Sunday, August 17, 2014

1454. Myanmar Yesin University Vet Science, Final Year Students Talk - Aug 15, 2014





Aug 18, 2014
Royal Golden View Hotel

Aug 16, 2014

Talk by 2 vets














































Aug 17, 2014
Car accident at around 80th mile

A fisherman with fish traps for rice fields

Thursday, August 14, 2014

1453. Myanmar travel stories - Rottweiler ate duck bones

Aug 14, 2014
Great Glory Hotel, Rm 107
greatgloryhotelmyanmar.com
New hotel, 21 rooms. Checked in last night after 12 midnight. Has wireless

Must be having the smallest TV screen of all new hotels. No CNN channel. Has one English movie channel, football channel and National Geographic.
Room rates US$70 lowest but no bath tub. Spacious room.  Has feedback form on table.


SURPRISE in Room 107.
The writing table has a wooden bar across such that I could not sit properly as my knees could not get in under the table. Very uncomfortable for typing.

No hot water for morning shower but water was not very cold.
Bath towel about 1/3 of standard hotel size. This is a surprise.
Shower leaks at junction spurting out water.

Visited Excellent Vet Hospital after dinner at Golden Duck.
Interesting

Visited Royal Asia Veterinary Surgery.
Case 1. Rottweiler, M, 6 months. Fed duck and chicken bones for at least 3 periods of time. Started vomiting for past 3 days. Very weak. Drank water, vomited. I saw reddish vomitus with water on the floor. What was the problem?

Gas anaesthesia. No sedation injections. IV drip.
Exporatory laparotomy by Dr Thein Tun Aung - dark red and thickened gastric mucosal folds. Parts have yellowish spots seen under the serosa. Some friable mucosal ulcerated areas. Swollen large intestines (transverse and descending colon) seen.

X-ray. Stomach with gas and what looked like duck bones.
Mucosal folds are enlarged but no intact duck neck vertebrae seen on exploratory laparotomy.

  
Dog stomach irrigated. Closed. Will dog survive after surgery?
"Hard to tell as the stomach was badly inflamed and ulcerated with thickened mucosal folds", I said to the concerned owners.

Case 2.
One year old Terrier neutered using closed pre-scrotal approach. 1/0 catgut used to ligate. 3/0 closed skin. Some bleeding seen from wound. Half hour later, scrotal swelling. Scrotum was bruised dark red due to dog licking.
"Any pain-killers given post-op?" I asked.
"No," the vet said.
"The dog had attacked the left side of the scrotum, causing dark red bruises on skin.   Best to check for bleeding."

Dr Aung sedated and gave gas by mask.
No ligature slippage.
"There must be blood as the scrotum is swollen," I said.
There were blood clots when Dr Aung expressed the scrotal bag. Was closed pre-scrotal method not good? He preferred open approach.  Or was it due to use of 1 catgut? Or dog licking?
"A few older male dogs will lick scrotum after neuter if no pain-killers are given," I commented from my experience. Tramadol was given and the dog was OK.










 
"Now, be good. You eat your dinner first. We will be late," the 76-year-old young-looking woman spoke over the phone. She spoke good English and was teaching 7 students English lessons in her home. So far 42 had been taught. This was more a hobby. Not a business. They practiced speaking English before going overseas for business. Lawyers, doctors etc.

"Were you talking to your husband?" I asked.
"That was my husband," she said. "He is god-sent."
The husband was 77 years old. The daughter who worked in Singapore for 8 years had returned to spend time with her parents. After all, no point going home when the parents are dying or dead and so she decided to go home. An extended family who cared very much for their dog.

She said RAVS is well renovated and well kept and that Yangon does not have such big clinics. That means good house-keeping.  I think the important thing is the experienced vet. Cases come in from other vets and midnight emergencies. It is actually too much for one vet. Will get burnt out with time.

A large variety of interesting cases everyday. Like distemper, parvovirus, fractures, artificial insemination in two English bulldogs.


Wednesday, August 13, 2014

Aug 13, 2014 AMENDED TALK TO FINAL YEAR STUDENTS FOR MR BAK to amend videos





YOU CAN BE A VERY GOOD VET  IN MYANMAR
- Belief, Passion, Drive, Perseverance and Focus

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS, Toa Payoh Vets, Singapore.
http://www.toapayohvets.com/

TALK TO FINAL YEAR VET STUDENTS
UNIVERSITY OF VETERINARY SCIENCE, YEZIN, MYANMAR
Aug 15, 2014


PART 1.  INTRODUCTION

I graduated from Glasgow University in 1974. I worked as an army vet (Guard and Tracker dogs), a government vet (pigs and poultry), a horse vet (racehorses) and a small animal vet. I started Toa Payoh Vets in 1982 and am still practising there.

40 years ago, I was a final year veterinary student like all of you. I had to buy veterinary books and subscribe to veterinary magazines to acquire skills and knowledge to become a competent young vet. Now, you have online sources of veterinary information anytime to help you with your research and study for examinations.

Veterinary medicine and surgery is too large a subject for any vet to master. Vets are expected to know how to diagnose and treat many animals, unlike the general practitioner who can refer difficult cases to the specialists who focus on only people. 

So, how can you be a very good vet in Myanmar?  My opinion is that you must acquire or possess at least 5 values - Belief, Passion, Drive, Perseverance and Focus for your many years of practice as a vet.  


1.  BELIEF. A feeling that veterinary medicine and surgery is good, right or valuable for you.
If curing sick animals is what you believe in, you must practise veterinary science and do it well.


2.  PASSION. A strong enthusiasm or interest for practising veterinary medicine and surgery for as long as you live.  You need to be motivated but how do you do it?

Motivation is said to be either internal or instrumental. Internal refers to being self motivated. You look forward to every new day to practise vet medicine without considering how much money you will make. Instrumental refers to a person wanting to make more and more money every day. Be a trader, banker or property developer as veterinary medicine does not make the average vet rich.

3.  DRIVE.  A determination to always try very hard to acquire veterinary knowledge and and be successful in treatment outcomes. You need:

- Lots of energy to do emergencies, read up, research and be available for clients.
- Hard work with most time spent at work.
- Little sleep. You may age faster, get burned out or divorced.

If you want a work-life balance, office hours 5 days a week job and time for your family, it is your choice.  

4.  PERSEVERANCE.  A continued effort to become a very good veterinarian despite difficulties, failures or opposition from other people.

- Your reputation of delivering good outcomes in the diagnosis and treatment will get you many referrals.


- Referrals sustain your practice but you must work hard and be available for clients. If you keep going abroad for holidays, your clients just go to the competitors. 

- It is much easier to retain an existing client compared to getting new ones.  

5. FOCUS. An ability to concentrate on how to provide better veterinary diagnosis and treatment and pay particular attention to the case/surgery handled. 

-  You need to focus on the bigger picture of what you hope to be 10 years later.

- Do you want to start your own practice?If you do, you need to focus on acquiring a wide range of relevant knowledge and skills to correctly diagnose and treat the animals and to manage your financial aspect of your business.


PART 2 - SOLVE THE PROBLEMS
OF CLIENTS/PATIENTS



Five of my interesting case studies showing some or all of the 5 above-mentioned values are discussed. I hope they may be useful in your revisions for your September examinations.

These are:

1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.
2. The egg-laying hens produced more abnormal eggs. Egg Drop Sydrome 76 viral infections.
3. The professional dog breeders wanted the cheapest Caesarean sections.
4. More racehorses were being shot by the vets.
5. Giving back to the veterinary community.

-----------------------------------------------------------------------------------


Case Study 1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.

He became tired easily after a few minutes of dog patrol with his handler, guarding the Tengah Air Base. The Army wanted me as an army vet, to put him to sleep. He was young and had a curable congenital heart diagnosed by me as Patent Ductus Arteriosus (PDA). He needed a heart surgery. What should I do to help him avoid death by lethal injection?

SOLUTION

1. The Ductus Arteriosus is a foetal blood vessel that connects the pulmonary artery to the descending aorta. During pregnancy, it shunts blood away from the collapsed foetal lungs as the foetus is still not breathing inside the womb. After birth it closes by around 8 days of age and becomes a fibrous tissue called ligamentum arteriosum.

If it is still present, it is called Patent Ductus Arteriosus. In this case, some of the unaerated (venous) blood from the pulmonary artery by-passes the lungs and goes to the the descending aorta via the PDA. As he had less oxygenated blood, he tired easily and was useless as a military guard dog.    

2.  In 1976, Singapore vets did not have diagnostic imaging like echocardiography and angiography. I diagnosed PDA based on a characteristic continuous (machinery) murmur heard at the left axillary region and a palpable cardiac "thrill".IMAGE


3.  I got Dr James Tan, an experienced veterinary surgeon to operate free of charge. Intercostal thoracotomy at the left fourth space to assess the PDA. The PDA in dogs is around 1 cm wide and less than 1 cm in length.  The lungs would collapse when the thorax is opened and since we did not have the mechanical ventilator.  I pressed the anaesthetic bag regularly as a manual ventilator to inflate the lungs while Dr James Tan operated fast, being experienced. He ligated the PDA. The dog was cured as he no longer felt tired so easily. He went back to work.

4.  Be humble and spend time to network and learn from more experienced vets. Ask for help if you need it. 
-----------------------------------------------------------------------------------


Case Study 2. The egg-laying hens produced more abnormal eggs. The Egg Drop Syndrome 76 (EDS 76) virus caused severe drop in the egg production in Singapore's large commercial poultry farms. This disease, present in Europe, was confirmed by the government lab vet testing for HI
(hemagglutination inhibition) titres. But the government (Primary Production Department) prohibited EDS 76 vaccine imports from Europe unless the vet could proven them to be locally effective. This big farmer had over 100,000 layers and he would need to illegally import the vaccine to avoid being bankrupted.  

I could see the egg layers producing soft-shelled and abnormal shaped eggs for many months. The farmer was losing a lot of money as the egg production was less than 50% instead of 80%.

IMAGE

I was the government vet in charge of extension work. Seeking vaccine import approval from the big boss was the responsibility of the Vaccine Production Unit. There was a solution - I proposed a vaccine trial. 

SOLUTION

An EDS 76 vaccine trial with Dr Ng Fook Kheong, Head of Vaccine Production Unit and the poultry farm was done. Half the layers in one house would not be vaccinated. The other half was vaccinated. HI titres were taken from each group. The vaccinated half of the house did not have egg production drop or abnormal eggs. With this evidence of the efficacy of the EDS 76 vaccine, the government approved import.
Try to solve the veterinary problems of farmers by being pro-active in seeking help from other vets.

-----------------------------------------------------------------------------------
Case Study 3. The professional dog breeders wanted cheap Caesarean sections. A vet provided cheap Caesarean sections for $250 and sold dog hundreds of vaccines/week to the professional dog breeders instead of vaccinating the puppies personally. He was suspended from practice.

Jenny, my nurse asked if I wanted to offer similar cheap C-sections to a big breeder with several hundred female dogs?

Should I work 24 hours/day, 7 days a week? Should I sacrifice my free time and not switch off my hand phone after 9 pm?  For the first 2 years, I provided $300 C-section services for all the professional dog breeders at any hour of the day. I gained valuable surgical skills with over 300 C-sections.

After each C-section, I would usually take images of the dam and/or puppies. I would review each surgery and how I would better manage the outcome in similar situations. See my webpage at:
http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm

IMAGES

Some vets who start their own practice may have insufficient number of cases. A good idea is to volunteer to spay and neuter stray dogs and cats cheaply to gain more surgical practice rather than watch online videos. Animal welfare people will appreciate your good work and refer more clients to you.


-----------------------------------------------------------------------------------
Case Study 4. More racehorses were being shot by the vets - Adding value to my employer. Singapore Turf Club employed me as a vet on a 3-yearly contract. At one time, Singapore's economy was in recession. I could see that the horse owners were not paying their horse trainers and the number of race horses were dropping as they had to be put down.

In one race, there were only 3 racehorse running. Ideally, there should be more than 10. This decline in horse racing was a serious financial loss to the Club.. As a horse vet, I should not bother with the management problems of the racing industry. My job was to look after the health of racehorses.

IMAGES

What could a vet do besides advising on health care of racehorses?

SOLUTION

I was a member of the Club's task force to look into the racing problems and suggest solutions. The Club sent us to talk to the administrators of the racing clubs of Hong Kong, South Korea and Thailand. The Racing Manager of the task force was responsible for a management report.

I suggested interviewing two respectable horse owners who were stock brokers and loved horse racing. They provided valuable feedback. I wrote to several racing clubs in the USA, South Africa and Hong Kong to ask them to send me 5 years of their annual reports for my research. I read up marketing books as I did not write management reports as a vet.

A new racing magazine wanted an article on horses. I submitted the following report entitled "What makes a horse racing club profitable?" and got paid $200. The board and management got a copy of this magazine. See my report at:
http://www.asiahomes.com/dev/20120513history-1988-horse-racing-decline-veterinary-ToaPayohVets.htm

IMAGES X 2
Page 1 of the report
http://www.asiahomes.com/dev/Stc1.JPG

-----------------------------------------------------------------------------------

Case Study 5. Giving back to the community.  When the internet started around 1997,  I believed that it would would be very useful in educating the pet owners in Singapore as they can read the contents anytime. The usual method was to print out articles on diseases or show the text book. This is time-consuming in a busy practice. 

SOLUTION

With online, conveniently accessed knowledge, better vets and pet owners will be better equipped to take good care of the sick pets or animals.

1. I started a blog in blogger.com and wrote case studies in this blog and in my website around one case per day. 

The IMAGE of my first blog page, written in 2007 is at:

 http://singaporecatskittens.blogspot.sg/2007/06/1-lady-who-loved-cats-was-chased-by-dog.html

2.  I set up my company website, http://www.toapayohvets.com when the internet was just available and the webpages were grey and black.  Free websites sometimes close down their operations and all your veterinary content will be lost.


3.  In the last 2 years, I started You Tube videos to teach undergraduate vets and inform pet owners of veterinary cases. The younger generation prefers videos to reading text.  The webpage of my videos  is at:
http://www.kongyuensing.com/animals/20100609Educational_Vet_Videos_ToaPayohVets.htm


In this talk, all the following videos will be shown if there is time.

1. An experienced vet gives an I/V drip efficiently. Dr Thein Tun Aung of Royal Asia Veterinary Surgery, Yangon, Myanmar.

2. Spay of a cat at Toa Payoh Vets  - Myanmar language


3. Castration of a dog at Toa Payoh Vets - Myanmar language
http://youtu.be/0_c2ypTg6T0

4. Mammary neoplasia. Toa Payoh Vets - surgical techniques - Myanmar language
http://youtu.be/7qBCpl9Dg2I


5. Traumatic Proptosis of a dog's eye. Toa Payoh Vets - surgical techniques -  Myanmar language
http://youtu.be/BNFXO5a8t7U

6. Dwarf Hamster with ear warts - English

7. Turtle with ear abscesses - English

I usually wake up at 3 am to do the social media writing and uploading and producing digital images.
This has been going on since around 2007. 

All vets should make a difference and contribute to the society which gives them the opportunity to study to become veterinarians. A Singaporean studying in an Australian veterinary university needs to pay more than S$250,000 = 195,000,000 kyats.

I note that Drs Thein Tun Aung and his wife donates to the building and for the
education of the students at a monastery.

IMAGES 

CONCLUSION

HARD WORK AND TIME ARE NEEDED TO BE A VERY GOOD VET

1. Be proactive in helping the animals or clients to solve their problems. Add value to your employer. This makes your veterinary career so much more interesting as you wake up every morning.

2.  At the of the day, nobody in Myanmar know who you are if you are inexperienced or poorly located.  You will need to work hard and usually long hours for an experienced vet and tolerate office politics in order to be be a very good vet.

3. You may need to work a few years in Singapore, Japan or overseas to improve your skills. Dr Thein Tun Aung worked for around 10 years in Singapore for different vets, seeing so many varieties of cases and it was very hard work.

4. Distractions and pleasures nowadays are many. Some young vets prefer online gaming and partying  till 3 am or watching online movies at the work place. This take up the time you could use to gain more veterinary knowledge by writing case studies, following up with the owner, research on how to do a better diagnosis and treatment. Why the outcome was not so good.

5.  It is a pain to write case studies and research more on medical cases.  

However, hard work and time are required if you want to be a very good vet. The above-mentioned 5 values, amongst others, will guide you to be a very good vet in Myanmar.  

6.  I hope you enjoy this talk and wish you all good luck to your final year examinations.

ACKNOWLEDGEMENTS

I thank Dr Tin Tin Myaing, President; Dr Soe Min, Secretary and committee members  of the Myanmar Veterinary Association for organising this talk. I thank Drs Ling Ling Soe and Thein Tun Aung of Royal Asia Veterinary Surgery for their generous sponsorship.

IMAGES AND YOU TUBE VIDEOS will be presented at the talk. A powerpoint presentation with images and videos will be shown at the talk on Aug 15, 2014 to the final year vet students.



REFERENCES


Toa Payoh Vets webpage
http://www.toapayohvets.com/

Case studies of dogs at Toa Payoh Vets
http://www.bekindtopets.com/animals/20081201Dog_Surgery_Anaesthesia_ToaPayohVets.htm


Article of "What Makes A Horse Racing Club profitable?". 12 pages.
http://www.asiahomes.com/dev/20120513history-1988-horse-racing-decline-veterinary-ToaPayohVets.htm

Page 1
http://www.asiahomes.com/dev/Stc1.JPG

Page 2
http://www.asiahomes.com/dev/Stc2.JPG

Page 3
http://www.asiahomes.com/dev/Stc3.JPG

Page 12
http://www.asiahomes.com/dev/Stc12.JPG


Case studies of Caesarean Sections at Toa Payoh Vets
http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm

Case studies of hamsters at Toa Payoh Vets
http://www.toapayohvets.com/surgery/050609hamsters_ToaPayohVets.htm

Be Kind To Pets website
http://www.bekindtopets.com/

Veterinary Videos from Toa Payoh Vets
http://www.kongyuensing.com/animals/20100609Educational_Vet_Videos_ToaPayohVets.htm

Blog No. 2
http://2010vets.blogspot.sg/


------------------------------------------

Aug 13, 2014  4.20 am. To Mr Bak and Marcus

AMENDMENTS AND ADDITIONS TO VIDEO

1. Insert in References the following:

INFO
Dr Sing Kong Yuen graduated from Glasgow University in 1974. He worked as an army vet (Guard and Tracker dogs), a government vet (pigs and poultry), a horse vet (racehorses) and a small animal vet. He started Toa Payoh Vets in 1982 and am still practising there.





2. Insert name of President of MVA as follows:

ACKNOWLEDGEMENTS

I thank Dr Tin Tin Myaing, President;

3.

3.1  Insert screen capture image of my first blog. click on

 http://singaporecatskittens.blogspot.sg/2007/06/1-lady-who-lovaed-cats-was-chased-by-dog.html

3.2 Amend/replace the text in the relevant section in the video. Repetition of first paragraph about starting my first blog (repeated info on 2nd line again .


3. REPLACE PARTS WITH THE FOLLOWING:

With online, conveniently accessed knowledge, better vets and pet owners will be better equipped to take good care of the sick pets or animals.

1. I started to blog in blogger.com in 2007. Perseverance is needed to write from 2007 to 2014 as it is hard work and takes lots of time to write and process pretty images. I wrote around one case study/day in this blog around one case per day. My first blog article is at:

 http://singaporecatskittens.blogspot.sg/2007/06/1-lady-who-loved-cats-was-chased-by-dog.html



It is a case of a cat with an armpit abscess.




4. Insert latest SCREEN IMAGES OF MY CORPORATE WEBSITE
under section saying "I started my corporate website.... "

5. Insert "All articles in my corporate website are archived in www.bekindtopets.com."

Insert a link to "Be Kind To Pets"   www.bekindtopets.com   and insert screen capture image.

6. Part 1 of your present video has 'abrupt ending." A black screen. Try to give some warning with text or pic to inform about transistions for Parts to Parts 1 to 3.

Try to make each part 20 minutes for 3 parts rather than present 1 hour for Part 2.
Excellent work. I learn about movie-making from experience in this project. I hope you acquire some practical skills too.  






Monday, August 11, 2014

1451. FINAL YEAR TALK 7A --- WITH IMAGES & POWERFPOINT

TALK TO FINAL YEAR VET STUDENTS
UNIVERSITY OF VETERINARY SCIENCE, YEZIN, MYANMAR
Aug 15, 2014

YOU CAN BE A VERY GOOD VET  IN MYANMAR
- Belief, Passion, Drive, Perseverance and Focus.

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS, Toa Payoh Vets, Singapore.
http://www.toapayohvets.com/



PART 1.  INTRODUCTION

I graduated from Glasgow University in 1974. I  had worked as an army vet (Guard and Tracker dogs), a government vet (pigs and poultry), a horse vet (racehorses) and a small animal vet. I started Toa Payoh Vets in 1982 and am still practising there.

40 years ago, I was a final year veterinary student like all of you. I had to buy veterinary books and subscribe to veterinary magazines to acquire skills and knowledge to become a competent young vet. Now, you have online sources of veterinary information anytime to help you with your research and study for examinations.

Veterinary medicine and surgery is too large a subject for any vet to master. Vets are expected to know how to diagnose and treat many animals, unlike the general practitioner who can refer difficult cases to the specialists who focus on only people. 

So, how can you be a very good vet in Myanmar?  My opinion is that you must acquire or possess at least 5 values - Belief, Passion, Drive, Perseverance and Focus for your many years of practice as a vet.  






1.  BELIEF. A feeling that veterinary medicine and surgery is good, right or valuable for you.
If curing sick animals is what you believe in, you must practise veterinary science and do it well.


2.  PASSION. A strong enthusiasm or interest for practising veterinary medicine and surgery for as long as you live.  You need to be motivated but how do you do it?


Motivation is said to be either internal or instrumental. Internal refers to being self motivated. You look forward to every new day to practise vet medicine without considering how much money you will make. Instrumental refers to a person wanting to make more and more money every day. Be a trader, banker or property developer as veterinary medicine does not make the average vet rich.

3.  DRIVE.  A determination to always try very hard to acquire veterinary knowledge and and be successful in treatment outcomes. You need:

- Lots of energy to do emergencies, read up, research and be available for clients.
- Hard work with most time spent at work.
- Little sleep. You may age faster, get burned out or divorced.

If you want a work-life balance, office hours 5 days a week job and time for your family, it is your choice.  

4.  PERSEVERANCE.  A continued effort to become a very good veterinarian despite difficulties, failures or opposition from other people.

- Your reputation of delivering good outcomes in the diagnosis and treatment will get you many referrals.

- Referrals sustain your practice but you must work hard and be available for clients. If you keep going abroad for holidays, your clients just go to the competitors. 

- It is much easier to retain an existing client compared to getting new ones.  

5. FOCUS. An ability to concentrate on how to provide better veterinary diagnosis and treatment and pay particular attention to the case/surgery handled. 

-  You need to focus on the bigger picture of what you hope to be 10 years later.

- Do you want to start your own practice?If you do, you need to focus on acquiring a wide range of relevant knowledge and skills to correctly diagnose and treat the animals and to manage your financial aspect of your business.


PART 2 - PROBLEMS OF CLIENTS/PATIENTS AND THEIR SOLUTIONS


Five of my interesting case studies showing some or all of the 5 above-mentioned values are discussed. I hope they may be useful in your revisions for your September examinations.

These are:

1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.
2. The egg-laying hens produced more abnormal eggs. Egg Drop Sydrome 76 viral infections.
3. The professional dog breeders wanted the cheapest Caesarean sections.
4. More racehorses were being shot by the vets.
5. Giving back to the veterinary community.

-----------------------------------------------------------------------------------


Case Study 1. The young military German Shepherd Guard Dog had Patent Ductus Arteriosus.

He became tired easily after a few minutes of dog patrol with his handler, guarding the Tengah Air Base. The Army wanted me as an army vet, to put him to sleep. He was young and had a curable congenital heart diagnosed by me as Patent Ductus Arteriosus (PDA). He needed a heart surgery. What should I do to help him avoid death by lethal injection?

SOLUTION

1. The Ductus Arteriosus is a foetal blood vessel that connects the pulmonary artery to the descending aorta. During pregnancy, it shunts blood away from the collapsed foetal lungs as the foetus is still not breathing inside the womb. After birth it closes by around 8 days of age and becomes a fibrous tissue called ligamentum arteriosum.

If it is still present, it is called Patent Ductus Arteriosus. In this case, some of the unaerated (venous) blood from the pulmonary artery by-passes the lungs and goes to the the descending aorta via the PDA. As he had less oxygenated blood, he tired easily and was useless as a military guard dog.

  

2.  In 1976, Singapore vets did not have diagnostic imaging like echocardiography and angiography. I diagnosed PDA based on a characteristic continuous (machinery) murmur heard at the left axillary region and a palpable cardiac "thrill".

3.  I got Dr James Tan, an experienced veterinary surgeon to operate free of charge. Intercostal thoracotomy at the left fourth space to assess the PDA. The PDA in dogs is around 1 cm wide and less than 1 cm in length.  The lungs would collapse when the thorax is opened and since we did not have the mechanical ventilator.  I pressed the anaesthetic bag regularly as a manual ventilator to inflate the lungs while Dr James Tan operated fast, being experienced. He ligated the PDA. The dog was cured as he no longer felt tired so easily. He went back to work.

4.  Be humble and spend time to learn to network and learn from more experienced vets. Ask for help if you need it. 
-----------------------------------------------------------------------------------


Case Study 2. The egg-laying hens produced more abnormal eggs. The Egg Drop Syndrome 76 (EDS 76) virus caused severe drop in the egg production in Singapore's large commercial poultry farms. This disease, present in Europe, was confirmed by the government lab vet testing for HI
(hemagglutination inhibition) titres. But the government (Primary Production Department) prohibited EDS 76 vaccine imports from Europe unless the vet could proven them to be locally effective. This big farmer had over 100,000 layers and he would need to illegally import the vaccine to avoid being bankrupted.  

I could see the egg layers producing soft-shelled and abnormal shaped eggs for many months. The farmer was losing a lot of money as the egg production was less than 50% instead of 80%.




I was the government vet in charge of extension work. Seeking vaccine import approval from the big boss was the responsibility of the Vaccine Production Unit. There was a solution - I proposed a vaccine trial. 

SOLUTION

An EDS 76 vaccine trial with Dr Ng Fook Kheong, Head of Vaccine Production Unit and the poultry farm was done. Half the layers in one house would not be vaccinated. The other half was vaccinated. HI titres were taken from each group. The vaccinated half of the house did not have egg production drop or abnormal eggs. With this evidence of the efficacy of the EDS 76 vaccine, the government approved import.


-----------------------------------------------------------------------------------
Case Study 3. The professional dog breeders wanted cheap Caesarean sections. A vet provided cheap Caesarean sections for $250 and sold dog hundreds of vaccines/week to the professional dog breeders instead of vaccinating the puppies personally. He was suspended from practice.

Jenny, my nurse asked if I wanted to offer similar cheap C-sections to a big breeder with several hundred female dogs?

Should I work 24 hours/day, 7 days a week? Should I sacrifice my free time and not switch off my hand phone after 9 pm?  For the first 2 years, I provided $300 C-section services for all the professional dog breeders at any hour of the day. I gained valuable surgical skills with over 300 C-sections.  After every C-section, I would take some images for review and what were the problems encountered and how I could do operate and manage better in similar situations. See my case studies at:
http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm


Some vets who start their own practice may have insufficient number of cases. A good idea is to volunteer to spay and neuter stray dogs and cats cheaply to gain surgical practice. Animal welfare people appreciate your good work. Practice on surgery makes you perfect.


-----------------------------------------------------------------------------------
Case Study 4. More racehorses were being shot by the vets - Adding value to my employer. Singapore Turf Club employed me as a vet on a 3-yearly contract. At one time, Singapore's economy was in recession. I could see that the horse owners were not paying their horse trainers and the number of race horses were dropping as they had to be put down.

In one race, there were only 3 racehorse running. Ideally, there should be more than 10. This decline in horse racing was a serious financial loss to the Club.
As a horse vet, I should not bother with the management problems of the racing industry. My job was to t
he health of racehorses. What could I do besides advising on health care of racehorses?

SOLUTION

I was a member of the Club's task force to look into the racing problems and suggest solutions. The Club sent us to talk to the administrators of the racing clubs of Hong Kong, South Korea and Thailand. The Racing Manager of the task force was responsible for a management report.

I suggested interviewing two respectable horse owners who were stock brokers and loved horse racing. They provided valuable feedback. I wrote to several racing clubs in the USA, South Africa and Hong Kong to ask them to send me 5 years of their annual reports for my research. I read up marketing books as I did not write management reports as a vet.

A new racing magazine wanted an article on veterinary conditions in racehorses. I submitted my management report titled "What makes horse racing profitable?" and got paid S$200. The board and management got a copy of this magazine. See my report at:

Article of "What Makes A Horse Racing Club profitable?". 12 pages.
http://www.asiahomes.com/dev/20120513history-1988-horse-racing-decline-veterinary-ToaPayohVets.htm




Researching on horse racing business enabled me to understand how to manage and market my small animal practice as it is a related business too.

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Case Study 5. Giving back to the community.  When the internet started around 1997,  I believed that it would would be very useful in educating the pet owners in Singapore as they can read the contents anytime. The usual method was to print out articles on diseases or show the text book. This is time-consuming in a busy practice. 

SOLUTION
With online, conveniently accessed knowledge, better vets and pet owners will be better equipped to take good care of the sick pets or animals.

1. I started to blog in blogger.com in 2007. Perseverance is needed to write from 2007 to 2014 as it is hard work and takes lots of time to write and process pretty images. I wrote around one case study/day in this blog around one case per day. My first blog article is at:

 http://singaporecatskittens.blogspot.sg/2007/06/1-lady-who-loved-cats-was-chased-by-dog.html


It is a case of a cat with an armpit abscess.



I improve my digital photography skills by reading the many types of photography magazines from the public libraries in Singapore.






2.  I set up my company website, http://www.toapayohvets.com.  Free websites sometimes close down and all your content will be gone. Many vets use Facebook but have no perseverance to post veterinary articles.


3.  From 2013, I produced You Tube videos with the help of the young energetic interns to teach undergraduate vets and inform pet owners of veterinary cases. The younger generation does not read much but loves videos and so I seldom write up cases in my blogs. Seven examples of BE KIND TO PETS VETERINARY EDUCATIONAL VIDEOS are presented for this talk.


 



 1. An experienced vet giving an I/V drip by Dr Thein Tun Aung
2. Spay of a cat at Toa Payoh Vets  - Myanmar language
3. Castration of a dog at Toa Payoh Vets - Myanmar language.
4. Mammary neoplasia. Toa Payoh Vets - surgical techniques - Myanmar language
5. Traumatic Proptosis of a dog's eye. Toa Payoh Vets - surgical techniques -  Myanmar language


6. Dwarf Hamster with ear warts - English
A You Tube video on lateral ear canal resection in a dwarf hamster with ear warts by Dr Sing Kong Yuen
http://www.youtube.com/watch?v=fxJ2AH0raKk

7. Turtle with ear abscesses - English
A You Tube video on ear abscess drainage under anaesthesia in a terrapin performed by Dr Daniel Sing of Toa Payoh Vets.
 http://youtu.be/fj_eBwMGtns


I usually wake up at 3 am to do the writing and uploading and producing digital images.
This has been going on since around 2007.  I borrowed photography magazines and taught myself photoshop and how to take better pictures for my website and videos. Presently I find that the Canon Camera EOS 70D with Canon lens 18-135 mm Image stabiliser takes excellent images and videos for for my case studies. 

CONCLUSION

HARD WORK AND TIME ARE NEEDED TO BE A VERY GOOD VET

1. Be proactive in helping the animals or clients to solve their problems. Add value to your employer. This makes your veterinary career so much more interesting as you wake up every morning.



2.  At the of the day, nobody in Myanmar knows who you are if you are inexperienced or poorly located.  You will need to work hard and usually long hours for an experienced vet with a busy practice.  You need to tolerate office politics and be humble, in a busy practice, to learn from a variety of cases, in order to be be a very good vet.






3. You may need to work a few years in Singapore, Japan, Australia, UK, USA or overseas to improve your skills. Dr Thein Tun Aung had worked very hard for around 10 years in Singapore for different vets. He saw so many varieties of cases and his Royal Asia Veterinary Surgery is very busy.


4. Distractions and pleasures nowadays are many. Some young vets prefer online gaming and partying  till 3 am or watching online movies at the work place. This take up the time you could use to gain more veterinary knowledge by writing case studies, following up with the owner, research on how to do a better diagnosis and treatment. Why the outcome was not so good.



5.  It is a pain to write case studies and research more on medical cases. More enjoyment watching online videos and TV and do nothing. Responsibilities of being a mother can take up much time and energy.



But hard work and time are required if you want to be a very good vet. I hope the above-mentioned 5 values, amongst others, will guide you to the path of being a very good vet in Myanmar and enjoy your profession every single day.



6.  I hope you enjoy this talk and wish you all good luck to your final year examinations.

 














ACKNOWLEDGEMENTS


I thank Dr Tin Tin Myaing, President, Dr Soe Min, Secretary and committee members  of the Myanmar Veterinary Association for organising this talk. I thank Drs Ling Ling Soe and Thein Tun Aung of Royal Asia Veterinary Surgery for their generous sponsorship. 





Case studies of cats at Toa Payoh Vets
http://www.bekindtopets.com/animals/20081202Cat_Surgery_Anaesthesia_ToaPayohVets.htm

Case studies of dogs at Toa Payoh Vets
http://www.bekindtopets.com/animals/20081201Dog_Surgery_Anaesthesia_ToaPayohVets.htm


Article of "What Makes A Horse Racing Club profitable?". 12 pages.
http://www.asiahomes.com/dev/20120513history-1988-horse-racing-decline-veterinary-ToaPayohVets.htm

Page 1
http://www.asiahomes.com/dev/Stc1.JPG

Page 2
http://www.asiahomes.com/dev/Stc2.JPG

Page 3
http://www.asiahomes.com/dev/Stc3.JPG

Page 12
http://www.asiahomes.com/dev/Stc12.JPG


Case studies of Caesarean Sections at Toa Payoh Vets
http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm

Case studies of hamsters at Toa Payoh Vets
http://www.toapayohvets.com/surgery/050609hamsters_ToaPayohVets.htm

Be Kind To Pets website
http://www.bekindtopets.com/

Veterinary Videos from Toa Payoh Vets
http://www.kongyuensing.com/animals/20100609Educational_Vet_Videos_ToaPayohVets.htm

Blog No. 2
http://2010vets.blogspot.sg/