A big thank you to the young Singaporeans who produced the following videos to educate pet owners and bring veterinary medicine and surgery alive to the vet students studying hard for their exam.
As these google-generation people are very busy and have not charged me for services, I have not asked them to edit again to make a perfect production.
The following are the videos:
http://www.youtube.com/watch?v=tmTYP8T95V4 - Kennel Cough video the Sec 3 St Andrew boys produced. The "owner" of the pug was the student but the other characters are genuine. The video producer was another student and his teacher had kindly recommended him to me to help in this production. It turned out to be quite fun to watch this video, in my opinion.
For example, locking the door of the black Mercedes car is not done nowadays but we all had great fun in producing this video. The "owner" seemed to be smiling when he came for a second vet visit with a puppy that had worsened in coughing! I mean, the real owner would be very worried!
After hospitalisation in a crate, there was a scene of the puppy on the consultation table inside the vet consultation room! This should be cut! This is the first video production and no more other versions. That is why I explained the "deficiencies" in the production!
http://www.youtube.com/watch?v=FYeG9tUXp78 - Responsible Pet Ownership video - Nicole Pereira. Excellent summary of some of the main problems seen at Toa Payoh Vets. Great work.
http://www.youtube.com/watch?v=ExTT2a8eUCs - Oronasal Fistula Follow Up - Temasek Polytechnic Vet Tech students who do not wish to be credited
http://www.youtube.com/watch?v=9vKmXgAS_SA - FIV in stray cats 2 - Temasek Polytechnic Vet Tech students who do not wish to be credited
Overall, it took a lot of time. Too much time.
Monday, November 21, 2011
734. Educational videos produced by young Singaporeans for Toa Payoh Vets
E-MAIL FROM DR SING DATED NOV 21, 2011
Thank you very much for your help in producing the Responsible Pet video meant for the AVA Responsible Dog Ownership Road show. The KC video was also good thanks to your help. The voices of the narrators were distinct and clear, to my surprise and the narrative scenes were not boring unlike a power point presentation or a professor's lecture. I hope the vet students do learn a bit about complicated kennel cough.
I gave each party general guidelines as I want other views and presentation.
Each party brings in something new (ideas and presentation and music) in video production and that is why it is so interesting to watch them. Thanks again.
I am only worried about the microchip scanning pic and some other pic you put on the Responsible Pet Ownership video as they may be copyright. Pl confirm the source as we can get sued or get a legal warning to remove it! Pl look into this matter and it is best to remove them and put in original images.
On Sun, Nov 20, 2011 at 5:06 PM, Nicole Pereira wrote:
Hi Dr Sing, here's the links to the videos i uploaded to your 99pups account-
http://www.youtube.com/watch?v=tmTYP8T95V4 - Kennel Cough video the St Andrew boys produced
http://www.youtube.com/watch?v=FYeG9tUXp78 - Responsible Pet Ownership video
http://www.youtube.com/watch?v=ExTT2a8eUCs - Oronasal Fistula Follow Up
http://www.youtube.com/watch?v=9vKmXgAS_SA - FIV in stray cats 2
Thank you very much for your help in producing the Responsible Pet video meant for the AVA Responsible Dog Ownership Road show. The KC video was also good thanks to your help. The voices of the narrators were distinct and clear, to my surprise and the narrative scenes were not boring unlike a power point presentation or a professor's lecture. I hope the vet students do learn a bit about complicated kennel cough.
I gave each party general guidelines as I want other views and presentation.
Each party brings in something new (ideas and presentation and music) in video production and that is why it is so interesting to watch them. Thanks again.
I am only worried about the microchip scanning pic and some other pic you put on the Responsible Pet Ownership video as they may be copyright. Pl confirm the source as we can get sued or get a legal warning to remove it! Pl look into this matter and it is best to remove them and put in original images.
On Sun, Nov 20, 2011 at 5:06 PM, Nicole Pereira
Hi Dr Sing, here's the links to the videos i uploaded to your 99pups account-
http://www.youtube.com/watch?v=tmTYP8T95V4 - Kennel Cough video the St Andrew boys produced
http://www.youtube.com/watch?v=FYeG9tUXp78 - Responsible Pet Ownership video
http://www.youtube.com/watch?v=ExTT2a8eUCs - Oronasal Fistula Follow Up
http://www.youtube.com/watch?v=9vKmXgAS_SA - FIV in stray cats 2
Sunday, November 20, 2011
Sunday Nov 20, 2011 interesting cases
EYES
1. Pug with right eye perforated ulcer treated by me some months ago came in for annual vaccination. A young couple who remembered me as much as I remember them due to this serious eye injury drama as described in my case:
Ulcer healed very well but two very small green ulcers (fluorescein stain) seen to the 7 o'clock. Extraordinary amount of hairs clumped together on corneal surface when I cleaned it (see image). Dr Vanessa had applied the fluroescein strip and had flushed out the green dye. I took over while she checked another dog as the couple wanted to consult me.
Left eye - no ulcers but brown pigmentation covers 50$% of central area - friction from owner cleaning facial fold daily?
I advised facial fold excision as the hairs from the fold must have irritaed the corena (central area) and the pug must be rubbing the eye. "Alternative is to close the eyelids when cleaning the facial fold area," I said.
"Will the surgery affect the health of the pug?" the lady asked. "No," I said. Less itchiness and no more need to wipe the secretions off the facial fold. If irritation continues, the cornea will be seeded by brown black pigments over the years and the dog can't see clearly in front.
The owners would think about the surgery. Their other pug has no corneal ulceration problems. It is hard to foresee the future. "The facial fold is part of the pug's beauty but healthy is more important than beauty," I said.
2. CORNEAL DYSTROPHY
The miniature pinscher owner had texted to consult me yesterday to review the eye. She firmly believes that the circle of whiteness of the inside of the cornea had been reduced with the use of garasone eye drops daily with one small drop.
I will refer to the other picture I took some time ago and see. It seems that the circle has shrunk a bit and the edges are more firm. I need to review the old pic.
The left eye has some interesting developments when I view the images. The dog was fidgety and therefore no proper examination was possible. The owner did not want fluroescein eye stain test for the eyes and so I can't confirm whether the left eye still has ulcers in the upper half near the melanomas.
The pic traken toaday shows "crocodile skin" areound the eyelids. Must check previous pic soon.
CASE 3
A 13-year-old pug passed away after 11 pm yesterday. My assistant Min saw him alive and resting at 11 pm when he did his last checking.
"Why did you send a pug for grooming?" I asked the young couple who told me that the pug had never coughed once before going to the groomer two days ago (Friday). Then she coughed vigorously at home for a long time and so I was consulted on Saturday morning. The pug did not cough when I saw him. "The likely cause of coughing is due to kennel cough," I said as kennel cough is a common disease in places where dogs of various ages mix and it is a very contagious disease. The old dog had not been vaccinated forl many years. So, the primary diagnosis was kennel cough - a dry hacking cough.
I recommended to ward the old dog in a cage so she could rest. "Continuous coughing will result in blood vessel rupture in the lungs," I said to the young couple. Blood test was advised to check for infectious situation but the owners declined.
When the pug died, both her nostrils had red blood. Her tongue was cyanotic. So there was some respiratory damage and bleeding. "An independent post-mortem by the AVA will be needed to ascertain the cause of death," I said to the lady whom I phoned. "The dog is old and her immune system would be weak and she was not able to fight off the viruses and bacteria of kennel cough," I said. Cremation was arranged and the urn would be available in 2 days' time. It is one of the cases where old dogs without vaccination should not be exposed to other dogs. The pug was having her nails clipped and she panted at the pet shop. It was a sad Sunday for me as the pug had not shown any signs of impending death at the Surgery. In fact he had eaten some food after treatment with antibiotics and a drip. However, I had warned the owner of a possible death and the owners were understanding.
1. Pug with right eye perforated ulcer treated by me some months ago came in for annual vaccination. A young couple who remembered me as much as I remember them due to this serious eye injury drama as described in my case:
Ulcer healed very well but two very small green ulcers (fluorescein stain) seen to the 7 o'clock. Extraordinary amount of hairs clumped together on corneal surface when I cleaned it (see image). Dr Vanessa had applied the fluroescein strip and had flushed out the green dye. I took over while she checked another dog as the couple wanted to consult me.
Left eye - no ulcers but brown pigmentation covers 50$% of central area - friction from owner cleaning facial fold daily?
I advised facial fold excision as the hairs from the fold must have irritaed the corena (central area) and the pug must be rubbing the eye. "Alternative is to close the eyelids when cleaning the facial fold area," I said.
"Will the surgery affect the health of the pug?" the lady asked. "No," I said. Less itchiness and no more need to wipe the secretions off the facial fold. If irritation continues, the cornea will be seeded by brown black pigments over the years and the dog can't see clearly in front.
The owners would think about the surgery. Their other pug has no corneal ulceration problems. It is hard to foresee the future. "The facial fold is part of the pug's beauty but healthy is more important than beauty," I said.
2. CORNEAL DYSTROPHY
The miniature pinscher owner had texted to consult me yesterday to review the eye. She firmly believes that the circle of whiteness of the inside of the cornea had been reduced with the use of garasone eye drops daily with one small drop.
I will refer to the other picture I took some time ago and see. It seems that the circle has shrunk a bit and the edges are more firm. I need to review the old pic.
The left eye has some interesting developments when I view the images. The dog was fidgety and therefore no proper examination was possible. The owner did not want fluroescein eye stain test for the eyes and so I can't confirm whether the left eye still has ulcers in the upper half near the melanomas.
The pic traken toaday shows "crocodile skin" areound the eyelids. Must check previous pic soon.
CASE 3
A 13-year-old pug passed away after 11 pm yesterday. My assistant Min saw him alive and resting at 11 pm when he did his last checking.
"Why did you send a pug for grooming?" I asked the young couple who told me that the pug had never coughed once before going to the groomer two days ago (Friday). Then she coughed vigorously at home for a long time and so I was consulted on Saturday morning. The pug did not cough when I saw him. "The likely cause of coughing is due to kennel cough," I said as kennel cough is a common disease in places where dogs of various ages mix and it is a very contagious disease. The old dog had not been vaccinated forl many years. So, the primary diagnosis was kennel cough - a dry hacking cough.
I recommended to ward the old dog in a cage so she could rest. "Continuous coughing will result in blood vessel rupture in the lungs," I said to the young couple. Blood test was advised to check for infectious situation but the owners declined.
When the pug died, both her nostrils had red blood. Her tongue was cyanotic. So there was some respiratory damage and bleeding. "An independent post-mortem by the AVA will be needed to ascertain the cause of death," I said to the lady whom I phoned. "The dog is old and her immune system would be weak and she was not able to fight off the viruses and bacteria of kennel cough," I said. Cremation was arranged and the urn would be available in 2 days' time. It is one of the cases where old dogs without vaccination should not be exposed to other dogs. The pug was having her nails clipped and she panted at the pet shop. It was a sad Sunday for me as the pug had not shown any signs of impending death at the Surgery. In fact he had eaten some food after treatment with antibiotics and a drip. However, I had warned the owner of a possible death and the owners were understanding.
736. Health of Westie
The Westie Foundation of Amercia - health matters funded.
Atopic dermatitits (an allergice skin disease)
Bladder cancer
Idiopathic pulmonary fibrosis (lung scars)
Copper toxicity (hepatitis & liver failure)
Legg-Calve-Perthes disease (hip joint degenerative disease)
Luxating patellas (dislocating knee caps)
Addison's disease
Inflammatory bowel disease
Cataract
Dry eye (keratoconjunctivitis sicca)
Cranio-mandibular osteopathy (painful bone growths in the skull and jaw b ut usually OK by 12 months of age)
White shaker dog syndrome (entire body shakes or trembles - appear in other small white breeds - immune system disorder suspected - successfully treated with steroids).
Atopic dermatitits (an allergice skin disease)
Bladder cancer
Idiopathic pulmonary fibrosis (lung scars)
Copper toxicity (hepatitis & liver failure)
Legg-Calve-Perthes disease (hip joint degenerative disease)
Luxating patellas (dislocating knee caps)
Addison's disease
Inflammatory bowel disease
Cataract
Dry eye (keratoconjunctivitis sicca)
Cranio-mandibular osteopathy (painful bone growths in the skull and jaw b ut usually OK by 12 months of age)
White shaker dog syndrome (entire body shakes or trembles - appear in other small white breeds - immune system disorder suspected - successfully treated with steroids).
Friday, November 18, 2011
735. Inspirational picture
MESSAGE TO AN ENTREPRENEUR
As regards your water project, I am reminded of this martial arts movie "Dead Or Alive" which is free online and just watched by me as I do my early morning internet work. In the movie, the antagonist mentioned 3 words about the Japanese lady not up to the mark as her brother. She needs "Skills, Timing and Strength" but she has no "strength".
Somehow, these 3 words seem apt for your project in wanting to expand your business from Singapore to China and Indonesia. I was wondering what to write in a picture of flowers I just took last Saturday at Sentosa. Now, I know and I produce a picture to encourage you.
1. The timing is right (environmental health concern for clean water), the skill is there (your brother) but the strength (of the parties doing marketing) is to be established and you have got the expatriate
and others you are networking to build up a team to increase your strength.
2. Thinking of making money all the time will not make one be successful in business, in my opinion.
As regards your water project, I am reminded of this martial arts movie "Dead Or Alive" which is free online and just watched by me as I do my early morning internet work. In the movie, the antagonist mentioned 3 words about the Japanese lady not up to the mark as her brother. She needs "Skills, Timing and Strength" but she has no "strength".
Somehow, these 3 words seem apt for your project in wanting to expand your business from Singapore to China and Indonesia. I was wondering what to write in a picture of flowers I just took last Saturday at Sentosa. Now, I know and I produce a picture to encourage you.
1. The timing is right (environmental health concern for clean water), the skill is there (your brother) but the strength (of the parties doing marketing) is to be established and you have got the expatriate
and others you are networking to build up a team to increase your strength.
2. Thinking of making money all the time will not make one be successful in business, in my opinion.
Thursday, November 17, 2011
734. SOP - Lameness in a Golden Retriever
Thursday, Nov 17, 2011
9.30 am
I usually consult from 9.30 am to 11 am.
A lady owner and two friends consulted me for a 2nd opinion as regards her 9-month-old male Golden Retriever. born Feb 2011, limping on right hind for the last few weeks. Vet 1 had been consulted earlier regarding some skin disease.
Below are my Standard Operating Procedures for examination of canine lameness at Toa Payoh Vets for this case as a real case example as it is easier for reader to understand. Basically it is similar to examination of a lame horse.
1. HISTORY OF LAMENESS - Right Hind lamenss
Purchase - 3 months old from a Pasir Ris breeder
Onset - RH lame seen at 7th month
Duration - 2 months
Further questioning: The puppy does not jump up or down car and does not hop down stairs since purchase. Pain in hip and other joints likely to be present before purchase as most normal puppies will do the jumping.
2. LAMENESS EXAMINATION - Outside the Surgery. As in the racehorse lameness exam.
2.1 Walk
2.2 Trot
2.3 Turn
Limping on right hind obvious as the dog did not put weight on this leg and the left hind hip dipped on trotting.
3. PUT ON EXAMINATION TABLE - Do not examine on the floor!
3.1 Pain check of dog standing esp. spinal area. Spinal T5-L5 slightly painful.
3.2 Pain check by palpation of joints with dog lying down sideways on the table.
Slight pain on extension of right hip and right knee.
3.3 Dog recumbent on right side. Extend and flex all joints vigorously. The owners were worried about my vigorous manipulations but the dog did not react since he had no pain from the extensions and flexions. Some vets do gentle manipulations and mis-diagnose.
3.4 Dog standing on table. Compare length of right and left hind limb by extension and show to the owner the lengths of two hind limbs. In this case, the owner could see that the riight hind was noticeably shorter by 2-4 cm. Subluxation? Mild pain only. To X-ray both hip joints later.
3.5 There are other reflexes to be checked if the dog is paralysed but in this case, it is not. Refer to your neurological exam book.
4. TENTATIVE DIAGNOSIS
Right hip dysplasia likely as this condition is better shown at the 9th - 12th month than as a young pup. To X-ray hip joints at a later date.
5. ADVICES
5.1 No weight gain throughout his life, thereby avoiding surgery
5.2 No slopes or stair climbing or jumping from sofas etc
6. SKIN DISEASE. A separate case study and procedure which will not be written up here. Generalised pustular dermatitis, elbow and hock sores. Dog likes to sleep on wet floors. Anal sacculitis (pink hairless areas below anus pointed out by the owner). Rashes seen on elbows and hock area pigmentation suggested licking and early onset of elbow and hock sores. Preventive measures including moisturers for a time. The owner asked for Neoderm cream. No cream advised by me as the hair will not grow if the cream is used for a long time.
Best is daily grooming and inspection of the coat for this Golden Retriever and know where the "hot spots" will occur. Dog is clipped bald. Generally, the skin infections are due to bacteria but the vet cannot rule out ringworm and demodectic mites. Vet 1 had scraped skin and found no mites but there was no medical report given to the owner.
9.30 am
I usually consult from 9.30 am to 11 am.
A lady owner and two friends consulted me for a 2nd opinion as regards her 9-month-old male Golden Retriever. born Feb 2011, limping on right hind for the last few weeks. Vet 1 had been consulted earlier regarding some skin disease.
Below are my Standard Operating Procedures for examination of canine lameness at Toa Payoh Vets for this case as a real case example as it is easier for reader to understand. Basically it is similar to examination of a lame horse.
1. HISTORY OF LAMENESS - Right Hind lamenss
Purchase - 3 months old from a Pasir Ris breeder
Onset - RH lame seen at 7th month
Duration - 2 months
Further questioning: The puppy does not jump up or down car and does not hop down stairs since purchase. Pain in hip and other joints likely to be present before purchase as most normal puppies will do the jumping.
2. LAMENESS EXAMINATION - Outside the Surgery. As in the racehorse lameness exam.
2.1 Walk
2.2 Trot
2.3 Turn
Limping on right hind obvious as the dog did not put weight on this leg and the left hind hip dipped on trotting.
3. PUT ON EXAMINATION TABLE - Do not examine on the floor!
3.1 Pain check of dog standing esp. spinal area. Spinal T5-L5 slightly painful.
3.2 Pain check by palpation of joints with dog lying down sideways on the table.
Slight pain on extension of right hip and right knee.
3.3 Dog recumbent on right side. Extend and flex all joints vigorously. The owners were worried about my vigorous manipulations but the dog did not react since he had no pain from the extensions and flexions. Some vets do gentle manipulations and mis-diagnose.
3.4 Dog standing on table. Compare length of right and left hind limb by extension and show to the owner the lengths of two hind limbs. In this case, the owner could see that the riight hind was noticeably shorter by 2-4 cm. Subluxation? Mild pain only. To X-ray both hip joints later.
3.5 There are other reflexes to be checked if the dog is paralysed but in this case, it is not. Refer to your neurological exam book.
4. TENTATIVE DIAGNOSIS
Right hip dysplasia likely as this condition is better shown at the 9th - 12th month than as a young pup. To X-ray hip joints at a later date.
5. ADVICES
5.1 No weight gain throughout his life, thereby avoiding surgery
5.2 No slopes or stair climbing or jumping from sofas etc
6. SKIN DISEASE. A separate case study and procedure which will not be written up here. Generalised pustular dermatitis, elbow and hock sores. Dog likes to sleep on wet floors. Anal sacculitis (pink hairless areas below anus pointed out by the owner). Rashes seen on elbows and hock area pigmentation suggested licking and early onset of elbow and hock sores. Preventive measures including moisturers for a time. The owner asked for Neoderm cream. No cream advised by me as the hair will not grow if the cream is used for a long time.
Best is daily grooming and inspection of the coat for this Golden Retriever and know where the "hot spots" will occur. Dog is clipped bald. Generally, the skin infections are due to bacteria but the vet cannot rule out ringworm and demodectic mites. Vet 1 had scraped skin and found no mites but there was no medical report given to the owner.
Tuesday, November 15, 2011
733. Kennel cough follow-up by text message
The young generation prefers to text but it is not good when it comes to your pug's illness as illustrated in the following case.
Nov 13, 2011 10.59 am
Good morning Dr Sing.This is ... the owner of Zorro (Pug). We visited your cllinic on 8th. My puppy was having kennel cough and runny nose. He used to eat well and was active but this morning, he is not having any food and keeps on sleeping. When he walks, he has difficulty walking due to heavy coughing. So he walks a bit and then just sits down and he is not active anymore. Antibiotic has not been finished yet but since he seems not well, should I bring him back to the clinic?
It would be much appreciated if you could reply to my sms
Nov 13, 2011 12.04 pm
Pl tel me
NO REPLY. I PHONED. NO REPONSE.
Nov 13, 2011 9.31 pm
Dr Sing, I really need your help now with my pug. For all day, he rarely moved and seems no energy with him. Is there any chance we can bring him for emergency now?
I PHONED THE OWNER. As the pug was ok, I advised giving him a teaspoonful of honey + water and bring back to the clinic at 10 am on Nov 14.
On examination, the pug had copious amounts of nasal discharge. Difficulty in breathing. Some lung sounds, but no fever. I gave treatment and cough mixture.
"It is not possible to cage him 100% at home," I had advised the couple who brought the pug to me for examination one day after purchase on Nov 8.
"Play with the pug for only 5 minutes after meals which were given twice a day," I had advised. "Kennel cough is caused by virus and bacteria. Viral diseases do not have antibiotics but resting the puppy by confinement strictly in a cage will help speed recovery. Some cases take up to 3 weeks to recover."
In this case, the pug had space to run around as all puppies take advantage of freedom at a new house. He also hated taking medicine as he fought me when I syringe him 0.05 ml of the cough mixture.
"It is difficult to give him medicine by mouth," the young man said. "My pug rests his head on a soft toy," the gentleman said.
"Puppies do that when they can't breathe properly," I said. I rolled up a towel like a small pillow. The pug rested his neck on the edge of the pillow. Eyes bright but he was tired.
"Can we visit him for 15 minutes?" the gentleman asked.
"Yes," I said. "But this pug must be inside the cage for the next 2-3 days to rest." The couple came at 7 pm on the same day. Nursing, feeding, electrolytes and observation are made every 2 hourly to ensure that the pug is OK.
Nov 13, 2011 10.59 am
Good morning Dr Sing.This is ... the owner of Zorro (Pug). We visited your cllinic on 8th. My puppy was having kennel cough and runny nose. He used to eat well and was active but this morning, he is not having any food and keeps on sleeping. When he walks, he has difficulty walking due to heavy coughing. So he walks a bit and then just sits down and he is not active anymore. Antibiotic has not been finished yet but since he seems not well, should I bring him back to the clinic?
It would be much appreciated if you could reply to my sms
Nov 13, 2011 12.04 pm
Pl tel me
NO REPLY. I PHONED. NO REPONSE.
Nov 13, 2011 9.31 pm
Dr Sing, I really need your help now with my pug. For all day, he rarely moved and seems no energy with him. Is there any chance we can bring him for emergency now?
I PHONED THE OWNER. As the pug was ok, I advised giving him a teaspoonful of honey + water and bring back to the clinic at 10 am on Nov 14.
On examination, the pug had copious amounts of nasal discharge. Difficulty in breathing. Some lung sounds, but no fever. I gave treatment and cough mixture.
"It is not possible to cage him 100% at home," I had advised the couple who brought the pug to me for examination one day after purchase on Nov 8.
"Play with the pug for only 5 minutes after meals which were given twice a day," I had advised. "Kennel cough is caused by virus and bacteria. Viral diseases do not have antibiotics but resting the puppy by confinement strictly in a cage will help speed recovery. Some cases take up to 3 weeks to recover."
In this case, the pug had space to run around as all puppies take advantage of freedom at a new house. He also hated taking medicine as he fought me when I syringe him 0.05 ml of the cough mixture.
"It is difficult to give him medicine by mouth," the young man said. "My pug rests his head on a soft toy," the gentleman said.
"Puppies do that when they can't breathe properly," I said. I rolled up a towel like a small pillow. The pug rested his neck on the edge of the pillow. Eyes bright but he was tired.
"Can we visit him for 15 minutes?" the gentleman asked.
"Yes," I said. "But this pug must be inside the cage for the next 2-3 days to rest." The couple came at 7 pm on the same day. Nursing, feeding, electrolytes and observation are made every 2 hourly to ensure that the pug is OK.
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