"Where are your front teeth?" I asked a little girl sitting on the left side of the van which had parked to pick up her mother who had brought in the old Pomeranian for oxygen therapy (gasping for breath and coughing earlier and was treated by Dr Vanessa). "How many teeth have you lost?"
The little girl smiled when I said "hello" and so I could see that she had lost 2 front teeth upper and lower. She also had two backward aligned corner incisors. The mother came and I asked: "Is this your daughter? How old is she?"
I couldn't believe that 6 years had passed. The mother was a single mother working for a dog breeder and running his pet shop in Marine Parade and then in MacPherson Road. The breeder had packed his bags and left the industry. Wow, the baby is a very happy 6-year-old girl.
"You will have to spend around $3,000 to align your daughter's teeth when she is older," I said to the happy mum. I am glad she is still a groomer and making ends meet. I don't know much about her love child and did not intrude on her privacy. She takes so much trouble to come to Toa Payoh Vets when there are over 45 vet clinics and some nearer to Pasir Ris.
Dr Vanessa gave her dog the necessary treatment and the oxygen therapy. This was her sister's dog. I said to her: "This dog will not live past one week. If you give the medication for the heart problems, give 3 to 4 times a day according to her panting."
She had brought her sister's dog for treatment and since I was not available, my associate treated the dog. She said: "I was told to give two times a day."
"Yes, that is the standard recommendation. Giving to effect will let this Pomeranian live a bit longer. In the end, the heart fails and the dog passes away peacefully."
I heard a hissing sound when I was in the room where the dog had the oxygen therapy by mask and the necessary injections. I noted that Dr Vanessa had pressed the red button a few times to flush out any isoflurane gas before giving the oxygen. The anaesthetic man had replaced my "faulty" vaporiser 3 days earlier as there was a leakage of oxygen. But all was well since.
Now, I could hear a faint hissing sound. Was there another leak in the piping? I phoned the anaesthetic man who was busy and wanted the whole set back to his factory. "Is there some elephant glue to seal the hairline crack in the piping under the vaporiser?" I asked him. "We need to operate and can't afford to wait a few days."
Dr Vanessa was going to postpone surgeries but I stopped her. The anaesthetic man came and saw the crack. His girl had placed some soapy water and I could see the bubbles from the blue tubing. So, there was a crack here too or was it there earlier? Was it due to the pressing of the red button repeatedly? Well, equipment piping do wear and tear.
Surprisingly, my old car had this ping message "Add one litre of engine oil when you next fill up." I had the car repaired by the mechanic when this message appeared earlier. Still now, the problem showed itself. Wear and tear or an inability of the mechanic to diagnose and treat? I top up the engine oil and the message disappeared. There must be a hairline crack somewhere. Should I sell off the car? But COE prices had shot up and 2nd hand cars fetch a good value. But it is much more expensive and stupid to buy a new car now. So, I have two identical problems of hairline cracks - in a car engine oil system and in my veterinary anaestethic gas system. Both need management and assessment of risks.
Sunday, April 17, 2011
406. I want to sue the vet
"I want to sue Dr ...!" the employment agent who could never control her demons in her brain shouted over the phone. I had her to get a replacement for Mr Saw who left at the expiry of his lease on amicable terms last week. Mr Min started work for less than a week and here I had this threat to sue my associate vet because Mr Min could not get his regular break for dinner during some busy days.
I had known her for more than 15 years and know that she bears grudges and will tell me off whenever the anger demons dominate her brain. She would rattle off her anger over the handphone though I had told her to call me back later. Her loud voice could be heard distinctly by my friends in a car in Penang and during other inappropriate occasions when she aired her complaints about work-related problems. I could switch off the handphone as she would not let me speak but I consider it better that her demons get out of her brain through her big mouth and cool down.
However a threat to sue any my associate vets is not tolerated by me at all. I said to Mr Min and the associate vet at a meeting I convened: "When Khin Khin wants to sue Dr ..., she is suing me as I own the practice. Dr ...has no share in this practice. I will engage a lawyer to defend any associate vet who is sued. Has she got a lot of money to sue? Don't threaten to sue. Just sue."
I had advised my vet to ensure that Mr Min, the vet assistant get his meal breaks. I said to Mr Min: "Khin Khin does not respect older people. Maybe she thinks I am old and stupid and therefore can shout at me. You have to think for yourself as to what is good for you. If you don't want to work at Toa Payoh Vets, have you got another offer from another vet?
"Old people have gone through the life of war, meeting all sort of nonsenses and people and suffering losses while gaining experiences and wisdom," I said to both parties who are at least 30 years younger than me. "They are a valuable source of knowledge and I always respect people older than me so that they can share their experiences with me. Obviously if you have no respect for the seniors, you can't expect them to share their experiences with you so that you don't suffer losses.
"You will have to think for yourself as regards your need to respect your employment agent. You had paid her the money for her services. Do you want this job or not? Do you have another employer waiting for you now? I have many applicants from the Philippines asking for your job."
Mr Min wanted this job as he was practically unemployed in Myanmar and earned very little. In Myanmar, the vets don't earn more than S$500 a month, I believe.
I told Mr Min and my associate vet a bit of my philosophy and why I employ Myanmar vets as vet technicians.
"I employed my first Vet Technician many years ago. She was a Myanmar Vet working for Dr XXX. Dr... did not want to continue employing her because she was slow in her work. She also could not speak English well, just like you now. So, it was very difficult for her.
"I employed her and she completed her year of employment and wanted to go home to see her sick father. An army officer, I believe. Around 2 years later, she visited me and gave me a present. I was much surprised. You can check her out as she is in Yangon and Khin Khin knows her.
"In your first week here, I have complaints from a pet shop owner that her referred customers cannot understand what you are talking about over the phone. This is a common complaint of Myanmar vet technicians as their standard of conversational English is not good. You just start your job in Singapore. Over time, like your friend, Mr Saw, your English will be good. This is one reason why most vet technicians employed in Singapore are Filipinos as they speak very good English and can start work without the employer worrying about client services being downgraded.
"You may be able to get a job at one of the 45 vet clinics in Singapore, but do you want to work in a clinic where there are no cases during some days? Just sit and go for your scheduled lunch and dinner times waiting for cases? You learn nothing because there are no cases over the year of employment. Or you work in a very big practice in a small area like Haematology. You can't do other aspects of vet medicine as there are other vet technicians assigned.
"So you can't start your own practice confidently because you have no cases in the new clinics. Do you want that?
Mr Min did not want to work in such a situation. All employees have this "what's in it for me" attitude and I accept that they are in a job for themselves. Times have changed.
I can easily employ a Filipino vet and grow my practice very fast due to good service as Filipinos are culturally excellent in English language communications and services.
However, making a small difference to the disadvantaged and the underdog have always been my philosophy as others had made a difference to me by awarding my a scholarship to study vet medicine in Glasgow in 1969.
It is very difficult for most of the younger vets in Singapore to understand my philosophy when their parents pay and pay for their vet studies. Pay and Pay? PAP? Elections in May 2011? Some distraction here.
In any case, I had instructed the associates to ensure that Mr Min get his meal breaks and I am personally checking on this. Time management is important for a vet and also for the employee.
I don't want the demons to re-appear again in Khin Khin's brains and there have been so many incidents from her such that I can write a novel of some interest to human relationship readers.
This incident is just one of the chapters of this novel. I said to Mr Min: "If you want to sue, don't threaten. Just do it. Pay the lawyer and sue the pants off the vet!"
I told Mr Min and the vet: "When I started Toa Payoh Vets, there were around 4 competitors. During the first few years, there were few customers. Just sit down and wait as vets cannot advertise. Now that Toa Payoh Vets is busier, I cannot be taking it easy. There are now at least 45 competitors and I know some of them have not sufficient number of customers to make ends meet."
Mr Min is a gentle person in his early 30s. He does not lose his cool and that is a good trait. I also advised Mr Min to buy some food during busy times when he can't go for the break as scheduled. In the end, he has to decide. Does he want the job or not? He is slow in his work but this will change with my training. He is not indispensible and there are so many stronger and better qualified Filipino vet technicians. Hire the best talent if you want your business to grow in this competitive world, the business management books will teach us. Why care about the disadvantaged with no experience or a good command of the English language. Why care for the underdog in this world? Why bother with employment agents who can't exorcise their demons? Why patronise a small businessman in a niche in veterinary anaesthesia when you can get business from an established corporation? All these encounters make life stressful. However, make a small difference to change the world if you are blessed with health and can do it. That is my philosophy.
I had known her for more than 15 years and know that she bears grudges and will tell me off whenever the anger demons dominate her brain. She would rattle off her anger over the handphone though I had told her to call me back later. Her loud voice could be heard distinctly by my friends in a car in Penang and during other inappropriate occasions when she aired her complaints about work-related problems. I could switch off the handphone as she would not let me speak but I consider it better that her demons get out of her brain through her big mouth and cool down.
However a threat to sue any my associate vets is not tolerated by me at all. I said to Mr Min and the associate vet at a meeting I convened: "When Khin Khin wants to sue Dr ..., she is suing me as I own the practice. Dr ...has no share in this practice. I will engage a lawyer to defend any associate vet who is sued. Has she got a lot of money to sue? Don't threaten to sue. Just sue."
I had advised my vet to ensure that Mr Min, the vet assistant get his meal breaks. I said to Mr Min: "Khin Khin does not respect older people. Maybe she thinks I am old and stupid and therefore can shout at me. You have to think for yourself as to what is good for you. If you don't want to work at Toa Payoh Vets, have you got another offer from another vet?
"Old people have gone through the life of war, meeting all sort of nonsenses and people and suffering losses while gaining experiences and wisdom," I said to both parties who are at least 30 years younger than me. "They are a valuable source of knowledge and I always respect people older than me so that they can share their experiences with me. Obviously if you have no respect for the seniors, you can't expect them to share their experiences with you so that you don't suffer losses.
"You will have to think for yourself as regards your need to respect your employment agent. You had paid her the money for her services. Do you want this job or not? Do you have another employer waiting for you now? I have many applicants from the Philippines asking for your job."
Mr Min wanted this job as he was practically unemployed in Myanmar and earned very little. In Myanmar, the vets don't earn more than S$500 a month, I believe.
I told Mr Min and my associate vet a bit of my philosophy and why I employ Myanmar vets as vet technicians.
"I employed my first Vet Technician many years ago. She was a Myanmar Vet working for Dr XXX. Dr... did not want to continue employing her because she was slow in her work. She also could not speak English well, just like you now. So, it was very difficult for her.
"I employed her and she completed her year of employment and wanted to go home to see her sick father. An army officer, I believe. Around 2 years later, she visited me and gave me a present. I was much surprised. You can check her out as she is in Yangon and Khin Khin knows her.
"In your first week here, I have complaints from a pet shop owner that her referred customers cannot understand what you are talking about over the phone. This is a common complaint of Myanmar vet technicians as their standard of conversational English is not good. You just start your job in Singapore. Over time, like your friend, Mr Saw, your English will be good. This is one reason why most vet technicians employed in Singapore are Filipinos as they speak very good English and can start work without the employer worrying about client services being downgraded.
"You may be able to get a job at one of the 45 vet clinics in Singapore, but do you want to work in a clinic where there are no cases during some days? Just sit and go for your scheduled lunch and dinner times waiting for cases? You learn nothing because there are no cases over the year of employment. Or you work in a very big practice in a small area like Haematology. You can't do other aspects of vet medicine as there are other vet technicians assigned.
"So you can't start your own practice confidently because you have no cases in the new clinics. Do you want that?
Mr Min did not want to work in such a situation. All employees have this "what's in it for me" attitude and I accept that they are in a job for themselves. Times have changed.
I can easily employ a Filipino vet and grow my practice very fast due to good service as Filipinos are culturally excellent in English language communications and services.
However, making a small difference to the disadvantaged and the underdog have always been my philosophy as others had made a difference to me by awarding my a scholarship to study vet medicine in Glasgow in 1969.
It is very difficult for most of the younger vets in Singapore to understand my philosophy when their parents pay and pay for their vet studies. Pay and Pay? PAP? Elections in May 2011? Some distraction here.
In any case, I had instructed the associates to ensure that Mr Min get his meal breaks and I am personally checking on this. Time management is important for a vet and also for the employee.
I don't want the demons to re-appear again in Khin Khin's brains and there have been so many incidents from her such that I can write a novel of some interest to human relationship readers.
This incident is just one of the chapters of this novel. I said to Mr Min: "If you want to sue, don't threaten. Just do it. Pay the lawyer and sue the pants off the vet!"
I told Mr Min and the vet: "When I started Toa Payoh Vets, there were around 4 competitors. During the first few years, there were few customers. Just sit down and wait as vets cannot advertise. Now that Toa Payoh Vets is busier, I cannot be taking it easy. There are now at least 45 competitors and I know some of them have not sufficient number of customers to make ends meet."
Mr Min is a gentle person in his early 30s. He does not lose his cool and that is a good trait. I also advised Mr Min to buy some food during busy times when he can't go for the break as scheduled. In the end, he has to decide. Does he want the job or not? He is slow in his work but this will change with my training. He is not indispensible and there are so many stronger and better qualified Filipino vet technicians. Hire the best talent if you want your business to grow in this competitive world, the business management books will teach us. Why care about the disadvantaged with no experience or a good command of the English language. Why care for the underdog in this world? Why bother with employment agents who can't exorcise their demons? Why patronise a small businessman in a niche in veterinary anaesthesia when you can get business from an established corporation? All these encounters make life stressful. However, make a small difference to change the world if you are blessed with health and can do it. That is my philosophy.
405. BARF/raw food diet query to Dr Sing
On Sat, Apr 16, 2011 at 9:35 AM, ...@uqconnect.edu.au> wrote:
Dear Mdm Judy,
I have a question for Dr Sing which I hope you can pass on to him. I am interested to know about Dr Sing's position on feeding a BARF/raw food diet for small animals.
Thank you,
(Name given)
Kong Yuen Sing to Mr,
Thank you for your email. I am Dr Sing from Toa Payoh Vets, www.toapayohvets.com. The answer to your question can be several pages an even be a book as there are many pros and cons. There are various formulas recommended by various proponents for the BARF/raw food diet.
Briefly, I am not recommending the BARF/raw food diet to my Singapore clients for the simple reason that most of them have no time to educate themselves on what makes a balanced diet for their dogs. My clients will also not be able to provide the necessary supplements to make sure that the diet is balanced during the different stages of life in a dog. Feeding such a diet to puppies, for example, will not be good for the puppies.
Best wishes.
Dear Mdm Judy,
I have a question for Dr Sing which I hope you can pass on to him. I am interested to know about Dr Sing's position on feeding a BARF/raw food diet for small animals.
Thank you,
(Name given)
Kong Yuen Sing to Mr,
Thank you for your email. I am Dr Sing from Toa Payoh Vets, www.toapayohvets.com. The answer to your question can be several pages an even be a book as there are many pros and cons. There are various formulas recommended by various proponents for the BARF/raw food diet.
Briefly, I am not recommending the BARF/raw food diet to my Singapore clients for the simple reason that most of them have no time to educate themselves on what makes a balanced diet for their dogs. My clients will also not be able to provide the necessary supplements to make sure that the diet is balanced during the different stages of life in a dog. Feeding such a diet to puppies, for example, will not be good for the puppies.
Best wishes.
Thursday, April 14, 2011
404. Follow-up on the itchy and scootering DachshundXJR
This is a follow up to a very interesting perplexing case I saw 2 days ago. My tentative diagnosis was allergy to the environment or dog food. The owner was more worried that the dog still scootered despite consulting Vet 1 earlier. Scootering was just continuous.
"My dog is calmer now. No more scootering and I don't scratch her anymore," the owner could not hear me distinctly as she was at the mall.
"What do you mean when you say you scratch the dog?" I asked the caregiver. "Well, I had to pet her and she would want more petting before I consulted you!". English is a hard language to understand. I was wondering why she would scratch her dog who was already itchy all over the body.
"How much hair loss?" I asked. She was not able to confirm as she was busy.
So far so good. I called to ask her to pick up the Hills' Canine d/d Potato and Salmon formula. It is a single animal protein source for allergic pets. The dog is not permitted to eat treats and any home-cooked or other food for the next 3 months. Then the owner can introduce treats and see if the body itch occur.
Painful ears with no infection, biting all four paws, whole body itch without skin diseases and hair falling out. These are one of the possible signs of dog food allergy. The dog just arrived from the USA. There could be multiple causes like heat, humidity, shampoos, stress and so many others.
We will have to wait and see. It is important that the dog does not scooter anymoe as that seems to be the main issue of the owner. She was very observant and said that I squeezed the anal sacs from quite deeply into the anal region. Of course, I did produce the grey particles and anal fluid. Evidence is important in veterinary medicine. The proof of the eating is in the pudding if there is such an English expression?
TODAY'S CASE
Old Jack Russell. Female, 8 years old said to be spayed 8 years ago and had no heat period.
Lost 2 kg from Oct 2010 (fat as a pig) to April 2011. Lethargy. Not eating much during past 3 weeks. Dried purulent eye discharge in both eyes suggested a serious systemic illness as in the hamster. Examine the whole body from mouth to private parts.
Dehydrated. Left gum ulcerated around Left Upper PM4. Yellow pus in swollen vagina (I showed to the busy lady owner's mother who brought the dog in). I suspected stump pyometra if the dog had not been properly sterilised but it could be UTI with pus inside the bladder and kidneys. No signs of vomiting. The dog just wanted to sleep and die.
BLOOD TEST. Low blood pressure and so I taught Min to use the tubing around the elbow and clamp with forceps just to collect 2 ml of blood successfully. Min is not inexperienced but he tended to do blood collection from the forelimbs and then the hind limbs but was unsuccessful today with both legs. So, I taught him how to fish rather than give him fish.
BLOOD TEST RESULTS
Very low platelets = 40 (normal 200-500). No platelet clumps. Large platelets present.
Liver enzymes elevated. Urea 15.6 (normal 4.2 - 6.3.
Red cell and haemoglobin below normal.
Total White Cell Count normal.
So what is the cause of the low platelets? I phoned the young lady. She said no Chinese medicine was given but the dog had the chicken flavouring or some powder added to the chicken meat for some weeks. Could this be the toxic substance depleting platelets? Would the dog live? Hard to say.
"My dog is calmer now. No more scootering and I don't scratch her anymore," the owner could not hear me distinctly as she was at the mall.
"What do you mean when you say you scratch the dog?" I asked the caregiver. "Well, I had to pet her and she would want more petting before I consulted you!". English is a hard language to understand. I was wondering why she would scratch her dog who was already itchy all over the body.
"How much hair loss?" I asked. She was not able to confirm as she was busy.
So far so good. I called to ask her to pick up the Hills' Canine d/d Potato and Salmon formula. It is a single animal protein source for allergic pets. The dog is not permitted to eat treats and any home-cooked or other food for the next 3 months. Then the owner can introduce treats and see if the body itch occur.
Painful ears with no infection, biting all four paws, whole body itch without skin diseases and hair falling out. These are one of the possible signs of dog food allergy. The dog just arrived from the USA. There could be multiple causes like heat, humidity, shampoos, stress and so many others.
We will have to wait and see. It is important that the dog does not scooter anymoe as that seems to be the main issue of the owner. She was very observant and said that I squeezed the anal sacs from quite deeply into the anal region. Of course, I did produce the grey particles and anal fluid. Evidence is important in veterinary medicine. The proof of the eating is in the pudding if there is such an English expression?
TODAY'S CASE
Old Jack Russell. Female, 8 years old said to be spayed 8 years ago and had no heat period.
Lost 2 kg from Oct 2010 (fat as a pig) to April 2011. Lethargy. Not eating much during past 3 weeks. Dried purulent eye discharge in both eyes suggested a serious systemic illness as in the hamster. Examine the whole body from mouth to private parts.
Dehydrated. Left gum ulcerated around Left Upper PM4. Yellow pus in swollen vagina (I showed to the busy lady owner's mother who brought the dog in). I suspected stump pyometra if the dog had not been properly sterilised but it could be UTI with pus inside the bladder and kidneys. No signs of vomiting. The dog just wanted to sleep and die.
BLOOD TEST. Low blood pressure and so I taught Min to use the tubing around the elbow and clamp with forceps just to collect 2 ml of blood successfully. Min is not inexperienced but he tended to do blood collection from the forelimbs and then the hind limbs but was unsuccessful today with both legs. So, I taught him how to fish rather than give him fish.
BLOOD TEST RESULTS
Very low platelets = 40 (normal 200-500). No platelet clumps. Large platelets present.
Liver enzymes elevated. Urea 15.6 (normal 4.2 - 6.3.
Red cell and haemoglobin below normal.
Total White Cell Count normal.
So what is the cause of the low platelets? I phoned the young lady. She said no Chinese medicine was given but the dog had the chicken flavouring or some powder added to the chicken meat for some weeks. Could this be the toxic substance depleting platelets? Would the dog live? Hard to say.
403. New anaesthetic gas machine
April 13, 2011.
I got a new anaesthetic machine vaporiser as the old one had leaked at the bottom. There is a hole on the lower right, hissing oxygen and depleting my oxygen tank. This vaporiser is only 3 years old. But I don't want it repaired. I bought a new one as gas anaesthesia is very useful and very safe, esp. for old dogs.
The vaporiser started hissing oxygen 3 days ago on a Saturday. All gas operations ceased and I had to get the experienced man to service but Mr Goh was in Malaysia doing some vet clinics set up there. So, on Wednesday (yesterday), I told him to treat urgently as I did not want to buy a vaporiser from his competitor. I support Mr Goh as he needs the help. If one does not support the small technical person who specialises in vet machines, he will go out of business and the vet community will be much worse. The big boys are not interested in vet machines anyway. Sales persons can't service.
"It is only $8,000," my Myanmar friend James said. "Throw away the old one. Even if you give to me, I don't want it. It is hard to repair in Myanmar." James is starting his clinic in Yangon soon. A few weeks ago, I offered him my old Shoreline veterinary surgery table which costs $7,000 to purchase as I bought a new one. He said no but his wife later said yes. So, there was much unhappiness with the
I got a new anaesthetic machine vaporiser as the old one had leaked at the bottom. There is a hole on the lower right, hissing oxygen and depleting my oxygen tank. This vaporiser is only 3 years old. But I don't want it repaired. I bought a new one as gas anaesthesia is very useful and very safe, esp. for old dogs.
The vaporiser started hissing oxygen 3 days ago on a Saturday. All gas operations ceased and I had to get the experienced man to service but Mr Goh was in Malaysia doing some vet clinics set up there. So, on Wednesday (yesterday), I told him to treat urgently as I did not want to buy a vaporiser from his competitor. I support Mr Goh as he needs the help. If one does not support the small technical person who specialises in vet machines, he will go out of business and the vet community will be much worse. The big boys are not interested in vet machines anyway. Sales persons can't service.
"It is only $8,000," my Myanmar friend James said. "Throw away the old one. Even if you give to me, I don't want it. It is hard to repair in Myanmar." James is starting his clinic in Yangon soon. A few weeks ago, I offered him my old Shoreline veterinary surgery table which costs $7,000 to purchase as I bought a new one. He said no but his wife later said yes. So, there was much unhappiness with the
Wednesday, April 13, 2011
iPhone 4 or an Android phone
2 weeks ago, I decided to upgrade myself from the conventional mobile phone which was good for nothing but useful to send and receive calls. I could not surf.
iPhone 4 is already one year old. The Samsung was a new model. So, brand-name or the latest technology? iPhone 5 may come soon but maybe not.
I was much tempted to take the brand-name. But it is never good to do it when the brand name does not bother to upgrade and lose to its competitors. So, I took the Samsung. The HTC was sexy but it had caused me loss as it malfunctioned some 3 years ago when I first got one (I could write instead of thumb). The company took months to repair and the problem of hanging came back again. As you can see, good performance counts even in mobile phone sales and service.
Same tough competitions exist for the 45 vet clinics now existing in Singapore. Brand name clinics definitely lose out in numbers to the new ones with sexy renovations and frills. And that attract many younger pet owners.
iPhone 4 is already one year old. The Samsung was a new model. So, brand-name or the latest technology? iPhone 5 may come soon but maybe not.
I was much tempted to take the brand-name. But it is never good to do it when the brand name does not bother to upgrade and lose to its competitors. So, I took the Samsung. The HTC was sexy but it had caused me loss as it malfunctioned some 3 years ago when I first got one (I could write instead of thumb). The company took months to repair and the problem of hanging came back again. As you can see, good performance counts even in mobile phone sales and service.
Same tough competitions exist for the 45 vet clinics now existing in Singapore. Brand name clinics definitely lose out in numbers to the new ones with sexy renovations and frills. And that attract many younger pet owners.
401. Give what the owner wants
April 12, 2011
9.30am. 1-year-old JackRussellXDachshund spayed dog was itchy all over. She arrived from US one month ago, quarantined at Sembawang for 10 days and had been boarded at a Pasir Ris boarding place where there were numerous rescued dogs.
"My dog is itchy all over the body and scoots her backside," the slim European lady said. She had consulted another surgery and the vet did press some tissue around the anal area. She was not shown what was expressed from the anal area.
I put the dog on he exam table and pressed the anal sacs. I showed her the greyish particles in the anal sacs to the owner. "The normal colour is like cooking oil - light yellow," I said and explained what the anal sac oil was used for by the dog. She was quite happy.
As for the ears, I palpated the ears. The dog yelped in pain at the horizontal and vertical canal junction. I scoped the ear but found no mites. A cotton bud tip showed light brown discharge. No smell. So what was the pain? "I am no ear-person," the woman in her 40s said to me when I asked if she knows the structure of the dog's ears. I remained professional by not cracking jokes about anatomy which may be offensive since I met her the first time. Some men are said to be attracted by certain anatomy of the female and therefore, cracking such jokes as a "butt" person may not be welcome unless the client has a sense of humour.
As for the itchy body, the lady said: "My friends asked me to examine the body for skin infections but there are none. Yet the dog keeps losing hairs eve1y day. What is the problem? Also she chews her 4 paws "
I examined the dog's skin. Good coat. Strands of brown hair fall out. The lady said: "She is also developing those long harder coarse hairs. Could it be the weather in Singapore being so hot?"
"There is no skin problem," I confirmed. "Those coarse hairs could be the result of the dog's parents being wire-haired Jack Russell. Now she is one year old, her adult coat is being formed."
It sounded logical to her. As for the cause of generalised body itch, it was hard to tell what was the cause. "It is most likely allergy from the food or environment. A skin patch test may not give you the answers but costs you some money." I advised her to get the ears and paws cleaned regularly and to go on a low-allergic prescription diet for 3 months. "No treats or other foods", I said. "After 3 months, you can test her with dog treats or your food and see whether the dog itches."
I said: "It is extremely difficult to let you know what is the exact cause of the dog itching all over and so we do the food trial first. In some cases, it could be due to the loss of hormones due to spaying but these are rare cases. Hot weather and stress can cause the dog to shed hairs too as the dog came from the US."
This dog has no skin or ear problems and so a dog food or human shampoo allergy is suspected at this stage. The dog uses her human shampoo. There are so many factors and so it is best to take time to explain and illustrations of the ear canal and anal sacs to show the anatomy.
In this dog, the owner even remarked that I could have gone deeper to express the anal sacs than Vet 1 who did not show her any oil (probably).
Nowadays, it is hard to be a vet. See the following case 2.
Case 2. "Has my dog got CCD?"
This was the 2nd case in the last 3 days that a client who had researched the internet asked me about the dog having CCD.
"My dog could not recognise me and knocked onto furniture," the man in his late 50s said to me. His dog had been examined by a vet and had blood and urine tests done. "Nothing wrong with the blood and urine tests, the vet said. Can you prescribe a drug so that my dog can be alert and active?"
I was on counter receptionist duty and so got this feedback. I was surprised that another dog owner had researched the internet and diagnosed CCD again and asked for the drug.
I said: "Nowadays, owners research the internet. Sometimes, they are better informed than the vet. There is a drug but are you sure that the dog has no other health problems?"
I continued: "Many cases, the old dog has painful mouth due to teeth decay. Poison from the bacteria goes to the surrounding areas including the eyes and brain. So, the owner diagnoses CCD and asks for the drug. In the end, the dog is still suffering from pain."
"My dog eats the same amount of food every day," the man said when I asked why the dog had dropped 1.5kg in weight when it had the same appetite and was less active, esp. for the last 2 weeks. He was positive that his dog ate the same amount and had no vomiting or diarrhoea.
So I asked to check the blood and urine test results. The significant finding was a high blood urea (12 instead of the maximun value of 6). So, there was an abnormality but his vet said it was normal as the creatinine was low, meaning the dog does not have kidney disease.
It is not normal to have high blood urea, I said to the owner. As to the cause, the vet said it could be due to disorders in the muscles and internal organs and possibly cancer but since an X-ray would be useless, an ultrasound was proposed. Multivitamins were prescribed for the time being.
As the owner stated that he was referred to me by his friend, I handled his case and asked the dog to be admitted for an examination as he did not bring his dog when he came to see me.
Old dogs that have not been given dental checkup for the last 5 years (his vet did not want to do it since the dog was 8 years old) would have bad breath and oral infections. These problems needed dentistry and not a drug for CCD. Then there is the ear problems as many of the old dogs are neglected. They just get fed.
Much will depend on what I find but dentistry under general anaesthesia is needed. I strongly advised the high risks and he ought to tell his wife. His wife phoned me and I explained the possibility that her dog could just die on the operating table. That is the reason why most vets don't want to do the dentistry. "How about half dose?" the man asked me. "I use gas only and it should be quite safe if given over a short time of less than 15 minutes, but no guarantees."
"How about no anaesthetic?" the man asked. I said: "It is extremely painful to extract decayed teeth. I had only done once in dental extraction of a 16-year-old Pomeranian. It survived. However, some dogs may die of fright. Did you read the Straits Times forum letter where the writer's dog was lost and found by the AVA? The AVA micro-chipped the dog but it died. What did it die of? The AVA is doing an autopsy to ascertain the cause of death." From this incident, I prefer not to do any dentistry without anaesthesia.
Case 3.
A Chinese National sought my advice about her Silkie puppy that had fractured his right fore leg. "What can be done?" she asked me as I was on counter duty. The dog's legs were cast by Plaster of Paris and the dog had come in for a change of the Plaster. I asked Dr Vanessa what was the outcome. She showed me the X-rays before and after the cast. The tranverse fractures of the radius and ulna had closed and the fragments were aligned. So, there was good news. I told the lady that the progress was good. She had phoned me earlier wanting no invasive surgery for the fracture as proposed by another vet and Dr Vanessa had done a good job. A second opinion would be better service for the client and I was glad that she appeared satisfied.
She was from Yunnan. I had seen paintings by Chinese painters of Yunnan and read about the refugee problems from Myanmar to Yunnan which is part of China. I would like to visit this place as it appeared to be the equivalent "wild wild West" of the USA after reading about drug lords and other news.
"The travel agent in Yunnan cannot be trusted. Contact your travel agent. Many Singaporean businessmen go to Yunnan for gold," she said to me.
I asked her about the presence of elephants in the Yunnan mountains after hearing a story of a Myanmar businessman whose truck driver impatiently sound the horn to quicken the mother elephant and baby to walk past faster along the mountain road. The dam rushed onto the truck and this businesman was flung deep into the ravine. A tree broke his fall and he was hospitalised for 3 months. When he went home after that, he said to me: "My family members sprinted fast and ran away as they thought I was a ghost." In the old days before the mobile phone, he could not inform his family and they thought the elephant had killed him.
So I asked this Yuannan lady about the wandering wild elephants which I could not imagine, being a frog in the well in the small island of Singapore.
It is just too expensive to travel and I prefer the off-the-tourist places which can be more expensive and dangerous.
"There are wild elephants in the mountains. Tourists can view the mountains from the tree top."
"How do I do it?" I asked. "Just sit on the tree?"
The young lady in the IT field said: "I will not advise you to watch the wild elephants. It is very dangerous. The elephants may bang the tree and knock you down!"
9.30am. 1-year-old JackRussellXDachshund spayed dog was itchy all over. She arrived from US one month ago, quarantined at Sembawang for 10 days and had been boarded at a Pasir Ris boarding place where there were numerous rescued dogs.
"My dog is itchy all over the body and scoots her backside," the slim European lady said. She had consulted another surgery and the vet did press some tissue around the anal area. She was not shown what was expressed from the anal area.
I put the dog on he exam table and pressed the anal sacs. I showed her the greyish particles in the anal sacs to the owner. "The normal colour is like cooking oil - light yellow," I said and explained what the anal sac oil was used for by the dog. She was quite happy.
As for the ears, I palpated the ears. The dog yelped in pain at the horizontal and vertical canal junction. I scoped the ear but found no mites. A cotton bud tip showed light brown discharge. No smell. So what was the pain? "I am no ear-person," the woman in her 40s said to me when I asked if she knows the structure of the dog's ears. I remained professional by not cracking jokes about anatomy which may be offensive since I met her the first time. Some men are said to be attracted by certain anatomy of the female and therefore, cracking such jokes as a "butt" person may not be welcome unless the client has a sense of humour.
As for the itchy body, the lady said: "My friends asked me to examine the body for skin infections but there are none. Yet the dog keeps losing hairs eve1y day. What is the problem? Also she chews her 4 paws "
I examined the dog's skin. Good coat. Strands of brown hair fall out. The lady said: "She is also developing those long harder coarse hairs. Could it be the weather in Singapore being so hot?"
"There is no skin problem," I confirmed. "Those coarse hairs could be the result of the dog's parents being wire-haired Jack Russell. Now she is one year old, her adult coat is being formed."
It sounded logical to her. As for the cause of generalised body itch, it was hard to tell what was the cause. "It is most likely allergy from the food or environment. A skin patch test may not give you the answers but costs you some money." I advised her to get the ears and paws cleaned regularly and to go on a low-allergic prescription diet for 3 months. "No treats or other foods", I said. "After 3 months, you can test her with dog treats or your food and see whether the dog itches."
I said: "It is extremely difficult to let you know what is the exact cause of the dog itching all over and so we do the food trial first. In some cases, it could be due to the loss of hormones due to spaying but these are rare cases. Hot weather and stress can cause the dog to shed hairs too as the dog came from the US."
This dog has no skin or ear problems and so a dog food or human shampoo allergy is suspected at this stage. The dog uses her human shampoo. There are so many factors and so it is best to take time to explain and illustrations of the ear canal and anal sacs to show the anatomy.
In this dog, the owner even remarked that I could have gone deeper to express the anal sacs than Vet 1 who did not show her any oil (probably).
Nowadays, it is hard to be a vet. See the following case 2.
Case 2. "Has my dog got CCD?"
This was the 2nd case in the last 3 days that a client who had researched the internet asked me about the dog having CCD.
"My dog could not recognise me and knocked onto furniture," the man in his late 50s said to me. His dog had been examined by a vet and had blood and urine tests done. "Nothing wrong with the blood and urine tests, the vet said. Can you prescribe a drug so that my dog can be alert and active?"
I was on counter receptionist duty and so got this feedback. I was surprised that another dog owner had researched the internet and diagnosed CCD again and asked for the drug.
I said: "Nowadays, owners research the internet. Sometimes, they are better informed than the vet. There is a drug but are you sure that the dog has no other health problems?"
I continued: "Many cases, the old dog has painful mouth due to teeth decay. Poison from the bacteria goes to the surrounding areas including the eyes and brain. So, the owner diagnoses CCD and asks for the drug. In the end, the dog is still suffering from pain."
"My dog eats the same amount of food every day," the man said when I asked why the dog had dropped 1.5kg in weight when it had the same appetite and was less active, esp. for the last 2 weeks. He was positive that his dog ate the same amount and had no vomiting or diarrhoea.
So I asked to check the blood and urine test results. The significant finding was a high blood urea (12 instead of the maximun value of 6). So, there was an abnormality but his vet said it was normal as the creatinine was low, meaning the dog does not have kidney disease.
It is not normal to have high blood urea, I said to the owner. As to the cause, the vet said it could be due to disorders in the muscles and internal organs and possibly cancer but since an X-ray would be useless, an ultrasound was proposed. Multivitamins were prescribed for the time being.
As the owner stated that he was referred to me by his friend, I handled his case and asked the dog to be admitted for an examination as he did not bring his dog when he came to see me.
Old dogs that have not been given dental checkup for the last 5 years (his vet did not want to do it since the dog was 8 years old) would have bad breath and oral infections. These problems needed dentistry and not a drug for CCD. Then there is the ear problems as many of the old dogs are neglected. They just get fed.
Much will depend on what I find but dentistry under general anaesthesia is needed. I strongly advised the high risks and he ought to tell his wife. His wife phoned me and I explained the possibility that her dog could just die on the operating table. That is the reason why most vets don't want to do the dentistry. "How about half dose?" the man asked me. "I use gas only and it should be quite safe if given over a short time of less than 15 minutes, but no guarantees."
"How about no anaesthetic?" the man asked. I said: "It is extremely painful to extract decayed teeth. I had only done once in dental extraction of a 16-year-old Pomeranian. It survived. However, some dogs may die of fright. Did you read the Straits Times forum letter where the writer's dog was lost and found by the AVA? The AVA micro-chipped the dog but it died. What did it die of? The AVA is doing an autopsy to ascertain the cause of death." From this incident, I prefer not to do any dentistry without anaesthesia.
Case 3.
A Chinese National sought my advice about her Silkie puppy that had fractured his right fore leg. "What can be done?" she asked me as I was on counter duty. The dog's legs were cast by Plaster of Paris and the dog had come in for a change of the Plaster. I asked Dr Vanessa what was the outcome. She showed me the X-rays before and after the cast. The tranverse fractures of the radius and ulna had closed and the fragments were aligned. So, there was good news. I told the lady that the progress was good. She had phoned me earlier wanting no invasive surgery for the fracture as proposed by another vet and Dr Vanessa had done a good job. A second opinion would be better service for the client and I was glad that she appeared satisfied.
She was from Yunnan. I had seen paintings by Chinese painters of Yunnan and read about the refugee problems from Myanmar to Yunnan which is part of China. I would like to visit this place as it appeared to be the equivalent "wild wild West" of the USA after reading about drug lords and other news.
"The travel agent in Yunnan cannot be trusted. Contact your travel agent. Many Singaporean businessmen go to Yunnan for gold," she said to me.
I asked her about the presence of elephants in the Yunnan mountains after hearing a story of a Myanmar businessman whose truck driver impatiently sound the horn to quicken the mother elephant and baby to walk past faster along the mountain road. The dam rushed onto the truck and this businesman was flung deep into the ravine. A tree broke his fall and he was hospitalised for 3 months. When he went home after that, he said to me: "My family members sprinted fast and ran away as they thought I was a ghost." In the old days before the mobile phone, he could not inform his family and they thought the elephant had killed him.
So I asked this Yuannan lady about the wandering wild elephants which I could not imagine, being a frog in the well in the small island of Singapore.
It is just too expensive to travel and I prefer the off-the-tourist places which can be more expensive and dangerous.
"There are wild elephants in the mountains. Tourists can view the mountains from the tree top."
"How do I do it?" I asked. "Just sit on the tree?"
The young lady in the IT field said: "I will not advise you to watch the wild elephants. It is very dangerous. The elephants may bang the tree and knock you down!"
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