This was the 2nd Sunday that the young lady came. She wanted to be a vet although she had already a degree. Overseas universities do give mature students a second chance to study veterinary medicine. There needs to be a plan for the next 3 years and financial savings amounting to at least $300,000.
CASES
1. FALSE PREGNANCY in a cross-bred. I noted that the dog was seen by me in April 2010 and the notes said: "Breasts full of milk. Advised spay one month later." Of course, the owner never came back. Now, the same dog had the back two breasts filled with milk and the couple and their child brought the dog to Dr Vanessa for spaying. Spaying is possible but not in the interest of the dog as the milk may leak into the abdomen through the operation site. "Only the last two breasts have milk," Dr Vanessa told me.
So she was prepared to spay. I cautioned the owners again as peritonitis due to milk seepage into the abdomen is always a possibility. "What if there is a need to extend the incision further back in some cases?" I said to the owners. They could disappear again if asked to wait, as in the past. History repeats itself. Or they just go to another vet. In the interest of the dog, this surgery ought to be delayed. In the interest of the owner and the vet, the spay should be done on the spot. Why lose a client to the competition due to advice in delay? I have had lost such cases to other vets. So, much depends on the vet's philosophy. In this case, the owner accepted my advice again, to wait for one month. Maybe I should follow up.
ULTRA-SOUND SCANNING FOR PREGNANCY
"The owners asked for ultrasound," Dr Vanessa told me when I asked why an X-ray was not done instead. "The owners think that an X-ray is harmful to the puppies."
In this case, the ultrasound showed "2 pups" one of whom looked like a female with the word "vulva" highlighted in the scan. An X-ray will not show the gender but will show definitely how many puppies are present (skeletons) and their position.
The two boys 7 and 8 years old were quite active. Both wanted to know how the paper cutter worked and I permitted one to push down the handle to cut the paper. The older brother wanted to cut but mum objected as it could be risky. So he said: "Why is my brother allowed?" I ensured that he could safely press the cutting handle down to cut the envelope. I am recycling envelopes as covers for case cards and have to cut them to appropriate sizes. It does not look high class to use recycled envelopes but it does save trees.
Then the older brother showed me a video of his iPhone of the male Golden Retriever mating with the female Spitz. "About 20 minutes of marking," he said. I thought he said "marching". Mum asked what he said. I said: "Mating. You don't need to talk about the birds and the bees nowadays to the children."
Tuesday, September 6, 2011
4444. The dwarf hamster has a gigantic cyst
This would be her 3rd anaesthesia and surgery. I prefer not to do it as she had survived two and this 3rd surgery would take a long time. Anaesthesia less than 15 minutes would give an excellent survival rate. But this surgery would not be 15 minutes. Would she die on the operating table?
It is like going on a 3rd tour of duty to the war zone of Afghanistan after surviving two tours. The probability of being killed on patrols will be higher. However, in this hamster, there was no choice. Some big swelling had irritated her daily. She scratched this swelling to get rid of it. Those who suffers from skin itch will understand. Scratching the skin till it becomes hairless and then traumatised and infected.
So, this hamster went under the knife (scalpel) again. I gave the lowest dose of Zoletil IM as just using isoflurane gas + oxygen would not be sufficient for a lengthy surgery.
Surgery - Cyst and abscesses in a dwarf hamster and follow-up 3 days later
I followed up 3 days later by phoning the lady owner. The wound was healing well. The hamster was not bothered with the stitches. But she scratched another area. The owner sent me a picture via e-mail. Yes, there was a hairless area in front of and above the horizontal canal opening (as I reviewed the previous images) that I did not incise.
This was because I did not want to lengthen the anaesthesia by incising this area. In addition, I assessed that it was not necessary. The dwarf hamster is such a small creature that one extra cut is equivalent to a big wound in a dog or cat.
Every second after 15 minutes of anaesthesia increases the risk of the hamster's heart failing. She was only 26 gram in bodyweight and her heart must be very small unlike dogs and cats. So, the speedier the surgery, the better the chances of good outcome.
As to what to do with this red area, I asked the owner to continue with the medication and wait-and-see. Three times lucky. Superstitious? I may have to decline any 4th anaesthesia. It is just too risky for the dwarf hamster although she did not lose her 26 g body weight since the first anaesthesia.
MORE INFORMATION IS AT:
http://www.sinpets.com/F6/20110906dwarf-hamster-cyst-abscesses-ear-canal-ablation-singapore_ToaPayohVets.htm.
AS THE WEBPAGE CONTAINS SURGICAL PROCEDURES, VIEWER DISCRETION IS ADVISED.
It is like going on a 3rd tour of duty to the war zone of Afghanistan after surviving two tours. The probability of being killed on patrols will be higher. However, in this hamster, there was no choice. Some big swelling had irritated her daily. She scratched this swelling to get rid of it. Those who suffers from skin itch will understand. Scratching the skin till it becomes hairless and then traumatised and infected.
So, this hamster went under the knife (scalpel) again. I gave the lowest dose of Zoletil IM as just using isoflurane gas + oxygen would not be sufficient for a lengthy surgery.
Surgery - Cyst and abscesses in a dwarf hamster and follow-up 3 days later
I followed up 3 days later by phoning the lady owner. The wound was healing well. The hamster was not bothered with the stitches. But she scratched another area. The owner sent me a picture via e-mail. Yes, there was a hairless area in front of and above the horizontal canal opening (as I reviewed the previous images) that I did not incise.
This was because I did not want to lengthen the anaesthesia by incising this area. In addition, I assessed that it was not necessary. The dwarf hamster is such a small creature that one extra cut is equivalent to a big wound in a dog or cat.
Every second after 15 minutes of anaesthesia increases the risk of the hamster's heart failing. She was only 26 gram in bodyweight and her heart must be very small unlike dogs and cats. So, the speedier the surgery, the better the chances of good outcome.
As to what to do with this red area, I asked the owner to continue with the medication and wait-and-see. Three times lucky. Superstitious? I may have to decline any 4th anaesthesia. It is just too risky for the dwarf hamster although she did not lose her 26 g body weight since the first anaesthesia.
MORE INFORMATION IS AT:
http://www.sinpets.com/F6/20110906dwarf-hamster-cyst-abscesses-ear-canal-ablation-singapore_ToaPayohVets.htm.
AS THE WEBPAGE CONTAINS SURGICAL PROCEDURES, VIEWER DISCRETION IS ADVISED.
-----------------
INSTAGRAM IMAGES IN 2020
BE KIND TO PETS VETERINARY STORIES. Image 1/8
How
to treat a gigantic cyst below a hamster's ear
Dr Sing Kong
Yuen, BVMS (Glasgow).
Some dwarf hamsters suffer from diseased ears. You can see redness, swelling and persistent ear scratching. Early veterinary treatment may prevent the need for ear surgeries. This 1-year-old female dwarf hamster had an ear surgery 2 months ago.
Now the owner brought her in to Toa Payoh Vets when the large lump beside her right ear was too big to ignore. The lump was a cyst which enclosed two encapsulated abscesses. This was the 3rd anaesthesia and surgery.
The surgery would be risky althoug the hamster was not aged and active. She survived. In retrospect, there was another swelling with pus on the other side of the cyst. Operating on it would prolong anaesthetic time and kill the hamster. So it was not done at this stage.
As the images show surgical procedures, viewer discretion is advised if you go to the blog.
MORE
INFORMATION IS AT:
Update
at blog:
https://2010vets.blogspot.com/2011/09/dwarf-hamster-has-gigantic-cyst.html
Treatment of tick infestation in Singapore dogs: e-mail query
EMAIL TO DR SING DATED AUG 30, 2011
Hi, i have a problem with my silky terrier, this past few months, june exactly,he was infected by ticks,i applied a frontline spot, it was gone by month of july, but now august, again have, and i dont know how to manage, it seem his so irritated now.
Just want to know how much for de ticking for small dog.
Thank you so much.
Hope to heat from you.
...
EMAIL TO DR SING DATED AUG 30, 2011
Cost is around $120 for clipping of coat to get rid of all ticks, bathing of deticking insecticide for small breed like Silkie. Antibiotic and anti-inflam injection $30. Total is around $150
SMS TO DR SING DATED AUG 31, 2011
Il sent my dog today around 1:30pm.
Thanks
...
Sent from Samsung tablet
Hi, i have a problem with my silky terrier, this past few months, june exactly,he was infected by ticks,i applied a frontline spot, it was gone by month of july, but now august, again have, and i dont know how to manage, it seem his so irritated now.
Just want to know how much for de ticking for small dog.
Thank you so much.
Hope to heat from you.
...
EMAIL TO DR SING DATED AUG 30, 2011
Cost is around $120 for clipping of coat to get rid of all ticks, bathing of deticking insecticide for small breed like Silkie. Antibiotic and anti-inflam injection $30. Total is around $150
SMS TO DR SING DATED AUG 31, 2011
Il sent my dog today around 1:30pm.
Thanks
...
Sent from Samsung tablet
584. Animal Shelter for dogs
E-MAIL TO DR SING DATED SEP 5, 2011
E-MAIL REPLY TO DR SING DATED SEP 5, 2011
Attention to the Veterinary Head of Toa Payoh Vets,
My name is ... and I am working full time for a church in Singapore.
Our church is currently in the process of getting a new animal shelter set up in Singapore. We are waiting for tenders from AVA or SLA for dog farms in Sungei Tengah. The shelter should be up and going in about 1 or 2 year's time. Our emphasis will specifically be to help stray or abandoned dogs. We are serious about this ministry and is looking forward toward setting it up as soon as possible.
The reason for writing to you is to ask if your clinic would be be interested to participate in the sterilization, vaccination and medical treatment program of our dogs.
We hope that you could partner with us in this good cause.
If so, please let us know how much you will charge us (roughly) for the following services so that we can better estimate our financial planning. We would greatly appreciate if you could give us a subsidized rate that is lower than the market.
Vaccination of a dog (regardless of size & inclusive of medication)
Sterilization of a dog (regardless of size & inclusive of medication)
Microchipping
Consultation fee
Medication discount
Essential Products such as heartguard, frontline
Medicated shampoos
Hope to hear from you soon. Thank you.
Alternatively, if any of your vets are interested to help on an individual, voluntary or private basis, please also respond to me.
God bless you,
...
E-MAIL REPLY FROM DR SING DATED SEP 5, 2011
I am Dr Sing. As there is inflation and prices go up yearly, it is not possible to quote now and there will be misunderstandings when your shelter is built in 2-4 years' s time. Please let me know when the tender has been successful.
E-MAIL REPLY TO DR SING DATED SEP 6, 2011
Dear Dr Sing
Thank you for your prompt reply. We will contact you again when we have the latest update.
God bless you,
...
E-MAIL REPLY TO DR SING DATED SEP 5, 2011
Attention to the Veterinary Head of Toa Payoh Vets,
My name is ... and I am working full time for a church in Singapore.
Our church is currently in the process of getting a new animal shelter set up in Singapore. We are waiting for tenders from AVA or SLA for dog farms in Sungei Tengah. The shelter should be up and going in about 1 or 2 year's time. Our emphasis will specifically be to help stray or abandoned dogs. We are serious about this ministry and is looking forward toward setting it up as soon as possible.
The reason for writing to you is to ask if your clinic would be be interested to participate in the sterilization, vaccination and medical treatment program of our dogs.
We hope that you could partner with us in this good cause.
If so, please let us know how much you will charge us (roughly) for the following services so that we can better estimate our financial planning. We would greatly appreciate if you could give us a subsidized rate that is lower than the market.
Vaccination of a dog (regardless of size & inclusive of medication)
Sterilization of a dog (regardless of size & inclusive of medication)
Microchipping
Consultation fee
Medication discount
Essential Products such as heartguard, frontline
Medicated shampoos
Hope to hear from you soon. Thank you.
Alternatively, if any of your vets are interested to help on an individual, voluntary or private basis, please also respond to me.
God bless you,
...
E-MAIL REPLY FROM DR SING DATED SEP 5, 2011
I am Dr Sing. As there is inflation and prices go up yearly, it is not possible to quote now and there will be misunderstandings when your shelter is built in 2-4 years' s time. Please let me know when the tender has been successful.
E-MAIL REPLY TO DR SING DATED SEP 6, 2011
Dear Dr Sing
Thank you for your prompt reply. We will contact you again when we have the latest update.
God bless you,
...
Monday, September 5, 2011
583. Follow up on hamster with cyst and two abscesses
I have not uploaded the full surgery images on a website yet. Three surgery images are as follows as follows:
"The hamster ate soon after surgery but was selective on eating only sunflower seeds," the lady owner said when I phoned on Sunday yesterday. This was around 3 days post-operation.
She said: "There seems to be something white coming out from the hole in the ear. She is not scratching the nylon stitches."
I asked the owner to e-mail to me 2 pictures. One showed the horizontal ear canal opening. The upper right quadrant with the ear canal opening as centre looked very red and inflamed. "The hamster scratched this area, avoiding the nylon stitches," the owner said when I phoned her.
In my e-mail reply after seeing the pictures, I could only speculate as follows:
Thanks for 2 pictures. There may be some growing internal abscess/cyst in the reddish area to the upper right quadrant of the ear canal opening. That is why the hamster is scratching it as in the previous time.
See if the medication can work.
It is hard to diagnose based on digital images.
"The hamster ate soon after surgery but was selective on eating only sunflower seeds," the lady owner said when I phoned on Sunday yesterday. This was around 3 days post-operation.
She said: "There seems to be something white coming out from the hole in the ear. She is not scratching the nylon stitches."
I asked the owner to e-mail to me 2 pictures. One showed the horizontal ear canal opening. The upper right quadrant with the ear canal opening as centre looked very red and inflamed. "The hamster scratched this area, avoiding the nylon stitches," the owner said when I phoned her.
In my e-mail reply after seeing the pictures, I could only speculate as follows:
Thanks for 2 pictures. There may be some growing internal abscess/cyst in the reddish area to the upper right quadrant of the ear canal opening. That is why the hamster is scratching it as in the previous time.
See if the medication can work.
It is hard to diagnose based on digital images.
Surgery - Circum-anal and tail tumours in a very old male dog
Gigantic circum-anal tumours - a type of surgery where fools go in where angels fear to tread as the dog is very old and the post-operation complications of not healing well are present.
Other than the very anaesthetic risks of operating on a very old dog, the other challenge is getting sufficient skin to stitch after excision of the gigantic circum-anal tumours.
Should this case just be rejected as being in-operable? I study the 3 images. In this type of high risk case, a short surgery of less than 15 minutes under just isoflurane anaesthesia is best for survival. Unfortunately, this will be at least one hour operation!
I got the dog on antibiotics and Tardak injection for 7 days first. Blood test showed high liver ALT and urea. To operate or not to? It is a very difficult decision for the owner.
Other than the very anaesthetic risks of operating on a very old dog, the other challenge is getting sufficient skin to stitch after excision of the gigantic circum-anal tumours.
Should this case just be rejected as being in-operable? I study the 3 images. In this type of high risk case, a short surgery of less than 15 minutes under just isoflurane anaesthesia is best for survival. Unfortunately, this will be at least one hour operation!
I got the dog on antibiotics and Tardak injection for 7 days first. Blood test showed high liver ALT and urea. To operate or not to? It is a very difficult decision for the owner.
581. Hari Raya Puasa invitation
"You old people are afraid of the (Singapore) government," the hostess who had invited me to her HDB maisonette to celebrate Hari Raya Puasa on Saturday Sep 3, 2011 had asked me who I voted for as the 7th President of Singapore and I had said "Dr Tony Tan". She is around 40 years old and anybody past the age of 50 will be old. I am 61 actually.
The Prime Minister had given his support for Dr Tony Tan in one of his speeches and so he was deemed to be the government-backed horse. Many unions had voiced their support for him too.
Dr Tony Tan had been the Deputy Prime Minister and had held various high posts in politics, the government and in banking. "I voted for him as he was the best of the 4 candidates. He had the track record of international networking and financial experience," I said to my hostess who is a very vocal woman. I did not ask who she voted for at the beginning. She asked her best friend, a Chinese lady in her 40s. She said: "Dr Tan Cheng Bock." This was a satisfactory answer to the hostess.
"Why are you against Dr Tony Tan as President?" I asked.
"He is from a monied generation and from the elitist part of society. What does he know about the poor people's suffering? His mother was not a washer woman and so how would he know about the disadvantaged in society?"
I had no comment as I don't know Dr Tony Tan nor had I met him. For that matter, I had not met the Prime Minister personally too but I believe he was the best person to govern Singapore.
As the vocal minority of the younger generation grows bigger and bigger, the internet fans the flames of the opposition voices louder and louder. Change for the sake of change. More demands. More competition.
The same changes in politics applies to veterinary practice. Yesterday, Sunday, a senior vet of over 70 years asked me whether it is more competitive nowadays as I get presented a moon cake.
"Well, there are at least 43 veterinary practices now and soon it will be 50. Competition is inevitable. Much depends on the vet's ability to build up his reputation. His competence and track record will matter to the younger generation that is more sophisticated. If you don't want to spay big breeds and refer to the (brand-name) practice, you will just lose the confidence of your clients. This means less clientele as less referrals will be made."
Old vets will have to retire as the new generation prefers the younger vets. This is what is happening in politics too and that is why younger office holders are introduced.
As for my hostess, she voted for Mr Tan Jee Say who was from a poor family. He got around 25% of the votes while Dr Tony Tan got just around a thousand votes more than Dr Tan Cheng Bock and became the President of Singapore. The two doctors each got around 35% of the votes. So, there seems to be a political tsunami of Singaporeans wanting a change. When the old generation passes away, there will be a new political party in power. Unless the incumbent party politicians or the practising vet knows how to keep in touch with the common people or clients, many of the supporters will be lost to the opposition or competitors in 2016.
The Prime Minister had given his support for Dr Tony Tan in one of his speeches and so he was deemed to be the government-backed horse. Many unions had voiced their support for him too.
Dr Tony Tan had been the Deputy Prime Minister and had held various high posts in politics, the government and in banking. "I voted for him as he was the best of the 4 candidates. He had the track record of international networking and financial experience," I said to my hostess who is a very vocal woman. I did not ask who she voted for at the beginning. She asked her best friend, a Chinese lady in her 40s. She said: "Dr Tan Cheng Bock." This was a satisfactory answer to the hostess.
"Why are you against Dr Tony Tan as President?" I asked.
"He is from a monied generation and from the elitist part of society. What does he know about the poor people's suffering? His mother was not a washer woman and so how would he know about the disadvantaged in society?"
I had no comment as I don't know Dr Tony Tan nor had I met him. For that matter, I had not met the Prime Minister personally too but I believe he was the best person to govern Singapore.
As the vocal minority of the younger generation grows bigger and bigger, the internet fans the flames of the opposition voices louder and louder. Change for the sake of change. More demands. More competition.
The same changes in politics applies to veterinary practice. Yesterday, Sunday, a senior vet of over 70 years asked me whether it is more competitive nowadays as I get presented a moon cake.
"Well, there are at least 43 veterinary practices now and soon it will be 50. Competition is inevitable. Much depends on the vet's ability to build up his reputation. His competence and track record will matter to the younger generation that is more sophisticated. If you don't want to spay big breeds and refer to the (brand-name) practice, you will just lose the confidence of your clients. This means less clientele as less referrals will be made."
Old vets will have to retire as the new generation prefers the younger vets. This is what is happening in politics too and that is why younger office holders are introduced.
As for my hostess, she voted for Mr Tan Jee Say who was from a poor family. He got around 25% of the votes while Dr Tony Tan got just around a thousand votes more than Dr Tan Cheng Bock and became the President of Singapore. The two doctors each got around 35% of the votes. So, there seems to be a political tsunami of Singaporeans wanting a change. When the old generation passes away, there will be a new political party in power. Unless the incumbent party politicians or the practising vet knows how to keep in touch with the common people or clients, many of the supporters will be lost to the opposition or competitors in 2016.
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