Xylazine IM injection normally causes a dog to vomit. But nothing happened in this Jack Russell that ate swallowed half of his mistress' white tablet (around 2.5 cm in diameter). "This Japanese-made tablet is to keep my medication dry," the lady in her 30s wrinkled her nose and her brows.
After waiting 10 minutes, the dog dozed off inside the crate. Not a tinge of vomit. When I do not want a dog to vomit after xylazine sedation for anaesthesia, it will vomit. Now, this Jack Russell does not vomit. This is the second case it happened to me. The recent case was a case of the dog swallowing a condom.
What to do? I got some salt from the restaurant behind my surgery as I had run out of stock and such cases are rare in my surgery.
"What to do now?" I asked my assistant Mr Saw and intern Ms Lai. Both shook their heads in amazement as to why I need salt.
I wanted my assistant to be hands on. "Put some salt at the back of the dog's tongue," I said. But easier said than done.
"What if the dog bites me?" Ms Lai stood back a bit and did not volunteer. Male Jack Russells can bite and his long canines are sharp and brand new. He is around one year old but is actually a gentle dog.
"How to put salt at the back of the tongue?" I asked. I took out a dropper which is used for eye drops. No use as not much salt could not stay inside. In any case, how to drop salt to the back of the tongue?
"Can you get a long spoon?" I asked Mr Saw. He could not find one.
"Just pinch some salt, open the dog's mouth and rub the salt onto the tongue," I advised. It is easy to advise. However, I wanted to train Mr Saw to do it. Hands on experience is the only way for him to learn if he wanted to start his own practice in Myanmar. He had never heard of this method nor the use of salt and so he did not know exactly what to do.
"The dog is tranquilised," I told Ms Lai. "He will not bite." But I did not want Ms Lai to do it as she looked worried. Mr Saw tried. No reaction. "Try again," I said. He placed more salt at the back of the tongue. Nothing happened.
"Rub the throat a bit," I said. I demonstrated. "Then give 2 ml of water in a syringe." Ms Lai walked away to fill a syringe with water. The dog was outside the surgery on the table.
After what seemed like an eternity, she returned. Mr Saw squirted the syringe of water inside the dog's mouth. The dog swallowed. We waited. Nothing happened.
"This will take time," I said to the two people whom I hope, had trust in my professionalism. "Give another 2 ml of water."
This was dutifully done by Mr Saw. We waited. Holding our breath. Both of them must think I have a whacky way of inducing a dog to vomit.
After a minute, the dog gurgled and wrinkled his muzzle. Mr Saw put his head downwards. The dog vomited three times, the last time being white froth. Brown rice grains and pieces of white tablets spilled over the grey table where the dog was positioned.
I showed them to the lady owner and she was happy. She had gone home first as she noted that the dog had not vomited after tranquilisation with xylazine 2% but I asked her to come back to see the evidence and bring the dog home. I had initially wanted to put the dog on an IV drip to dilute the poison but this was now not necessary as the dog had swallowed the half tablet only 2 hours ago.
Does salt work? Well, it does. It is not an elegant way and is quite messy. In times when xylazine does not work, I used this method effectively and I remembered this strange incident. Once a young lady bought in a dog who had swallowed a condom. I gave a xylazine injection IM as usual. No reaction. The dog blinked at me.
The young lady said: "I am responsible for this. What if the condom jams up the small intestine and the dog need an operation to get it removed?"
"Please don't worry, " I said. I just placed salt on the back of the dog's tongue as what Mr Saw did today. I rubbed the back of the tongue with my finger three times. I syringe in a bit of water for the dog to swallow. The lady was pleased on seeing the condom out of the stomach.
Veterinary medicine is full of surprises. There is never a dull day and challenges presented. I read a lot of inducing vomiting in dogs. With all those modern drugs for vomiting, a simple solution of using salt may be used. Don't try this if the dog has swallowed bones or stones. X-rays and surgery will be highly recommended.
Thursday, July 29, 2010
143. Toilet training problem - email
E-MAIL TO DR SING DATED JUL 29, 2010
Hello my name is Kia...
i am so worried i have a 5 month old snoodle named Princess. She is in inside dog very active puppy. At first her potty training was great a kept her in a small place and took her out early morning and couple of times a day and also put newspaper which she would use. Now she uses the restoom everywhere. Its so frustrating because i have carpet. It seems like she pees a lot a lot a lot!She is still not spayed which i am going to do soon. What can i do, i think she is peeing alot because before she was just in the small place and now she is everywhere. What should i do...also she drinks a lot of water... help thankz
E-MAIL REPLY BY DR SING
Pl bring her for vet check up promptly. She may have a urinary tract infection. Then please keep her in a small place again and train her again.
COMMENTS
It is hard to advise as an e-mail cannot be as good as speaking to the owner directly.
Hello my name is Kia...
i am so worried i have a 5 month old snoodle named Princess. She is in inside dog very active puppy. At first her potty training was great a kept her in a small place and took her out early morning and couple of times a day and also put newspaper which she would use. Now she uses the restoom everywhere. Its so frustrating because i have carpet. It seems like she pees a lot a lot a lot!She is still not spayed which i am going to do soon. What can i do, i think she is peeing alot because before she was just in the small place and now she is everywhere. What should i do...also she drinks a lot of water... help thankz
E-MAIL REPLY BY DR SING
Pl bring her for vet check up promptly. She may have a urinary tract infection. Then please keep her in a small place again and train her again.
COMMENTS
It is hard to advise as an e-mail cannot be as good as speaking to the owner directly.
Tuesday, July 27, 2010
144. Eyeball prolapse. The Shih Tzu's left eyeball pops out
Tue July 27, 2010. Back to work after visiting Penang yesterday to talk to a swiftlet farm consultancy with my mentor who is interested in this cloak-and-dagger business. I presume the underworld has a hand in the swiftlet and bird nest production business but then where there is money to be made, the triads will be there.
At 3 pm after finishing perineal hernia in a Shih Tzu that cried during defaecation, I was surprised to see a lady in her 30s waiting in my reception. She was early for her appointment. She showed me her female Shih Tzu with a green left eye.
"Her left eyeball popped out after 5 pm yesterday as I saw her at that time and she was OK," lady owner said. Another dog had jumped onto this Shih Tzu. The eyeball pops out <24 hours. I could see that the dog had been rubbing eye vigorously till the upper area above the eyelid was a purplish red and the sclera (eye white) was as blood shot as it could ever be.
The lady consulted Vet 1 who had instilled green ophthalmic fluoroescein. This dye showed that > 80% of the eye cornea is ulcerated. She wanted a second quotation and Clara, a dog groomer and friend had referred her to my surgery where charges are apparently lower. Groomers sometimes play a great role in referrals according to the Penang vet I visited in Penang yesterday. The Penang vet showed me the pet shop whose owner regularly sent him cases. Well, I don't have such good connections as pet shop owners in Singapore tend to be promiscuous in veterinary referrals.
"The Shih Tzu has a high fever," I warned the lady of the risk of death on the operating table for an old dog. An old dog with a high fever too aggravated the risk. "However, eye injuries are emergencies and cannot wait another 24 hours." The lady had no choice and left the decision to me.
I gave the anti-fever and painkiller tolfedine and antibiotics baytril injection subcutaneous around 5 minutes before I used Isoflurane gas to anaesthesize the dog. There was no sedation as this would be riskier.
Surgery: Lateral canthoplasty increases the space for this enlarged injured popped out eye. The prolapsed eyeball was too large for a simple stitching up of the eyelids (tarsorraphy).
"But I had a previous Shih Tzu whose eyes popped out bigger and the vet did not do that," the young lady said.
"Each case is different," I said. "If you don't want the side of the eyelid to be cut to enlarge the eye socket to accommodate the eyeball, please don't blame me if the stitching of the upper and lower eyelids break down before 7 days."
The lady consented to leave the technical matters to me. Many owners want to voice their opinions on treatments and in some cases, they are more knowledgeable than he vet who has to treat several thousands of various cases and may not be an expert in a particular condition.
The following is a summary for vet students of what I did.
1. "Clip both eye area and eyelid lashes," I said to Mr Saw as he presented me with the dog. "Take out the 3rd eyelid and wash off any hairs and debris. Also rinse the eyeball thoroughly."
2. I note an embedded foreign body inside the eye-white. I used a scalpel blade cut off.
3. I ensured that all green dye and hairs are washed away.
4. Sub conj gentamycin and prednisolone subconjuctiva.
5. 3rd eyelid flap, use tension tubes and stitch lateral canthus.
6. For old dogs with fever, reduce the fever and stablised the dog first in normal situations. This will take 24 hours. Eye injuries are emergencies and so the vet has to decide whether to operate soon or not.
The beloved Shih Tzu recovered well from anaesthesia as if from a nap. I phoned the worried lady to let her know that her dog was OK. The eyeball should shrink back to normal in 7-14 days. The lady wanted her dog back and took her home the next morning.
At 3 pm after finishing perineal hernia in a Shih Tzu that cried during defaecation, I was surprised to see a lady in her 30s waiting in my reception. She was early for her appointment. She showed me her female Shih Tzu with a green left eye.
"Her left eyeball popped out after 5 pm yesterday as I saw her at that time and she was OK," lady owner said. Another dog had jumped onto this Shih Tzu. The eyeball pops out <24 hours. I could see that the dog had been rubbing eye vigorously till the upper area above the eyelid was a purplish red and the sclera (eye white) was as blood shot as it could ever be.
The lady consulted Vet 1 who had instilled green ophthalmic fluoroescein. This dye showed that > 80% of the eye cornea is ulcerated. She wanted a second quotation and Clara, a dog groomer and friend had referred her to my surgery where charges are apparently lower. Groomers sometimes play a great role in referrals according to the Penang vet I visited in Penang yesterday. The Penang vet showed me the pet shop whose owner regularly sent him cases. Well, I don't have such good connections as pet shop owners in Singapore tend to be promiscuous in veterinary referrals.
"The Shih Tzu has a high fever," I warned the lady of the risk of death on the operating table for an old dog. An old dog with a high fever too aggravated the risk. "However, eye injuries are emergencies and cannot wait another 24 hours." The lady had no choice and left the decision to me.
I gave the anti-fever and painkiller tolfedine and antibiotics baytril injection subcutaneous around 5 minutes before I used Isoflurane gas to anaesthesize the dog. There was no sedation as this would be riskier.
Surgery: Lateral canthoplasty increases the space for this enlarged injured popped out eye. The prolapsed eyeball was too large for a simple stitching up of the eyelids (tarsorraphy).
"But I had a previous Shih Tzu whose eyes popped out bigger and the vet did not do that," the young lady said.
"Each case is different," I said. "If you don't want the side of the eyelid to be cut to enlarge the eye socket to accommodate the eyeball, please don't blame me if the stitching of the upper and lower eyelids break down before 7 days."
The lady consented to leave the technical matters to me. Many owners want to voice their opinions on treatments and in some cases, they are more knowledgeable than he vet who has to treat several thousands of various cases and may not be an expert in a particular condition.
The following is a summary for vet students of what I did.
1. "Clip both eye area and eyelid lashes," I said to Mr Saw as he presented me with the dog. "Take out the 3rd eyelid and wash off any hairs and debris. Also rinse the eyeball thoroughly."
2. I note an embedded foreign body inside the eye-white. I used a scalpel blade cut off.
3. I ensured that all green dye and hairs are washed away.
4. Sub conj gentamycin and prednisolone subconjuctiva.
5. 3rd eyelid flap, use tension tubes and stitch lateral canthus.
6. For old dogs with fever, reduce the fever and stablised the dog first in normal situations. This will take 24 hours. Eye injuries are emergencies and so the vet has to decide whether to operate soon or not.
The beloved Shih Tzu recovered well from anaesthesia as if from a nap. I phoned the worried lady to let her know that her dog was OK. The eyeball should shrink back to normal in 7-14 days. The lady wanted her dog back and took her home the next morning.
Shih Tzu passes blood a few weeks, incontinent
"Blood in the urine and can't control bladder for past few weeks" the man with the dyed bronze hair said.
His usual vet, Vet 1 diagnosed bladder stones and did not charge him. He referred to Vet 2 as he did not want to do any surgery. Owner read that Vet 2 had a bad name in the internet forum. So, sms me regarding costs of surgery, X-rays etc.
Shih Tzu, Female, 1.5 years
"When's the last heat?" I asked as the vulval lips were still swollen.
"Last month," the young man said. "I thought it was due to heat problems."
BLADDER PALPATION
Crepitus (gas-like sensation) inside the bladder. A common indication of bladder stones.
BLOOD TEST
1. Blood urea above normal
URINE TEST
pH 6.5
SG 1.004
Nitrite +
Blood 4+
Bacteria Occasional
Protein +
Sometimes, no crystals in urine as stone is formed. Acidify urine. Change diet to wet food.
Goes home for one week of antibiotics. Then x-ray if the owner wants it.
His usual vet, Vet 1 diagnosed bladder stones and did not charge him. He referred to Vet 2 as he did not want to do any surgery. Owner read that Vet 2 had a bad name in the internet forum. So, sms me regarding costs of surgery, X-rays etc.
Shih Tzu, Female, 1.5 years
"When's the last heat?" I asked as the vulval lips were still swollen.
"Last month," the young man said. "I thought it was due to heat problems."
BLADDER PALPATION
Crepitus (gas-like sensation) inside the bladder. A common indication of bladder stones.
BLOOD TEST
1. Blood urea above normal
URINE TEST
pH 6.5
SG 1.004
Nitrite +
Blood 4+
Bacteria Occasional
Protein +
Sometimes, no crystals in urine as stone is formed. Acidify urine. Change diet to wet food.
Goes home for one week of antibiotics. Then x-ray if the owner wants it.
142. Swiftlet farming and Golden Retriever split humerus repair
Monday July 26, 2010
"Switch off the phone, switch it off," the group of "aunties" spoke loudly to a member of the group whose phone emitted extremely loud musical noises as the Air Asia plane from Penang was about to land in Singapore at 8.30 pm Monday July 26, 2010. But the old woman answered her phone in the Hokkien dialect: "I am in Singapore now. What did you say? Can't hear you well. Speak up, speak up..."
"The plane is going to crash if you don't switch off your mobile phone," one aunty shouted. "Switch off, switch off..your phone."
But no cabin crew or passenger rushed to take the phone off the culprit. Air Asia cabin crew had advised about switching off the mobile phone before the plane lifted off from Penang, but the language was English and Malay. The old Chinese woman understood neither and so she did not switch off her mobile phone. No Singapoeans died as the plane did not explode.
I was in Penang to visit a swiftlet farming consultancy, Crystal Swiftlets, www.crystalswiftlets.com, with my mentor. A vet there picked us up. It was a bright sunny day in Penang. I will just record briefly in draft form, my visit this morning before I get sucked into the daily routine in Singapore and don't record anything.
SWIFTLET FARMING
1. Swiftlet farming can mean big money as there is no need to provide feed for the swiftlets. Food can account for a big % of the production cost. They fly out to eat only flying insects (airborne and therefore healthy).
2. According to the consultancy, only 2 of around 15 species of swiftlets are worth investing. "In such situation, building a house for swiftlet production may result in losses if the wrong species come to nest," I asked. The consultant said that a site test would be conducted to see whether there is the useful species. This involved the use of vocalisation (music in CD, etc) and other methods by the consultancy.
The most useful species is Aerodramus fuciphagus which produces the high quality birds' nest in great demand. Its bird nest consists of white edible nest. 97.5% of the nest is made up of valuable glyco-proteins said to be good for the health of the consumer. The other useful species is Aerodramus maximus. Other species produce nests mixed with other twigs and branches.
3. Prices. In 2006, RM$4,000 - RM5,000/kg. l kg = around 110 nests. Wholesale price is around RM 40.00/nest.
4. Breeding cycle: 4-monthly. Weight of the adult bird is 8-10 grams. The birds have such short legs that they don't land on the ground since they can fly up again.
5. Swiftlet farming in Malaysia. It is a dirty smelly job and there are predators, the consultant said to me. There are scam investments asking people for money and then disappearing. Sungei Pantai and Alor Star syndicate claims they have >30 successful swiftlet farms. 1 farm produces 3 kg of birds' nest = RM9,000/month. A Penang couple tricked church goers into investing in their bird nest business and disappeared with the money. The Penang vet said that 80% of the farms close down.
5.5 storeys allowed in Malaysia now. Ground floor is housing for workers or holiday guests. Cost of construction around RM400,000. For 3.5 storeys, cost is around RM300,000.
Adult and bigger birds do not sleep inside the small nests. Baby birds fall down and die if disturbed. They cling onto the sides of the nests as they grow up. Within 3 days, a swiftlet will build another nest if people start removing the nest. "Obviously, the swiftlet will go away if nests or eggs get removed," the consultant said. The swiftlet lays a maximum of two eggs per season. If one egg is removed, it will not encourage more eggs to be laid unlike chickens. Eggs artificially incubated will result in weak flyers or birds that don't return to the nesting place. Adult weight said to be 6-8 g. I saw a dead swiftlet at the office. It was small but had long wings. Cannot walk on the ground as it has short legs.
A.fuciphagus nests further inside the house while A. maximus nest further out, the consultant said.
Rainy season, few airborne insects, affects production. The swiftlets need flying insects.
Attend courses at the consultancy:
1. Private individuals from Myanmar and elsewhere. Buy least cost players (RM140) to play the USB vocals to attract the swiftlets.
2. Big joint-venture private-govt company in Ho Chih Min, Vietnam was provided consultancy and had built 11 farms for the company. Now, the company wants to build another 22 farms.
6. "Just build a house in an area where the birds have access to flying insects and provide the appropriate environment including the vocal cries of A. fuciphagus," my mentor thought. "Not so easy," the consultant said. "There needs to be a site test to see if A. fuciphagus or maximus are present. A. fuciphagus produces 95 - 99% of the white colour in the nest with few % of feathers unlike other species. A. maximus produces 55%." South east Asia is the area where swiftlets are found. Indonesia, Thailand and Malaysia are the top producers of birds' nest.
7. Predators are many. Owls, snakes (green ones love eggs), bats, lizards and cockroaches (eats nest and baby birds). "I think the main predator is human beings," I said to my mentor. "If the birds' nests are so valuable, what is there to stop the workers from selling the nests enriching themselves?"
8. Government regulations in Malaysia. Land control (does not permit residences to be used for swiftlet farming or give licence yearly), veterinary control (audit of bird nests, check for nitrite contamination), export licence needed nowadays. Agriculture land may be the long-term solution. Can bird nests be produced in urban areas? Yes, if conditions are right. She said that Georgetown has around 500 bird nest farms, mostly in shophouses, according to the consultant. I don't hear any swiftlet farming in Singapore but then prices of land are higher here. In Malaysia, only 10% of the one-acre agricultural land is permitted for buildings for swiftlet production. The rest is for planting of dragon fruits (v. popular), mushrooms, fishes, holiday homes. Shophouses not encouraged. Licence is renewable annually. Consultancy sells speakers (music to attract birds to come into house and music to stay inside the house). Players to play the music. Both must match. Can fly >100 km per day. "Swiftlet farming can be done anywhere in Malaysia," the consultant said. "The environment must be suitable." 3 companies in Penang had their export licence revoked as their processed birds' nests were found to contain high nitrite levels.
Raw birds' nest. 3 types of bacteria checked by veterinary authorities.
Approval for building is very complicated.
Many investment scams. Kulim scheme RM500,000/investor share. Offers investors 80% of proceeds. Pumps to blow up insects for the birds to eat. Kulim, KL and Malacca firms raided for scams.
In my analysis, swiftlet farming is not a viable investment unless the investor does his own farming initially or has proper audit and financial controls as evident in the apparent success in Ho Chih Min joint-venture.
"Switch off the phone, switch it off," the group of "aunties" spoke loudly to a member of the group whose phone emitted extremely loud musical noises as the Air Asia plane from Penang was about to land in Singapore at 8.30 pm Monday July 26, 2010. But the old woman answered her phone in the Hokkien dialect: "I am in Singapore now. What did you say? Can't hear you well. Speak up, speak up..."
"The plane is going to crash if you don't switch off your mobile phone," one aunty shouted. "Switch off, switch off..your phone."
But no cabin crew or passenger rushed to take the phone off the culprit. Air Asia cabin crew had advised about switching off the mobile phone before the plane lifted off from Penang, but the language was English and Malay. The old Chinese woman understood neither and so she did not switch off her mobile phone. No Singapoeans died as the plane did not explode.
I was in Penang to visit a swiftlet farming consultancy, Crystal Swiftlets, www.crystalswiftlets.com, with my mentor. A vet there picked us up. It was a bright sunny day in Penang. I will just record briefly in draft form, my visit this morning before I get sucked into the daily routine in Singapore and don't record anything.
SWIFTLET FARMING
1. Swiftlet farming can mean big money as there is no need to provide feed for the swiftlets. Food can account for a big % of the production cost. They fly out to eat only flying insects (airborne and therefore healthy).
2. According to the consultancy, only 2 of around 15 species of swiftlets are worth investing. "In such situation, building a house for swiftlet production may result in losses if the wrong species come to nest," I asked. The consultant said that a site test would be conducted to see whether there is the useful species. This involved the use of vocalisation (music in CD, etc) and other methods by the consultancy.
The most useful species is Aerodramus fuciphagus which produces the high quality birds' nest in great demand. Its bird nest consists of white edible nest. 97.5% of the nest is made up of valuable glyco-proteins said to be good for the health of the consumer. The other useful species is Aerodramus maximus. Other species produce nests mixed with other twigs and branches.
3. Prices. In 2006, RM$4,000 - RM5,000/kg. l kg = around 110 nests. Wholesale price is around RM 40.00/nest.
4. Breeding cycle: 4-monthly. Weight of the adult bird is 8-10 grams. The birds have such short legs that they don't land on the ground since they can fly up again.
5. Swiftlet farming in Malaysia. It is a dirty smelly job and there are predators, the consultant said to me. There are scam investments asking people for money and then disappearing. Sungei Pantai and Alor Star syndicate claims they have >30 successful swiftlet farms. 1 farm produces 3 kg of birds' nest = RM9,000/month. A Penang couple tricked church goers into investing in their bird nest business and disappeared with the money. The Penang vet said that 80% of the farms close down.
5.5 storeys allowed in Malaysia now. Ground floor is housing for workers or holiday guests. Cost of construction around RM400,000. For 3.5 storeys, cost is around RM300,000.
Adult and bigger birds do not sleep inside the small nests. Baby birds fall down and die if disturbed. They cling onto the sides of the nests as they grow up. Within 3 days, a swiftlet will build another nest if people start removing the nest. "Obviously, the swiftlet will go away if nests or eggs get removed," the consultant said. The swiftlet lays a maximum of two eggs per season. If one egg is removed, it will not encourage more eggs to be laid unlike chickens. Eggs artificially incubated will result in weak flyers or birds that don't return to the nesting place. Adult weight said to be 6-8 g. I saw a dead swiftlet at the office. It was small but had long wings. Cannot walk on the ground as it has short legs.
A.fuciphagus nests further inside the house while A. maximus nest further out, the consultant said.
Rainy season, few airborne insects, affects production. The swiftlets need flying insects.
Attend courses at the consultancy:
1. Private individuals from Myanmar and elsewhere. Buy least cost players (RM140) to play the USB vocals to attract the swiftlets.
2. Big joint-venture private-govt company in Ho Chih Min, Vietnam was provided consultancy and had built 11 farms for the company. Now, the company wants to build another 22 farms.
6. "Just build a house in an area where the birds have access to flying insects and provide the appropriate environment including the vocal cries of A. fuciphagus," my mentor thought. "Not so easy," the consultant said. "There needs to be a site test to see if A. fuciphagus or maximus are present. A. fuciphagus produces 95 - 99% of the white colour in the nest with few % of feathers unlike other species. A. maximus produces 55%." South east Asia is the area where swiftlets are found. Indonesia, Thailand and Malaysia are the top producers of birds' nest.
7. Predators are many. Owls, snakes (green ones love eggs), bats, lizards and cockroaches (eats nest and baby birds). "I think the main predator is human beings," I said to my mentor. "If the birds' nests are so valuable, what is there to stop the workers from selling the nests enriching themselves?"
8. Government regulations in Malaysia. Land control (does not permit residences to be used for swiftlet farming or give licence yearly), veterinary control (audit of bird nests, check for nitrite contamination), export licence needed nowadays. Agriculture land may be the long-term solution. Can bird nests be produced in urban areas? Yes, if conditions are right. She said that Georgetown has around 500 bird nest farms, mostly in shophouses, according to the consultant. I don't hear any swiftlet farming in Singapore but then prices of land are higher here. In Malaysia, only 10% of the one-acre agricultural land is permitted for buildings for swiftlet production. The rest is for planting of dragon fruits (v. popular), mushrooms, fishes, holiday homes. Shophouses not encouraged. Licence is renewable annually. Consultancy sells speakers (music to attract birds to come into house and music to stay inside the house). Players to play the music. Both must match. Can fly >100 km per day. "Swiftlet farming can be done anywhere in Malaysia," the consultant said. "The environment must be suitable." 3 companies in Penang had their export licence revoked as their processed birds' nests were found to contain high nitrite levels.
Raw birds' nest. 3 types of bacteria checked by veterinary authorities.
Approval for building is very complicated.
Many investment scams. Kulim scheme RM500,000/investor share. Offers investors 80% of proceeds. Pumps to blow up insects for the birds to eat. Kulim, KL and Malacca firms raided for scams.
In my analysis, swiftlet farming is not a viable investment unless the investor does his own farming initially or has proper audit and financial controls as evident in the apparent success in Ho Chih Min joint-venture.
Sunday, July 25, 2010
141. Spaying A Chow Chow
Chow Chows are an uncommon breed in Singapore. They have a compact narrow abdominal area and a broad chest unlike Miniature Schnauzers or cats. So, it is hard to hook out the ovary using the method I am describing below. I record one case of a spay in a Chow Chow to share knowledge with veterinary students.
Patient: Chow Chow, female, 10 months old, 18kg. 39.7C (due to car ride and excitement, vomiting inside the car. Don't spay till 4 hours later)
Last Estrus: 3 months ago. This means that there will be less bleeding when the dog is spayed 3 months after the heat.
Anaesthesia: Domitor 0.25 ml IV although 0.3 ml should be OK too. Then isoflurane gas mask and intubate. IV saline drip given.
"Emergency drugs are to be given inside the IV drip," I explained to Ms Lai, the young intern who wants to study to be a vet. "But the best way is to prevent emergencies from happening by having one assistant monitoring the breathing bag, checking the eyelid reflexes and gum and tongue colour every few seconds. Equipment like ECG, pressure measurement, breathing sound measurement and others are useful but nothing can be beat a competent focused assistant."
Ms Lai already has a degree but she intends to be a vet and is doing a 2-month internship at Toa Payoh Vets. She seems passionate about veterinary medicine and so I explained much about the behaviour and medical and surgical problems to her the new world of dogs and cats, rabbits and hamsters and other small animals to her.
"Old man James used to be my assistant," I said to Ms Lai. "But now he is 75 years old and so he can only observe the breathing bag. When the dog under anaesthesia stops breathing, the bag will stop moving. If the assistant only observes the bag and nothing else, it may not be sufficient or too late. He has to observe the mucous membrane colour and check the eyelid reflexes as well as observing the rotation of the eyeball downwards to confirm surgical anaesthesia."
I don't know how much Ms Lai understands my explanation as she is so new to this world of veterinary anaesthesia and this is the first spay she is watching. My competent assistant Mr Saw was focused on anaesthesia.
"In the case of the Chow Chow, there is no point checking her tongue," I said to Ms Lai. "Look at her tongue. It is naturally purplish black and so we can't see the red colour of oxygenated tongue. We have to check the eyelids."
There was no problem with anaesthesia. Mr Saw tends to put on the lowest dosage to sometimes as low as 0.5%. "It is best not to put to such low rates," I said to Mr Saw. "The omental fat keeps popping out making it very difficult to stitch the muscles to close the wound. 2% gas will be sufficient for this Chow Chow. When I go to the skin incision, you can switch off the gas as Domitor is still sedating."
Overall, this Chow Chow had a very smooth anaesthesia. I took out the endotracheal tube as I saw her reacting by moving her mouth. She woke up with a head turned sideways for a few seconds. This was normal as she was under Domitor sedation. An Antisedan antidote would wake her up completely but we had to clean up the wound and apply the plaster.
Surgery:
1. Body fully stretched out.
"Stretch out the dog as much as possible," I said to my assistant and intern. "I use a 2-cm incision and insert the spay hook to the right and 45 degrees downwards to hook up the ovary. From my experience, it is much easier to hook out the left ovary. Otherwise, the vet may take a very long time to hook out the ovary. I have seen one new vet graduate actually sweating when he spay a big fat mongrel as he could not hook out the ovary for over 10 minutes. If it is difficult to hook out from a small incision, just extend the incision and it will be much easier."
My assistant could not stretch out the left hind leg as there was some jam in the operating table's sliding ring. "I will use my hand to pull the left hind leg," the intern proposed. Well, she had ideas as she could not manage to resolve the jam. My assistant did it.
N.B. Some vets incise around 4 cm from the umbilical hernia scar. In this position, the ovaries are harder to assess and the taut ovarian ligament may not be assessed and cut so easily as in my method. The vet has to pull the ovarian ligament to cut or rupture it using fingers. There is a danger of bits of the ovarian tissue retained during this difficult manipulation. However, each vet has his own ideas and experiences.
2. Skin incision:
Approximately 1.5 to 2 cm from the umbilical scar.
3. Linea alba incision:
Remove the subcutaneous fat. Look for the linea alba. The Chow Chow's body is compact and this 1.5 - 2 cm incision is too small to see the linea alba clearly. But it can be seen. Incise the linea alba. Subcutaneous fat can be seen below this small hole.
4. Spay hook:
With one forcep holding one edge of the muscle, I inserted the spay hook at 45 degrees to the right (dog's head to the vet's left), tilted the hook downwards and had to arc the hook upwards and to the left to hook out the abdominal fat with the ovary. In this Chow Chow, there was much omental fat. I failed the first two times to hook out the ovary as the fat was in the way. At the 3rd time, I saw a glistening knob at one end of the omental fat hooked out. This was the ovary. I used the forceps to clamp a bit of the ovarian tissue and after that, it was simple.
5. Bleeding after separation of omental fat from the uterine horns:
As I separated the omental fat around the uterine horns, prior to clamping the uterine body, there was a gush of bleeding. I clamped the uterine body lower to the bleeding area. The bleeding stopped. I ligate the uterine horns in two locations. No bleeding. Put the uterine stump inside the body.
6. Loosen the tautness of the body:
I asked my assistant to loosen the tight ropes around the dog's paws so that the body is now relaxed. The rest of the spay is as described elsewhere in my website.
7. 2/0 absorbable suture. 2 simple interrupted stitches closed the peritoneum and the muscles. I gave an additional 1 more stitch. Skin is closed with 2 horizontal mattress.
8. Bleeding in the skin sutures. I asked the intern to press swab onto the bleeding area. Bleeding stopped after 10 minutes.
9. Elastoplast bandage covered the wound. The dog could be bathed. No e-collar as I doubt that this Chow Chow likes e-collars. In any case, tolfedine painkillers post-op injection and oral for next 4 days would prevent pain and licking.
10. The dog was able to wag her tail and walk when the owners came one hour after the operation to take the dog home. No Anti-sedan antidote was given as the dog could stand up and walk. The mother was relieved as she was worried about anaesthesia but did not express this worry to me earlier. I could sense it as deaths on the operating table due to anaesthesia are are common worry for many owners.
Spaying this Chow Chow at 3 months after the last heat was the correct timing made by the knowledgeable lady owner. There was practically no bleeding from the omental or ovarian fat and surgery could be completed earlier. Still it took some 30 minutes to do the surgery and I don't look forward to do more spays in Chows Chows owing to the greater difficulty of hooking up the ovaries.
Patient: Chow Chow, female, 10 months old, 18kg. 39.7C (due to car ride and excitement, vomiting inside the car. Don't spay till 4 hours later)
Last Estrus: 3 months ago. This means that there will be less bleeding when the dog is spayed 3 months after the heat.
Anaesthesia: Domitor 0.25 ml IV although 0.3 ml should be OK too. Then isoflurane gas mask and intubate. IV saline drip given.
"Emergency drugs are to be given inside the IV drip," I explained to Ms Lai, the young intern who wants to study to be a vet. "But the best way is to prevent emergencies from happening by having one assistant monitoring the breathing bag, checking the eyelid reflexes and gum and tongue colour every few seconds. Equipment like ECG, pressure measurement, breathing sound measurement and others are useful but nothing can be beat a competent focused assistant."
Ms Lai already has a degree but she intends to be a vet and is doing a 2-month internship at Toa Payoh Vets. She seems passionate about veterinary medicine and so I explained much about the behaviour and medical and surgical problems to her the new world of dogs and cats, rabbits and hamsters and other small animals to her.
"Old man James used to be my assistant," I said to Ms Lai. "But now he is 75 years old and so he can only observe the breathing bag. When the dog under anaesthesia stops breathing, the bag will stop moving. If the assistant only observes the bag and nothing else, it may not be sufficient or too late. He has to observe the mucous membrane colour and check the eyelid reflexes as well as observing the rotation of the eyeball downwards to confirm surgical anaesthesia."
I don't know how much Ms Lai understands my explanation as she is so new to this world of veterinary anaesthesia and this is the first spay she is watching. My competent assistant Mr Saw was focused on anaesthesia.
"In the case of the Chow Chow, there is no point checking her tongue," I said to Ms Lai. "Look at her tongue. It is naturally purplish black and so we can't see the red colour of oxygenated tongue. We have to check the eyelids."
There was no problem with anaesthesia. Mr Saw tends to put on the lowest dosage to sometimes as low as 0.5%. "It is best not to put to such low rates," I said to Mr Saw. "The omental fat keeps popping out making it very difficult to stitch the muscles to close the wound. 2% gas will be sufficient for this Chow Chow. When I go to the skin incision, you can switch off the gas as Domitor is still sedating."
Overall, this Chow Chow had a very smooth anaesthesia. I took out the endotracheal tube as I saw her reacting by moving her mouth. She woke up with a head turned sideways for a few seconds. This was normal as she was under Domitor sedation. An Antisedan antidote would wake her up completely but we had to clean up the wound and apply the plaster.
Surgery:
1. Body fully stretched out.
"Stretch out the dog as much as possible," I said to my assistant and intern. "I use a 2-cm incision and insert the spay hook to the right and 45 degrees downwards to hook up the ovary. From my experience, it is much easier to hook out the left ovary. Otherwise, the vet may take a very long time to hook out the ovary. I have seen one new vet graduate actually sweating when he spay a big fat mongrel as he could not hook out the ovary for over 10 minutes. If it is difficult to hook out from a small incision, just extend the incision and it will be much easier."
My assistant could not stretch out the left hind leg as there was some jam in the operating table's sliding ring. "I will use my hand to pull the left hind leg," the intern proposed. Well, she had ideas as she could not manage to resolve the jam. My assistant did it.
N.B. Some vets incise around 4 cm from the umbilical hernia scar. In this position, the ovaries are harder to assess and the taut ovarian ligament may not be assessed and cut so easily as in my method. The vet has to pull the ovarian ligament to cut or rupture it using fingers. There is a danger of bits of the ovarian tissue retained during this difficult manipulation. However, each vet has his own ideas and experiences.
2. Skin incision:
Approximately 1.5 to 2 cm from the umbilical scar.
3. Linea alba incision:
Remove the subcutaneous fat. Look for the linea alba. The Chow Chow's body is compact and this 1.5 - 2 cm incision is too small to see the linea alba clearly. But it can be seen. Incise the linea alba. Subcutaneous fat can be seen below this small hole.
4. Spay hook:
With one forcep holding one edge of the muscle, I inserted the spay hook at 45 degrees to the right (dog's head to the vet's left), tilted the hook downwards and had to arc the hook upwards and to the left to hook out the abdominal fat with the ovary. In this Chow Chow, there was much omental fat. I failed the first two times to hook out the ovary as the fat was in the way. At the 3rd time, I saw a glistening knob at one end of the omental fat hooked out. This was the ovary. I used the forceps to clamp a bit of the ovarian tissue and after that, it was simple.
5. Bleeding after separation of omental fat from the uterine horns:
As I separated the omental fat around the uterine horns, prior to clamping the uterine body, there was a gush of bleeding. I clamped the uterine body lower to the bleeding area. The bleeding stopped. I ligate the uterine horns in two locations. No bleeding. Put the uterine stump inside the body.
6. Loosen the tautness of the body:
I asked my assistant to loosen the tight ropes around the dog's paws so that the body is now relaxed. The rest of the spay is as described elsewhere in my website.
7. 2/0 absorbable suture. 2 simple interrupted stitches closed the peritoneum and the muscles. I gave an additional 1 more stitch. Skin is closed with 2 horizontal mattress.
8. Bleeding in the skin sutures. I asked the intern to press swab onto the bleeding area. Bleeding stopped after 10 minutes.
9. Elastoplast bandage covered the wound. The dog could be bathed. No e-collar as I doubt that this Chow Chow likes e-collars. In any case, tolfedine painkillers post-op injection and oral for next 4 days would prevent pain and licking.
10. The dog was able to wag her tail and walk when the owners came one hour after the operation to take the dog home. No Anti-sedan antidote was given as the dog could stand up and walk. The mother was relieved as she was worried about anaesthesia but did not express this worry to me earlier. I could sense it as deaths on the operating table due to anaesthesia are are common worry for many owners.
Spaying this Chow Chow at 3 months after the last heat was the correct timing made by the knowledgeable lady owner. There was practically no bleeding from the omental or ovarian fat and surgery could be completed earlier. Still it took some 30 minutes to do the surgery and I don't look forward to do more spays in Chows Chows owing to the greater difficulty of hooking up the ovaries.
Saturday, July 24, 2010
140. Doing research
Article: In search of Ma - Mother's Day Story
The Straits Times, May 1, 2010
Devonshire Road, Teochew Tong San Tng temple photo with Mia Tan's mum praying taken by a German photographer almost 20 years ago. Photo was exhibited in the temple. How to trace him for the photo? Took one year to get result.
1. Countless online searches, emails to German photograhers working or had worked in Singapore, photojournalists, Goethe Institute for names, but disappointed.
2. Friend suggested online National Library Board Digitalised Newspaper archives. Found a newspaper article "Candles kindle love for temple photography" by Wolfgang Pippert.
3. Went to National Library microfilm reels and books to get a photo of Mr Pippert.
4. Finally, search Facebook. Mr Pippert sent her a scanned photo in her email. Gave to mum on Mother's Day.
Mum is 70 years old but the photo is a constant reminder of Mum's values of steadfastness, patience, compassion and wisdom.
The Straits Times, May 1, 2010
Devonshire Road, Teochew Tong San Tng temple photo with Mia Tan's mum praying taken by a German photographer almost 20 years ago. Photo was exhibited in the temple. How to trace him for the photo? Took one year to get result.
1. Countless online searches, emails to German photograhers working or had worked in Singapore, photojournalists, Goethe Institute for names, but disappointed.
2. Friend suggested online National Library Board Digitalised Newspaper archives. Found a newspaper article "Candles kindle love for temple photography" by Wolfgang Pippert.
3. Went to National Library microfilm reels and books to get a photo of Mr Pippert.
4. Finally, search Facebook. Mr Pippert sent her a scanned photo in her email. Gave to mum on Mother's Day.
Mum is 70 years old but the photo is a constant reminder of Mum's values of steadfastness, patience, compassion and wisdom.
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