681. A Tourist Under Suspicion - Part 2

For some reasons unknown to me, on August 20, 2011, I was interviewed for 3 hours by the Hong Kong Airport Immigration Office from 6 am to 9 am. My visit was said to be "not in the national interest of Hong Kong." I had not visited Hong Kong since it became a Special Administrative Region (SAR) of China and that would be many years. I have no friends in Hong Kong when the Officer asked me. I was on a 4D/3N tour of Hong Kong and Macau. I just wanted to re-visit Hong Kong since the last visit as a member of the Bukit Turf Club task force to review the racing decline in Singapore. And that last visit was in 1988!

"Since the fish is in the net," I said to the Immigration Officer as I answered all his questions in a cordial manner and nearly 3 hours had passed, "Why not ask your relevant Department to interview me?"

"It is not so easy as you said," the Immigration Officer spoke to me courteously. "What offence did I commit?" I asked as the Officer persisted in advising me to by-pass Hong Kong by proceeding to Macau directly. In this situation, he would not stamp my passport as being "denied entry into Hong Kong."

"Why is my visit not in the national interest of Hong Kong?" I can't imagine me being the master spy or terrorist.

"I am sorry I can't tell you," the Officer implied that I would be sent back on the next plane to Singapore but did not say directly. "I am trying to make it easy for you by asking you to go direct to Macau."

My wife was waiting outside at the Baggage area as she usually walked fast and did not know I was detained. And 3 hours had passed so fast.

"If I accept your advice to go direct to Macau, how do I know that I would be denied entry to Macau, since Macau is also under China's control?" I asked as Macau is also a SAR of China.

"Macau's Immigration system is different from ours," the Officer implied that both SARs don't share the same data about me as a threat to the national interest of Hong Kong. However, I would not believe him.

"If I am denied entry to Hong Kong and just leave and go to Macau, I will have a black mark and will be denied entry into China."

"No," the Officer said. "I see that you had visited Hainan two years ago and had no problem."

"That was two years ago," I said.
"Things may change," the Officer said. "You may be able to visit Hong Kong another time. For today, I advise you to proceed to Macau directly from the Airport."

"Time is not on my side," I said sadly to the Officer. "I am 61 years old. "Have you spoken to your superior officer about my case?"

"Yes, I had discussed your situation with two levels above me," the Officer held his ground. "I am sorry you cannot enter Hong Kong."

"But what offence did I commit?" I asked.
"You did not commit any offence. You are more the 'victim'."
"Did somebody use my name and passport to commit a crime?" I asked.
"I am sorry I cannot reveal more to you,"

A victim of circumstances? Three hours had passed. I saw the light at the end of the tunnel. Each country has a right to reject tourists, no reasons need to be given. I said: "OK, ask my wife to come back to the Immigration Office and we proceed directly to Macau."

Her passport had been stamped as being permitted to enter Hong Kong. Mine was not stamped.

The Immigration Officer went to a room to speak to another person. Then he came to me and said: "You are permitted to enter Hong Kong."
I thanked him and asked that my wife be permitted to come back to the Immigration Counter.
"I am surprised that you did not get angry over this matter," the Officer said to me as a parting shot.
"Every country has a right to deny entry to tourists," I replied. "Thank you for your help."

I was sure I was videoed as there was already a written notice on the wall about being under closed-circuit television survellance of interviewees.

My wife was angry when she was brought back to the Immigration counter as she had waited at the Baggage Area for 3 hours. I quickly asked her to cool down, as a favourable situation can become disadvantageous to me if she made a lot of noise.

"Just focus on sight-seeing," the Officer advised me as we parted. I still can't figure out why he said that. Life is full of surprises. It is always best to keep cool in difficult situations.

In Singapore, I discovered that my younger brother had also been denied entry to Hong Kong 2 years ago and he just proceeded to Macau. He had not told me earlier. I wrote to the Hong Kong Immigration Officer, as advised by the Singapore's Ministry of Foreign Affairs. The reply is as follows:





Our reference : L/M in CD/HQ/23 Pt. 52

Dear Dr. Sing,

Thank you for your e-mail of 6 October 2011.

Persons arriving in the Hong Kong Special Administrative Region are subject to immigration examination under the Immigration Ordinance, Laws of Hong Kong. Each and every case will be considered and determined on its individual merits.

The Immigration Department attaches great importance to providing a courteous and efficient service to the public. It is regretful that you have encountered inconvenience at our control point.

Thank you for bringing the matter to our attention. Proper action has been taken. Hoping that your next visit will be a pleasant one.


Yours sincerely,

Mrs HO TSE Bing-yee
for Director of Immigration

CONCLUSION
Keep cool in difficult situations so that you can analyse and argue your case constructively will at least not burn the bridges. Showing anger and being abusive to civil service officers will not get you anywhere in this world. Not being proactive to argue your case courteously when you have had not done anything wrong is also not good for you.

680. Cystitis, lower urinary tract infection, upper urinary tract infection

Tuesday, Oct 11, 2011

"Both of you better go home in the afternoon," I said to the two young adults who kept yawning as I discussed the case of the Maltese that urinated dark red urine. I guess a Maltese peeing blood in the urine is not exciting as the dog belonged to somebody else.

"I stayed up late to produce the video," the young lady said. "It is a good video," I commented as she showed it on the monitor, "The hook is missing." The hook is the image of a bottle of dark red blood and that image was with her classmate. This was her first draft. I asked her to e-mail it to me. The final draft will need to include the hook, the X-rays and urine test results which I had created and more text. How to make it interesting to the pet owner is the challenge.

I asked the two students to tell me the difference between cystitis, lower urinary and upper urinary tract infections. I hope this case study will make their lessons on urinary diseases much more alive and interesting when they go back to the Polytechnic soon.

679. A dog and a cat hate each other

I got a phone call today from a young lady who has a 2-year-old male dog and a male cat.

Questions:
1. Why should I neuter my cat?
Answer:

678. The male Maltese pees thick dark red urine. Why?

Case teaching for 3 Temasek Polytechnic students 2nd year. Students should research write up a case rather than seeing many cases as an observer if they want to excel in veterinary medicine. I asked them to produce a video of the case. No need perfection. Just a first draft and we discuss further to bring vet medicine alive to pet lovers. So far, 5 days had passed. Not a frame of video!

676. Advices from a friend at Raffles Town Club

A man aged 63 years, retired from the civil service.

1. Success in private sector requires good EQ, IQ, networking, hard work. Be able to control one's anger even though the person is disliked. Success is not guaranteed in private sector.

2. He said that generally the smartest employees are in the private sector, followed by the civil service and then the welfare organisations. E.g. smartest people work in banks as bankers where they are paid most.

3. I should write courteous letters if I want favourable response to situations from civil servants. Anger will be unproductive. I was asking him some advices on a business project.

4. In PR, prepare your story and your angle rather than let the press decide the angle, but somertimes, the press editor has the last say and change the whole point of view.

5. Be available when needed by the press and help the rookies.

675. Synovial cyst on thumb

Today I had my bandage changed, 6 days post-surgery by Dr Foo Chee Liam, at SGH. Histopath results said it is not malignant. Dr Foo had diagnosed it as a synovial cyst (will post picture). My GP diagnosed it as part of an auto-immune disease which fortunately is not.

SURGERY
Dr Foo outlined a rotating flap. I told him earlier: "I need the right thumb for surgery in small animals." A rotating flap cutting a very incision (the whole length of the thumb at the medial side would be over 5 cm, width 2 cm). from the medial aspect of the thumb to close the circular wound after removal of the cyst (0.8 x 0.8 cm in my estimation.)

Fortunately, he took a full thickness skin graft from my wrist to cover the wound. I thought he had a fantastic solution as my thumb had not been cut to produce a rotating flap.

This case shows that the patient's interest and care is at the heart of the surgeon. I presume my synovial cyst behind the nail bed on top of the thumb was one of those rare presentations. Services were excellent from the front line to the surgeon.

674. Taxidermy but not for dogs and cats

Hi Dr Sing Kong Yuen,

My name is ..., a taxidermist operating in Singapore and is featured in ... (...). I read with regret your blog posting on 2010vets that a client had a taxidermied chihuahua by a local taxidermist that did not met his/her expectations.

I'm trained in my trade in New Zealand for a long time and can guessed what the problems your client have for the chihuahua. This is coming from my background in taxidermy and, more importantly, knowledge and skill in tanning animal skins with fur/hair on! However, I don't do dogs or cats out of personal principles (see ... report), but will still help out if sorely requested.

Being a current member of the Taxidermy Association Of New Zealand (www.nzta.co.nz), I'm in constant update of the state-of-the-art in taxidermy.

I hope to put right whatever misgivings you have regards taxidermy in Singapore. If you or your clients do have taxidermy needs in future, please do not hesitate to contact me. I'm sure your opinion will change once my work is seen by you.

Regards,

673. Pet Carnival in Singapore in Nov 2011

Dear Dr Sing,

Thank you very much for your advice previously. I would like to invite you to a Pet Carnival organised by my company.

First, allow me to introduce myself. My name is ...

My company is organizing a Pet Carnival.

The Pet Carnival will be conducted in late November as we are planning, and the location is still to be confirmed. Currently we are sincerely seeking for joint organizers, sponsors, and passionate participants of any form. All of the participating companies must be pet related, and we will allow only one company from each area to eliminate competition and increase the benefit for participating companies. The planned areas of pet industry include pet service, pet clinic, comprehensive pet store, pet online forum, pet online store, pet training/consulting, pet hotel and pet mover. Thus, we will only allow around 8 companies as either joint organizer or sponsor.

We are expecting to draw a population of 200 people with pets, and another 100 people who love pets but currently do not own one. The marketing power is projected to expand to around 1000 people. As my company is specialized in marketing and consulting, after the carnival, we are hoping to build long-term relationship to help the participating companies to expand their business. Thus, this is not just a pet carnival with tons of fun, opportunities and sales, but also a platform to help your company grow in the future.

Thus, on half of ... and as the organizer of the Pet Carnival, I am inviting you to join our event, as a joint organizer, sponsor, or any other form of participants, at your own choice. If you are interested, we can set up a meeting and further discuss about it.

Should you have any inquiries, please feel free to contact me.

Look forward to your response!

E-MAIL REPLY FROM DR SING DATED OCT 9, 2011

Thank you for your invitation. Will be glad to meet you to discuss further. Can make a lot of money (not really millions of dollars) if you know how to do it as pet ownership has increased.


In November, 2 "big" veterinary events in Singapore in which I am participating are:
Nov 5+6 - Singapore Vet Association Seminar and AGM
Nov 12+13 AVA Responsible Pet Ownership Roadshow 2011 - giving 2 talks or videos on Nov 12 + 13.

Therefore do be careful that you do not clash with above events and others I don't know. Phone me 9668 6468 to meet on weekday.

649.Everted cheek pouch in a dwarf hamster.

CASE STUDY by Dr Sing Kong Yuen, BVMS (Glasgow).

The young lady's vet gave a baytril 1% oral antibiotic 2 days ago. He said he would not operate as he was not able to do so.

So the young lady must have had surfed the net and brought her hamster to me. I did not ask her. Nowadays, young people are "google" people and they sometimes know more than the vet regarding specific niche conditions of their pets! A vet has to know everything in the hamster from nose to toe and that is only one species. How about dogs, cats, terrapins, guinea pigs, birds and fishes, iguanas and others? This comes from time in practice. 

 

 

 
She knew that her hamster's left pouch had turned inside out and needed to get a vet to operate. A pink mass dangled from the left cheek. One end had become black, a sign of gangrene. Blood supply had been cut off. The surrounding part had turned yellow due to bacterial infection. A speck of yellow pus dried on the upper eyelid.

"Antibiotics will not shrink the dwarf hamster's cheek pouch inwards," I said. "Your hamster needs surgery and the end of the infected pouch needs to be cut away. There is anaesthetic risk. Will you accept the risk?"

The young lady had no choice. If she did not consent to the operation, the hamster will die from infections. If she consented, the hamster may return to a normal life.

I would operate by amputation of the cheek pouch in this case. Everted cheek pouch surgery is best seen early as it may be pushed back and there is no need for surgery. The risk is not surgery but anaesthesia.

Isoflurane gas was used. The assistant must focus on this. "It is a simple surgery compared to Caesarean section or spay. Clamp the pouch first," I said to my assistant. "Cut and stitch".

It is easy to lecture. The hamster woke up from the gas anaesthesia and needed to be given the gas again. The necrotic end was excised with scalpel. Anaesthesia again. Stitch 6/0 absorbable x 3 interrupted.

"Don't stress the hamster," I gave this advice to my assistant. "Unclamp as the hamster had woken up and may die of fright struggling with a clamp. The correct way is to give the gas anaesthesia again."

On unclamping, the cut end of the pouch shrank inwards. "No problem with that," I said. "Used the forceps to pull out the cut ends to give 3 simple interrupted stitches".

As long as the hamster is anaesthesized adequately without killing him, the stitching is not a problem. The pouch was thus stitched with 6/0 absorbable sutures. The hamster went home to a happy young lady. There was slight bleeding and she would take care of it. "Use the other vet's antibiotics to save you some money," I said. "Do you want to take the excised pouch home with you?"

She shook her head. I showed her the illustration of how the pouch was excised. She seemed to be in a hurry and so I did not detain her. Overall, this was a satisfactory outcome. As long as the hamster survives the anaesthesia, the surgery is not complicated and the hamster owner is usually very delighted with the surgical outcome.

Questions asked by owner:
1. Feed liquid food? No need.
2. Can she store food? Not much as 80% had been cut off in the left cheek pouch. The right cheek pouch is still there.
3. What if she did not get surgery done?
Pus already in pouch. Gangrene tip. Hamster will die from infections.
4. "The hamster had pulled out a stitch," she phoned me later. "The stitch could have been cut longer and therefore looked loose," I said. But she did not turn up for a check up. I presumed all are well as I did not see her 7 days after surgery nor hear from her by phone.

UPDATES AT:
https://2010vets.blogspot.com/2011/10/update-on-blog-no-648-everted-cheek.html

 

 

 

Isoflurane + oxygen gas anaesthesia was used in this case. 

 

671. Update on xylazine + ketamine IV anaesthesia in dogs and cats

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

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

My associate vet loves to use Domitor pre-anaesthetic dosage, isoflurane and then Anti-sedan reversal. Another vet loves the xylazine/ketamine combination for anaesthesia. Another one loves zoletil injectable anaesthesia. Other vets may premedicate with ACP and use domitor + diazepam.

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

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

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

FOR SEDATION, the dosage is reduced as follows:
26kg, 5-year old dog
Xylazine 2% at 1.3 ml
Ketamine 100mg/ml at 0.3 ml
In one syringe, the total is 1.6 ml. IV
This was what I gave to the dog
After 1 minute, the dog was sedated.
After 5 minutes, I injected prednisolone into his large LH 5th digit granuloma. Slick flicker of pain reaction. He was sedated well.

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

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

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

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

XYLAZINE + KETAMINE IM IN CATS
I find this method most effective and safe for cat spays and neuters and short surgeries of <30 minutes. My dosage is
For cats below 2 kg, xylazine 0.1 ml + ketamine 0.4 ml IM = 0.5 ml in one syringe.
For cats 6-8 kg, xylazine 0.2 + ketamine 0.8 ml = 1.0 ml in one syringe.
For cats 2-6 kg, xylazine 0.15 ml + ketamine 0.6 ml IM = 0.75 ml in one syringe.

GENERAL GUIDELINE FOR IV ANAESTHESIA
More ketamine in cats, less in dogs.


Toa Payoh Vets Web page veterinary anaesthesia knowledge sharing at:
http://www.sinpets.com/F5/20110611veterinary-anaesthesia-knowledge-sharing_ToaPayohVets.htm