The 2-year-old female hamster with the stinking right ear still had infection, this time, at another place. The lady owner had red eyes as I explained to her that the risks are higher everytime her dwarf hamster undergoes anaesthesia and surgery. I guessed she delayed as long as possible and now the hamster kept scratching her right ear tip. I noted that the tip was blackened. So, she came to me.
I gave isoflurane gas. Cut a big vertical cut and dug out all the yellowish granules of pus deep inside. I irrigated the holes as big as 1.5 cm and that is big if you are a hamster. The rotting smell (like bad breath) came back slightly. Now, the incision extended into the right cheek and into mouth.
The hamster was still alive 4 days after surgery when I phoned her.
"Not eating much," the owner said. "One melon seed and soft food."
"This is a tough cookie. She survived 4 anaesthesia though she is quite old. It must be very painful to eat. Can you weigh her? She had lost 3 g during surgery" I asked.
She had no appropriate small weighing machine. "You can count the number of faecal pellets," I said.
"My hamster is now having soft stools. Shall I stop the vegetables?" she asked.
"Yes," I said. "Otherwise we will get a serious 'wet tail' problem"
What to advise now?
"Feed her by syringe, a drop at a time," I advised. "10 times a day. For example, mash up the pellet and feed her. Give her water by syringe as she does not drink much. This will prevent dehydration. Hand feeding is very important for recovery. I had a case of a gentleman who nursed his severely dehydrated hamster back to health through feeding many times a day. I didn't expect him (as a man) to have the patience to do it but he proved me wrong."
I hope this hamster survives. As to what causes this evil smelling infection, it is hard to say since no bacterial culture has been done. The lower the vet cost, the better for the owner. There seemed to be a deep infection. It could be the inner ear but since hamsters are so small, no X-ray is practical unlike in dogs. The infection could be from the mouth to the Eustachian tube to the inner ear. Hard to verify. This is one of those unusual cases where the lady owner did not give up caring for a dwarf hamster. A new dwarf hamster costs around $15.00 if one is calculating and this is the way the older generation thinks.
Wednesday, September 21, 2011
621. Health screening for your older dog - update
Health Screening For the Older Dogs
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date: 21 September, 2011 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
Most pet owners in Singapore live hectic lives. There is just too many distractions and too much work.
After an intense care for their puppies, the senior dogs are just left alone as there is no time for them after their puppyhood. It is usually too late for many dogs when they are sent to the veterinarian for some chronic disease problems. Veterinary costs become high as the dog is in poor health and need more intensive care.
Senior dogs are:
Small and Medium-sized breeds: Over 7 years
Large and Giant-sized breeds: Over 5 years.
For those who may want their senior dogs to live longer, here are the following recommendations available at Toa Payoh Vets:
1. Veterinary examination every 6-12 months including examination for tumours and growths, ear infections, eye diseases, skin diseases
2. Blood tests to check for blood disorders, diabetes, liver and kidney diseases.
3. Urine tests to check on bladder and kidney infections and presence of urinary stones.
4. X-rays for arthritic hip joints (can't stand up easily), spinal column, heart and lungs.
5. Dental check up and scaling every year.
6. Heart check for murmurs and heart diseases.
7. Stool test for blood, parasites
8. A report and discussion about the delay in senility, obesity, behavioural problems, skin problems and any questions related to each individual dog. Tumours detected early can be excised saving the dog's life and reducing veterinary costs.
An example of the investigation tests and surgeries done for one older dog with heart disease and another with gum tumour is shown below
Case 1: Heart disease confirmed in an old companion
Cardiac Tamponade in a Labrador Retriever - Pt 1 Cardiac Tamponade in a Labrador Retriever - Pt 2
subcutaneous swelling - edema - cardiac tamponade - heart base tumour likely - toapayohvets, singapore Cardiac tamponade, 13 days after pericardiocentesis, lab retriever, toapayohvets, singapore Labrador Retriever, Male, 8 years, short of breath, transthoracic echocardiography, toapayohvets, singapore
labrador retriever, male, 8 years, skin swellings, cardiac tamponade, toapayohvets, singapore labrador retriever, male, 8 years, skin swellings, cardiac tamponade, toapayohvets, singapore Labrador Retriever, Male, 8 years, short of breath, transthoracic echocardiography, toapayohvets, singapore
Case 2: Get tumours excised by your vet when they are smaller
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Isoflurane Gas Anaesthesia. Electro-cutting removed gum tumour first. Note hard palate tumour. Toa Payoh Vets
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets
Electrosurgery stops profuse bleeding during gum & hard palate tumour removal. Toa Payoh Vets Gum and hard palate tumours in old dogs can be prevented with good dental hygiene and health. Toa Payoh Vets.
Large cancerous gum and hard palate tumou excised. Jack Russell, 10 years. Toa Payoh Vets Jack Russell, Gum & Hard Palate Tumour excised. Vet Intern. Toa Payoh Vets.
Old dogs are very high anaesthetic risks as they are seldom in the best of health unlike younger ones. Everyone is happy when the old dog does not die on the operating table after surgery. But every vet will have cases of old dogs dying on the operating table as it is impossible to get good clinical outcomes when the vets undertake high-risk16 years old fox terrier, not neutered, male, circum-anal, tail gland tumours, toapayohvets, singapore anaesthetics. This is one main reason why some vets discourage or reject old dog surgeries. "The old dog will pass away before the circum-anal tumours grow much bigger," one vet said to the owner. But the dog lived longer, splattering the apartment with blood from the bleeding tumour and requiring frequent cleaning up.
When a dog dies on the operating table, it is just too emotional for everyone including the operating veterinary surgeon. Such deaths may be bad-mouthed by the owner or the family members to friends and recorded on the internet forum. The bad news adversely affect a vet's reputation that takes so much time and effort to build. So it is understandable if a vet does not want to operate on high-risk cases. I do avoid such cases if possible as deaths on the operating table means a beloved family member that has been growing up with the family children who have become adults is lost forever.
The average life-span of a big breed dog is 12 years. Oldest small breeds in Singapore can live up to 20 years. However, many die before they are 10 years of age due to bad health and other preventable causes such as bacterial infection of the heart valves due to severe gum diseases (preventable by regular 2-yearly dental scaling and checks), pyometra (preventable by early detection or spaying), kidney diseases, diabetes and tumours like breast, gum and circum-anal tumours. Many diseases such as circum-anal tumours rarely occur in male dogs that have been neutered. If you don't wish to neuter your dog, please check his backside monthly as small circum-anal tumours are easily removed and cost you less too.
Tumours are best removed when they are small.
Make an appointment with your pet shop groomer if you have a close working relationship with them and needs pet transport to the vet of your choice. Or tel 6254-3326, 9668-6469 for an appointment to discuss health screening for your senior companion. Or e-mail judy@toapayohvets.com your requirements.
Website with images are at:
http://www.toapayohvets.com/surgery/20080807Senior_Dogs_Health_Checks_ToaPayohVets.htm
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date: 21 September, 2011 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
Most pet owners in Singapore live hectic lives. There is just too many distractions and too much work.
After an intense care for their puppies, the senior dogs are just left alone as there is no time for them after their puppyhood. It is usually too late for many dogs when they are sent to the veterinarian for some chronic disease problems. Veterinary costs become high as the dog is in poor health and need more intensive care.
Senior dogs are:
Small and Medium-sized breeds: Over 7 years
Large and Giant-sized breeds: Over 5 years.
For those who may want their senior dogs to live longer, here are the following recommendations available at Toa Payoh Vets:
1. Veterinary examination every 6-12 months including examination for tumours and growths, ear infections, eye diseases, skin diseases
2. Blood tests to check for blood disorders, diabetes, liver and kidney diseases.
3. Urine tests to check on bladder and kidney infections and presence of urinary stones.
4. X-rays for arthritic hip joints (can't stand up easily), spinal column, heart and lungs.
5. Dental check up and scaling every year.
6. Heart check for murmurs and heart diseases.
7. Stool test for blood, parasites
8. A report and discussion about the delay in senility, obesity, behavioural problems, skin problems and any questions related to each individual dog. Tumours detected early can be excised saving the dog's life and reducing veterinary costs.
An example of the investigation tests and surgeries done for one older dog with heart disease and another with gum tumour is shown below
Case 1: Heart disease confirmed in an old companion
Cardiac Tamponade in a Labrador Retriever - Pt 1 Cardiac Tamponade in a Labrador Retriever - Pt 2
subcutaneous swelling - edema - cardiac tamponade - heart base tumour likely - toapayohvets, singapore Cardiac tamponade, 13 days after pericardiocentesis, lab retriever, toapayohvets, singapore Labrador Retriever, Male, 8 years, short of breath, transthoracic echocardiography, toapayohvets, singapore
labrador retriever, male, 8 years, skin swellings, cardiac tamponade, toapayohvets, singapore labrador retriever, male, 8 years, skin swellings, cardiac tamponade, toapayohvets, singapore Labrador Retriever, Male, 8 years, short of breath, transthoracic echocardiography, toapayohvets, singapore
Case 2: Get tumours excised by your vet when they are smaller
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Isoflurane Gas Anaesthesia. Electro-cutting removed gum tumour first. Note hard palate tumour. Toa Payoh Vets
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets
Electrosurgery stops profuse bleeding during gum & hard palate tumour removal. Toa Payoh Vets Gum and hard palate tumours in old dogs can be prevented with good dental hygiene and health. Toa Payoh Vets.
Large cancerous gum and hard palate tumou excised. Jack Russell, 10 years. Toa Payoh Vets Jack Russell, Gum & Hard Palate Tumour excised. Vet Intern. Toa Payoh Vets.
Old dogs are very high anaesthetic risks as they are seldom in the best of health unlike younger ones. Everyone is happy when the old dog does not die on the operating table after surgery. But every vet will have cases of old dogs dying on the operating table as it is impossible to get good clinical outcomes when the vets undertake high-risk16 years old fox terrier, not neutered, male, circum-anal, tail gland tumours, toapayohvets, singapore anaesthetics. This is one main reason why some vets discourage or reject old dog surgeries. "The old dog will pass away before the circum-anal tumours grow much bigger," one vet said to the owner. But the dog lived longer, splattering the apartment with blood from the bleeding tumour and requiring frequent cleaning up.
When a dog dies on the operating table, it is just too emotional for everyone including the operating veterinary surgeon. Such deaths may be bad-mouthed by the owner or the family members to friends and recorded on the internet forum. The bad news adversely affect a vet's reputation that takes so much time and effort to build. So it is understandable if a vet does not want to operate on high-risk cases. I do avoid such cases if possible as deaths on the operating table means a beloved family member that has been growing up with the family children who have become adults is lost forever.
The average life-span of a big breed dog is 12 years. Oldest small breeds in Singapore can live up to 20 years. However, many die before they are 10 years of age due to bad health and other preventable causes such as bacterial infection of the heart valves due to severe gum diseases (preventable by regular 2-yearly dental scaling and checks), pyometra (preventable by early detection or spaying), kidney diseases, diabetes and tumours like breast, gum and circum-anal tumours. Many diseases such as circum-anal tumours rarely occur in male dogs that have been neutered. If you don't wish to neuter your dog, please check his backside monthly as small circum-anal tumours are easily removed and cost you less too.
Tumours are best removed when they are small.
Make an appointment with your pet shop groomer if you have a close working relationship with them and needs pet transport to the vet of your choice. Or tel 6254-3326, 9668-6469 for an appointment to discuss health screening for your senior companion. Or e-mail judy@toapayohvets.com your requirements.
Website with images are at:
http://www.toapayohvets.com/surgery/20080807Senior_Dogs_Health_Checks_ToaPayohVets.htm
Tuesday, September 20, 2011
619. Two weeks after surgery & treatment - pemphigus in a Shih Tzu - Part 4
Sunday Sep 18, 2011
The Shih Tzu is now so energetic and inquisitive that it was so hard to believe that she was causing so much distress to her caring lady owner for many weeks before treatment. She had literally a mouthful of "tumours" as you can see from the picture as follows:
The long history of this case is at:
1. http://www.sinpets.com/F6/201108031Five-oral-tumours-old-shih-tzu-singapore_ToaPayohVets.htm
2. http://www.sinpets.com/F6/20110902pemphigus-foliaceus-vulgaris-shih-tzu-singapore_ToaPayohVets.htm
"This is an auto-immune disease that will return if not treated with drugs," I explained to the owner that the dog's bodies produce antibodies to attack her skin cells.
At this review 2 weeks after surgery, it was sunshine as this old companion looked almost normal. What's more, she could eat and run, like a "reborn" dog.
"Is there another tumour inside the mouth?" the young lady asked me. The Shih Tzu objected to me opening her mouth. She twisted her head here and there. So, I took a picture when she yawned. "It is hard to say if she has another tumour inside the mouth," I replied. "Wait another two weeks."
I asked her to take the two types of auto-immune drugs and will review 2 weeks later. The dog had put on weight and the hair in the body had grown more. She looked so much prettier now that the hideouos lower lip and other mouth tumours had been excised by me using electro-surgery 2 weeks ago.
The drugs must be given at the lowest safest dose and this is why reviews and 3-6 monthly blood tests are necessary. In most cases, I don't see the owners coming for reviews after the first time. This is the culture of city living in Singapore and that is the way it is.
The Shih Tzu is now so energetic and inquisitive that it was so hard to believe that she was causing so much distress to her caring lady owner for many weeks before treatment. She had literally a mouthful of "tumours" as you can see from the picture as follows:
The long history of this case is at:
1. http://www.sinpets.com/F6/201108031Five-oral-tumours-old-shih-tzu-singapore_ToaPayohVets.htm
2. http://www.sinpets.com/F6/20110902pemphigus-foliaceus-vulgaris-shih-tzu-singapore_ToaPayohVets.htm
"This is an auto-immune disease that will return if not treated with drugs," I explained to the owner that the dog's bodies produce antibodies to attack her skin cells.
At this review 2 weeks after surgery, it was sunshine as this old companion looked almost normal. What's more, she could eat and run, like a "reborn" dog.
"Is there another tumour inside the mouth?" the young lady asked me. The Shih Tzu objected to me opening her mouth. She twisted her head here and there. So, I took a picture when she yawned. "It is hard to say if she has another tumour inside the mouth," I replied. "Wait another two weeks."
I asked her to take the two types of auto-immune drugs and will review 2 weeks later. The dog had put on weight and the hair in the body had grown more. She looked so much prettier now that the hideouos lower lip and other mouth tumours had been excised by me using electro-surgery 2 weeks ago.
The drugs must be given at the lowest safest dose and this is why reviews and 3-6 monthly blood tests are necessary. In most cases, I don't see the owners coming for reviews after the first time. This is the culture of city living in Singapore and that is the way it is.
619. House-call in Singapore
Toa Payoh Vets do make house-calls. The e-mail to Dr Sing is probably a case of a cat ringworm.
E-MAIL TO DR SING DATED SEP 20, 2011
Dear Vet Team ,
I have 3 Munchkin Kittens . At least one of them is growing a dermal fungus since yesterday .
As I m working trough the day I would like to take your service of home-visits .
I haven't been your client before so here my particularis :
Owner's particulars and address given
HP :
Patients : M1 (Blue Bi -Col , 4 Month , male ) , P1 (Gray Lepard Tabby , 4 Month , male ) , S1 (Ginger Bi-Col ,4 Month ,male )
It would be great if you would have time to visit me tomorrow evening after 7pm .
Thank you and best regards ,
E-MAIL TO DR SING DATED SEP 20, 2011
Dear Vet Team ,
I have 3 Munchkin Kittens . At least one of them is growing a dermal fungus since yesterday .
As I m working trough the day I would like to take your service of home-visits .
I haven't been your client before so here my particularis :
Owner's particulars and address given
HP :
Patients : M1 (Blue Bi -Col , 4 Month , male ) , P1 (Gray Lepard Tabby , 4 Month , male ) , S1 (Ginger Bi-Col ,4 Month ,male )
It would be great if you would have time to visit me tomorrow evening after 7pm .
Thank you and best regards ,
Monday, September 19, 2011
618. Urethral Obstruction in the Dog: Retrograde urohydropropulsion
Each vet has his own way of handling a case of urethral obstruction in the dog. The outcome may be similar in that the dog can pass urine normally but the post-operation complications and implications vary.
In the following case, the Miniature Schnauzer dribbled urine. X-ray showed the urethra blocked by more than 10 small stones 3x5 mm in diameter. The catheter was obstructed and could not pass into the bladder.
SURGICAL APPROACHES
1. Cystotomy and retrograde urohydropropulsion of the stones into the bladder.
2. Cystotomy and urethrostomy.
When there are too many stones, I usually take the second surgical approach. There will be less trauma to the glans penis and urethra as the urohydropropulsion (syringing 20-35 ml of water to push back the stones into the bladder). I will make a 0.5 mm cut behind the os penis, take out the stones with a forceps, close the urethra and skin. Then I take out the 3 stones from the bladder. In my experience, the urethral wound heals well if proper post-op care is given.
However, in some cases, the dog is sent home within 2 days after surgery. There is a lack of care by the owner due to inexperience in animal nursing. The wound breaks down and the urine leaks from the wound perpetually. This is because some owners do not bother to refer to the vet on seeing the wound breakdown, owing to various reasons. So, the first approach eliminates this post-op complication of an unnatural urethral gap as the penile urethra is not incised. All stones are taken out via the bladder in the first approach.
In this case, Vet 1 preferred the first approach. There are more than one surgical approaches in treating urethral obstruction and each has its own pros and cons.
However, on Saturday (my day off and 24 hours after surgery by Vet 1), I visited Toa Payoh Vets to check on this Miniature Schnauzer in the afternoon. I noted the glans penis was much swollen and so did the owner.
In this case, the dog was scheduled to go home 48 hours after surgery. The owner was concerned about this swollen glans penis - reddish and not able to get back inside the prepuce. This swelling is a post-op complication of retrograde urohydropropulsion in some cases. What makes it occur? It is due to the traumatic pressure of gripping the glans in the process of retrograde urohydropropulsion via a catheter.
Numerous small urinary stones inside the os penis (penile bone) can be removed via a urethrostomy or via flushing back into the bladder and removed via cystostomy
The Miniature Schnauzer dribbles urine for the past 2 weeks. Partial urethral obstruction with >10 small stones is seen in the X-ray. Cystostomy and urohydropropulsion removed the stones via the bladder. The owner and I see dog peeing normally as seen 2 days after the surgery before going home.
he catheter has not been able to pass through more than 10 cm inside the penis as its passage is obstructed by the numerous stones inside the penile urethra. To prevent it being dislodged as water is pumped into the catheter to push the stones back into the bladder for removal, the glans penis has been gripped as an anchor point, resulting in swelling. Gripping the penile bone may not be practical but will be preferred. In any case, the outcome was excellent in the sense that after 3 irrigations, the stones were pumped back into the bladder where they were removed. So, the penile urethra is not cut open.
In this case, there was a problem. I had to intervene to resolve this problem. I decided to give an anti-inflammatory pred injection which is not normally used after surgery. Leaving the glans penis to shrink will take many days and any traumatic injury to it will lead to much unhappiness for the owner as it will cost her money.
Although the dog has a big size 20 e-collar, the owner disagreed with me that the dog can can't reach his surgical area to bruise it. There was a small bruised area near his sutures (see picture). The lady owner told me that there was no way her dog could have licked that area since he had the collar. I said it was possible but there was no point arguing with an owner as she had not seen incidents in other cases.
Within 24 hours of the injection, the glans penis had shrunk by 50% and was much less inflamed (see picture). He peed normally, had a good appetite and an excellent caregiver. He was sent home on Sunday.
For dogs with swollen glans penis, it is best not to send home till the dog has recovered but that would take many days and trauma could still occur in the Surgery. NSAID does not work very well in such cases if they are given as the "first line of defence." NSAID was prescribed for the home stay.
More pictures are at:
http://www.sinpets.com/F6/20110920retrograde-hydrouropropulsion-singapore_ToaPayohVets.htm
In the following case, the Miniature Schnauzer dribbled urine. X-ray showed the urethra blocked by more than 10 small stones 3x5 mm in diameter. The catheter was obstructed and could not pass into the bladder.
SURGICAL APPROACHES
1. Cystotomy and retrograde urohydropropulsion of the stones into the bladder.
2. Cystotomy and urethrostomy.
When there are too many stones, I usually take the second surgical approach. There will be less trauma to the glans penis and urethra as the urohydropropulsion (syringing 20-35 ml of water to push back the stones into the bladder). I will make a 0.5 mm cut behind the os penis, take out the stones with a forceps, close the urethra and skin. Then I take out the 3 stones from the bladder. In my experience, the urethral wound heals well if proper post-op care is given.
However, in some cases, the dog is sent home within 2 days after surgery. There is a lack of care by the owner due to inexperience in animal nursing. The wound breaks down and the urine leaks from the wound perpetually. This is because some owners do not bother to refer to the vet on seeing the wound breakdown, owing to various reasons. So, the first approach eliminates this post-op complication of an unnatural urethral gap as the penile urethra is not incised. All stones are taken out via the bladder in the first approach.
In this case, Vet 1 preferred the first approach. There are more than one surgical approaches in treating urethral obstruction and each has its own pros and cons.
However, on Saturday (my day off and 24 hours after surgery by Vet 1), I visited Toa Payoh Vets to check on this Miniature Schnauzer in the afternoon. I noted the glans penis was much swollen and so did the owner.
In this case, the dog was scheduled to go home 48 hours after surgery. The owner was concerned about this swollen glans penis - reddish and not able to get back inside the prepuce. This swelling is a post-op complication of retrograde urohydropropulsion in some cases. What makes it occur? It is due to the traumatic pressure of gripping the glans in the process of retrograde urohydropropulsion via a catheter.
Numerous small urinary stones inside the os penis (penile bone) can be removed via a urethrostomy or via flushing back into the bladder and removed via cystostomy
The Miniature Schnauzer dribbles urine for the past 2 weeks. Partial urethral obstruction with >10 small stones is seen in the X-ray. Cystostomy and urohydropropulsion removed the stones via the bladder. The owner and I see dog peeing normally as seen 2 days after the surgery before going home.
he catheter has not been able to pass through more than 10 cm inside the penis as its passage is obstructed by the numerous stones inside the penile urethra. To prevent it being dislodged as water is pumped into the catheter to push the stones back into the bladder for removal, the glans penis has been gripped as an anchor point, resulting in swelling. Gripping the penile bone may not be practical but will be preferred. In any case, the outcome was excellent in the sense that after 3 irrigations, the stones were pumped back into the bladder where they were removed. So, the penile urethra is not cut open.
In this case, there was a problem. I had to intervene to resolve this problem. I decided to give an anti-inflammatory pred injection which is not normally used after surgery. Leaving the glans penis to shrink will take many days and any traumatic injury to it will lead to much unhappiness for the owner as it will cost her money.
Although the dog has a big size 20 e-collar, the owner disagreed with me that the dog can can't reach his surgical area to bruise it. There was a small bruised area near his sutures (see picture). The lady owner told me that there was no way her dog could have licked that area since he had the collar. I said it was possible but there was no point arguing with an owner as she had not seen incidents in other cases.
Within 24 hours of the injection, the glans penis had shrunk by 50% and was much less inflamed (see picture). He peed normally, had a good appetite and an excellent caregiver. He was sent home on Sunday.
For dogs with swollen glans penis, it is best not to send home till the dog has recovered but that would take many days and trauma could still occur in the Surgery. NSAID does not work very well in such cases if they are given as the "first line of defence." NSAID was prescribed for the home stay.
More pictures are at:
http://www.sinpets.com/F6/20110920retrograde-hydrouropropulsion-singapore_ToaPayohVets.htm
617. Singing for their wedding guests
What was most memorable about this wedding dinner was that the bride and bridegroom each held a mike and sang a duet as they walked into the wedding dining room. I could not hear what they sang in Mandarin. Confetti were thrown at them as they walked hand in hand to the stage. The waitresses and waiters did a dance with their plates near the stage before serving dinner. This was unusual. The place was a golf country club. Guests were mainly from the travel industry in Singapore including patrons.
In the other wedding I attended, the couple walked into the wedding dining room without pomp, dry ice or any music as the guests stood up. "Why no dry ice and music?" I asked the bride's father. The parents whom I knew well were very happy. This was the 3rd wedding reception (Australia, Shanghai and now Singapore). A singer was present. The place was a hotel. The waitresses and waiters served without much ado. Guests were from Australia, Shanghai and Singapore. "Was the baby born after the wedding?" I asked the father. "No," he said. "My daughter has been too busy to organise the Singapore wedding and by the time she did it, the baby has been born!"
Both brides looked great and radiant.
In the other wedding I attended, the couple walked into the wedding dining room without pomp, dry ice or any music as the guests stood up. "Why no dry ice and music?" I asked the bride's father. The parents whom I knew well were very happy. This was the 3rd wedding reception (Australia, Shanghai and now Singapore). A singer was present. The place was a hotel. The waitresses and waiters served without much ado. Guests were from Australia, Shanghai and Singapore. "Was the baby born after the wedding?" I asked the father. "No," he said. "My daughter has been too busy to organise the Singapore wedding and by the time she did it, the baby has been born!"
Both brides looked great and radiant.
Sunday, September 18, 2011
616. Urethral Obstruction - Veterinary Procedures
TOA PAYOH VETS
FORM TO BE FILLED BY THE VETERINARY SURGEON
Date:
1. ( )Consultation - Dysuria, haematuria, usually male dogs and cats
2. ( )Body weight, rectal temperature, time recorded
3. ( )General & detailed examination - illustration recorded and notes written
4. ( )Abdominal palpation - Bladder palpation and pain. Other findings
5. ( )Financial considerations and approval for tests with the owner recorded
Estimated range of cost to be approved by the owner
5.1 ( )Blood test
5.2 ( )Catetherise bladder
5.3 ( )Urine test
5.4 ( )X-rays - 2 views
5.5 ( )Antibiotics & Painkillers
5.6 ( )E-collar
6. ( )Consent Form For Anaesthesia & Surgery
7. ( )Deposit
MEDICAL AND SURGICAL RECORDS - DATE & TIME & PROCEDURES
1. Pre-medication start:
2. Sedation start:
3. Anaesthesia - Isoflurane + Oxygen start
4. Anaesthesia - Isoflurane + Oxygen end
5. Sutures used - number of packets and types
6. Post-op antibiotic and painkillers
7. Post-op medication
8. Post-op catheter check
9. Send urinary stones for analysis - date and time
10.Discharge date and time after joint inspection with owner
11.Name of veterinary surgeon discharging the pet
12.Signature of owner taking over the pet
13.Comments of condition of pet during handing over and instructions from the vet to be recorded below:
FORM TO BE FILLED BY THE VETERINARY SURGEON
Date:
1. ( )Consultation - Dysuria, haematuria, usually male dogs and cats
2. ( )Body weight, rectal temperature, time recorded
3. ( )General & detailed examination - illustration recorded and notes written
4. ( )Abdominal palpation - Bladder palpation and pain. Other findings
5. ( )Financial considerations and approval for tests with the owner recorded
Estimated range of cost to be approved by the owner
5.1 ( )Blood test
5.2 ( )Catetherise bladder
5.3 ( )Urine test
5.4 ( )X-rays - 2 views
5.5 ( )Antibiotics & Painkillers
5.6 ( )E-collar
6. ( )Consent Form For Anaesthesia & Surgery
7. ( )Deposit
MEDICAL AND SURGICAL RECORDS - DATE & TIME & PROCEDURES
1. Pre-medication start:
2. Sedation start:
3. Anaesthesia - Isoflurane + Oxygen start
4. Anaesthesia - Isoflurane + Oxygen end
5. Sutures used - number of packets and types
6. Post-op antibiotic and painkillers
7. Post-op medication
8. Post-op catheter check
9. Send urinary stones for analysis - date and time
10.Discharge date and time after joint inspection with owner
11.Name of veterinary surgeon discharging the pet
12.Signature of owner taking over the pet
13.Comments of condition of pet during handing over and instructions from the vet to be recorded below:
Saturday, September 17, 2011
615. Veterinary Dentistry in Yangon, Myanmar
"I don't believe that there is not one vet who uses the dental ultrasonic machine to scale the dogs' teeth in Myanmar," I said to my ex-assistant who had worked for me for 3 years as a Veterinary Technician. He is qualified as a vet in Myanmar and can open his own practice.
"I have visited the pet shops and veterinary clinics in May," my assistant said. "Only manual scaling is done," he said. Yangon now has over 40 vet clinics like Singapore and it is a growth city with property prices shooting up.
As my assistant is a sincere and honest person, I will not doubt his statement. In this situation, a vet with an ultrasonic dental scaler will be at a competitive advantage.
As he said he would be opening his own clinic in Yangon, I presented him my existing dental scaling machine and ordered a new one today Saturday. He would be at the Airport at 7 am today.
Finally he has decided to strike out on his own as he had been offered to join another Myanmar vet to jointly run a practice. However, nothing materialised since he left me in April 2011. It had been 5 months and the opening of this practice might be in December 2011. Something happened in between.
"If you concentrate on doing one thing, you will succeed," he said to me yesterday when I visited him at Peninsula Plaza. "You fall down, get up, do again and again till you succeed." What he meant was "focus" on veterinary medicine and surgery and not be distracted and you will succeed in practice. Work long hours too, I would say as clients want you to be available as this is a personalised business.
I am most happy for him as he had 3 years of hands-on experience at Toa Payoh Vets and had been willing to learn. He had been a good hard working colleague and had seen most common cases and the emergency anaesthetic problems.
I know he will do well in Yangon. I know he has a passion for veterinary medicine because of one incident: my printer cartridge runs out of ink fast despite my printer output of less than 50 printed pages per month. He had been using it to download veterinary info from the internet.
One year later, I should know how he is doing. I still can't believe that the most famous and experienced vet in Yangon does not have an ultrasonic dental scaler. It is expensive, costing over $3,000 in Singapore. Also, there is no isoflurane gas + oxygen machine being used by the vets there. It costs around $5,000 in Singapore for the basic set.
There may be good reasons for not having such sets in Myanmar.
"I have visited the pet shops and veterinary clinics in May," my assistant said. "Only manual scaling is done," he said. Yangon now has over 40 vet clinics like Singapore and it is a growth city with property prices shooting up.
As my assistant is a sincere and honest person, I will not doubt his statement. In this situation, a vet with an ultrasonic dental scaler will be at a competitive advantage.
As he said he would be opening his own clinic in Yangon, I presented him my existing dental scaling machine and ordered a new one today Saturday. He would be at the Airport at 7 am today.
Finally he has decided to strike out on his own as he had been offered to join another Myanmar vet to jointly run a practice. However, nothing materialised since he left me in April 2011. It had been 5 months and the opening of this practice might be in December 2011. Something happened in between.
"If you concentrate on doing one thing, you will succeed," he said to me yesterday when I visited him at Peninsula Plaza. "You fall down, get up, do again and again till you succeed." What he meant was "focus" on veterinary medicine and surgery and not be distracted and you will succeed in practice. Work long hours too, I would say as clients want you to be available as this is a personalised business.
I am most happy for him as he had 3 years of hands-on experience at Toa Payoh Vets and had been willing to learn. He had been a good hard working colleague and had seen most common cases and the emergency anaesthetic problems.
I know he will do well in Yangon. I know he has a passion for veterinary medicine because of one incident: my printer cartridge runs out of ink fast despite my printer output of less than 50 printed pages per month. He had been using it to download veterinary info from the internet.
One year later, I should know how he is doing. I still can't believe that the most famous and experienced vet in Yangon does not have an ultrasonic dental scaler. It is expensive, costing over $3,000 in Singapore. Also, there is no isoflurane gas + oxygen machine being used by the vets there. It costs around $5,000 in Singapore for the basic set.
There may be good reasons for not having such sets in Myanmar.
614. The younger generation has its own mindset
E-MAIL FROM A YOUNG SINGAPOREAN 25 YEARS OLD DATED SEP 17, 2011
We just have to adapt to our colleagues and people around us and the only thing you can do is advise them. If they do not wish to take it on board you cannot force them. However, if you explain to them why something is done and they find it logical and useful, then they will be more receptive. This is because that is the way the government and schools are trying to implement. Critical thinking and reasonable challenge of ideas are promoted by the Ministry of Education.
MY REPLY
Agree with you regarding advices to the young ones. Can't force them to do things. Just need to spend more time explaining the rationale. Or they learn from experience of mistakes.
http://www.sinpets.com/F5/20110917younger-generation-singapore_ToaPayohVets.htm
MY COMMENTS
The different mindset of the Google Generation has much to do with the availability of information in the internet as well as with a new type of education in Singapore and other developed countries.
I am listening to an audio "Thinking for a Living" by Thomas H Davenport. He says that knowledge workers (find, create, package knowledge for a living) are much independent-minded and their performance is hard to measure. How to choose appropriate intervention and performance measure and how to maximise productivity.
We just have to adapt to our colleagues and people around us and the only thing you can do is advise them. If they do not wish to take it on board you cannot force them. However, if you explain to them why something is done and they find it logical and useful, then they will be more receptive. This is because that is the way the government and schools are trying to implement. Critical thinking and reasonable challenge of ideas are promoted by the Ministry of Education.
MY REPLY
Agree with you regarding advices to the young ones. Can't force them to do things. Just need to spend more time explaining the rationale. Or they learn from experience of mistakes.
http://www.sinpets.com/F5/20110917younger-generation-singapore_ToaPayohVets.htm
MY COMMENTS
The different mindset of the Google Generation has much to do with the availability of information in the internet as well as with a new type of education in Singapore and other developed countries.
I am listening to an audio "Thinking for a Living" by Thomas H Davenport. He says that knowledge workers (find, create, package knowledge for a living) are much independent-minded and their performance is hard to measure. How to choose appropriate intervention and performance measure and how to maximise productivity.
Friday, September 16, 2011
613. Internal controls of a Vet Practice
All firms must have a robust and effectie system of internal controls that adresses financial, operational and compliance risks.
How does this apply to a vet practice? I can think of a few
FINANCIAL
Stock inventory and check on losses/pilferage
Usage of isoflurane and other drugs compared to caseloads
OPERATIONAL
Productivity of the vet - how much and how long is his or her operation?
Unnecessary use of tools e.g. swabs, sutures
COMPLIANCE
1. Microchip data to AVA
2. Rabies vaccine data to AVA
3. Controlled Drugs
4. Proper medical records
5. Advices to owners to be recorded
How does this apply to a vet practice? I can think of a few
FINANCIAL
Stock inventory and check on losses/pilferage
Usage of isoflurane and other drugs compared to caseloads
OPERATIONAL
Productivity of the vet - how much and how long is his or her operation?
Unnecessary use of tools e.g. swabs, sutures
COMPLIANCE
1. Microchip data to AVA
2. Rabies vaccine data to AVA
3. Controlled Drugs
4. Proper medical records
5. Advices to owners to be recorded
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