Sunday 30th May 2010
The lady wanted a second opinion. Vet 1 said that her 5-year-old Chihuahua had heart disease and had prescribed a cough mixture (on the first visit) and heart drugs (Fortekor 5mg and a white capsule) on the second visit. The owner does not know what the white capsules were for.
It was a beautiful Sunday morning. One entrepreneur had opened a small office at Peninsula Plaza and I had dropped by at 9.30 am to congratulate her. Then I rushed back to the Surgery for this second opinion.
I put the stethoscope on the dog's chest on the right and left. "I confirm that your dog has a serious heart disease. Is he still coughing?"
"Well, he did cough 2 days ago, but not today."
"Your heart drugs need to be given regularly and listen to the coughing period. Your dog must not be permitted to be too active."
"I can give him the cough mixture when he coughs," the lady in her late 40s said.
"In heart disease, there will be water in the lungs. The dog wants to cough up the water from the lungs. If you give the cough mixture to prevent coughing, your dog will "drown" with excessive water inside the lungs."
Fortunately she did not self-medicate or her dog would have had died. She sought a second opinion and that was good for her dog.
"I must tell you that your dog will not live to a ripe old age of 15 years unlike some Chihuahuas," I had to give the owner the prognosis. "If you are careful with the heart drugs and monitor him closely for coughing or other signs, he may live longer. He may need more dosage over time or other drugs. I don't expect him to live more than 1-2 years."
The owner held back her tears. I checked my records as this dog had dental scaling and teeth extraction done by me one year ago. He was OK.
"Coughing at night started one month ago," the owner said.
"Why did you consult Vet 1?" I asked for feedback to improve my services. Was something lacking in this case? Well, Vet 1's surgery was much nearer to her apartment and that would be the main reason.
"Vet 1 does not need appointments," the lady said. "She is very busy as there is a big crowd of patients. I had to wait one and a half hours to see her."
This feedback is important to me. No appointments mean more business perhaps? Dog owners in Singapore dislike appointments or are there more factors for owners to switch loyalty? I am sure the causes are many. I am glad that this owner got a second opinion. I asked her to check with Vet 1 what the white capsules were for and to keep in touch.
P.S It is deadly to give cough mixture to dogs with heart disease. Try and get proper veterinary advices.
Monday, May 31, 2010
83. Sudden death during boarding
May 29, 2010 Saturday was my day off and it was a hot sunny day. Sex and City 2 movie was shown. I appreciated the better script and the great humour about menopausal hot flushes and irritable moods in Abu Dhabi, of actress called Samantha in the movie Sex and City 2.
During dinner, I went to the Inle Restaurant at Marina Square served a well cooked fried sweet, sour and chilly bass. This was the first time I had been to this outlet although I had eaten several times at the Peninsula outlet. I was pleasantly surprised that the fish was well presented and cooked to my taste. I am wary of smelly fish dishes not cooked properly. Then my mobile phone rang at 8.30 pm.
"A dog boarded at a kennel had died after a shower. Can you certify that he is dead?" Groomer Clara phoned me. I had known her for over 5 years and could trust her when she said she would come. Some people don't turn up after making emergency or ordinary appointments and don't inform me. Therefore, I have to be careful nowadays. Still I had to wait 45 minutes at the Surgery for Clara to arrive.
"Can you wait till tomorrow Sunday morning?" I asked.
"The owner wants it done today," Clara said.
I went back to Toa Payoh Vets. Clara arrived with a dog boarding kennel operator in a very small rectangular type of van for 2 people.
The Maltese had died. Rigor mortis had set in. His tongue was dark purple. I could just certify that the dog had died and go away. However this sudden death would be very distressful to the owner. She might want some answers for closure.
"Let me talk to the owner," I said to Clara.
"I had transported this owner's other dog to see you," Clara said. As I saw Clara rarely, I had presumed that this owner was not a client of mine.
I asked my assistant to take out the case card after checking the computer and to write a death certificate while I phoned the owner. My assistant took the card out and wrote the certificate. I checked the certificate and spoke to Mr Saw: "Do check the dog as your details are those of another breed of the owner." As the card showed one dog's details, he assumed the dog info was that of the dead dog.
I spoke to the grieving owner: "Your dog had passed away suddenly from a heart attack. Did he show any breathing problem or coughing?"
"No," the lady said. "He went for urinary stone removal via the penis and then 2 months later, the vet took the stones out from the bladder."
"When was that?" I asked.
"One year ago," she said.
"The dog had fully recovered," I said. "I don't know what is the cause of the heart attack. Do you want a post-mortem to check the cause of death?"
The owner was not keen on this advice. She said: "I am in confinement." By that I presume she had just given birth to a baby. "What do you want to do with the dog? Do you wish to have him cremated?"
After some discussion, Clara would bring the dog back to the kennel and the owner would see him on Sunday.
Some dogs do die during boarding. Many owners don't do annual health screening of old dogs. This dog was around 7 years old and was in good body condition. The teeth was encrusted with tartar as no dental check up was done.
P.S
It is important for the vet to communicate with the owner as regards sudden death in a boarding kennel as sudden death of a beloved pet during boarding, far away from home, is a very emotional issue.
Annual health screening using blood and urine tests and dental examination are seldom done by the Singaporean dog owner. Many diseases can be prevented or controlled from annual health checks if you want your pet to live long.
During dinner, I went to the Inle Restaurant at Marina Square served a well cooked fried sweet, sour and chilly bass. This was the first time I had been to this outlet although I had eaten several times at the Peninsula outlet. I was pleasantly surprised that the fish was well presented and cooked to my taste. I am wary of smelly fish dishes not cooked properly. Then my mobile phone rang at 8.30 pm.
"A dog boarded at a kennel had died after a shower. Can you certify that he is dead?" Groomer Clara phoned me. I had known her for over 5 years and could trust her when she said she would come. Some people don't turn up after making emergency or ordinary appointments and don't inform me. Therefore, I have to be careful nowadays. Still I had to wait 45 minutes at the Surgery for Clara to arrive.
"Can you wait till tomorrow Sunday morning?" I asked.
"The owner wants it done today," Clara said.
I went back to Toa Payoh Vets. Clara arrived with a dog boarding kennel operator in a very small rectangular type of van for 2 people.
The Maltese had died. Rigor mortis had set in. His tongue was dark purple. I could just certify that the dog had died and go away. However this sudden death would be very distressful to the owner. She might want some answers for closure.
"Let me talk to the owner," I said to Clara.
"I had transported this owner's other dog to see you," Clara said. As I saw Clara rarely, I had presumed that this owner was not a client of mine.
I asked my assistant to take out the case card after checking the computer and to write a death certificate while I phoned the owner. My assistant took the card out and wrote the certificate. I checked the certificate and spoke to Mr Saw: "Do check the dog as your details are those of another breed of the owner." As the card showed one dog's details, he assumed the dog info was that of the dead dog.
I spoke to the grieving owner: "Your dog had passed away suddenly from a heart attack. Did he show any breathing problem or coughing?"
"No," the lady said. "He went for urinary stone removal via the penis and then 2 months later, the vet took the stones out from the bladder."
"When was that?" I asked.
"One year ago," she said.
"The dog had fully recovered," I said. "I don't know what is the cause of the heart attack. Do you want a post-mortem to check the cause of death?"
The owner was not keen on this advice. She said: "I am in confinement." By that I presume she had just given birth to a baby. "What do you want to do with the dog? Do you wish to have him cremated?"
After some discussion, Clara would bring the dog back to the kennel and the owner would see him on Sunday.
Some dogs do die during boarding. Many owners don't do annual health screening of old dogs. This dog was around 7 years old and was in good body condition. The teeth was encrusted with tartar as no dental check up was done.
P.S
It is important for the vet to communicate with the owner as regards sudden death in a boarding kennel as sudden death of a beloved pet during boarding, far away from home, is a very emotional issue.
Annual health screening using blood and urine tests and dental examination are seldom done by the Singaporean dog owner. Many diseases can be prevented or controlled from annual health checks if you want your pet to live long.
Saturday, May 29, 2010
82. 6-month-old cat neuter and spay
SHARING KNOWLEDGE ON INJECTABLE ANAESTHESIA IN THE STERILISATION OF CATS AT WWW.TOAPAYOHVETS.COM, SINGAPORE - PART 1
Frequently Asked Questions For Dr Sing
1. Best time to spay my female cat?
If cats are home-based and not permitted to stray outdoors, it is best to spay at 6 months of age as their private parts (vulva) will be be able to develop into adult size.
2. Best time to neuter my male cats?
I advise 6 months of age. However, if there is a male and female sibling cats living in the same apartment, the male will be much interested in the female at 6 months of age. Get them sterilised when interest is shown or neuter the male at 5 months.
One case study
Two domestic short haired cats were adopted as kittens.
At 6 months of age, the male was very interested in the female cat at 6 months.
During sterilisation, the female cat's ovaries were enlarge and blood vessels were very red and big, indicating the cat was on heat. However she was not pregnant. The owner stopped water and food at 10 pm the previous night. One website claims that cats can still be given water prior to surgery. I don't agree with this.
3. What anaesthesia I use in the sterilisation of cats in 2010?
I find the following combination in one syringe given by IM safe and effective
INJECTABLE ANAETHESIA IM
Male cat 4.2 kg
Xylazine 2% @ 0.15ml + Ketamine 0.6 ml IM
Surgery: 10 minutes after injection.
Excellent analgesia
Female cat 3.0 kg
Xylazine 2% @ 0.1 ml + Ketamine 0.4 ml IM
Surgery: 20 minutes after injection as there was some delay by my assistant in the clipping of hair and cleaning of the surgical area. The cat was awake by then. There is no problem as isoflurane gas by mask at 5% for around 60 seconds and to effect provided excellent analgesia.
The combination dosage for this cat should be similar to the one in the male cat if isoflurane gas top up is not needed.
4. Cat cats be sterilised at 3 months of age or younger?
I am aware that cat-control activists and shelters spay them as early as 3-4 months to prevent unwanted pregnancies. On one websigte, one "vet" working for an animal shelter said that anaesthesia is safe for such age groups as anaesthesia nowadays are better than those in the 1960s. She did not give the % of deaths or type of anaesthesia used.
5. Will my cat's left ear tip be cut off after sterilisation?
No. I don't do it, even in stray cats, unless the owner requests it to be done. Many owners actually dislike seeing their cats being "disfigured" but stray cat activists do get such surgeries done.
6. Can vaccinations be done at the same time?
Yes. However, I don't advise it as the cat is under stress of anaesthetic drugs, pain-killer drugs and antibiotics. But some owners don't have time. So, vaccination is done. Usually there are no adverse effects.
SHARING KNOWLEDGE ON INJECTABLE ANAESTHESIA IN THE STERILISATION OF CATS AT WWW.TOAPAYOHVETS.COM, SINGAPORE - PART 2
1. Observations of one cat neutered by me
I find the following combination effective as one IM injection
1.1. 3 kg cat. Today, I spayed a Ragamuffin, female, 1 year. 3 kg using injectable anaesthetic.
Xylazine 0.15 ml Ketamine 0.6 ml in one syringe IM
Duration of anaesthesia around 20 minutes in this case. I don't need isoflurane gas top up. This is the ideal situation as it means less operating time.
1.2 5 kg cat. I have used xylazine 0.2 ml and ketamine 0.8 ml IM without side effects.
2. IV
I don't use IV as I find it time consuming but it is one vet's favourite mode of administration and he following simple formula, easy to remember is shared with vets.
2.1 3-kg cat. xylazine 0.1 ml, ketamine 0.2 ml in one syringe, totalling 0.3 ml. Inject 0.1 ml IV first, then another 0.1 ml to effect.
2.2 5-kg cat. xylazine 0.1 ml and ketamine 0.4 ml, totalling 0.5 ml.
Note that you give 0.2 ml IV first. Then increase by 0.05 ml doses to effect. You don't need to use all 0.5 ml.
3. MY CONCLUSIONS
I prefer the IM method for ease of administration and permitting me to focus on surgery. I do give isoflurane gas by mask for a few seconds to top up if necessary. This is very effective.
However, the IV top-up method is excellent if you don't have isoflurane facilities. The cat is shaved 5 minutes after IM and I operate 10 minutes after injection. Many years ago, I used xylazine IM and then isoflurane gas for cat spay. Now, I don't use it as I find the IM method extremely effective in healthy cats.
In the IV top up method, an IV catheter has to be used and this seems to be less efficient in my opinion. Every time the analgesia is insufficient by observation of the painful movement or cries, the IV anaesthetic is injected by increments to effect. This method is important in countries where the gas anaesthetic machine and isolfurane gas are costly.
For me, a whiff of the isoflurane gas by mask for a few seconds seems more efficient and quieter. Obviously, the vet has to be vigilant on the signs of surgical anaesthesia in both the IV and gas top up. The cat under my regime wakes up earlier than those using IV and I prefer to see a cat up and about as soon as surgery ends.
Friday, May 28, 2010
81. High cost of webmasters in Singapore
1. It was great meeting you one morning to talk about IT from a practitioner.
2. I attach two pictures about "Be Proactive To Make Your Dreams Come True" to inspire you as you are a young man and can achieve so many great things in life. I hope you like the 2 pictures and can see the story in the picture. If not, I will explain to you the story behind my 2 pictures.
3. You are I are service providers in our own industry. Sometimes, our points of view may differ from the customers' point of views. If we can give what our customers want, we will get excellent referrals and lots of businesses. Good quality business clients are from referrals who trust me rather than think that I am the cheapest vet in Singapore.
4. I wish to share with you my experience in looking for a webmaster from a "customer's point of view". Yesterday, a client of mine whose dog I treated, introduced me to her boss who has a website producing company in Joo Chiat. It is a small office with 2 men and my client. It is called .... This young girl will make an excellent frontline administration officer as she follows up for her boss and ensures that I meet him.
4.1 COSTS OF AN E-COMMERCE WEBPAGE
The boss had only one account that suited my requirements. It was a website with e-commerce payments by Nets, Master and Visa credit cards for a charity run by a local university. "How much to produce this website?" I asked. "$15,000".
Definitely, I can't afford this amount."Can I see the website?" I asked since the boss was showing me printouts from his file. I am looking for past performances before I engage a webmaster as webmasters in Singapore are extremely expensive compared to South Korea. From a report I read some years ago, most Korean companies have online pages as the costs are much lower. Singapore is still in the Dark Ages as many companies don't do it. Now I understand why few small enterprises in Singapore do e-commerce as $15,000 is really a lot of money.
When I asked for the website to be demonstrated online, the boss said, "Sorry, No more," He suggested that I use PayPal for e-commerce. This is a sensible idea as it saves a lot of costs from webmasters.
4.2 CONTENT MANAGEMENT SYSTEM (CMS). I can't afford to pay the webmaster for updates. In any case, the webmaster will have no timely updates for me as I update anytime and daily. The boss said he can provide a CMS whereby the client updates pictures and pictures himself. As to the software used for webpage design, he said it is proprietary.
4.3 WHAT I WANT IN A WEBMASTER. Basically, it is e-commerce and self-updating at least cost. To save a lot of time for both of us at the meeting, I had an example of what I want from another company and asked the boss to click on "Asia Travel Concierge". Unfortunately, this webpage seems to have "expired" when the boss tried to access it. And I could see it in the morning before I met him.
I hope the above will be useful in letting you know what I want from a webmaster. I hope you will persevere and succeed in your IT enterprise. Go for it. Build up your commercial client base. Be amongst the best webmasters by giving what your customers want and having a large portfolio to prove it if this aspect of IT is what you are passionate about. Sometimes, bread on the table may be more important for your long-term survival. But if passion is there, your clients will sense it and with referrals, you will get "manna from heaven." I have the wording on my desktop to remind me daily. It is "Belief, Passion, Drive & Perseverance".
With best wishes.
2. I attach two pictures about "Be Proactive To Make Your Dreams Come True" to inspire you as you are a young man and can achieve so many great things in life. I hope you like the 2 pictures and can see the story in the picture. If not, I will explain to you the story behind my 2 pictures.
3. You are I are service providers in our own industry. Sometimes, our points of view may differ from the customers' point of views. If we can give what our customers want, we will get excellent referrals and lots of businesses. Good quality business clients are from referrals who trust me rather than think that I am the cheapest vet in Singapore.
4. I wish to share with you my experience in looking for a webmaster from a "customer's point of view". Yesterday, a client of mine whose dog I treated, introduced me to her boss who has a website producing company in Joo Chiat. It is a small office with 2 men and my client. It is called .... This young girl will make an excellent frontline administration officer as she follows up for her boss and ensures that I meet him.
4.1 COSTS OF AN E-COMMERCE WEBPAGE
The boss had only one account that suited my requirements. It was a website with e-commerce payments by Nets, Master and Visa credit cards for a charity run by a local university. "How much to produce this website?" I asked. "$15,000".
Definitely, I can't afford this amount."Can I see the website?" I asked since the boss was showing me printouts from his file. I am looking for past performances before I engage a webmaster as webmasters in Singapore are extremely expensive compared to South Korea. From a report I read some years ago, most Korean companies have online pages as the costs are much lower. Singapore is still in the Dark Ages as many companies don't do it. Now I understand why few small enterprises in Singapore do e-commerce as $15,000 is really a lot of money.
When I asked for the website to be demonstrated online, the boss said, "Sorry, No more," He suggested that I use PayPal for e-commerce. This is a sensible idea as it saves a lot of costs from webmasters.
4.2 CONTENT MANAGEMENT SYSTEM (CMS). I can't afford to pay the webmaster for updates. In any case, the webmaster will have no timely updates for me as I update anytime and daily. The boss said he can provide a CMS whereby the client updates pictures and pictures himself. As to the software used for webpage design, he said it is proprietary.
4.3 WHAT I WANT IN A WEBMASTER. Basically, it is e-commerce and self-updating at least cost. To save a lot of time for both of us at the meeting, I had an example of what I want from another company and asked the boss to click on "Asia Travel Concierge". Unfortunately, this webpage seems to have "expired" when the boss tried to access it. And I could see it in the morning before I met him.
I hope the above will be useful in letting you know what I want from a webmaster. I hope you will persevere and succeed in your IT enterprise. Go for it. Build up your commercial client base. Be amongst the best webmasters by giving what your customers want and having a large portfolio to prove it if this aspect of IT is what you are passionate about. Sometimes, bread on the table may be more important for your long-term survival. But if passion is there, your clients will sense it and with referrals, you will get "manna from heaven." I have the wording on my desktop to remind me daily. It is "Belief, Passion, Drive & Perseverance".
With best wishes.
80. Employee vets and locums
May I share with you my personal views on veterinary assistants and locums in Singapore since I graduated in 1974 and had started my own practice www.toapayohvets.com in 1980?
Employee vets in Singapore want the maximum pay and the least hours of work. Many married lady vets want to work part-time and less days. It seems to me that there are many newly graduated vets but they are mainly ladies. They don't want the hard work - night duties, after-hour emergencies and so expatriate vets have opportunities in Singapore.
Inevitably, those hard-working ones will think they have better be their own bosses, after 2 years. Why work long hours and get a "salary"? But this is the reality of private practice. The employee vet who is calculating will never be happy because he or she feels exploited when the practice is very busy.
For you, I will advise you to think what you want in life? If you want to work in Singapore, take a package that is a "stepping stone" to know about the culture and make contacts in Singapore after your locum work is completed.
If you are really good in your veterinary work, I have no doubt you will earn more once you are here as referrals are very powerful in Singapore. There is a large expatriate community here and they do have the spending power. The practice you will be working in does not have the expatriate business. This is an opportunity for you to start getting expatriates for this practice and later to be your own boss.
But what do you want in life? Just be a flitting butterfly by doing locums? Locums are highly paid for hours worked but they do not build up a practice. If you just want to be a hired gunman on a project, as in the film "Have Gun Will Travel" (a famous English TV movie in the early 1960s), then, so be it. You may out-price yourself as there are other expatriate locums looking for jobs in Singapore too.
It is best to be your own boss from what I can read about you in your emails. In that case, you can fail as well as being successful. Much depends on you. Nobody knows what you want. I met a lady English Vet in Siem Reap in Cambodia. She was closing down the clinic as business was poor. She was there for around 2 years and was the only expatriate vet. But Singapore's small animal practice is so much different from Siem Reap and you, as an expatriate vet with many years of experience, should have a large clientele of Caucasian expatriates when you start up. Obviously, it is not a guarantee.
With best wishes.
Employee vets in Singapore want the maximum pay and the least hours of work. Many married lady vets want to work part-time and less days. It seems to me that there are many newly graduated vets but they are mainly ladies. They don't want the hard work - night duties, after-hour emergencies and so expatriate vets have opportunities in Singapore.
Inevitably, those hard-working ones will think they have better be their own bosses, after 2 years. Why work long hours and get a "salary"? But this is the reality of private practice. The employee vet who is calculating will never be happy because he or she feels exploited when the practice is very busy.
For you, I will advise you to think what you want in life? If you want to work in Singapore, take a package that is a "stepping stone" to know about the culture and make contacts in Singapore after your locum work is completed.
If you are really good in your veterinary work, I have no doubt you will earn more once you are here as referrals are very powerful in Singapore. There is a large expatriate community here and they do have the spending power. The practice you will be working in does not have the expatriate business. This is an opportunity for you to start getting expatriates for this practice and later to be your own boss.
But what do you want in life? Just be a flitting butterfly by doing locums? Locums are highly paid for hours worked but they do not build up a practice. If you just want to be a hired gunman on a project, as in the film "Have Gun Will Travel" (a famous English TV movie in the early 1960s), then, so be it. You may out-price yourself as there are other expatriate locums looking for jobs in Singapore too.
It is best to be your own boss from what I can read about you in your emails. In that case, you can fail as well as being successful. Much depends on you. Nobody knows what you want. I met a lady English Vet in Siem Reap in Cambodia. She was closing down the clinic as business was poor. She was there for around 2 years and was the only expatriate vet. But Singapore's small animal practice is so much different from Siem Reap and you, as an expatriate vet with many years of experience, should have a large clientele of Caucasian expatriates when you start up. Obviously, it is not a guarantee.
With best wishes.
Tuesday, May 25, 2010
79. 13-year-old Shih Tzu with black corneas
I was surprised that the Shih Tzu recovered fully from having pus leaking out from his almost 100$% pigmented cornea in his right eye. This meant he was blind in the right eye.
He was 13 years old and was with the young man since he was 6 years of age. I did a 3rd eyelid flap under general anaesthesia to close up his eye ulcer and also removed all his rotten teeth. He was very thin. Surprisingly he survived the anaesthesia. That was 6 months ago. He looked and behaved as young as a 8-year-old dog. "He recovered completely," the young man said. "Just a white spot in the centre of his right eye. What's his problem?
6 months later, he had tearing in his right eye. Lots of tears and red sclera and conjunctiva. The eye was infected. He was rubbing his right eye. A white blob of tissue has protruded from the central ulcer. An eye infection. It could be from the inside of the eyeball. Antibiotics and eye drops are given.
P.S
1. Check your Shih Tzu'e eyes daily. Don't let the black or brown pigments grow till they cover the cornea 100% as the dog will not be able to see. Pigmentation is usually due to corneal irritation over several years. Singapore owners don't know that the hairs in the nasal fold grows and irritate the eyeball, causing pigmentation in some Shih Tzus and ultimately blindness. How would you feel if you can' see because your cornea is painted black? Prevention is better. Get your vet to snip off the nasal fold and no hairs will grow towards and irriate the cornea.
He was 13 years old and was with the young man since he was 6 years of age. I did a 3rd eyelid flap under general anaesthesia to close up his eye ulcer and also removed all his rotten teeth. He was very thin. Surprisingly he survived the anaesthesia. That was 6 months ago. He looked and behaved as young as a 8-year-old dog. "He recovered completely," the young man said. "Just a white spot in the centre of his right eye. What's his problem?
6 months later, he had tearing in his right eye. Lots of tears and red sclera and conjunctiva. The eye was infected. He was rubbing his right eye. A white blob of tissue has protruded from the central ulcer. An eye infection. It could be from the inside of the eyeball. Antibiotics and eye drops are given.
P.S
1. Check your Shih Tzu'e eyes daily. Don't let the black or brown pigments grow till they cover the cornea 100% as the dog will not be able to see. Pigmentation is usually due to corneal irritation over several years. Singapore owners don't know that the hairs in the nasal fold grows and irritate the eyeball, causing pigmentation in some Shih Tzus and ultimately blindness. How would you feel if you can' see because your cornea is painted black? Prevention is better. Get your vet to snip off the nasal fold and no hairs will grow towards and irriate the cornea.
72. Male dog barking. 6 months. Success story toilet training
Barking male dogs
In Singapore, barking male dogs are commonly encountered. I describe 2 cases of male dogs I have just neutered in the last 2 days.
CASE 1
Problem: Social nuisance in the HDB apartment neighbourhood.
1. Jack Russell male, 5 years. Barking non-stop. When he sees another dog, he barks loudly at them, trying to get at them. In the surgery, he was to be vaccinated but he barked ferociously at the other dogs in the waiting room.
"This dog must be a noise nuisance at home," I said to the mother who is over 50 years old. "I know my neighbours for over 20 years. None has complained to me."
The domestic worker shook her head and said. "They are complaining about the barking." It is difficult for neighbours to sleep when this dog barks a lot. The mother agreed to neutering.
This male Jack Russell barked every second at the surgery where he was warded for 5 days for post-neutering care. Too good a chance to miss as there were other patients facing him.
CASE 2
Shih Tzu, Male, 6 months.
Problem: Barks loudly at 8 am nowadays. Owner bought him in for neutering.
Breakfast at 7 am. Pees and poop on grate + pee pan.
Put back into the playpen as lady has to work and he mum has to do house-work. Barks at 8 am. May disturb neighbours.
Male dog matures at 6 months. Starts to dominate
"He is mature now and knows barking will get him out of the playpen," I advised. "Neutering must be done together with obedience training."
Oral commands: "Quiet," or "No barking". The lady owner will grip the muzzle before saying one of the two commands.
Advice: "Just say 'No barking' in a firm voice, grip the muzzle and give a light tap." The gentle lady was not too keen on tapping the dog. For male dogs, a more assertive training is needed.
GRATE + PEE PAN TRAINING SUCCESS STORY
I could follow up this toilet training case because the lady owner told me that earlier, she had e-mailed to me for toilet-training advice. Her puppy was confined inside a playpen and given a grate + pee pan. Sometimes he would pee and poop outside the grate after one month. I had replied that the grate + pee pan would be soiled and so the puppy would not step onto it later. If she had no time to clean the soiled grate or remove the poop, she should buy a second grate + pee pan. She bought another one.
Secrets of success
1. Confinement for over 1 month in the playpen unless supervised.
2. 2nd grate + pee pan.
3. Immediate removal of morning stools and cleaning the grate with an enzymatic disinfectant. Nowadays, the dog seldom use the second grate + pee pan. He poops 2-3X/day and pees on the grate.
4. Sleeps inside the playpen at night. See floor plan in image.
5. Lots of training and patience.
6. When let out, watch for signs of elimination (turning, sniffing) closely. Pick up puppy quickly and put onto the grate.
7. Take leave to train the puppy in the first 2 weeks or ask mum to help.
8. Feed bowl put inside cage. Remove soon after eating. No free feeding.
9. Routine. Eats at am and 7 pm. Poops at 7.30 am, 11.30 am or 7.30 pm or 10 pm.
In Singapore, barking male dogs are commonly encountered. I describe 2 cases of male dogs I have just neutered in the last 2 days.
CASE 1
Problem: Social nuisance in the HDB apartment neighbourhood.
1. Jack Russell male, 5 years. Barking non-stop. When he sees another dog, he barks loudly at them, trying to get at them. In the surgery, he was to be vaccinated but he barked ferociously at the other dogs in the waiting room.
"This dog must be a noise nuisance at home," I said to the mother who is over 50 years old. "I know my neighbours for over 20 years. None has complained to me."
The domestic worker shook her head and said. "They are complaining about the barking." It is difficult for neighbours to sleep when this dog barks a lot. The mother agreed to neutering.
This male Jack Russell barked every second at the surgery where he was warded for 5 days for post-neutering care. Too good a chance to miss as there were other patients facing him.
CASE 2
Shih Tzu, Male, 6 months.
Problem: Barks loudly at 8 am nowadays. Owner bought him in for neutering.
Breakfast at 7 am. Pees and poop on grate + pee pan.
Put back into the playpen as lady has to work and he mum has to do house-work. Barks at 8 am. May disturb neighbours.
Male dog matures at 6 months. Starts to dominate
"He is mature now and knows barking will get him out of the playpen," I advised. "Neutering must be done together with obedience training."
Oral commands: "Quiet," or "No barking". The lady owner will grip the muzzle before saying one of the two commands.
Advice: "Just say 'No barking' in a firm voice, grip the muzzle and give a light tap." The gentle lady was not too keen on tapping the dog. For male dogs, a more assertive training is needed.
GRATE + PEE PAN TRAINING SUCCESS STORY
I could follow up this toilet training case because the lady owner told me that earlier, she had e-mailed to me for toilet-training advice. Her puppy was confined inside a playpen and given a grate + pee pan. Sometimes he would pee and poop outside the grate after one month. I had replied that the grate + pee pan would be soiled and so the puppy would not step onto it later. If she had no time to clean the soiled grate or remove the poop, she should buy a second grate + pee pan. She bought another one.
Secrets of success
1. Confinement for over 1 month in the playpen unless supervised.
2. 2nd grate + pee pan.
3. Immediate removal of morning stools and cleaning the grate with an enzymatic disinfectant. Nowadays, the dog seldom use the second grate + pee pan. He poops 2-3X/day and pees on the grate.
4. Sleeps inside the playpen at night. See floor plan in image.
5. Lots of training and patience.
6. When let out, watch for signs of elimination (turning, sniffing) closely. Pick up puppy quickly and put onto the grate.
7. Take leave to train the puppy in the first 2 weeks or ask mum to help.
8. Feed bowl put inside cage. Remove soon after eating. No free feeding.
9. Routine. Eats at am and 7 pm. Poops at 7.30 am, 11.30 am or 7.30 pm or 10 pm.
Monday, May 24, 2010
77. Injectable anaesthesia IM and IV for cat spay
SHARING KNOWLEDGE ON INJECTABLE ANAESTHESIA IN THE SPAY OF A CAT
1. IM
I find the following combination effective as one IM injection
1.1. 3 kg cat. Today, I spayed a raggamuffin, female, 1 year. 3 kg using injectable anaesthetic.
Xylazine 0.15 ml Ketamine 0.6 ml in one syringe IM
Duration of anaesthesia around 20 minutes in this case. I don't need isoflurane gas top up. This is the ideal situation as it means less operating time.
1.2 5 kg cat. I have used xylazine 0.2 ml and ketamine 0.8 ml IM without side effects.
2. IV
I don't use IV as I find it time consuming but it is one vet's favourite mode of administration and he following simple formula, easy to remember is shared with vets.
2.1 3-kg cat. xylazine 0.1 ml, ketamine 0.2 ml in one syringe, totalling 0.3 ml. Inject 0.1 ml IV first, then another 0.1 ml to effect.
2.2 5-kg cat. xylazine 0.1 ml and ketamine 0.4 ml, totalling 0.5 ml.
Note that you give 0.2 ml IV first. Then increase by 0.05 ml doses to effect. You don't need to use all 0.5 ml.
3. MY CONCLUSIONS
I prefer the IM method for ease of administration and permitting me to focus on surgery. I give isoflurane gas by mask for a few seconds to top up if necessary. However, the IV top-up method is excellent if you don't have isoflurane facilities. The cat is shaved 5 minutes after IM and I operate 10 minutes after injection. Many years ago, I used xylazine IM and then isoflurane gas for cat spay. Now, I don't use it as I find the IM method extremely effective in healthy cats.
1. IM
I find the following combination effective as one IM injection
1.1. 3 kg cat. Today, I spayed a raggamuffin, female, 1 year. 3 kg using injectable anaesthetic.
Xylazine 0.15 ml Ketamine 0.6 ml in one syringe IM
Duration of anaesthesia around 20 minutes in this case. I don't need isoflurane gas top up. This is the ideal situation as it means less operating time.
1.2 5 kg cat. I have used xylazine 0.2 ml and ketamine 0.8 ml IM without side effects.
2. IV
I don't use IV as I find it time consuming but it is one vet's favourite mode of administration and he following simple formula, easy to remember is shared with vets.
2.1 3-kg cat. xylazine 0.1 ml, ketamine 0.2 ml in one syringe, totalling 0.3 ml. Inject 0.1 ml IV first, then another 0.1 ml to effect.
2.2 5-kg cat. xylazine 0.1 ml and ketamine 0.4 ml, totalling 0.5 ml.
Note that you give 0.2 ml IV first. Then increase by 0.05 ml doses to effect. You don't need to use all 0.5 ml.
3. MY CONCLUSIONS
I prefer the IM method for ease of administration and permitting me to focus on surgery. I give isoflurane gas by mask for a few seconds to top up if necessary. However, the IV top-up method is excellent if you don't have isoflurane facilities. The cat is shaved 5 minutes after IM and I operate 10 minutes after injection. Many years ago, I used xylazine IM and then isoflurane gas for cat spay. Now, I don't use it as I find the IM method extremely effective in healthy cats.
76. Ventral dermatitis. Itchy dwarf hamster. Allergy?
A very itchy hamster.
Dwarf hamster, male, around 2 years old. Scratching ears non-stop, lower body hairless and red. Right leg, one hairless lump.
"You understand that the hamster has around 6 months of life left," the hamster bit my assistant through his fabric gloved hand when handled. He bits family members too. He pees everywhere unlike other hamsters who pees in a separate area.
My observations on Day 1 when the hamster came to the Surgery.
His cage:
He stays inside his food bowl and his sleep bowl (with tissue papers put in by the mother). "He takes the tissues and put in one right corner above the pelleted floor to sleep," the mother said.
"A new hamster costs $5.00. Veterinary charges will be more." I said.
"Should the hamster be put to sleep?" the mum asked. "I take care of the hamster. My daughter plays with him."
"New hamsters are free of charge," the mum replied.
"However, the younger generation will not want their pets to be put to sleep. Ask her."
The girl shook her head. So, the mum decided to get the hamster treated. I warded him for 4 days.
History
"Could he be suffering from allergy? His mother who lived separately had same red hairless lower body and itchiness. Vet 1 diagnosed allergy. The mother had died recently.
Any changes of the environment?
1. New litter in December 2009 - grey pelleted ones as the pet shop had stopped selling the white cottony litter which was used previously. Itchiness started for the mother and the son.
"Why don't you buy the coloured ones?" I asked. The owner did not like the coloured ones and so bought the grey pellets.
2. New sand bath in December 2009 too. No more sand bath for some weeks.
From the history, this seemed to be contact or ventral dermatitis due to irritation of the litter.
Treatment
Avoidance of irritating litter, sand and prevention of the hamster squatting inside the food bowl. I used a flat small food bowl. Wait and see for the next few days. On Day 2, I observed considerable less scratching and took some pictures.
Dwarf hamster, male, around 2 years old. Scratching ears non-stop, lower body hairless and red. Right leg, one hairless lump.
"You understand that the hamster has around 6 months of life left," the hamster bit my assistant through his fabric gloved hand when handled. He bits family members too. He pees everywhere unlike other hamsters who pees in a separate area.
My observations on Day 1 when the hamster came to the Surgery.
His cage:
He stays inside his food bowl and his sleep bowl (with tissue papers put in by the mother). "He takes the tissues and put in one right corner above the pelleted floor to sleep," the mother said.
"A new hamster costs $5.00. Veterinary charges will be more." I said.
"Should the hamster be put to sleep?" the mum asked. "I take care of the hamster. My daughter plays with him."
"New hamsters are free of charge," the mum replied.
"However, the younger generation will not want their pets to be put to sleep. Ask her."
The girl shook her head. So, the mum decided to get the hamster treated. I warded him for 4 days.
History
"Could he be suffering from allergy? His mother who lived separately had same red hairless lower body and itchiness. Vet 1 diagnosed allergy. The mother had died recently.
Any changes of the environment?
1. New litter in December 2009 - grey pelleted ones as the pet shop had stopped selling the white cottony litter which was used previously. Itchiness started for the mother and the son.
"Why don't you buy the coloured ones?" I asked. The owner did not like the coloured ones and so bought the grey pellets.
2. New sand bath in December 2009 too. No more sand bath for some weeks.
From the history, this seemed to be contact or ventral dermatitis due to irritation of the litter.
Treatment
Avoidance of irritating litter, sand and prevention of the hamster squatting inside the food bowl. I used a flat small food bowl. Wait and see for the next few days. On Day 2, I observed considerable less scratching and took some pictures.
Sunday, May 23, 2010
Teresa Teng's Chinese songs
I don't listen to Chinese songs. I got to know about Teresa Teng from an intern's mother in the following way. On the 10th day of Chinese New Year (CNY), the intern's mother invited me for a CNY lunch at a Novena Square Chinese restaurant to thank me. The intern had gone back to Australia to study. In the 15 days of CNY, Chinese people in Singapore might celebrate by eating "raw fish" with slices of vegetables. This eating of raw fish would be considered a ritual to symbolise get good luck and prosperity for the New Year. A brand new silver Mercedes 250 rolled outside my Surgery at 1 pm to pick me up for the lunch appointment. The intern's aunty had just got her new car on the eve of the New Year and had arrived with her sister (the intern's mother). My friend Khin Khin was visiting me at my Surgery. I asked Khin Khin to come out so that I could introduce a role model to her. I hoped that Khin Khin who wants to be a business woman would be able to see a successful business woman who was doing the type of business she was going to do. The aunty got out of the car, was introduced and shook hands with Khin Khin instead of saying "hello" inside the car. This act showed she had the proper manners and was one reason she was successful in her cut-throat trading business.
At the restaurant, the aunty of the intern who would be paying for the lunch said: "No raw fish today." It was impolite to ask why. The aunty said: "I am a vegetarian. So, all of you eat meat." She checked the menu and ordered meat for us while she ate as small amount of rice and vegetables as she could. She even offered me half of her small bowl of rice. No wonder she was as slim as a fashion model on the runway. She dressed in a glittering violet material and wore light brown long boots. The intern's mother, her friend and I would appear to be under-dressed. The aunty produced an National Trades Union Congress birthday voucher which entitled her to $100 off the price of lunch at this restaurant. She gave it to the Captain. "No, we don't accept this voucher today. It is for to be used for weekends and holidays like Valentine's Day and Mother's Day." "Today is the 10th day of CNY," the aunty replied. "In CNY, there are 15 days of celebration and so the 10th day is a holiday. The voucher did not specify that it was not for use for the 15 days of CNY." This cut no ice with the Captain. The aunty stood her ground on the basis of principles. The Captain rejected her. So the voucher was no use for this strong-willed woman. The aunty apologised to me after losing out to the Captain who had her instructions. The intern's mother said: "It is embarrassing for the doctor". After all, the aunty had bought a new Mercedes which would mean she was not in need of this discount voucher. "And in the presence of two accountants," I added. The mother said: "Two CPAs." The aunty did not retort. I don't think it was embarrassing. It was business. A free voucher was to be claimed. The intern's mother said: "Phone the (name of a Chinese newspapers). They give $50.00 if they publish such news." "At least you recover 50%," I said since her $100 voucher was not useful. What was there to talk to 3 career women who had seen at least 40 years of life? I asked whether the intern's mother had attended the ABBA show and heard their songs. "Who is ABBA?" the intern's mother asked. She said: "I listen to Chinese songs. My favourite singer is Deng Lijun." I had heard about this famous Taiwanese pop singer and asked: "Do you mean Teresa Teng?" The aunty nodded her head as the mum did not know. The lunch was fun as all could converse. The lunch crowd left. It was 3 pm when I returned to the Surgery. I checked out Teresa Teng on youtube.com and discovered that she had a large fan base and could sing English songs too. Some very good ones like Stevie Wonders' "I just called to say I love you" at: http://www.youtube.com/watch?v=FIc1aodkQk0 Unfortunately she died of an asthmatic attack at the age of 42 years. That was 15 years ago. One of her famous folk songs and romantic ballads is: "The Moon Represents My Heart". See: http://www.youtube.com/watch?v=97-GXzi6PPw From a website, a writer wrote: Well, it's always hard to do a word-by-word translation, but the following is roughly what the original lyrics mean: You ask me how deep's my love, and to what degree. My feelings 're true, my love is true, the moon reflects my heart. You ask me how deep's my love, and to what degree. My feelings won't ebb, my love won't change... the moon reflects my heart. The above translation of her song was not the complete lyrics but it would do. TIPS FOR STUDENTS Listening to her Chinese songs could help Singaporean students finding difficulty in studying Chinese. Pop songs in Chinese may help them to be motivated and to learn more about the Chinese language.
Subscribe to:
Posts (Atom)