1350. A "James Herriot" practice in Australia

TOA PAYOH VETS toapayohvets.com Date: 06 April, 2013 Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits A "James Herriot" practice in Australia Dr Sing Kong Yuen, BVMS (Glasgow), MRCVSDate: 06 April, 2013 toapayohvets.com Be Kind To Pets Veterinary Education Project 2010-0129 1350. A "James Herriot" practice in Australia "Have you ever worked in a small practice where the veterinarian consults and manages the practice and where there is only one or two assistants during your undergraduate internship?" I had interviewed this newly minted veterinarian whose resume showed that she worked as an intern for big-name practices with lots of gadgets and equipment. Mine is a small practice and the type of vet I need is the "entrepreneur" type - a hands-on manager vet who could become a partner later. The type who will take my frank criticism with no beating around the bush if the new vet's standard of care is not up to standard. "I don't have time being a nice mentor when the mentee does not perform to expectations in the diagnosis and treatment or do not comply with my instructions on the care of patients," I said to this lady vet. Not the "lazy" vet who needs two assistants at the front desk and two assistants in the back end. New graduates want to join big practices so that they can be mentored and have all the necessary and unnecessary tools to treat and diagnose. But in 2013, such practices want vets with one or two years of experience. Every year I estimate around 50 vets would graduate from overseas and there will be more job applicants than jobs. Recently I offered a part-time position to a vet who had worked for the AVA but resigned after a short period of time. The vet said she preferred to work in a big practice where could be mentored. In any case, she did not want to work part-time. So, it is better for her to wait till the right offer from a private practice to come in. The new vet has to change his or her mindset. Having mentors is a good thing but there are not many around. But how do new vets hone their skills if they can't find a big practice and mentor? Sit and wait till the months pass by to find what he or she wants? As for this newly minted vet I interviewed, I knew she would not find employment in my practice to her liking. As she had a good work attitude, I introduced her to a bigger practice and advised her that she should not have hair falling to cover her face during the interview with me. I was at a coffee shop conducting the interview. There was an overhead fan whirling. Her hair kept covering her eyes and she kept holding it back. It was too distracting to interview. So I switched to another table with no whirling fan. I told her that she was the second lady with falling hair. The first one was a Myanmar lady whom my employment agency friend Khin Khin asked to interview. I have no business interest in this employment agency but helped out whenever I could to prevent this start up from failing. This Myanmar lady, dark and in her late 30s had a Master's degree in Library Science. She kept sweeping her long hair back as it keeps falling down covering her face. First impression counts. She could have cut her hair short before the interview. Same for this newly minted vet. I don't know why they don't do it. "I am looking for the 3rd lady with falling hair," I said to this vet. "Things come in threes." She thanked me for the referral and I hope she would get the job. Much depends on how the person fares in this interview but first impressions count especially when the job market is tight. Did this newly minted vet worked in a small practice as a locum in Australia? I was surprised she did. I was surprised that such "James Herriot" practice exist in Australia. "This practice has no gaseous anaesthetic machine," she recounted. "IV anaesthesia is very safe nowadays if the vet knows the dosage," I replied. "Just insert an IV catheter to do the topping up. All vet practices in Singapore are mandated by the AVA to have a gaseous anaesthetic machine. However, most short surgeries can be done without the need for a gaseous anaesthetic machine. "In developing countries, the gaseous anaesthetic machine and the drug are too expensive. A cat spay in Yangon costs around S$14.00. The private vet in Singapore will go bankrupt charging such rates. What is the name of this practice? I would like to visit it if I ever go to that part of Australia as I will learn some skills from them." She was reluctant to disclose the name. "Is the practice illegal, not licensed by the government?" I wondered how she would be doing her internship there. She revealed the name. For the new graduate, "James Herriot" type practices are old school and to be ashamed of. But this is the wrong mindset. Such practices cater to a clientele who can't afford the high medical costs of practices full of gadgets and equipment and they exist in many developing countries. "The vet must be quite old," I asked. "Such practices teaches you how to be good at the basic of veterinary medicine and surgery instead of relying of machines and high technology. Being hands on. Palpation skill needs to be good as the vet can't rely on ultrasound and X-rays." "Yes, the vet is around 70 years old," she surprised me as she recalled fondly the excellent treatment she had with the vets in her 3.5 weeks there. It must be fun too with such a diversity of cases and how the vets diagnosed and treated them. "What anaesthesia the vets use for Caesarean sections?" I asked. "Did the puppies survive?" The vet has a variety of cases from the less affluent clientele including a pug with a large bladder stone. "There was an emergency C-section," she replied. "But I was living too far away to be present. I don't know whether the pups survive or not." Of course, in Singapore, all C-sections in dogs would be done using gaseous anaesthesia. Still I had knowledge of one case where the breeder complained to me that his Golden Labrador dam died during C-section. As I know that practice preferred IV anaesthesia, I wondered whether it could be due to the topping up. This "James Herriot" practice in Australia could possibly be the last one. This newly minted vet told me she visited the James Herriot museum in Britain. I did not know it existed. I hope she will find her big name practice to work in. However there are more smaller practices than big ones. The market rate may be $3,400 to $3,800 for a new vet. "Ask for lower pay to work in a big practice as you can learn much more," I advised this lady vet as there seems to be difficulty finding jobs. "Don't be a bean counter, like all accountants. No vet will be able to repay their parents for the undergraduate studies. In fact, parents still have to help out with buying a car as it is just too expensive in Singapore!" Update will be on this webpage: www.bekindtopets.com/dogs/20130406new_vets_toapayohvets.htm More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: April 06, 2013 Toa Payoh Vets

 

    

1349. CPE: Cat talk by Dr Susan Little - Mar 30, 2013. Nasogastric tube

1. Anorexia in feline patients
2. The constipated cat
3. Feline feeding management

I enquired whether it is easy to put in a nasogastric tube and how it stays there. She said it is very easy as her cat patients don't object to it. The tube is glued onto the nose. E-collar is worn to prevent dislodgement. I have my doubts that it is so easy for Singapore cats. One image showed the tube stitched to nasal skin.
The tube is meant for feeding 3-5 days. For long term, use esophagostomy tube.


Procedure: Use 3-5F feeding tubes, insert medio-ventrally in the nasal meatus. I had done many nasogastric tube in the racehorse and so I know what she meant.
"How to tell if the tube goes into the lung?" I asked Dr Susan Little.
"Not usually. You can pump 1 ml of water. It will not adversely affect the cat if it goes to the lungs."

In the horse, I listen to lung sounds (air breathing). Stomach sounds are more musical.  Pumping liquid paraffin via the nasogastric tube into the horse's lungs will kill the horse. So, always listen to the sounds, In the cat, I wonder whether this applies? Will the cat scratch the vet's face when he does it?

Much can be learnt attending talks by other vets sharing their experience.

catcare@vin.com
felinevet.wordpress.com
facebook.com/BytownCatHospital

 CONSTIPATION DRUGS
Cisapride hard to get nowadays
Lactulose
Polyethylene glycol works very well in cats (syrup)
Psyllium (vetagyl) capsule very effective (mix with canned food, no flavour)
High fibre diet. Feline i/d, w/d

Pain elief
rehydrate
K+ correct
B12

Can will then eat








   

1348. Toa Payoh Vets web page Apr 4, 2013

TOA PAYOH VETS toapayohvets.com   Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074 Tel: 6254-3326, 9668-6469, judy@toapayohvets.com   04 April, 2013					Focus: Small animals - dogs, cats, guinea pigs, hamsters, turtles & rabbits
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6045 - 6049. Dandruff all over the puppy's body. Recovered after > 8weeks of treatment. Head & body scales overwhelm the skin surface
6050. Sharpei with oily skin passes blood in the urine for months	6051 - 6052. Services from Toa Payoh Vets		6053. Seamstresses from Myanmar
6054 - 6064. >Six hours' delay resulted in two distressed pups barely alive. The vet or breeder must know how to swing the pups to save their lives (video). Dam and pups are well.
6056 -6075. Script for video: My Shih Tzu has a red spot in his eye
6076. Health screening your older dog			*Draft Case Studies:  2010vets	Advert. Unique Singapore homes: A heritage bungalow	Advert. Apr 2013 9D/8N for 4 pax Yangon-Bagan_Inle with high quality hotel accommodation
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