Likely a malignant mast cell tumour as it reappears at its original site on the left hind limb. 5 years ago, Vet 1 excised a small tumour with 1-cm resection margin. Histology shows neoplastic cells at the edges of the excised tumour.
5 years later, a grape-sized tumour was discovered on the same spot. Vet 2 did a fine needle aspirate which drew no cells. The tumour grew from small grape sized to kiwi ro apple and now mango-sized when they came to Toa Payoh Vets.
Vet 2's senior surgeon said that FNA could have caused the tumour to expand. I disagreed as it was a recurring malignant tumour and so do grow aggressively. The senior surgeon gave 2 choices with no guarantees of success: 1. amputate the left limb 2. excise the tumour. The dog could die on the operating table owing to old age high anaesthetic risks. The owner decided not to operate and the tumour grew to the mango-sized when they came to Toa Payoh Vets. Dr Daniel was the surgeon for this case.
Feb 14, 2014. Valentine's Day & 15th day of Chinese New Year.
The dwarf hamster had been scratching for the past few weeks. "Keeps scratching her elbows. Very itchy," the lady took leave from work in her Jurong office to send the hamster for treatment. I checked the past records and on Sep 8, 2013, there was an inflamed right elbow.
Now both elbows and inside the two thighs and above the knees are hairless and red. There were bite marks. The hamster was anaesthesized and the hairs around the inflamed joints clipped and washed. Oral pred was given and the hamster is restricted to eating seeds but no more orange and green coloured pellets common in the hamster food. The bedding is paper now.
It is hard to know the cause of the allergies. The colouring in the food pellets may be a cause as the hamster is not given sand bath nor shampoo or spray.
"Is it serious? Is it serious?" the young lady asked me. "Yes, if the hamster keeps scratching non-stop to relieve the itch. Sometimes, they pull out their body hairs as I had one case earlier!"
TP XX988
Maltese, female, not spayed, born Feb 20, 2000
An elderly couple takes care of this dog as the daughter has married and left her dog to parents.
On Feb 12, 2014, the dog had eaten very little for the past 6 days. Yesterday, heavy breathing, limping and was unable to stand up on hind legs. Could walk but slowly. Had "fits" lasting few seconds. What's the problem?
"When was the last menses bleeding?" I asked as the dog was not spayed and I detected some mammary gland swelling and dirty black brown nipple discharge which I showed the couple. .
"No more bleeding for a long time," the wife said.
"Is there a period of time when the dog was continuously cleaning her private parts?"
"She cleans herself after urination," the wife said.
"Any cleaning even though there was no peeing? For example, 2 months ago, before Christmas?"
"Yes, sometime in December. She was busy cleaning herself."
"14-year-old dogs still can cycle," I palpated the lower abdomen and the spinal area. The uterus was swollen at around 1 cm in diameter and the T/L spinal region was painful on palpation.
"Your dog has pyometra and false pregnancy," I said. "A hormonal imbalance. If she had been spayed at a young age, there will be no problem."
Blood test showed an elevated AST/SGOT of 106 (normal <81 89.4="" at="" but="" cell="" count="" glucose="" high="" neutrophils="" normal.="" normal="" p="" the="" total="" was="" white=""> "This is the start of pyometra," I said. "The dog is aged too but the blood test is normal except for increase in neutrophils.Did the dog vomit?" "No," the wife said. "She vomited once and was not eating for 2 days in Feb 6, and Dr Daniel had a blood test done."
The blood test was normal except for glucose at 9.4 (3.9-6.0) and Neutrophils at 86.4% similar to the recent one.
The owners did not want an X-ray.
It was lucky that I could show the nipple discharge of false pregnncy. "The hormonal imbalance can cause the dog to lose appetite as in this case. The dog would eat a bit of the canned A/D diet and nothing else. I advise spaying to remove the abnormal ovaries but the anaesthetic risks are very high as the dog is 134 years old now."
The couple would let the daughter decide. Strangely, without eating much, the Maltese came in for the 3rd injection (today) was much alert and walking with unsteady gait. Her rectal temp was normal at 38.3. The husband remarked that she was much stronger now. Dental scaling by Dr Daniel yesterday appeared to be good for the dog as she permitted me to open her mouth unlike previous days.
Today I would give the antibiotic and S/C amino acids. The problem is that the owner cannot syringe feed he dog with antibiotics and canned food as the daughter lived far away. Without hand or forced feeding and electrolytes, this dog will soon get emaciated.
Feb 10, 2014 Monday
Hotel Grand United Rm 709. 6.30 am
Yesterday, I had a Myanmar breakfast at a monastery and saw a local wedding in the monastery. The bridal costume was white but was not a "real" wedding dress according to Thin Thin. It was a white Myanmar dress.
My friend Khin Khin is a benefactor to the monastery and has donated money to build a library cum bedroom for the monk. "Don't use the monk's bathroom," Khin Khin advised me. I used the common public bathroom in another building. It was dark and needed renovation.
Donors are appreciated and their names are shown on the buildings. Her grandparents and parents had been donating money to help this monastery. Recently, her mum and she donated $80,000 to build a new 2-storey building. The head monk showed us the location of the building to be built. "Plan for 3-storeys," I advised. "In case there is another donor with $40,000 later."
This monastery has a school to educate around 140 student monks as in the traditional monastery made of wood and housing student monks, seen in Inle Lake area. I was surprised to see the young student monks reciting their mantras in a big class-room.
Lucky Two Guest House in Hintinda is a guest house. Next to it is a shop selling Myanmar silk and longi. Bought 2 blouses for two Myanmar friends in Singapore. Singapore ladies will never wear these traditional Myanmar blouses with shiny sequeins, so I don't waste money buying for them.
A straight road to Yangon from Hintinda cut travelling time by 1-2 hours but being unpaved, it was rocky bumpy ride for over 1 hour. Saw some sunflowers on the way. Lunch in a restaurant where the food is so good that local wealthy people send their staff to take away.
Prices will be higher but there is this niche for good food with good cooking oil, according to Thin Thin. She bought me some fish "stomach" dish which is expensive but I did not eat it. Went to Royal Asia Veterinary Surgery in the afternoon to visit the vet. A 2-seat ride around the back lanes in the evening. New apartment blocks of 3 storeys exist with run-down houses. The land in this suburb is so expensive. Had dinner at Coca Restaurant set up by a Singaporean. The family had a trusted Myanmar employee who now runs the show after the passing away of the founder, according to Thin Thin. A graduate in history who can speak English and had worked in Singapore as a domestic worker earned around 0.8 laks was serving us in a room since Dr Aung always bring his foreigner friends for dinner and is well known. She is worth more since she can understand and understand English. Poaching for good English-speaking staff will continue in modernising Yangon.
Got to go. 6.45 am. Breakfast and out at 7 am as Khin Khin has a driver to bring me to see some travel agents and a realtor.
May I ask some details? How long will it take from I bring it in the vet to everything finished? And pre health check? And how long should the cat fasting before and after neuter?
In reply to your above questions, the answers are: 1. The cat is brought to the clinic in the morning and spayed in the afternoon. The cat is not neutered immediately unless there is no consultation at that time.. The time of injection of sedation to completion of spay is around 20-30 minutes. The cat is given time to wake up from anaethesia and goes home at around 6 pm.
2. A pre-health general physical examination is done to check especially the heart, lungs and abdomen.. However no pre-anaethestic blood testing is done for the average normal cat. If the owner wants it done, the cost is $150 for a complete blood test.
3. Fasting will be no food after 10 pm the night before the operation. After neuter, the cat will be given food the next day.
"Lucky Two is a brand new hotel," my friend Khin Khin told me. "Just like Ocean Blue. I hope you are not afraid of ghosts!" I had completely forgotten about ghosts in this Feb 8, 2014 hectic visit and here she reminded me again.
Yesterday, I had a most enjoyable time being able to re-visit nature, to meet a Myanmar-English translator scholar, a famous fortune-teller whose clientele includes the top military brass and to visit a 140-year-old monastery, another monastery with the Buddha made from cane by Shan State people and an older monastery with two Buddha trees and a good artist. There were art pieces of landscape and farms on the wall of this older monastery painted by a monk and I could see that the art is of a good standard.
I wanted to visit a village far away from the city or town. "Why not visit the family of her daughter's uncle?" I presumed he was a farmer. Khin Khin tried to discourage me as it would be dusty but I was used to dust as a national service soldier many years back. "I can wear mask," I said. So, she arranged for me.to visit this village of Karen people. It was sunset when I sat on the bullock cart to view the bean fields which stretched as far as the horizon as the two bullocks pulled 7 adults on the dirt track between bean plants for a tour of the farm land.
To my right, a large reddish orange golden sun was setting, making the sky pink. Acres of short green bean plants on all sides. A few trees. A special tree with reddish flowers stood out. I tried to video the beautiful sun setting onto the green plantation but it was all shaking as the bullock cart undulated. The farmer could not converse in English but he was most happy to meet me. Villagers are mostly friendly towards foreigners in general. He plucked the bean pods, a thorny plant to prevent cows eating the beans or for some purposes and a bunch of red flowers from the tall tree with red flowers able to forecast rainy seasons. Much laughter. Clean air. Two black pigs, two mongrel dogs, a few chickens and some ducks. Mango flowers just forming buds. This is a really big farm just like some of those sprawling ones you see in the USA.
I had some stiffness in my back and the 50-year-old farmer got a stool for me to climb up onto the back of the cart. The others and a young monk just climbed up from the spokes of the wheel nimbly. I was worried about falling and breaking my legs, being quite ancient at 63 years. I know cows could kick, being a vet student in Scotland which has cows unlike Singapore. So, I was careful not to climb up the front of the cart where the two bullocks were tethered. The farmer was especially worried for this ancient. So he held my hand as I walked, in case I stumbled as I proceeded to the bullock cart area and his family and children looked on..
Such a beautiful green land stretching infinity while the large reddish-pinkish golden sun started dropping down at this time of 6.00 pm. A lone tall tree with red flowers. Cloudless grey skies streaked in hues of pink. Only a city dweller like me will appreciate this scenery, all too common for the farmer.
Then Khin Khin told me that he is a very famous fortune teller and even the top military brass consulted him. I can't image the Brigader-General in Singapore consulting a fortune teller but this is part of the culture in Myanmar. Khin Khin had consulted him several times as regards imminent personal and work challenges and had received excellent accurate predictions and advices.
Recently, she had serious bleeding from a mouth ulcer or a hard palate ulcer. "Big clots inside my mouth," she told me. "Continuous bleeding. I thought it was oral cancer." She consulted the fortune teller who told her not to worry and that the bleeding would stop. She got a biopsy done in Yangon and the test was negative for cancer and the bleeding has stopped.
"Since the fortune teller had seen you, I will ask him to tell you your future esp. your health," she volunteered. "No," I said. "I don't want to know that I will be dying soon." .
At around 3 am, I woke up suddenly as I heard a cracking sound, as if a balloon had burst. Just before I went to sleep, I heard an identical sound and thought it was from the TV program as I had not switched off the TV. All lights were switched on as well as the TV as my friend Khin Khin told me that there could be ghosts in a new hotel with only 3 rooms occupied.
Ocean Blue, Ngwe Suang Beach Hotel at had just opened for business 2 days ago and the 3 rooms were rented by me, Khin Khin and her daughter and the driver Sonny for one night. After a 6-hour drive, we had reached Ngwe Suang, a fine-sand beach very popular with Caucasians from Europe. We ended in Aureum Resort - Spa Ngwe Saung. Such a beautiful luxurious hotel with villas, manicured lawns and palm trees very close to the beach. The villas or bungalows has two rooms at US$195/room and an additional US$80 for the communal living room between the two rooms.
"You can share your room with Sonny," Khin Khin said. "My daughter and I will be in the other room." So, the total rental for just one night would be US$390 without the communal room. She would have to pay US$470 for the whole villa out of her own pocket. That is a lot of money as a Myanmar graduate earns around US$300 per month.
"I need my own room," I told Khin Khin who wanted to give me a treat as I seldom visit her in Myanmar declining her many invitations. "I wake up at 3 am to do my computer work and switch on the TV. I will be disturbing Sonny." Khin Khin then decided that Sonny ought to stay in a cheaper place. "I don't mind," Sonny said. He is around 50 years old and is a close friend of her husband for many years. He had volunteered to drive me from Yangon to Ngwe Saung and so he is more than a driver to Khin Khin's husband. It just did not seem the right thing to do. He was not a paid driver from a rental car company and such drivers do stay in much cheaper accommodation.
"Why not go to Ocean Blue hotel and check it out?" I suggested after we found that the other 2 hotels nearer to Aureum Resort - Spa Ngwe Saung were fully booked. "Brand new hotels are much better than old ones," I said. "The bathrooms would be newer and there should be no malfunctions of the shower. Yesterday, I stayed in Grand Palace Hotel Yangon and the shower could not be switched on when I wanted to bathe before breakfast!"
"So what did you do?" Khin Khin asked as it was too late to switch rooms as I had not checked on the functions of the bathroom tub with shower. After all, Grand Palace Hotel looks new and impressive. The rental was US$90 and as it has many Caucasian clientele, we presume it must be good.
"I have to bath sideways inside the bath tub!" I joked. The shower had lost its "button" and so I could not push or pull to activate the shower.
"Furthermore, I woke up to the sounds of dripping water, as if an invisible tap had been turned on and somebody was having a bath! That is why I don't want to stay in this hotel again."
"How long did these sounds last?" Khin Khin wanted to know. "Maybe 10 minutes. It could be somebody next door bathing. But at 2 am in the morning. It is possible that the guest could have come back from the night club."
I didn't think much about it until Khin Khin mentioned that it could be ghosts. So, now we were checked in at the brand new Ocean Blue with a 10% discount US$90 for my bigger corner room with a large living area and a balcony facing the ocean waves and sunset, I thought this would be a good arrangement with all of us living in the same hotel, rather than banishing the driver to Ocean Blue while we indulge in the surroundings of the Aureum. I bargained but got 5% for the other two rooms as Khin Khin did not bargain. After all, this hotel was not opened to receive guests till the next day although it was opened 2 days ago. Kind of confusing, isn't it? The supervisor had to decide as the manager was not around and he gave us the rates we bargained for. So, we took Rooms 213, 215 and 216.
"Don't take 214," I advised. "The digit '4' means death in Chinese."
"I am afraid of ghosts in this new hotel," Khin Khin said. I did mention death in numerology of "4" and this must have had triggered her phobias. Yet she has her daughter sharing the room 215 with her and the driver would be in 216. Of course 214 was vacant and the ghosts could lurk there.
"Talking about ghosts," I added fuel to fire and joked. "I have two beds in Room 213. A ghost could sleep on the other bed and would really frighten me when I wake up!"
This was really a frightful thought. Do I believe in spirits and ghosts? I do when I sleep alone. To allay me fears, I sleep with all lights switched on. As if ghosts are deterred by lights. It is hard to sleep with lights on and I cover my eyes with the spare pillows.
"What's those sounds of bells tinkling?" I frightened Khin Khin more as we came back from a wonderful sea food dinner at the restaurant favoured by many Caucasians. "Why is it so popular with Europeans?" Khin Khin asked me. "It could be from the websites as Caucasians always consult the travel websites" I told Khin Khin. "There is the band of two men singing English songs and the food is good and cheap." This beach resort restaurant seems to attract Caucasian couples young and old as I saw them streaming in while the competitors were not full on this February 7, 2014 fine evening.
Back to the tingling sounds of bells after we returned from dinner back to Ocean Blue and climbing up the stairs to the 2nd level. "These tingling sounds appear to be bells around the cow's neck. As the cows walk, the bells ting and ting!" Her daughter was carrying the metallic Ocean Blue disc with key and when these two collide, the tingling sounds commenced. I knew about it but not Khin Khin and so she was worried. More tingling sounds as her daughter walked behind her up to the rooms on the second floor, with the balcony facing the sea. This aggravated her fears of ghosts and put the chills in my spine too as I would be sleeping alone in a big room of some 250 sq ft. Room 214 would be vacant and so I had no buffer as the others would be in Rooms 215 and 216 while I would be in 213!
I could sleep with the TV on but there would be some creaky noises in some TV programs and it would be worse than ghosts walking about in my room. So I switched off the TV. All dead silence as the balcony was closed and there would be no sound of waves or insecurity from burglars.
Khin Khin discovered the source of the tingling sounds but was not secure from ghosts. "I paid 5,000 kyats one hotel staff to sleep outside the corridor," she told me. She really meant business. The appearance of "water flowing from taps" sound in my Yangon hotel at 2 am waking me up was so frightening an experience. A new hotel with no other residents. Rooms would be slept in by "nyats" or ghosts. So, she paid a hotel boy to sleep outside the corridor.
Of course, I was worried about the supernatural. Before I slept, I heard a cracking sound as if a balloon had burst which I thought was from the TV program. Then I got waken up by the same cracking sound. I dared not sleep. I went to the writing desk to download my images to the hard drive. On the brand new tiled floor, to the left of my small writing desk of about 4-foot in length, there were a row of blood-like stains. Could these be the trail of the bleeding ghost who arrived while I slept? This was really frightening as I had not been observant enough to see them when I checked in. This sighting meant that I should not sleep anymore. I was not sure whether the blood stains existed when I checked in as I was more interested in knowing that the shower was working and it was functional.
Then, I withdrew the sun curtains and stared out of the locked sliding glass doors to the blackness of the sea beyond and in between tall trees. Any spirits floating around. One should be more worried about human burglars in a deserted new hotel as they would be more dangerous.
I decided to open the sliding doors, seeing no human on the balcony. Spirits from the blackness could drift into my room. I took the risk. After all, there were lights of bulbs along the perimeter of the building facing the beach. Any spirits or ghosts would glide into the room in any case. The swishing of the sea waves pounding the beach was OK with me as I have heard such sounds before. I videoed the blackness, not expecting any ghosts to be around.
Suddenly, to the right side of the ground, near the main lobby and reception area, there loomed a big figure. Tall and stout. Silent and staring up at me as my video camera panned to his area. I did not drop my camera but was shocked. Was this the real ghost? At 4.30 am in the morning. Sounds of waves, blackness in the background and now a big figure looking up at me. Solid like the old teak wood tree of Myanmar.
What should I do? Quickly depart from the balcony, close the sliding doors and draw the curtains immediately. IA - Immediate Action during military training. No, I did not do that. It would be too late as ghosts flit in faster than the speed of sound. Really? I don't know.
I waved to this figure and he waved back at me. It could be the security guard. Otherwise why would a ghost wave to me. In any case, I have the evidence on video. I could not sleep anymore. I opened the door to check whether the hotel staff was sleeping outside the corridor to guard us. Sure enough, there was protection from the spirtis or "nyats" in Myanmar culture. Not one hotel boy but two sleeping on mattresses at the corner. Two is for protection. One is vulnerable should ghosts appear. Even the hotel boys were worried too.
It is nearly 6 am now and the hotel supervisor had said electricity to the rooms would be from 6 am to 6 pm. I can't understand why. I had bathed at night and so would not be shrouded in darkness when the room lights were off at 6 am. Better save this story to the cloud. The two hotel boys have had rolled up their two mattresses as I could hear the clicking sounds outside and some voices.
Ocean Blue Ngwe Saung Beach Hotel is a great place to stay, in my opinion. The beach is clean and has fine sand tingling the toes as you walk on it. The surroundings make you closer to nature and tranquility.
Feb 6, 2014 Grand Palace Hotel, Yangon, Rm 343 US$90, single
A new hotel with bright clean lobby. One block with lifts is for foreigners. The other block is without lift and is for locals, according to my friend. Room is very spacious with king-sized bed. Wireless connection was excellent at 4.30 - 6 am when I used this computer but was limited after 6 am.
Surprisingly, the room has no power point near the writing desk where I use the computer. Only one power point near left side of the bed. This may be owing to great demand for electrical supply in Myanmar and I presume the room is limited to one power point. So I can't charge my camera battery and the laptop at the same time as the points are far away. Could use an extension cord.
Visited 3 Veterinary Clinics in Yangon, Myanmar. There is said to be around 100 such clinics in Myanmar in 3 different townships.
1. Royal Asia Veterinary Surgery.
2. Forever Vet Clinic
3. Excellent Care Vet Clinic/ Hospital started by an accountant employing 4 vets. Just opened one month ago. US$450 rental/month for a 3-storey house with roof terrace. Will buy land to build own clinic.
With strong financial support from the accountant, X-ray machines, ultrasound, ultrasonic nebuliser, desktop and gaseous anaesthetic machines are purchased. Software development is being done.
Will visit Irrawaddy and Bay of Bengal today Feb 7, 2014.
An image of Emma, a groomer I knew since 9 years ago. I am glad she is doing well in her career. I treated her two cats with upper respiratory tract infection. The old Persian was thin and had been having runny nose now and then. The young cat got infected with loud sneezing.
The "tree trunk" above her head was not obvious during photography. The groomer and dogs were in the shade with the 1 pm sunlight behind. I set autofocus on the groomer's eyes. It is hard to get a good image of black and white dogs together with eyes visible as the white dog will be over-exposed if I focused on the black dog. I used "P" mode, Autofocus, Image stabilizer and took the picture with the Canon SLR. The bright light was behind. The subjects sit on a bench and are shaded since the afternoon sun is far behind. If I focus on the black dog's eyes, the white dog will be over-exposed and so I focused on the groomer's eyes.
Always focus on eyes in digital photography and make eye contact to get interesting images.
The scales over-running the edges of both ears of this 3-year-old Sheltie who had been to a groomer one month ago, suggested Sarcoptes mite infestation. The crusts on the ear near the opening of the vertical canal in the right ear suggested another type of ear mite.
However the owner permitted on skin scraping and it was negative for mites. "One negative does not mean no mites, as some vets may conclude," I said to this banker working for a Japanese Bank. "It is just like you getting rejected by one prospect when you market your bank investment product. It does not mean that your product will be rejected by others. At least 5 skin scrapings would be needed to check for skin mites esp. since you have used some ointment."
He would not permit more than one skin scraping and accepted my treatment for ear mites.
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