"Sometimes, it is not the money but the shortage of time," I said to my associate vet who had amputated the kitten's left forelimb and had hospitalised it for 3 weeks. The wound did not heal well and the cat foster lady could not nurse the wound at home. So it was hospitalised here for some time.
2 evenings ago, the foster lady came to visit the cat after being absent for 3 days due to her workload. My associate vet had gone to visit the ailing grandma on that Friday evening and so I spent some minutes talking her. "Should the bandage be changed?" she asked me. "No need to change everyday," I said. The wound is healing by granulation. She usually spent time with the kitten till she had to go home. This time, the kitten peed onto her pink T-shirt. She went to the bathroom and changed to a floral one.
Today, Monday, Nov 19, 2012, the lady came. She was overjoyed when my associate vet released the cat to go home.
More Singaporeans are being kinder to stray cats and dogs now than 10 years ago. What happened to this stray kitten was that her left forelimb was paralysed. Her left eye cornea was 90% opaque and her right eye cornea had two large spherical bulges.
Monday, November 19, 2012
1186. Haematuria in a British bulldog. Durian seed, bladder stone or a botched up spay?
"Could it be a durian seed? My dog rushed and swallowed one yesterday, before I could stop her," the be-spectacled woman in her late 40s was not fully convinced that the X-ray showed a big bladder stone in the ventral dorsal view was really a bladder stone. Her 4-year-old spayed female British bulldog had peed blood in the urine for the past 2 days.
"There is a lot of food in the stomach and intestines," I said. "It is hard to see the durian seed. Definitely, the stone is a large bladder stone. Have you been feeding dry dog food for the past 4 years?"
"No, I stopped after she was over one year old because the other vet advised me to feed home-cooked food to resolve the skin disease problem. I only gave her the dry food in the last 2 days when she passed blood in the urine. Could it be a botched spay operation done by Vet 1 when she was one year old? When she passed urine, I could see the blood in the urine."
"If the spay had not been well done, the dog would be passing blood without any urine every 6-monthly. The blood would not just be present together with the urination." I said.
"I do not see such occurrences," she said. "How about the durian seed? I forgot to tell Dr Daniel about it earlier."
"There may be a durian seed but it is not seen in the X-ray," I said. "The big mass is the bladder stone in the bladder."
I advised antibiotics for 3 days before surgery. The owner brought her trolley and dumped her Bulldog upright inside it and took her home today. The urine analysis and blood test results are pending.
Sunday, November 18, 2012
1185. Audit Review of skin disease: The black Mini Schnauzer still bites her legs again
Sunday Nov 18, 2012 9.58 am
Skin diseases are due to many causes and each vet has his or her own way of diagnosis and treatment. Some cases need regular reviews monthly but rarely do owners bother to do it. Some cases get cured with one or two treatments. In the following audit case, I review the case treated by my associate vet in more detail as the owner came back again some 3 months later after the first treatment at Toa Payoh Vets on Nov 15, 2012 and as she spoke in Hokkien, I took over the case from the associate vet who could not speak a word of this dialect.
I was present on Nov 15 and saw her male friend shaking his head disapprovingly. "Your husband is shaking his head," I said. "He is a friend. I am a divorcee," she informed me. So, one must not presume spouses anytime. I asked for her history from the previous vet. There were 13 pages of record.
Today Sunday, I phoned the owner at 9.50 am. Nobody answered. Too early for a Sunday morning or she had gone out. Over 50 years old lady.
Mini Sch black, female, spayed
Skin diseases are due to many causes and each vet has his or her own way of diagnosis and treatment. Some cases need regular reviews monthly but rarely do owners bother to do it. Some cases get cured with one or two treatments. In the following audit case, I review the case treated by my associate vet in more detail as the owner came back again some 3 months later after the first treatment at Toa Payoh Vets on Nov 15, 2012 and as she spoke in Hokkien, I took over the case from the associate vet who could not speak a word of this dialect.
I was present on Nov 15 and saw her male friend shaking his head disapprovingly. "Your husband is shaking his head," I said. "He is a friend. I am a divorcee," she informed me. So, one must not presume spouses anytime. I asked for her history from the previous vet. There were 13 pages of record.
Today Sunday, I phoned the owner at 9.50 am. Nobody answered. Too early for a Sunday morning or she had gone out. Over 50 years old lady.
Mini Sch black, female, spayed
Saturday, November 17, 2012
Social media and google docs. Can old dogs learn new tricks?
Nov 17, 2012
To: Young new graduates - marketing your expertise in the social media is hard work
From: Dr Sing Kong Yuen
To: Young new graduates - marketing your expertise in the social media is hard work
From: Dr Sing Kong Yuen
Use google docs and social media to promote your expertise
The golden age of the internet is here. Yet, most young people don't know how to use the social media to promote their skills for prospective cients.
Gaming is fun and pleasure but will not create awareness of your hobbies, skills and expertise as a vet or hobbyists.
Facebook with pictures of fun and beer drinking and outrageous behaviour of the young undergraduates at school will make the their baby-boomer mothers blush, but actually such images cast the young persons involved as being lacking in self-discipline and morals and demonstrate irresponsibility to hold top management positions to prospective employers.
Use google docs to get your financial statements stored, rather than emailing attachments to the employer. The employer just click on the link with a password. This is what I mean by using social media to be more efficient, productive and smart in your profession.
With the new Samsung Notebook Lte, it is possible to write directly onto the phone-tablet. I can see this as a new way to record case studies by writing instead of typing on the keyboard and then storing the record in the cloud. Typing during consultation takes a lot of time and so this Samsung Notebook with pen will be an advance in medical recording, if you know how to apply the tools of the trade.
Gaming is fun and pleasure but will not create awareness of your hobbies, skills and expertise as a vet or hobbyists.
Facebook with pictures of fun and beer drinking and outrageous behaviour of the young undergraduates at school will make the their baby-boomer mothers blush, but actually such images cast the young persons involved as being lacking in self-discipline and morals and demonstrate irresponsibility to hold top management positions to prospective employers.
Use google docs to get your financial statements stored, rather than emailing attachments to the employer. The employer just click on the link with a password. This is what I mean by using social media to be more efficient, productive and smart in your profession.
With the new Samsung Notebook Lte, it is possible to write directly onto the phone-tablet. I can see this as a new way to record case studies by writing instead of typing on the keyboard and then storing the record in the cloud. Typing during consultation takes a lot of time and so this Samsung Notebook with pen will be an advance in medical recording, if you know how to apply the tools of the trade.
Read, research and apply the tools of social media to promote your expertise. It will be dull and boring compared to thumbing text messages to your friends and they thumb back trivial news to you, back and forth during your working hours. It is hard work and requires daily input on the blog, facebook or other social media. Few young ones will do it. So, this is where you distinguish yourself as a professional or hobbyists. Rarely do baby-boomer generation people do it but then they are set in their ways watching TVS or online movies and have no time to learn and apply new technologies to promote their expertise. Well, they are either established in their management positions or about to retire. Why would old dogs learn new tricks?
It is time to change your mindset if you want to distinguish yourself in this extremely competitive world where prospective clients are much more sophisticated and demanding of the highest standard of service at the lowest costs by surfing the internet.
It is time to change your mindset if you want to distinguish yourself in this extremely competitive world where prospective clients are much more sophisticated and demanding of the highest standard of service at the lowest costs by surfing the internet.
1183. Visual arts - artist
I rarely encounter artists as clients.
One of my clients is a visual artist.
Website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=35
Her father's website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=14
Many times, I can't figure out how an artist can earn a living as their art pieces need promotion, marketing, affordable pricing. Many don't seem to like to draw Singapore River scenes or local cultures as I presume there is no demand.
In some art exhibitions locally at the malls, some of such local scenes are good pieces of art but the prices are over $1,000.
It is time for the new artist to start their own website and display their artwork and pricing. But most don't do it and so the average man can see their artwork and can't buy their art pieces without having to go through an art gallery!
Lately Singapore has an "Affordable Art Fair".
Should young practising vets display their "artwork" which would be case studies with photos of before and after so that the prospective clients know what they are skilled at? Well, most don't do it. It is just too much time needed to do it!
One of my clients is a visual artist.
Website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=35
Her father's website
http://tfcsea.nafa.edu.sg/artist_biography.aspx?id=14
Many times, I can't figure out how an artist can earn a living as their art pieces need promotion, marketing, affordable pricing. Many don't seem to like to draw Singapore River scenes or local cultures as I presume there is no demand.
In some art exhibitions locally at the malls, some of such local scenes are good pieces of art but the prices are over $1,000.
It is time for the new artist to start their own website and display their artwork and pricing. But most don't do it and so the average man can see their artwork and can't buy their art pieces without having to go through an art gallery!
Lately Singapore has an "Affordable Art Fair".
Should young practising vets display their "artwork" which would be case studies with photos of before and after so that the prospective clients know what they are skilled at? Well, most don't do it. It is just too much time needed to do it!
Friday, November 16, 2012
1182. Intense scratching of face and neck - poodle case review
Nov 16, 2011
I was reviewing a skin disease case and phoned the retired pharmacist.
"My poodle is OK now. 95% cured. Nibbles at front paws and will stop when I scold him."
"You can't be monitoring him 24 hours," I said. "Did you eat the Z/D diet?"
"He didn't like it, so I mix it with the usual dry dog food,"
Some info
Poodle, M, 4 years, landed property
Fed various brands of dry dog food
May 5, 2012
Itchy face, neck, paws, elbows. Skin scraping - no mites. No ringworm. Ears normal.
Medication and an anti-mite insecticide wash.
No further complaint.
Oct 20, 2012
Went to emergency night clinic.
Uncontrollable scratching of lower night all night until it bleeds.
Blood test normal. Skin scraping fungus and bacteria, no mites.
Hyperpigmented skin on ventral neck and dorsal surface of front paws - suggestive of chronic skin disease. Advised skin allergery/atopy workup.
Oct 21, 2012
Treated for bacteria and fungus. Canine Z/D trial for 3 months accepted by owner.
But the dog did not like it. So he did not give 100% when I phoned him on Nov 16, 2012 (today). He said the dog is 95% Ok with hair growth back to the areas. Except for front paws licking occasionally.
This case illustrated the great difficulty of some owners to do the Z/D food allergy elimination trial. "The dog is OK in the past 4 weeks," I said. "This is due to the medication. The real test will be the next 4 months. If you don't try the ZD, the dry dog food allergy may return once the drugs wear off."
Skin diseases are costly to treat but many owners don't realise the importance of review 4 weekly or the use of Z/D or equivalent food trials. The vet may need to keep a record and call the owner but we seldom do as we don't even have time to sit down.
Oct 21, 2012
Case came to me.
I was reviewing a skin disease case and phoned the retired pharmacist.
"My poodle is OK now. 95% cured. Nibbles at front paws and will stop when I scold him."
"You can't be monitoring him 24 hours," I said. "Did you eat the Z/D diet?"
"He didn't like it, so I mix it with the usual dry dog food,"
Some info
Poodle, M, 4 years, landed property
Fed various brands of dry dog food
May 5, 2012
Itchy face, neck, paws, elbows. Skin scraping - no mites. No ringworm. Ears normal.
Medication and an anti-mite insecticide wash.
No further complaint.
Oct 20, 2012
Went to emergency night clinic.
Uncontrollable scratching of lower night all night until it bleeds.
Blood test normal. Skin scraping fungus and bacteria, no mites.
Hyperpigmented skin on ventral neck and dorsal surface of front paws - suggestive of chronic skin disease. Advised skin allergery/atopy workup.
Oct 21, 2012
Treated for bacteria and fungus. Canine Z/D trial for 3 months accepted by owner.
But the dog did not like it. So he did not give 100% when I phoned him on Nov 16, 2012 (today). He said the dog is 95% Ok with hair growth back to the areas. Except for front paws licking occasionally.
This case illustrated the great difficulty of some owners to do the Z/D food allergy elimination trial. "The dog is OK in the past 4 weeks," I said. "This is due to the medication. The real test will be the next 4 months. If you don't try the ZD, the dry dog food allergy may return once the drugs wear off."
Skin diseases are costly to treat but many owners don't realise the importance of review 4 weekly or the use of Z/D or equivalent food trials. The vet may need to keep a record and call the owner but we seldom do as we don't even have time to sit down.
Oct 21, 2012
Case came to me.
1181. Urine collection from guinea pigs for the vet - blood in the urine
PROCEDURES FROM TOA PAYOH VETS
BLOOD IN THE URINE
URINE COLLECTION BY THE OWNER/VET
1. Put guinea pig in a clean plastic box without chemicals. Syringe him or her 10 ml of water slowly.
2. Tilt the box slightly so urine will flow away from the faecal pellets.
3. Use a sterile syringe to collect the urine and give it to the vet. At least 0.5 ml of the urine or up to 5 ml.
URINE ANALYSIS
Urine dipstick test for blood etc.
Urine analysis by the lab
Urine cultures
X-RAY
5. X-ray of the bladder by the vet advised
Urinary sediments - amorphous urates (acidic urine) or amorphous phosphates (alkaline urine). In this case, urine analysis detected amorphous phosphates ++, the pH was 9.0 and bacteria was present in the urine.
CLINICAL SIGNS TO CO-RELATE WITH LAB FINDINGS
Loss of appetite
Difficulty in urination
Blood in the urine - red urine due to plant pigments or blood due to infection/trauma or urinary tract
Drinks a lot or little
ADVICES
It is difficult to use diet to acidify the urine. I advised a course of antibitoics, cutting down on too much wheat grass and hay and more water to drink as well as pesticide-free vegetables.Will need to follow up on another urine analysis. As at Nov 19, 2012, no complaint of haematuria.
BLOOD IN THE URINE
URINE COLLECTION BY THE OWNER/VET
1. Put guinea pig in a clean plastic box without chemicals. Syringe him or her 10 ml of water slowly.
2. Tilt the box slightly so urine will flow away from the faecal pellets.
3. Use a sterile syringe to collect the urine and give it to the vet. At least 0.5 ml of the urine or up to 5 ml.
URINE ANALYSIS
Urine dipstick test for blood etc.
Urine analysis by the lab
Urine cultures
X-RAY
5. X-ray of the bladder by the vet advised
Urinary sediments - amorphous urates (acidic urine) or amorphous phosphates (alkaline urine). In this case, urine analysis detected amorphous phosphates ++, the pH was 9.0 and bacteria was present in the urine.
CLINICAL SIGNS TO CO-RELATE WITH LAB FINDINGS
Loss of appetite
Difficulty in urination
Blood in the urine - red urine due to plant pigments or blood due to infection/trauma or urinary tract
Drinks a lot or little
ADVICES
It is difficult to use diet to acidify the urine. I advised a course of antibitoics, cutting down on too much wheat grass and hay and more water to drink as well as pesticide-free vegetables.Will need to follow up on another urine analysis. As at Nov 19, 2012, no complaint of haematuria.
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