Today I saw a case of rectal prolapse of over one week in a rabbit. The lady brought her in as there was bleeding. Stools were hard.
"The rabbit has to eat daily and passes stool frequently. When I stitch up the anus after pushing in the rectal tissues, I need to take out the stitches after 3 days."
7 days would be better for the rectal tissues to heal.
Monday, September 16, 2013
1137. Be meticulous
Today the lab phoned to say that the 3 blood tubes sent were not labelled. But my vet assistant swore he had done so, including the urine bottle sent on Saturday.
"The complaint is from the blood tubes," I was angry with him. "This is not the first time and it should not happen at all after the first time. I had just advised you to label the tubes before taking the blood but you would prefer to label them after taking the blood."
The lab girl said the tubes were not labelled, otherwise why should she waste her time phoning me. For unlabelled tubes, no blood test would be done. "I want to see the tubes, not just an image" I said. After all, Naing was adamant he did write. The lab would not want to return the tubes.
If he had adopted my system, he would not have neglected to do it. It is possible that the lab had mis-placed the tubes and said that they were not labelled but I doubt it. Many young people would prefer to do it their own way and it takes a lot of patience to supervise them.
I asked him to sit down to have a chat. "You are veterinary graduate from Myanmar and you will know the importance of proper recording," I said. "There must be a system of labelling tubes and I have given you a new system because the other vets and staff had made similar mistakes of not labelling in the submission." I hope he will not repeat the 3rd time.
Many young employees and interns may not accept advices and instructions from the old persons and they waste time in their work due to inefficiency or mistakes. This seems to be part of the culture of the younger generation used to the good life and affluence of Singapore and the region over the last 30 years. Patience is needed but they should be aware that they brand themselves as incompetent and risk being fired from the job if they persist in doing a bad job.
"The complaint is from the blood tubes," I was angry with him. "This is not the first time and it should not happen at all after the first time. I had just advised you to label the tubes before taking the blood but you would prefer to label them after taking the blood."
The lab girl said the tubes were not labelled, otherwise why should she waste her time phoning me. For unlabelled tubes, no blood test would be done. "I want to see the tubes, not just an image" I said. After all, Naing was adamant he did write. The lab would not want to return the tubes.
If he had adopted my system, he would not have neglected to do it. It is possible that the lab had mis-placed the tubes and said that they were not labelled but I doubt it. Many young people would prefer to do it their own way and it takes a lot of patience to supervise them.
I asked him to sit down to have a chat. "You are veterinary graduate from Myanmar and you will know the importance of proper recording," I said. "There must be a system of labelling tubes and I have given you a new system because the other vets and staff had made similar mistakes of not labelling in the submission." I hope he will not repeat the 3rd time.
Many young employees and interns may not accept advices and instructions from the old persons and they waste time in their work due to inefficiency or mistakes. This seems to be part of the culture of the younger generation used to the good life and affluence of Singapore and the region over the last 30 years. Patience is needed but they should be aware that they brand themselves as incompetent and risk being fired from the job if they persist in doing a bad job.
1136. A resourceful pet relocation man
"The life-style of the top (expatriate) dog is definitely hard to imagine," I said to this senior citizen who is much active in his pet relocation business. We met today at the practice where I had brought a poodle for a digital x-ray of the paws. He told me he served the most senior management and in one house, there were 4 Rhodesian Ridgebacks staying in a living room and cared for by 3 servants. This big house has two living rooms.
Once he saw a very old wobbly big Rottweiler to be shipped back to Texas, USA. He asked the expatriate how old the dog was. "15 years old," the top dog said. The journey would be 33 hours from Singapore to Texas by the usual airlines.
"At the end of the 33 hours, the dog would be exhausted or dead," I speculated. But he had his contacts and found a Singapore Airlines flight via Hong Kong and this trip took 18 hours. "At the meeting in Texas, the old dog was standing tall and pouncing on his expatriate owner."
He told me of his business plan to expand the business in partnership with an owner of a big boarding house by having an office in Changi Airport. All the airlines would contact him to relocate dogs and pets.
But this partner wanted another partner and he did not want 3 partners and so he backed out. "There must be a reason," I said. "Nobody would want another partner to share the profits. What happened to this prospective partner and what does he do?"
"He imports wine and other goods," the retiree said. "The Changi Airport gives an office only to people who has a track record of moving at least 50,000 tons of goods."
That is the catch. The authorities want big proven companies and so it is the little man that cannot be given the opportunity with no money to prosper. But he is still serving good clientele.
Once he saw a very old wobbly big Rottweiler to be shipped back to Texas, USA. He asked the expatriate how old the dog was. "15 years old," the top dog said. The journey would be 33 hours from Singapore to Texas by the usual airlines.
"At the end of the 33 hours, the dog would be exhausted or dead," I speculated. But he had his contacts and found a Singapore Airlines flight via Hong Kong and this trip took 18 hours. "At the meeting in Texas, the old dog was standing tall and pouncing on his expatriate owner."
He told me of his business plan to expand the business in partnership with an owner of a big boarding house by having an office in Changi Airport. All the airlines would contact him to relocate dogs and pets.
But this partner wanted another partner and he did not want 3 partners and so he backed out. "There must be a reason," I said. "Nobody would want another partner to share the profits. What happened to this prospective partner and what does he do?"
"He imports wine and other goods," the retiree said. "The Changi Airport gives an office only to people who has a track record of moving at least 50,000 tons of goods."
That is the catch. The authorities want big proven companies and so it is the little man that cannot be given the opportunity with no money to prosper. But he is still serving good clientele.
1135. Myanmar stories - international investment
|
|||||||||||||
TOA
PAYOH VETS
1134. A Husky has an eyelid tumour irritating her
REPLY TO EMAIL FOR SURGERY APPOINTMENT
Sep 16, 2013
Hi
Thank you for your email. Pl bring the Husky in at around 11am on Friday Sep 20, 2013. Surgery and anaesthesia will be done using electro-surgery in the afternoon. She goes home at around 6 pm after recovery from anaesthesia. No food and water after 10 pm the night before.
EMAIL REPLY TO OWNER DATED SEP 16, 2013
Thank you for your energetic response. I am sorry that I do not permit all clients to be present at the surgery as I need to focus 100% on the anaesthesia of old dogs and thereby not getting anaesthetic deaths due to distractions or conversations.
In addition, the surgery room is small and you are welcome to inspect it.
The whole process takes around 30 minutes including pre-op preparation. It may take longer if there are complications like cardiac emergencies in which I have to revive the patient. With the owner present, there will be much emotional distress when such emergencies occur and distract me from my resuscitation of the patient. No vet can assume that the old dog will not have any cardiac or respiratory emergencies during anaesthesia and surgery and so it is best that the owner not be present.
In my younger days, I permited one lady to watch her hamster being operated for a small tumour as she requested. She fainted at the sight of blood when I excised the tumour. From that experience, I do not permit any owner to be present at surgery. Pl accept my apologies.
The dog needs to recover fully from anaesthesia and this takes around 2-4 hours for old dogs. That is why you pick the dog at around 6 pm.
Sunday, September 15, 2013
1133. Audit of my 2009 case. The vet must be able to deliver results?
Proximity is important for the time-pressed Singaporean dog owner. There are around 60 vet practices and so, there will be one down the road.
Recently an owner from Farrer Road phoned me as his other poodle was trembling and was unable to walk normally. His dog had seen two other vets and the second vet referred him to another vet for a CT scan which would cost $1500 - $2000.
He remembered me and phoned to confirm that I was still in business at Toa Payoh Vets, a 'corner unit in Toa Payoh Industrial Park'. After all, it was 4 years ago and he had only consulted me on this male poodle, 5 years old, with blood in the urine in Oct 1, 2009. The dog had vomited many times brownish black fluid for a few days at 2-3 x per day and had passed blood in the urine for 7 days. The dog was severely dehydrated and had a very painful bladder. Surgery to remove the stones would be done on the same day and so I gave him this poor survival chance on the operating table. After surgery and 8 days of hospitalisation, he took the dog home and I did not hear from him again.
In the years to follow, at least 30 new vet practices were started and so proximity was the draw for most owners and the older practices bleed clientele. I was not spared the reality of life.
"You gave 20% chance of survival for my poodle to survive the bladder stone surgery in 2009," he said. "He is still alive."
Today, Sunday Sep 15, 2013, I audit my case record of this dog's bladder stone surgery and to assess as to why I gave 20% chance of survival on the operating table.
Poodle,
Oct 1, 2009
Haematuria for a few days and severe dehydration.
1. BLOOD TEST with significant abnormalities as follows:
ALT/SGOT 102 (<59 -="" 6.3="" 69.6="" br="" nbsp="" urea="">Creatinine 499 (89-177)
Total white cell count 38.9 (6-17)
N 85% Absolute 33
L 1.4% Absolute 0.54
M 13.5% Absolute 5.3
E 0.03% Absolute 0.01
B 0.31% Absolute 0.12
Overall there was a severe bacterial infection involving the kidneys although there was no fever.
2. URINE TEST
Brown and turbid. pH 8, SG 1.021, Nitrite +ve, Protein 2+, Ketones trace, Blood 4+, white blood cells 333, red blood cells >2250, Bacteria 3+. Crystals Nil.
3. SURGERY ON Oct 1, 2009.
Spikey stones removed.
The dog was hospitalised for 5 days and went home. No stone analysis or follow up was done owing to fianancial constraints. As the dog has recovered, the owner did not come back during the past 4 years. Now his other poodle has generalised tremors all over the body and head and he wanted a 3rd opinion as to what was causing this nervous disease. As the first 2 vets had not done a blood test, one is being done. The dog is under observation. "Not all nervous disease cases can be cured," I said to Intern Daniel. "This is likely to be a case of cerebellar disease."
Recently an owner from Farrer Road phoned me as his other poodle was trembling and was unable to walk normally. His dog had seen two other vets and the second vet referred him to another vet for a CT scan which would cost $1500 - $2000.
He remembered me and phoned to confirm that I was still in business at Toa Payoh Vets, a 'corner unit in Toa Payoh Industrial Park'. After all, it was 4 years ago and he had only consulted me on this male poodle, 5 years old, with blood in the urine in Oct 1, 2009. The dog had vomited many times brownish black fluid for a few days at 2-3 x per day and had passed blood in the urine for 7 days. The dog was severely dehydrated and had a very painful bladder. Surgery to remove the stones would be done on the same day and so I gave him this poor survival chance on the operating table. After surgery and 8 days of hospitalisation, he took the dog home and I did not hear from him again.
In the years to follow, at least 30 new vet practices were started and so proximity was the draw for most owners and the older practices bleed clientele. I was not spared the reality of life.
"You gave 20% chance of survival for my poodle to survive the bladder stone surgery in 2009," he said. "He is still alive."
Today, Sunday Sep 15, 2013, I audit my case record of this dog's bladder stone surgery and to assess as to why I gave 20% chance of survival on the operating table.
Poodle,
Oct 1, 2009
Haematuria for a few days and severe dehydration.
1. BLOOD TEST with significant abnormalities as follows:
ALT/SGOT 102 (<59 -="" 6.3="" 69.6="" br="" nbsp="" urea="">Creatinine 499 (89-177)
Total white cell count 38.9 (6-17)
N 85% Absolute 33
L 1.4% Absolute 0.54
M 13.5% Absolute 5.3
E 0.03% Absolute 0.01
B 0.31% Absolute 0.12
Overall there was a severe bacterial infection involving the kidneys although there was no fever.
2. URINE TEST
Brown and turbid. pH 8, SG 1.021, Nitrite +ve, Protein 2+, Ketones trace, Blood 4+, white blood cells 333, red blood cells >2250, Bacteria 3+. Crystals Nil.
3. SURGERY ON Oct 1, 2009.
Spikey stones removed.
The dog was hospitalised for 5 days and went home. No stone analysis or follow up was done owing to fianancial constraints. As the dog has recovered, the owner did not come back during the past 4 years. Now his other poodle has generalised tremors all over the body and head and he wanted a 3rd opinion as to what was causing this nervous disease. As the first 2 vets had not done a blood test, one is being done. The dog is under observation. "Not all nervous disease cases can be cured," I said to Intern Daniel. "This is likely to be a case of cerebellar disease."
Saturday, September 14, 2013
1132. Fur mites in rabbits
http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Leporacarus_Inf.htm
http://wildpro.twycrosszoo.org/Lists_HealthMan/FLOWCHARTDisease_Control/FLOWCHARTDiseaseInvestigation.htm#Surgical
http://wildpro.twycrosszoo.org/Lists_HealthMan/FLOWCHARTDisease_Control/FLOWCHARTDiseaseInvestigation.htm#Surgical
Subscribe to:
Posts (Atom)