Saturday, October 26, 2013

1127. My Jack Russell has a "fistula" - oro-chin fistulas?

Friday Oct 25, 2013

As there was no need for 2 vets on this Friday evening, I asked Dr Daniel to brief his client about the treatment and medication and to go home early at around 7.15 pm. We close at 8 pm. One of his clients came in a white Mercedes at around 7.45 pm to pick up his Jack Russell that had dental scaling.

I thought it was an ordinary case of dental scaling. He pointed to an open wound of around 8 mm x68 mm on the right lower jaw below the right lower premolar tooth.

"I was so happy when I saw similar cases of fistulas in your website," he pointed to this sore. "Now I know that my Jack Russell has a fistula".

"Why do you say that?" I doubted he knows what a fistula is but many Singapore dog owners are much more knowledgeable and informed nowadays.

"This wound has pus. It takes a long time to heal. It disappears and then appears. I have 6 Jack Russells and only this one has the problem. Sometimes the wound appears on the left side and also in the back side."
"Are you sure it is not due to a dog bite or self-inflicted scratching from the paws?"
"No, I am sure of that. My two female Jack Russells do fight with each other. Over him, I suppose."
"Do you have a video camera switched on 24 hours to monitor them since you are frequently overseas on business?"
"I am sure the sore is a fistula, as in your cases. I have consulted two other vets in the past 4 years but the sores below the side come back now and then. Now, it is the right side. It is a fistula!"
"What did the other vets recommend?" I asked.
"They said nothing is wrong and prescribe some mouth wash. But it is a fistula!"

I was skeptical.
But vet medicine is full of surprises. An oro-chin fistula is possible in theory.
"I have not seen fisulas on the lower jaw," I replied. "Almost 100% are from the upper jaw below the eye! They are oro-nasal fistulas. But it is possible."
I asked if the dog bites and since he appeared docile, I opened the mouth to examine the white teeth scaled by Dr Daniel in the afternoon.  The teeth were sound in this 6-year-old dog. Except for 4 canine teeth which had decayed brown as their sharp tips had been cut off by somebody to prevent this Jack Russell from inflicting deep bite wounds on family members. This was done some 5 years ago.
Decay had set inside the four canine teeth. The lower right had a cracked side of 3 mm x 2 mm brown exposed dentine.

It is just possible that the infection had gone inside the pulp cavity of the lower canines and into the side of the gums. I asked my assistant Naing to flash his phone light onto the right lower gum. There was a small hole with blood. This hole was 3 mm x 2 mm and was bleeding.
"Check the other left lower gum as well," I said to Naing. "This is for comparison."
There was also a much smaller hole also below the first lower premolar. So, it is possible that infection had gone into the roots and seeped out through the gums laterally.

The owner would return 10 days later and get X-rays done. He was a busy man in his 50s but he loves the dog very much and is confidently sure he has a fistula! An oro-chin fistula due to decay in the fractured canine. Their pulp cavity in the long root became infected and the bacterial infection seeped downwards to the tip of the roots over the last 4 years. The infection leaked out from the long root and into the skin causing open sores with pus.

It is a hypothesis. The treatment is to extract the whole planed canine teeth of the left and right and there should be no oro-chin fistulas. Does it sound logical to readers?  .



 

1126. Protected by "Ah Pek"

On my return to Singapore on Oct 24, 2013, after a tiring 14-day packaged tour to visit the Niagara Falls and New York, my first client was the man who believes in "Ah Pek".  He parked his shiny blue car and came in to buy the 2nd bag of H/D dry food for his 10-year-old Chihuahua with heart disease.

"How's the old dog?" I asked.
"Much more active and energetic," he had given the furosemide tablets regularly nowadays.
He had just returned from Thailand and had donated some money for 30 coffins for the poor. I introduced him to Dr Daniel to open his mind. I asked him to relate his personal stories of "Ah Pek", such stories being unbelievable as compared to hard science, facts and empirical evidence of training of Dr Daniel. I had written some of his encounters in an earlier report.

He was an excellent story teller using hands to illustrate and Hokkien slangs to emphasize his experiences and spoke for over 15 minutes. I doubt Dr Daniel believed in his testimonials of being protected by "Ah Pek" and so I switched his focus to talking about Porsches, Maseratis, Lamborghinis, Ferraris and BMWs, a subject of interest to young men particularly. This was his niche as he was into advising rich car owners who want to buy those sports cars, boost them, modify them and race them in Johor. He was a sports car consultant as he had in-depth knowledge and was owning one Japanese brand modified to give off those "voom" sounds from the exhaust pipe and attracting LTA and Traffic Police cops on bikes.

THE GREEN PAPER GIVES PROTECTION
There were 2 instances when the green paper given by his medium protected him. He would have to burn the paper, mix the ashes with water and drink it.
1. After a severe bike accident in Bugis in which his forehead hit the road, his doctor had told him that his head needed to be opened up to access and repair his fractured facial bones below both his eyes. He asked his friend to consult the medium and was given the green paper with its chops and was asked to drink the ashes.
"Bro," he said to Dr Daniel. "In the early hours of the morning on the day of the surgery, I was asleep in the hospital. I heard loud foot-steps outside my room, as if there was dragging of chains. I closed my eyes tightly and prayed that my brain would not be opened up for the surgery. After the surgery, the doctor told me that I did not need my forehead to be cut open and my facial fractures were repaired!"
Since he was normal now, I don't know whether Dr Daniel was skeptical or believed in him.
"Bro," he said to Dr Daniel. "My chest was injured and I was coughing blood often. After drinking the green paper ashes, there was no more blood. Just unbelievable." We did not comment. It is hard for Singapore mediums to validate and have great credentials as there is no research done unlike some counterparts in the Western world as in an example of Debra Martin at www.goldenmiracles.com.

2. The other instance where the green paper ashes protected him was when he passed the driving test despite hitting the kerb. In Singapore, hitting the kerb means instant failure."
"Why?" I asked as I took my driving lessons and tests in the UK.
"f you hit the kerb, that eans you can kill people too!"

"Bro," he said to Dr Daniel. "The medium had told me that I would pass the test and now I hit the kerb. The instructor stopped the car and had some discussions with someone. Get on with it and tell me I have failed instead! I want to rush out to book another test. The instructor returned and said I should continue driving and passed me."

I doubted Dr Daniel believe his "Ah Pek" story although he did not say anything. Communication with the spirit world is extremely hard for many to believe. He seemed quite consistent in his recounting of his accident experiences with "Ah Pek" I had written some time ago.
The one instant he narrated about "Ah Pek" protecting him from being caught for speeding at Mandai Road was incredible.
"Bro," he said to Dr Daniel.
"Do you know the stretch of Mandai Road where it goes uphill? When your car speeds and goes downhill, the traffic cops would point their speed meter and book you as you can't see them!"
"How does Ah Pek help?" I asked.
"My heart became hotter and hotter and so I slowed down. The cops were downhill!"   

My report does not do justification for his narration, his tones, gestures and use of Hokkien slangs to emphasize the points. His stories of survival from accidents are just incredible, as if there is a guardian angel healing him fast. Many of such incidents have no scientific explanations.  

   
  

     

      

1125. Listing of vet clinics on the SVA webpage

Oct 26, 2013
I am Dr Sing Kong Yuen from Toa Payoh Vets.

If it is not too late, please bring up the subject of "Veterinary clinic" listings in the SVA webpage under AOB at the AGM tomorrow.
LISTINGS OF VETERINARY CLINICS
As at Oct 26, 2013, there are 11 clinics listed out of a estimated 60 licensed practices in Singapore. 1/11 has closed down. I know it is extremely difficult to provide updated information on veterinary clinics. I believe there are some criteria that must be met before a clinic is listed on the website but I cannot find this information today as I visit the webpage.
Is it possible for the SVA to find another way of providing a more comprehensive list of clinics to the members of the public? Members at the AGM or of SVA may be asked to provide feedback. This is the reason I ask for the matter to be discussed under AOB at the AGM tomorrow.
Best wishes.    
Dr Sing Kong Yuen

1124. Blood transfusion in dogs

EMAIL DATED OCT 26, 2013

Dear ToaPoyahVets,

My dog has contracted Babesiosis and her HCT is only 15%. The vets that I went to recommended to perform a blood transfusion for her. (I went to 2 different clinics to confirm her illness.) However, she is blood type of DEA 1.1 negative, which I had difficulty finding. Most donors are positive. Vet 1 said there would be any severe problems for first timers if both are of different blood type. Vet 2 advised me not to as negative and positive will cause more problems. I would like to seek your opinion regarding this matter. I would greatly appreciate any feedback you have.


Thank you and sorry for any inconvenience caused. 
 
----------------------------
EMAIL REPLY FROM DR SING DATED OCT 26, 2013
 
 
Hi
I am Dr Sing Kong Yuen from Toa Payoh Vets. I apologise for not being able to give you advices as I don't perform blood transfusion in dogs. 

Monday, October 21, 2013

DoubleTree Hilton Somerset New Jersey
Rm 376

 The coach took around 2 hours to go to New York's downtown as the hotel was in New Jersey.







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Last of 3rd day to visit New York was Oct 23, 2013

Visited Times Square and had a good lunch there at Bubba Gum.  Good service Walking tour to see the financial district including Wall Street & Stock Exchanges and the new World Trade Centre building. No time to visit Barnes & Noble on 18th at 5th Avenue (text books) but saw another one and bought a You Tube How to book.









Back to Singapore on Oct 24, 2013 at 6.57 am and back to work.

Tiring journey. I wasted one whole morning and afternoon at the Factory Outlet but the ladies were all for it. I should have visited the Barnes & Noble bookshops in 5th Ave and the Public Library. None of the 35 tourists from Singapore would be interested. 

Sunday, October 20, 2013

1122. An 87-year-old woman at DoubleTree by Hilton, Somerset, New Jersey

Oct 20, 2013

Had breakfast at DoubleTree by Hilton. The white haired slim woman Flo is 87 years old, no need for drugs, can walk and talk normally. Hearing aid and new eyes. Incredibly healthy.

Saturday, October 19, 2013

Embezzlement tales

Travelling broadens your mind if you do talk to the others or listen to stories of experiences. For example, tales of embezzlement are:

1.  The partner of this Chinese Restaurant was sacked for dipping his hand into the cash register. He opened a restaurant down the road. Our tour guide switched to him. "He actually told you he stole money from his partners' business?" I asked him as he was narrating this story to us. "The previous place will close down soon."

Heavy reliance on a working partner who embezzles is what happens to most businesses. Best to keep your own money and not invest if you are not working or having a proper accounting system. Even then, the partner can still take cash without giving receipts.


2.  I met a 60-year-old American sales person at the Williamsport's Wegans. He was friendly and I asked why he still worked as a retiree. He told me he had to work because the stock broker embezzled all his savings. "How much?" I asked. him. "$250,000".  He was a medic during the Vietnam War but he was posted to Korea. "Many medics were killed," he told me. Yet he was killed by embezzlement in his autumn years. He did blame President Bush for some reasons I did not ask.
Many Singaporeans have lost money in shares of well known branded US companies.

So, it is hard for the common man to place his savings in stocks and shares, hoping to beat inflation. Property bubbles are also not safe for the younger ones. 

3. A Singapore vet started a practice in China. His groomer and probably others "embezzled" and he had to close the practice.