr Richard Goh who picked me up from Equatorial Hotel on arrival in Melaka to send me to Philea Resort, thinks that church people may not have the spending power to host the retreat in Philea Resort & Spa.
3.3 If you send corporate customers, they will be those that appreciate the finer things in life like living in a spacious all-pinewood rooms including flooring and walls, new bathroom with long bath and showers rustic environment far from the city crowds and noises and villas instead of apartment-type or room-type hotel, low rise low density resort alternative to hotel high-rise of around 200 units or as pre-arranged.
3.4 Caucasians will definitely like this wooded villa ambience and the Russian-sourced pinewood buildings. Pictures are at the website.
3.5 Food & Beverage was generally good. During my 2 nights stay, the buffet dinner was excellent. The baby lobster was great on the first night but not so good on the second night. The satay of beef and chicken was consistently great. I like the braised beef. No pork is served. So this resort may appeal to the Singapore Muslim community for retreats.
3.6 50% F&B discount for senior citizens is a great incentive. The buffet dinner had 2 types of soups. There was a great interest in baby lobsters, prawns, shell fish, squids, Italian food, cakes, ice-cream etc was around RM26.00 per senior citizen. The breakfast coffee was bad and tasted like charcoal. Waiters' service was great. Dinner may be outdoors with no air-condition as the air conditioned cafe can seat around 100 people.
3.7. New resort. This is a selling point. Opened around June 2010.
3.8 Around 10-minute drive to the town centre. There are taxis available. For our corporate clients, you will need to provide a shuttle service and driver. I know of one operator who picked me up from Hotel Equatorial to this place. He is a travel agent and is contracted to Transtar. He has his own coaches and tour guides as well as taxis. Will give you the email later.
3.9 A Butterfly farm is just 5-10 minute walk by the back gate from Philea Resort. I will go there today, Sunday morning before I check out.
4.0 3-4 hour coach ride from Singapore to Melaka. There was an accident somewhere during my departure from Singapore to Melaka on Friday, Deepavali. The Causeway jam was from 9 am to 1.30 pm. I reached Philea Resort & Spa at around 6 pm.
4.1 The coach could have dropped me at the last toll gate which is a short walk to Philea Resort & Spa. Instead Transtar arranged for me to go to Hotel Equatorial. The taxi driver and travel agency owner, Mr Richard Goh was not around. I had to ask the Equatorial hotel receptionist to phone him. Transnational Travels had not made any arrangments for delayed arrivals nor give me instructions on what to do or tel when there is a delay in arrival. This was bad planning. Mr Richard Goh said it was unusual as most people from Singapore took 3-4 hours to reach Melaka by 3 p.m. So, he left the Equatorial Hotel which was just a drop-off point.
5. Room in the Pavillion Villa (180 units - 2 storeys bungalows, each with 4 units, upper and lower separated by a central staircase). Spacious and is bigger than some Singapore's 5-star hotel rooms like Westin. Pinewood flooring looks clean and bright. It feels great to walk upon, without the need to wear shoes. Bathroom has pinewood doors, rectangular white porcelain basin top, no-closed up screen on long bath, spacious shower area with glassed partition, big mirror and black tiled flooring giving a luxurious appearance. No adjoining room for big families but the central staircase of each level has doors facing each other and therefore the families with children can connect via the staircase landing.
6. Possibly Philea Resort & Spa has only two competitors. One in the same class will be A' Famosa Resort Malaysia, http://www.afamosa.com/main.php?m=Content&op=page&id=160. Philea Resort is not a theme-park concept unlike A'Famosa. It is said to be the only resort with pinewood logs (inter-locking, no screws and nails) with logged villa accommodation in Malaysia. There is one new development with villas built over the sea in KL I can't recall its name.
I hope the above info helps.
Best wishes.
MARKETING INFO FOR DESIGN TRAVEL PTE LTD, www.designtravel.com.sg
1. Philea Resort & Spa, Ayer Keroh, Melaka. I arrived on Friday (Deepavali), 5 Nov 2010. There was a Bridal Fair 2010 at the Philea Ballroom which can seat a maximum of 500 people for weddings. For 200 people, the ballroom can be partitioned. There are small meeting rooms which seat around 10-20 people.
2. All info on the Philea Resort is at:
http://www.phileahotel.com/resort_melaka_malaysia/index.html
3. MARKETING SEGMENT. I believe that the type of corporate customers for this resort is:
3.1 Not those on budget like young adults who want to shop and dine till past midnight as they will need a taxi to come back to the Philea Resort & Spa which is not in the down-town location.
It will be OK for expatriates who can afford taxis and I have seen 2 older Caucasian expats in their 30s, returning by taxi at around 9pm.
3.2 Prospects with spending power including families and professional bodies. According to travel agency owner, Mr Richard Goh who picked me up from Equatorial Hotel on arrival in Melaka to send me to Philea Resort, thinks that church people may not have the spending power to host the retreat in Philea Resort & Spa.
3.3 If you send corporate customers, they will be those that appreciate the finer things in life like living in a spacious all-pinewood rooms including flooring and walls, new bathroom with long bath and showers rustic environment far from the city crowds and noises and villas instead of apartment-type or room-type hotel, low rise low density resort alternative to hotel high-rise of around 200 units or as pre-arranged.
3.4 Caucasians will definitely like this wooded villa ambience and the Russian-sourced pinewood buildings. Pictures are at the website.
3.5 Food & Beverage was generally good. During my 2 nights stay, the buffet dinner was excellent. The baby lobster was great on the first night but not so good on the second night. The satay of beef and chicken was consistently great. I like the braised beef. No pork is served. So this resort may appeal to the Singapore Muslim community for retreats.
3.6 50% F&B discount for senior citizens is a great incentive. The buffet dinner had 2 types of soups. There was a great interest in baby lobsters, prawns, shell fish, squids, Italian food, cakes, ice-cream etc was around RM26.00 per senior citizen. The breakfast coffee was bad and tasted like charcoal. Waiters' service was great. Dinner may be outdoors with no air-condition as the air conditioned cafe can seat around 100 people.
3.7. New resort. This is a selling point. Opened around June 2010.
3.8 Around 10-minute drive to the town centre. There are taxis available. For our corporate clients, you will need to provide a shuttle service and driver. I know of one operator who picked me up from Hotel Equatorial to this place. He is a travel agent and is contracted to Transtar. He has his own coaches and tour guides as well as taxis. Will give you the email later.
3.9 A Butterfly farm is just 5-10 minute walk by the back gate from Philea Resort. I will go there today, Sunday morning before I check out.
4.0 3-4 hour coach ride from Singapore to Melaka. There was an accident somewhere during my departure from Singapore to Melaka on Friday, Deepavali. The Causeway jam was from 9 am to 1.30 pm. I reached Philea Resort & Spa at around 6 pm.
4.1 The coach could have dropped me at the last toll gate which is a short walk to Philea Resort & Spa. Instead Transtar arranged for me to go to Hotel Equatorial. The taxi driver and travel agency owner, Mr Richard Goh was not around. I had to ask the Equatorial hotel receptionist to phone him. Transnational Travels had not made any arrangments for delayed arrivals nor give me instructions on what to do or tel when there is a delay in arrival. This was bad planning. Mr Richard Goh said it was unusual as most people from Singapore took 3-4 hours to reach Melaka by 3 p.m. So, he left the Equatorial Hotel which was just a drop-off point.
5. Room in the Pavillion Villa (180 units - 2 storeys bungalows, each with 4 units, upper and lower separated by a central staircase). Spacious and is bigger than some Singapore's 5-star hotel rooms like Westin. Pinewood flooring looks clean and bright. It feels great to walk upon, without the need to wear shoes. Bathroom has pinewood doors, rectangular white porcelain basin top, no-closed up screen on long bath, spacious shower area with glassed partition, big mirror and black tiled flooring giving a luxurious appearance. No adjoining room for big families but the central staircase of each level has doors facing each other and therefore the families with children can connect via the staircase landing.
6. Possibly Philea Resort & Spa has only two competitors. One in the same class will be A' Famosa Resort Malaysia, http://www.afamosa.com/main.php?m=Content&op=page&id=160. Philea Resort is not a theme-park concept unlike A'Famosa. It is said to be the only resort with pinewood logs (inter-locking, no screws and nails) with logged villa accommodation in Malaysia. There is one new development with villas built over the sea in KL I can't recall its name.
I hope the above info helps.
Best wishes.
233. Hamster vets
E-MAIL TO DR SING DATED NOV 7, 2010
I am writing to you because I have a dwarfhamster that has not emptied
his cheek pouch in two weeks not even when I gently press on the back
of his pouch. It also seems that his teeth might be too long, although
I am not quite sure how long hamster teeth should be. On your website
you have many stories about how you have treated hamsters, and it
seems that you have a lot of knowledge on this subject therefore I am
asking you for your help.
I live in the Netherlands where it is very hard to find a veterinarian
that knows how to treat small animals. I have called the vet and they
said they could not say anything without seeing the hamster first and
that they do have knowledge of hamsters. I have had several small pets
and this is their usual reply and when I bring my pet over the vet
usually knows a lot less than I do and always recommends just putting
it to sleep. The consultations are quite expensive therefore I really
would not like to go unless I would find a doctor that actually knows
something about small animals, they always say they do on the phone
but a soon as you stand in front of them they do not even know its
head from its tail.
The hamster seems to be doing fine, he does not look in distress and
he still eats and drinks. However, he seems to have slowed down.
Normally he is a very active animal that runs in his wheel for hours
and moves everything around in his cage but lately he is less active
and he seems to keep tripping and falling over when he is climbing
around on his toys, in such a manner that I have actually removed most
of his toys so that he would not be able to hurt himself. He is almost
two years old now, so maybe him slowing down is just because he is
getting older. Although my previous hamsters would remain active until
their death.
Another of my concern to bring the hamster to the vet is because he is
getting older and I am afraid that maybe the stress of being there and
maybe being handled by an inexperienced vet would make him die from
stress. Therefore, I hope you will be willing to give me advice on how
to take care of my hamster myself so I can do it in the comfort of his
own home. I would be very grateful! Could you tell me step by step how
to clean out his cheek pouch? Also how I could locate it, because when
I hold him by the scruff of his neck which makes him "smile" I cannot
see any entrance to his cheek pouch. Would you maybe be able to send
me a picture of how long the teeth of a dwarfhamster should normally
look like? I can find a lot of pictures online where the teeth are
extremely long and curled up, but my hamster does not have this. Oh I
almost forgot to say that my hamster also does not drool from the
mouth but he has not closed his mouth in a couple of days its always
just open for a little bit.
I really hope you can help me quickly before he gets sicker, I am of
course willing to pay for your consultation.
Kind regards,
Name of Owner
E-MAIL REPLY FROM DR SING
If the cheek pouch is impacted, you need to empty it. Usually I put the hamster under gas anaesthesia as it will be stressed and may die.
As for your case, your hamster may be comfortable with you. You need to restrain him and this is not easy, to empty his pouch. Use a blunt ended forceps to do it in this case. If the cheek pouch is inflamed and infected, you will need to look for an experienced hamster vet to use anaesthesia and do surgery.
I hope this advice will help. Impacted and/or infected cheek pouches are sometimes very difficult to empty as some seeds may have stuck inside and become embedded causing great pain in the mouth. If there is no anaesthesia and you try to force the hamster to empty its pouch, it may just die during your manipulation. That is why many vets don't like hamster treatment. No vets want to damage his reputation when the hamster dies during treatment. Best wishes.
I am writing to you because I have a dwarfhamster that has not emptied
his cheek pouch in two weeks not even when I gently press on the back
of his pouch. It also seems that his teeth might be too long, although
I am not quite sure how long hamster teeth should be. On your website
you have many stories about how you have treated hamsters, and it
seems that you have a lot of knowledge on this subject therefore I am
asking you for your help.
I live in the Netherlands where it is very hard to find a veterinarian
that knows how to treat small animals. I have called the vet and they
said they could not say anything without seeing the hamster first and
that they do have knowledge of hamsters. I have had several small pets
and this is their usual reply and when I bring my pet over the vet
usually knows a lot less than I do and always recommends just putting
it to sleep. The consultations are quite expensive therefore I really
would not like to go unless I would find a doctor that actually knows
something about small animals, they always say they do on the phone
but a soon as you stand in front of them they do not even know its
head from its tail.
The hamster seems to be doing fine, he does not look in distress and
he still eats and drinks. However, he seems to have slowed down.
Normally he is a very active animal that runs in his wheel for hours
and moves everything around in his cage but lately he is less active
and he seems to keep tripping and falling over when he is climbing
around on his toys, in such a manner that I have actually removed most
of his toys so that he would not be able to hurt himself. He is almost
two years old now, so maybe him slowing down is just because he is
getting older. Although my previous hamsters would remain active until
their death.
Another of my concern to bring the hamster to the vet is because he is
getting older and I am afraid that maybe the stress of being there and
maybe being handled by an inexperienced vet would make him die from
stress. Therefore, I hope you will be willing to give me advice on how
to take care of my hamster myself so I can do it in the comfort of his
own home. I would be very grateful! Could you tell me step by step how
to clean out his cheek pouch? Also how I could locate it, because when
I hold him by the scruff of his neck which makes him "smile" I cannot
see any entrance to his cheek pouch. Would you maybe be able to send
me a picture of how long the teeth of a dwarfhamster should normally
look like? I can find a lot of pictures online where the teeth are
extremely long and curled up, but my hamster does not have this. Oh I
almost forgot to say that my hamster also does not drool from the
mouth but he has not closed his mouth in a couple of days its always
just open for a little bit.
I really hope you can help me quickly before he gets sicker, I am of
course willing to pay for your consultation.
Kind regards,
Name of Owner
E-MAIL REPLY FROM DR SING
If the cheek pouch is impacted, you need to empty it. Usually I put the hamster under gas anaesthesia as it will be stressed and may die.
As for your case, your hamster may be comfortable with you. You need to restrain him and this is not easy, to empty his pouch. Use a blunt ended forceps to do it in this case. If the cheek pouch is inflamed and infected, you will need to look for an experienced hamster vet to use anaesthesia and do surgery.
I hope this advice will help. Impacted and/or infected cheek pouches are sometimes very difficult to empty as some seeds may have stuck inside and become embedded causing great pain in the mouth. If there is no anaesthesia and you try to force the hamster to empty its pouch, it may just die during your manipulation. That is why many vets don't like hamster treatment. No vets want to damage his reputation when the hamster dies during treatment. Best wishes.
Sunday, October 31, 2010
232. Brand name opens the door
I would teach Mr Saw, my assistant whenever I had a good case. He would be going back to Myanmar in April 2011 to start-up a vet surgery in Yangon with a friend. He had been working for me for nearly 3 years and he would be considered an "experienced vet from Singapore" in Yangon.
I said to Mr Saw: "You can have a good name - experienced vet who has worked in Singapore, but remember one thing: if you can't give what the owner wants, your brand name is no use to him.
"See this case of the cat (with a problem that the brand name practice vet was not given a second chance to review). He takes his ten cats to this famous and big vet practice for the past years. He could have consulted Toa Payoh Vets as he lives in Toa Payoh. But he would never do it for some reasons.
"His wife had consulted Toa Payoh Vets once, the husband had said to me. That means there is something I had not done correctly or given to what the wife wanted. So I have to improve my services or the facilities and review my operations.
"Brand name opens the door for you, but if you can't give what the owner wants, you can be the most famous vet practice in Singapore and he will go elsewhere. You must be able to resolve his cat's problem at the price he can afford. If your practice is famous, you cannot solve his problem and you quote him a high vet cost, he will not come back to you the second time. This applies only to those who don't want to spend and spend on their pets' veterinary treatment."
Mr Saw nodded his head and appreciated the advices I gave him regarding competitiveness, the need to save on costs so as to give affordable vet treatment and not waste materials and medicine as many vet employees are prone to do so. He learns the running of the practice by working for an old vet who has been battle-tested. He was fortunate in this aspect as I had time for him to mentor him knowing that he has a good work attitude.
I said to Mr Saw: "You can have a good name - experienced vet who has worked in Singapore, but remember one thing: if you can't give what the owner wants, your brand name is no use to him.
"See this case of the cat (with a problem that the brand name practice vet was not given a second chance to review). He takes his ten cats to this famous and big vet practice for the past years. He could have consulted Toa Payoh Vets as he lives in Toa Payoh. But he would never do it for some reasons.
"His wife had consulted Toa Payoh Vets once, the husband had said to me. That means there is something I had not done correctly or given to what the wife wanted. So I have to improve my services or the facilities and review my operations.
"Brand name opens the door for you, but if you can't give what the owner wants, you can be the most famous vet practice in Singapore and he will go elsewhere. You must be able to resolve his cat's problem at the price he can afford. If your practice is famous, you cannot solve his problem and you quote him a high vet cost, he will not come back to you the second time. This applies only to those who don't want to spend and spend on their pets' veterinary treatment."
Mr Saw nodded his head and appreciated the advices I gave him regarding competitiveness, the need to save on costs so as to give affordable vet treatment and not waste materials and medicine as many vet employees are prone to do so. He learns the running of the practice by working for an old vet who has been battle-tested. He was fortunate in this aspect as I had time for him to mentor him knowing that he has a good work attitude.
Friday, October 29, 2010
231. Brand name v. benefits to the customer
My vet assistant, Mr Saw had worked with me for nearly 3 years. As he will be leaving next year to work in Yangon, I shared experiences of cases with him today and whenever we work together.
Case 1
Tumour in gum of Chihuahua, M, Neutered, 6 years.
"It is best to advise histopathology of this tumour," I said to him. "Some owners are not aware of the need to get this test. We want to lower our vet costs by not advising this test. However, the tumour may be cancerous and if we do not advise, the next time the tumour comes back, the owner will not have confidence in the vet.
The owner is a young woman with internet knowledge and so she will know many things by researching the internet for gum tumours. She had asked whether I would be doing a histopathology and I said yes. Not every owner wants the lowest price.
Case 2
Urinary stone stuck inside the penis. "Different vets will operate differently to take out the stones jammed packed behind the os penis, inside the penis ," I said to Mr Saw. "In this Yorkshire, the vet leaves the urethra wound open by NOT stitching the incision. I will not operate this way. Why?"
Mr Saw did not know. "Well, this is a male dog. So he usually lifts his one leg to pee. When he pees, his urine will leak out from under his penis where the urethostomy incision has not been closed. So he sprays urine or dribble urine all over the apartment. In Singapore, 80% of the people lives in apartments. By NOT stitching up the urethra, the male dog may pee from his penile end and from below the penis. If you are the dog's owner, you will be very unhappy as you have to clean up. Worse still, the dog dribbles urine all over the whole floor due to urine marking.
Case 2.1
"Don't let the dog go home on day 3," I advised my associate. "The catheter may be rubbed out at home or pulled out as the dog will be roaming all over the apartment. In the Surgery, he is confined and monitored and nursed every day. At home, most owners don't bother. Things become nasty when the catheter is pulled out and the urethostomy wound at the bottom of the penis has not healed yet. Worse of all, the urethostomy wound closes and cause obstruction before the 10th day as recommended. The owner will want 'free' surgery or treatment. In any case, you get an unhappy owner."
The dog was put in for at least 10 days as this was a serious case of bladder and lower urethra being cut to take out the stones. (see X-ray).
Case 3
Skin disease.
"What the owner wants is a cure after payment and not have to come again," I referred to a case. "Vet 1 had treated and prescribed anti-fungal drugs and washes for the last 14 days. You saw the owner who was very unhappy as the dog was very itchy in the elbow, backside and lower body."
Mr Saw learnt from how I handled this case.
1. Skin scraping
2. Ultra-violet light. This was most impressive to the owner as ringworm hairs flouresce in the umbilical area and backside.
3. Communication with the owner. "You need to clip the dog bald," I said. "Otherwise you will curse me 2 weeks later when the disease is not gone away."
4. Clipping bald.
5. Anti-fungal wash.
After clipping bald, I discovered scabies mites on the ear edgess. So this dog had arcptic mange as well. No wonder he was so itchy and wanted to bite the owner!
Case 1
Tumour in gum of Chihuahua, M, Neutered, 6 years.
"It is best to advise histopathology of this tumour," I said to him. "Some owners are not aware of the need to get this test. We want to lower our vet costs by not advising this test. However, the tumour may be cancerous and if we do not advise, the next time the tumour comes back, the owner will not have confidence in the vet.
The owner is a young woman with internet knowledge and so she will know many things by researching the internet for gum tumours. She had asked whether I would be doing a histopathology and I said yes. Not every owner wants the lowest price.
Case 2
Urinary stone stuck inside the penis. "Different vets will operate differently to take out the stones jammed packed behind the os penis, inside the penis ," I said to Mr Saw. "In this Yorkshire, the vet leaves the urethra wound open by NOT stitching the incision. I will not operate this way. Why?"
Mr Saw did not know. "Well, this is a male dog. So he usually lifts his one leg to pee. When he pees, his urine will leak out from under his penis where the urethostomy incision has not been closed. So he sprays urine or dribble urine all over the apartment. In Singapore, 80% of the people lives in apartments. By NOT stitching up the urethra, the male dog may pee from his penile end and from below the penis. If you are the dog's owner, you will be very unhappy as you have to clean up. Worse still, the dog dribbles urine all over the whole floor due to urine marking.
Case 2.1
"Don't let the dog go home on day 3," I advised my associate. "The catheter may be rubbed out at home or pulled out as the dog will be roaming all over the apartment. In the Surgery, he is confined and monitored and nursed every day. At home, most owners don't bother. Things become nasty when the catheter is pulled out and the urethostomy wound at the bottom of the penis has not healed yet. Worse of all, the urethostomy wound closes and cause obstruction before the 10th day as recommended. The owner will want 'free' surgery or treatment. In any case, you get an unhappy owner."
The dog was put in for at least 10 days as this was a serious case of bladder and lower urethra being cut to take out the stones. (see X-ray).
Case 3
Skin disease.
"What the owner wants is a cure after payment and not have to come again," I referred to a case. "Vet 1 had treated and prescribed anti-fungal drugs and washes for the last 14 days. You saw the owner who was very unhappy as the dog was very itchy in the elbow, backside and lower body."
Mr Saw learnt from how I handled this case.
1. Skin scraping
2. Ultra-violet light. This was most impressive to the owner as ringworm hairs flouresce in the umbilical area and backside.
3. Communication with the owner. "You need to clip the dog bald," I said. "Otherwise you will curse me 2 weeks later when the disease is not gone away."
4. Clipping bald.
5. Anti-fungal wash.
After clipping bald, I discovered scabies mites on the ear edgess. So this dog had arcptic mange as well. No wonder he was so itchy and wanted to bite the owner!
Thursday, October 28, 2010
230. The ends justify the means
What is the meaning of "the ends justify the means?" I will illustrate. A father who is the sole breadwinner earns $3,000 a month. His daughter failed to get into the Singapore University due to not having straight As.
But she is accepted into an Australian University to pursue her dreams. The yearly cost of accommodation and tuition fees around $50,000. The mum does not work. So the source of income is around $36,000 from the father's earnings as an employee.
The company permitted the father to do outside work. He did manage to pay for the daughter's first year of overseas education through a stroke of luck. In the second year, Lady Luck enabled him to rent and sell a $3 million condo, thereby giving the daughter sufficient funds. But the timing was not right. So the father issued 2 cheques of $5,000 and $1,500 for an interest-free loan in cash. The cheques were dud ones as they could not be banked in. So, he got part of the money for his daughter. His "ends justify the means". Without the money, the daughter would be evicted from the course. Lady Luck had been kind to him again as no complaints to his company were made about his dud cheques. He repaid the monies 3 months later when the sales of the condo was completed. But there are two more years to go. Will Lady Luck still favour the brave father? Can he go round issuing dud checks to get money for his daughter and his own expenses? Is this an honest way to live? I don't think so. But there are such people using dud cheques to get the money. It is best not to lend any money to anybody.
But she is accepted into an Australian University to pursue her dreams. The yearly cost of accommodation and tuition fees around $50,000. The mum does not work. So the source of income is around $36,000 from the father's earnings as an employee.
The company permitted the father to do outside work. He did manage to pay for the daughter's first year of overseas education through a stroke of luck. In the second year, Lady Luck enabled him to rent and sell a $3 million condo, thereby giving the daughter sufficient funds. But the timing was not right. So the father issued 2 cheques of $5,000 and $1,500 for an interest-free loan in cash. The cheques were dud ones as they could not be banked in. So, he got part of the money for his daughter. His "ends justify the means". Without the money, the daughter would be evicted from the course. Lady Luck had been kind to him again as no complaints to his company were made about his dud cheques. He repaid the monies 3 months later when the sales of the condo was completed. But there are two more years to go. Will Lady Luck still favour the brave father? Can he go round issuing dud checks to get money for his daughter and his own expenses? Is this an honest way to live? I don't think so. But there are such people using dud cheques to get the money. It is best not to lend any money to anybody.
Wednesday, October 27, 2010
New puppy health check
E-MAIL TO DR SING DATGED OCT 27, 2010
Hi,
I am looking to adopt a new dog into my house, she is currently 1month old and still being weaned.
As i already have a 5 year old dog, i want to ensure that the newest addition is healthy and free from any disease.
Please let me know what tests which need to be run and at what age.
And also how long in advance would i need to make an appointment.
Thank you,
Name of owner
I am Dr Sing. My advice is to isolate the puppy from the adult dog for one month. Get the adult dog vaccinated 2 weeks before the puppy arrives if it is not vaccinated for the past one year. The puppy can be sent to me for general examination, testing of parvovirus +/- distemper and general examination after weaning and one day before going to your house. A blood test may be requested to check for liver and kidney disorders and blood status.
This will be around 6-8 weeks. First vaccination is at 6 weeks.
Appointment 24 hours earlier by phone 6254 3326 can be made. Best wishes.
Hi,
I am looking to adopt a new dog into my house, she is currently 1month old and still being weaned.
As i already have a 5 year old dog, i want to ensure that the newest addition is healthy and free from any disease.
Please let me know what tests which need to be run and at what age.
And also how long in advance would i need to make an appointment.
Thank you,
Name of owner
I am Dr Sing. My advice is to isolate the puppy from the adult dog for one month. Get the adult dog vaccinated 2 weeks before the puppy arrives if it is not vaccinated for the past one year. The puppy can be sent to me for general examination, testing of parvovirus +/- distemper and general examination after weaning and one day before going to your house. A blood test may be requested to check for liver and kidney disorders and blood status.
This will be around 6-8 weeks. First vaccination is at 6 weeks.
Appointment 24 hours earlier by phone 6254 3326 can be made. Best wishes.
228. Exploitation of a top performer
The following is my advice to any person who wants to be a joint-venture partner without putting down cash.
In this case study, I shall call this person Alan. In this private limited company, there are 2 directors at 50:50 share. Alan feels that he should be paid $5,000 per month as a "salaried" director as he brings in the bacon. The other director, Bernice puts in the money 100%.
So, Alan will get $60,000 per annum for the first year of operation. Bernice does not get paid but contributes in administration and management of the staff and office. At the end of one year, Alan wants 50% of the net profits but he will not be responsible for any loss. He thinks that there will never be losses since he has a wide network of prospective and loyal clientele. Bernice is only a "godmother" who pays for everything including his "salary".
The important issue is that he wants to consider $5,000/month to be classified under "operating manpower expense". That means he gets $60,000 per annum for the first year whether the company makes a profit or loses money.
After deduction of this expense and other expenses like salaries of supporting staff, office rental, utilities and miscellaneous expenses which may amount to around $72,000 per year, the estimated "operating expenses" will be $72,000 and with Alan's "salary", the total will be $132,000. Bernice does not get a cent for that first year.
Therefore the total loss to the investing director for this first year, will be around $132,000 in the worst case scenario of losses.
Alan, the paid director projects "profits" based on his extensive network of relevant clientele and your more than 30 years specialising in the industry. He brings in the bacon (as the clientele and expertise are his initially), but he does not bear the financial losses if the business fails.
There may be SARS virus equivalent or long periods of haze when nobody travels, a regional war, Singapore being attacked by terrorists. Money is needed to keep the business going during such unforeseen times and also to advance to him as the "directors' fees" which he wants to considers as his "salary".
Now, if Alan is merely an employee of the start up agency, the $5,000/month is classified as "salary." If not, it is considered "director's drawings".
Man proposes. God disposes. If the reader does not understand this idiom, I clarify that there is no sure thing as success in any start-up business. If there is, why are there so many more employees than self-employed?
With Alan's proposal to get $60,000 and 50% of the net profits (if any) but not the losses, Alan is effectively taking more than 50% of the net profits if the business makes profits. He does not take the losses and so he can just say goodbye and look for another job by becoming another employee after one year.
I told Alan that his proposal is unfair and unacceptable to any investor. "Obviously, you have considered that Bernice, the investing director doesn't deserve any monthly payment as she does not bring in the bacon. Well, she does the necessary administrative work saving time that permits you to do business development and she is putting down the money where her mouth is."
I elaborated: "Both directors in this 50:50 share holdings must be fair. When 2 people start up, they put in money and their initial shares are based on the monies they invested. They may pay themselves a small salary or forgo salary. Certainly, $5,000 a month is not the amount the start up will pay the partner as that depletes the operating capital.
"Bernice also thinks she deserves $5,000/month too as she bears more responsibilities being answerable to the regulatory authority as the key executive officer, her valuable time spent in administration and in bringing some business (though Alan presumes he will be the only one doing it). The investing director is also responsible for the family money invested ($100,000 paid up capital). $100,000 is not a small sum."
Alan said" "I can easily get a 80:20 deal with established agencies whereby I get 80% of the commission as a referring agent."
I replied: "Well, you should do what gives him the highest financial benefit."
Alan did not like the idea of sowing his odds to various agencies as he would not be able to project a solid reputation.
Alan said: "My friend runs an agency himself. He is given a salary and a share of the profits."
I said; "You can be sure that it will not be 50% of the net profits in the general cases. Do check with him. If he gets 50% of the net profit and does not put his hands inside the till, he must be a very lucky person."
I continued: "I doubt it. It is just not financially viable for the investing partner to give such a big share when he does not put up a dollar.
"A start up is like a baby. It needs a father and a mother ideally. Obviously, a mother (in this case, Alan) can do it alone. Many single mothers have raised children to be outstanding graduates. But we hear of such success stories. Many more single mothers have had failed miserably and we don't hear sad stories. We don't want to hear sad stories."
In conclusion, I spent much time elaborating the realities of commercial business life to Alan. "You have had been a very good employee for much of your life time by being honest and able to deliver the sales without the company getting into bad debts. Such employees are in great demand but there is a limit to what most agencies can afford to pay.
"See the other side of the coin. Business is feast and famine. When there is feast, you, as an employee feels "exploited" as a top performing employee bringing in 6 million dollars worth of sales income. You don't get to share the fruits of your big deals or get "appreciated" by being given some percentage of the revenue generated. But how much of the crumbs will satisfy you?
"You feel exploited as you feel you deserve high financial incentives that the company should give you for generating the six million dollars' revenue. You do not realise that the net profits may be as little as 5% as there are lots of overheads of a company. You feel that the net profits from your sales are 15-20% but you don't take into account the cost of overheads of the company and other factors like depreciation.
"The company may give you some bonus but it can't be lavish on you alone as there are the managing director, the finance director, the accounts director and others to pay. These are the supporting staff.
"A business development person brings in the bacon but they do the support. If the business development person gets exceptional big bonuses out of his performance, what about the supporting staff and the Chairman who invested in the infrastructure of the business. Without his investment, this person will not have been employed in the first place. You contracted as an employee with an agreed salary and you had been paid for that amount. Any bonus would be up to the boss.
"When there is famine or office politics, you seek other employers. This is also the reality of the life of an employee. In a start up, you needs to understand that you are no longer an employee and must get rid of your "exploitation" mindset.
"There will be no more exploitation of you by anybody because you are your own boss. Bernice does not give you targets since she knows that a start up is an uncertain business, no matter how optimistic projections of past performance you have made. If you are so sure that the start up agency is going to be profitable, why not sell your HDB apartment, rent one for the family for the interim period and go all out guns blazing. Sure to win. In no time, you have made millions."
In conclusion, I reminded Alan the harsh reality: "A start up is not a sure to win business. Even a successful business will have its ups and downs. There will be economic recessions and Bernice has to continue payment to tide over the bad times. This is the other side of the coin that you, a long-serving honest and productive employee cannot understand as you have not suffered considerable losses of a business set up and encounter stiff competition to lower pricing and high demands for cheap and good services from Singaporeans and elsewhere."
In this case study, I shall call this person Alan. In this private limited company, there are 2 directors at 50:50 share. Alan feels that he should be paid $5,000 per month as a "salaried" director as he brings in the bacon. The other director, Bernice puts in the money 100%.
So, Alan will get $60,000 per annum for the first year of operation. Bernice does not get paid but contributes in administration and management of the staff and office. At the end of one year, Alan wants 50% of the net profits but he will not be responsible for any loss. He thinks that there will never be losses since he has a wide network of prospective and loyal clientele. Bernice is only a "godmother" who pays for everything including his "salary".
The important issue is that he wants to consider $5,000/month to be classified under "operating manpower expense". That means he gets $60,000 per annum for the first year whether the company makes a profit or loses money.
After deduction of this expense and other expenses like salaries of supporting staff, office rental, utilities and miscellaneous expenses which may amount to around $72,000 per year, the estimated "operating expenses" will be $72,000 and with Alan's "salary", the total will be $132,000. Bernice does not get a cent for that first year.
Therefore the total loss to the investing director for this first year, will be around $132,000 in the worst case scenario of losses.
Alan, the paid director projects "profits" based on his extensive network of relevant clientele and your more than 30 years specialising in the industry. He brings in the bacon (as the clientele and expertise are his initially), but he does not bear the financial losses if the business fails.
There may be SARS virus equivalent or long periods of haze when nobody travels, a regional war, Singapore being attacked by terrorists. Money is needed to keep the business going during such unforeseen times and also to advance to him as the "directors' fees" which he wants to considers as his "salary".
Now, if Alan is merely an employee of the start up agency, the $5,000/month is classified as "salary." If not, it is considered "director's drawings".
Man proposes. God disposes. If the reader does not understand this idiom, I clarify that there is no sure thing as success in any start-up business. If there is, why are there so many more employees than self-employed?
With Alan's proposal to get $60,000 and 50% of the net profits (if any) but not the losses, Alan is effectively taking more than 50% of the net profits if the business makes profits. He does not take the losses and so he can just say goodbye and look for another job by becoming another employee after one year.
I told Alan that his proposal is unfair and unacceptable to any investor. "Obviously, you have considered that Bernice, the investing director doesn't deserve any monthly payment as she does not bring in the bacon. Well, she does the necessary administrative work saving time that permits you to do business development and she is putting down the money where her mouth is."
I elaborated: "Both directors in this 50:50 share holdings must be fair. When 2 people start up, they put in money and their initial shares are based on the monies they invested. They may pay themselves a small salary or forgo salary. Certainly, $5,000 a month is not the amount the start up will pay the partner as that depletes the operating capital.
"Bernice also thinks she deserves $5,000/month too as she bears more responsibilities being answerable to the regulatory authority as the key executive officer, her valuable time spent in administration and in bringing some business (though Alan presumes he will be the only one doing it). The investing director is also responsible for the family money invested ($100,000 paid up capital). $100,000 is not a small sum."
Alan said" "I can easily get a 80:20 deal with established agencies whereby I get 80% of the commission as a referring agent."
I replied: "Well, you should do what gives him the highest financial benefit."
Alan did not like the idea of sowing his odds to various agencies as he would not be able to project a solid reputation.
Alan said: "My friend runs an agency himself. He is given a salary and a share of the profits."
I said; "You can be sure that it will not be 50% of the net profits in the general cases. Do check with him. If he gets 50% of the net profit and does not put his hands inside the till, he must be a very lucky person."
I continued: "I doubt it. It is just not financially viable for the investing partner to give such a big share when he does not put up a dollar.
"A start up is like a baby. It needs a father and a mother ideally. Obviously, a mother (in this case, Alan) can do it alone. Many single mothers have raised children to be outstanding graduates. But we hear of such success stories. Many more single mothers have had failed miserably and we don't hear sad stories. We don't want to hear sad stories."
In conclusion, I spent much time elaborating the realities of commercial business life to Alan. "You have had been a very good employee for much of your life time by being honest and able to deliver the sales without the company getting into bad debts. Such employees are in great demand but there is a limit to what most agencies can afford to pay.
"See the other side of the coin. Business is feast and famine. When there is feast, you, as an employee feels "exploited" as a top performing employee bringing in 6 million dollars worth of sales income. You don't get to share the fruits of your big deals or get "appreciated" by being given some percentage of the revenue generated. But how much of the crumbs will satisfy you?
"You feel exploited as you feel you deserve high financial incentives that the company should give you for generating the six million dollars' revenue. You do not realise that the net profits may be as little as 5% as there are lots of overheads of a company. You feel that the net profits from your sales are 15-20% but you don't take into account the cost of overheads of the company and other factors like depreciation.
"The company may give you some bonus but it can't be lavish on you alone as there are the managing director, the finance director, the accounts director and others to pay. These are the supporting staff.
"A business development person brings in the bacon but they do the support. If the business development person gets exceptional big bonuses out of his performance, what about the supporting staff and the Chairman who invested in the infrastructure of the business. Without his investment, this person will not have been employed in the first place. You contracted as an employee with an agreed salary and you had been paid for that amount. Any bonus would be up to the boss.
"When there is famine or office politics, you seek other employers. This is also the reality of the life of an employee. In a start up, you needs to understand that you are no longer an employee and must get rid of your "exploitation" mindset.
"There will be no more exploitation of you by anybody because you are your own boss. Bernice does not give you targets since she knows that a start up is an uncertain business, no matter how optimistic projections of past performance you have made. If you are so sure that the start up agency is going to be profitable, why not sell your HDB apartment, rent one for the family for the interim period and go all out guns blazing. Sure to win. In no time, you have made millions."
In conclusion, I reminded Alan the harsh reality: "A start up is not a sure to win business. Even a successful business will have its ups and downs. There will be economic recessions and Bernice has to continue payment to tide over the bad times. This is the other side of the coin that you, a long-serving honest and productive employee cannot understand as you have not suffered considerable losses of a business set up and encounter stiff competition to lower pricing and high demands for cheap and good services from Singaporeans and elsewhere."
Monday, October 25, 2010
227. Oronasal fistula in a dog - veterinary costs
ORONASAL FISTULA IN A DOG - ESTIMATED VETERINARY COST IN 2010
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written: November 15, 2007
Update: 25 October, 2010
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
I am Dr Sing from Toa Payoh Vets, toapayohvets.com. Thank you for your email. Your dog is suffering from oro-nasal fistula caused usually by the abscess in the root of the big cheek tooth, the 4th premolar. In reply to your queries, see CAPITAL LETTERS below.
2010/10/24 ....@hotmail.com
Hi,
I have a jack russell of 7 years old, lately, we have been noticing small bumps on her face, right under her right eye. We have brought her to a vet and was told that it was due to gum problem, and this was further caused by tooth decay.
In that case, if we would like to proceed with a tooth extraction, how much would that cost?
1. SEDATION + ISOFLURANE GAS ANAESTHESIA $200
2. TOOTH EXTRACTION $20/TOOTH
3. DENTAL SCALING OF OTHER TEETH $50
4. POST-OP PAINKILLER AND ANTIBIOTIC INJECTION $30
5. POST-OP PAINKILLER AND ANTIBIOTIC ORAL $30 APPROXIMATELY
6. I/V DRIP + ANTIBIOTICS I/V $60
7. BLOOD TEST $150 (IF YOU DON'T WANT THE TEST, THEN THIS IS ZERO CHARGE)
8. CONSULTATION FEE $40 (NO CHARGE IN THIS CASE AS DIAGNOSIS IS DONE BY YOUR VET)
and what are the procedures?
NO FOOD AND WATER AFTER 10 PM THE DAY BEFORE. THE DOG COMES IN THE MORNING.
WEIGHED, EXAMINED GENERALLY, HEART CHECKED, TEMPERATURE, PULSE AND RESPIRATION DONE. BLOOD TEST (OPTIONAL).
THEN I/V DRIP + ANTIBIOTIC I/V, SEDATION AND GAS ANAESTHESIA. PREMOLAR TOOTH EXTRACTED. OTHER LOOSE ROTTEN TEETH EXTRACTED. DENTAL SCALING OF GOOD TEETH.
INJECTION SC PAINKILLER AND ANTIBIOTICS. THE DOG RESTS IN CAGE FOR >4 HOURS AND OBSERVED. GOES HOME IN THE EVENING.WITH PAIN-KILLER AND ANTIBIOTICS.
Two of my pet owner educational cases of canine oronasal fistula are at: A Pomeranian's facial wound that never heals
When is the soonest that we can have it done? Cause my dog seems to be in great pain.
WITHIN 24 HOURS OF YOU MAKING AN APPOINTMENT BY TEL 6254 3326.LET US KNOW AS SOON AS POSSIBLE.
Thanks!
Regards,
Name of Owner
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written: November 15, 2007
Update: 25 October, 2010
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
I am Dr Sing from Toa Payoh Vets, toapayohvets.com. Thank you for your email. Your dog is suffering from oro-nasal fistula caused usually by the abscess in the root of the big cheek tooth, the 4th premolar. In reply to your queries, see CAPITAL LETTERS below.
2010/10/24 ....@hotmail.com
Hi,
I have a jack russell of 7 years old, lately, we have been noticing small bumps on her face, right under her right eye. We have brought her to a vet and was told that it was due to gum problem, and this was further caused by tooth decay.
In that case, if we would like to proceed with a tooth extraction, how much would that cost?
1. SEDATION + ISOFLURANE GAS ANAESTHESIA $200
2. TOOTH EXTRACTION $20/TOOTH
3. DENTAL SCALING OF OTHER TEETH $50
4. POST-OP PAINKILLER AND ANTIBIOTIC INJECTION $30
5. POST-OP PAINKILLER AND ANTIBIOTIC ORAL $30 APPROXIMATELY
6. I/V DRIP + ANTIBIOTICS I/V $60
7. BLOOD TEST $150 (IF YOU DON'T WANT THE TEST, THEN THIS IS ZERO CHARGE)
8. CONSULTATION FEE $40 (NO CHARGE IN THIS CASE AS DIAGNOSIS IS DONE BY YOUR VET)
and what are the procedures?
NO FOOD AND WATER AFTER 10 PM THE DAY BEFORE. THE DOG COMES IN THE MORNING.
WEIGHED, EXAMINED GENERALLY, HEART CHECKED, TEMPERATURE, PULSE AND RESPIRATION DONE. BLOOD TEST (OPTIONAL).
THEN I/V DRIP + ANTIBIOTIC I/V, SEDATION AND GAS ANAESTHESIA. PREMOLAR TOOTH EXTRACTED. OTHER LOOSE ROTTEN TEETH EXTRACTED. DENTAL SCALING OF GOOD TEETH.
INJECTION SC PAINKILLER AND ANTIBIOTICS. THE DOG RESTS IN CAGE FOR >4 HOURS AND OBSERVED. GOES HOME IN THE EVENING.WITH PAIN-KILLER AND ANTIBIOTICS.
Two of my pet owner educational cases of canine oronasal fistula are at: A Pomeranian's facial wound that never heals
When is the soonest that we can have it done? Cause my dog seems to be in great pain.
WITHIN 24 HOURS OF YOU MAKING AN APPOINTMENT BY TEL 6254 3326.LET US KNOW AS SOON AS POSSIBLE.
Thanks!
Regards,
Name of Owner
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