Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Monday, January 13, 2014
7 days after the ear surgery, the wound is healing well. The lady owner cleans up the bleeding with cotton swab. It appears that bleeding still persists but overall, the wound is clean. The "yellow" piece is the ear cartilage below the ear canal while the red black piece is the blood clot on the ear cartilage.
"I have watched the Youtube videos of other cases and I know what the operation is meant to do," the young lady said to me. So there was no need to educate her. "I have a video done by an intern, but it is not ready yet!"
Sunday Jan 12, 2014's interesting cases of 6 dental cases.
Sunday Jan 13, 2014
"You have 10 surgeries to do," I said seriously to Dr Daniel who took over at 12 noon while I went to attend the official lion dance opening of Dr Jason Teo's Telok Blangah Vet Surgery. It is difficult to do surgeries and consultation from 12 noon to 5 pm on Sunday if only one vet is working.
So I returned to work in the afternoon as well as in the morning when I had the following 6 dental scaling and check up to do.
Case 1. The deaf Jack Russell. He became deaf suddenly yesterday. The owner requested dental work as the foul bad breath got worse in the past month. "The sudden onset deafness is unlikely to reverse with dental work," I explained. "The origin would likely be in the brain. A blood test will be taken but more tests need to be done." Brain and ear canal scans need to be done but it would cost more than $1,000.
Case 2. The 14-year-old Papillon came in for dental work. The lady was referred to me as the dog had fits. "Blood tests show kidney failure, likely to be aging as the dog is very old," I said. "Dental extraction of all the rotten infected loose teeth may stop his fits and reliance on anti-fits medication. I had only one case where dental work eliminated fits but most causes of fits are unknown."
"My dog was very wobbly yesterday but had not fits after being given a (30-mg phenobarb) tablet," she said."The medication causes drowsiness and incoordination," I replied. "It controls fits if taken but is not a cure."
"Will my dog die under anaesthesia?" she had never done any dental on this old dog before.
"There is a high risk esp. when he has fits, kidney failure and now a low rectal temperature of 37.1C," I replied. "Dental extractions do not stop the kidney failure in aged dogs," I made it clear to her to prevent misunderstanding. I got the teeth out under gas anaesthesia and the dog was OK.
Case 3. A young lady adopted a poodle from a Voices For Dogs and went to 2 vets. Her friend in a blue Volkswagon drove her to Toa Payoh Vets to consult Dr Daniel who was not yet at work. So I talked to them as they were referred to me by two Straits Times journalists whose pets were treated by me.
"The first vet says all teeth must be extracted. A second vet says that not all teeth need to be extracted. We are confused. We spoke to Ms A and she said to send the dog to Toa Payoh Vets and we have phoned Dr Daniel for an appointment."
"Dr Daniel will be here soon," I said. So, this was the 3rd dental case. When Dr Daniel came, I had a look at the dog's teeth. Due to poor nutrition or tetracycline drugs as a puppy, his teeth lost the enamel covering at the tips. I left this case to Dr Daniel so as not to confuse the two ladies. He estimated the dog to be 3-4 years old and extracted 2 black loose teeth.
Case 4. A young lady studying in Tasmania back on holiday in Singapore, came with her mother for a dental scaling for the old Miniature Schnauzer. "I cannot be bothered to spend time and money on this dog," the mum told me. "But she keeps pestering me and so I bring this dog in for dental scaling." The young lady was silent as mum was the paymaster. Dental scaling prevents bacterial in the tartar spreading toxins inside the mouth and spreading to the heart causing heart disease or oral tumours and loss of teeth. But there was no point educating the older baby boomer generation who feels that it was a waste of money and time doing dental health for an older dog. And probably thinking the vet would have personal interest in recommending dental.
Case 5. This working lady in her 30s was too busy to seek veterinary treatment for her 9-year-old Maltese who kept passing dark brown vaginal discharge in the past 3 years. Last week, the dog was not eating and I palpated nodular lumps in the dog's uterus. Small balls of around 2 cm x 2 cm of various sizes big and small. A blood test was done but no X-rays owing to economics.
"Do the dental at the same time as spaying," she said and so the dog had the appointment today for spay and dental scaling. So this was the fifth case of dental. The Maltese has mult-lobulated uterine horns and the surgery took a much longer time than a simple spay. "This could be uterine cancer," Dr Daniel said. I thought it was a case of chronic open pyometra not treated over a long period of 3 years. Surprisingly the blood test did not show a high total white cell count. No histology of the uterus was advised by me as the owner wanted the least medical costs. I showed her the 200-gram flaming purple-red womb asking my assistant Naing to retrieve them from the bin as he had discarded them. Nothing is more impactful as the real womb. Digital images are of no use in showing the seriousness of the infection of the womb. The lady was thankful that her dog survived.
"No dental work is done," I showed her the pale gums as she came one hour post-surgery to take the dog home. "My dog never leaves home," she said.
Case 6. Cellulitis. The 13-year-old Maltese had raw seeping ear flaps and neck skin due to many weeks of rubbing by the back legs. Previously she had ear canal infections and was treated but the owner failed to maintain ear cleaning. "The teeth are all rotten," I said to the lady. "Since the dog needs to be sedated to clip and clean the cellulitis areas of the ear flaps and neck. The dental was done by Dr Daniel and the dog went home the next day.
I usually schedule one or two dentals on Sundays as they take at least 30 minutes per dental. But on this Sunday, 6 prospective dental cases flowed in. So I had to work on Sunday afternoon and let Dr Daniel handle the dental and pyometra cases without the stress of doing consultations in between.
Sunday, January 12, 2014
Sunday Jan 14, 2014's interesting case - uterine carcinomas?
Maltese, Female, 9 years old.
"My dog has this dirty brown vaginal discharge for a long time," the busy working lady had no time for veterinary check up. The dog was lethargic 8 days ago when I first checked her. Dripping vaginal discharge. Vulval lips and the area above it were swollen due to licking. I thought it was a case of hyperestrogenism. On abdominal palpation, numerous swollen nodules in the uterine horns of sizes as big as 2 cm x 2 cm.
blood test
low calcium 0.7 (1.5-3.6)
total white cell count is normal at 8.0 (6-17), but neutrophils 91.7% (60-70%),
platelets 63 (200-500)
This appears to be the start of a closed pyometra as the total white cell count is normal.
SURGERY today
Multiple lobulated uterine lumps with dirty brown pus + blood.Weighs 200g.The dog weighs 4.2 kg.
No dental is done as the surgery is quite lengthy.
"My dog has this dirty brown vaginal discharge for a long time," the busy working lady had no time for veterinary check up. The dog was lethargic 8 days ago when I first checked her. Dripping vaginal discharge. Vulval lips and the area above it were swollen due to licking. I thought it was a case of hyperestrogenism. On abdominal palpation, numerous swollen nodules in the uterine horns of sizes as big as 2 cm x 2 cm.
blood test
low calcium 0.7 (1.5-3.6)
total white cell count is normal at 8.0 (6-17), but neutrophils 91.7% (60-70%),
platelets 63 (200-500)
This appears to be the start of a closed pyometra as the total white cell count is normal.
SURGERY today
Multiple lobulated uterine lumps with dirty brown pus + blood.Weighs 200g.The dog weighs 4.2 kg.
No dental is done as the surgery is quite lengthy.
1295. Leather muzzles for dogs for sale
leather muzzles for dogs available for sale and exporr.
Tel +65 9668 6468, email judy@toapayohvets.com
Saturday, January 11, 2014
Intern rage
In the past, I used to be very strict towards the young interns as they would arrive late for work and find excuses to take time off. Recently, one polytechnic lady told me she had been accepted at Glasgow University and wanted to work one week.
Previously she had worked as a kennel maid cleaning up kennels at a bigger practice but had no exposure to veterinary work. In any case, the practice did not want her after one week as the full-timer had "returned". This was a red flag as regards work performance but I had an open mind.
In the first few days, she would turn up late or not at all. I got her to see some cases with Dr Daniel and did not ask her to do kennel work as she was supposed to study to be a vet. "Is $300,000 worth of vet education be justified?" she asked. "The money can be earned back if the vet works very hard," I said. "It may take 5 years to recover the full amount based on average salaried income. You are better off studying banking or accountancy if you want money."
Yesterday, she took a Golden Retriever for a walk to pee. This dog was lethargic but after the IV drip, Vit K1 of 8 ml and antibiotic and anti-spasmogesic, she was full of energy. She had not peed and I asked her to continue patiently. The dog's mouth started to show blood. She called me and literally instructed me to hold the dog's lease. I told her to wait while my assistant Naing would come and Naing did come and said the bleeding was due to tongue biting.
After that, I asked her what was the cause of bleeding?"
She shouted: "How do I know? I am not a vet!"
This outburst seemed to be a pent-up anger. I asked her to my room and spoke to her.
"Many young people have this anger for some reason," I said. "A excited energetic dog with fresh blood in the mouth could be due to injury and many owners can find out the cause. It does not need a vet to do so."
"I asked you earlier to hold the lease but you did not!" she had this outburst.
"I was busy but I had asked Naing who came immediately," I could not understand what was she angry about.
This behaviour is very unpredictable and I had a chat with her. She said she would finish her internship on Sunday. I had to ask her to go immediately as I don't know what will happen if she stayed and in any case, she was not paid unlike Intern Clara.
Intern Clara was the other intern and I have only good comments about her work attitude from the others. Clara is 16 years old and she does not display such anger although she has her video production targets to met, without success!
Previously she had worked as a kennel maid cleaning up kennels at a bigger practice but had no exposure to veterinary work. In any case, the practice did not want her after one week as the full-timer had "returned". This was a red flag as regards work performance but I had an open mind.
In the first few days, she would turn up late or not at all. I got her to see some cases with Dr Daniel and did not ask her to do kennel work as she was supposed to study to be a vet. "Is $300,000 worth of vet education be justified?" she asked. "The money can be earned back if the vet works very hard," I said. "It may take 5 years to recover the full amount based on average salaried income. You are better off studying banking or accountancy if you want money."
Yesterday, she took a Golden Retriever for a walk to pee. This dog was lethargic but after the IV drip, Vit K1 of 8 ml and antibiotic and anti-spasmogesic, she was full of energy. She had not peed and I asked her to continue patiently. The dog's mouth started to show blood. She called me and literally instructed me to hold the dog's lease. I told her to wait while my assistant Naing would come and Naing did come and said the bleeding was due to tongue biting.
After that, I asked her what was the cause of bleeding?"
She shouted: "How do I know? I am not a vet!"
This outburst seemed to be a pent-up anger. I asked her to my room and spoke to her.
"Many young people have this anger for some reason," I said. "A excited energetic dog with fresh blood in the mouth could be due to injury and many owners can find out the cause. It does not need a vet to do so."
"I asked you earlier to hold the lease but you did not!" she had this outburst.
"I was busy but I had asked Naing who came immediately," I could not understand what was she angry about.
This behaviour is very unpredictable and I had a chat with her. She said she would finish her internship on Sunday. I had to ask her to go immediately as I don't know what will happen if she stayed and in any case, she was not paid unlike Intern Clara.
Intern Clara was the other intern and I have only good comments about her work attitude from the others. Clara is 16 years old and she does not display such anger although she has her video production targets to met, without success!
Friday, January 10, 2014
The lady who googled "ear abscess terrapin"
Jan 9, 2014
The IT lady sms to me an image of her terrapin with ear abscesses, but I could not download it as my 2nd Samsung phone 9668 6469 which receives calls from my surgery is very basic and has no 3 or 4 G plans. I apologized to her and estimated $150-$200 for the surgery to lance the abscesses.
It is always good to quote upfront to avoid surprises to clients. One Singapore dentist was fined $15,000 for professional misconduct as he told his client that she would be able to claim from insurance the dental implant. This was misrepresentation and she had to pay a lot and so complained to the dental association.
This terrapin seemed to be hyperactive, banging against the container to get out. After the surgery to lance the abscess by Dr Daniel using Zoletil 50 0.01 IM and isoflurane gas. The terrapin behaved calmer after the surgery. The above image showed his ears 4 hours post op. A video is to be produced.
Nowadays, the young people uses social media a lot esp. google. I asked how she found the Toa Payoh Vets.
"I googled for ear abscess," she said.
"Then you would have seen a lot of dogs and cats with ear abscess?" I said,
"I googled for ear abscess terrapin and there was your video."
I checked google for ear abscess terrapin using chrome and indeed there was a youtube video done by my interns as shown below:
About 114,000 results (0.49 seconds)
Ad related to ear abscess terrapin
Ear Pain / Infection - Specialises in Ear Pain/Ear Block
www.entheadneck.com/Medisave_Clinic
Dr Soh -23 years Senior Ear ENT
Contact Us - Ear Treatment
Search Results
A terrapin has a painful right ear abscess - YouTube
► 9:23► 9:23
www.youtube.com/watch?v=TtbQ0ZJDoCo
Sep 4, 2013 - Uploaded by Kong Yuen Sing
How to treat an ear abscess in a red-eared slider (terrapin). A "Be Kind To Pets" Veterinary Educational ...
I have a terrapin which i think has an ear abscess . O - JustAnswer
www.justanswer.com/pet-reptile/2fgpj-terrapin-think-ear-abscess.html
Question - I have a terrapin which i think has an ear abscess . O - K7. Find the answer to this and other Reptile questions on JustAnswer.
You've visited this page 2 times. Last visit: 8/15/13
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Ear abscesses before operation
.
Follow up: Sat Jan 11, 2014
"He won't take medicine," the lady phoned me back when I sms her "Is Turtle eating food?". She wanted to bring him to the Surgery so that we can give him medication. It is extremely difficult to medicate terrapins as they don't open their mouths voluntarily.
"Smear the pellets with medication and put the pellets with a small amount of water, separately from the usual tank," I advised since this terrapin ate hungrily.
Another method will be to close his nostrils and he will open his mouth (sometimes). Syringe the medication inside his mouth.
The other concern is that the ear swelling is present though smaller in size. "Are you sure that all the pus had been taken out?" she asked.
"90% of the pus," I replied. "The abscess is quite large and deep. The swelling is due to inflammation of the tissues under the skin. It will disappear with time."
A video of the pus drainage would be useful to show her.
Wednesday, January 8, 2014
A Cavalier King Charles suffers ear pain for over 6 years
Many floppy-eared dogs need not suffer several years of pain and ear scratching due to lack of ventilation and drainage. However, the average Singaporean dog owner is now sufficiently educated to know that this lateral ear canal resection surgery is a solution to such a problem. A video is produced.
1291. Videos for Jan 8, 2014
Video: The Golden
Retriever has a painful left shoulder
Video: The hamster is irritated by two toe warts
Video: Ear surgery resolves painful infected ears of the Cavalier King Charles
Video: The bullied vomiting cat has painful rib cage and back
Video: The wealth prophecy came true on New Year's Day
Video: The hamster is irritated by two toe warts
Video: Ear surgery resolves painful infected ears of the Cavalier King Charles
Video: The bullied vomiting cat has painful rib cage and back
Video: The wealth prophecy came true on New Year's Day
Monday, January 6, 2014
1290. An old cat can't pee after boarding
This was the first time the old cat was boarded for 6 days. A younger cat was boarded. But only the old cat could not pee after boarding. The old cat, around 11 years old had never been boarded.
A blood and urine test showed high white blood cell count and bacteria in the urine respectively.
Dr Daniel unblocked the bladder with the urinary cathether, irrigated the bladder and stitched the catheter for 2 days of hospitalization.
"The cat is meowing whenever I pass by," I said to the happy older couple who visited on Day 2. "He can go home today with medication and special canned food. No more boarding for him!"
As at Jan 6, 2014, some 10 days after treatment, no news from the owner. No news is good news in this situation. Not all cases of FLUTD have happy endings. Early treatment results in better chances of success. Do not wait for several days if your cat cannot pee.
Video of the cat at Day 2 of hospitalization is at:
http://youtu.be/EOcpGnSzZBg
The cat is catheterized for 2 days and went home on Day 3 to his familiar environment. No news from the owner so far.
A blood and urine test showed high white blood cell count and bacteria in the urine respectively.
Dr Daniel unblocked the bladder with the urinary cathether, irrigated the bladder and stitched the catheter for 2 days of hospitalization.
"The cat is meowing whenever I pass by," I said to the happy older couple who visited on Day 2. "He can go home today with medication and special canned food. No more boarding for him!"
As at Jan 6, 2014, some 10 days after treatment, no news from the owner. No news is good news in this situation. Not all cases of FLUTD have happy endings. Early treatment results in better chances of success. Do not wait for several days if your cat cannot pee.
Video of the cat at Day 2 of hospitalization is at:
http://youtu.be/EOcpGnSzZBg
The cat is catheterized for 2 days and went home on Day 3 to his familiar environment. No news from the owner so far.
Sunday, January 5, 2014
1289. A prophecy of wealth comes true in the New Year.
"Wealth will flow to those who stayed back for the New Year's prayers and countdown," my hostess said to me. All her guests and family members left before midnight after arriving at 8 pm for the New Year's Eve dinner.
I wondered what she meant. One of her family members had told me that I had no luck after he had bought $12 bets on my behalf for my car number "8131" for the Sunday Dec 28, 2013. That was before the New Year Eve which fell on a Tuesday and the family members do buy 4-D and so I gave $12 to this member who suggested that I buy 4D bet on my car number since I visited my hostess on Sunday Dec 28, 2013 as invited by her. She had wanted some business writing help from me and was free on that day.
4-D bets in Singapore can be purchased on Saturday, Sunday and Wednesday and the results come in the next day. So, I could have place a $10 bet on "8131" on Wednesday Jan 1, 2014 after the prayers and countdown on Tuesday. I would have won $10,000 for 2nd prize or $1,000 for a combination bet. Wealth did come to me, but I did not bet as I don't buy 4D at all! My hostess said she won $15,000.
An incredible but true story of divine blessings. Unfortunately the family member who suggested I could follow up buying the 2nd time also did not buy this number!
I wondered what she meant. One of her family members had told me that I had no luck after he had bought $12 bets on my behalf for my car number "8131" for the Sunday Dec 28, 2013. That was before the New Year Eve which fell on a Tuesday and the family members do buy 4-D and so I gave $12 to this member who suggested that I buy 4D bet on my car number since I visited my hostess on Sunday Dec 28, 2013 as invited by her. She had wanted some business writing help from me and was free on that day.
4-D bets in Singapore can be purchased on Saturday, Sunday and Wednesday and the results come in the next day. So, I could have place a $10 bet on "8131" on Wednesday Jan 1, 2014 after the prayers and countdown on Tuesday. I would have won $10,000 for 2nd prize or $1,000 for a combination bet. Wealth did come to me, but I did not bet as I don't buy 4D at all! My hostess said she won $15,000.
An incredible but true story of divine blessings. Unfortunately the family member who suggested I could follow up buying the 2nd time also did not buy this number!
1288. Videos
An itchy Schnauzer passes blood in the urine
http://youtu.be/x1iB9WMWjCY
The hamster 2 days after nose abscess lancing operation - Part 2/2
http://youtu.be/JCsUFQWJAT0
The hamster 2 days after nose abscess lancing operation - Part 1/2
http://youtu.be/I6V9v572t6s
The hamster has a nose abscess lancing operation
http://youtu.be/y-onI8CyhsY
Armpit abscess Part 1/8
http://www.youtube.com/watch?v=HL8sEkuNYbA
Armpit abscess Part 2/8
http://www.youtube.com/watch?v=XD88yD-AmEI
Armpit abscess Part 3/8
http://www.youtube.com/watch?v=ub4H6Oys5p0
Armpit abscess Part 4/8
http://www.youtube.com/watch?v=fI9WVy-EgCI
5/8
http://www.youtube.com/watch?v=HvfIQUOgucg
6/8
http://www.youtube.com/watch?v=drtmLfcie2I
7/8
http://www.youtube.com/watch?v=h6sH6bRY3f4
8/8
http://www.youtube.com/watch?v=yJAwkmgO7B0
Social media is not so important if the product sells like hot cakes - Part 1
http://www.youtube.com/watch?v=32G-hiiIkcc
Social media is not so important if the product sells like hot cakes - Part 2
http://www.youtube.com/watch?v=44ww3B5ZY4U
How to treat a large hardened-nosed dwarf hamster
Saturday, Jan 4, 2014
A father with 2 lovely little daughters aged 8 years and a younger one, brought this 14-month-old female dwarf hamster to Toa Payoh Vets on Dec 28, 2013. The nose swelling was a gigantic inflamed swelling of 1.5 cm x 0.8 cm x 0.5 cm. Incredibly large and hard. She has wet tail too.
She was hospitalized for treatment with antibiotics, anti-inflammatory and fluids.
Only on Jan 2, 2014 was the abscess softened and the hamster could eat. Pus could be seen lying inside the bridge of the nose as a swelling. The hamster was given isoflurane gas anaesthesia and the abscess lanced. There was a lot of bleeding after expressing the pus. The tip of the nose had a circular scab which concealed caseated balls of pus. These were removed.
The hamster was in shock after the surgery and I thought she would die. Subcutaneous fluid and medication were given for 2 days. The blood clots were cleared on Jan 3, 2014.
On Jan 4, 2014, she looked better (image above) and was sent home for owner to nurse her. It is not easy to treat a hamster with a gigantic hard inflamed nose as the bacterial infection inside the bridge of the nose spreads extensively. The principles of treatment is similar as that for the dog or cat but in the dwarf hamster, the risks of anaethesia in a sick hamster is much higher.
Vets must perform too and a hamster is expected to be alive and cured at the end of hospitalization. This hamster survived and everybody is happy.
Some Youtube videos have been posted.
A father with 2 lovely little daughters aged 8 years and a younger one, brought this 14-month-old female dwarf hamster to Toa Payoh Vets on Dec 28, 2013. The nose swelling was a gigantic inflamed swelling of 1.5 cm x 0.8 cm x 0.5 cm. Incredibly large and hard. She has wet tail too.
She was hospitalized for treatment with antibiotics, anti-inflammatory and fluids.
Only on Jan 2, 2014 was the abscess softened and the hamster could eat. Pus could be seen lying inside the bridge of the nose as a swelling. The hamster was given isoflurane gas anaesthesia and the abscess lanced. There was a lot of bleeding after expressing the pus. The tip of the nose had a circular scab which concealed caseated balls of pus. These were removed.
The hamster was in shock after the surgery and I thought she would die. Subcutaneous fluid and medication were given for 2 days. The blood clots were cleared on Jan 3, 2014.
On Jan 4, 2014, she looked better (image above) and was sent home for owner to nurse her. It is not easy to treat a hamster with a gigantic hard inflamed nose as the bacterial infection inside the bridge of the nose spreads extensively. The principles of treatment is similar as that for the dog or cat but in the dwarf hamster, the risks of anaethesia in a sick hamster is much higher.
Vets must perform too and a hamster is expected to be alive and cured at the end of hospitalization. This hamster survived and everybody is happy.
Some Youtube videos have been posted.
Thursday, January 2, 2014
1286. The lab retriever puppy has a painful swollen shoulder
3 days after purchase, the 2-month-old lab retriever's left shoulder swells. Why?
This case was seen by Dr Daniel a day earlier, when the owner complained of the $2,500 pup being unable to bear weight on the left fore leg. The shoulder was X-rayed but no fractures were found. The "growth plate" was abnormal.
On Day 2, I spent some time talking to the owner and videoed the puppy whose elbow is now swollen. Blood would have gone down from the shoulder to the elbow now, in my observation.
"It is best to get a veterinary check up after purchase," I advised. The gentleman had purchased the last of the litter from the private home breeder.
"He said he did not want to sell as this is the last puppy left," the owner showed me a video that the breeder had sent to his mobile phone.
The short clip showed this puppy climbing up the playpen fence and jumping down from the top of the fence to meet the dam.
"The pup landed on his left front paw which is hidden from view," I said to the owner. "This could be the evidence that he had injured his shoulder which swells 3 days after purchase since you said that the puppy was walking and running about normally during the day of purchase."
The owner kept the puppy and it appears to be bearing weight on the left fore limb when I phoned 3 days later.
This case was seen by Dr Daniel a day earlier, when the owner complained of the $2,500 pup being unable to bear weight on the left fore leg. The shoulder was X-rayed but no fractures were found. The "growth plate" was abnormal.
On Day 2, I spent some time talking to the owner and videoed the puppy whose elbow is now swollen. Blood would have gone down from the shoulder to the elbow now, in my observation.
"It is best to get a veterinary check up after purchase," I advised. The gentleman had purchased the last of the litter from the private home breeder.
"He said he did not want to sell as this is the last puppy left," the owner showed me a video that the breeder had sent to his mobile phone.
The short clip showed this puppy climbing up the playpen fence and jumping down from the top of the fence to meet the dam.
"The pup landed on his left front paw which is hidden from view," I said to the owner. "This could be the evidence that he had injured his shoulder which swells 3 days after purchase since you said that the puppy was walking and running about normally during the day of purchase."
The owner kept the puppy and it appears to be bearing weight on the left fore limb when I phoned 3 days later.
1285. A dwarf hamster has a painful swollen red nose
Videos on progress of treatment at Toa Payoh Vets
DAY 1
DAY 4 OF HOSPITALISATION. EATING NOW
Wednesday, January 1, 2014
1284. A dwarf hamster has an itchy swollen right ear
A young couple brought in this 50-g hamster with a red hairless swollen right ear.
"He has an ear infection in the ear canal," I said. "I need to hospitalize him to reduce his swelling with medication and later to irrigate his ear canal which is now swollen and so no irrigation can be done." I said. The couple was OK with this.
Jan 1, 2014. I checked on the dwarf hamster after 2 days of medication. His ear canal is not so red and liquid yellow pus oozed out (arrow in the image).
Day 3 of hospitalization on Jan 1, 2014
"He has an ear infection in the ear canal," I said. "I need to hospitalize him to reduce his swelling with medication and later to irrigate his ear canal which is now swollen and so no irrigation can be done." I said. The couple was OK with this.
Jan 1, 2014. I checked on the dwarf hamster after 2 days of medication. His ear canal is not so red and liquid yellow pus oozed out (arrow in the image).
Videos are as follows:
Day 3 of hospitalization on Jan 1, 2014
Tuesday, December 31, 2013
1283. A cat with bald flanks, belly and tail
Dec 31, 2013
Last case of 2013.
I had operated on this 8-year-old cat that had a bladder stone. Now she comes to me with a bald tail, side flanks and belly.
"After your bladder stone operation, the belly area never produce hairs!" the gentleman told me as I advised clipping the cat bald as she had too many fur mites irritating her. The owner decided to take the Samsung smartphone video of this mite under the microscope.
"The whole tail is bald," I am surprised. "This could be due to the anal sac infections." I pulled up the tail and some light brown oil was expressed by the fingers releasing the oil. The cat turned his head and hissed at me
"The bald belly area will be due to the cat's continual licking daily," I said. "So no hairs can grow. As for both flanks being bald, this could be due to a hormonal imbalance condition called bilateral endocrine alopecia. Only that, the tail is not balding in such conditions."
As I looked closed at the upper neck area, there were specks of 3mm x 3 mm seen. Some specks were alive and kicking. So there were fur mites. The
What is the treatment for this cat?
An insecticidal wash in a bath tub after clipping off the contaminated coat.
"What if the hairs don't grow after clipping?" the owner asked.
So I dared not clip off the whole coat. I would sedate the cat and bathe him. The owner will need to decontaminate his big cage and the whole room. As to the source of the mites, the cat loves to lie down on cardboard boxes from China, stored in the room. This cat does not go out of the house or go boarding kennels.
"I live on the 17th floor and no stray cats ever visit him," the gentleman snapped video of the moving mite. Did the fur mites cause hair loss so extensively? What species are they? I need to identify them by doing some research.
I took a video of the species for further research. 6.40 pm Dec 31, 2013. Will close shop to celebrate New Year.
Last case of 2013.
I had operated on this 8-year-old cat that had a bladder stone. Now she comes to me with a bald tail, side flanks and belly.
"After your bladder stone operation, the belly area never produce hairs!" the gentleman told me as I advised clipping the cat bald as she had too many fur mites irritating her. The owner decided to take the Samsung smartphone video of this mite under the microscope.
"The whole tail is bald," I am surprised. "This could be due to the anal sac infections." I pulled up the tail and some light brown oil was expressed by the fingers releasing the oil. The cat turned his head and hissed at me
"The bald belly area will be due to the cat's continual licking daily," I said. "So no hairs can grow. As for both flanks being bald, this could be due to a hormonal imbalance condition called bilateral endocrine alopecia. Only that, the tail is not balding in such conditions."
As I looked closed at the upper neck area, there were specks of 3mm x 3 mm seen. Some specks were alive and kicking. So there were fur mites. The
What is the treatment for this cat?
An insecticidal wash in a bath tub after clipping off the contaminated coat.
"What if the hairs don't grow after clipping?" the owner asked.
So I dared not clip off the whole coat. I would sedate the cat and bathe him. The owner will need to decontaminate his big cage and the whole room. As to the source of the mites, the cat loves to lie down on cardboard boxes from China, stored in the room. This cat does not go out of the house or go boarding kennels.
"I live on the 17th floor and no stray cats ever visit him," the gentleman snapped video of the moving mite. Did the fur mites cause hair loss so extensively? What species are they? I need to identify them by doing some research.
I took a video of the species for further research. 6.40 pm Dec 31, 2013. Will close shop to celebrate New Year.
1282. Urethral obstruction in a young male dog
Monday Dec 31, 2013
Last day of 2013. The old cat with difficulty in urination and treated by Dr Daniel who had flown off to HongKong today is more lively (Blog 1281).
Suddenly an older Indian owner of a 3-year-old male Jack Russell that could not pee came into the Surgery. He had been boarded a few days ago as is the case with Blog 1281's old cat. Now he could not pee.
A 2nd case of urethral obstruction but in a dog. Same procedure. Owner permitted X-rays and blood test. I got 20 ml of air pumped into the bladder. No radio-dense stones are seen. "Some stones are not seen on X-rays," the short and slim nurse at the vet practice reminded me.
Blood test and urine test are done.
Last day of 2013. The old cat with difficulty in urination and treated by Dr Daniel who had flown off to HongKong today is more lively (Blog 1281).
Suddenly an older Indian owner of a 3-year-old male Jack Russell that could not pee came into the Surgery. He had been boarded a few days ago as is the case with Blog 1281's old cat. Now he could not pee.
A 2nd case of urethral obstruction but in a dog. Same procedure. Owner permitted X-rays and blood test. I got 20 ml of air pumped into the bladder. No radio-dense stones are seen. "Some stones are not seen on X-rays," the short and slim nurse at the vet practice reminded me.
Blood test and urine test are done.
1281. Urethral obstruction in an old male cat
Rex, male, neutered cat, 11 years. Usually inactive, plump at 8.1 kg. Only active when given treats.
When young kitten, not active. Grouchy towards other cats.
Ate dry food since young
Boarded 6 days. On lst day home, went to cat litter, not much urine seen.
On 2nd day, did not want to eat treats or wet food. Recently tends to eat less dry food.
For next 3 days cannot pee. lethargic, anorexic.
Dec 29, 2013 See Toa Payoh Vets. Mango-sized bladder palpated.
Urethral obstruction first time, after boarding for 6 days -- FLUTD. Change of environment.
Had not been to boarding for the last 5 years except recently.
Blood test - urea and creatinine very high urea 119.0 (7-11), creatinine 2321 (71-160).
- glucose high 11.8 (3.9-6.0)
- total white cell count and neutrophils high, platelets low.
Urine test - glucose negative.
- bacteria +, protein +, blood +, crystals nil, white blood cells 15, red blood cells >2250,
Dr Daniel had to sedate the old cat called Rex to insert the IV drip and take blood from the jugular vein. With the IV drip and medication, the cat responded well the next day. He sedated the cat, flush open the urethra, sucked out the urine, irrigated the bladder (Intern Clara to insert video clip - VIDEO 1)
Both cats were boarded but the 2-year-old male neutered cat is OK.
Dec 31, 2013 is day 3. The owners ( a lady and gentleman in their late 30s) came today. The cat greeted them and her eyes were bright and alert. The
owners commented on the brightness of the eyes (I took an image and video (VIDEO 2),4 pm Dec 31, 2013).
CONCLUSION
Since the cat was eating,drinking, pooping and peeing as normal
before boarding, this problem would have been avoided if the old cat was not boarded. The couple had to go overseas and the mother could not take care of two cats - this old Rex and the young cat. So both were boarded.
Rex will be warded for 3 more days for antibiotic injections & drips to flush out the toxins from the blood via the bladder. He should recover. No more boarding days as some cats cannot adapt to new environments and develop FLUTD (Feline Lower Urinary Tract Disease) which has many causes..
When young kitten, not active. Grouchy towards other cats.
Ate dry food since young
Boarded 6 days. On lst day home, went to cat litter, not much urine seen.
On 2nd day, did not want to eat treats or wet food. Recently tends to eat less dry food.
For next 3 days cannot pee. lethargic, anorexic.
Dec 29, 2013 See Toa Payoh Vets. Mango-sized bladder palpated.
Urethral obstruction first time, after boarding for 6 days -- FLUTD. Change of environment.
Had not been to boarding for the last 5 years except recently.
Blood test - urea and creatinine very high urea 119.0 (7-11), creatinine 2321 (71-160).
- glucose high 11.8 (3.9-6.0)
- total white cell count and neutrophils high, platelets low.
Urine test - glucose negative.
- bacteria +, protein +, blood +, crystals nil, white blood cells 15, red blood cells >2250,
Dr Daniel had to sedate the old cat called Rex to insert the IV drip and take blood from the jugular vein. With the IV drip and medication, the cat responded well the next day. He sedated the cat, flush open the urethra, sucked out the urine, irrigated the bladder (Intern Clara to insert video clip - VIDEO 1)
Both cats were boarded but the 2-year-old male neutered cat is OK.
Dec 31, 2013 is day 3. The owners ( a lady and gentleman in their late 30s) came today. The cat greeted them and her eyes were bright and alert. The
owners commented on the brightness of the eyes (I took an image and video (VIDEO 2),4 pm Dec 31, 2013).
CONCLUSION
Since the cat was eating,drinking, pooping and peeing as normal
before boarding, this problem would have been avoided if the old cat was not boarded. The couple had to go overseas and the mother could not take care of two cats - this old Rex and the young cat. So both were boarded.
Rex will be warded for 3 more days for antibiotic injections & drips to flush out the toxins from the blood via the bladder. He should recover. No more boarding days as some cats cannot adapt to new environments and develop FLUTD (Feline Lower Urinary Tract Disease) which has many causes..
Saturday, December 28, 2013
1280. How ro be an excellent tour guide
Dec 28, 2013
I toured Turkey from Dec 17 to 26, 2013 on a packaged tour. Packaged tours tend to be quite boring as tourist sleep while the coach passes various towns and villages as the Singaporean tour leader would not have comments nor knowledge of the places passed by.
However, this tour to Turkey was unusually fun as the Turkish tour guide, Mr Serkam could connect with the Singaporeans and gave comments on the cities passed such that one Malay mother with a 26-year-old career daughter who is still single told me that she had "no time to sleep during the journey."
Here are the best practices of Mr Serkam
1. Greeting the tourists every morning in their languages - Malay, Chinese and other foreign languages.
2. Diction. Use of a microphone and speak clearly in English.
3. Making eye contact with the tourists is important to him. Towards the end of the travel, our Singaporean tour leader slipped and hurt his knee and was sitting down on the front of the coach, obstructing his eye contact with the back of the coach. After enqniring about his injury, the Singaporean tour leader sat down on the aisle to ease his pain. He politely asked him to walk to the back so that Mr Serkam could see the tourists.
4. Getting up to point out various characteristics of towns and villages. For example, heavily polluted industrial area in Turkey where people are not expected to live past 65 years of age. A corporate logo of Noah's Ark on the side of a wall belonging to a corporation. Taxi drivers being ex-criminals and not to be honked at. The coporate SASA logo of the richest man in Turkey, Salt Lake's dimensions much bigger than the State of Singapore. This was why the travellers had no time to doze off for long periods of time as for other packaged tours led by Singaporean tour laaders.
5. Informing the travellers that the whole journey was 3,000 miles.
6. Recap the places visit at the last day. This seemed to be appreciated by Mr On who mentioned this to others. Mr On is the "vocal minority" who filled up the tour feedback forms for his Hokkien group
of 14 senior citizens.
7. Cracking numerous jokes at the expense of his Singaporean tour leader who did not mind.
Two videos of his jokes is uploaded. Some tour guides can't joke as it is not part of their personality and so the tour is serious and the travellers just sleep. No person can sleep when he cracks relevant jokes.
8. Connecting with the travellers by applying "organic olive oil" personally to moisturise their hands at the start of each day's journey. The other coach's tour guide did it once only. This daily contact with the travellers put them in a good frame of mind. So his optional tours are highly subscribed to as compared to the other coach. However, in the other coach, the large proportion of travellers were senior citizens with at least 14 of them being Hokkien speaking friends including Mr On. Mr On and myself were allotted to the first coach where our Turkish guide was not cracking jokes as that was not his character to do so.
It so happened that Mr On and I decided to pay $55 for the optional tours. We had to join the other coach led by Mr Serkam as there were around 8/35 opting for such tours. The others in the 2nd coach not opting for the tours came over to take our seats. As explained by our Singaporean tour leader, there were two coaches and so optional tours could be conducted. If there was one coach, there needed to be 100% opting in or no optional tours as in previous single-coach packaged deals.
"$55 is worth it," Mr On kept telling anyone who will listen to how he got a fun journey with Mr Serkam. He is 63 years old and has travelled much in his retirement years. He commented on one China Tour where the Chinese tour guide would not speak to Singaporeans if they didn't patronise the souvenier stalls. One had told me that he would not be able to make it up the high wall of a place. So he bad-mouthed this Singaporean travel agency.
He was the type who would share his views. He told us to claim back the over-charging of $35 in airport tax by our tour company. He had done so before the trip. It is not right for the tour company to keep quiet as airport tax is not part of the packaged tour cost. On returning home, I discovered that he was correct and the company agreed to give back the excessive paid. It is surprising to me as I trust this travel agency and did not query when asked for payment of the airport taxes.
9. Communicating well with travellers is not easy as it is part of the DNA of a service provider. There are doctors with excellent bedside manners and there are others who can't please the clients no matter how he or she tries.
10. "The other tour guide is old and therefore tired," Mr On was frank in his perception of the oldies. There will be such comments from a group of travellers. Such comments can influence the silent majority. In this first coach, the tour guide with 20 years of experience did his best, in my opinion. It would be out of his character to joke and he had no "clown" in the Singaporean tour leader who was only one instead of two for two coaches. This gives the impression that our company is trying to make more money by not providing one tour leader per coach of over 35 people. So, the one Singaporean tour leader in the first 3 days was absent as he decided to stay one day in one coach. Later, he decided to spend half a day in each coach and that would be better than being absent for the whole day.
From Day 3-10, Mr On and I had opted for the 4 optional tours and so was in the 2nd coach of Mr Serkam. We did not opt for the 5th optional tour - air balloon led by Mr Serkam but he had quite a good number. There was the optional Bosphorous River Cruise which Mr On and I subscribed to
and had another 8 of the Hokkien group from Coach 1 deciding to join.
11. Optional tours provide additional income for the tour guides. By getting the travellers in a right frame of mind to buy the tours, Mr Serkam was very successful in getting a coach full, not an easy task with previous tour leaders of single coaches.
One successful strategy used and encountered by me in a European tour was to thrown in another "free tour" if the whole coach agreed to the optional tour or letting the Singaporean tourists know that they would just be loitering in the shopping mall if they don't opt 100% for such tours. The optional tours permit the guide to earn some income as many are free lancers but some guides just can't sell the optiional tours. Some can do it as they are able to earn the trust and get the traveller in the buying frame of mind by communications. Life is unfair if the service provider's personality is such that he or she is not able to connect to close sales.
12. Providing statistics to tourists. Mr On asked the other coach friends whether the guide mentioned about the dimensions of the Salt Lake. He said Mr Serkam said it was of dimensions that are bigger than the State of Singapore.
13. Language barrier. Also Mr Serkam had better English diction but Mr Serkam had studied in the US for one year, in my talk to him.
14. Stereotypes of the old being tired and not energetic. Unfortunately this stereotype of the worn out oldie is quite common. Mr Serkam is in his late 30s and is deemed energetic.
15, Telling personal life stories. This can be difficult for some tour guides but those who do it, get some attention. The average people like gossips of lifestyles of the tour guides too. So, gigolo jokes from Mr Serkam about his Singapore counterpart, Sebastian, being a busy "gigolo", caused much laughter in the coach. I had a short video clip on this joking laughter in one of the 3 videos posted below.
14. Be proactive. Mr Serkam chartered the whole boat for the Bosphorous River Cruise and personally pointed out the various interesting aspects of the European side and the Asian side of the River. This is better than the usual taped recording of Boat Cruises on the River Seine in Paris.
3 videos to illustrate what I mean about being an excellent tour guide:
I toured Turkey from Dec 17 to 26, 2013 on a packaged tour. Packaged tours tend to be quite boring as tourist sleep while the coach passes various towns and villages as the Singaporean tour leader would not have comments nor knowledge of the places passed by.
However, this tour to Turkey was unusually fun as the Turkish tour guide, Mr Serkam could connect with the Singaporeans and gave comments on the cities passed such that one Malay mother with a 26-year-old career daughter who is still single told me that she had "no time to sleep during the journey."
Here are the best practices of Mr Serkam
1. Greeting the tourists every morning in their languages - Malay, Chinese and other foreign languages.
2. Diction. Use of a microphone and speak clearly in English.
3. Making eye contact with the tourists is important to him. Towards the end of the travel, our Singaporean tour leader slipped and hurt his knee and was sitting down on the front of the coach, obstructing his eye contact with the back of the coach. After enqniring about his injury, the Singaporean tour leader sat down on the aisle to ease his pain. He politely asked him to walk to the back so that Mr Serkam could see the tourists.
4. Getting up to point out various characteristics of towns and villages. For example, heavily polluted industrial area in Turkey where people are not expected to live past 65 years of age. A corporate logo of Noah's Ark on the side of a wall belonging to a corporation. Taxi drivers being ex-criminals and not to be honked at. The coporate SASA logo of the richest man in Turkey, Salt Lake's dimensions much bigger than the State of Singapore. This was why the travellers had no time to doze off for long periods of time as for other packaged tours led by Singaporean tour laaders.
5. Informing the travellers that the whole journey was 3,000 miles.
6. Recap the places visit at the last day. This seemed to be appreciated by Mr On who mentioned this to others. Mr On is the "vocal minority" who filled up the tour feedback forms for his Hokkien group
of 14 senior citizens.
7. Cracking numerous jokes at the expense of his Singaporean tour leader who did not mind.
Two videos of his jokes is uploaded. Some tour guides can't joke as it is not part of their personality and so the tour is serious and the travellers just sleep. No person can sleep when he cracks relevant jokes.
8. Connecting with the travellers by applying "organic olive oil" personally to moisturise their hands at the start of each day's journey. The other coach's tour guide did it once only. This daily contact with the travellers put them in a good frame of mind. So his optional tours are highly subscribed to as compared to the other coach. However, in the other coach, the large proportion of travellers were senior citizens with at least 14 of them being Hokkien speaking friends including Mr On. Mr On and myself were allotted to the first coach where our Turkish guide was not cracking jokes as that was not his character to do so.
It so happened that Mr On and I decided to pay $55 for the optional tours. We had to join the other coach led by Mr Serkam as there were around 8/35 opting for such tours. The others in the 2nd coach not opting for the tours came over to take our seats. As explained by our Singaporean tour leader, there were two coaches and so optional tours could be conducted. If there was one coach, there needed to be 100% opting in or no optional tours as in previous single-coach packaged deals.
"$55 is worth it," Mr On kept telling anyone who will listen to how he got a fun journey with Mr Serkam. He is 63 years old and has travelled much in his retirement years. He commented on one China Tour where the Chinese tour guide would not speak to Singaporeans if they didn't patronise the souvenier stalls. One had told me that he would not be able to make it up the high wall of a place. So he bad-mouthed this Singaporean travel agency.
He was the type who would share his views. He told us to claim back the over-charging of $35 in airport tax by our tour company. He had done so before the trip. It is not right for the tour company to keep quiet as airport tax is not part of the packaged tour cost. On returning home, I discovered that he was correct and the company agreed to give back the excessive paid. It is surprising to me as I trust this travel agency and did not query when asked for payment of the airport taxes.
9. Communicating well with travellers is not easy as it is part of the DNA of a service provider. There are doctors with excellent bedside manners and there are others who can't please the clients no matter how he or she tries.
10. "The other tour guide is old and therefore tired," Mr On was frank in his perception of the oldies. There will be such comments from a group of travellers. Such comments can influence the silent majority. In this first coach, the tour guide with 20 years of experience did his best, in my opinion. It would be out of his character to joke and he had no "clown" in the Singaporean tour leader who was only one instead of two for two coaches. This gives the impression that our company is trying to make more money by not providing one tour leader per coach of over 35 people. So, the one Singaporean tour leader in the first 3 days was absent as he decided to stay one day in one coach. Later, he decided to spend half a day in each coach and that would be better than being absent for the whole day.
From Day 3-10, Mr On and I had opted for the 4 optional tours and so was in the 2nd coach of Mr Serkam. We did not opt for the 5th optional tour - air balloon led by Mr Serkam but he had quite a good number. There was the optional Bosphorous River Cruise which Mr On and I subscribed to
and had another 8 of the Hokkien group from Coach 1 deciding to join.
11. Optional tours provide additional income for the tour guides. By getting the travellers in a right frame of mind to buy the tours, Mr Serkam was very successful in getting a coach full, not an easy task with previous tour leaders of single coaches.
One successful strategy used and encountered by me in a European tour was to thrown in another "free tour" if the whole coach agreed to the optional tour or letting the Singaporean tourists know that they would just be loitering in the shopping mall if they don't opt 100% for such tours. The optional tours permit the guide to earn some income as many are free lancers but some guides just can't sell the optiional tours. Some can do it as they are able to earn the trust and get the traveller in the buying frame of mind by communications. Life is unfair if the service provider's personality is such that he or she is not able to connect to close sales.
12. Providing statistics to tourists. Mr On asked the other coach friends whether the guide mentioned about the dimensions of the Salt Lake. He said Mr Serkam said it was of dimensions that are bigger than the State of Singapore.
13. Language barrier. Also Mr Serkam had better English diction but Mr Serkam had studied in the US for one year, in my talk to him.
14. Stereotypes of the old being tired and not energetic. Unfortunately this stereotype of the worn out oldie is quite common. Mr Serkam is in his late 30s and is deemed energetic.
15, Telling personal life stories. This can be difficult for some tour guides but those who do it, get some attention. The average people like gossips of lifestyles of the tour guides too. So, gigolo jokes from Mr Serkam about his Singapore counterpart, Sebastian, being a busy "gigolo", caused much laughter in the coach. I had a short video clip on this joking laughter in one of the 3 videos posted below.
14. Be proactive. Mr Serkam chartered the whole boat for the Bosphorous River Cruise and personally pointed out the various interesting aspects of the European side and the Asian side of the River. This is better than the usual taped recording of Boat Cruises on the River Seine in Paris.
3 videos to illustrate what I mean about being an excellent tour guide:
Friday, December 27, 2013
1277. Create a fun experience to close sales
It is difficult for a doctor to create a fun experience to close sales as medicine is a serious matter. For the Spice Market salesperson in orange uniform, the competition is intense. By creating a fun experience, the Singaporean tourists stay longer and he closes sales. His boss will find him a high performer
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