Wednesday, July 14, 2010 inspection
Dusk fell fast in July. The waiting room was pitch dark as my assistant was at the back feeding the dog while the intern had just gone for her dinner. I was in the consultation room typing up my ear canal resection observations for my record and experience. Delays in writing mean never writing them up as every day seems to fly by so fast.
I noticed a young lady in black spectacle frames coming into the waiting area at 6.30 pm on July 14, 2010 as my consultation room door has a glass window on the top half.
I thought she was going to pick up her dog, cat or hamster as my associate Dr Teo has several in-patients. 3 cat fight wounds and 3 other dogs and two hamsters. I had two ear canal resection cases, a motorbike abrasion trauma case and 4 hamsters from one owner and two young rabbits nobody wanted to adopt. The kennel at Toa Payoh Vets was full house today.
After a while, I left my computer to speak to her. She had made appointment to inspect the Surgery prior to spaying her dog on Sunday. This was the first time I get an inspection from the non-regulatory veterinary authorities and I showed her the premises and answered all her queries.
The following queries regarding the spay of her Chow Chow this Sunday are recorded for the benefit of dog owners and for my knowledge management archives.
Dear Ms ....
1. No food and water 10 hours before arrival at the Surgery.
2. Your Chow Chow will arrive at 12 noon on Sunday and surgery will be performed around 1-2 hours later depending on my caseload.
3. Bathe your dog before coming to the Surgery and check that she has no skin disease on her belly area.
4. She should be active and has had normal appetite on Saturday. If she has vomiting, diarrhoea, loss of appetite or is inactive, do not bring her for spay. Let us know when you cancel the appointment.
5. At the Surgery, she will examined and if she has no fever or heart problems, spaying will be done by me.
6. Belly hair will be clipped. Dog goes to Operation Room. Surgery takes around 15 minutes.
7. Anaesthesia domitor IV and isoflurane gas will be given.
8. An IV saline drip will be set up.
9. An antidote to domitor called Antisedan will be injected post-operation. This injection wakes up the dog in a few seconds as if from a short nap.
10. Post-op tolfedine and baytril antibiotic injection will be given.
11. The dog can go home 2 hours later with antibiotics and tolfedine pain-killers for the next 4 days. We will phone you.
12. For the first 2 days, the dog may or may not be active or eating much. It will be good if you take leave on Monday. If not, ensure that the dog is crated or in a small room.
13. Check the surgical area daily for pus or abnormal bleeding. Replace the plaster 2 days later after using a piece of facial cotton with clean warm water to wash away the blood clots. Dry the wound after washing. Then put on the new plaster.
14. No e-collar will be used in your dog although I do recommend in many female dogs. Your Chow Chow may not like it.
The plaster usually protects the wound. Usually the dog does not lick the wound if the painkillers are given as instructed. Some owners are unable to give the tablets directly onto the back of the tongue, close the mouth, stroke the neck while lifting up the head. Some dogs are too smart and just spit out the tablets and therefore do not get the pain-killing effect. They start to lick the operation wound.
Therefore, an alternative method is to conceal the tablets in cheese or meat balls. The first two ball given will not contain the drug. The third will contain the drug. Delay the meal time by one hour as an example. Usually the dog just swallow her favourite food quickly.
15. The absorbable skin stitches will dissolve in 21 -28 days. So you need not come for stitch removal unless you want to get the stitches removed in 14 days as some dogs do get irritated by the stitches. Stitch abscesses form and are irritating. Observe daily and you can use clean scissors to cut off the knots on Day 14. Usually I stitch 2 skin stitches and they can be cut off easily 14 days after surgery.
16. If possible don't let the dog walk up and down slopes or stairs in the first 7 days. As the wound is 2 cm long (if there is no complications), this will not be a big problem with stitch breakdown. However, try not to let the dog jump and run around as she will feel active by Day 2 as the painkillers mask the pain.
17. Air-condition post-operation for the Chow Chow with her thick coat. In my experience, the body temperature after surgery drops due to the sedation and anaesthetic. No air condition is necessary and no Alaskan malamute, Siberian Huskies or Chow Chow have suffered from heat stress due to the lack of air conditioning post-operation. In your case, the dog goes home two hours post-operation and therefore she should be OK with you.
18. During the past years, I seldom get post-operation infections and complications after the spay if the owner nurses the dog well. Some 10-15 years ago, I did not give pain-killers post-surgery and the dog may howl in pain at home and during the first night. With pain-killers and antibiotics properly taken, no spayed dog will howl at home 24 hours after spay.
19. I hope all the questions are answered. E-mail your questions if there are more. Best wishes.
Thursday, July 15, 2010
Wednesday, July 14, 2010
127. Lateral ear canal resection - Cocker Spaniel
Dog went home 4 days after surgery as I wanted the owner to save veterinary costs.
35 maggots 1 cm long in left lateral ear below the horizontal canal 14 days later.
Drainage cartilage eaten away. Ear and e-collar full of blood.
"Was the dog outdoors?" I asked.
"Yes," the mother said.
"Any flies buzzing around the dog? There is a strong smell of maggot wound."
"No flies," the mother said.
"Yes," the teenaged daughter replied.
I had to ward the dog for treatment. 20 maggots extracted out. Negasunt powder given. After 3 days of antibiotics and anti-inflam treatment, the wound was fresh red. I phoned for permission to close up the wound. Permission given.
The dog's wound looked wet and yellowish. Some 15 maggots still were around. Maggots removed. Wound stitched. Drainage tube.
35 maggots 1 cm long in left lateral ear below the horizontal canal 14 days later.
Drainage cartilage eaten away. Ear and e-collar full of blood.
"Was the dog outdoors?" I asked.
"Yes," the mother said.
"Any flies buzzing around the dog? There is a strong smell of maggot wound."
"No flies," the mother said.
"Yes," the teenaged daughter replied.
I had to ward the dog for treatment. 20 maggots extracted out. Negasunt powder given. After 3 days of antibiotics and anti-inflam treatment, the wound was fresh red. I phoned for permission to close up the wound. Permission given.
The dog's wound looked wet and yellowish. Some 15 maggots still were around. Maggots removed. Wound stitched. Drainage tube.
Sunday, July 11, 2010
Sunday's interesting case: The case of the missing Struvite Stones
E-MAIL TO DR SING SUN JUL 11, 2010
On Sun, Jul 11, 2010 at 3:15 AM, ...@gmail.com> wrote:
Hi. I found out about Toa Payoh vets as I was browsing pet forums and blogs. I have a 5yr old female mini schnauzer (high risk for stones). I adopted her from one of my husband's friend's last year. She has been struggling with struvite stones ever since we adopted her. There was blood in her urine last July/Aug. It subsided after a course of antibiotics. The condition recurred again this year (June). I reckon it was due to the new food supplement I gave her. I have already consulted 2 vets, but they said surgery is main cure. I was browsing your website and saw that you guide owners who do not want surgery. I am interested in this approach.
I hope to have a second opinion. I am already cooking for my pet and she eating home cook food with Urinary s/o and cranberry juice. I hope to do more for her to ensure she has a better quality of life. Not sure if I can bring my pet down this coming week (preferably Mon, Fri or Sat mornings) for a consultation.
P/s: My pet is outside trained, and if she starts peeing indoors for no reason, it means the stones are back. She urinated at home again today, but not sure if it is due to stones or the change in schedule since we brought her for grooming and didn't bring her for her usual long walk due to the heavy downpour.
Thank you for patience in reading this long email.
An anxious owner,
Name and telephone
FOR THE BENEFIT OF OWNERS WHO WANT TO USE MEDICAL TREATMENT FOR THEIR WITH URINARY STRUVITE STONES, HERE IS A CASE STUDY.
Sunday July 11, 2010. Bright sunshine. Blue skies. Should be outdoors.
I phoned the owner after reading the e-mail as this is a case with no definitive diagnosis!
HISTORY
Spayed dog was adopted when she was 4 years old.
July 2009. Passed blood in urine. Vet 1 took X-ray and check urine pH. Vet 1 was unsure whether there were bladder stones but said urine pH was alkaline but the owner could not say whether it was pH 7 or 8. Clavet antibiotics for 2 weeks and Royal Canine Urinary S/O diet for one month. No problem. The owner stopped giving dry and canned dog food and treats. Home-cooked food with a piece of chicken meat now gave her peace of mind till the dog started peeing at home, an abnormal behaviour in July 2010.
June 2010. Passed blood in urine and urinary incontinence. Vet 2 from the same practice prescribed same antibiotics for 2 weeks. Now no blood in the urine and bladder control. Will the stones come back again?
WHAT THE OWNER WANTS
"What do you want for your dog?" I asked. I might have woken her up from sleep by phoning at 10 am.
"No recurrence of the blood in the urine and urinary incontinence problem for the 3rd time." She forgot to mention no urinary stone removal surgery.
OTHER INFORMATION
Licked vulval area most of the time after outdoor walk.
Dental hygiene poor - tartar.
PHONE DIAGNOSIS:
It seemed that there was no veterinary diagnosis of struvite stones. The owner believed that the dog has struvite urinary stones. The presence of struvite stones was not confirmed by urinary analysis. Although the Miniature Schnauzer is one breed prone to getting urinary stones, this case may be a case of urinary tract infection. She may not have non-struvite urinary stones.
ADVICE
1. Get a proper diagnosis:
t is best to get the dog examined for stones by palpation. A blood test to check the kidney function as the owner had been giving her own prescriptions. A urine test for crystals - collect urine via catherisation. X-ray after emptying bladder and use air contrast.
2. If the struvite urinary stones are very small, medical dissolution of the stones + acidification + prescription diet may be possible. 3-monthly check ups of urine will still be necessary.
3.
Behaviour - licking of vulval area must be stopped. Dental work must be done as the mouth is full of bacteria which may have infected the bladder via vulval licking. The female dog has a short urethra and bacterial infections are common. Veterinary cases such as this case of the recurrence of blood in the urine are more interesting than Sherlock Holmes' cases. However, I don't have Dr Watson to help me.
On Sun, Jul 11, 2010 at 3:15 AM, ...@gmail.com> wrote:
Hi. I found out about Toa Payoh vets as I was browsing pet forums and blogs. I have a 5yr old female mini schnauzer (high risk for stones). I adopted her from one of my husband's friend's last year. She has been struggling with struvite stones ever since we adopted her. There was blood in her urine last July/Aug. It subsided after a course of antibiotics. The condition recurred again this year (June). I reckon it was due to the new food supplement I gave her. I have already consulted 2 vets, but they said surgery is main cure. I was browsing your website and saw that you guide owners who do not want surgery. I am interested in this approach.
I hope to have a second opinion. I am already cooking for my pet and she eating home cook food with Urinary s/o and cranberry juice. I hope to do more for her to ensure she has a better quality of life. Not sure if I can bring my pet down this coming week (preferably Mon, Fri or Sat mornings) for a consultation.
P/s: My pet is outside trained, and if she starts peeing indoors for no reason, it means the stones are back. She urinated at home again today, but not sure if it is due to stones or the change in schedule since we brought her for grooming and didn't bring her for her usual long walk due to the heavy downpour.
Thank you for patience in reading this long email.
An anxious owner,
Name and telephone
FOR THE BENEFIT OF OWNERS WHO WANT TO USE MEDICAL TREATMENT FOR THEIR WITH URINARY STRUVITE STONES, HERE IS A CASE STUDY.
Sunday July 11, 2010. Bright sunshine. Blue skies. Should be outdoors.
I phoned the owner after reading the e-mail as this is a case with no definitive diagnosis!
HISTORY
Spayed dog was adopted when she was 4 years old.
July 2009. Passed blood in urine. Vet 1 took X-ray and check urine pH. Vet 1 was unsure whether there were bladder stones but said urine pH was alkaline but the owner could not say whether it was pH 7 or 8. Clavet antibiotics for 2 weeks and Royal Canine Urinary S/O diet for one month. No problem. The owner stopped giving dry and canned dog food and treats. Home-cooked food with a piece of chicken meat now gave her peace of mind till the dog started peeing at home, an abnormal behaviour in July 2010.
June 2010. Passed blood in urine and urinary incontinence. Vet 2 from the same practice prescribed same antibiotics for 2 weeks. Now no blood in the urine and bladder control. Will the stones come back again?
WHAT THE OWNER WANTS
"What do you want for your dog?" I asked. I might have woken her up from sleep by phoning at 10 am.
"No recurrence of the blood in the urine and urinary incontinence problem for the 3rd time." She forgot to mention no urinary stone removal surgery.
OTHER INFORMATION
Licked vulval area most of the time after outdoor walk.
Dental hygiene poor - tartar.
PHONE DIAGNOSIS:
It seemed that there was no veterinary diagnosis of struvite stones. The owner believed that the dog has struvite urinary stones. The presence of struvite stones was not confirmed by urinary analysis. Although the Miniature Schnauzer is one breed prone to getting urinary stones, this case may be a case of urinary tract infection. She may not have non-struvite urinary stones.
ADVICE
1. Get a proper diagnosis:
t is best to get the dog examined for stones by palpation. A blood test to check the kidney function as the owner had been giving her own prescriptions. A urine test for crystals - collect urine via catherisation. X-ray after emptying bladder and use air contrast.
2. If the struvite urinary stones are very small, medical dissolution of the stones + acidification + prescription diet may be possible. 3-monthly check ups of urine will still be necessary.
3.
Behaviour - licking of vulval area must be stopped. Dental work must be done as the mouth is full of bacteria which may have infected the bladder via vulval licking. The female dog has a short urethra and bacterial infections are common. Veterinary cases such as this case of the recurrence of blood in the urine are more interesting than Sherlock Holmes' cases. However, I don't have Dr Watson to help me.
Friday, July 9, 2010
125. Head tilt when ear drops applied
Friday July 9, 2010
English Cocker Spaniel, Female, Spayed, 12 years. 12.7 kg
Rotten tissue decay smell in the right ear
Scratches right ear onto the floor. Vet 2 advised 1,5 years ago to use ear drops from pet shop and seeing him 6-monthly. Ear drops worked till recently. Very smelly liquid from ear.
Advised: Surgery as permanent cure rather than visit Vet 2 six-monthly. 3 days of antibiotics, I would operate on Monday.
Last 3 days, head tilted to the right after pet shop Nova ear drops applied onto ear for one hour before sleeping.
1. It is important to check head tilt before surgery. Asked owner to exercise the dog. Slight head tilt to the right. May be blamed by the owner if head tilts after surgery.
2. Checked heart. OK for anaesthesia.
3. Blood tests. Father wanted to buy new puppy as $500 operation would pay for new puppy. "Does he want this old dog to be put to sleep?" I asked. "I will never agree to it," the young lady said. Due to economics, did not insist on a blood test.
4. Economics.
In August 2009, I removed 31 urinary stones (blood in the urine, complained that Vet 1 prescribed medication for few times, ineffective). No dry food or canned food. Fed vegetables, soup and little meat. No blood in urine colour. She used dipstick to check pH.
Then on January 2010, my vet removed a mammary tumour. No recurrence of tumour as checked today. So the young lady had to budget her expenses and savings as taught by her father from young. Very few parents teach their children financial management.
OLD DOG. 3rd anaesthesia after 31 bladder stones removed and breast tumour removal n 2009.
Sedation: Domitor 0.2 ml IM, Zoletil 100 0.1 ml IV, Atropine 1.0 ml IV. Top up with isoflurane gas. Excellent general anaesthesia.
SURGERY - A different surgical approach from my usual method.
Midline incision of vertical ear canal
Separate skin and SC tissues
Lateral wall seen
V-shaped cut of lateral wall from anterior and posterior ends.
Lots of bleeding controlled by swab
Cut lateral wall - cartilage end trimmed by cutting to depth of around 2mm so that the skin ends are free of cartilage (like ear cropping) and can be stitched. Nylon stitches.
NO drainage board. Much shorter operation time and incision.
POST OP
Antibiotics. Rimadyl 50mg/ml at 1.0 ml effective painkiller. Dog eating the next day.
Photograph on Day 2.
To stay 5 days.
English Cocker Spaniel, Female, Spayed, 12 years. 12.7 kg
Rotten tissue decay smell in the right ear
Scratches right ear onto the floor. Vet 2 advised 1,5 years ago to use ear drops from pet shop and seeing him 6-monthly. Ear drops worked till recently. Very smelly liquid from ear.
Advised: Surgery as permanent cure rather than visit Vet 2 six-monthly. 3 days of antibiotics, I would operate on Monday.
Last 3 days, head tilted to the right after pet shop Nova ear drops applied onto ear for one hour before sleeping.
1. It is important to check head tilt before surgery. Asked owner to exercise the dog. Slight head tilt to the right. May be blamed by the owner if head tilts after surgery.
2. Checked heart. OK for anaesthesia.
3. Blood tests. Father wanted to buy new puppy as $500 operation would pay for new puppy. "Does he want this old dog to be put to sleep?" I asked. "I will never agree to it," the young lady said. Due to economics, did not insist on a blood test.
4. Economics.
In August 2009, I removed 31 urinary stones (blood in the urine, complained that Vet 1 prescribed medication for few times, ineffective). No dry food or canned food. Fed vegetables, soup and little meat. No blood in urine colour. She used dipstick to check pH.
Then on January 2010, my vet removed a mammary tumour. No recurrence of tumour as checked today. So the young lady had to budget her expenses and savings as taught by her father from young. Very few parents teach their children financial management.
OLD DOG. 3rd anaesthesia after 31 bladder stones removed and breast tumour removal n 2009.
Sedation: Domitor 0.2 ml IM, Zoletil 100 0.1 ml IV, Atropine 1.0 ml IV. Top up with isoflurane gas. Excellent general anaesthesia.
SURGERY - A different surgical approach from my usual method.
Midline incision of vertical ear canal
Separate skin and SC tissues
Lateral wall seen
V-shaped cut of lateral wall from anterior and posterior ends.
Lots of bleeding controlled by swab
Cut lateral wall - cartilage end trimmed by cutting to depth of around 2mm so that the skin ends are free of cartilage (like ear cropping) and can be stitched. Nylon stitches.
NO drainage board. Much shorter operation time and incision.
POST OP
Antibiotics. Rimadyl 50mg/ml at 1.0 ml effective painkiller. Dog eating the next day.
Photograph on Day 2.
To stay 5 days.
124. Fever, Anaemia & anterior abdominal pain 2-year-old male Shih Tzu
History
Shih Tzu, M, 2 years
Admitted on Jul 6, 2010, 9pm. Lethargy, not eating for 2 days. Fever and white gums and tongue. The domestic worker said that the dog was given (chicken +/or fish) bones by a family member recently.
Presenting signs
Acute abdomen (anterior). Bites vet when the anterior abdomen was palpated.
Blood test on Jul 7, 2010 - anaemia, dehydration and toxaemia
Low red cell count ( 4.1) and haemoglobin (10.4)
Low packed cell volume (0.3)
Low platelets (47). No platelet clumps seen but few giant platelets present.
Surprisingly, the WCC on admission was below normal at 5.4 with neutrophils 94% and lymphocytes 4% instead of a big increase.
Liver profile normal. Kidney profile - urea is normal. Creatinine is below normal.
Urine test on Jul 8, 2010. Full bladder catheterised to collect urine. There appears to be one urinary stone in the bladder on X-ray.
Catherised urine results taken after X-ray showing one urinary stone are as follows:
brown, turbid, SG 1.020 pH 7.0. Abnormal findings are as follows:
Protein 3+, urobilinogen 1+, bilirubin 3+, blood 4+, WBC 58, RBC 243, Crystals of amorphous phosphate 2+, triple phosphate occasional, bacteria 3+
X-rays on Jul 8, 2010.
Stomach is filled with radio-opaque granules. Some larger radio-opaque lumps are present in the intestines. These are likely bones.
Spleen is enlarged.
Diagnosis
Toxaemia. Impacted stomach and intestines and urinary tract infections.
Treatment on Jul 7 & 8, 2010
IV drip x 2 bottles (glucose saline + saline) x 500 ml each for 24 hours
Vit K1 2ml in drip
Baytril 1.0 ml, Tolfedine 4% 1.0 ml x 2 days in IV.
No fever on Jul 8, 2010. Dog more alert but does not want to walk or poop.
Stomach mucosa bleeding. Surgical removal of foreign bodies in the stomach is needed but highly risky. The dog is unlikely to survive the anaesthesia.
Goes home for the next 2 days for observation of pooping. Owner has been informed about poor prognosis if the dog does not poop or has more stomach bleeding
X-ray images x 2 showed stomach and intestine are impacted with radio-opaque foreign bodies
Shih Tzu, M, 2 years
Admitted on Jul 6, 2010, 9pm. Lethargy, not eating for 2 days. Fever and white gums and tongue. The domestic worker said that the dog was given (chicken +/or fish) bones by a family member recently.
Presenting signs
Acute abdomen (anterior). Bites vet when the anterior abdomen was palpated.
Blood test on Jul 7, 2010 - anaemia, dehydration and toxaemia
Low red cell count ( 4.1) and haemoglobin (10.4)
Low packed cell volume (0.3)
Low platelets (47). No platelet clumps seen but few giant platelets present.
Surprisingly, the WCC on admission was below normal at 5.4 with neutrophils 94% and lymphocytes 4% instead of a big increase.
Liver profile normal. Kidney profile - urea is normal. Creatinine is below normal.
Urine test on Jul 8, 2010. Full bladder catheterised to collect urine. There appears to be one urinary stone in the bladder on X-ray.
Catherised urine results taken after X-ray showing one urinary stone are as follows:
brown, turbid, SG 1.020 pH 7.0. Abnormal findings are as follows:
Protein 3+, urobilinogen 1+, bilirubin 3+, blood 4+, WBC 58, RBC 243, Crystals of amorphous phosphate 2+, triple phosphate occasional, bacteria 3+
X-rays on Jul 8, 2010.
Stomach is filled with radio-opaque granules. Some larger radio-opaque lumps are present in the intestines. These are likely bones.
Spleen is enlarged.
Diagnosis
Toxaemia. Impacted stomach and intestines and urinary tract infections.
Treatment on Jul 7 & 8, 2010
IV drip x 2 bottles (glucose saline + saline) x 500 ml each for 24 hours
Vit K1 2ml in drip
Baytril 1.0 ml, Tolfedine 4% 1.0 ml x 2 days in IV.
No fever on Jul 8, 2010. Dog more alert but does not want to walk or poop.
Stomach mucosa bleeding. Surgical removal of foreign bodies in the stomach is needed but highly risky. The dog is unlikely to survive the anaesthesia.
Goes home for the next 2 days for observation of pooping. Owner has been informed about poor prognosis if the dog does not poop or has more stomach bleeding
X-ray images x 2 showed stomach and intestine are impacted with radio-opaque foreign bodies
Wednesday, July 7, 2010
A needle and thread inside a cat's mouth
Going to an apartment to treat a ferocious cat with a needle and thread inside his mouth can send shivers down a vet's spine. It is like going to a lion's den. But Mr Hall said he could not put his cat inside a crate to bring him to the Surgery. So I had to make a house-call on a fine weekday evening. I drove to the Grand Hyatt in less than 15 minutes and such prompt attendance impressed Mr Hall. I parked outside the hotel after being given permission to do so as I told the valet I was treating Mr Hall's cat.
In the semi-darkened glowing lights of the lobby, I met my two assistants, Mr Aung and Mr Saw at the lobby. The receptionist in smart black jackets and well groomed ushered us into a lift and took us up to Mr Hall's apartment.
I knew what to do as I am an old vet and would finish the job in 20 minutes. But it would be best for my two assistants to get hands-on experience as they wanted to open their own practice in Myanmar next year. They are veterinarians if they practise in Myanmar but they are veterinary technicians or assistants when they work in Singapore.
PREPARATION FOR THE BATTLE
"What will you bring to this case?" I had phoned Mr Aung earlier. "Domitor and swabs to stop bleeding," he said. I packed my bag with Domitor, Antisedan, Xylazine, Ketamine, antibitoics, swabs, a pair of forceps, needles 21G and one-ml syringes. I forgot to pack 23G needles for use in the femoral vein injection as the cat has fine veins which bled in front of the Mrs Hall when Antisedan was injected IV using the bigger 21G needle. Experience is usually gathered after a case handled.
AT THE SCENE
Mr Aung is a hands-on man and he went for the cat. This cat was crouched tightly inside the master bathroom between the water closet and the wall. Mr Aung grabbed the scruff and got him out and placed him on the cat's white towel on the bed in the master bedroom. I had not briefed my assistants and was therefore surprised.
"It is best to prepare the sedative before catching the cat," I said to Mr Aung. "Look at the cat to estimate his weight and prepare the correct dose."
The cat was displeased and pawed Mr Aung vigorously. Mr Aung released him. The cat bounced off the bed and went under the master bed, exactly in the middle of the sanctuary. There was a moment of indecision as Mr and Mrs Hall and I did not know what to do.
"Maybe Mrs Hall should under the bed to get the cat out," I said like a General who bark orders from the safety of an army headquarters fall from the battle scene. Nobody moved.
"Let's lift up the bed," Mr Hall suggested intelligently. Mr Hall and my two assistants lifted up one end. I helped. It was surprisingly a very light bed but there were four of us. Mrs Hall looked on.
Being exposed, the cat sprang to hide behind the day curtains. The room has two sets of curtains. The day curtains are the translucent type. Mr Aung walked quickly towards the curtains to make friends with the cat. What he does normally is to talk to the cat and slowly let the cat (or dog) get used to the smell of his hand. The cat was ready to scratch him as he had scratched Mr Hall's hand a few times when Mr Hall tried to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare the sedative first," I said to Mr Aung. That would be what I would do before touching the cat. I estimated the cat to weigh 3 kg. Though he was adopted as a local cat, he certainly was bigger and fatter than the stray cats we see around the neighbourhood. Mr Aung got 0.1 ml Domitor and 0.1 ml Ketamine in one syringe and gave it to me. He realised that this cat would never accept an IV injection. IV injections at the Surgery could be done because the cat would be in foreign territory and would not be so ferocious usually. Here, the cat was on home ground.
FRONTLINE
Being a hands-on man, Mr Aung walked swiftly to the curtains and in one speedy grab, the cat's scruff was lifted up. He placed the cat on the white blanket on the master bed. I was ready and in less than one second, I had injected the cat's backside muscle with 0.2 ml IM of the combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It is always safe to under-dose a frightened cat. I knew the dose was insufficient. For the next 5 minutes, the cat ambled out of the master bedroom, dashed across the living cum dining room with the open concept kitchen and disappeared into Bedroom 2 at the other end of this apartment. Another 5 minutes passed. The cat was as fresh as a daisy.
REINFORCEMENTS
In a losing battle, the commander must call for reinforcements. "Give the cat Domitor IV," Mr Aung proposed catching the cat as he was one never afraid of getting cat scratches. "All three of us are veterans with cat scars on our hands" I had said to assure Mr Hall who must be wondering what was going on. The sedative seemed to be dud. A dud missile that fell and did not explode.
CAUTION
Soldiers could shock and awe in battle with more bombings to kill the enemies. But this is a cat that must be alive at the end of the house-call. "Better not to give another sedative," I advised Mr Aung. "The cat may react and die. Just wrap the cat inside a towel with his head sticking out. That would be safer. The cat would be sedated slightly by now. 15 minutes had passed." I asked Mr Saw to take the white towel and he went to the bedroom to get the cat for me. I could do everything myself but my assistants would never learn.
SUICIDE BOMBER ATTACK
Mr Aung went inside Bedroom 2 to risk his hands and got the cat by the scruff of the neck. Mr Hall and Mr Saw and possibly Mrs Hall were inside Bedroom 2. As the room was small, I stood outside the door to supervise. Like those consultants who talk but no action.
While Mr Aung was holding the cat for Mr Saw to wrap the towel around, the second cat, white with grey patches suddenly leapt up to claw either Mr Aung or the cat. I just could not believe this suicide bomber attack from the friendly troop. This attacking cat hissed and swung his paws widely. He leapt up and gravity pulled him down. From my point of view, he was attacking Mr Aung.
In cat attacks, it is wise not to interfere. Water hosing would be ideal but not inside the apartment. Mr Hall managed to get the attacker out of the room. He slinked outside the room and would not go away. He was just so furious. Was it the attention the other cat was getting? Mr Hall said to me: "This cat is very protective and was protecting me." Well, next time, no other cats should be present.
The next day, I noted that Mr Saw's left hand had two cat scratches too when we were taking blood from a dog. So, Mr Saw had suffered.
ACTION
After wrapping the cat in the towel, the cat seemed quiet. I said to Mr Saw: "Put the cat on this kitchen counter." I gave Mr Aung the forceps from my bag. He opened the cat's mouth. "There's the needle stuck in the hard palate!" he showed the culprit. I took some pictures with a zoom lens inappropriately. The zoom would not work at first until I stepped back further. Mr Aung took the needle out. A black thread with slimy saliva was attached to the end of the needle. I should have put the needle onto the tissue paper as Mr Hall seemed not too pleased when I placed it directly onto the kitchen counter. Mrs Hall took away the needle. I opened the cat's mouth to give a final check. "No injuries or ulcers," I said to Mr Hall.
ANTIDOTE
"Should give Antisedan," Mr Aung advised me. "Antisedan is an antidote," I said to Mr Hall. "The cat will wake up immediately. If Antisedan is not given, he would wake up fully over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr Hall said.
"There is a small risk that the cat may not wake up. A very small risk. An antisedan injection is an antidote that ensures that the cat's heart and lung systems are back to normal promptly."
The cat inside the towel hissed and hissed. Mr Hall agreed to the Antisedan injection. This was given via the cat's femoral vein at 0.1 ml IV. "Take the cat out of the towel and put him on the floor," I said to Mr Saw rather urgently. Mr Saw could not understand what I mean. In any case, he had no time to think. The cat looked up, assessed his situation well. The cat crawled out of the loosened towel, stood on the counter and in one spring, he leapt onto the floor and disappeared into the sanctuary of the master bedroom.
HAPPY ENDING
Everybody was happy that this cat was back to normal. Mr Hall asked me for my namecard as he was surprised that I was prompt in answering his house call. Mrs Hall would be more careful with her sewing needles and threads from now on.
CONCLUSION
Never give the frightened cat a second dose of sedatives as the cat may just die. This case took three times as long but the cat was alive and that was what every owner wants. It is best to treat such cases at the Surgery. Normally I don't even want to do it at the house as there are so many complications and surprises. Besides, it takes a longer time.
REVIEW
In this case, Xylazine 20 + Ketamine 100 at 0.1 ml + 0.4 ml respectively in one syringe IM would be more effective for this.
In the semi-darkened glowing lights of the lobby, I met my two assistants, Mr Aung and Mr Saw at the lobby. The receptionist in smart black jackets and well groomed ushered us into a lift and took us up to Mr Hall's apartment.
I knew what to do as I am an old vet and would finish the job in 20 minutes. But it would be best for my two assistants to get hands-on experience as they wanted to open their own practice in Myanmar next year. They are veterinarians if they practise in Myanmar but they are veterinary technicians or assistants when they work in Singapore.
PREPARATION FOR THE BATTLE
"What will you bring to this case?" I had phoned Mr Aung earlier. "Domitor and swabs to stop bleeding," he said. I packed my bag with Domitor, Antisedan, Xylazine, Ketamine, antibitoics, swabs, a pair of forceps, needles 21G and one-ml syringes. I forgot to pack 23G needles for use in the femoral vein injection as the cat has fine veins which bled in front of the Mrs Hall when Antisedan was injected IV using the bigger 21G needle. Experience is usually gathered after a case handled.
AT THE SCENE
Mr Aung is a hands-on man and he went for the cat. This cat was crouched tightly inside the master bathroom between the water closet and the wall. Mr Aung grabbed the scruff and got him out and placed him on the cat's white towel on the bed in the master bedroom. I had not briefed my assistants and was therefore surprised.
"It is best to prepare the sedative before catching the cat," I said to Mr Aung. "Look at the cat to estimate his weight and prepare the correct dose."
The cat was displeased and pawed Mr Aung vigorously. Mr Aung released him. The cat bounced off the bed and went under the master bed, exactly in the middle of the sanctuary. There was a moment of indecision as Mr and Mrs Hall and I did not know what to do.
"Maybe Mrs Hall should under the bed to get the cat out," I said like a General who bark orders from the safety of an army headquarters fall from the battle scene. Nobody moved.
"Let's lift up the bed," Mr Hall suggested intelligently. Mr Hall and my two assistants lifted up one end. I helped. It was surprisingly a very light bed but there were four of us. Mrs Hall looked on.
Being exposed, the cat sprang to hide behind the day curtains. The room has two sets of curtains. The day curtains are the translucent type. Mr Aung walked quickly towards the curtains to make friends with the cat. What he does normally is to talk to the cat and slowly let the cat (or dog) get used to the smell of his hand. The cat was ready to scratch him as he had scratched Mr Hall's hand a few times when Mr Hall tried to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare the sedative first," I said to Mr Aung. That would be what I would do before touching the cat. I estimated the cat to weigh 3 kg. Though he was adopted as a local cat, he certainly was bigger and fatter than the stray cats we see around the neighbourhood. Mr Aung got 0.1 ml Domitor and 0.1 ml Ketamine in one syringe and gave it to me. He realised that this cat would never accept an IV injection. IV injections at the Surgery could be done because the cat would be in foreign territory and would not be so ferocious usually. Here, the cat was on home ground.
FRONTLINE
Being a hands-on man, Mr Aung walked swiftly to the curtains and in one speedy grab, the cat's scruff was lifted up. He placed the cat on the white blanket on the master bed. I was ready and in less than one second, I had injected the cat's backside muscle with 0.2 ml IM of the combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It is always safe to under-dose a frightened cat. I knew the dose was insufficient. For the next 5 minutes, the cat ambled out of the master bedroom, dashed across the living cum dining room with the open concept kitchen and disappeared into Bedroom 2 at the other end of this apartment. Another 5 minutes passed. The cat was as fresh as a daisy.
REINFORCEMENTS
In a losing battle, the commander must call for reinforcements. "Give the cat Domitor IV," Mr Aung proposed catching the cat as he was one never afraid of getting cat scratches. "All three of us are veterans with cat scars on our hands" I had said to assure Mr Hall who must be wondering what was going on. The sedative seemed to be dud. A dud missile that fell and did not explode.
CAUTION
Soldiers could shock and awe in battle with more bombings to kill the enemies. But this is a cat that must be alive at the end of the house-call. "Better not to give another sedative," I advised Mr Aung. "The cat may react and die. Just wrap the cat inside a towel with his head sticking out. That would be safer. The cat would be sedated slightly by now. 15 minutes had passed." I asked Mr Saw to take the white towel and he went to the bedroom to get the cat for me. I could do everything myself but my assistants would never learn.
SUICIDE BOMBER ATTACK
Mr Aung went inside Bedroom 2 to risk his hands and got the cat by the scruff of the neck. Mr Hall and Mr Saw and possibly Mrs Hall were inside Bedroom 2. As the room was small, I stood outside the door to supervise. Like those consultants who talk but no action.
While Mr Aung was holding the cat for Mr Saw to wrap the towel around, the second cat, white with grey patches suddenly leapt up to claw either Mr Aung or the cat. I just could not believe this suicide bomber attack from the friendly troop. This attacking cat hissed and swung his paws widely. He leapt up and gravity pulled him down. From my point of view, he was attacking Mr Aung.
In cat attacks, it is wise not to interfere. Water hosing would be ideal but not inside the apartment. Mr Hall managed to get the attacker out of the room. He slinked outside the room and would not go away. He was just so furious. Was it the attention the other cat was getting? Mr Hall said to me: "This cat is very protective and was protecting me." Well, next time, no other cats should be present.
The next day, I noted that Mr Saw's left hand had two cat scratches too when we were taking blood from a dog. So, Mr Saw had suffered.
ACTION
After wrapping the cat in the towel, the cat seemed quiet. I said to Mr Saw: "Put the cat on this kitchen counter." I gave Mr Aung the forceps from my bag. He opened the cat's mouth. "There's the needle stuck in the hard palate!" he showed the culprit. I took some pictures with a zoom lens inappropriately. The zoom would not work at first until I stepped back further. Mr Aung took the needle out. A black thread with slimy saliva was attached to the end of the needle. I should have put the needle onto the tissue paper as Mr Hall seemed not too pleased when I placed it directly onto the kitchen counter. Mrs Hall took away the needle. I opened the cat's mouth to give a final check. "No injuries or ulcers," I said to Mr Hall.
ANTIDOTE
"Should give Antisedan," Mr Aung advised me. "Antisedan is an antidote," I said to Mr Hall. "The cat will wake up immediately. If Antisedan is not given, he would wake up fully over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr Hall said.
"There is a small risk that the cat may not wake up. A very small risk. An antisedan injection is an antidote that ensures that the cat's heart and lung systems are back to normal promptly."
The cat inside the towel hissed and hissed. Mr Hall agreed to the Antisedan injection. This was given via the cat's femoral vein at 0.1 ml IV. "Take the cat out of the towel and put him on the floor," I said to Mr Saw rather urgently. Mr Saw could not understand what I mean. In any case, he had no time to think. The cat looked up, assessed his situation well. The cat crawled out of the loosened towel, stood on the counter and in one spring, he leapt onto the floor and disappeared into the sanctuary of the master bedroom.
HAPPY ENDING
Everybody was happy that this cat was back to normal. Mr Hall asked me for my namecard as he was surprised that I was prompt in answering his house call. Mrs Hall would be more careful with her sewing needles and threads from now on.
CONCLUSION
Never give the frightened cat a second dose of sedatives as the cat may just die. This case took three times as long but the cat was alive and that was what every owner wants. It is best to treat such cases at the Surgery. Normally I don't even want to do it at the house as there are so many complications and surprises. Besides, it takes a longer time.
REVIEW
In this case, Xylazine 20 + Ketamine 100 at 0.1 ml + 0.4 ml respectively in one syringe IM would be more effective for this.
Monday, July 5, 2010
122. Compassion From Friends Is Not Forever
A father suffering hard times finds it hard to pay for his daughter's education overseas. The father asked me for a small loan to pay for his daughter's accommodation. He said he would pay me back two months later. I rejected him because I had helped him several times and he had not returned any money to me. He persevered. Compassion Fatigue sets in when interest-free loans to help a friend in financial distress are forgotten over the years.
An overseas undergraduate law education costs around A$150,000. The daughter had excellent A-level grades but the 3As could not qualify her to study law in Singapore. 4As would qualify and save the father a lot of financial stress.
She was therefore a "victim of circumstances" and deserved a helpomg jamd. The father's salary was insufficient to support her overseas. The father said to me: "My wife asks me to tell you we eat porridge everyday." I just could not believe my ears but it was probably true. He was the type of father who would "beg, steal of borrow" to ensure that his bright daughter would have sufficient funds to become a lawyer. She was the apple of his eye and she had the brains to be accepted by a top University in Australia to study law.
3 As were academic excellence but not good enough to study law in Singapore as there were many with 4As applying for the law, medical and accountancy courses. This was one lucky young lady as many fathers simply tell the bright progeny that there was no money to study in a subject the latter is interested.
"How's her studies?" I asked the father. I wanted to assess whether this girl deserved help one more time. "Is she getting high distinctions? Is she passing all her examinations?"
The father said: "She is a good girl. She does not go out partying and getting drunk like one of her classmates." This was not the answer I expected. But I did not pursue further as I expected a girl with 3As to pass her undergraduate examinations knowing that her sole breadwinner father had much financial distress to support her.
I don't know how this father is going to support her to graduation. As a lawyer, she would make big bucks as there is a shortfall of lawyers in Singapore. But the road to graduation is now full of financial pot holes. The father could downgrade by selling off the condo and rent a place for the time being. But there was an enbloc sale prospect and he would lose a lot of money. In enbloc sales, the property developer pays a premium price for the apartments.
"What happen to your real estate income over the past years?" I asked. This father had an inborn excellent marketing skills and could close cases unlike many realtors in Singapore. His employer was the compassionate type and permitted him to do real estate work to supplement his income. This was a rare type of employer in Singapore.
When he started as a part-time realtor with my company in 2005, he was grossing $100,000 in agency commissions handling the internet expatriate rental cases referred by me. He needed loans frequently to pay for his debts. After a year, I could no longer afford to give him loans as he borrowed more than he earned. You would assume that an agent earning $100,000 part-time would not need loans from anybody. But he needed more. So I had to cut him off. I was haemorrhaging badly as his loans exceeded his income and there was no light at the end of the tunnel. Compassion from friends and acquaintance cannot be not unlimited.
After 5 years, the father needed A$5,000 to pay for his daughter's accommodation. "Why don't you close some real estate cases?" I asked. It is easier said than done as he has to work full-time. His employer was still compassionate as long as he did his job competently and efficiently. This he did for the past 30 years in the same firm but his income was at a maximum for his position. He was not a graduate and I presumed the firm did not promote him further or found that he was not suitable.
He just dared not become self-employed as a realtor as income could be variable. He could be a hero for earning $100,000 a year - 3 times his salary. But he could be a vagabond when recession kicked in as it did in 2008. So, he did not strike out on his own as he had children in school. Which was a pity as I know he could do very well in real estate. Real estate is where the money is if you excel. Veterinary medicine and surgery give you a steady small income but if you want to be wealthy, get into the hot seat of real estate.
"My wife says that I am lucky when I work together with you," the father reminded me. Certainly he did perform as $100,000 in 2005 with me was not peanuts. "Do you have a case where we can work together?" I asked him. "If you close that case, you would be able to earn some money for your daughter's accommodation fees." He has a good network and should have some clients.
"I have a condo which the owner asks me to sell at $3.3 million or rent at $10,000 per month."
"That's great." I said. "Have you advertised this property in the Straits Times?"
The father said: "The Tenant's agent prohibits viewing. He makes it very difficult making various excuses."
"So you did not advertise in the Straits Times?" I inferred. "Straits Times advertisements still are the best way. I had over 10 phone calls a day when I advertised an HDB apartment for resale recently. Did you advertise in the Straits Times? The tenancy is in its last month. You ought to be advertising to secure a buyer or tenant before the lease expires."
Advertising 1 month prior to the expiry of the lease is the professional way to practise real estate in the interest of the realtor and the owner.
An apparently obstructive incumbent Tenant or protective Tenant's agent was no excuse, in my opinion. The owner had entrusted him with the property and he ought to do what was the right thing to do. I sensed that something was not right. Was there more to it than the behaviour of the Tenant's agent in repelling all appointments? The Tenant's agent had to be present for viewing as the Tenant was a multi-national. This Tenant's agent would have no financial income just by being present and therefore it was possible that he would delay or prevent viewings, attributing the rejection to the Tenant's policies.
I enquired about the type and location of the property the father was given exclusive marketing. The 2009 recession had passed by but the upscale $10,000 - $20,000 rental market was not booming. There was considerable interest in buying new property developments and not this 3-year-old condo.
"I will pay for the Straits Times Advertisements 2 to 3 times a week if you will split 50:50 on a successful outcome," I said. Advertisement of 3-lines cost around S$35.00/insert. It would be money down the drain if there was no response.
I advertised the property for sale at $3.45 million for the first week on a Wednesday and a Saturday. Not even one phone call. During the second week, there was only one phone call from an agent of a prospective buyer. The father made the appointment for the prospective buyer's wife to view. A second viewing with the husband was made two days later. "This case will close," the happy father said as the couple had asked about bank loans.
"Well, don't count your chickens before the eggs are hatched. The prospective buyer's wife was practically selling the advantages of the property to the husband during the viewing." I did not want to dampen the spirits of this father. He was a real estate veteran and now he had had unbridled optimism. I had stopped the newspaper advertisements as I did not want to throw good money away as the phone call response had been very poor. Money down the drain.
Several days passed. The eggs did not hatch. The tenancy would expire in 10 days. The owner texted saying that he would need a tenant to defray his mortgage loans. I placed 4 advertisements to rent over two weeks. Only 3 enquiries. I was pessimistic. It was my advertisement money down the drain. Nowadays, I don't do large Straits Times advertisement for properties as I find that they seldom effective. Many realtors now resort to mass-texting their properties for rent or sale as I received at least two per day on my mobile phone.
A victim of circumstances need the money. Of the 3 rental enquiries to my mobile phone, two prospective tenants with the budget of $12,000 rental wanted to view the apartment on Friday at 2.30 pm. The Tenant's agent was creating obstacles saying the Occupant prohibited viewing during her last week of tenancy. The Occupant would vacate the property in 3 days' time.
"So, what are you going to do?" I asked the father. He suggested waiting as the Tenant's Agent rejected him. I suspected that the Tenant's Agent had no time to be present on this Friday 2.30 pm viewing and therefore said that the Tenant would not permit viewing. This is because there was no financial incentive for the Tenant's Agent to close. Not a dime. So why should he oblige?
"You don't wait in real estate," I admonished the father gently. He was a very patient man not prone to raise his voice or get angry during our encounters. A smooth-talking guy? "These two prospects have the budget. No other phone queries. Do something."
But what could the father do? He phoned the Tenant's Agent and the owner but his head was butting against a brick wall. So he suggested that we wait for the Occupant to vacate the properties in 3 days' time as he would have the keys to the condo.
Now, there were two interested qualified prospective Tenants. Was there a solution to this problem? I had to think. Yes, there was one. I said to the father, "Is there not a clause in the tenancy agreement that the Tenant is to permit viewing of properties for rental or sale?"
"Yes," the father said.
"What happens if the Tenant breach the terms and conditions of the tenancy agreement? Will he have to pay penalties to the Landlord for loss of income?" I didn't have to state that the Landlord could deduct from the rental deposit and litigate for loss of income due to the Tenant's breach. The Tenant's Agent had to be given notice now and he should know how to advise his client early. He would lose his multi-national client if he was inert. However, the father had to know what to do without me telling him.
The father texted a message to the Tenant's Agent, c.c. to me. It read as follows:
"There is a prospective tenant willing to pay 11K fr the aptmt n yr tenant is deprivd my owner opportunity to show the aptmt this is breach of the terms n conditions of the tenancy agmt thanks."
The Tenant's Agent permitted a viewing on Saturday 10.30 am instead of Friday 2.30 pm. Well, that was a chance now.
I spent around $380 for the newspaper advertisements and there was a successful outcome. One of the expatriates rented the property. This is an incredible happy ending as I had only 2 qualified prospects from 4 rental advertisements placed over 10 days. Time is of the essence in real estate. Strike while the iron is hot. Life is full of hurdles to jump across. Be able to close a case. Performance counts in real life, not awards for being the top realtor.
God was kind to this father if you believe in Divine Powers. I am very happy for the victim of circumstance, a young lady I had never met. The laws of real estate contract had helped her as the case was closed. I hope she would study very hard and get High Distinctions. Lately, I know of a Singaporean who failed his first year at Murdoch University and came home. His sister had paid for his studies and he had failed. This was not good for the airline cabin crew sister who worked so hard.
Overseas undergraduates whose parents and family members have "apparently" no problems to finance their overseas studies must note that they have a rare opportunity to better themselves through education. Though they may not aim to get High Distinctions, passing their examinations and graduate will be the least they can do.
An overseas undergraduate law education costs around A$150,000. The daughter had excellent A-level grades but the 3As could not qualify her to study law in Singapore. 4As would qualify and save the father a lot of financial stress.
She was therefore a "victim of circumstances" and deserved a helpomg jamd. The father's salary was insufficient to support her overseas. The father said to me: "My wife asks me to tell you we eat porridge everyday." I just could not believe my ears but it was probably true. He was the type of father who would "beg, steal of borrow" to ensure that his bright daughter would have sufficient funds to become a lawyer. She was the apple of his eye and she had the brains to be accepted by a top University in Australia to study law.
3 As were academic excellence but not good enough to study law in Singapore as there were many with 4As applying for the law, medical and accountancy courses. This was one lucky young lady as many fathers simply tell the bright progeny that there was no money to study in a subject the latter is interested.
"How's her studies?" I asked the father. I wanted to assess whether this girl deserved help one more time. "Is she getting high distinctions? Is she passing all her examinations?"
The father said: "She is a good girl. She does not go out partying and getting drunk like one of her classmates." This was not the answer I expected. But I did not pursue further as I expected a girl with 3As to pass her undergraduate examinations knowing that her sole breadwinner father had much financial distress to support her.
I don't know how this father is going to support her to graduation. As a lawyer, she would make big bucks as there is a shortfall of lawyers in Singapore. But the road to graduation is now full of financial pot holes. The father could downgrade by selling off the condo and rent a place for the time being. But there was an enbloc sale prospect and he would lose a lot of money. In enbloc sales, the property developer pays a premium price for the apartments.
"What happen to your real estate income over the past years?" I asked. This father had an inborn excellent marketing skills and could close cases unlike many realtors in Singapore. His employer was the compassionate type and permitted him to do real estate work to supplement his income. This was a rare type of employer in Singapore.
When he started as a part-time realtor with my company in 2005, he was grossing $100,000 in agency commissions handling the internet expatriate rental cases referred by me. He needed loans frequently to pay for his debts. After a year, I could no longer afford to give him loans as he borrowed more than he earned. You would assume that an agent earning $100,000 part-time would not need loans from anybody. But he needed more. So I had to cut him off. I was haemorrhaging badly as his loans exceeded his income and there was no light at the end of the tunnel. Compassion from friends and acquaintance cannot be not unlimited.
After 5 years, the father needed A$5,000 to pay for his daughter's accommodation. "Why don't you close some real estate cases?" I asked. It is easier said than done as he has to work full-time. His employer was still compassionate as long as he did his job competently and efficiently. This he did for the past 30 years in the same firm but his income was at a maximum for his position. He was not a graduate and I presumed the firm did not promote him further or found that he was not suitable.
He just dared not become self-employed as a realtor as income could be variable. He could be a hero for earning $100,000 a year - 3 times his salary. But he could be a vagabond when recession kicked in as it did in 2008. So, he did not strike out on his own as he had children in school. Which was a pity as I know he could do very well in real estate. Real estate is where the money is if you excel. Veterinary medicine and surgery give you a steady small income but if you want to be wealthy, get into the hot seat of real estate.
"My wife says that I am lucky when I work together with you," the father reminded me. Certainly he did perform as $100,000 in 2005 with me was not peanuts. "Do you have a case where we can work together?" I asked him. "If you close that case, you would be able to earn some money for your daughter's accommodation fees." He has a good network and should have some clients.
"I have a condo which the owner asks me to sell at $3.3 million or rent at $10,000 per month."
"That's great." I said. "Have you advertised this property in the Straits Times?"
The father said: "The Tenant's agent prohibits viewing. He makes it very difficult making various excuses."
"So you did not advertise in the Straits Times?" I inferred. "Straits Times advertisements still are the best way. I had over 10 phone calls a day when I advertised an HDB apartment for resale recently. Did you advertise in the Straits Times? The tenancy is in its last month. You ought to be advertising to secure a buyer or tenant before the lease expires."
Advertising 1 month prior to the expiry of the lease is the professional way to practise real estate in the interest of the realtor and the owner.
An apparently obstructive incumbent Tenant or protective Tenant's agent was no excuse, in my opinion. The owner had entrusted him with the property and he ought to do what was the right thing to do. I sensed that something was not right. Was there more to it than the behaviour of the Tenant's agent in repelling all appointments? The Tenant's agent had to be present for viewing as the Tenant was a multi-national. This Tenant's agent would have no financial income just by being present and therefore it was possible that he would delay or prevent viewings, attributing the rejection to the Tenant's policies.
I enquired about the type and location of the property the father was given exclusive marketing. The 2009 recession had passed by but the upscale $10,000 - $20,000 rental market was not booming. There was considerable interest in buying new property developments and not this 3-year-old condo.
"I will pay for the Straits Times Advertisements 2 to 3 times a week if you will split 50:50 on a successful outcome," I said. Advertisement of 3-lines cost around S$35.00/insert. It would be money down the drain if there was no response.
I advertised the property for sale at $3.45 million for the first week on a Wednesday and a Saturday. Not even one phone call. During the second week, there was only one phone call from an agent of a prospective buyer. The father made the appointment for the prospective buyer's wife to view. A second viewing with the husband was made two days later. "This case will close," the happy father said as the couple had asked about bank loans.
"Well, don't count your chickens before the eggs are hatched. The prospective buyer's wife was practically selling the advantages of the property to the husband during the viewing." I did not want to dampen the spirits of this father. He was a real estate veteran and now he had had unbridled optimism. I had stopped the newspaper advertisements as I did not want to throw good money away as the phone call response had been very poor. Money down the drain.
Several days passed. The eggs did not hatch. The tenancy would expire in 10 days. The owner texted saying that he would need a tenant to defray his mortgage loans. I placed 4 advertisements to rent over two weeks. Only 3 enquiries. I was pessimistic. It was my advertisement money down the drain. Nowadays, I don't do large Straits Times advertisement for properties as I find that they seldom effective. Many realtors now resort to mass-texting their properties for rent or sale as I received at least two per day on my mobile phone.
A victim of circumstances need the money. Of the 3 rental enquiries to my mobile phone, two prospective tenants with the budget of $12,000 rental wanted to view the apartment on Friday at 2.30 pm. The Tenant's agent was creating obstacles saying the Occupant prohibited viewing during her last week of tenancy. The Occupant would vacate the property in 3 days' time.
"So, what are you going to do?" I asked the father. He suggested waiting as the Tenant's Agent rejected him. I suspected that the Tenant's Agent had no time to be present on this Friday 2.30 pm viewing and therefore said that the Tenant would not permit viewing. This is because there was no financial incentive for the Tenant's Agent to close. Not a dime. So why should he oblige?
"You don't wait in real estate," I admonished the father gently. He was a very patient man not prone to raise his voice or get angry during our encounters. A smooth-talking guy? "These two prospects have the budget. No other phone queries. Do something."
But what could the father do? He phoned the Tenant's Agent and the owner but his head was butting against a brick wall. So he suggested that we wait for the Occupant to vacate the properties in 3 days' time as he would have the keys to the condo.
Now, there were two interested qualified prospective Tenants. Was there a solution to this problem? I had to think. Yes, there was one. I said to the father, "Is there not a clause in the tenancy agreement that the Tenant is to permit viewing of properties for rental or sale?"
"Yes," the father said.
"What happens if the Tenant breach the terms and conditions of the tenancy agreement? Will he have to pay penalties to the Landlord for loss of income?" I didn't have to state that the Landlord could deduct from the rental deposit and litigate for loss of income due to the Tenant's breach. The Tenant's Agent had to be given notice now and he should know how to advise his client early. He would lose his multi-national client if he was inert. However, the father had to know what to do without me telling him.
The father texted a message to the Tenant's Agent, c.c. to me. It read as follows:
"There is a prospective tenant willing to pay 11K fr the aptmt n yr tenant is deprivd my owner opportunity to show the aptmt this is breach of the terms n conditions of the tenancy agmt thanks."
The Tenant's Agent permitted a viewing on Saturday 10.30 am instead of Friday 2.30 pm. Well, that was a chance now.
I spent around $380 for the newspaper advertisements and there was a successful outcome. One of the expatriates rented the property. This is an incredible happy ending as I had only 2 qualified prospects from 4 rental advertisements placed over 10 days. Time is of the essence in real estate. Strike while the iron is hot. Life is full of hurdles to jump across. Be able to close a case. Performance counts in real life, not awards for being the top realtor.
God was kind to this father if you believe in Divine Powers. I am very happy for the victim of circumstance, a young lady I had never met. The laws of real estate contract had helped her as the case was closed. I hope she would study very hard and get High Distinctions. Lately, I know of a Singaporean who failed his first year at Murdoch University and came home. His sister had paid for his studies and he had failed. This was not good for the airline cabin crew sister who worked so hard.
Overseas undergraduates whose parents and family members have "apparently" no problems to finance their overseas studies must note that they have a rare opportunity to better themselves through education. Though they may not aim to get High Distinctions, passing their examinations and graduate will be the least they can do.
Sunday, July 4, 2010
121. Performance counts in the real world
Text message to the Tenant's Agent c.c to me:
"There is a prospective tenant willing to pay 11K fr the aptmt n yr tenant is deprivd my owner opportunity to show the aptmt this is breach of the terms n conditions of the tenancy agmt thanks."
The players in this real estate rental stage are:
Tenant: A multi-national corporation
Tenant's Agent: Dominic
Occupant: A Japanese family
Landlord's Agent: Barry
Prospective Tenant's Agent: Shirley
A friend of Barry: Myself
Situation: In the tenancy agreement, the Tenant agrees to permit the Landlord to bring prospective tenants to view during the last month of tenancy at times convenient to both parties. However, Dominic had been saying that the Tenant would not permit any viewing. So Barry thought that the best way would be for viewing to be done when the Tenant vacated the property.
"That is not the right thing to do as it is not in the interest of the Landlord who entrusted you with his property exclusively," I said to Barry. "You have to be proactive and get a new Tenant before the lease expires. Otherwise the Landlord loses a month or more when you start viewing after the Occupant leaves."
"There is a prospective tenant willing to pay 11K fr the aptmt n yr tenant is deprivd my owner opportunity to show the aptmt this is breach of the terms n conditions of the tenancy agmt thanks."
The players in this real estate rental stage are:
Tenant: A multi-national corporation
Tenant's Agent: Dominic
Occupant: A Japanese family
Landlord's Agent: Barry
Prospective Tenant's Agent: Shirley
A friend of Barry: Myself
Situation: In the tenancy agreement, the Tenant agrees to permit the Landlord to bring prospective tenants to view during the last month of tenancy at times convenient to both parties. However, Dominic had been saying that the Tenant would not permit any viewing. So Barry thought that the best way would be for viewing to be done when the Tenant vacated the property.
"That is not the right thing to do as it is not in the interest of the Landlord who entrusted you with his property exclusively," I said to Barry. "You have to be proactive and get a new Tenant before the lease expires. Otherwise the Landlord loses a month or more when you start viewing after the Occupant leaves."
Cat declawing
Cat owners are strongly discouraged in requesting declawing of cats. Very rarely do I encountered declawing requests in my surgery. Declawing will be done only if there are good reasons. The owner had used anti-scratching medication, nail covers and provided the scratching post. But the active cat still scratches furniture and people.
For Toa Payoh Vets Knowledge Management records, the following is written to share knowledge as it is a relatively uncommon operation.
Cat: British Shorthair, Male, Neutered, 1 year, 4.8 kg, rectal temp: 38.3 degrees C
Anaesthesia: Xylazine 20@ 0.15 ml + Ketamine 100@ 0.6 ml IM. Front paw hairs clipped.
The above dosage was insufficient for surgical anaesthesia as clipping the soft furs in the paws took a longer time than usual to clip. I had to use scissors as well to get a clean hairless area for surgery. This cat's paw hairs were like wool and the clipper could not shave effecively.
Isoflurane gas top by mask for a few seconds was effective.
Surgery: Rubber band tourniquet Electro-incision was used. However, it was not practical due to the need to trim at an angle of 45 degrees ventrally from the posterior end of phalanx 2 with the claw in extension. A bone cutter was used. 3-4 stitches of 3/0 absorbable sutures closed wound.
Bandaging: Gauze was applied to the front of the paws while the rubber band tourniquet was cut. Blood flowed freely. Then a elastic bandage wrapped the gauze and the paws (picture). A strip of sticky bandage around the end of the elastic bandage was used to prevent the cat pulling off the whole bandage.
Pain killers: Tolfedine injection (0.5ml and then tolfedine tablets x 4 days (3 tab of 6 mg/day). Injection and oral dosage is the same, at 4mg/kg. Baytril @ 0.5 ml SC after surgery and 1/2 tab/day for 4 days.
The cat went home on Day 1 and advised to be crated or confined to a small room. However, the cat was active and kept flinging his paws. So he was warded at Toa Payoh Vets for 4 days.
On Day 2, the bandage was taken off to review the paws for bleeding. Not a drop of bleeding as the bandaging was tight but not too tight to cause paw swelling. So, the cat was given a bigger e-collar. With NSAID tolfedine being effective in this case, the cat was not bothering her front paws.
Unusual Complication: Part of the right whiskers of the cat was clipped off inadvertently. This was discovered by the owner. As it was difficult to clip the woolly fur of the paws and the cat was sedated with his head to the right side, near his right fore paw, the clipper must have accidentally clipped part of the whiskers.
In future, it would be best for one person to hold the head up during clipping of the paws.
Outcome. The results were excellent. Apologies were made for the clipping of the right whiskers.
P.S. For a successful outcome, it is best not to permit the cat to go home immediately.Some owners don't know how to do post-surgical nursing and checking or give the medication. The cat may pull out the bandage and lick the wound. Some owners don't bother to phone up the vet and when they do, it is too late as the paw has been badly infected. The paws may also gangrenous. Therefore I advise 4 days for observation.
For Toa Payoh Vets Knowledge Management records, the following is written to share knowledge as it is a relatively uncommon operation.
Cat: British Shorthair, Male, Neutered, 1 year, 4.8 kg, rectal temp: 38.3 degrees C
Anaesthesia: Xylazine 20@ 0.15 ml + Ketamine 100@ 0.6 ml IM. Front paw hairs clipped.
The above dosage was insufficient for surgical anaesthesia as clipping the soft furs in the paws took a longer time than usual to clip. I had to use scissors as well to get a clean hairless area for surgery. This cat's paw hairs were like wool and the clipper could not shave effecively.
Isoflurane gas top by mask for a few seconds was effective.
Surgery: Rubber band tourniquet Electro-incision was used. However, it was not practical due to the need to trim at an angle of 45 degrees ventrally from the posterior end of phalanx 2 with the claw in extension. A bone cutter was used. 3-4 stitches of 3/0 absorbable sutures closed wound.
Bandaging: Gauze was applied to the front of the paws while the rubber band tourniquet was cut. Blood flowed freely. Then a elastic bandage wrapped the gauze and the paws (picture). A strip of sticky bandage around the end of the elastic bandage was used to prevent the cat pulling off the whole bandage.
Pain killers: Tolfedine injection (0.5ml and then tolfedine tablets x 4 days (3 tab of 6 mg/day). Injection and oral dosage is the same, at 4mg/kg. Baytril @ 0.5 ml SC after surgery and 1/2 tab/day for 4 days.
The cat went home on Day 1 and advised to be crated or confined to a small room. However, the cat was active and kept flinging his paws. So he was warded at Toa Payoh Vets for 4 days.
On Day 2, the bandage was taken off to review the paws for bleeding. Not a drop of bleeding as the bandaging was tight but not too tight to cause paw swelling. So, the cat was given a bigger e-collar. With NSAID tolfedine being effective in this case, the cat was not bothering her front paws.
Unusual Complication: Part of the right whiskers of the cat was clipped off inadvertently. This was discovered by the owner. As it was difficult to clip the woolly fur of the paws and the cat was sedated with his head to the right side, near his right fore paw, the clipper must have accidentally clipped part of the whiskers.
In future, it would be best for one person to hold the head up during clipping of the paws.
Outcome. The results were excellent. Apologies were made for the clipping of the right whiskers.
P.S. For a successful outcome, it is best not to permit the cat to go home immediately.Some owners don't know how to do post-surgical nursing and checking or give the medication. The cat may pull out the bandage and lick the wound. Some owners don't bother to phone up the vet and when they do, it is too late as the paw has been badly infected. The paws may also gangrenous. Therefore I advise 4 days for observation.
Friday, July 2, 2010
119, FAQ cat neutering
Jul 1, 2010 at 4:02 PM, ...@yahoo.com.sg> wrote:
Dear Judy,
I chanced upon a blog with your posting and email address. Pardon me for the abrupt email. I need help.
My male cat is about 1yr and 2 mths old. He is not neutered as I can't bring myself to see him go thru the pain. He has been a good cat all along. Very well toilet trained and will never poo or pee anywhere except his litter tray. However, 2 weeks ago, I realised he pee-ed on my couch! That was a 1 time off thing. It did not happen again after that. I've read about male cats spraying pee around the house if not neutered. Besides this, he also starts meowing pitifully at the door hoping to take a stroll outside. He is a 98% strictly indoor cat. The remaining 2% is only strictly for him to walk around the corridor outside my house. He has no contacts with other cats unless he is out for grooming or to the vet.
I have booked an appointment to have him neutered this coming Saturday. But, I am still in a dilemma. Should I neuter him? Is it necessary to neuter? Will he become depressed after the neuter? Will he be in great pain? Does he need to wear a cone after the neuter? (He hates wearing cone.) Is it very cruel of me to neuter him?
Sigh... Please help me!
Regards,
Name of Owner
E-MAIL REPLY FROM DR SING DATED JUL 2, 2010
I am Dr Sing Kong Yuen from Toa Payoh Vets, www.toapayohvets.com. In reply to your following questions:
Should I neuter him? Is it necessary to neuter? Will he become depressed after the neuter? Will he be in great pain? Does he need to wear a cone after the neuter? (He hates wearing cone.) Is it very cruel of me to neuter him?
1. Neutering a male cat or spay a female cat is perceived by many younger generation as cruel. So, it is a matter of choice for you.
2. Neutering is not necessary in the sense that it does not mean death if the surgery is not done. However, neutering at a young age (6 months of age) does help to stop, reduce and/or prevent your cat's male territorial marking (peeing on the couch) and mate-seeking behaviour (meowing loudly wanting to go out to find a mate, NOT to go for a stroll as you wrote).
3. After less than 14 days post-surgery, the cat does not feel the pain and is not "depressed" after the neuter.
4. After 2-3 days of poor appetite in most cases, the cat will start to eat. In any case, painkillers are given after surgery and for the next 4 days.
5. No need to wear the e-collar (cone) after neutering.
6. It is not cruel to neuter the male or female cat if the cat can has a better quality of life. A cat after 6 months of age has matured and though kept indoors, can still hear the meows and cries of outdoor cats fighting or looking for mates.
Caterwauling the whole night is a noise nuisance to everybody and is the main reason that owners start to get the cat neutered or spayed. The adult cat can't help himself or herself as he or she has heard the meows of other cats outdoors and want to go out to find the mates. Some make such loud noises at night that neighbours think that the cats are being beaten up by the owners. Neutering will prevent such sexual behaviours.
Please let me know if you have more queries.
Dear Judy,
I chanced upon a blog with your posting and email address. Pardon me for the abrupt email. I need help.
My male cat is about 1yr and 2 mths old. He is not neutered as I can't bring myself to see him go thru the pain. He has been a good cat all along. Very well toilet trained and will never poo or pee anywhere except his litter tray. However, 2 weeks ago, I realised he pee-ed on my couch! That was a 1 time off thing. It did not happen again after that. I've read about male cats spraying pee around the house if not neutered. Besides this, he also starts meowing pitifully at the door hoping to take a stroll outside. He is a 98% strictly indoor cat. The remaining 2% is only strictly for him to walk around the corridor outside my house. He has no contacts with other cats unless he is out for grooming or to the vet.
I have booked an appointment to have him neutered this coming Saturday. But, I am still in a dilemma. Should I neuter him? Is it necessary to neuter? Will he become depressed after the neuter? Will he be in great pain? Does he need to wear a cone after the neuter? (He hates wearing cone.) Is it very cruel of me to neuter him?
Sigh... Please help me!
Regards,
Name of Owner
E-MAIL REPLY FROM DR SING DATED JUL 2, 2010
I am Dr Sing Kong Yuen from Toa Payoh Vets, www.toapayohvets.com. In reply to your following questions:
Should I neuter him? Is it necessary to neuter? Will he become depressed after the neuter? Will he be in great pain? Does he need to wear a cone after the neuter? (He hates wearing cone.) Is it very cruel of me to neuter him?
1. Neutering a male cat or spay a female cat is perceived by many younger generation as cruel. So, it is a matter of choice for you.
2. Neutering is not necessary in the sense that it does not mean death if the surgery is not done. However, neutering at a young age (6 months of age) does help to stop, reduce and/or prevent your cat's male territorial marking (peeing on the couch) and mate-seeking behaviour (meowing loudly wanting to go out to find a mate, NOT to go for a stroll as you wrote).
3. After less than 14 days post-surgery, the cat does not feel the pain and is not "depressed" after the neuter.
4. After 2-3 days of poor appetite in most cases, the cat will start to eat. In any case, painkillers are given after surgery and for the next 4 days.
5. No need to wear the e-collar (cone) after neutering.
6. It is not cruel to neuter the male or female cat if the cat can has a better quality of life. A cat after 6 months of age has matured and though kept indoors, can still hear the meows and cries of outdoor cats fighting or looking for mates.
Caterwauling the whole night is a noise nuisance to everybody and is the main reason that owners start to get the cat neutered or spayed. The adult cat can't help himself or herself as he or she has heard the meows of other cats outdoors and want to go out to find the mates. Some make such loud noises at night that neighbours think that the cats are being beaten up by the owners. Neutering will prevent such sexual behaviours.
Please let me know if you have more queries.
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