Sunday's interesting cases
Aug 12, 2012
Case 1
Bright sunshine. I came to work at 8.15 am as Mr Min took Sunday off at 7 am.
I had an appointment as the lady of a biting chihuahua, female, spayed, 14 years old decided to get dental work done. This was the first sister. She wanted me to do the dental on her dog and no other associate vet here to do it.
"Why?" I asked this fair lady of around 30 years of age, arriving in a taxi so early on Sunday morning. "My associate vets can do dental too."
"Because you are experienced. Because, Kiki is very precious to me."
She lived quite close to a vet practice but would not go there. Two years ago, she went to a big practice but she had to go back twice to treat her dog's dental problems as the vet missed the oro-nasal fistula at the first visit. So her father, her sister and she tried my services on Nov 4, 2011.
Her sister's dog, Teddy had bad breath and decayed fractured maxillary Right canine.
Dental scaling and 8 teeth extracted. I checked my case sheet and the following anaesthetic record was given to her sister:
Nov 4, 2011 Teddy, Terrier X, 4.6 kg, 39.2C
Bad breath & decayed fractured canine R maxillary
AMA - does not want blood test
11.05 am xylazine 0.1 ml IM. Wait 10 min.
11.16 am isoflurane + O2 1% intubated
11.29 am isoflurane + O2 1% maintenance
11.32 am isoflurane + O2 0.5%
11.35 am end of dental. wakes up fast.
Post op tolfedine + baytril, trimeth + multivit.
Whole dental work process 11.35 am - 11.05 am = 30 minutes
Isoflurane used = 11.35 am - 11.16 am = 19 minutes
Today, 9 months later, I phoned the owner of Teddy. No dental problem. As for Kiki who came today, the owner agreed to do a blood test first. Now this was a biting dog. How to do it efficiently?
"Be gentle. The last time your vet did it," the lady said. "She had to take blood from 4 legs! This is because her veins are very thin."
I was surprised. "Normally one leg will do."
I told Dr Daniel to get a tourniquet.
"Shave the cephalic vein area," I said. "You can see the vein better.
A tourniquet, muzzle and shaving the vein area enable Dr Daniel to draw blood in sufficient amounts. But the dog shot out several stools and peed. I gave antibiotics for 7 days and will do the dental next Sunday.
Case 2. Surprisingly, one lady phoned to say that her dog was on heat. The dog was spayed as a 6-month-old in Aug 2011. The vet had told her that the left ovary could not be found and to phone if the dog was on heat. So, now, almost one year later, the dog was on heat and she asked:"When should I get the dog spayed?"
Sunday, August 12, 2012
1035. Email - hamster swelling in lower body
E-MAIL TO DR SING DATED AUG 11, 2011
...@hotmail.com
Aug 11, 2011 12:41 PM (17 hours ago)
Dear Judy,
can you help me with what this swelling is and does it need professional attention?
It 's at the hind end of the hamster
The female hamster is otherwise well.
Thank you
(Name)
E-MAIL FROM DR SING DATED AUG 12, 2011
I am Dr Sing from Toa Payoh Vets. Thank you for your email query. The big swelling is likely a tumour. As it is pinkish and hairless, I would say that your hamster has had been "licking" it to get rid of it. I advise prompt surgical removal before it grow bigger and gets infected. Pl make appointment with me or one of the vets at Toa Payoh Vets by tel 6254 3326 to get it excised under anaesthesia. The estimated cost of anaesthesia and surgery is $150-$180.
...@hotmail.com
Aug 11, 2011 12:41 PM (17 hours ago)
Dear Judy,
can you help me with what this swelling is and does it need professional attention?
It 's at the hind end of the hamster
The female hamster is otherwise well.
Thank you
(Name)
E-MAIL FROM DR SING DATED AUG 12, 2011
I am Dr Sing from Toa Payoh Vets. Thank you for your email query. The big swelling is likely a tumour. As it is pinkish and hairless, I would say that your hamster has had been "licking" it to get rid of it. I advise prompt surgical removal before it grow bigger and gets infected. Pl make appointment with me or one of the vets at Toa Payoh Vets by tel 6254 3326 to get it excised under anaesthesia. The estimated cost of anaesthesia and surgery is $150-$180.
Saturday, August 11, 2012
1034. The father said: "Send the vomiting dog to the SPCA"
1034. The father said: "Send your vomiting dog to the SPCA"
Friday Aug 10, 2012, 8 pm
It is difficult getting a taxi at 8 pm on Fridays and so I was glad to see a cab coming to Toa Payoh Vets. A young lady stepped out to visit her sick Miniature Schnauzer, 9 years old, female and having a belly as swollen as a Schnauzer with 6 big pups.
She had sent in her dog earlier to my associate vet. I noted in the vet case notes that "the dog had been not been eating for 3 days, was very weak and had pale mucous membranes, not spayed. Pyometra?"
The taxi-driver was her father. He agreed to be hired and on the way to my home, I asked him regarding this dog that was being operated by my associate vet. He was 60 years old but his white hairs and wrinkled face aged him to 70 years.
"Parents end up looking after the children's dog," he said. "During the last 3 days, the dog just was not interested in the food, unlike other days. She would just lie down as if she was tired when my wife put the food bowl on the floor in the morning."
"Did she drink a lot of water?" I asked.
"Yes,"
"Did she pee more than normal?" I asked.
"Yes."
"How many days had she been vomiting?" I asked again.
"Seven days," he said. "She vomited every day. We thought she had stomach upset. My wife gave her bits of apples as these were her favourite. She would not eat more than a piece and then would vomit them out."
"What was the colour of her vomit and how long she been vomiting?" I asked.
"She vomited water for 7 days. I told my daughter that she ought to send the dog to the SPCA!"
She said to me: 'When you are old, I will send you to the old folks home!"
"The younger generation loves their dogs very much. SPCA does not treat sick dogs normally. Sending the sick dog to the SPCA means a death sentence and therefore, you ought to advise her to send the dog to the vet. Vomiting for 7 days every day is serious."
"I did tell her to send to the vet," the father said. "But she did not do so. That was why I said to send the dog to the SPCA."
The dog's temp was 37 C when she was examined by my associate vet.
The dog was operated by my associate vet yesterday at 7.30 pm. The daughter came at 8.15 pm and would have seen the infected womb which was larger than the biggest German sausage on sale at the supermarkets.
Today, this sunny Saturday morning at 9.35 am, I saw her standing up and wagging her tail on seeing me. I phoned the young lady at 9.40 am and let her know: "Chances are good that your dog will recover." She asked if her dog was eating and I said: "No, but she had her IV dextrose saline drip and would be OK." She thanked me with a sleepy voice as this was Saturday morning and young ones in developed countries don't wake up till noon time, having partied till 5 am on Fridays to Saturdays. She was most happy.
Blood test results were typical of pyometra in that the total WCC was extremely high at 150 (6-17). Nearly 10 x higher than the higher range of normal. This confirms an overwhelming bacterial infection. Any delay in surgery for 2 more days meant death for this gentle Schnauzer.
The differential cell count was even more interesting as Neutrophils (N) = 92% when the normal is around 70%.
N=92%, Absolute 138
L=0.7%, Absolute 1.05
M=5.2% Absolute 7.8
E=0% Absolute 0
B=1.8% Absolute 2.7
KEY PERFORMANCE INDICATORS
ANAESTHESIA & SURGERY FOR A CLOSED PYOMETRA CASE
Surgeon: An associate vet of Toa Payoh Vets
Domitor + Ketamine 0.24+0.30ml IV for 6 kg, 9-year-old dog vomiting for the past 7 days.
First sedation injection to last stitch: 70 minutes
Isoflurane gas maintenance: 45 minutes
First incision to last stitch: 41 minutes
Monosyn 2/0 x 2 packets absorbable
This report is my continuing efforts to audit veterinary surgeries done by my associate vets to achieve my vision of making Toa Payoh Vets the top 5 veterinary surgeries in Singapore.
As a licensee, I am responsible for the overall standard of care in Toa Payoh Vets.
Today, Saturday, 10.39 am, I have audited this case as regards the operational process and record keeping.
INCORRECT RECORDING. The suture used was not 3/0 as recorded by my assistant Min in the anaesthetic records. Min writes the details but the operating vet is responsible for the accuracy of the anaesthetic records. This case shows that a "trust and audit" process is necessary to maintain a high standard of care in any profession as human beings are not Gods.
The sutures used should be 2/0, Min told me. I did an inventory check of the sutures. There was no 3/0 stock of Monosyn. One associate vet uses Monosyn although the PDS is excellent too.
As the uterus was grossly enlarged (the biggest German sausage you can find), it would take 41 minutes to remove them. However, the time to achieve should be 30 minutes. The shorter the anaesthesia, the lower the risks of death of an old dog on the operating table and a dog alive is what makes or breaks a vet's reputation over the years.
OTHER KPI OF CASES RESEARCHED AT TOA PAYOH VETS ARE AT:
http://www.bekindtopets.com/animals/20081201PG9standard-operating-procedures-vets_ToaPayohVets.htm
Friday Aug 10, 2012, 8 pm
It is difficult getting a taxi at 8 pm on Fridays and so I was glad to see a cab coming to Toa Payoh Vets. A young lady stepped out to visit her sick Miniature Schnauzer, 9 years old, female and having a belly as swollen as a Schnauzer with 6 big pups.
She had sent in her dog earlier to my associate vet. I noted in the vet case notes that "the dog had been not been eating for 3 days, was very weak and had pale mucous membranes, not spayed. Pyometra?"
The taxi-driver was her father. He agreed to be hired and on the way to my home, I asked him regarding this dog that was being operated by my associate vet. He was 60 years old but his white hairs and wrinkled face aged him to 70 years.
"Parents end up looking after the children's dog," he said. "During the last 3 days, the dog just was not interested in the food, unlike other days. She would just lie down as if she was tired when my wife put the food bowl on the floor in the morning."
"Did she drink a lot of water?" I asked.
"Yes,"
"Did she pee more than normal?" I asked.
"Yes."
"How many days had she been vomiting?" I asked again.
"Seven days," he said. "She vomited every day. We thought she had stomach upset. My wife gave her bits of apples as these were her favourite. She would not eat more than a piece and then would vomit them out."
"What was the colour of her vomit and how long she been vomiting?" I asked.
"She vomited water for 7 days. I told my daughter that she ought to send the dog to the SPCA!"
She said to me: 'When you are old, I will send you to the old folks home!"
"The younger generation loves their dogs very much. SPCA does not treat sick dogs normally. Sending the sick dog to the SPCA means a death sentence and therefore, you ought to advise her to send the dog to the vet. Vomiting for 7 days every day is serious."
"I did tell her to send to the vet," the father said. "But she did not do so. That was why I said to send the dog to the SPCA."
The dog's temp was 37 C when she was examined by my associate vet.
The dog was operated by my associate vet yesterday at 7.30 pm. The daughter came at 8.15 pm and would have seen the infected womb which was larger than the biggest German sausage on sale at the supermarkets.
Today, this sunny Saturday morning at 9.35 am, I saw her standing up and wagging her tail on seeing me. I phoned the young lady at 9.40 am and let her know: "Chances are good that your dog will recover." She asked if her dog was eating and I said: "No, but she had her IV dextrose saline drip and would be OK." She thanked me with a sleepy voice as this was Saturday morning and young ones in developed countries don't wake up till noon time, having partied till 5 am on Fridays to Saturdays. She was most happy.
Blood test results were typical of pyometra in that the total WCC was extremely high at 150 (6-17). Nearly 10 x higher than the higher range of normal. This confirms an overwhelming bacterial infection. Any delay in surgery for 2 more days meant death for this gentle Schnauzer.
The differential cell count was even more interesting as Neutrophils (N) = 92% when the normal is around 70%.
N=92%, Absolute 138
L=0.7%, Absolute 1.05
M=5.2% Absolute 7.8
E=0% Absolute 0
B=1.8% Absolute 2.7
KEY PERFORMANCE INDICATORS
ANAESTHESIA & SURGERY FOR A CLOSED PYOMETRA CASE
Surgeon: An associate vet of Toa Payoh Vets
Domitor + Ketamine 0.24+0.30ml IV for 6 kg, 9-year-old dog vomiting for the past 7 days.
First sedation injection to last stitch: 70 minutes
Isoflurane gas maintenance: 45 minutes
First incision to last stitch: 41 minutes
Monosyn 2/0 x 2 packets absorbable
This report is my continuing efforts to audit veterinary surgeries done by my associate vets to achieve my vision of making Toa Payoh Vets the top 5 veterinary surgeries in Singapore.
As a licensee, I am responsible for the overall standard of care in Toa Payoh Vets.
Today, Saturday, 10.39 am, I have audited this case as regards the operational process and record keeping.
INCORRECT RECORDING. The suture used was not 3/0 as recorded by my assistant Min in the anaesthetic records. Min writes the details but the operating vet is responsible for the accuracy of the anaesthetic records. This case shows that a "trust and audit" process is necessary to maintain a high standard of care in any profession as human beings are not Gods.
The sutures used should be 2/0, Min told me. I did an inventory check of the sutures. There was no 3/0 stock of Monosyn. One associate vet uses Monosyn although the PDS is excellent too.
As the uterus was grossly enlarged (the biggest German sausage you can find), it would take 41 minutes to remove them. However, the time to achieve should be 30 minutes. The shorter the anaesthesia, the lower the risks of death of an old dog on the operating table and a dog alive is what makes or breaks a vet's reputation over the years.
OTHER KPI OF CASES RESEARCHED AT TOA PAYOH VETS ARE AT:
http://www.bekindtopets.com/animals/20081201PG9standard-operating-procedures-vets_ToaPayohVets.htm
Friday, August 10, 2012
1033. Maltese shivering and not eating
August 9, 2012's interesting case
A young couple phoned one hour before closing at 5 pm. They wanted to consult Dr Jason Teo as they knew his brother. But Dr Teo could not be contacted on handphone. So, they don't mind any vet or Dr Vanessa.
As Dr Vanessa was busy with dental scaling, I did not want to delay the closing of the Surgery at 5 pm as this was a public holiday and I try to let Mr Min off to celebrate. Working over time can be de-motivating for most staff and so I ensured that this does not happen. So, I handled the case with Dr Daniel.
The 7-year-old female, not spayed Maltese had a swollen tense abdomen. The vulva was swollen 10X.
"When was her last heat?" I asked the lady in her 30s.
"She has once a year and so far, I don't see any bleeding or spotting on the bed."
I checked the milk production but there was none except for a black "inverted" nipple which secreted yellow "milk."
"Has your dog been behaving strangely like carrying a towel around recently, vomiting, scratching the floors or hiding in a corner?"
"She did carry a soft toy yesterday," the lady said. "Scratching of the floors is her common habit. No vomiting except for last month. She did hide in a corner yesterday."
I diagnosed this dog as having her heat 1-2 months ago and was now suffering from a closed pyometra (womb infected with pus). The dog did not have a fever. The owners were not convinced although the wife said that the stomach was swollen. A blood test was taken.
"The blood test may be normal," I said to Dr Daniel. "If the closed pyometra has just commenced."
A young couple phoned one hour before closing at 5 pm. They wanted to consult Dr Jason Teo as they knew his brother. But Dr Teo could not be contacted on handphone. So, they don't mind any vet or Dr Vanessa.
As Dr Vanessa was busy with dental scaling, I did not want to delay the closing of the Surgery at 5 pm as this was a public holiday and I try to let Mr Min off to celebrate. Working over time can be de-motivating for most staff and so I ensured that this does not happen. So, I handled the case with Dr Daniel.
The 7-year-old female, not spayed Maltese had a swollen tense abdomen. The vulva was swollen 10X.
"When was her last heat?" I asked the lady in her 30s.
"She has once a year and so far, I don't see any bleeding or spotting on the bed."
I checked the milk production but there was none except for a black "inverted" nipple which secreted yellow "milk."
"Has your dog been behaving strangely like carrying a towel around recently, vomiting, scratching the floors or hiding in a corner?"
"She did carry a soft toy yesterday," the lady said. "Scratching of the floors is her common habit. No vomiting except for last month. She did hide in a corner yesterday."
I diagnosed this dog as having her heat 1-2 months ago and was now suffering from a closed pyometra (womb infected with pus). The dog did not have a fever. The owners were not convinced although the wife said that the stomach was swollen. A blood test was taken.
"The blood test may be normal," I said to Dr Daniel. "If the closed pyometra has just commenced."
1032. August 9, 2012 - National Day - 47th birthday of Singapore
August 9, 2012
National Day
I started work at 8.45 am and finished at 5.30 pm. A bright sunshine morning. I was photographing a yellow hibiscus flower with deep purple central when another fellow tenant - a contractor in his late 50s came to me and said: "It is very sad. Our founding father (ex-Prime Minister Mr Lee Kuan Yew) had passed away on Aug 5. He had not been seen since he paid a visit to his elder brother who passed away recently. You know, he had been hospitalised in July and passed away on the 5th of August."
"How come there is no news?" I said. "Nobody can hide such news."
"Well, announcing his death would dampen the happy spirits of the National Day and so his death was kept secret. Flags have to be half-mast as he had died and that would not do for National Day celebrations today."
He was the second man to inform me. Yesterday at 9 pm, I went to buy some fruits from the fruit seller in the wet market in Ang Mo Kio. He also spread the rumour as he said: "Mr Lee died at 5 pm yesterday. But his death is a secret as the government does not want to spoil the happy mood of Singaporeans for National Day tomorrow."
I was surprised as this rumour seemed to be widespread, apparently on Facebook.
I asked my wife and she said she knew about Mr Lee's death. She did not tell me.
So, I was the last to know.
"Well, if he had passed away," I said. "He would not be present at the National Day Parade this evening and I would not see him on TV. Unless a look-alive can represent him but I don't believe the Singapore Government would do such deception."
So, I watched the National Day Parade. The TV showed the ministers coming into the stadium. Then switched to showing the crowds. Most of the PAP ministers no longer wore their white uniforms this year. Some men wore pink shirts. A lady was in all white. Still no signs of Mr Lee appearing.
"He must be dead," my wife said. Another person said that if Mr Lee was not dead, he would have issued a public statement to say he was alive. Why should he?
"Well, Mr Goh Chok Tong (ex-Prime Minister) had not appeared too," I said. "He can't be dead at the same time."
It seemed the TV station was keeping the audience in suspense as they switched to views of the crowds and no more glimpses of the ministers.
Suddenly, the TV zoomed on a door. There was Mr Goh Chok Tong and Mr Lee Kuan Yew. The TV zoomed on his face - rosy pink under the evening sun set rays. In the pink of health.
Well, so much for this national rumours.
National Day
I started work at 8.45 am and finished at 5.30 pm. A bright sunshine morning. I was photographing a yellow hibiscus flower with deep purple central when another fellow tenant - a contractor in his late 50s came to me and said: "It is very sad. Our founding father (ex-Prime Minister Mr Lee Kuan Yew) had passed away on Aug 5. He had not been seen since he paid a visit to his elder brother who passed away recently. You know, he had been hospitalised in July and passed away on the 5th of August."
"How come there is no news?" I said. "Nobody can hide such news."
"Well, announcing his death would dampen the happy spirits of the National Day and so his death was kept secret. Flags have to be half-mast as he had died and that would not do for National Day celebrations today."
He was the second man to inform me. Yesterday at 9 pm, I went to buy some fruits from the fruit seller in the wet market in Ang Mo Kio. He also spread the rumour as he said: "Mr Lee died at 5 pm yesterday. But his death is a secret as the government does not want to spoil the happy mood of Singaporeans for National Day tomorrow."
I was surprised as this rumour seemed to be widespread, apparently on Facebook.
I asked my wife and she said she knew about Mr Lee's death. She did not tell me.
So, I was the last to know.
"Well, if he had passed away," I said. "He would not be present at the National Day Parade this evening and I would not see him on TV. Unless a look-alive can represent him but I don't believe the Singapore Government would do such deception."
So, I watched the National Day Parade. The TV showed the ministers coming into the stadium. Then switched to showing the crowds. Most of the PAP ministers no longer wore their white uniforms this year. Some men wore pink shirts. A lady was in all white. Still no signs of Mr Lee appearing.
"He must be dead," my wife said. Another person said that if Mr Lee was not dead, he would have issued a public statement to say he was alive. Why should he?
"Well, Mr Goh Chok Tong (ex-Prime Minister) had not appeared too," I said. "He can't be dead at the same time."
It seemed the TV station was keeping the audience in suspense as they switched to views of the crowds and no more glimpses of the ministers.
Suddenly, the TV zoomed on a door. There was Mr Goh Chok Tong and Mr Lee Kuan Yew. The TV zoomed on his face - rosy pink under the evening sun set rays. In the pink of health.
Well, so much for this national rumours.
Thursday, August 9, 2012
1031. Photo-essay of a case of squamous papilloma in a Cavalier King Charles
--------------------------------------------------------------
PHOTO ESSAY
FAST GROWING ORAL TUMOUR OLD DOG
Differential diagnosis - epulis or papilloma?
Cancerous or not cancerous
Cancerous or not cancerous
---------------------------------------------------------------
http://www.sinpets.com/dogs/20120725squamous_papilloma_older_Cavalier_King_Charles_toapayohvets.htmis the full report, as blogger.com can't publish in the format for easy reading.
The text is as follows:
1026. How to make a compelling photo essay in the internet age - Michael Freeman
Ref: Digital photopro
Feb 2012 digitalphotopro.com A photo essay or picture essay is a sequence of photos telling a story. It has:
1. A theme and the following fundamental structure 2. The Opener - The opening shot 3. The Body 4. The Closer 5. The Key Shots ( = climax or climaxes in short stories) The Opener is the "hook" or attention grabber of the reader. Openers are not where you place the key shots. The Body has a definite storyline. The Closer - end with a bang or whimper? Ending with a bang is better choice. The Key Shot. Not all images are fantastic. Be ruthless in weeding out images that do not make a photo essay strong. A high impact or key shot need to be part of a paced rhythmic photo essay. Earlier images need to build toward it. The internet. The future is in the form of the online slideshow. The tools are almost cinematographic, including strictly linear sequencing, transitions like cross-fades, audio, pans and zooms and more. BASIC BUILDING BLOCKS FOR A PHOTO ESSAY Title sequence Opener (Opening image) Establishment, setup Buildup (= minor climax?) Counter story, Second situation Continuation Climax, Key Shot Resolution Closer (Closing Image) e.g. LIFE magazine 1948 "The Country Doctor" show young dedicated smart doctors like Dr Ceriani can handle everything without federal interference. Opening image - rural doctor walk down a road, doctor's bag to house call. Closing image - modern surgeon exhausted after a late-night op but completely dedicated. (Code) www.michaelfreemanphoto.com |
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http://www.sinpets.com/dogs/20120725squamous_papilloma_older_Cavalier_King_Charles_toapayohvets.htm
An old dog is much loved, usually by the elderly mother, providing companionship while the children are out most of the time. “What is that fast-growing lump on the front lower gum enclosing the three teeth?”
DIAGNOSIS
An oral papilloma.
1. Cancerous or not
2. Fast growing
3. Biopsy
PROBLEMS - Anaesthetic death
SOLUTION
1. Surgery only option.
1. Procedures: 1.1 Health check.
1.2 Gas or IV anaesthesia.
1.3 Dental work
TREATMENT
Surgical excision - scalpel blade or electro-excision
CONCLUSION
Lab test - not cancerous
Follow up.
Outcome excellent
Prevention - weekly check up of mouth. Tooth brushing.
1031. Singapore bats - do they have rabies?
On Thu, Aug 9, 2012 at 12:57 AM, Harpreet wrote:
E-MAIL REPLY FROM SINGAPORE DATED AUG 9, 2012
Presently, Singapore is free from rabies. There have been no rabies in people and animals including bats. Therefore, local dogs are not permitted rabies vaccine. Rabies vaccine is available in Singapore and is permitted for dogs that are exported and therefore need to be vaccinated against rabies as required by the country of export.
Hi just wondering if the bats around my house can pass rabies to my dog!! Why no rabies vaccine in Singapore??
Sent from my iPad
E-MAIL REPLY FROM SINGAPORE DATED AUG 9, 2012
Presently, Singapore is free from rabies. There have been no rabies in people and animals including bats. Therefore, local dogs are not permitted rabies vaccine. Rabies vaccine is available in Singapore and is permitted for dogs that are exported and therefore need to be vaccinated against rabies as required by the country of export.
On Thu, Aug 9, 2012 at 1:24 PM, Harpreet Kaur wrote:
E-MAIL REPLY FROM SINGAPORE DATED AUG 12, 2012
Sorry, the authorities presently disallows rabies vaccinations in Singapore dogs
But also if I want to put rabies vaccine just in case for my dog am I allowed? Cos there are too many bats around my house and just in case one of them has rabies ?
E-MAIL REPLY FROM SINGAPORE DATED AUG 12, 2012
Sorry, the authorities presently disallows rabies vaccinations in Singapore dogs
Tuesday, August 7, 2012
1030. Email about euthanasia
E-MAIL TO DR SING DATED JUL 25, 2012
Hi Judy,
I have a 17 yrs old dog and she is partially blind, cant hear much as well.
She whines alot and we feel it's a torture for her, so we have decided to put her to sleep.
May I know how much is the fees and if we can make an appointment for end of this month?
Cheers,
XXX
E-MAIL FROM DR SING DATED JUL 25, 2012 | ||||
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I
am Dr Sing from Toa Payoh Vets. The cost is $60 for euthanasia.
Cremation may be around $200 depending on the size and breed.
Appointment ok for end of month. Pl phone 6254-3326.
E-MAIL TO DR SING DATED JUL 25, 2012
Jul 25
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1029. Papilloma in a CKC - a photo-essay
My script for this photo-essay
STRUCTURE OF A PHOTO-ESSAY - ORAL TUMOURS
1. Opening shot - TUMOUR
2. Middle - Contents - Diagnosis and treatment
3. Closing Shot - NO TUMOUR
4. Key Shots x 2
5. Theme - Be Kind To Pets - Examine her mouth weekly
The older dog is a family member. Externally groomed, eats and drinks normally
Mouth seldom examined
A lump appears. It grows bigger and bigger
Is it cancerous? Doubles in size within a week. Likely to be cancerous.
How to find out?
Anaesthetic risks in old dogs. Blood test to screen health. Health OK. Take the risk. Yes.
Biopsy as recommended by the vet professors during undergraduate studies. This is the usual practice.
No. Fast growing tumour may be malignant.
Anaesthesia. What type? Intubation normally. But this endotracheal tube blocks the view.
IV Anaesthesia. Effective? Yes if you know the dosage. 50% will do.
Electro-surgical excision including extraction of teeth
Send to lab for histopathology - Squamous papilloma. So not an epulis.
Good news. Not cancerous.
Goes home happy owner.
Examine your older dog's mouth weekly for oral tumours
STRUCTURE OF A PHOTO-ESSAY - ORAL TUMOURS
1. Opening shot - TUMOUR
2. Middle - Contents - Diagnosis and treatment
3. Closing Shot - NO TUMOUR
4. Key Shots x 2
5. Theme - Be Kind To Pets - Examine her mouth weekly
The older dog is a family member. Externally groomed, eats and drinks normally
Mouth seldom examined
A lump appears. It grows bigger and bigger
Is it cancerous? Doubles in size within a week. Likely to be cancerous.
How to find out?
Anaesthetic risks in old dogs. Blood test to screen health. Health OK. Take the risk. Yes.
Biopsy as recommended by the vet professors during undergraduate studies. This is the usual practice.
No. Fast growing tumour may be malignant.
Anaesthesia. What type? Intubation normally. But this endotracheal tube blocks the view.
IV Anaesthesia. Effective? Yes if you know the dosage. 50% will do.
Electro-surgical excision including extraction of teeth
Send to lab for histopathology - Squamous papilloma. So not an epulis.
Good news. Not cancerous.
Goes home happy owner.
Examine your older dog's mouth weekly for oral tumours
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