Friday, April 29, 20911
REAL ESTATE AGENCY (REA) PAPER 3. Real Estate Agency Practice & Regulations
Ethics & Client Care
I remembered this lecture more than the 12 Golden Rules of the CEA (Council for Estate Agencies). The lecturer was showing a power point presentation slide to illustrate Rule No. 8 which is Ethics & Client Care - Advertisement.
The slide showed two advertisements of an agent before and one week after the CEA was formed. The advertisement showed the agent's photo on the left and her viewings of the HDB flat.
The lecturer said: "This is a top agent. Every 15 minutes from 5pm to 7.15pm, she had an apartment for sale viewing. There were 10 viewings every 15 minutes on one Saturday afternoon."
The mature students would have been exhausted by this 3-hour-long lecture of power point slides and after slides did not comment. 7 Golden Rules had been preached and must be memorised for the dreaded examinations. We had several housing and property rules to remember too.
To lighten the solemn mood, I asked: "Is she good-looking?". What I meant to communicate to the class was that this was a well posed professionally taken photograph (angle of body slightly tilted unlike most agents' face-direct photography), long hair to below the shoulders and a comely smile.
"What do you mean," the lecturer turned and looked at me with atomic eyes that could annihilate me. "I am already so old! She can be my daughter!"
I was shocked at his response. Had I implied that he was having some hanky panky? Or was there a clash of cultures, he being nearly 7 decades old and deadly serious in affairs of the heart?
I kept silent but it seemed the classmates paid more attention.
The lecturer said: "See the heading of the first advertisement. It says 'XXX International Top All Around No. 1 Achiever For Year 2009 - XXX USA.'"
We focus on this impressive claim. In the second advertisement one week later, the heading was not presented. What was the reason? I checked my lecture notes of Estate Agency Act & Practice, Ethics & Client Care, 8/12 Rule:
CEA Regulation of Rule 8:
"ALL FORMS of an advertisement must be supported by proof".
Then the lecturer pointed to the bottom of the first advertisement which stated:
"Senior Marketing Director" and then to the second advertisement which stated: "Senior Team Director". Why?
CEA Regulation of Rule 8:
ALL FORMS of an advertisement must be supported by proof
If necessary, VETTED/APPROVED by the Estate Agent.
I would infer that the Estate Agent did not now approve of the position of "Senior Marketing Director".
The 3rd change he showed was "Just Sold by ..." in the first advertisement was replaced by "My Achievement for the Year 2010". Why?
CEA Regulation of Rule 8:
All advertisements to be REMOVED if withdrawn/sold/rented e.g. website. The lecturer's notes did not give newspapers as an example but this type of trumpet-blowing advertisements of past properties that had been sold had been a common practice by the more successful agents.
Going into more details as I write this report to attempt to retain some knowledge for the exam, there is another CEA Regulation of Rule 8 which states:
Advertising/Promotion/Letter MATERIALS must have
1. Name/Contact number same as in the CEA Register
2. Registration/Licence NUMBERS
3. If necessary VETTED/APPROVED by estate agent.
The 2nd advertisement did not show the Registration/Licence Numbers. So, is the R and L numbers compulsory in every advertisement?
If we cannot remember all the 12 Golden Rules, I hope my classmates can at least remember Rule No. 8 due to the reaction of the serious lecturer who would be their father for many of them, due to the age gap.
To summarise for my revision for the May 2011 exam, here are the 12 Golden Rules:
1. Knowledge of and compliance with applicable laws, practice, circulars and guidelines (laws of agency, contract, tort).
2. Due diligence and compliance with law and statutory requirements.
3. General duty to clients and public (mislead, misrepresent, lack of integrity and honesty, unethical practices).
4. Not to bring discredit or disrepute to real estate industry (I will write on an case of touting in a lawyer setting up a real estate referral company, as reported recently in the Straits Times)
5. Duty to clients in relation to signing of documents (explain meaning and consequences, seek professional advice).
6. Obligations in respect of agreements (all in writing, no blank spaces and accurate recording).
7. Conveying offers, counter offers etc. (Counter offer is not legally an offer or part of a contract).
8. Advertisement
9. Interpretation or translation if necessary (record interpreted by...).
10. Duty to avoid conflict of interests
11. Recommending professional advice where appropriate.
12. Safeguarding confidential information (e.g. distress sales).
Many of the rules of ethics and client care can be applied to the veterinary practices too. For the real estate agent, he or she must be careful of mis-communication between clients and agent (all relevant contracts and services to be in writing- Rule 6). In particular, regarding Rule No.8, there should be no misleading advertisements (property not accurately described), misrepresentation (impersonating as buyer in flyers and newspapers) or advertise without proof (e.g. claiming to be a HDB specialist).
Sunday, May 1, 2011
Saturday, April 30, 2011
421. Put Non-Profits on the road to sustainability
Sat Apr 30, 2011 National Library Victoria St
I spend some time to read the book "ROI for Nonprofits" by Tom Ralser, 2007 as I am interested in non-profit organisation.
I don't have much time to read nowadays, due to my having to study for the CEA REA real estate course exam in May 25, 2011 (3 evenings, 2 hours, 5/8 questions, passing the exam does not mean getting the licence according to my lecturer).
Tom Ralser is a Chartered Financial Analyst (CFA) and taught finance and investments to college seniors for 7 years.
ROI (return on investment).
I spend some time to read the book "ROI for Nonprofits" by Tom Ralser, 2007 as I am interested in non-profit organisation.
I don't have much time to read nowadays, due to my having to study for the CEA REA real estate course exam in May 25, 2011 (3 evenings, 2 hours, 5/8 questions, passing the exam does not mean getting the licence according to my lecturer).
Tom Ralser is a Chartered Financial Analyst (CFA) and taught finance and investments to college seniors for 7 years.
ROI (return on investment).
Wednesday, April 27, 2011
420. The hissing cat has difficulty in urination. Initiating cause due to amitriptyline?
Sunday, April 24, 2010. Bright sunshine, blue skies. Should be outdoors. I was at work at 9.30 am. 3 clients came in but they were my associate vet's clients and so I told him they had to wait as she comes in at 11 am. Suddenly a couple with a cat carrier came in at 10.15 am. They would be 4th in the queue and by the time, they get attended by my associate, it would be past 12.30 pm which meant a 2-hour wait. As they have no preference, I took over the case, thinking it was a simple case of a cat that can't pee. A commonly presented case, usually of an older male cat fed on dry food.
HISTORY. Cat, Male, Neutered, 7 years old. Could not pee 2 weeks ago. Vet 1 relieved urethral obstruction, gave one "2-week-lasting" SC injection. Cat went home. OK for first 2 days. Then difficulty in peeing. Squatted but no urine. After for around 2 weeks, the couple in their 30s consulted me for a second opinion on Sunday April 24, 2011, 10 am. "Be careful," the husband warned. "The cat is very ferocious since the visit to Vet 1." According to the wife, Vet 1 had used anaesthesia to catherised the cat at the first time. However, the second and third bladder irrigation via the catheter was done without sedation as witnessed by the wife who was called to help. The wife was unhappy at seeing her cat traumatised. "Now the cat hisses whenever he is taken to the vet," the wife said. "The vet may think that it is risky to give sedation/anaesthesia again," I said. "The cat may die from the sedation and that would be disastrous." I don't do repeat bladder irrigation but each vet has his own ideas.
Now the cat warned me with a loud hiss as I examined his backside and palpated his abdomen. There was no point traumatising the cat. So, I gave a sedation and asked the owner to wait. Was this a recurrence of the urethral obstruction?
SEDATION & EXAMINATION Weight: 6kg, xylazine 0.15ml ketamine 0.5ml. Catheter passed in smoothly. No obstruction. But the unusual problem was that the penis of the cat could not be extended. The prepuce had swollen to a ball-shaped lump. An unusual case. I took a picture.
After some massage, it was possible to extend the cat's penis and insert the catheter. There was no penile inflammation. Bladder palpation. Bladder was swollen to twice the ping pong ball size. Urine collected for analysis. No crystals. Blood, white cells and red cells, bacteria + present.
DIAGNOSIS. Feline Lower Urinary Tract Disease (FLUTD).
The owner was not prescribed oral antibiotics by Vet 1 but the wife said to me: "The cat had been given a "2-week-lasting antibiotic injection". Therefore, there was no need for oral antibiotics. However, Vet 1 prescribed an anti-depression oral medication which the cat objected forcefully. So the owners did not give him the amitriptyline after two tablets. This drug licensed use in people is for depressive illness, bedwetting (nocturnal enuresis) in children aged 6 years and over.
Vet 1's X-ray show that the bladder is large and distended. No urinary stones seen, according to the owner.
4109 - 4111. The cat can't pee again. He hisses at the owners and at me (the 2nd vet). Why? Is there a permanent cure for feline lower urinary tract disease (FLUTD)? The hissing cat has difficulty peeing again
One of the adverse side effects of amitriptyline is "difficulty in passing urine" and this is reasonable since it is used to prevent bedwetting in children. I don't use it in cats or dogs and so I have no experience with this drug. But after two tablets, the owner observed that the cat had difficulty peeing! So was this the effect of amitriptyline or not? The cat continued to have dysuria for the next 10 days and that was when on this bright sunshine Sunday morning, I encountered this interesting case. Interesting only to veterinary knowledge on the use of amitriptyline, not to the owners as it had been traumatising for them and their cat.
To make a long story short, the cat did not have urethral obstruction as the catheter went into the bladder smoothly. He was warded for 2 days. The diagnosis was feline lower urinary tract disease confirmed by urine analysis. This was an intelligent cat as he sat on the litter box all the time while warded for 2 days in the surgery. If you understand that a cat wants to be clean, he is leaking urine via the catheter and so, by sitting on top of the litter box, he does not mess up the surrounding area. Even after removal of the catheter, he still sat on top of the litter on day 3 when the owner came to take him home.
When the owner came to take him home, he hissed at the owner! So, the couple patiently took time to get him to relax and put him inside the crate. In the morning I had sedated him (xylazine 0.1 ml + ketamine 0.4 ml IM) to remove the 6/0 stitches tying his catheter to his prepuce in 4 places and take rectal temperature (fever 39.8 deg C) and to weigh him. I treated his fever with baytril and tolfedine injections SC.
According to the wife, at Vet 1, the e-collar had been taken out once and the cat pulled off his catheter but with the sutures still knotting one end to the prepuce. Therefore, she asked whether I had put an e-collar all the time. Better to use oral pain-killers for cats post-treatment as the cat is very difficult to medicate and will claw you.
In any case, I don't usually put catheters in cats after bladder irrigation, except in some cases such as this case and only for 1-2 days. I don't bladder irrigation more than once but some vets do, without sedation.
The cat will be on oral antibiotics for 12 days. I don't believe in giving one single injection lasting "2 weeks" as Vet 1 did, but if the owner can't medicate at home, this may be the alternative. Pound medicine into powder and add to sugary paste. Spread on cat's body or paws without the cat knowing it. But cats may be too smart and flick away the medicated sugar.
Close monitoring of water intake and canned food, urine analysis in 2 weeks. Change to sand litter. Continue canned SD diet for 1-3 months and urine test monthly for 1-3 months. Then canned food. No shampoo for the first week. The cat is shampooed once a month as the owners find its coat oily. "Cats seldom get bathed in Singapore," I said. I did not take blood test so as to lower the veterinary costs.
However, urine tests are important for diagnosis of FLUTD and this was done in this case as the owner wants to know what is happening. Bacterial antibiotic sensistivity tests of the urine was not done in this case but would be done if there is another episode, so as to save the owners some money as they had spent quite a large sum at Vet 1.
P.S.
1. Cause of the FLUTD
I said to the owner on the second day: "You must have given dry food after treatment by Vet 1, thus leading to difficulty in urination."
"No, I did not," the husband said.
Then he remembered that Vet 1 had given him the dry food of Hills' Prescription SD as canned ones were out of stock. So, there was a dry food involved. Could it be the dry food? Could it be the action of amitriptyline retaining the urine in the bladder and permitting bacterial infection? Could it be the sharp pelleted litter injuring the prepuce and causing it to swell and prevent ease of urination? Could it be the re-infection of the bladder after going home? Was Vet 1's "long-term guaranteed to last 2-week" antibiotic injection of Synulox (clavulanic acid and amoxicillin) ineffective since it was apparently given once only? There are so many factors causing the urinary tract infection presented to me now and so it is hard to specify one causative factor.
It is a mystery but a urine analysis is important and must be done as part of the vet's duty of care. Certainly there was bacteria and white cells in the urine, indicating urine retention had led to cystitis or was a cause of cystitis. The SD diet had acidfied the urine apparently as the urine pH was 6.5 in the test.
It is quite painful for the couple to see their cat going to the litter box many times, tried to pee and not able to do so on the 3rd day after going home from Vet 1's treatment. They decided to seek another opinion and I was present on this bright sunshine blue-skies Sunday that I would like to spend at the Botanic Gardens.
2. Follow-up 24 hours after going home on Tuesday, April 26, 2011. I phoned at around 4 pm on April 27, 2011 as the cat had a fever of 39.8 deg C on Tuesday morning (when I took out the catheter and checked the rectal temperature under sedation). I had informed the husband of the fever and asked him to observe the cat closely. I had given tolfedine injection which would reduce the fever.
The husband said: "Everything is OK. The cat ate a lot and drank a lot on reaching home. Then he became quiet and not moving much. My wife smeared the baytril antibiotic in brown sugar onto his body and he licked it off."
This was one of the tips of medication I had given to the handsome couple in their 30s.
I replied: "It is possible that she is very tired after spending two stressful nights at Toa Payoh Vets which is a new environment for her.
"She is also not hungry after eating a lot. Check whether she has fever by feeling her lower abdomen with the hand but this is not accurate. Let me know if the cat is not eating. You have the anti-fever tolfedine tablets ready. Have you bought the sand litter?"
The owner had not and would do so. I expect this case to stabilise and that the emotional coaster-ride of the couple would fade away. The veterinary costs of two vets would be over a thousand dollars but this could not be avoided since there were so many procedures and tests.
The management at home is most important as there are many causes involved in the development of FLUTD (Feline Lower Urinary Tract Infection). The causes include uroliths (stones), urethral obstruction (plugged-penis syndrome and blocked cat syndrome), infectious causes and others (unknown causes in about 60% of the cases, physical trauma to penile area, tumours of the urinary tract, congenital abnormalities, neurological problems and intentional urinary retention (common behaviour seen in cats not given a litterbox or dirty litterbox).
In this case, the sophisticated owners told me the cat was shifted to a new house and that would be the cause.
The risk factors would be
1.1. Age. Uncommon in cats less than one year old but most common in cats 2-5 years old. This cat is 7 years old).
1.2 Sex. Male and neutered cats are at greater risk of urethral obstruction as their urethra is longer and narrower.
1.3 Neutering.
1.4 Dehydration.
1.5 Dry food high in magnesium or other minerals and high in pH.
1.6 Obesity.
All the above factors are present in this case. Dehydration could be due to the lack of adequate water intake as the cat was adjusting to the new house environment. Most cats on dry cat food do NOT get FLUTD. The causes are many and therefore, amitriptyline was not the only cause of the recurrence of the dysuria. Good management at home and regular veterinary check ups are very important to prevent recurrence of the dreaded Feline Lower Urinary Tract Disease (FLUTD).
Updates and more pictures of this webpage for my blog readers:
http://www.sinpets.com/F5/20110437urinary-tract-infection-amitriptyline-cystitis-toapayohvets-singapore.htm
HISTORY. Cat, Male, Neutered, 7 years old. Could not pee 2 weeks ago. Vet 1 relieved urethral obstruction, gave one "2-week-lasting" SC injection. Cat went home. OK for first 2 days. Then difficulty in peeing. Squatted but no urine. After for around 2 weeks, the couple in their 30s consulted me for a second opinion on Sunday April 24, 2011, 10 am. "Be careful," the husband warned. "The cat is very ferocious since the visit to Vet 1." According to the wife, Vet 1 had used anaesthesia to catherised the cat at the first time. However, the second and third bladder irrigation via the catheter was done without sedation as witnessed by the wife who was called to help. The wife was unhappy at seeing her cat traumatised. "Now the cat hisses whenever he is taken to the vet," the wife said. "The vet may think that it is risky to give sedation/anaesthesia again," I said. "The cat may die from the sedation and that would be disastrous." I don't do repeat bladder irrigation but each vet has his own ideas.
Now the cat warned me with a loud hiss as I examined his backside and palpated his abdomen. There was no point traumatising the cat. So, I gave a sedation and asked the owner to wait. Was this a recurrence of the urethral obstruction?
SEDATION & EXAMINATION Weight: 6kg, xylazine 0.15ml ketamine 0.5ml. Catheter passed in smoothly. No obstruction. But the unusual problem was that the penis of the cat could not be extended. The prepuce had swollen to a ball-shaped lump. An unusual case. I took a picture.
After some massage, it was possible to extend the cat's penis and insert the catheter. There was no penile inflammation. Bladder palpation. Bladder was swollen to twice the ping pong ball size. Urine collected for analysis. No crystals. Blood, white cells and red cells, bacteria + present.
DIAGNOSIS. Feline Lower Urinary Tract Disease (FLUTD).
The owner was not prescribed oral antibiotics by Vet 1 but the wife said to me: "The cat had been given a "2-week-lasting antibiotic injection". Therefore, there was no need for oral antibiotics. However, Vet 1 prescribed an anti-depression oral medication which the cat objected forcefully. So the owners did not give him the amitriptyline after two tablets. This drug licensed use in people is for depressive illness, bedwetting (nocturnal enuresis) in children aged 6 years and over.
Vet 1's X-ray show that the bladder is large and distended. No urinary stones seen, according to the owner.
4109 - 4111. The cat can't pee again. He hisses at the owners and at me (the 2nd vet). Why? Is there a permanent cure for feline lower urinary tract disease (FLUTD)? The hissing cat has difficulty peeing again
One of the adverse side effects of amitriptyline is "difficulty in passing urine" and this is reasonable since it is used to prevent bedwetting in children. I don't use it in cats or dogs and so I have no experience with this drug. But after two tablets, the owner observed that the cat had difficulty peeing! So was this the effect of amitriptyline or not? The cat continued to have dysuria for the next 10 days and that was when on this bright sunshine Sunday morning, I encountered this interesting case. Interesting only to veterinary knowledge on the use of amitriptyline, not to the owners as it had been traumatising for them and their cat.
To make a long story short, the cat did not have urethral obstruction as the catheter went into the bladder smoothly. He was warded for 2 days. The diagnosis was feline lower urinary tract disease confirmed by urine analysis. This was an intelligent cat as he sat on the litter box all the time while warded for 2 days in the surgery. If you understand that a cat wants to be clean, he is leaking urine via the catheter and so, by sitting on top of the litter box, he does not mess up the surrounding area. Even after removal of the catheter, he still sat on top of the litter on day 3 when the owner came to take him home.
When the owner came to take him home, he hissed at the owner! So, the couple patiently took time to get him to relax and put him inside the crate. In the morning I had sedated him (xylazine 0.1 ml + ketamine 0.4 ml IM) to remove the 6/0 stitches tying his catheter to his prepuce in 4 places and take rectal temperature (fever 39.8 deg C) and to weigh him. I treated his fever with baytril and tolfedine injections SC.
According to the wife, at Vet 1, the e-collar had been taken out once and the cat pulled off his catheter but with the sutures still knotting one end to the prepuce. Therefore, she asked whether I had put an e-collar all the time. Better to use oral pain-killers for cats post-treatment as the cat is very difficult to medicate and will claw you.
In any case, I don't usually put catheters in cats after bladder irrigation, except in some cases such as this case and only for 1-2 days. I don't bladder irrigation more than once but some vets do, without sedation.
The cat will be on oral antibiotics for 12 days. I don't believe in giving one single injection lasting "2 weeks" as Vet 1 did, but if the owner can't medicate at home, this may be the alternative. Pound medicine into powder and add to sugary paste. Spread on cat's body or paws without the cat knowing it. But cats may be too smart and flick away the medicated sugar.
Close monitoring of water intake and canned food, urine analysis in 2 weeks. Change to sand litter. Continue canned SD diet for 1-3 months and urine test monthly for 1-3 months. Then canned food. No shampoo for the first week. The cat is shampooed once a month as the owners find its coat oily. "Cats seldom get bathed in Singapore," I said. I did not take blood test so as to lower the veterinary costs.
However, urine tests are important for diagnosis of FLUTD and this was done in this case as the owner wants to know what is happening. Bacterial antibiotic sensistivity tests of the urine was not done in this case but would be done if there is another episode, so as to save the owners some money as they had spent quite a large sum at Vet 1.
P.S.
1. Cause of the FLUTD
I said to the owner on the second day: "You must have given dry food after treatment by Vet 1, thus leading to difficulty in urination."
"No, I did not," the husband said.
Then he remembered that Vet 1 had given him the dry food of Hills' Prescription SD as canned ones were out of stock. So, there was a dry food involved. Could it be the dry food? Could it be the action of amitriptyline retaining the urine in the bladder and permitting bacterial infection? Could it be the sharp pelleted litter injuring the prepuce and causing it to swell and prevent ease of urination? Could it be the re-infection of the bladder after going home? Was Vet 1's "long-term guaranteed to last 2-week" antibiotic injection of Synulox (clavulanic acid and amoxicillin) ineffective since it was apparently given once only? There are so many factors causing the urinary tract infection presented to me now and so it is hard to specify one causative factor.
It is a mystery but a urine analysis is important and must be done as part of the vet's duty of care. Certainly there was bacteria and white cells in the urine, indicating urine retention had led to cystitis or was a cause of cystitis. The SD diet had acidfied the urine apparently as the urine pH was 6.5 in the test.
It is quite painful for the couple to see their cat going to the litter box many times, tried to pee and not able to do so on the 3rd day after going home from Vet 1's treatment. They decided to seek another opinion and I was present on this bright sunshine blue-skies Sunday that I would like to spend at the Botanic Gardens.
2. Follow-up 24 hours after going home on Tuesday, April 26, 2011. I phoned at around 4 pm on April 27, 2011 as the cat had a fever of 39.8 deg C on Tuesday morning (when I took out the catheter and checked the rectal temperature under sedation). I had informed the husband of the fever and asked him to observe the cat closely. I had given tolfedine injection which would reduce the fever.
The husband said: "Everything is OK. The cat ate a lot and drank a lot on reaching home. Then he became quiet and not moving much. My wife smeared the baytril antibiotic in brown sugar onto his body and he licked it off."
This was one of the tips of medication I had given to the handsome couple in their 30s.
I replied: "It is possible that she is very tired after spending two stressful nights at Toa Payoh Vets which is a new environment for her.
"She is also not hungry after eating a lot. Check whether she has fever by feeling her lower abdomen with the hand but this is not accurate. Let me know if the cat is not eating. You have the anti-fever tolfedine tablets ready. Have you bought the sand litter?"
The owner had not and would do so. I expect this case to stabilise and that the emotional coaster-ride of the couple would fade away. The veterinary costs of two vets would be over a thousand dollars but this could not be avoided since there were so many procedures and tests.
The management at home is most important as there are many causes involved in the development of FLUTD (Feline Lower Urinary Tract Infection). The causes include uroliths (stones), urethral obstruction (plugged-penis syndrome and blocked cat syndrome), infectious causes and others (unknown causes in about 60% of the cases, physical trauma to penile area, tumours of the urinary tract, congenital abnormalities, neurological problems and intentional urinary retention (common behaviour seen in cats not given a litterbox or dirty litterbox).
In this case, the sophisticated owners told me the cat was shifted to a new house and that would be the cause.
The risk factors would be
1.1. Age. Uncommon in cats less than one year old but most common in cats 2-5 years old. This cat is 7 years old).
1.2 Sex. Male and neutered cats are at greater risk of urethral obstruction as their urethra is longer and narrower.
1.3 Neutering.
1.4 Dehydration.
1.5 Dry food high in magnesium or other minerals and high in pH.
1.6 Obesity.
All the above factors are present in this case. Dehydration could be due to the lack of adequate water intake as the cat was adjusting to the new house environment. Most cats on dry cat food do NOT get FLUTD. The causes are many and therefore, amitriptyline was not the only cause of the recurrence of the dysuria. Good management at home and regular veterinary check ups are very important to prevent recurrence of the dreaded Feline Lower Urinary Tract Disease (FLUTD).
Updates and more pictures of this webpage for my blog readers:
http://www.sinpets.com/F5/20110437urinary-tract-infection-amitriptyline-cystitis-toapayohvets-singapore.htm
Tuesday, April 26, 2011
My 3 Ninja turtles
"Eat your vegetables!" the mum would command and the child would clamp his mouth shut. All children hate vegetables, I believe. So, the same with this 8-year-old red-eared slider turtle. He would clamp his mouth shut very tightly as I tried to dose him with medication from a dropper and a syringe. I tickled his nostrils expecting him to open his mouth. No way.
Then I covered his nostril for a few seconds so that he would open his mouth to breathe and then I would drop his medication into his mouth as I did with the smaller red-eared glider I treated last week. But this 7-inchx5-inch slider held his breath and I did not want to suffocate him.
There was no way to open his mouth unlike dogs and cats whom I could grip the upper jaws and prise the mouth open. Maybe I don't have the technique as turtles are rarely treated by me since most Singaporean owners do-it-yourself treatments. In any case, I had 3 sliders in a short time.
Remember my comments about things happening in threes? I had 3 gliders with eye problems in a short time and for the past year, not a turtle or tortoise seen. It was like famine and feast in the biblical sense.
The first one was a very young one with eyes closed for a day or two and came to see Dr Vanessa. I took over the case and I treated its eyes with eye drops since Dr Vanessa was busy and from her expressions, turtles are not one of her favourite things. After that, I the young lady owner to keep the water clean.
The second one was another small one, a week before this big boy came in. It was around 4-inch by 3-inch and the owner failed to open its eyes for the last two months and so sent to me for treatment. The owner had bought eye drops from the pet shop but since the eyes would not open, how to apply the eye drops? The glider's dried prawn and commercial food and eye drops arrived with it as advised by me.
No hope, I thought. Two months and the mucous membranes of the mouth of this turtle was deadly bluish maroon. A cyanosis as if from cyanmide poisoning.
It needed antibiotics and vitamins. I opened its mouth when I pressed my finger against its nostrils and got its medicine. It opened its eyes partially on the 6th day and I sent it home for nursing. Now, this big boy just would not open his mouth despite me doing the same nostril tickling and covering as in turtle No. 2.
His owner sent him down to me for treatment as the glider's eyes remained tightly shut and swollen for the past two weeks. Dr Jason Teo received the turtle at night and left the treatment to me. I guess he's not into turtles as many vets don't really like treating this species.
"Is it Vitamin A deficiency?" the gentleman asked over the phone.
I said: "I don't know. Do you just feed the commercial turtle sticks?"
The owner said: "Usually. My mum will give some meat. I brought this turtle back from the U.S."
The turtle shell looked quite dirty and so I had the turtle four baths. Dirty cellular debris floated off the water. On Good Friday morning, I had this turtle in a blue bath tub meant for babies and let him have some morning sun for 10 minutes. I had to keep an eye on him in case stray dogs come and grab him. This time the bath water was cleaner and not polluted with brown stuff. My assistant complained to me about the turtle not co-operating in opening his mouth. We did manage to give some medication and I put him inside the crate. My assistant Mr Min advised me: "Put him in the baby bath tub with water." I said: "No, he may not be safe. What if he can climb over and fall down? Or horrors and nightmares! What if Dr Vanessa's dog eats him should he fall out of the bath tub while we are busy?
"Rule No. 1. It is always best to crate the turtle." I teach this young man who is qualified as a veterinarian in Myanmar and now works for me. I like feedback from staff as there may be new angles and perspectives. But no turtle is going to run away or be eaten while under my care.
Then on the 4th day, on a bright sunshine Sunday morning, I got the turtle out for another bath. Wow, his eyes were opened. That was great. "Should he stay one or two days longer?" the owner asked me as the turtle had just opened his eyes. "No need to," my policy is to get the animals home as soon as possible to their well loved home to recuperate. Yet, around 4 hours later, the owner texted me to say that the turtle had closed his eyes. Why? I don't know but I presumed that given the freedom of the whole apartment to wander, this turtle must have been exhausted. I advised observation. Then the owner texted to say that the turtle did open his eyes for a while. "Confine to small space," I texted back. The turtle needed rest and two changes of clean water a day and good food. No more news from the owner and I presume all are well. The owner could not be contacted by phone once and I let sleeping dogs lie.
This ends my story of my 3 Ninja turtles and I hope you enjoy reading them. I got pictures of two of them for you to appreciate.
Then I covered his nostril for a few seconds so that he would open his mouth to breathe and then I would drop his medication into his mouth as I did with the smaller red-eared glider I treated last week. But this 7-inchx5-inch slider held his breath and I did not want to suffocate him.
There was no way to open his mouth unlike dogs and cats whom I could grip the upper jaws and prise the mouth open. Maybe I don't have the technique as turtles are rarely treated by me since most Singaporean owners do-it-yourself treatments. In any case, I had 3 sliders in a short time.
Remember my comments about things happening in threes? I had 3 gliders with eye problems in a short time and for the past year, not a turtle or tortoise seen. It was like famine and feast in the biblical sense.
The first one was a very young one with eyes closed for a day or two and came to see Dr Vanessa. I took over the case and I treated its eyes with eye drops since Dr Vanessa was busy and from her expressions, turtles are not one of her favourite things. After that, I the young lady owner to keep the water clean.
The second one was another small one, a week before this big boy came in. It was around 4-inch by 3-inch and the owner failed to open its eyes for the last two months and so sent to me for treatment. The owner had bought eye drops from the pet shop but since the eyes would not open, how to apply the eye drops? The glider's dried prawn and commercial food and eye drops arrived with it as advised by me.
No hope, I thought. Two months and the mucous membranes of the mouth of this turtle was deadly bluish maroon. A cyanosis as if from cyanmide poisoning.
It needed antibiotics and vitamins. I opened its mouth when I pressed my finger against its nostrils and got its medicine. It opened its eyes partially on the 6th day and I sent it home for nursing. Now, this big boy just would not open his mouth despite me doing the same nostril tickling and covering as in turtle No. 2.
His owner sent him down to me for treatment as the glider's eyes remained tightly shut and swollen for the past two weeks. Dr Jason Teo received the turtle at night and left the treatment to me. I guess he's not into turtles as many vets don't really like treating this species.
"Is it Vitamin A deficiency?" the gentleman asked over the phone.
I said: "I don't know. Do you just feed the commercial turtle sticks?"
The owner said: "Usually. My mum will give some meat. I brought this turtle back from the U.S."
The turtle shell looked quite dirty and so I had the turtle four baths. Dirty cellular debris floated off the water. On Good Friday morning, I had this turtle in a blue bath tub meant for babies and let him have some morning sun for 10 minutes. I had to keep an eye on him in case stray dogs come and grab him. This time the bath water was cleaner and not polluted with brown stuff. My assistant complained to me about the turtle not co-operating in opening his mouth. We did manage to give some medication and I put him inside the crate. My assistant Mr Min advised me: "Put him in the baby bath tub with water." I said: "No, he may not be safe. What if he can climb over and fall down? Or horrors and nightmares! What if Dr Vanessa's dog eats him should he fall out of the bath tub while we are busy?
"Rule No. 1. It is always best to crate the turtle." I teach this young man who is qualified as a veterinarian in Myanmar and now works for me. I like feedback from staff as there may be new angles and perspectives. But no turtle is going to run away or be eaten while under my care.
Then on the 4th day, on a bright sunshine Sunday morning, I got the turtle out for another bath. Wow, his eyes were opened. That was great. "Should he stay one or two days longer?" the owner asked me as the turtle had just opened his eyes. "No need to," my policy is to get the animals home as soon as possible to their well loved home to recuperate. Yet, around 4 hours later, the owner texted me to say that the turtle had closed his eyes. Why? I don't know but I presumed that given the freedom of the whole apartment to wander, this turtle must have been exhausted. I advised observation. Then the owner texted to say that the turtle did open his eyes for a while. "Confine to small space," I texted back. The turtle needed rest and two changes of clean water a day and good food. No more news from the owner and I presume all are well. The owner could not be contacted by phone once and I let sleeping dogs lie.
This ends my story of my 3 Ninja turtles and I hope you enjoy reading them. I got pictures of two of them for you to appreciate.
418. Sudden onset "Shortness of breath and panting" & toilet-training a puppy
E-MAIL TO DR SING DATED APRIL 26, 2011
On Mon, Apr 25, 2011 at 1:03 PM, ...@yahoo.com.sg> wrote:
Hi Dr Sing,
it's me again. Actually I've a question in mind and was wondering if you're able to advise me. My Cookie has just turned 1 yr old 2 months ago. Every 2-3 months, he would pant very hard and gasping for breath for about 1 - 2 mins, so far I've seen him like that for about 3 times, however after every incident, he'll return to normal again like nothing has happened.
Is this common? Does dog gets asthma as well? We often bring him for long walks and he seems to enjoy and doesn't pant at all. I'm getting very worried, should I bring him to the vet asap?
Thanks & Regards,
XXX
E-MAIL REPLY FROM DR SING DATED APR 26, 2011
Hi
I thank you for the email. Cookie's condition is not common. It is hard to diagnose what is the problem without examination and X-rays (pharyngeal area, heart, lungs). Consult your vet asap if the problem persists as it is not easy to diagnose.
UPDATE: APRIL 26, 2011. It was one year ago that I got the following e-mail from Cookie's owner. Toilet-training queries by e-mail from her and my reply in CAPITAL LETTERS. It is rare to get the owner's point of views and problems as regards toilet-training so well written. As the situation for each owner, the puppy and living space is unique, affecting the toilet-training success, there is no one-stop solution but the basic principles of confinement, perseverance and positive reinforcement training are necessary for success.
On Tue, Apr 27, 2010 at 5:36 PM, ...@yahoo.com.sg> wrote:
Hi Dr Sing,
I’ve been reading up your toilet training blog and find it very useful when toilet training my puppy. However, I still have a few queries. I’m a first timer raising up a puppy and hence has been quite stress up. I’ve accompanied my puppy for the first 3 days (almost keeping him within my sight) and observed the following:
My puppy is a mix breed of Chihuahua and Pomeranian, 3 months named Cookie. He was with us since 24 Apr 10.
The pet shop owner came with a crate with wire flooring and a pee pan below. Initially I try to carry Cookie to the bathroom after nap/food with newspapers laid on the floor but was unsuccessful. Cookie usually poos twice a day, 1 in the early morning and another one in weird timing. I realized that he only pees in the middle of the crate; I supposed it’s due to the urine smell. He pooed everywhere though.
COOKIE IS USED TO THIS WIRE FLOOR SYSTEM. HE WAS IN THE PET SHOP WITH SUCH A SYSTEM. AS TO POOPING EVERYWHERE, ARE YOU SURE? Where is his sleeping area? Is the crate too small?
XXX: So far we've not really let him outta his crate for too long, only wanted him to get some exercise and will put him back aft 10 - 15 mins. We try to bring him outta his crate at least 3 times a day. He drinks a lot too esp aft play outside the crate. As for the crate size, please advise if it's too small or too big based on the attached pictures.
CRATE SIZE OK
QUESTION 1: Do you think Cookie will poo in the middle like where he used to pee if I spray those anti-pee/anti-poo spray (given by my friend) on those area that I don’t want him to do pee/poo? The spray has a strong smell and I'm contemplating to use it.
YOU CAN TRY. THE BEST IS TO ENSURE THAT HIS SLEEPING AND EATING AREAS ARE FURTHEST AWAY FROM THE POOPING AREA AND
THE MIDDLE OF THE CRATE.
XXX: I tried spraying on the red rubber mat and Cookie refused to eat after that. I guess its due to the pungent smell. He continues his eating after I wiped the mat.
SPRAY IS NOT VERY USEFUL IN MANY CASES
QUESTION 2: It seems like he’s trained to pee/poo in the crate. Is that a good idea? It’s ideal for us since we are working. However, if we bring Cookie out eg. to a friend’s place, will he pee/poo everywhere since there’s no crate?
YOU MAY NEED TO BRING YOUR CRATE ALONG. COOKIE WILL PEE AND POOP ANYWHERE IF LET ALONE FOR THE FIRST 2-4 WEEKS as he is not fully house broken.
XXX: how do we determine if a puppy is fully house broken?
WHEN THE PUPPY KNOWS WHERE TO PEE AND POOP IN AREA REQUIRED BY THE OWNER. E.G. PAPER TRAINED PUPPY WILL ELIMINATE ON PAPERS ONLY AT ALL TIMES, UNLESS THERE IS NO PAPER. OR HOP INTO CRATE WHEN HE NEEDS TO ELIMINATE AND NOWHERE ELSE. OR TO A SPOT IN THE GARDEN.
QUESTION 3: Cookie seems to be stepping hard on his own poo when all of us are asleep. He’s also seems to be shifting them around. I can see portions of it at different areas of the crate. We also caught him eating his own poo once. How do we prevent such action from happening especially when we are all asleep?
EATING STOOLS IS A COMMON COMPLAINT. YOU MAY NEED TO REMOVE STOOLS PROMPTLY. IF NOT PRACTICAL, YOU MAY NEED OTHER METHODS I had mentioned in my blog. These are not guaranteed to succeed.
XXX: Will try a few of the methods and update you on the improvement.
QUESTION 4: When I let him out to play in the living room, will it be better to leave the crate door open and let him run to the crate to pee/poo? YES. HOWEVER, MONITOR HIM CLOSELY SO THAT HE DOES NOT PEE/POOP OUTSIDE THE CRATE. KEEP ALL DOORS OF BEDROOMS CLOSED.
XXX: So far he hasn't poo outside but has an accidental pee just outside the toilet.
Or will it be better to lay newspapers on a pee pan (given by my friend) with Cookie’s urine smell at a corner so he can pee/poo when he’s out playing and need not rush back to the crate? DECIDE ON ONE METHOD - CRATE WITH WIRE FLOORING OR NEWSPAPERS FOR THE NEXT 2-4 WEEKS IF YOU WANT EARLY SUCCESS. In the Crate method, your dog will then use the Crate as the toilet area and outside as his den in 2-4 weeks, in most cases. So, you just clean the crate. Later, you can buy the GRATE + PEE PAN which is actually the same as the lower half of your present crate, without the enclosed vertical walls.
XXX: "In the Crate method, your dog will then use the Crate as the toilet area and outside as his den in 2-4 weeks, in most cases. So, you just clean the crate." When you said "outside as his den in 2 - 4 weeks", are you saying that Cookie will want to sleep outside of his crate in 2 - 4 weeks?
DEPENDS ON THE TYPE OF TOILET TRAINING PROVIDED BY THE OWNER IN THE FIRST 2-4 WEEKS.
MOST PUPPIES WILL SLEEP OUTSIDE THE CRATE AS THERE IS FREEDOM. JUST GOES INTO THE CRATE'S WIRE FLOORING TO PEE AND POOP. OTHER SMALL BREEDS WILL SLEEP INSIDE THE CRATE AND ELIMINATE OUTSIDE (ON NEWSPAPERS).
As for Grate & Pee Pan, can I just used the current pee tray and removed the vertical walls since it's similar to the one you recommended?
OK
I've let him out of the crate twice on 26 Apr and surprisingly, he climbs back to his crate when he's thirsty after running a few rounds. I see that as a good sign of recognising his own den?
FOCUS ON CRATE TRAINING FOR THE NEXT 2-4 WEEKS, SINCE YOU ARE WORKING AND HAVE NO TIME. IF YOU START PAPER-TRAINING, YOU WILL NEED TO FOCUS ON PAPER TRAINING. The puppy gets confused as to what you want.
XXX: Will heed your advice and focus on crate training for the next 2 - 4 weeks.
YOUR PICTURE SOLVES THE MYSTERY OF WHY YOUR PUPPY PEES EXACTLY IN THE CENTRE. THE PUPPY 'FEELS' THE FLOORING AND IS USED TO THE WIRED FLOORING OF THE PET SHOP. SO HE PEES IN THE CENTRE SINCE YOUR LEFT 1/3 AND RIGHT 1/3 HAS RUBBER MATS WITH A DIFFERENT FEELING.
IN THEORY, YOU SHOULD HAVE ONLY RUBBER MATS ON THE RIGHT 1/3, THE WATER BOTTLE ON THE RIGHT 1/3 FRONT PART AND FEEDING NEAR THE WATER BOTTLE.
SO THE LEFT 2/3 IS THE WIRE FLOORING INTENDED TO BE A TOILET AREA. WIRE FLOOR GRATING. THIS WILL NOT CONFUSE THE PUPPY AS IT DOES "FEEL" THE FLOORING AS WELL AS DETECT THE URINE SMELL IN THE NEWSPAPERS BELOW FOR PEEING AND POOPING.
I HOPE YOU KNOW WHAT I AM WRITING ABOUT.
Sorry for the long post and thank you for the time to read my email, I would be very much delighted to receive your reply J
Regards,
XXX
--------------------------------------------------------------------------------------------------------
On Wed, Apr 28, 2010 at 10:42 PM, ........@yahoo.com.sg> wrote:
Hi Dr Sing,
as promised, I've attached 2 pictures of Cookie's crate & pee pan. By the way my mum is a housewife but she goes out like 2 - 3 days a week and hence Cookie is not under full supervision on these days. I'll have to follow the way a working adult trains his/her puppy.
Hope it helps. I've also added further comments in my email to you (her comments are in the above email).
From: Kong Yuen Sing <99pups@gmail.com>
To: ...@yahoo.com.sg>
Sent: Thursday, 29 April 2010 05:34:35
Subject: Re: Toilet Training My lovely darling Cookie(Chihuahua x Pom)
SAW ONE PICTURE.
FORTUNATELY, YOU EMAIL PICTURES AS I WAS WONDERING WHY YOUR PUPPY PEES IN THE CENTRE ALL THE TIME. FROM YOUR PICTURE, YOU HAVE RUBBER MATS WITH HOLES ON THE LEFT 1/3 AND RIGHT 1/3 WITH THE MIDDLE BEING THE ORIGINAL WIRE FLOORING OF THE GRATE. IN THE LEFT 1/3,
THE BACK HALF OF THE LEFT IS THE POOPING AREA, THE FRONT PART IS THE FEEDING AND WATER AREA.
THE BACK HALF OF THE RIGHT IS THE SLEEPING CLEAN AREA.
THE RIGHT 1/3 IS THE CLEAN AREA AND SO HE DOES NOT PEE AND POOP THERE. HOWEVER THE LEFT 1/3 IS ALSO THE DRINKING BOTTLE AND FEEDING AREA. SO THE POOR PUPPY HAS TO WALK DIAGONALLY PAST THE SOILED CENTRE (WHERE HE PEES) TO GOTO THE WATER BOTTLE ON THE FRONT RIGHT.
I WILL RECOMMEND THAT THE FRONT OF THE RIGHT 1/3 AREA BE THE AREA WHERE THE PUPPY EATS AND DRINKS. THAT MEANS THE WATER BOTTLE SHOULD BE ON THE RIGHT, NOT ON THE LEFT.
IF YOU CAN, SEND ME 2 PICTURES IN .JPG FOR MY RECORDING PURPOSES.
E-MAIL REPLY FROM DR SING DATED SEP 23, 2010
From your email, I have the following observations:
1. Cookie is an adult dog now. He can be neutered anytime.
2. As an adult male dog, he wants to keep his den (crate) clean and so he waits till you let him out to eliminate.
3. As a male dog, he wants to urine-mark his territory (natural instinct). So he pees everywhere. It is not that he "forgets" but that when you are around, he has to behave himself otherwise he may get punishment.
4. As a male dog, he may want to mark his territory with poop although most male dogs mark with urine.
5. Solutions:
5.1. Neutering as early as 6 months may reduce his urine-poop marking but you have delayed this. Still it is not too late although it may not be as effective.
5.2 Neutralise your flooring with white vinegar: water in 3 parts to 1 part respectively.
5.3 Confine the dog to his crate or to a small toilet area for the next 264 weeks after neutering.
5.4 Every day, twice a day, after meals, bring him outdoors to eliminate. Praise and reward with dog treat when he eliminates outdoors in an area not used by members of the public.
5.4.1 Pick up the poop with papers and dispose properly. Going outdoors is a positive "reward" and he will learn not to dirty the whole apartment which is his "den". This takes patience and time. Many owners find the above-mentioned tips to be useful.
6. Adult dogs are harder to toilet-train but you need to have a routine for him now. He must have realised that you are his "subordinate" and this is natural for dogs. Dogs need a firm leader and I believe you are gentle towards him when he is growing up. Now, he thinks you are his follower. Therefore, you need to be a leader and start with him going outdoors at least once a day (morning and/or evening).
As blogger.com can't do proper tabulations, goto:
http://www.bekindtopets.com/stories/20110434chihuahuaxpom-toilet-training-emails-drsing-toapayohvets-singapore.htm
to read in proper layout.
On Mon, Apr 25, 2011 at 1:03 PM, ...@yahoo.com.sg> wrote:
Hi Dr Sing,
it's me again. Actually I've a question in mind and was wondering if you're able to advise me. My Cookie has just turned 1 yr old 2 months ago. Every 2-3 months, he would pant very hard and gasping for breath for about 1 - 2 mins, so far I've seen him like that for about 3 times, however after every incident, he'll return to normal again like nothing has happened.
Is this common? Does dog gets asthma as well? We often bring him for long walks and he seems to enjoy and doesn't pant at all. I'm getting very worried, should I bring him to the vet asap?
Thanks & Regards,
XXX
E-MAIL REPLY FROM DR SING DATED APR 26, 2011
Hi
I thank you for the email. Cookie's condition is not common. It is hard to diagnose what is the problem without examination and X-rays (pharyngeal area, heart, lungs). Consult your vet asap if the problem persists as it is not easy to diagnose.
UPDATE: APRIL 26, 2011. It was one year ago that I got the following e-mail from Cookie's owner. Toilet-training queries by e-mail from her and my reply in CAPITAL LETTERS. It is rare to get the owner's point of views and problems as regards toilet-training so well written. As the situation for each owner, the puppy and living space is unique, affecting the toilet-training success, there is no one-stop solution but the basic principles of confinement, perseverance and positive reinforcement training are necessary for success.
On Tue, Apr 27, 2010 at 5:36 PM, ...@yahoo.com.sg> wrote:
Hi Dr Sing,
I’ve been reading up your toilet training blog and find it very useful when toilet training my puppy. However, I still have a few queries. I’m a first timer raising up a puppy and hence has been quite stress up. I’ve accompanied my puppy for the first 3 days (almost keeping him within my sight) and observed the following:
My puppy is a mix breed of Chihuahua and Pomeranian, 3 months named Cookie. He was with us since 24 Apr 10.
The pet shop owner came with a crate with wire flooring and a pee pan below. Initially I try to carry Cookie to the bathroom after nap/food with newspapers laid on the floor but was unsuccessful. Cookie usually poos twice a day, 1 in the early morning and another one in weird timing. I realized that he only pees in the middle of the crate; I supposed it’s due to the urine smell. He pooed everywhere though.
COOKIE IS USED TO THIS WIRE FLOOR SYSTEM. HE WAS IN THE PET SHOP WITH SUCH A SYSTEM. AS TO POOPING EVERYWHERE, ARE YOU SURE? Where is his sleeping area? Is the crate too small?
XXX: So far we've not really let him outta his crate for too long, only wanted him to get some exercise and will put him back aft 10 - 15 mins. We try to bring him outta his crate at least 3 times a day. He drinks a lot too esp aft play outside the crate. As for the crate size, please advise if it's too small or too big based on the attached pictures.
CRATE SIZE OK
QUESTION 1: Do you think Cookie will poo in the middle like where he used to pee if I spray those anti-pee/anti-poo spray (given by my friend) on those area that I don’t want him to do pee/poo? The spray has a strong smell and I'm contemplating to use it.
YOU CAN TRY. THE BEST IS TO ENSURE THAT HIS SLEEPING AND EATING AREAS ARE FURTHEST AWAY FROM THE POOPING AREA AND
THE MIDDLE OF THE CRATE.
XXX: I tried spraying on the red rubber mat and Cookie refused to eat after that. I guess its due to the pungent smell. He continues his eating after I wiped the mat.
SPRAY IS NOT VERY USEFUL IN MANY CASES
QUESTION 2: It seems like he’s trained to pee/poo in the crate. Is that a good idea? It’s ideal for us since we are working. However, if we bring Cookie out eg. to a friend’s place, will he pee/poo everywhere since there’s no crate?
YOU MAY NEED TO BRING YOUR CRATE ALONG. COOKIE WILL PEE AND POOP ANYWHERE IF LET ALONE FOR THE FIRST 2-4 WEEKS as he is not fully house broken.
XXX: how do we determine if a puppy is fully house broken?
WHEN THE PUPPY KNOWS WHERE TO PEE AND POOP IN AREA REQUIRED BY THE OWNER. E.G. PAPER TRAINED PUPPY WILL ELIMINATE ON PAPERS ONLY AT ALL TIMES, UNLESS THERE IS NO PAPER. OR HOP INTO CRATE WHEN HE NEEDS TO ELIMINATE AND NOWHERE ELSE. OR TO A SPOT IN THE GARDEN.
QUESTION 3: Cookie seems to be stepping hard on his own poo when all of us are asleep. He’s also seems to be shifting them around. I can see portions of it at different areas of the crate. We also caught him eating his own poo once. How do we prevent such action from happening especially when we are all asleep?
EATING STOOLS IS A COMMON COMPLAINT. YOU MAY NEED TO REMOVE STOOLS PROMPTLY. IF NOT PRACTICAL, YOU MAY NEED OTHER METHODS I had mentioned in my blog. These are not guaranteed to succeed.
XXX: Will try a few of the methods and update you on the improvement.
QUESTION 4: When I let him out to play in the living room, will it be better to leave the crate door open and let him run to the crate to pee/poo? YES. HOWEVER, MONITOR HIM CLOSELY SO THAT HE DOES NOT PEE/POOP OUTSIDE THE CRATE. KEEP ALL DOORS OF BEDROOMS CLOSED.
XXX: So far he hasn't poo outside but has an accidental pee just outside the toilet.
Or will it be better to lay newspapers on a pee pan (given by my friend) with Cookie’s urine smell at a corner so he can pee/poo when he’s out playing and need not rush back to the crate? DECIDE ON ONE METHOD - CRATE WITH WIRE FLOORING OR NEWSPAPERS FOR THE NEXT 2-4 WEEKS IF YOU WANT EARLY SUCCESS. In the Crate method, your dog will then use the Crate as the toilet area and outside as his den in 2-4 weeks, in most cases. So, you just clean the crate. Later, you can buy the GRATE + PEE PAN which is actually the same as the lower half of your present crate, without the enclosed vertical walls.
XXX: "In the Crate method, your dog will then use the Crate as the toilet area and outside as his den in 2-4 weeks, in most cases. So, you just clean the crate." When you said "outside as his den in 2 - 4 weeks", are you saying that Cookie will want to sleep outside of his crate in 2 - 4 weeks?
DEPENDS ON THE TYPE OF TOILET TRAINING PROVIDED BY THE OWNER IN THE FIRST 2-4 WEEKS.
MOST PUPPIES WILL SLEEP OUTSIDE THE CRATE AS THERE IS FREEDOM. JUST GOES INTO THE CRATE'S WIRE FLOORING TO PEE AND POOP. OTHER SMALL BREEDS WILL SLEEP INSIDE THE CRATE AND ELIMINATE OUTSIDE (ON NEWSPAPERS).
As for Grate & Pee Pan, can I just used the current pee tray and removed the vertical walls since it's similar to the one you recommended?
OK
I've let him out of the crate twice on 26 Apr and surprisingly, he climbs back to his crate when he's thirsty after running a few rounds. I see that as a good sign of recognising his own den?
FOCUS ON CRATE TRAINING FOR THE NEXT 2-4 WEEKS, SINCE YOU ARE WORKING AND HAVE NO TIME. IF YOU START PAPER-TRAINING, YOU WILL NEED TO FOCUS ON PAPER TRAINING. The puppy gets confused as to what you want.
XXX: Will heed your advice and focus on crate training for the next 2 - 4 weeks.
YOUR PICTURE SOLVES THE MYSTERY OF WHY YOUR PUPPY PEES EXACTLY IN THE CENTRE. THE PUPPY 'FEELS' THE FLOORING AND IS USED TO THE WIRED FLOORING OF THE PET SHOP. SO HE PEES IN THE CENTRE SINCE YOUR LEFT 1/3 AND RIGHT 1/3 HAS RUBBER MATS WITH A DIFFERENT FEELING.
IN THEORY, YOU SHOULD HAVE ONLY RUBBER MATS ON THE RIGHT 1/3, THE WATER BOTTLE ON THE RIGHT 1/3 FRONT PART AND FEEDING NEAR THE WATER BOTTLE.
SO THE LEFT 2/3 IS THE WIRE FLOORING INTENDED TO BE A TOILET AREA. WIRE FLOOR GRATING. THIS WILL NOT CONFUSE THE PUPPY AS IT DOES "FEEL" THE FLOORING AS WELL AS DETECT THE URINE SMELL IN THE NEWSPAPERS BELOW FOR PEEING AND POOPING.
I HOPE YOU KNOW WHAT I AM WRITING ABOUT.
Sorry for the long post and thank you for the time to read my email, I would be very much delighted to receive your reply J
Regards,
XXX
--------------------------------------------------------------------------------------------------------
On Wed, Apr 28, 2010 at 10:42 PM, ........@yahoo.com.sg> wrote:
Hi Dr Sing,
as promised, I've attached 2 pictures of Cookie's crate & pee pan. By the way my mum is a housewife but she goes out like 2 - 3 days a week and hence Cookie is not under full supervision on these days. I'll have to follow the way a working adult trains his/her puppy.
Hope it helps. I've also added further comments in my email to you (her comments are in the above email).
From: Kong Yuen Sing <99pups@gmail.com>
To: ...@yahoo.com.sg>
Sent: Thursday, 29 April 2010 05:34:35
Subject: Re: Toilet Training My lovely darling Cookie(Chihuahua x Pom)
SAW ONE PICTURE.
FORTUNATELY, YOU EMAIL PICTURES AS I WAS WONDERING WHY YOUR PUPPY PEES IN THE CENTRE ALL THE TIME. FROM YOUR PICTURE, YOU HAVE RUBBER MATS WITH HOLES ON THE LEFT 1/3 AND RIGHT 1/3 WITH THE MIDDLE BEING THE ORIGINAL WIRE FLOORING OF THE GRATE. IN THE LEFT 1/3,
THE BACK HALF OF THE LEFT IS THE POOPING AREA, THE FRONT PART IS THE FEEDING AND WATER AREA.
THE BACK HALF OF THE RIGHT IS THE SLEEPING CLEAN AREA.
THE RIGHT 1/3 IS THE CLEAN AREA AND SO HE DOES NOT PEE AND POOP THERE. HOWEVER THE LEFT 1/3 IS ALSO THE DRINKING BOTTLE AND FEEDING AREA. SO THE POOR PUPPY HAS TO WALK DIAGONALLY PAST THE SOILED CENTRE (WHERE HE PEES) TO GOTO THE WATER BOTTLE ON THE FRONT RIGHT.
I WILL RECOMMEND THAT THE FRONT OF THE RIGHT 1/3 AREA BE THE AREA WHERE THE PUPPY EATS AND DRINKS. THAT MEANS THE WATER BOTTLE SHOULD BE ON THE RIGHT, NOT ON THE LEFT.
IF YOU CAN, SEND ME 2 PICTURES IN .JPG FOR MY RECORDING PURPOSES.
E-MAIL REPLY FROM DR SING DATED SEP 23, 2010
From your email, I have the following observations:
1. Cookie is an adult dog now. He can be neutered anytime.
2. As an adult male dog, he wants to keep his den (crate) clean and so he waits till you let him out to eliminate.
3. As a male dog, he wants to urine-mark his territory (natural instinct). So he pees everywhere. It is not that he "forgets" but that when you are around, he has to behave himself otherwise he may get punishment.
4. As a male dog, he may want to mark his territory with poop although most male dogs mark with urine.
5. Solutions:
5.1. Neutering as early as 6 months may reduce his urine-poop marking but you have delayed this. Still it is not too late although it may not be as effective.
5.2 Neutralise your flooring with white vinegar: water in 3 parts to 1 part respectively.
5.3 Confine the dog to his crate or to a small toilet area for the next 264 weeks after neutering.
5.4 Every day, twice a day, after meals, bring him outdoors to eliminate. Praise and reward with dog treat when he eliminates outdoors in an area not used by members of the public.
5.4.1 Pick up the poop with papers and dispose properly. Going outdoors is a positive "reward" and he will learn not to dirty the whole apartment which is his "den". This takes patience and time. Many owners find the above-mentioned tips to be useful.
6. Adult dogs are harder to toilet-train but you need to have a routine for him now. He must have realised that you are his "subordinate" and this is natural for dogs. Dogs need a firm leader and I believe you are gentle towards him when he is growing up. Now, he thinks you are his follower. Therefore, you need to be a leader and start with him going outdoors at least once a day (morning and/or evening).
As blogger.com can't do proper tabulations, goto:
http://www.bekindtopets.com/stories/20110434chihuahuaxpom-toilet-training-emails-drsing-toapayohvets-singapore.htm
to read in proper layout.
Saturday, April 23, 2011
417. Negligence lawsuit
I just read a Straits Times' report on a negligence suit against the doctors of Kandang Kerbau Hospital. The plaintiffs were the parents of a child who is not normal now since the doctors were alleged to have shifted the position of the endotracheal tube during the movement of the child. The endotracheal tube brings oxygen from the machine to the lungs. By shifting the position of the endotracheal tube, the oxygen was not delivered to the child and the child's brain was damaged, making her now unable to look after herself.
Was there medical negligence? Was there a lack of care by the doctors?
I refer to my real estate REA notes to pass my examinations in late May, some 6 weeks later by reviewing this real case.
1. WAS THERE MEDICAL NEGLIGENCE?
LAW OF TORT - NEGLIGENCE
To succeed in an action for negligence, the plaintiff must show that:
- the defendant owes him a duty of care - YES
- the defendant has beached that duty of care - NOT ADMITTED
- his breach causes damage/loss to the plaintiff - YES
- the damage/loss is not too remote (not controllable, not foreseeable, not an expert on a particular subject matter) - YES. THE DOCTORS WERE EXPERTS IN CARDIO-RESPIRATORY FIELD
2. WAS THERE A LACK OF CARE?
LAW OF TORT - DUTY OF CARE - TEST
Duty of Care - "But For" Test
A test of duty of care is: "You must take reasonable care to avoid acts and omissions that you can reasonably foresee, would be likely to injure your neighbour"
The cause of damage is established by the "but for" test:
The court will ask - would the plaintiff (patient, buyer, tenant, owner) has suffered the injury but for the defendant's (doctor's, agent's) negligence?
LAW OF TORT - DUTY OF CARE - BREACH
Standard of Care - Breach.
More important in professions requiring special skill or expertise, the person must exercise a reasonable standard of care that must be measured.
The standard of care is measured by the "reasonable man" test:
Whether the defendant's conduct fall below the standard of care which is expected of the reasonable man.
CONCLUSION
The Kandang Kerbau Hospital settled out of court (High Court's claim for damages must be above $250,000) without admitting liability and this was accepted by the parents. Otherwise, legal fees would be much more and the parents may win or lose the case.
P.S
The above incident reminds me of one case some 30 years ago. A vet spayed a dog. The dog became comatose during surgery, according to the operating vet who was not in private practice at that time.
The owner (a leading flight stewardess) was asked to take the dog home as the vet could not do anymore. I saw the dog. It was paddling and not able to live normally. So, was this a case of deprivation of oxygen during the spay or some reactions? I don't know. Many complications can occur during anaesthesia, in medicine and surgery and the only advice I can give is that one must not be complacent.
An endotracheal tube in veterinary medicine is shown below:
something wrong with blogger's layout: The picture is at:
http://www.sinpets.com/dogpix/20081124Tooth_ache_Old_Dalmatian_Bites_People_Singapore_ToaPayohVets.jpg
Was there medical negligence? Was there a lack of care by the doctors?
I refer to my real estate REA notes to pass my examinations in late May, some 6 weeks later by reviewing this real case.
1. WAS THERE MEDICAL NEGLIGENCE?
LAW OF TORT - NEGLIGENCE
To succeed in an action for negligence, the plaintiff must show that:
- the defendant owes him a duty of care - YES
- the defendant has beached that duty of care - NOT ADMITTED
- his breach causes damage/loss to the plaintiff - YES
- the damage/loss is not too remote (not controllable, not foreseeable, not an expert on a particular subject matter) - YES. THE DOCTORS WERE EXPERTS IN CARDIO-RESPIRATORY FIELD
2. WAS THERE A LACK OF CARE?
LAW OF TORT - DUTY OF CARE - TEST
Duty of Care - "But For" Test
A test of duty of care is: "You must take reasonable care to avoid acts and omissions that you can reasonably foresee, would be likely to injure your neighbour"
The cause of damage is established by the "but for" test:
The court will ask - would the plaintiff (patient, buyer, tenant, owner) has suffered the injury but for the defendant's (doctor's, agent's) negligence?
LAW OF TORT - DUTY OF CARE - BREACH
Standard of Care - Breach.
More important in professions requiring special skill or expertise, the person must exercise a reasonable standard of care that must be measured.
The standard of care is measured by the "reasonable man" test:
Whether the defendant's conduct fall below the standard of care which is expected of the reasonable man.
CONCLUSION
The Kandang Kerbau Hospital settled out of court (High Court's claim for damages must be above $250,000) without admitting liability and this was accepted by the parents. Otherwise, legal fees would be much more and the parents may win or lose the case.
P.S
The above incident reminds me of one case some 30 years ago. A vet spayed a dog. The dog became comatose during surgery, according to the operating vet who was not in private practice at that time.
The owner (a leading flight stewardess) was asked to take the dog home as the vet could not do anymore. I saw the dog. It was paddling and not able to live normally. So, was this a case of deprivation of oxygen during the spay or some reactions? I don't know. Many complications can occur during anaesthesia, in medicine and surgery and the only advice I can give is that one must not be complacent.
An endotracheal tube in veterinary medicine is shown below:
something wrong with blogger's layout: The picture is at:
http://www.sinpets.com/dogpix/20081124Tooth_ache_Old_Dalmatian_Bites_People_Singapore_ToaPayohVets.jpg
416. Good Friday's "Source Code"
Good Friday, April 22, 2011
A bright sunshine blue-sky day. The lady with the 2nd Dachshund was at Toa Payoh Vets when I arrived at 9.30 am to operate on her 2nd Dachshund (10-year-old male neutered) with two growths on the right side of the body. One appeared to be a large lipoma similar but 10% smaller as in the first Dachshund sibling I operated successfully on Tuesday.
Somehow, I felt that I was repeating a scenario as if I was going back in time and improving myself with this second repeat electro-surgery to remove a lipoma and another tumour from the Dachshund.
As if there was a Divine Power presenting me a repeat of my first surgery - report in "A fast-growing tumour in an old Dachshund - a lipoma or liposarcoma?" with website at:
http://kongyuensing.com/folder5/20110338lipoma-liposarcoma-old-dachshund-singapore-toapayohvets.htm
- which was done on the same breed (sibling Dachshund) at the same time (around 10 am), in the same place (Toa Payoh Vets operating room) and with the same procedure (xylazine 0.2 IM and isoflurane gas, then electro-surgical excision to excise the big lipoma out to show the owner, no bleeding during the operation due to electro-surgery). But the dog had dental scaling as requested by the owner. The dog worked up uneventfully as if from a nap and the happy owner took him back around 2 hours later (same time in going home and same happy ending).
However this time, I had the big lipoma to show to the owner as in the previous case, the Laboratory courier came to take it to the lab before the owner came 2 hours after surgery as she did for the Good Friday operation.
In the afternoon, I took time off to watch the movie "Source Code" which is a science fiction which reminds me of my above-mentioned Dachshund surgeries. As if I had experienced "Source Code" in the canine version. I will elaborate further below.
In the Source Code movie, Captain Colter Stevens is a decorated army helicopter pilot has had died. His body is kept alive and a source code (computer software) is inserted into his brain. The scientist sends him back to the past by activating the source code. He then appears as a teacher (another person) inside a moving train where the bomber is present but he has to find out the identity of the bomber and where the bomb is to prevent a second explosion which will follow this explosion. The first time he is sent back to the past, he cannot find the bomb or the bomber and the train explodes killing everybody including the teacher and a pretty girl who secretly loves this teacher.
At another time, he finds the bomb and takes the handphone attached to the bomb. But the train still explodes killing everybody. He is sent back to the past again. After a few times of going back to the past, he learns what to do and identifies the bomber. The story has a happy ending as he lives in the alternate universe with this girl he appears opposite her on the train and saves her from death. He gets to live and fall in love with this girl in an alternate world since he has prevented the first explosion.
P.S. My repeat surgery is a short canine version of the Source Code. It is not as thrilling as this popular move and will never be made into a film. There is only one repeat of the surgery for me, unlike Stevens but there is the happy ending. The dog owner as both Dachshunds are alive at the end of the surgery and she may have prevented nasty large liposarcomas from forming if she has had delayed surgery by a few years as the big lipomas were growing fast. As the outcome was great, I am also very happy as old dogs are very high anaesthetic risks and many vets will prefer not to operate.
P.S. The smaller tumour of around 3 cm x 3cm under the skin and near the breast looked yellowish. It could be a mammary tumour. I made a large excision and removed the nipple as well. I could see a small yellow spot of less than 2 mm x 2mm in the muscle area beneath this skin tumour. This was excised. Male dogs do get breast cancer but rarely. I did not send this small tumour for histopathology to save the owner some money as the lump was really small. Only this woman could detect it. It was "nodular" and present in the mammary area, like those of firm small starting breast tumours in the female dog.
I advised Hills' R/D diet for the two dogs and if that prevents lipoma formation by slimming the dogs down, I will let readers know in 2 years' time. These two dogs should live past 18 years of age as they are healthy at 10 years of age based on health screening of their blood and general physical examination.
I don't look forward to doing surgery of old dogs as it is not worth taking anaesthetic risks. These are high stress surgeries and I don't tempt fate. It is just too emotional for the owner, her family members, myself and my staff whenever a dog dies on the operating table.
The owner did bring her other dog to enquire about the backside bleeding. "It is not a problem," I said. The wound had closed and the bleeding was minor but present.
A bright sunshine blue-sky day. The lady with the 2nd Dachshund was at Toa Payoh Vets when I arrived at 9.30 am to operate on her 2nd Dachshund (10-year-old male neutered) with two growths on the right side of the body. One appeared to be a large lipoma similar but 10% smaller as in the first Dachshund sibling I operated successfully on Tuesday.
Somehow, I felt that I was repeating a scenario as if I was going back in time and improving myself with this second repeat electro-surgery to remove a lipoma and another tumour from the Dachshund.
As if there was a Divine Power presenting me a repeat of my first surgery - report in "A fast-growing tumour in an old Dachshund - a lipoma or liposarcoma?" with website at:
http://kongyuensing.com/folder5/20110338lipoma-liposarcoma-old-dachshund-singapore-toapayohvets.htm
- which was done on the same breed (sibling Dachshund) at the same time (around 10 am), in the same place (Toa Payoh Vets operating room) and with the same procedure (xylazine 0.2 IM and isoflurane gas, then electro-surgical excision to excise the big lipoma out to show the owner, no bleeding during the operation due to electro-surgery). But the dog had dental scaling as requested by the owner. The dog worked up uneventfully as if from a nap and the happy owner took him back around 2 hours later (same time in going home and same happy ending).
However this time, I had the big lipoma to show to the owner as in the previous case, the Laboratory courier came to take it to the lab before the owner came 2 hours after surgery as she did for the Good Friday operation.
In the afternoon, I took time off to watch the movie "Source Code" which is a science fiction which reminds me of my above-mentioned Dachshund surgeries. As if I had experienced "Source Code" in the canine version. I will elaborate further below.
In the Source Code movie, Captain Colter Stevens is a decorated army helicopter pilot has had died. His body is kept alive and a source code (computer software) is inserted into his brain. The scientist sends him back to the past by activating the source code. He then appears as a teacher (another person) inside a moving train where the bomber is present but he has to find out the identity of the bomber and where the bomb is to prevent a second explosion which will follow this explosion. The first time he is sent back to the past, he cannot find the bomb or the bomber and the train explodes killing everybody including the teacher and a pretty girl who secretly loves this teacher.
At another time, he finds the bomb and takes the handphone attached to the bomb. But the train still explodes killing everybody. He is sent back to the past again. After a few times of going back to the past, he learns what to do and identifies the bomber. The story has a happy ending as he lives in the alternate universe with this girl he appears opposite her on the train and saves her from death. He gets to live and fall in love with this girl in an alternate world since he has prevented the first explosion.
P.S. My repeat surgery is a short canine version of the Source Code. It is not as thrilling as this popular move and will never be made into a film. There is only one repeat of the surgery for me, unlike Stevens but there is the happy ending. The dog owner as both Dachshunds are alive at the end of the surgery and she may have prevented nasty large liposarcomas from forming if she has had delayed surgery by a few years as the big lipomas were growing fast. As the outcome was great, I am also very happy as old dogs are very high anaesthetic risks and many vets will prefer not to operate.
P.S. The smaller tumour of around 3 cm x 3cm under the skin and near the breast looked yellowish. It could be a mammary tumour. I made a large excision and removed the nipple as well. I could see a small yellow spot of less than 2 mm x 2mm in the muscle area beneath this skin tumour. This was excised. Male dogs do get breast cancer but rarely. I did not send this small tumour for histopathology to save the owner some money as the lump was really small. Only this woman could detect it. It was "nodular" and present in the mammary area, like those of firm small starting breast tumours in the female dog.
I advised Hills' R/D diet for the two dogs and if that prevents lipoma formation by slimming the dogs down, I will let readers know in 2 years' time. These two dogs should live past 18 years of age as they are healthy at 10 years of age based on health screening of their blood and general physical examination.
I don't look forward to doing surgery of old dogs as it is not worth taking anaesthetic risks. These are high stress surgeries and I don't tempt fate. It is just too emotional for the owner, her family members, myself and my staff whenever a dog dies on the operating table.
The owner did bring her other dog to enquire about the backside bleeding. "It is not a problem," I said. The wound had closed and the bleeding was minor but present.
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