Monday, October 23, 2017

3163. Travel Stories. Fashion berets in Fukuoka, Japan on Sunday Oct 22, 2017


Sunday. Oct 22, 2017
Nishitetsu Grand Hotel, Room 1388

Drizzling. Fukuoka in Japan is a city with around 1.5 million people.
Downtown is vibrant today. Fashion berets seem to be worn by a few ladies, around 1 in 500 on this drizzling Sunday October 22, 2017.
The real woollen fashion berets will be rare as it is expensive.




Downloading travel images daily before breakfast.


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Airport
 


Fukuoka downtown on a Sunday































Sales girl selling berets and head wear




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Starbucks



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McDonalds






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Branded fashion berets in a large Mitsuikosi departmental store


In Iwata departmental store







Not fashion berets



Advert


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Other berets seen in Fukuoka







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Christian Dior fashion berets worn by sales persons at a large departmental store and a big poster advertisement - 2 images



Saturday, October 21, 2017

3162. A 2-year-old dwarf hamster has a large ear tumour.

Oct 21, 2017

"How long is the hamster's life span?" the father of the 12-year-old daughter had brought the hamster to consult me today.

"Around 2 and a half to 3 years," I replied. "Usually said to be 2.5 years."
"This hamster is 2 years old," he said. "Around 6 months of life. Should she be operated to get the ear tumour removed?"

"6 months of life is equivalent to around 120 months in human age," I explained. "Besides, the hamster is already scratching his large ear tumour. It will become infected and painful. The hamster will stop eating later."

The father permitted the surgery as this is his daughter's pet.
"When the ear tumour is smaller, surgery is easier. Now part of the ear may need to be cut off together with the hamster!"

Pre-op video

  The ear tumour was excised today by Dr Daniel. This ear tumour surgery is a common surgery at Toa Payoh Vets.

3161. Unbelievable stories: A Samoyed barked at "deities"

Oct 20, 2017

"How is your Samoyed?" I asked the coffeeshop assistant who speaks in Cantonese, "Has she reduced weight?"

"No, no," she lamented as she carried the food dishes from the stall to the customer coming for breakfast. She was the typical aunty in her early 50s, matronly and with boyish cut in her hairstyle.
 
. "Dogs given the Hills' RD diet as according to the amount lose weight within 3 months," I was surprised to know that her dog was still plumpish. "Did you take your dog for walks?"

"I do everyday," she said loudly. "My dog would walk around a small area downstairs and would want to come back to the apartment. "She would not venture further."

"On the lst and 15th of the month (in Chinese calendar), my dog would bark loudly as if she sees spirits outside the area she would walk! This happens all the time! I have to quickly take her back to the apartment!"

Many believers make food offerings and pray on the lst and 15th of the month. That is part of the Chinese religion. But this dog barks on these two days.

"I have to bring her back home as her barking is so loud and would disturb the ground-floor neighbours. "In any case, she may be brave but I worry about that the deities my dog sees and so quickly take her home!"

A dog can see spirits? This is an unbelievable tale but the aunty does not joke and had been with her grandmother to visit temples since she was a little girl. So, she knows all about Chinese deities.

"Is there a deity with a dog?" I asked.
"Yes, he has 3 eyes and his dog saves people!"  I cannot remember the Cantonese name of this deity. There are many.  
 

3160. A 12-year-old Miniature Schnauzer has a large gum swelling - gum tumour or carnassial tooth abscess?

VETERINARY STORIES

Oct 21, 2017

The dog came in for his annual vaccination. Physical examination showed a large gum tumour or a carnassial tooth abscess of the right upper 4th premolar tooth.

"I got a vet to do dental work for my dog 2 months ago," the owner told me. "My friend scolded me for permitting such an old dog to undergo anaesthesia,

He looked drunk as he could not walk normally, " she said "He needed a week to recover from anaesthesia."

So she did not want any more anaesthesia to do dental scaling. "The dog is eating well and looks good. I wish to try antibiotics first," she requested."I will come 2 months later if the gum swelling is still there."

A trim and active dog. So, antibiotics are given. The owner decided to wait and see.




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REFERENCE:

Dog with his mouth openThe “carnasial” tooth or more correctly the upper fourth premolar is one of the primary chewing teeth of carnivores. It functions as a shearing tooth to shred food and is the largest tooth in your dog’s mouth. It is a somewhat flattened tooth in the upper jaw (maxilla) just below the eye.

Because this is a major tooth that is important in chewing (its role being slicing and grinding food being chewed) it is somewhat prone to injury and secondary problems. This tooth frequently accumulates excessive tarter, perhaps, in part because of its proximity to the duct of the parotid salivary gland1.

The upper fourth premolar often demonstrates extensive gingivitis and gum retraction. To prevent this buildup it is necessary to practice good oral hygiene and to maintain good oral health through regular brushing of the teeth and regular preventive dental care by a veterinarian1. Click here to see a video about how to brush your dog's teeth.

The carnassial tooth is particularly prone to “slab fractures” and cracking that often allow exposure of the root canal and result in secondary infections. Slab fractures of this tooth should be treated aggressively. Oral radiographs should be a regular part of the dental examination to evaluate the roots of all teeth. Cracked or broken teeth should be evaluated for exposure of the pulp cavity. If the pulp cavity is open there is an increased risk of infection.

Anatomy of the carnasial toothThe carnassial tooth has three distinct roots and each of them may be involved in an infection. Recent fractures may be sealed and capped but more long standing exposures may require a root canal. If infection is allowed to continue the root system will become infected and may ultimately cause an abscess formation.

Carnassial tooth abscesses may open and drain between the tooth and the gum tissue but it is common for the abscess to involve the maxillary facial bone that overlies the tooth. The result will be an abscess that extends to the facial tissue just below the eye.

Clinical signs of tooth abscess in dogs
Abscessed teeth will commonly drain around the gum line but in the case of the carnasial tooth the roots are very close to the skin just below the eye. Gaurdians may often see a draining track just below the eye that discharges blood tinged fluid and pus. A complete oral examination may reveal chips or cracks of teeth.

Causes of tooth abscess in dogsThe primary cause of carnasial abscesses is bacteria getting into the roots of the tooth either by way of the area between the gums and the tooth or more commonly from bacteria that enter the pulp cavity by way of a fracture or crack in the tooth2.

Diagnosis of tooth abscess in dogsThe most obvious sign of carnasial tooth abscess is a swelling on the side of the face just below the eye. Frequently this lump will drain blood or purulent material.
Less obviously the clinical signs will be visible as a draining tract in the mouth stemming from the area of the tooth root.
Confirmatory diagnosis and evaluation of the extent of an abscess requires dental radiographs that allow visualization of the entire root.
Treatment of tooth abscess in dogs
Depending on the duration and extent of the abscess there are two general treatment approaches. The first being a root canal and the second being extraction of the affected tooth. Antibiotics are given to prevent or resolve infections and pain relievers may well be needed. Root canal procedures require very specialized training and equipment and success is not assured. Extraction is curative but not simple. This tooth has three large roots and the tooth must be removed in two parts.
Although this is a major tooth the negative impact of extraction are minimal and your dog can function normally without the tooth.
Any fractured teeth should be evaluated by radiographs to determine the best treatment option

Prognosis of tooth abscess in dogs With prompt and appropriate treatment by a veterinarian skilled in veterinary dentistry, the prognosis for salvaging the tooth is good. In more long standing abscesses the prognosis is less positive. The prognosis with extraction is also very good, as mentioned above.

Prevention of tooth abscess in dogsFractures of the carnasial tooth and subsequent abscesses can be prevented by not allowing dogs to chew on rocks or bones, both of which are common causes of dental injuries.
Prompt attention to fractured teeth will help prevent abscess formation. Should your dog break or crack a tooth see your veterinarian at once to prevent the tooth from becoming infected.


3159. Royal Asia Veterinary Surgery, Yangon, Myanmar

1 June 2023.


Dr Sing Kong Yuen, BVMS (Glasgow) is the veterinary consultant for Royal Asia Veterinary Surgery, Yangon (RAVS). He had been the consultant since the founding of RAVS over 15 years ago.

RAVS is a thriving practice under Dr Thein Tun Aung who had worked in veterinary practices in Singapore for over 15 years and is able to communicate well in English. RAVS is considered a top veterinary surgery in Myanmar as Dr Thein performs various types of surgeries not available  at the other clinics.

Many cases such as rabies, parvovirus and distemper which can be prevented by vaccination can be seen in Myanmar. These are rarely seen in Toa Payoh Vets or Singapore's veterinary practices in 2023, as almost all puppies are vaccinated. Some 15 years ago, Dr Sing has seen distemper, kennel cough and other viral diseases in puppies.


Dr Thein Tun Aung (left)


Veterinary Reception Area


Veterinary Reception Area

The address is:
 Royal Asia Veterinary Surgery
 296A Than Thu Mar Road
 South Okkalapa township
 Yangon, Myanmar
 Tel: 01-85007115
 Emergency Tel: 09-4210-66887

Interesting case studies in the videos were seen during Dr Sing's visits pre-Covid 19 pandemic are:

 https://www.youtube.com/watch?v=DaeMBn66jmk

 https://www.youtube.com/watch?v=LV0Z2lgptsA

 https://www.youtube.com/watch?v=CDAXZPBljJg

 https://www.youtube.com/watch?v=P-Jofu1cXa0

 https://www.youtube.com/watch?v=kEB_Kak9uME

Perineal urethrostomy surgery in the cat
 

Thursday, October 19, 2017

3158. A 10-year-old Shih Tzu had eye problem for 4 days.

"She is very thin and sick," I examined the lethargic and recumbent Shih Tzu with the swollen prolapsed eyeball with corneal ulcerations and descemeotocoele. "I need to do a blood test to check the health."

The daughter had surfed the net and asked to see me.  
"Vet 1 had done the blood test  2 days ago and said the report showed kidney failure,"  the mother had consulted Vet 1 who prescribed eye drops, antibiotics and stesolid enema. 
"Vet 1 advised an MRI scan and CT scan," the mother said. "I cannot afford it."
"Why would Vet 1 want an MRI scan for eye problem?"
"I complained about the dog being giddy."


 BLOOD TEST DONE AT TOA PAYOH VETS ON 17.10.17
Liver ALT 225 (less than 59), AST 398 (less than 81) -- suggestive of liver disorder.
Kidney urea 40.4 (4.2-6.3)
             creatinine 189 (89-177).

Haemoglobin 7.2   (12-18)
Red cell count 3.4   (5.5 - 8.5)
Total white cell count 27(6-17)
Haematocrite (PCV) 0.20   (0.37-0.55)
Platelets 46  (200-500). Platelet clumping noted.

Later in the afternoon, the dog passed away while beingiven IV drip.

3157. 2-year-old Corgi had 2 mummified foetus and one small live pup

Oct 19, 2017

"Corgis are hard to breed," the breeder said. "Hence the pups are expensive, over $10,000".

Record: Mated on Aug 17, 2017. One mating only if there is a tie, the breeder said.  So, this would be 62nd day of gestation. Black vaginal discharge seen today. The breeder went to Vet 1 to scan as the dam was overdue 2 days.

He used stethoscope. "Only one pup had heart beat. Do Caesarean section fast!"

The breeder thought the dam was short of 2 days but she was overdue by 2 days. Vet 1 had never performed Caesarean before. 2 vets were on leave. 1 had resigned. So the breeder came to Toa Payoh Vets as he did not want sn inexperienced vet to do the surgery. The fees are much lower at Vet 1.

"What happened to the 6 big healthy Dachshund puppies I did Caesarean section some weeks earlier?" I asked.
"3 died," he said sadly.
2 were bitten by the dam at 2 days of age. 1 died by itself."

Sunday, October 15, 2017

3156. A love bird, budgie and 2 cockatiels live in harmony

Sat Oct 15, 2017

The 4 birds were perched inside a carrier in harmony. They were less than 1 year old and were raised together at a young age by this lady owner.






3155. A rabbit stops eating suddenly - molar spurs and tongue plaque








The owner came early for treatment a few hours after the rabbit stopped eating.
"Likely to be dental problems," I pried open the front lips. "The front teeth are normal and not overgrown. I suspect the problem is molar spurs which are sharp edges of the cheek teeth cutting the underside of the tongue. I need gas anaesthesia to examine the cheek teeth."

The owner gave consent and signed the form.  "I detect a small lump of around 4 mm in the abdomen and this could be hair ball. Has the rabbit been grooming excessively?"  The owner was not sure.

Gas anaesthesia. Dental instruments. Molar spurs on the lingual side of the tongue on both left and right cheek teeth. I got them filed.

The next day, the rabbit eats and poops. The 3rd day of inpatient, the rabbit is OK and eating and pooping. Sent home. Evidence of more than 20 faecal pellets and the above images sent to owner. .

Saturday, October 14, 2017

3154. Rabbit hip dislocation X-rays & cat and dog hip dislocation

Will a femoral head osteotomy work in rabbit hip dislocation? This case did not have the surgery.


TP46483
Rabbit. Peanut.  3 yrs old. Left hip dislocation



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A 3-month-old rabbit hip dislocation. No surgery.








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TP50133

In the dog, the operation is generally successful in permitting the dog to walk almost normally as seen in the video of Kobe post op some months later.





Oct 13, 2017. Surgery on Aug 7, 2017.  The happy owner sent a video to Toa Payoh Vets on Oct 13, 2017 as follows: 

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Cat hip dislocation. Closed reduction. The owner does not come back for review.

 Case at:

http://2010vets.blogspot.sg/2015/08/a-cat-has-dislocated-right-hip.html














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TP 43447
Left hip pain






3153. My family dentist. Molar amalgam fell off on Oct 12, 2017

On Oct 12, 2017, I felt a large hole inside my left upper molar. This was due to the falling out of the mercury amalgam covering my large cavity over 50 years ago. I could feel the sharp edges and a large hole, but no pain. This meant that the pulp cavity was not there or the tooth was "dead."

On Oct 13, 2017, I walked in to my family dentist who said: "Your cavity is large and challenging. I will do my best to plug it. If you feel the pain later, you will need a root canal treatment. I will refer to you a specialist in Takashimaya Shopping Centre as I don't do this treatment."

I sat on the dental chair. The dentist educated me on the anatomy of the tooth by showing me a chart of illustrations. "The pulp is where the nerve is," she said. "If my treatment of plugging up the cavity cause pain later, that means there is pressure on the pulp and you will need a root canal treatment."

"Why don't you extract the molar since the crown is 90% cavity?" I asked.
"It is best to save the tooth," she said. "Hence the root canal treatment. Do not worry."

Some drilling of the tooth. Suction. Rinse my mouth. More drilling. Only a short time of mild pain during drilling, all to my surprise. Is the tooth dead?

"It has been some years since 2009 since I saw you," the dentist checked the records. "If I depend on you for dental services, I will need to close down," she joked. Two new dental clinics have now opened.

"How many dental clinics are there now?" I asked.
"When I started, it was 300," she reminisced. "Now there are over 1,000."

"I ask my children not to go into private medical practices," she said. "The big private medical groups need to make more money every year. It is better to work for institutions."

She advised me not to go to private practices as they need to justify their bottom lines and therefore will recommend unnecessary treatments to generate revenue. Large groups are now formed from mergers and acquisitions of smaller groups and so they must make more money for the shareholders. That means more unnecessary treatments.

"The younger generation is not loyal," my dentist said.
"Most of the young is time-pressed and wants convenience of proximity, immediacy and low price," I said. "So, there is no loyalty. 

We spoke on family. Her son is a medical undergraduate overseas. "The senior consultant is good," she said. "He has many important clients. That day, he told the other younger doctor to get out as this doctor came to work without a tie."

She is pro-family as she said that a married couple should have children soon after marriage. "Some wives may want to achieve success in their new careers and motherhood meant being side-tracked," I said.

"The Chinese saying: ''Suffer hardship early (in life), enjoy sweetness later (in life)," she told me that I was westernised in advocating a married woman's right to choice of career over motherhood.  If the wife is ambitious in being top in her profession, let her do it. It is not possible to have both although there is "work-life" balance being advocated and there are domestic helpers to look after children.  It is her personal choice and the husband has better accept it.

"What would you do if you have a person who says he has no money but insisted vehemently to be treated by you?" she had such a male aggressor. "If he was poor, I can reduce the charges." This person just wanted free services by being aggressive and hope to get away with it.

"There are such people in life," I said. "Some years ago, I have a case when a young couple had no money for deposit. I did a Caesarean section for their Jack Russell and never received a cent from the couple!"



My filling needed two tubes. I had to bite on some paper tissues to confirm the grip. Then I was not supposed to eat or drink for 2 hours. No hot and cold food and drinks for 2 months. Is my tooth dead?  Will I need root canal treatment which will be costly if down by the downtown specialist whom she says is good and has excellent bedside manners, from her feedback?  Only time will tell.

On Oct 19, after Deepavali, I have a 8.30 am dental scaling appointment with her. She is busy but not overwhelmed nowadays. The two new competitors open till 8.30 pm but she closes in the evening. So, it is her choice for family and to bring up the children well.  .

The two children are now undergraduates overseas and they prefer to come home rather than going around Europe during holidays. "They want the family to holiday together," she told me. It is such a joy to to have such filial children, well brought up and able to study to university level.




         

Friday, October 13, 2017

3152. A 10-year--old cat vomited greenish brown for 1 wk

Ferocious cat had vomiting for one week and is not eating now.
Kidney disease is one possible cause in older cats. But how to collect blood?
Sedation needed. Injection IM via the carrier.
Blood test showed slight elevation of creatinine and urea.
Cat was treated with antibiotics and recovered fully.

"He starts to scratch his scratching post and nudging me," the owner was happy when I phoned up one week later. 

3155. A Sheltie had ticks and dental scaling

The young Sheltie was referred to me for tick infestations. The owner requested health screening via blood test and dental scaling as the cheek teeth were stained with brown plaques. See picture of plaque.



Tuesday, October 10, 2017

3154. A Chow Chow was lame on Left fore and now lame on Right hind








Oct 9, 2017

X rays done by Vet 1. Dog was lame on left fore 5 days. Now the dog is lame on right hind.

"As in the racehorse, the Chow Chow bears weight on the right hind when the contralateral leg i.e. the left fore is very painful," I said. "So now the right hind is lame."

What is the cause of the left fore lameness?"  A large swelling on the wrist area. Vet 1 had X-rayed left fore (above) and prescribed meloxicam and tramdol and probiotic (dog had drunk some detergent).

Dog did not like tramadol and antibiotics.


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More than a year ago, I advised entropion surgery on scarred and closed eyes. Now eyes are open and this is the first time I get to see the outcome. Owner is satisfied with the outcome. The eyes need cleaning.  

Monday, October 9, 2017

3153. The Essential guide to customs & culture. Culture Smart! - Myanmar (Burma)

Myanmar is a vast country with numerous ethnic groups and cultures other than Buddhism.
www.culturesmart.co.uk

I had the fortune to visit this vast country and visited the homes of the locals
through Drs T T Soe and T T Aung and to experience the real Myanmar. Places visited included Naypyidaw and Zoo, Yangon, major tourist areas, numerous Buddhist temples and monasteries to know more about the religion of Buddhism.


Oct 10, 2017.
website hangs. Cannot buy the book.

3153. A 10-year-old male neutered cat has kidney stones - need blood and X-ray evidence

Sep 30, 2017

Fractious cat. Complaint of vomiting for one week.
"Blood test is necessary," I said to the owner.
"But the cat claws anyone near him, " my assistant lamented.
"So no blood collection can be done? Just treat and sent home?"

"You need to sedate the cat inside the carrier," I explained.
"Tilt the carrier and injection into the back side muscles."

So, we got a diagnosis based on evidence from the blood test of kidney failure. X-rays also showed small kidney stones.

Antibiotics given. The cat recovered one week when I phoned. The owner did not take up the advice of k/d diet. She feeds dry Purina Proplan for healthy kidneys as recommended by another vet earlier.
Reducing the cat's weight is advised.