Tuesday, November 26, 2013
Monday, November 25, 2013
1209. Sunday's interesting case Nov 24, 2013 -- A young Golden Retriever is still lame
Nov 24, 2013 Bright sunny Sunday
This young Golden Retriever, Male, born Apr 4, 2013 had a painful left shoulder joint on Nov 5, 2013. This was evident as he "cried" when I flexed and extended his left shoulder joint while he laid on the examination table. The owner heard the cries.
The dog had jumped one week ago. The diagnosis was sprain of the left shoulder joint.
Now, 19 days later, the dog is still limping. I had the dog walked and trotted outdoors twice as I would have done for a racehorse lameness examination.
There was a dipping of the left fore limb as the dog trotted but this was not very evident or replicated. There was some lameness of the front limbs but which joint?
I had the dog videoed during examination.
The left shoulder joint was no more painful but there were replicable "clicking" sounds indicating a loose shoulder joint. No cries or pain.
The right shoulder joint was more stable and no clicking sounds were heard. After many manipulations, the dog was not so happy as you can see in the video.
The right hind knee joint was "stiff" when I extended it. No pain. But the dog was not lame after manipulation. The left hind knee joint was flexible and there was no pain.
I advised X-ray of the left shoulder joint as it may be shallower. Give a "large breed" dog food - owner to check and no more jumping for one month. The dog was not supposed to go up and downstairs as advised during the first consultation but the owner did not come yesterday. The lifestyle of this dog could be very active as he is a puppy.
The "clicking" sounds of the left shoulder joint are reproduced in the video.
----------------------------------------------
The younger generation seems to have no time for their pets. The uncle travels a lot on business and had to take time today to send the Chow Chow to me for veterinary treatment of itchy head area.
"The tail is almost bald in the last half of its length," I asked my assistant Niang to express the Chow Chow's anal sacs. He did it once and lots of grey brown anal sac oil shot onto the tissue paper held in his hand. This accumulation of anal sac oil caused discomfort and itchiness and the Chow Chow bites his tail till all hairs fall out.
"Do one more time," I said and Naing expressed another similar amount of oil.
"Go to the groomer monthly or get a groomer to the house," I said. "Take this telephone number of Karen, an stray dog activist who has 48 dogs in her 8 kennels in Pasir Ris. She will do the house-calls to check on this Chow Chow!"
Younger generation has a moral obligation to take good care of their pets but they have so many distractions and so the father has to pay money to the vet for treatment which can be prevented by daily grooming. All my advices on regular care and grooming fall on deaf ears of the younger daughters and I see this Chow Chow for skin diseases owing to lack of good grooming! Fortunately the father and uncle are dog lovers and the uncle spares the time to drive the dog in his mercedes to seek vet treatment.
This young Golden Retriever, Male, born Apr 4, 2013 had a painful left shoulder joint on Nov 5, 2013. This was evident as he "cried" when I flexed and extended his left shoulder joint while he laid on the examination table. The owner heard the cries.
The dog had jumped one week ago. The diagnosis was sprain of the left shoulder joint.
Now, 19 days later, the dog is still limping. I had the dog walked and trotted outdoors twice as I would have done for a racehorse lameness examination.
There was a dipping of the left fore limb as the dog trotted but this was not very evident or replicated. There was some lameness of the front limbs but which joint?
I had the dog videoed during examination.
The left shoulder joint was no more painful but there were replicable "clicking" sounds indicating a loose shoulder joint. No cries or pain.
The right shoulder joint was more stable and no clicking sounds were heard. After many manipulations, the dog was not so happy as you can see in the video.
The right hind knee joint was "stiff" when I extended it. No pain. But the dog was not lame after manipulation. The left hind knee joint was flexible and there was no pain.
I advised X-ray of the left shoulder joint as it may be shallower. Give a "large breed" dog food - owner to check and no more jumping for one month. The dog was not supposed to go up and downstairs as advised during the first consultation but the owner did not come yesterday. The lifestyle of this dog could be very active as he is a puppy.
The "clicking" sounds of the left shoulder joint are reproduced in the video.
----------------------------------------------
The younger generation seems to have no time for their pets. The uncle travels a lot on business and had to take time today to send the Chow Chow to me for veterinary treatment of itchy head area.
"The tail is almost bald in the last half of its length," I asked my assistant Niang to express the Chow Chow's anal sacs. He did it once and lots of grey brown anal sac oil shot onto the tissue paper held in his hand. This accumulation of anal sac oil caused discomfort and itchiness and the Chow Chow bites his tail till all hairs fall out.
"Do one more time," I said and Naing expressed another similar amount of oil.
"Go to the groomer monthly or get a groomer to the house," I said. "Take this telephone number of Karen, an stray dog activist who has 48 dogs in her 8 kennels in Pasir Ris. She will do the house-calls to check on this Chow Chow!"
1208. Video on hamster tumour surgery at Toa Payoh Vets in Nov 2013
Video on dwarf hamster with two large subcutaneous tumours produced by Intern Daniel.
http://youtu.be/L2D50ARD5wM
2-stage anaesthesia and surgeries is advised by me as the tumours are large and the shorter the anaesthesia, the higher the chances of survival.
The hamster survived one anaesthesia and is happy at home. Histology shows a benign tumour.
--------------------- Details below:
Case TP 44770. Neepy the male hamster, 2 years
A "Be Kind To Pets" veterinary educational video teaching vet students how to do a physical examination and take history, receive informed consent to anaesthesia and surgery as well as histology efficicently by Dr Sing Kong Yuen, veterinarian at Toa Payoh Vets, Singapore .
Establish a good rapport with the new client by asking for relevant details and explaining the high anaesthetic and surgical risks since the tumours are more than one and large, necessitating longer operating time.
The hamster has been operated by Dr Daniel Sing excising two tumours at one go and is fully recovered. Histology of subcutaneous lump 1.5x1.0x0.5 cm shows a benigh tumour - benign spindle cell neoplasm
Zoletil 50 IM 2 drops sufficient analgesia to excise 2 tumours with scalpel blade
Injection IM 1.24 pm (A) First skin incision 1.26 pm (B) Skin stitched with 4/0 absorbable 1.33 pm (C). Time taken between end of stitching and first skin incision (C-B) = 7 minutes. No need isoflurane gas + O2 top up in this case.
The speedier the surgery, the better the chances of survival for dwarf hamsters
http://youtu.be/L2D50ARD5wM
2-stage anaesthesia and surgeries is advised by me as the tumours are large and the shorter the anaesthesia, the higher the chances of survival.
The hamster survived one anaesthesia and is happy at home. Histology shows a benign tumour.
--------------------- Details below:
Case TP 44770. Neepy the male hamster, 2 years
A "Be Kind To Pets" veterinary educational video teaching vet students how to do a physical examination and take history, receive informed consent to anaesthesia and surgery as well as histology efficicently by Dr Sing Kong Yuen, veterinarian at Toa Payoh Vets, Singapore .
Establish a good rapport with the new client by asking for relevant details and explaining the high anaesthetic and surgical risks since the tumours are more than one and large, necessitating longer operating time.
The hamster has been operated by Dr Daniel Sing excising two tumours at one go and is fully recovered. Histology of subcutaneous lump 1.5x1.0x0.5 cm shows a benigh tumour - benign spindle cell neoplasm
Zoletil 50 IM 2 drops sufficient analgesia to excise 2 tumours with scalpel blade
Injection IM 1.24 pm (A) First skin incision 1.26 pm (B) Skin stitched with 4/0 absorbable 1.33 pm (C). Time taken between end of stitching and first skin incision (C-B) = 7 minutes. No need isoflurane gas + O2 top up in this case.
The speedier the surgery, the better the chances of survival for dwarf hamsters
1207. Social Media in veterinary practice - draft
In social commerce, people buy products and services based on recommendations from others. Positive word of mouth is the best form of marketing. Many people no longer read the papers or news online but rely on friends' recommendations via social media (6).
ECONOMICS
Several million dollars are needed to be the best as technology to execute the use of social media is not cheap for the average veterinary practice. For example, Singapore's fashion start up, Clozette is like a Facebook for fashion. It helps women and others to shop for more than 3,500 brands of local an international retailers, has around 300,000 members and receives more than 8 million monthly page views from around South East Asia. In November 2013, it has raised US$ million funding to evolve online shopping beyond the click-and-buy model into an entertaining experience (2).
ECONOMICS
Several million dollars are needed to be the best as technology to execute the use of social media is not cheap for the average veterinary practice. For example, Singapore's fashion start up, Clozette is like a Facebook for fashion. It helps women and others to shop for more than 3,500 brands of local an international retailers, has around 300,000 members and receives more than 8 million monthly page views from around South East Asia. In November 2013, it has raised US$ million funding to evolve online shopping beyond the click-and-buy model into an entertaining experience (2).
However, the average veterinary practice cannot afford to do what Clozette is doing to get international clients. It can still use online networking to market its services and promotions of products and services to pet owners via the practice's Facebook or Twitter. Online networking is also an excellent way to provide better client service and even patient
care.
To stay in friends and followers' good graces, Tassava B. advises that the vets stick to these five social-media codes.
* Listen: Members of your community are talking. Be sure you hear them.
* Respond: Let members know that you hear them by participating in conversations.
* Engage: Create content that attracts and entertains members of your community.
* Use restraint: Don't bore your connections by being self-centered. Make the information you provide relevant and useful to them rather than being simply promotional.
* Personalize: Don't spam your network with mass, generic messages, such as sending identical "thank you" messages to every person who joins your network. (3).
A lot of money spent in advertising in the Yellow Pages can be saved as social media does build better rapport and relationships with your clients. However traditional print advertisements should not be discarded (3).
Most vets don't know how to set up properly a practice's Facebook page. Tassava (4) shares the most common social media problems she sees - and explains how to properly promote your practice.
Mistake 1: Accepting friend requests on your practice's Facebook page. If you're receiving friend requests, then you've set up your practice's page as a personal profile rather than a business page. This can lead to major problems - namely the potential to get kicked off Facebook. Your clients should only be able to "like" your page. No worries, though; switching is an easy fix. Once you sign into Facebook, click on the "Account" button in the top righthand corner, then click on the "Help Center" to find instructions.
Mistake 2: Believing social media will take up all your time. While it's easy to spend hours looking at pictures on Facebook and stalking celebrities on Twitter, this doesn't mean you have to be sucked into social media oblivion. Take time every Monday to plan out your posts and tweets for the week. Make a calendar strictly for social media so everyone knows the plan. Also, be sure you're receiving e-mail notifications when people comment or post to your social media sites. This will eliminate the need to log on frequently.
Mistake 3: Rejecting social media opportunities if you're older than 24. Don't confuse maturity and professionalism with being hip and cool. Social media doesn't require a lot of technological know-how and is user-friendly. If you're in charge of posting for the practice, make sure you know what's going on at the practice at all times so your posts are useful and relevant to your clients.
Mistake 4: USING ALL CAPS IN YOUR POSTS. This is the equivalent of yelling at clients. You don't want to offend loyal pet owners when speaking with the practice's voice, so check out other business sites to pick up on proper online etiquette.
Veterinary Economics. Every veterinary practice suffers from a large number of clients not coming for the annual health screening or treatment. Clients can purchase veterinary products from pet shops or online for de-ticking and de-fleaing, skin disease and anti-diarrhoea products. More convenient and much cheaper. Steve (5) believes that social media can be used to build a rapport and education for the client via email and social media and linking the educational information to the traditional vaccination reminder cards or handouts on diseases posted to clients. When the veterinary team members take the time to explain the importance of these exams, most clients see the value in them because they want what's best for their pets.
Younger generation is a big source of prospective clients. Vets who leverage on social media to engage Singaporeans will be able to better communicate with this generation. In Singapore, almost every ministry and Member of Parliament has a Facebook account. The Singapore Prime Minister, Mr Lee Hsien Loong also has a Twitter and Instagram account as Facebook is for the older generation (20-30 years old). He finds them effective channels of communication to engage Singaporeans directly and quickly (6). His recent Facebook post about a barn owl which flew into the Presidential Office garnered 500,000 views within a day.
BENEFITS
1. It is easier to share information, connect with one another, keep abreast of the latest trends, organise themselves for common causes e.g. animal welfare activism.
CHALLENGES
1. Hacking is a serious threat e.g. crashing the veterinary hospital management system. It is difficult and costly for the average vet practitioner to prevent serious hacking. Keeping copies of your files in an organised manner may be the only solution to rebuild the website.
2. Trolling (6) - the discussion and debate degenerating into abuse and hate-mongering. Trolls deter constructive participation. Trolling is possible because of online anonymity. It increases unethical behaviour and contempt as they feel that no one will know who they are and hence do whatever they want. Some websites like You Tube, New York Times require log-ins for posting comments. TODAYonline.com requires readers to log in using their Facebook accounts before posting comments, raising the quality of discussion.
To stay in friends and followers' good graces, Tassava B. advises that the vets stick to these five social-media codes.
* Listen: Members of your community are talking. Be sure you hear them.
* Respond: Let members know that you hear them by participating in conversations.
* Engage: Create content that attracts and entertains members of your community.
* Use restraint: Don't bore your connections by being self-centered. Make the information you provide relevant and useful to them rather than being simply promotional.
* Personalize: Don't spam your network with mass, generic messages, such as sending identical "thank you" messages to every person who joins your network. (3).
A lot of money spent in advertising in the Yellow Pages can be saved as social media does build better rapport and relationships with your clients. However traditional print advertisements should not be discarded (3).
Most vets don't know how to set up properly a practice's Facebook page. Tassava (4) shares the most common social media problems she sees - and explains how to properly promote your practice.
Mistake 1: Accepting friend requests on your practice's Facebook page. If you're receiving friend requests, then you've set up your practice's page as a personal profile rather than a business page. This can lead to major problems - namely the potential to get kicked off Facebook. Your clients should only be able to "like" your page. No worries, though; switching is an easy fix. Once you sign into Facebook, click on the "Account" button in the top righthand corner, then click on the "Help Center" to find instructions.
Mistake 2: Believing social media will take up all your time. While it's easy to spend hours looking at pictures on Facebook and stalking celebrities on Twitter, this doesn't mean you have to be sucked into social media oblivion. Take time every Monday to plan out your posts and tweets for the week. Make a calendar strictly for social media so everyone knows the plan. Also, be sure you're receiving e-mail notifications when people comment or post to your social media sites. This will eliminate the need to log on frequently.
Mistake 3: Rejecting social media opportunities if you're older than 24. Don't confuse maturity and professionalism with being hip and cool. Social media doesn't require a lot of technological know-how and is user-friendly. If you're in charge of posting for the practice, make sure you know what's going on at the practice at all times so your posts are useful and relevant to your clients.
Mistake 4: USING ALL CAPS IN YOUR POSTS. This is the equivalent of yelling at clients. You don't want to offend loyal pet owners when speaking with the practice's voice, so check out other business sites to pick up on proper online etiquette.
Veterinary Economics. Every veterinary practice suffers from a large number of clients not coming for the annual health screening or treatment. Clients can purchase veterinary products from pet shops or online for de-ticking and de-fleaing, skin disease and anti-diarrhoea products. More convenient and much cheaper. Steve (5) believes that social media can be used to build a rapport and education for the client via email and social media and linking the educational information to the traditional vaccination reminder cards or handouts on diseases posted to clients. When the veterinary team members take the time to explain the importance of these exams, most clients see the value in them because they want what's best for their pets.
Younger generation is a big source of prospective clients. Vets who leverage on social media to engage Singaporeans will be able to better communicate with this generation. In Singapore, almost every ministry and Member of Parliament has a Facebook account. The Singapore Prime Minister, Mr Lee Hsien Loong also has a Twitter and Instagram account as Facebook is for the older generation (20-30 years old). He finds them effective channels of communication to engage Singaporeans directly and quickly (6). His recent Facebook post about a barn owl which flew into the Presidential Office garnered 500,000 views within a day.
BENEFITS
1. It is easier to share information, connect with one another, keep abreast of the latest trends, organise themselves for common causes e.g. animal welfare activism.
CHALLENGES
1. Hacking is a serious threat e.g. crashing the veterinary hospital management system. It is difficult and costly for the average vet practitioner to prevent serious hacking. Keeping copies of your files in an organised manner may be the only solution to rebuild the website.
2. Trolling (6) - the discussion and debate degenerating into abuse and hate-mongering. Trolls deter constructive participation. Trolling is possible because of online anonymity. It increases unethical behaviour and contempt as they feel that no one will know who they are and hence do whatever they want. Some websites like You Tube, New York Times require log-ins for posting comments. TODAYonline.com requires readers to log in using their Facebook accounts before posting comments, raising the quality of discussion.
(1). Lambert, A. (2013). Face it, facebook is it: Why your practice needs social media. Veterinary Nursing, 28(3), 110-111.
(2) The Straits Times, November 23, 2013, Money, C13
(3) Tassava, B. (2010, 06). Making social media worth the time and effort. Firstline, 6, 38-38,40
(4) Tassava, B. (2011, 08). Your social media status. Firstline, 7, 10.
(5) Dale, Steve. (2013.03). The incredible vanishing veterinary visit. Firstline, 9, 3, 16-19.
(6) The Sunday Times, Taking advantage of changing media landscape. Nov 24, 2013. Think. 37.
(2) The Straits Times, November 23, 2013, Money, C13
(3) Tassava, B. (2010, 06). Making social media worth the time and effort. Firstline, 6, 38-38,40
(4) Tassava, B. (2011, 08). Your social media status. Firstline, 7, 10.
(5) Dale, Steve. (2013.03). The incredible vanishing veterinary visit. Firstline, 9, 3, 16-19.
(6) The Sunday Times, Taking advantage of changing media landscape. Nov 24, 2013. Think. 37.
| Title: | The incredible vanishing veterinary visit |
|---|---|
| Author: | Dale, Steve |
| Citation: | Firstline vol. 9, no. 3 (Mar 2013), p. 16-19 |
Sunday, November 24, 2013
1206 The female dwarf hamster weights 46 g with 3 gigantic chest tumours - video
http://www.youtube.com/watch?v=NVaxCDTtlPE&feature=youtu.be
Some tumours are gigantic and surgery is not advised as the surgical risk of loss of blood is very high. However there is no other option as they become inflamed and enlarged in this "one-year-old" female dwarf hamster. In this case, informed consent is given. The video shows physical
examination, history taking and the receipt of informed consent.
Time is of the essence in dwarf hamster surgeries. The shorter the duration of surgery, the higher the chances of survival on the operating table.
Some tumours are gigantic and surgery is not advised as the surgical risk of loss of blood is very high. However there is no other option as they become inflamed and enlarged in this "one-year-old" female dwarf hamster. In this case, informed consent is given. The video shows physical
examination, history taking and the receipt of informed consent.
Time is of the essence in dwarf hamster surgeries. The shorter the duration of surgery, the higher the chances of survival on the operating table.
Update on grape toxicosis Shih tzu
Follow up on earlier report on 9-year-old male shih tzu that vomited and passed blood in the urine. He peed dark red brownish urine on the floor of the waiting room and dark reddish brown urine on the newspaper inside the crate after the I/V drip and antibiotics. He went home on the same day in the evening and has recovered and the owners are happy.
An image of the urine collected afer the IV drip.
An image of the urine collected afer the IV drip.
Saturday, November 23, 2013
1204. Video imaging software for interns - Video Studio Ultimate X6 and the younger generation
I purchase Corel Video Studio Ultimate X6 from Funan Centre for an intern to use as the Windows Movie Maker (free in Windows 8) lack many features. It is distributed by GranTech Systems Pte Ltd www.grandtech.com.sg, tel 6283 7770.
Before the purchase, I asked her (completed her 'O' levels) to research for "best editing video software" in google. She suggested "good editing video software." I cannot understand why but it seems many younger generation do make alternative suggestions and it is a different generational mindset.
When I instruct the younger generation to do adopt a process or procedure, I need to "double-check" to ensure compliance as many don't do as instructed. It is as if they know better or have a better way of doing things. It is time consuming and does not generate trust between senior managers and new hires as work instructions and standard operating procedures may be ignored.
The young may be well educated but they must learn to follow to gain the experience of battle-tested veterans in a competitive global business.
Before the purchase, I asked her (completed her 'O' levels) to research for "best editing video software" in google. She suggested "good editing video software." I cannot understand why but it seems many younger generation do make alternative suggestions and it is a different generational mindset.
When I instruct the younger generation to do adopt a process or procedure, I need to "double-check" to ensure compliance as many don't do as instructed. It is as if they know better or have a better way of doing things. It is time consuming and does not generate trust between senior managers and new hires as work instructions and standard operating procedures may be ignored.
The young may be well educated but they must learn to follow to gain the experience of battle-tested veterans in a competitive global business.
Subscribe to:
Posts (Atom)