Friday, October 4, 2024

4642. SCRIPT FOR VIDEO PRODUCTION: Be Kind To Pets

 

Squamous papilloma in an older Cavalier King Charles
- How does a vet diagnose & treat such a case?

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written:  26 October 201.  Updated:
25 January, 2013
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
The following is my script for the video production

1.  THEME
Be Kind To Pets - Oral tumours in A Dog
 
This video describes the processes of how  a vet diagnoses & treats a case of squamous cell papilloma in an older Cavalier King Charles. These processes form part of the Standard Operating Procedures at Toa Payoh Vets
2.  HOOK
A large strawberry-like lump is spotted
by the young lady owner one day. She informed her father and brought the dog to Toa Payoh Vets
The Patient: Cavalier King Charles, Male, 10 years. Singapore
History: Dog was not active, had difficulty eating. Excessive salivation. Sometimes, blood seen dripping from the mouth. What is the problem with this old dog?
 
Music & Insert the image into the video: 

3.  INTRODUCTION
An old dog is like part of the house furniture.  Family members, especially children who grow up with him love him very much. But they have not much time for him unlike the time when he was a new puppy (video of Cavalier King Charles puppies at the pet shop being sold).
The older dog is a family member for most Singaporeans nowadays. Visits to groomers regularly, good food, dog treats of various brands and plenty of water available at all times. (video of regular visits to groomers)

The dog's mouth is seldom examined by most dog owners and bad breath is usually tolerated by many Singaporean dog owners.

Dental check ups are not usually done and the rotten teeth drop out. Many owners are not bothered when they see their old dogs dropping teeth. Oral tumours develop in some of these dogs. Their health is no longer a priority as they age.  The older dog is always happy to greet the owner and is a good companion to the senior citizen parents and retirees but many dog owners in Singapore do not have time to send the older dog for dental check up or annual health screening.  (video of dogs in apartments, being walked in Singapore). In 2010-2011, I note an increase in the number of younger Singaporeans seeking dental treatment for their older dogs. The younger generation of Singaporeans is better educated and more concerned about the welfare of the old pets and this is good news for the four-legged companions.

Back to my case.
One sunny day in August 2012, the owners of a male, 10-year-old Cavalier King Charles saw a pinkish lump appearing on the front of the lower jaw covering two of the front teeth. It grew bigger and bigger. The father and his daughter consulted me.

Video of Singapore's blue skies and sunshine, families at the Pasir Ris beach and Toa Payoh Vets

At Toa Payoh Vets, Dr Daniel Sing was on duty. I was present. 
"Is it cancerous?" the owners asked Dr Daniel and me. 
"If it doubles in size within a week, it is likely to be cancerous," I  said.

4.  BODY

4.1  Problem -- Is the dog suffering from a cancerous gum tumour or not? 

"How to find out whether it is cancerous? What can I do to resolve the dog's oral tumour problem?" the father asked. The financial costs must be explained fully before any operation is done.
There are several processes to be addressed to ensure a high standard of veterinary care and as a defence against negligence litigation.
(Video of lawyers and subordinate court)
But the owner must give his consent and that is where personality and financial conflicts come in.
CONFLICT NO.1  Biopsy
 
as recommended by the vet professors during undergraduate studies will be adopted by most vets especially the recent graduates. This is the standard practice as taught in the University. A small piece of the oral tumour is cut out and send to the laboratory for analysis of its type - cancerous or benign? If the biopsy shows that it is not cancerous, then, there is "no" need to do any surgery.

But biopsy takes time and involves anaesthesia. Sometimes as long as 7 - 14 days. Not much time is available in this case as the tumour was said to be fast growing. It may be malignant and must be excised within 24 hours.
 
Some vets do biopsy and find the tumour non cancerous. Some tell the owner there is no need for surgery. Some owners decide that they don't want surgery to remove the tumour since it is not cancerous.
(Video of consequences of not early removal of an oral tumour - images of oral tumours in other dogs)

As the weeks pass by, the tumour grows bigger. Excessive salivation, blood in the mouth, bad breath and difficulty in eating. Bacterial infection. By then, the owner has no choice but to get the gum tumour excised.
 
 
CONFLICT NO.2 X-RAYS should be done to find out whether the tumour has invaded the jaw bone and below the gums. Due to economic reasons, this was not done in this case as vet costs needed to be as low a possible.
 
CONFLICT NO.3 BLOOD TESTS Health screening is strongly advised before anaesthesia and surgery for all patients, esp. in the older dog.

Anaesthetic risks are much higher in old dogs. There is always the possibility that the older dog may die on the operating table. When the owner hears that the dog may die on the operating table, he may decide not to get the surgery done. Some deem the vet incompetent and consulted another vet. A health screening should be suggested by the vet to let the owner knows whether the risks are high or not.

"I advise a blood test to screen the health of the Cavalier King Charles," Dr Daniel said.  The owners must consent to take the anaesthetic risk if they give permission for the surgery as in this case. No surgeon can guarantee no risk in any anaesthesia, whether in people or animal.   

 
The total WCC  17.8 (Normal  is 6-17)
Neutrophils 81%, Lymphocytes 15%, Monocytes 3.2%, Eosinophils 0%, Basophils 0.4%. The platelets were below normal.
This blood test indicates a bacterial infection. The liver and kidneys were functioning normally.
"OK," the patriarch consented to the surgery.

Antibiotics were given to the dog.
 
 
CONFLICT NO.4 IV Anaesthesia

No  Intubation

Anaesthesia. What type? IV anaesthesia, gas anaesthesia or both? IV anaesthesia is shorter acting than gas anaesthesia. Intubation (a breathing tube connects anaesthetic gas and oxygen to the dog) is usually done in dental scaling which will be performed after oral tumour removal surgery.
 
Chihuahua young. Retained left upper canine tooth extracted. Toa Payoh Vets Early prevention of tooth decay by regular dental scaling. Toa Payoh Vets
(Insert above images of a dog intubated, left and dental scaling, right)

But this dog had a big oral tumour in the front of the mouth, obstructing the insertion of the endotracheal tube.

"No intubation, as we need good access to the gingival tumour and to excise all, if possible. It is growing fast." 
 

Domitor + Ketamine IV at 25% of calculated dosage for a young healthy dog was sufficient for electro-surgical excision. Dental scaling was done after that.
Cavalier_Squamous_Papilloma_mouth_toapayohvetsThe old dog survived the anaesthesia and that was what mattered most for the owners. It is not always possible for every old dog to survive anaesthesia during surgery. Therefore it is wiser to remove the tumour when it is smaller and when the dog is younger. 
  Informed consent form "This is an old dog. Explain in detail the anaesthetic risks of death on the operating table and operation and post-op complications. An informed consent needed. The form is to be signed by the owner.

In any case, the vet must delivers a dog alive at the end of surgery but no vet can guarantee. Therefore assess the risk and get the informed consent.
 
CONFLICT NO.5 Gas
Anaesthesia
The teeth need to be extracted. Dental scaling need to be done. That means surgery will take longer than normal. Isoflurane gas top up anaesthesia to be delivered by an endotracheal tube is needed. 

But this endotracheal tube blocks the operating view. "IV Anaesthesia is the best," I said to Dr Daniel. Will this be effective? Yes if you know how to use the appropriate drugs. The dosage must be just sufficient for surgery but safe for the older dog.  50% of the Domitor & Ketamine IV formula was used in this case. It was effective. No need topping with isoflurane gas in this case. 
 
CONFLICT NO.6 Histology "Is the oral tumour cancerous or not?" the father asked.

"Nobody can tell from the physical appearance," I said. "The tumour needs to be analysed by the laboratory and the tumour cells can be seen under the microscope if there are any. This is the process of histology.  Do you wish to get the tumour sent for histology?"

It is best to get the owner's permission to send the tumour for histology to check whether it is cancerous or not, as some owners may have a budget or do not wish to spend more money.
 
Write "AMA" (Against Medical Advice) in the medical report if the owner is not in favour of histology, blood tests or any process advised by the vet. This record serves as evidence to protect the vet in the event of negligence litigation.
 
4.2  SOLUTION Electro-surgery, not medication
 
It is unprofessional to give medication to the owner to treat the oral tumour as some owners may insist on having them as an alternative to the high risk of anaesthesia during surgery. It will not disappear.

Cavalier_Squamous_Papilloma_mouth_toapayohvetsElectro-surgical excision including extraction of 3 incisor teeth enclosed by the papilloma. Electro-surgery by Dr Daniel. "Transect at least 2 mm from the tumour and remove the entombed incisors," I said. "However this is not possible in this case. X-rays are not done to see whether the bone is involved to lower veterinary costs for the owner at this time."

 
  Histology - a microscopic examination of the tumour to check its cells as to whether the tumour is cancerous or not. The owner consented for the gum tumour to be sent to lab for histopathology  (Image of microscope)

 
Squamous papilloma with reactive atypia and chronic inflammation. No definite dysplasia or malignancy. (Video of a microscope)

Good news for the owner. However, the papilloma may return as it is extremely difficult to completely excise it. Lab Report:  Squamous papilloma. So it is not an epulis as I thought it would be except that it had various finger-like projections as in a wart.

The owner was happy with the good news. Not cancerous.
 
5.  CONCLUSION Final Diagnosis from histology The diagnosis is squamous cell papilloma.
The dog goes home 24 hours after surgery. There was no more gum bleeding. 

BE KIND TO YOUR OLDER DOG.  EXAMINE YOUR OLDER DOG'S MOUTH WEEKLY FOR ORAL TUMOURS. SMALL TUMOURS ARE EASIER TO REMOVE AND THERE IS A MUCH LOWER ANAESTHETIC RISK.
 
6.  ADVICES & TIPS Post surgical management 1. POST-OP REVIEWS. THREE-MONTHLY NEXT 12 MONTHS. Owner need to be advised and reminded by the vet but this is seldom done by me. Dog has not returned as at Jan 4, 2013.

2.  Older dogs must be checked by the owner daily and any mouth tumour be removed when it is small. In this case, the tongue covered the papilloma till it became chronically infected and swollen. It could have existed for some weeks without the owner seeing it.

3.
TIPS. Old and unhealthy dogs (>5 years) must be given 25-50% of the calculated dosage of IV anaesthesia for younger dogs to lessen risks of heart failure.
CREDITS
 
 
Toa Payoh Vets' Be Kind To Pets video
Veterinary Education for vet students and pet owners
 
Concept by:
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Video and narration by:

Video is at:
(Insert the name of the URL):

Date of video production:
For more information:
toapayohvets.com
+65 9668-6468, 6254-3326,

e-mail
judy@toapayohvets.com

4641: PHOTOGRAPHY TIPS: EVENING SUNLIGHT ONTO BUILDING

2 Oct 2024: PHOTOGRAPHY TIPS: EVENING SUNLIGHT ONTO BUILDING



Singapore Marriott Tang Plaza Hotel's location is arguably the best in Singapore. It is in prime Orchard Road and is easily accessible by subway and buses. It has the iconic pagoda roof which makes it outstanding and unique for hotel photography. However it is difficult to get a good angle of this hotel as there are many high rise buildings next to it.

For this review, I post this photo taken with the following photography tips:

2 October 2024. 6pm. Bright sunshine always help to create a better photo.

Viewed from Ion Orchard mall, EVENING SUNLIGHT onto the hotel building. Afternoon sunlight before 5pm will not create a nicer image.

Canon R5. AV Mode. 24 mm, 1/80 sec, f/11, ISO 200. Handheld.

#marriottsingapore
#tangplazahotel
#singapore
#
toapayohvets
#kongyuensing
#singkongyuen
#shutterstock.com/g/toapayohvets

TO BUY PHOTO: www.shutterstock.com/g/toapayohovets

UPDATE:
https://2010vets.blogspot.com/2024/10/4641-photography-tips-evening-sunlight.html

 

 




 

Thursday, October 3, 2024

4640. PHOTOGRAPHY TIPS: The MODE Dial. PASM. Manual exposure bracketing. sunsets.

 Ref: Digital Photographer. Issue 278.

PASM is an acronym for four main exposure modes.

1. Program Mode (P).  Semi-automatic, the camera selects the aperture and shutter speed but leaves you to adjust ISO, exposure compensation and white balance.

2. Aperture Priority (A or Av), you choose the aperture. Camera adjusts the shutter speed to achieve the 'correct' exposure.  

 

 

3. Shutter Priority (S, Tv, T), you set the shutter speed. Camera adjusts everything else.
LINK EXPOSURE TO THE AF POINT.
Shoot in changeable light where exposure is the priority.
Link chosen autofocus point to the SPOT metering mode.

Your camera sets the ISO as high as needed for a 'proper exposure'.
Set the ISO range e.g. max ISO 320. MINIMUM 200.

 

 

 



4. Manual Mode (M) control over all the parameters. Not for fast-paced action, spontaneous moments, changeable light.

Use when light is not changing suddenly or high-contrast scenes containing light and shadow contrasts (landscapes with dark foreground and bright sky - manual mode allows you to balance exposure and preserve details in the highlights and shadows). 

4a. MANUAL EXPOSURE BRACKETING.  Sunrise and sunsets where the sky is much brighter than the foreground. Tripod. Shoot at 'correct' metered exposure, then deliberately over and underexpose by enough increments to avoid clipping. Blend these frames during editing will provide more highlight and shadow data than just a single shot.  

Many modern cameras offer AUTOMATIC EXPOSURE BRACKETING but manual mode lets you adapt to any lighting by choosing how you bracket.

MEASURE THE EXPOSURE DIFFERENCES.
Discover the brightness differences between two subjects.
1. To ensure both are properly exposed. Easiest approach is to use manual mode with spot metering selected.

First, aim lens over one subject. Depress shutter halfway to take a reading, and then use exposure lock which allows you to reframe the scene but maintain the current exposure settings to focus on the 2nd subject. (AE-L, AF-L).

 






4639. PHOTOGRAPHY TIPS: Use TV Mode for moving buses. Vehicle wrap adverts

PHOTOGRAPHY TIPS: Use TV mode for moving buses. Vehicle wrap adverts

30 Sep 2024: 9am
Yishun Central bus stop. Canon R5. TV Mode.
24mm, 1/400 sec, f/4.0, ISO 125

#dbs
#vehiclewrap
#investment
#adverts

#toapayohvets
#kongyuensing
#singkongyuen
#shutterstock.com/g/toapayohvets

TO BUY PHOTO:  
www.shutterstock.com/g/toapayohvets

UPDATE:
https://2010vets.blogspot.com/2024/10/4639-photography-tips-use-tv-mode-for.html

 

 




 

 

 

 

Wednesday, October 2, 2024

4638. First Impressions Count

Yesterday, at a mall, I met a realtor 2 days older than me, handing a new condo project flyers to passers bv at the staircase landing. This was the 2nd time we met as I was going to the mall for meal with friends.
First impressions count a lot in one's profession, esp. if one is selling multi-million dollar condos off the plan.


"Your zip is showing from your worn out jeans," I said to him. "How do you expect prospects to buy a condo from you when there are other realtors who dress up professionally or refer anyone to you?"
Distributing flyers to passers by is part of real estate marketing. Very few young realtors bother to persevere, in my observation.


"Prospective buyers will contact me when they go to the showroom durin sales launch in the next 2 weeks," he said.


"Singaporeans are used to a high standard of service," I said. "First impressions count! His colleagues wear leather shoes while he wore sneakers. Will they do business with him or with a realtor who dress professionally?"


Story for you


Similarly with the realtor's handphone. He had a worn-out Samsung phone case and phone in the low end model of some years. Would this phone take good photos to send to prospective clients to provide property information?


In professional life, first impressions count as we sell ourselves as a service provider or sending photos and videos to prospects. If we don't bother with good first impressions, it will not give confidence to prospective clients to come to us or refer their friends to us.


grateful Dr Sing. More than  happy to know  you.
Share your invaluable thought

 

 
 
 

 

 
 
 
 

 

Saturday, September 28, 2024

4637. Pigeon culling - humane methods

 Pigeon culling - humane methods

 

Pest - health concerns (bird flu etc) and damage to property.

 

Humane alternatives to culling:

1. Use of contraceptive pigeon feed.
reduces birth rate and decreases population without causing harm to existing birds.
successfully implemented in cities worldwide.

2.  installation of deterrents e.g. spikes, nets, and bird wire on buildings to prevent pigeons from roosting and nesting.   

3. Regular cleaning of food waster, securing garbage bins limit the food supply that attracts pigeons.

4. Education plays a crucial role in humane wildlife management. Public awareness campaigns inform residents about the importance of not feeding pigeons an maintaining cleanliness in public areas.


Culling if necessary:
1. use trained professionals using methods approved by animal welfare organisations to ensure minimal animal suffering. The process should be closely monitored and reviewed to ensure compliance with humane standards.

Addressing pigeon overpopulation is essential, equally important to commit to humane treatment of all animals. Explore and implement compassionate and non-lethal methods of pigeon control. 



Thursday, September 26, 2024

4636. PHOTOGRAPHY TIPS: Electric vehicle models displayed at a Beijing mall at night. Use Manual mode, tripod

PHOTOGRAPHY TIPS: Electric vehicle models displayed at a Beijing mall. Use manual mode, tripod.

 A Beijing mall displays electruc cars. 3 Mar 2024. 7pm. 

Canon R5, Tripod, Manual, 24mm, 1/60sec, f/4.0, ISO 100.  

 #beijingmall
#electricvehicles
#electriccars
#huawei
#3Mar2024
#7pm

#toapayohvets
#kongyuensing
#singkongyuen
#shutterstock.com/g/toapayohvets

TO BUY PHOTO:  
www.shutterstock.com/g/toapayohvets 

The US fears the vast amount of sensitive and personal data collected on Americans by modern cars - Bluetooth connectivity, satellite modules and driveless systems - could be accessed by the China government. Also such vehicles can be hacked and shut down. 

 

 Good morning from Beijing. Photo taken on 3 Mar 2024, 7pm. I don't know whether a smartphone will get such a sharp photo such that you can see the young people inside the Huawei EV showroom. You need to use Manual mode and tripod.

 

UPDATE:
https://2010vets.blogspot.com/2024/09/4636-photography-tips-electric-vehicle.html

 

 
 
 
 
 

 

 

 





Tuesday, September 24, 2024

4635. PHOTOGRAPHY TIPS: Manual mode is best for sharp images of sculptures.


 

 PHOTOGRAPHY TIPS: Manual mode is best for sharp images of sculptures.

The Spirit of Ecstasy Sculpture is a bonnet mascot of the Rolls-Royce cars. It is in the form of a woman leaning forwards with her arms outstretched behind and above her. Billowing cloth runs from her arms to her back, resembling wings.

Canon R5, Manual Mode, 58mm, 1/160 sec, f/5.0, ISO 200.
23 SEP 2024: 4.11pm. Bright afternoon sun. Car in the shade.

Scotts Road, Grand Hyatt.

 

 Canon R5, Manual mode, 58mm, 1/160sec, f/5, ISO 200. Handheld.

TO BUY PHOTO:  shutterstock.com/g/toapayohvets


UPDATE:

https://2010vets.blogspot.com/2024/09/4635-photography-tips-manual-mode-is.html