Dec 30, 2010
INTERESTING CASES
2nd last day of 2010. Today was the low season (as in tourism) as I had only a handful of cases. But I could spend more time with each individual and this is the best part of veterinary medicine. If the vet has 40 cases a day, it is not possible to get to know the clients well since the waiting queues and dogs barking at each other in the very small reception room would be harassing.
Case 1. Neutering of big breeds
A young man in his 30s came with a big breed for neutering. He had been to the Surgery before. Since there are now over 40 veterinary practices in Singapore and the practice of vet-hopping is common and he lived in Changi which is a 30-minute drive to Toa Payoh Vets, I expected him to choose a vet based on proximity, not on reputation or skills. Therefore asked him: "You have several practices closer to your residence. Why do you come so far away to neuter your Golden Retriever?"
"Actually I phoned up Vet 1 (which is an established practice nearer to his residence than mine). The girl said that the practice does not neuter big breeds. So I come here."
I was surprised as I thought all vets in Singapore neuter all dogs irrespective of size. Neutering is a most common surgery in veterinary practices all over the world. Well, life is full of surprises and changes.
As to why Vet 1 does not neuter big dogs, I can only hazard a guess based on my observations and said to the young entrepreneur: "In big dogs, the bleeding complications after surgery can be very distressing. The scrotal sac swells to as big as a tennis ball if there is bleeding. Some dogs bite and lick the operation area vigorously and this is one cause of bleeding. The profuse bleeding leads to a lot of blood inside the scrotum and the owner becomes worried when they see it becoming a huge tennis ball." Big dogs seldom wear e-collars to prevent licking as some owners don't want it. E-collars should be worn for the first 48 hours but big dogs and owners don't like it. The dog finds it difficult to eat and drink properly. However, I have cases where e-collars do not prevent self-trauma licking and injury of the operation site. In such cases, pain-killers may not be effective or the dog is highly sensitive and clean.
In this case, I share with the vet students my surgical approach to get a good outcome of no post-operation trauma of the surgical site after neutering.
ANAESTHESIA. Golden Retriever, Male, 3 years
Domitor 0.3 ml IV. Wait 5 minutes. Isoflurane gas 2-3% maintenance. Intubated. Excellent surgical anaesthesia.
SURGERY. 2-cm incision in skin above scrotal area. (Some vets in Singapore incise the scrotal area apparently according to one of my clients). I took out one testicle. Then I clamp the tunica as a whole sheath enclosing the spermatic cord and blood vessels. 3 forceps are used to clamp.
TRANSFIXING LIGATURE. Below the lowest clamp (3rd forceps), I inserted the suture needle (2/0 absorbable) into the sheath away from the blood vessels. Then I ligate the blood vessel end. After that I ligate the opposite end.
DOUBLE LIGATURE. Then I release the clamp. I wrap one suture round the clamped area of the sheath and ligate. In this area, the suture is unlikely to slip. In any case, I knot on one side. Then I knot again on the other side.
I cut off the sheath between the lst and 2nd forceps. Push back the sheath into the inguinal canal. Checked for bleeding. There was none. I repeated the procedure on the other testicle.
SKIN INCISION. I put in 2 horizontal mattress sutures using the same 2/0 absorbable suture. There was profuse bleeding from the skin. This is quite common and not serious. I put on plaster to stop the bleeding which will be obvious.
POST-OP PAIN-KILLERS AND ANTIBIOTICS. Tolfedine and Baytril are given SC based on 10 kg post-surgery. The dog was OK. There was no need to give Anti-sedan to reverse the Domitor as the dog woke up after 10 minutes since I had reduced isoflurane gas go zero in the last 3 minutes before completion.
5 HOURS AFTER SURGERY. INSPECTION BEFORE GOING HOME. The owner and his wife came. The dog wagged his tail. There was no pain and he did not lick the area since tolfedine was effective. The owner rejected the e-collar. So I advised him to give tolfedine tablets 12 hours later (the next morning) and therefore for 7 days at one dosage per day. Antibiotics were prescribed. There ought to be no problem.
STITCH REMOVAL 10 DAYS LATER ADVISED. The owner was advised to wash the operation area and thigh with warm water as there was some blood stains.
TEETH SCALING AFTER NEUTERING. Some tartar in the back teeth. Teeth scaling was $100. This was a big discount to $250 since the dog was already under anaesthesia for neutering. Tooth brushing will prevent tartar formation.
This was a very friendly Golden Retriever. I took some pictures of him and tried a close up picture of his eye with my 18-55 mm lens. It was a most happy outcome for everybody as the dog appeared normal and happy.
Case 2. Shih Tzu with left eye corneal ulcer (generalised superficial keratitis).
"Vet 1 said that my dog must use artificial tears as my dog has dry eyes. She used a green dye on the eye and said it had dry eyes and conjunctivitis," two young ladies presented their Shih Tzu with a red left eye. Her father was present with her. The left eye was cloudy while the sclera was intensely red. It is unusual for a young dog to have dry eyes as this was what the young ladies reported as to what Vet 1 had said. However they had no medical report from Vet 1 with them and I did not want to go into the hassle of phoning Vet 1 to ask for medical records. Some vets would do it.
A simple eye examination would be practical and even if the dog had dry eyes, it would be possible and that would be some time ago. In any case, it had no dry eyes now. I asked: "How long has this left eye been so red?"
"Only 1 week." the older sister said.
I shone the torchlight on the eye. The cornea was cloudy for around 70% of the area esp. on the top half. I asked my assistant Mr Saw to put the fluorescein strip into the eye as part of my mentorship. He would be returning to Myanmar in 2011 to be involved in a new practice and as he has been working for me for 3 years, I wish him well and am sure he would be a better vet in Yangon after 3 hard years in Toa Payoh Vets.
Mr Saw came into the room and went to take a syringe, filled it with saline and squirted some onto the eye. Then he applied the fluorescein strip onto the eye. I was puzzled as why he did it this way. He had seen me doing it the direct way and here, he did it another way*.
The fluorescein strip started to disperse green dye onto the eye. However, the greenish was not so obvious as the saline squirted onto the eye was making the stain less green. In any case, the owners could see that the top half of the cornea was greenish, indicating ulcerations. I advised stitching up the eyelid for 7-10 days to enable ease of healing of the cornea which had been exposed to sunlight and wind and caused the dog to rub the left eye till it was red.
Domitor 0.1 ml IV was given. Isoflurane gas. The eyelids were stitched up. The dog went home. Eye ointment to be applied. Stitches should come out by itself in 7-14 days and there ought to be a good outcome. "Eye injuries are emergencies," I advised. "They should be treated within 24 hours of injury. The Shih Tzu commonly gets eye injuries. Sometimes it is the prominent nasal fold's hairs irritating the eyes," I said as I showed the illustration from the Ophthalmology book. "How much it costs for the surgery?" the father asked about the stitching of the eyelids. "Around $250." He was agreeable.
P.S. *I asked Mr Saw later as I showed him the direct way. He said this was what my associate vet did and therefore he did it. Mr Saw's friend came to visit, saw the faint green dye and said: "Nothing serious with the eye ulcer, no need to do surgery to stitch up the eye lids." This was his opinion as he clipped the dog bald including the eye area for my surgery.
During anaesthesia, I re-applied the strip directly onto the eye and this time, Mr Saw could see the intense green covering more than 50%of the cornea. The ulcers were obvious now since the green dye sticks onto the pitted cornea from 9 o'clock to 4 o'clock of the cornea mainly. I took a picture for record and educational purposes. "Show rather than tell" is the most effective way to mentor a person.
Life is full of surprises and changes. I told Mr Saw that the best way is to apply the fluorescein strip under the upper eye lid and there was no need of saline flushing first. I don't know whether he will remember but hands-on experience is the best way to learn. Nobody is perfect but sometimes I expect perfection in my veterinary assistants of procedures they have had seen done successfully. However, there are other ways to do a procedure in veterinary surgery and sometimes a new way is much better. So, it is hard to say that my way is the correct way and be narrow-minded.
Friday, December 31, 2010
Thursday, December 30, 2010
281. Ear problems and Injectable anaesthesia - xylazine & diazepam IV
Dec 29, 2010
I was on duty as Dr Vanessa Lin went on leave for the next 10 days. This was the 2nd day of work since I came back from the holidays. I thought it would be a quiet Wednesday and brought my laptop to do some writing and scheduled a house-call to micro-chip and vaccinate some dogs at Pets Zone in Dunearn Road at 4 pm. But it was a hectic day from 10 am to 8 p.m, with one-hour break at lunch-time. The cases were the usual ones of neutering and spaying, dental scaling, skin diseases, ear problems, eye infections in two stray kittens. Some interesting cases are as follows:
1. Animal activism in Singapore. A young lady wanted to know how much it would cost to hospitalise two stray kittens with flu for a few days while she looked for new homes for them. Her father would kill her if she brought these kittens home as she already had several. She was looking for the least cost veterinary care and dictating that the kittens should not be given antibiotics. This is a common situation encountered at all vet clinics. There is insufficient space at Toa Payoh Vets which is a small surgery of 60 sq metres. I do help a few stray cat cases but there is a limit in charitable work. A practice has high overheads although it does not look obvious to the average pet owner in Singapore. In this case of cat flu, home nursing would be best. I advised her to nurse the kittens herself as it would be better for the kittens.
2. Animal activism in Yangon. An old friend started to help homeless dogs and cats in a place in Yangon. This is his personal thing as he could better spend his time and skill earning more money in the IT field. However, the residents there wanted US$20,000 from him if he wanted to continue his mission. I had advised him of the risks of doing animal activism overseas as politics would become dominant. This happens even in Singapore, as cat welfare people tried in vain to get the Singapore Government to permit cat ownership for the average person living in HDB apartments.
From this incident, you can see that it is difficult for a Singaporean animal activist going across borders to help change the world unless he has powerful political connections. Politics and economics interact in animal activism and business. Such are the facts of life.
3. Ear problems. One dog had red ear flaps for many weeks. I did a microscopic examination of the hairs. It was ringworm. "A follow-up one month later is important," I said to the owner. Some owners blame the vet for not resolving their problem when they don't follow up but went to another vet.
4. Injectable anaesthesia. The following is one of many metods of injectable anaesthesia used safely in practices and countries with no access to isoflurane gas anaesthesia, unlike fortunate Singaporean pet owners where the best anaesthetic drugs are available for pets.
I am sharing this knowledge with vets working in such locations. The above dosage is a general guideline. An IV catheter is inserted so that top up injections can be given IV should the dog need more anaesthesia. For a 10-kg dog, the dosage of diazepam and ketamine in one syringe are respectively 0.4 ml + 0.4 ml IV.
Case 1. At 50% of the above dosage, ie. 0.2 ml diazepam + 0.2 ml ketamine in one syringe IV for a 10-kg mixed breed dog, the dog shows signs of head shaking sideways and salivation. It was not under surgical anaesthesia. I top up with 5% isoflurane gas by mask for a minute or two to effect and this provided excellent anaesthesia for neutering.
Case 2. At 100% of the above dosage, the dog's body muscles were tense. The dog's neck and legs were flexed. The eyes were open and the pupils dilated. However, dental scaling was done without pain or the need for top up.
CONCLUSION. Each vet has his own preferences in anaesthesia. As long as it is safe for the dog, injectable anaesthesia offers a cheaper alternative to isoflurane gas. The anaesthetic machine and isoflurance are expensive compared to the injectable anaesthetics. In an effort to lower veterinary costs, injectable anaesthetics are used. As for me, I prefer to use xylazine (or domitor) sedation and isoflurane gas anaesthesia as I find that the dog sleeps relaxed (not with tense muscles as in the diazepam and ketamine injectable anaesthesia) and surgery can be done smoothly without the need for topping up as the dog struggles when pain is experienced.
ECONOMICS OF PRACTICE. Each vet does what he prefers as long as the dog is safe and alive at the end of the day. I am just sharing my observations to benefit vets who may not have access to isoflurane facilities as not the isoflurane gas machine purchase cost and maintenance are very expensive. There are more less sophisticated pet owners who just want "cheap" veterinary anaesthesia and surgery and a veterinary practice needs to sustain its profitability to be around the next year. So, there is a need to reduce veterinary costs, sometimes performing loss-making surgeries!
INTERESTING CASE OF BLACK EAR DISCHARGE
"The (pet shop owner's son) was not in a good mood and so I talked to the counter staff," the matronly woman had brought the 7-month-old female salt and pepper Miniature Schnauzer in for his 3rd vaccination. Toa Payoh Vets had given the puppy 2 vaccinations earlier. She paid $350 for the dog which I thought was too cheap as it had such good physical characteristics. But older dogs are difficult to sell and only puppies fetch a premium price in Singapore.
"The young man may be having some personal problem," I said as the husband wanted the wife to complain that she was sold a dog with black ear discharge. "His father had died while delivering dog food and crashing his van. The hospital doctor did not diagnose that he had a head injury and sent him home. What ear drops have you been using to clean the dog's ears?"
"I use eucalyptus oil for the past few days," the lady said. "The next day, the black ear discharge appears again."
"This is is a good looking dog and you had got it at a cheap price," I could appreciate a Schnauzer with good conformation. A good sized head, proportionate body length and not too long legs. Not too bulky as Singaporeans prefer this type of size although dog show people will consider this dog under-sized. Female dogs of this size and shape are more valuable for breeders as there is a demand for "miniature" Miniature Schnauzers.
I took a cotton bud and spread some ear discharge on a slide and put it under the microscope but saw no mites. "You must have drowned all mites with oil," I said. "Not a mite can be seen."
What caused the blackness and the black particles inside the two ears? As black as black shoe polish. Ear discharge comes in all colours but pure black is rarely seen by me in practice over 40 years. It was as if the ear drops of oil were black in colour. I did not ask the owner the colour of the ear drops as it was an extremely hectic day and I still had not done the 3rd spay of the 3rd stray cat.
The owner who loves his 3 stray cats had brought in the 3rd one for spaying today. Yesterday, he got two in and I had neutered and spayed them. The 3rd one was "fierce" and was put inside a cardboard box, taped up but with gaps for the cat to breathe. It was as if he had a tiger inside the box and so we did not dare open the box and transfer the cat to the crate for the time being. The minutes ticked by and the whole afternoon had gone and still I had no time to spay this cat.
Spending time with the owner is essential in practice building but the other owners at the waiting room disliked waiting too long unfortunately. Some owners want fast service. I could see that the Schnauzer lady's husband was all ready to go to work. But he was the patient type who would wait for his wife to get the dog vaccinated. That was all she came for and vaccination should be fast. But for the black ear discharge, the dog would leave in 5 minutes.
I got the ears irrigated and taught the owner how to use the medicated ear drops. The best would be another ear irrigation the next day but I could sense that the husband was an extremely busy man but his wife mentioned about him working in an important post in a volunteer organisation. "You work for the famous Red Cross," I said to him as I was thinking of the excellent volunteerism and time it had done for so many unfortunate people in countries all over the world.
"The infamous Red Cross," he laughed. Yes, there was a newspaper report about some loss of money taken by a staff in the Singapore branch but I was not thinking of this matter. There will always be staff who steals money from the organisation all over the world.
In one case of a famous cosmetic surgeon in Singapore, I was shocked to read in the newspaper that he did not print his own receipt books. He bought commercial ones. So, he had 3 copies. The white for the client, the blue for audit and the yellow for the case file. Now, his billing staff found a way to milk him of over $100,000. She would buy another set of books. When she billed the client, she would give the client the white copy with say $1,000 and collected $1,000. Then she would write, say $500 on the blue and yellow copy from her own purchased set and discard the original blue and yellow copies of the surgeon's book. She could also under-declare the income by replacing the yellow or blue copies.
"How was she caught?" my wife asked me yesterday when I told her that the famous surgeon did not print his own receipt books which I found it hard to believe if not for this case in court.
"Well, another staff discovered that the blueness of the blue receipt was not similar to the blueness of the other receipts." But over $100,000 had been misappropriated and this sacked staff complained that the surgeon had not granted her medical leave.
I digressed. Back to the Schnauzer's black ears. The husband seemed appreciative when I asked the wife to use the medicated ear drops herself to clean the ears for the next 7 days and if the black discharge disappear, then there was no need to consult me.
This was one of the 4 interesting ear problems. The other one was the fiery red inside ear flap caused by ringworm infestation in both ears mentioned above. The 3rd one in a young cat with thick reddish black waxy ear discharge was even more interesting in the sense that I managed to find one dead ear mite under the microscope when I did an ear discharge examination.
"See the mite," I asked the young lady to peer into the microscope. "There is only one." The mite with a round body and six short legs in the front half was clearly visible and sharp under my newly purchased microscope. "Where's the mite," the lady asked. She was not into biology I presumed. I took out the Hill's Atlas of Clinical History and showed her the drawings. Maybe I should produce one myself. "See the book drawing of the mite," I showed her the cat and ear mite drawings inside the book. "What's the name of this ear mite in the cat?" I asked Mr Saw, my assistant who is qualified as a vet in Myanmar and would be returning home in April 2011. The book did not mention any name. Mr Saw shook his head. "It would be Otodectes cyanotis," I said. It was Greek to him and to all vet students. I got the ears irrigated and gave an anti-mite ivermectin injection. Follow up would be good.
It is 7.25 am and I have to get ready for work. The 4th ear case was one in which the young man's cotton tip fell into the dog's right ear canal while cleaning. The Pomeranian would bite when he tried to retrieve it deep inside the ear canal. "Surprisingly my dog did not shake his head. I would rather get it removed before it infects the ear. How long will it take?"
"That depends on whether the dog needs to be sedated," I said. I got the dog inside the surgery, muzzled it and Mr Saw held the dog properly. Mr Saw had wanted the ear scope to check out the ears. "No point in doing it," I said. "The ear scope will push the cotton bud deeper into the ear." Sometimes we have to visualise the impact of a particular procedure.
In theory, all ear examinations must be scoped. Sometimes it could even be considered negligent not to scope the ears as a routine. In practice, the dog owner had already given us the history that his cotton tip had dropped inside the right ear. Using an ear scope would push the cotton into the horizontal canal and that would be very difficult to extract.
I inserted a slim curved artery forceps into the right ear vertical canal to the base, open and clamp. Fortunately I got the cotton bud out at the first clamp. I showed the bud to the owner who was quite pleased. "It's time I buy good quality cotton buds to clean my dog's ears," he laughed.
So, in one day on Dec 29, 2010, I got at least 4 different causes of ear problems in 3 dogs and 1 cat. There was a 5th in a Westie. In this case, the Westie had itchy ears, paws and body. It could be a Westie-related genetic disease or allergy. So, there were actually 5 cases of variations of ear problems in dogs and cats in one day. And I thought this was going to be a laid-back day and smell the roses. At 8 pm, I completed my house-call vaccination and microchip at Pet's Zone in Dunearn Road apologising for the late arrival.
It was an unusual day of ears to remember. I record it to remember it when the years go by. I hope you did enjoy reading the report.
I was on duty as Dr Vanessa Lin went on leave for the next 10 days. This was the 2nd day of work since I came back from the holidays. I thought it would be a quiet Wednesday and brought my laptop to do some writing and scheduled a house-call to micro-chip and vaccinate some dogs at Pets Zone in Dunearn Road at 4 pm. But it was a hectic day from 10 am to 8 p.m, with one-hour break at lunch-time. The cases were the usual ones of neutering and spaying, dental scaling, skin diseases, ear problems, eye infections in two stray kittens. Some interesting cases are as follows:
1. Animal activism in Singapore. A young lady wanted to know how much it would cost to hospitalise two stray kittens with flu for a few days while she looked for new homes for them. Her father would kill her if she brought these kittens home as she already had several. She was looking for the least cost veterinary care and dictating that the kittens should not be given antibiotics. This is a common situation encountered at all vet clinics. There is insufficient space at Toa Payoh Vets which is a small surgery of 60 sq metres. I do help a few stray cat cases but there is a limit in charitable work. A practice has high overheads although it does not look obvious to the average pet owner in Singapore. In this case of cat flu, home nursing would be best. I advised her to nurse the kittens herself as it would be better for the kittens.
2. Animal activism in Yangon. An old friend started to help homeless dogs and cats in a place in Yangon. This is his personal thing as he could better spend his time and skill earning more money in the IT field. However, the residents there wanted US$20,000 from him if he wanted to continue his mission. I had advised him of the risks of doing animal activism overseas as politics would become dominant. This happens even in Singapore, as cat welfare people tried in vain to get the Singapore Government to permit cat ownership for the average person living in HDB apartments.
From this incident, you can see that it is difficult for a Singaporean animal activist going across borders to help change the world unless he has powerful political connections. Politics and economics interact in animal activism and business. Such are the facts of life.
3. Ear problems. One dog had red ear flaps for many weeks. I did a microscopic examination of the hairs. It was ringworm. "A follow-up one month later is important," I said to the owner. Some owners blame the vet for not resolving their problem when they don't follow up but went to another vet.
4. Injectable anaesthesia. The following is one of many metods of injectable anaesthesia used safely in practices and countries with no access to isoflurane gas anaesthesia, unlike fortunate Singaporean pet owners where the best anaesthetic drugs are available for pets.
I am sharing this knowledge with vets working in such locations. The above dosage is a general guideline. An IV catheter is inserted so that top up injections can be given IV should the dog need more anaesthesia. For a 10-kg dog, the dosage of diazepam and ketamine in one syringe are respectively 0.4 ml + 0.4 ml IV.
Case 1. At 50% of the above dosage, ie. 0.2 ml diazepam + 0.2 ml ketamine in one syringe IV for a 10-kg mixed breed dog, the dog shows signs of head shaking sideways and salivation. It was not under surgical anaesthesia. I top up with 5% isoflurane gas by mask for a minute or two to effect and this provided excellent anaesthesia for neutering.
Case 2. At 100% of the above dosage, the dog's body muscles were tense. The dog's neck and legs were flexed. The eyes were open and the pupils dilated. However, dental scaling was done without pain or the need for top up.
CONCLUSION. Each vet has his own preferences in anaesthesia. As long as it is safe for the dog, injectable anaesthesia offers a cheaper alternative to isoflurane gas. The anaesthetic machine and isoflurance are expensive compared to the injectable anaesthetics. In an effort to lower veterinary costs, injectable anaesthetics are used. As for me, I prefer to use xylazine (or domitor) sedation and isoflurane gas anaesthesia as I find that the dog sleeps relaxed (not with tense muscles as in the diazepam and ketamine injectable anaesthesia) and surgery can be done smoothly without the need for topping up as the dog struggles when pain is experienced.
ECONOMICS OF PRACTICE. Each vet does what he prefers as long as the dog is safe and alive at the end of the day. I am just sharing my observations to benefit vets who may not have access to isoflurane facilities as not the isoflurane gas machine purchase cost and maintenance are very expensive. There are more less sophisticated pet owners who just want "cheap" veterinary anaesthesia and surgery and a veterinary practice needs to sustain its profitability to be around the next year. So, there is a need to reduce veterinary costs, sometimes performing loss-making surgeries!
INTERESTING CASE OF BLACK EAR DISCHARGE
"The (pet shop owner's son) was not in a good mood and so I talked to the counter staff," the matronly woman had brought the 7-month-old female salt and pepper Miniature Schnauzer in for his 3rd vaccination. Toa Payoh Vets had given the puppy 2 vaccinations earlier. She paid $350 for the dog which I thought was too cheap as it had such good physical characteristics. But older dogs are difficult to sell and only puppies fetch a premium price in Singapore.
"The young man may be having some personal problem," I said as the husband wanted the wife to complain that she was sold a dog with black ear discharge. "His father had died while delivering dog food and crashing his van. The hospital doctor did not diagnose that he had a head injury and sent him home. What ear drops have you been using to clean the dog's ears?"
"I use eucalyptus oil for the past few days," the lady said. "The next day, the black ear discharge appears again."
"This is is a good looking dog and you had got it at a cheap price," I could appreciate a Schnauzer with good conformation. A good sized head, proportionate body length and not too long legs. Not too bulky as Singaporeans prefer this type of size although dog show people will consider this dog under-sized. Female dogs of this size and shape are more valuable for breeders as there is a demand for "miniature" Miniature Schnauzers.
I took a cotton bud and spread some ear discharge on a slide and put it under the microscope but saw no mites. "You must have drowned all mites with oil," I said. "Not a mite can be seen."
What caused the blackness and the black particles inside the two ears? As black as black shoe polish. Ear discharge comes in all colours but pure black is rarely seen by me in practice over 40 years. It was as if the ear drops of oil were black in colour. I did not ask the owner the colour of the ear drops as it was an extremely hectic day and I still had not done the 3rd spay of the 3rd stray cat.
The owner who loves his 3 stray cats had brought in the 3rd one for spaying today. Yesterday, he got two in and I had neutered and spayed them. The 3rd one was "fierce" and was put inside a cardboard box, taped up but with gaps for the cat to breathe. It was as if he had a tiger inside the box and so we did not dare open the box and transfer the cat to the crate for the time being. The minutes ticked by and the whole afternoon had gone and still I had no time to spay this cat.
Spending time with the owner is essential in practice building but the other owners at the waiting room disliked waiting too long unfortunately. Some owners want fast service. I could see that the Schnauzer lady's husband was all ready to go to work. But he was the patient type who would wait for his wife to get the dog vaccinated. That was all she came for and vaccination should be fast. But for the black ear discharge, the dog would leave in 5 minutes.
I got the ears irrigated and taught the owner how to use the medicated ear drops. The best would be another ear irrigation the next day but I could sense that the husband was an extremely busy man but his wife mentioned about him working in an important post in a volunteer organisation. "You work for the famous Red Cross," I said to him as I was thinking of the excellent volunteerism and time it had done for so many unfortunate people in countries all over the world.
"The infamous Red Cross," he laughed. Yes, there was a newspaper report about some loss of money taken by a staff in the Singapore branch but I was not thinking of this matter. There will always be staff who steals money from the organisation all over the world.
In one case of a famous cosmetic surgeon in Singapore, I was shocked to read in the newspaper that he did not print his own receipt books. He bought commercial ones. So, he had 3 copies. The white for the client, the blue for audit and the yellow for the case file. Now, his billing staff found a way to milk him of over $100,000. She would buy another set of books. When she billed the client, she would give the client the white copy with say $1,000 and collected $1,000. Then she would write, say $500 on the blue and yellow copy from her own purchased set and discard the original blue and yellow copies of the surgeon's book. She could also under-declare the income by replacing the yellow or blue copies.
"How was she caught?" my wife asked me yesterday when I told her that the famous surgeon did not print his own receipt books which I found it hard to believe if not for this case in court.
"Well, another staff discovered that the blueness of the blue receipt was not similar to the blueness of the other receipts." But over $100,000 had been misappropriated and this sacked staff complained that the surgeon had not granted her medical leave.
I digressed. Back to the Schnauzer's black ears. The husband seemed appreciative when I asked the wife to use the medicated ear drops herself to clean the ears for the next 7 days and if the black discharge disappear, then there was no need to consult me.
This was one of the 4 interesting ear problems. The other one was the fiery red inside ear flap caused by ringworm infestation in both ears mentioned above. The 3rd one in a young cat with thick reddish black waxy ear discharge was even more interesting in the sense that I managed to find one dead ear mite under the microscope when I did an ear discharge examination.
"See the mite," I asked the young lady to peer into the microscope. "There is only one." The mite with a round body and six short legs in the front half was clearly visible and sharp under my newly purchased microscope. "Where's the mite," the lady asked. She was not into biology I presumed. I took out the Hill's Atlas of Clinical History and showed her the drawings. Maybe I should produce one myself. "See the book drawing of the mite," I showed her the cat and ear mite drawings inside the book. "What's the name of this ear mite in the cat?" I asked Mr Saw, my assistant who is qualified as a vet in Myanmar and would be returning home in April 2011. The book did not mention any name. Mr Saw shook his head. "It would be Otodectes cyanotis," I said. It was Greek to him and to all vet students. I got the ears irrigated and gave an anti-mite ivermectin injection. Follow up would be good.
It is 7.25 am and I have to get ready for work. The 4th ear case was one in which the young man's cotton tip fell into the dog's right ear canal while cleaning. The Pomeranian would bite when he tried to retrieve it deep inside the ear canal. "Surprisingly my dog did not shake his head. I would rather get it removed before it infects the ear. How long will it take?"
"That depends on whether the dog needs to be sedated," I said. I got the dog inside the surgery, muzzled it and Mr Saw held the dog properly. Mr Saw had wanted the ear scope to check out the ears. "No point in doing it," I said. "The ear scope will push the cotton bud deeper into the ear." Sometimes we have to visualise the impact of a particular procedure.
In theory, all ear examinations must be scoped. Sometimes it could even be considered negligent not to scope the ears as a routine. In practice, the dog owner had already given us the history that his cotton tip had dropped inside the right ear. Using an ear scope would push the cotton into the horizontal canal and that would be very difficult to extract.
I inserted a slim curved artery forceps into the right ear vertical canal to the base, open and clamp. Fortunately I got the cotton bud out at the first clamp. I showed the bud to the owner who was quite pleased. "It's time I buy good quality cotton buds to clean my dog's ears," he laughed.
So, in one day on Dec 29, 2010, I got at least 4 different causes of ear problems in 3 dogs and 1 cat. There was a 5th in a Westie. In this case, the Westie had itchy ears, paws and body. It could be a Westie-related genetic disease or allergy. So, there were actually 5 cases of variations of ear problems in dogs and cats in one day. And I thought this was going to be a laid-back day and smell the roses. At 8 pm, I completed my house-call vaccination and microchip at Pet's Zone in Dunearn Road apologising for the late arrival.
It was an unusual day of ears to remember. I record it to remember it when the years go by. I hope you did enjoy reading the report.
Wednesday, December 29, 2010
280. Two para-police guards at the CEA office
I was surprised to see two senior para-police guards outside the CEA office as there were none two weeks ago. "We are protecting the CEA directors inside the offices. Many housing agents had their licences revoked and we have much experience handling such riotous people."
The CEA is set up to regulate the housing agents and started in Nov 2010. "There is a Chinese syndicate conning the people," the guard told me. I was surprised to know that. The world has changed and there may be more cunning scam and con men and women who want to make fast bucks without having to work.
The CEA is set up to regulate the housing agents and started in Nov 2010. "There is a Chinese syndicate conning the people," the guard told me. I was surprised to know that. The world has changed and there may be more cunning scam and con men and women who want to make fast bucks without having to work.
279. The man who loved 3 stray cats
Yesterday, Dec 28, 2010 was my first day back to work, after a 14-day packaged tour to Europe (Italy, Switzerland and France) and a subsidised stay in Dubai from Emirates Air and the Tourism Board.
It was extremely tiring as the tour leader had to rush us from one place to another. There was a group of 49 Singaporeans and a few would not be punctual throughout this packaged tour as they took their time to take photographs and eat their meals belatedly, making the majority wait for them.
Surprisingly, the Divine Powers had been kind to us as there were no major traffic jams from Rome to Turin to Switzerland and Paris. Nor were there delays in flights back from Paris to Singapore. Yet the the heavy snow falls affected road traffic and flights in London, the US and Europe at around this time (Dec 13 - 27, 2010). One Singapore Tour Group had to spend the night inside the coach from Milan to Rome as snowfall had caused traffic slowdown. We were clear all the way.
The only thing we missed was seeing The Colosseum in Rome. The students protested violently against Prime Minister's Belusconi's decision to cut funding for University research and expenditure and increased fees. So they burnt cars and caused closure of the Colosseum. The Eiffel Tower in Paris was closed before we arrived as there was strong winds or something but when we arrived, we could visit the 2nd floor. Strong winds did close the railway service to the top of Europe - the Jungfrau mountain or Matterhorn in Lake Interlaken, Switzerland. We went snow sledging. I did not want to risk my life as any mistake in rounding corners on the right could fling me down the ravine. I was no spring chicken and wanted to back out as the younger ones and some older folks took the risk of sitting on the snow sledge downhill.
I was the last one left holding the snow sledge as the others who did not want to do snow sledging were holed up in a cafe. Well, I took the risk. It could be death if I fell into the steep slope on the right and knocked my head.
The snow sledge's downhill slide was to be stopped by putting two heels down onto the snow as if braking a car. My heels were not deep into the snow and so the snow sledge continued to slip downhill increasing momentum as the gradient was steep, at around 45 degrees. I banged into the left side (of the hill) and slightly bruised my left shin. I did crash onto the right edge and quickly hopped off to avoid falling into the ravine below as my sledge could not turn left for two times. Midway down, I nearly crashed into a group standing around. There, the tour leader was phoning for ski patrol for help. A Singaporean was really flung down a bit of the ravine. A tree stopped his tumble further down and he received 4 stitches above his right eye-brow. That was the main excitement of the packaged tour. Fresh snow had just fallen a few days ago.
After snowsledging, we went to Lucerne for the night. The tour guide took the group there from Lucerne the next day and it was clear. I did not bother to take another 1.5-hour coach ride and explored the Lucerne town and its inhabitants and tourists. The two sons went skiing nearby.
Back to my first day at work. A family was too early and was waiting for Dr Vanessa to do dental scaling. An old client came with two stray cats. "The vet would only sterilise them at 6 months of age," he said. "However, these two cats were meowing and behaving like adults at 5 months of age. I want to sterilise them. There is a 3rd cat somewhere. I will get him later."
I examined the cats. The male was 2.8 kg. The female was 2.4 kg. Both could be sterilised and so I booked them in. I am teaching my veterinary staff to be efficient and not to waste material unnecessarily. I pointed out to them that the new $7,000 surgical operating table of two weeks had more than 30 scratches. "So, at the end of two months, the whole surface would be all scratched," I said. "This should not be the case. You need to put a tower on the table to protect it until the dog is under anaesthesia and surgery." The seller had delivered the table without informing me when I was on holiday. Sometimes it is common sense. Stainless steel surfaces should not be clawed by dogs as the scratches would rust later. So, use towels to protect the surface when a dog is awake and not fully sedated.
The examination table of over 10 years and sourced from the same U.S. manufacturer was hardier and did not suffer any serious scratches.
"Gauze?" my assistant got the gauze ready. "There is no need to use gauze," I said to him again. "There is little bleeding during a cat spay." That is the situation I encounter when I spay a cat.
"The start and end of the surgery must be recorded," I told my assistant. This will enable me to audit my surgery as well as those of my associates and learn from the situations needing unusual lengthy surgeries. An animal has a better survival rate if the surgery is as short as possible.
ANAESTHESIA
2.4 kg stray cat. Xylazine 0.1 ml and ketamine 0.4 ml in one syringe IM. Effective. There was no need for an assistant to hang around. I took around 25 minutes for the surgery doing it at a leisuredly pace. It could be done in 15 minutes.
VET-HOPPING
This is common in Singapore. Proximity and pricing would be the attracting factors. 6 months of age is the common recommendation for spay of dogs and cats. In this female cat, at 5 months, the ovaries and uterine bodies were enlarged with thick red blood vessles. Therefore the cat was on heat at 5 months.
2nd VACCINATION AND EAR CLIPPING. The gentleman in his late 50s said: "Clip the left ear so that the AVA would not grab the cat and kill it. My family is attached to these stray cats and that is why I want to sterilise them." He wanted to hospitalise them for a few days although I said it would not be necessary.
It was extremely tiring as the tour leader had to rush us from one place to another. There was a group of 49 Singaporeans and a few would not be punctual throughout this packaged tour as they took their time to take photographs and eat their meals belatedly, making the majority wait for them.
Surprisingly, the Divine Powers had been kind to us as there were no major traffic jams from Rome to Turin to Switzerland and Paris. Nor were there delays in flights back from Paris to Singapore. Yet the the heavy snow falls affected road traffic and flights in London, the US and Europe at around this time (Dec 13 - 27, 2010). One Singapore Tour Group had to spend the night inside the coach from Milan to Rome as snowfall had caused traffic slowdown. We were clear all the way.
The only thing we missed was seeing The Colosseum in Rome. The students protested violently against Prime Minister's Belusconi's decision to cut funding for University research and expenditure and increased fees. So they burnt cars and caused closure of the Colosseum. The Eiffel Tower in Paris was closed before we arrived as there was strong winds or something but when we arrived, we could visit the 2nd floor. Strong winds did close the railway service to the top of Europe - the Jungfrau mountain or Matterhorn in Lake Interlaken, Switzerland. We went snow sledging. I did not want to risk my life as any mistake in rounding corners on the right could fling me down the ravine. I was no spring chicken and wanted to back out as the younger ones and some older folks took the risk of sitting on the snow sledge downhill.
I was the last one left holding the snow sledge as the others who did not want to do snow sledging were holed up in a cafe. Well, I took the risk. It could be death if I fell into the steep slope on the right and knocked my head.
The snow sledge's downhill slide was to be stopped by putting two heels down onto the snow as if braking a car. My heels were not deep into the snow and so the snow sledge continued to slip downhill increasing momentum as the gradient was steep, at around 45 degrees. I banged into the left side (of the hill) and slightly bruised my left shin. I did crash onto the right edge and quickly hopped off to avoid falling into the ravine below as my sledge could not turn left for two times. Midway down, I nearly crashed into a group standing around. There, the tour leader was phoning for ski patrol for help. A Singaporean was really flung down a bit of the ravine. A tree stopped his tumble further down and he received 4 stitches above his right eye-brow. That was the main excitement of the packaged tour. Fresh snow had just fallen a few days ago.
After snowsledging, we went to Lucerne for the night. The tour guide took the group there from Lucerne the next day and it was clear. I did not bother to take another 1.5-hour coach ride and explored the Lucerne town and its inhabitants and tourists. The two sons went skiing nearby.
Back to my first day at work. A family was too early and was waiting for Dr Vanessa to do dental scaling. An old client came with two stray cats. "The vet would only sterilise them at 6 months of age," he said. "However, these two cats were meowing and behaving like adults at 5 months of age. I want to sterilise them. There is a 3rd cat somewhere. I will get him later."
I examined the cats. The male was 2.8 kg. The female was 2.4 kg. Both could be sterilised and so I booked them in. I am teaching my veterinary staff to be efficient and not to waste material unnecessarily. I pointed out to them that the new $7,000 surgical operating table of two weeks had more than 30 scratches. "So, at the end of two months, the whole surface would be all scratched," I said. "This should not be the case. You need to put a tower on the table to protect it until the dog is under anaesthesia and surgery." The seller had delivered the table without informing me when I was on holiday. Sometimes it is common sense. Stainless steel surfaces should not be clawed by dogs as the scratches would rust later. So, use towels to protect the surface when a dog is awake and not fully sedated.
The examination table of over 10 years and sourced from the same U.S. manufacturer was hardier and did not suffer any serious scratches.
"Gauze?" my assistant got the gauze ready. "There is no need to use gauze," I said to him again. "There is little bleeding during a cat spay." That is the situation I encounter when I spay a cat.
"The start and end of the surgery must be recorded," I told my assistant. This will enable me to audit my surgery as well as those of my associates and learn from the situations needing unusual lengthy surgeries. An animal has a better survival rate if the surgery is as short as possible.
ANAESTHESIA
2.4 kg stray cat. Xylazine 0.1 ml and ketamine 0.4 ml in one syringe IM. Effective. There was no need for an assistant to hang around. I took around 25 minutes for the surgery doing it at a leisuredly pace. It could be done in 15 minutes.
VET-HOPPING
This is common in Singapore. Proximity and pricing would be the attracting factors. 6 months of age is the common recommendation for spay of dogs and cats. In this female cat, at 5 months, the ovaries and uterine bodies were enlarged with thick red blood vessles. Therefore the cat was on heat at 5 months.
2nd VACCINATION AND EAR CLIPPING. The gentleman in his late 50s said: "Clip the left ear so that the AVA would not grab the cat and kill it. My family is attached to these stray cats and that is why I want to sterilise them." He wanted to hospitalise them for a few days although I said it would not be necessary.
Tuesday, December 28, 2010
278. Myanmar travel and tour travel agency
In December 2010, I have started Design Travel Pte Ltd, a travel agency focused on Myanamar travel and tours. The previous licence from the Singapore Tourism Board was for Asia USA Realty (S) asiahomes.com Pte Ltd in 2009. This was returned to the STB and replaced by a new licence for Design Travel Pte Ltd which is more appropriately named as a travel agency whereas the previous licence was part of a real estate agency.
My blog on my 2008 tours are at:
http://myanmar-singapore.blogspot.com/2009/03/asiahomes-start-up-travel-agency.html
My blog on my 2008 tours are at:
http://myanmar-singapore.blogspot.com/2009/03/asiahomes-start-up-travel-agency.html
Friday, December 24, 2010
277. KINDLE STORIES - Travel Stories. Christmas in North Myanmar
Thursday, December 23, 2010.
KINDLE STORIES - Christmas in North Myanmar
"Is it safe to tour Myanmar?" many Singaporean friends thought I was insane when I made arrangements to visit Central and North Myanmar in late 2008. The local newspapers seldom market or advertise tours to Myanmar in the past 10 years and so most Singaporeans do not visit this country of 50 million people.
"The planes there are not safe," one veterinarian's wife surprised me with her comment on air safety. Yet there have been no news of airplane crashing in Myanmar for at least 10 years. When a bomb exploded in a tour bus in Israel some 15 years ago, a few of the Singaporean pilgrims backed out of the Bible Land tour organised by my ex-National Service officer who became a pastor.
I was a non-believer but I toured with him to visit Bethlehem's Church of Nativity where Jesus was said to be born in a stable surrounded by farm animals and related Christian sites, making my Sunday School lessons of some 50 years ago alive.
So, should I go to Myanmar with my family during the Christmas holidays and endanger the safety of everyone? Fools rush in where angels fear to tread? An old Myanmarese friend assured me: "Myanmar is a safe country for tourists. The government prohibits tourists from visiting certain regions which are deemed not safe for foreigners."
After talking to other Myanmar nationals, I decided that there was no concern and embarked on an unforgettable journey whom I got to know more about my family members as well as the culture of the Myanmar nationals, one of whom was my veterinary assistant.
BEST SEASON TO VISIT MYANMAR & TOURIST ATTRACTIONS October to April is considered the best period of time to tour Myanmar as it is the dry season and the tourist does not get drenched and travel on muddy track roads in visiting rural areas.
TWO TOURS IN 2008
From Singapore, we boarded a Silk Air plane to Yangon in September for an 8-day travel to Central Myanmar. A tour guide met us at Yangon and we toured using local airplanes and a tour bus to visit Mandalay, Pyin Oo Lwin, Lake Inle and Kyaikhtiyo before going back to Singapore via Yangon.
In December for 14 days, from Yangon, a tour guide went with us. We took internal flights to North Myanmar's city of Myitkyina. Then we took two cars to travel over 7 hours on bumpy roads and broken bridges to Lake Indawygyi. Then we drove back to Myitkyina and took a plane to Bagan, by coach to Mount Poppa and then Pyin Oo Lwin before going back to Singapore.
LUXURY ACCOMMODATION.
The Racing Manager must be corrupted. He and his family stayed in Mandarin Oriental Hotel in Bangkok for their holidays," one strictly religious Turf Club Security Manager remarked to me when I was a racehorse veterinarian some 30 years ago.
Staying in a 5-star hotel in Singapore is still very expensive but the rates would be much lower in Bangkok, Thailand and affordable for many Singaporeans. In Myanmar, we could afford to stay one night each at the luxurious Strand Hotel, Myanmar and the Governor's House (rebuilt) in Pyin Oo Lwin to experience the ambience and the history of the British colonialists who designed and built both buildings.
KILL ALL SPIDERS AT GOLDEN ISLAND COTTAGES HOTELS, INLE LAKE
On checking in at the Golden Island Cottages villa built of bamboos over the Inle Lake, spider cobwebs lined the walls and several spiders scattered on top of the mosquito nets over the beds. My wife was not happy. The hotel staff rushed in with Bayon spray cans. "No need to kill the spiders," I stopped the staff from blasting the rooms with insecticide spray. "Just catch the spiders and put them outside. Sweep away the cobwebs with a brush and broom." Arachnophobia from a veterinarian's wife?
Well, one James Bond's movies had shown a tarantula crawling onto a sleeping person and killing him with painful bites and this could have caused arachnophobia in city dwellers like my wife. Now, I had a problem. How to resolve this? The tour guide had already booked the hotel. Yet, the fear of spiders should not be dismissed away.
We went on the boat ride to visit a hut where local women weaved lotus fabric and on the way, I saw Myanmar Treasure Resort Hotel and got the guide to book the rooms for us. It was a luxury hotel type. There was not a cobweb in sight in the bedroom. This solved my problem!
EXPOSURE TO LIGHTNING, THUNDER AND STRONG WINDS, KYAIKHTIYO
"I don't want to be electrocuted by lightning," I said to myself as four men carried me on a palanquin 11 km up the steep hill from Kinpun base camp to the mountain top where the Golden Rock Pagoda and Hotel were located.
Heavy showers erupted just as we reached Kyaikhtiyp by coach. I remembered that a golfer was killed by lightning in a Singapore golf course and the advice was to stay away from open areas during thunderstorms.
Here I was, fully vulnerable, damp and exposed to the elements. The four men on each end of the pole walked in tandem, switched positions of the pole swishing their slippers as they carried the tourists past boulders, shrubs and trees.
Black skies flashed yellow as if I was in a air bombing battlefield. It was too risky to drive up the mountain and the accommodation was booked at the top. So all of us had to pay to be carried uphill like what British officers were during the colonial period. It seemed like an eternity.
I was more worried that my camera and shoes would get wet as I wrapped them with plastic bags. It must be one of those unforgettable moments for my family as the fear of being killed by an act of God was too real and time to reach our destination was an eternity.
At the hotel, we had no dry clothes as the guide had left our luggage at the bottom of the Mountain. So we purchased some sarong. I thought it was fun. But not for the others. The manager told us that electricity would be switched off after midnight as there was this thunderstorm.
At 4 am, the bedroom was as dark as hell. I could not even see my finger. Where was the bathroom? "Grope the bedside," I said to my wife. "Feel the wall edges and then slowly glide your hand towards the direction of the bathroom door." This was worse than my national service military exercise past midnight. At least I could see the starlight then. Here, I was blind as a bat.
The next morning, I discovered that the hotel had torch-lights hanging on the wall. Well, the manager or hotel notices did not inform inexperienced travellers like us about the presence of torches in hotel rooms.
HARDSHIP ACCOMMODATION AT LAKE INDAWGYI
Cracked WCs, no hot water at the Lakeside Guest House in Lake Indawgyi in North Myanmar. "This is acceptable to the backpacker," my wife declared to me two years later as she recalled the visit to Lake Indawgyi. She was no more the young spirit who would sacrifice comfort to see the world. No electricity at dinner too? This was upsetting.
Candle-light for dinner at Lake Indawgyi's small restaurant was romantic, I thought. This was hardship dinner. I appreciated the boat tour of this clear and beautiful lake and the pagoda where pilgrims walked to pray during the season when there was no water.
"The fish was good," my second son recalled. "As for the rough bathroom amenities, the national service training had accustomed us to such situations."
TOILETS BEHIND THE BUSHES ON THE WAY FROM MYITKYINA TO LAKE INDAWGYI The 7-hour car ride from Myitkyina to Lake Indawgyi was hard on the backside of city dwellers. It was worse when it came to bathroom facilities. Once my wife had to go behind some low shrubs while her sons stood guard as she had to pee.
On the visit to the gold-mining area 2 hours's drive from Myitkyina, she could not stand the stench of the public toilets. My guide had the brains to persuade a monk to let her use the bathroom of the monastery. Well, no more Myanmar rural tours for her if there are no good bathrooms with fresh air.
COMMUNITY TOURISM
I would like to see the how the six bigger groups of ethinic minorities live in their communities. These are the Shan, the Karen, the Kachin, the Mon, the Rakhine and the Chin. Tourism revenue helps to improve the standards of living of a community and my travel may make a very small difference to the local people as it provides some employment for the hospitality staff.
Bagan with its archealogical and historical heritage was busy with Caucasian and Asian tourists during my visit there. There were worries that the pagoda floors would be worn out by the footsteps of such large numbers of tourists.
ECONOMICS Stunning beauty of the interior, cultural heritage, gentle people Oil, minerals and natural gas resources are abundant. Myanmar is of vital strategic value for its rich resources. Between two emerging giants, China and India. I would like to visit the jade mining areas of North Myanmar but my guide said it was not possible at that time.
STREET PHOTOGRAPHY, MILITARY & PROVINCIAL CHECK POINT BACK-UP CAMERA, CAMERA SHAKE AND RAIN CULTURE Novice monks and nuns, ear boring.
FESTIVALS WET MARKET ART AND THE FLOWER GIRL POLITICS AND TOURISM INDEPENDENCE HERO, General Aung San founded the Burmese army. His daughter, Aung San Suu Kyi (pronounced as "Awn Sun Sue Chee") was under house arrest in 2008 and was released in late 2010. Now she is said to support tourism. 1962 coup by army. Burma is called the Union of Myanmar. 1988 Demonstrators fought the military. 1990 NLD won national elections. Aung San Suu Kyi under house arrest for 15 out of past 21 years in Rangoon (Yangon). 1990s Western government imposed economic sanctions on Burma. Suu Kyi supported the sanctions by discouraging tourism. 2007 Saffron revolution by monks. 2009 An American Vietnam War veteran said he was on a mission from God swam to her lakeside home, thereby extending her house arrest 2010 Elections held and Aung San Suu Kyi is free from house arrest after the elections.
BUDDHISM Over 85% of the population are Buddhists. Philosophy of nonviolence.
INTERNET ACCESS in hotels - None or poor connections in 2008 except for top hotels in Yangon. BROWN OUTS. Power failures do happen in shops and small hotels in bigger towns and cities but generators are available to restore the electricity in 2008.
ART - Art galleries yes. I bought a painting at the Bagoyoke market for my surgery.
VET HOSPITAL - none in Yangon in 2008.
Thursday, December 23, 2010
Travel stories - Dog catches snowball?
Dec 23, 2010
Yesterday morning, while waiting to leave the Postillon Hotel in Lucern (Day 2 of 2-night stay), an elderly couple in a car let out two cross-bred dogs. Slim and active. One went towards the 2 single ladies in our group. They shrank in fear. So I presume these two Singapore ladies do not have experience with dogs. On the other hand, the 9-year-old Chinese girl who has a Maltese and rabbit at home, could not resist patting dogs she met.
The elderly gentleman made a snowball and threw it further away into the snowed field. The dog rushed forward but the snowball split and so it was a waste of time as the dog could not find it. It was a futile task for the canine companion but he barked for the owner to throw another ball. The other dog could not be bothered.
Paris today is 0 degrees C. Wake up call at 6 am automated. Will stop now to get ready to eat the bacon as I expect it to be of highest quality as in the Novotel hotel in Venice. I have stopped eating bacon for many years as it is not part of breakfast for the Singaporean Chinese family.
Yesterday morning, while waiting to leave the Postillon Hotel in Lucern (Day 2 of 2-night stay), an elderly couple in a car let out two cross-bred dogs. Slim and active. One went towards the 2 single ladies in our group. They shrank in fear. So I presume these two Singapore ladies do not have experience with dogs. On the other hand, the 9-year-old Chinese girl who has a Maltese and rabbit at home, could not resist patting dogs she met.
The elderly gentleman made a snowball and threw it further away into the snowed field. The dog rushed forward but the snowball split and so it was a waste of time as the dog could not find it. It was a futile task for the canine companion but he barked for the owner to throw another ball. The other dog could not be bothered.
Paris today is 0 degrees C. Wake up call at 6 am automated. Will stop now to get ready to eat the bacon as I expect it to be of highest quality as in the Novotel hotel in Venice. I have stopped eating bacon for many years as it is not part of breakfast for the Singaporean Chinese family.
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