Saturday Jan 12 2013
A bubbly Malay lady from Woodlands came with her blue-eyed cat and a little boy. "Why do you come all the way from Woodlands? There are clinics near your home." It was her personal choice.
After the usual examination, I said she could come back in one hour to take the cat home.
"One hour?" the little boy with bright big eyes said aloud. He was most attentive
"Yes," I said. "Do you know what is 'one hour'?" I asked him.
He did not reply. Mum laughed.
Two hours later, the mum came with him for the cat.
"There is some bleeding from the operation site," the mum said."
"Disgusting," the little boy added. I was surprised that he uttered this word and wondered whether he knew what it meant. He was 6 years old as his mother told me later as I thought he was 4 or 5 years old. He was bright and would do well in life if given proper attention and if he studied hard.
The cat was left in the surgery till 5 pm when another adult came with 3 more children. Lots of joy and laughter with these young kids around. "I am the 5th sister," the mum said. "This is my 3rd sister." Third sister was slim and more serious and drove a car. The cat was no longer bleeding and all went home happily.
As to why this 2-year-old cat was sent for neutering, it was because he was caterwauling.
"A stray pregnant female cat waits for him outside the door," 5th sister said. "He is on heat and wants to go out. That is why I want you to neuter him"
"Male cats do not stop meowing noisily immediately after neutering," I said. "It takes time for his male hormones to disappear.
"This male cat sprayed his urine and oil onto the neighbour's walls and they are so angry! That is why I want to neuter him!".
"In any case, why don't you get the pregnant female cat spayed?"
"She is my neighbour's cat," 5th sister replied. "Whe she heard it cost me $195," she did not want to do it.
"The cost of neuter is much less," I said to her. "You wanted the e-collar, the vaccination and the de-fleaing spot-on. This added up. The actual cost is around $125 with antibiotics and painkillers and surgery and anaesthesia@"
Sunday, January 13, 2013
1241. STANDARD OPERATING PROCEDURES. HOW LONG IT TAKES TO NEUTER A YOUNG POM?
Saturday Jan 12, 2013
STANDARD OPERATING PROCEDURES. HOW LONG IT TAKES TO NEUTER A YOUNG POM?
A young doctor came at 9.30 am on this fine Saturday morning, with a Pom as she had made an appointment for the neuter.
"Has he eaten?" I asked.
"Yes," she said.
"It is best not to feed the dog 10 hours before surgery as the dog may vomit during surgery."
"Your staff did not mention this when I phoned for an appointment," she said.
In the Singapore General Hospital where I went for surgery under general anaesthesia, surgery to remove a lump from my left wrist involved a consultation, blood test, X-rays, ECG and counselling on medical charges and anaesthetic risk and signing of informed consent after being informed of a possible risk of death on the operating table. A lot of time.
IV ANAESTHESIA
In veterinary medicine, such procedures would be costly. For this young dog, a general examination was done. The dog was deemed healthy and I operated 1 hour later. From my experience, the combined domitor + ketamine at 0.4 + 0.5 ml IV per 10 kg in a young healthy dog does not cause vomiting and permits short surgery without the need to top up with isoflurane gas.
My experienced vet assistant got the isoflurane gas ready. "If the vet is fast, there is no need for isoflurane gas top up because I gave 100% of the formula," I told Min. He was not convinced. As the dog would not permit shaving of the scrotal area, Min had to do it after I gave this formula.
Min recorded the time of the start of domitor and ketamine injection and the last stitch. It was 20 minutes which included shaving the scrotal area of around 2 minutes. It would be 18 minutes.
"What's the time between first skin incision and last stitch?" I asked Min to calculate. It was 10 minutes.
ANALGESIC EFFECTS
No isoflurane gas. Towards the 18th minute, the dog's leg moved a bit. As I started to stitch one horizontal mattress to close the skin, the dog moved a bit. "Standby for the isoflurane gas and mask," I said to Min.
I completed the surgery in 20 mintues from IV injection of domitor + ketamine + normal saline in one syringe of 0.55 ml IV.
SURGERY
Three forceps method clamping the tunica enclosing the spermatic cord and blood vessels is the best. The lowest forcep is released. I ligated 3/0 absorbable polysorb on the groove from the released forcep one way and repeat the other way. I threw in 5 knots. I excise the area between the 2nd and 3rd forceps. No bleeding.
The skin incison of around 1.3 cm long was stitched with just one horizontal mattress using the same 3/0.
Bandage.
PAIN-KILLERS AND ANTIBIOTICS given..
No complaint today, Sunday, 24 hours after surgery. I will follow up tomorrow.
CONCLUSION
I audit associate vets' efficiency. Surgery should be speedy, accurate and complete. Much time and resources are wasted when the vet is not well prepared by visualising the whole process. Pre-anaesthetic shaving saves a few mintues but this Pom would not have it done and so was shaved post-sedation.
STANDARD OPERATING PROCEDURES. HOW LONG IT TAKES TO NEUTER A YOUNG POM?
A young doctor came at 9.30 am on this fine Saturday morning, with a Pom as she had made an appointment for the neuter.
"Has he eaten?" I asked.
"Yes," she said.
"It is best not to feed the dog 10 hours before surgery as the dog may vomit during surgery."
"Your staff did not mention this when I phoned for an appointment," she said.
In the Singapore General Hospital where I went for surgery under general anaesthesia, surgery to remove a lump from my left wrist involved a consultation, blood test, X-rays, ECG and counselling on medical charges and anaesthetic risk and signing of informed consent after being informed of a possible risk of death on the operating table. A lot of time.
IV ANAESTHESIA
In veterinary medicine, such procedures would be costly. For this young dog, a general examination was done. The dog was deemed healthy and I operated 1 hour later. From my experience, the combined domitor + ketamine at 0.4 + 0.5 ml IV per 10 kg in a young healthy dog does not cause vomiting and permits short surgery without the need to top up with isoflurane gas.
My experienced vet assistant got the isoflurane gas ready. "If the vet is fast, there is no need for isoflurane gas top up because I gave 100% of the formula," I told Min. He was not convinced. As the dog would not permit shaving of the scrotal area, Min had to do it after I gave this formula.
Min recorded the time of the start of domitor and ketamine injection and the last stitch. It was 20 minutes which included shaving the scrotal area of around 2 minutes. It would be 18 minutes.
"What's the time between first skin incision and last stitch?" I asked Min to calculate. It was 10 minutes.
ANALGESIC EFFECTS
No isoflurane gas. Towards the 18th minute, the dog's leg moved a bit. As I started to stitch one horizontal mattress to close the skin, the dog moved a bit. "Standby for the isoflurane gas and mask," I said to Min.
I completed the surgery in 20 mintues from IV injection of domitor + ketamine + normal saline in one syringe of 0.55 ml IV.
SURGERY
Three forceps method clamping the tunica enclosing the spermatic cord and blood vessels is the best. The lowest forcep is released. I ligated 3/0 absorbable polysorb on the groove from the released forcep one way and repeat the other way. I threw in 5 knots. I excise the area between the 2nd and 3rd forceps. No bleeding.
The skin incison of around 1.3 cm long was stitched with just one horizontal mattress using the same 3/0.
Bandage.
PAIN-KILLERS AND ANTIBIOTICS given..
No complaint today, Sunday, 24 hours after surgery. I will follow up tomorrow.
CONCLUSION
I audit associate vets' efficiency. Surgery should be speedy, accurate and complete. Much time and resources are wasted when the vet is not well prepared by visualising the whole process. Pre-anaesthetic shaving saves a few mintues but this Pom would not have it done and so was shaved post-sedation.
1240. How to create an interesting video?
 TOA
PAYOH VETStoapayohvets.com Date: 13 January, 2013
|
||
|
First Romance or Fall In
Love With You? Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS First written: 9 January 2013 Date: 13 January, 2013 |
 toapayohvets.com
Be Kind To Pets Veterinary Education Project 2010-0129 |
|
|
For the past 20 years, I have been writing text and
inserting images. In 2013, I will try to learn how to create interesting videos. The following is one of my first few attempts to create video with interest. This video was filmed by me at at the 25th Anniversary of the Nonyas and Babas in Malacca in late 2012. I was not really keen to go as such functions would be boring as I am not a Peranakan and I don't know anybody in this Association. Surprisingly, there were around 700 participants from Malaysia, Singapore, Indonesia, Thailand and Australia and the organisation was superb as compared to heavy rain at the outdoor function in the previous year. Instead of sitting down with strangers making small talk during dinner, I took my camera to the dance floor and tried to create some videos. The following video with a story line may be of interest to viewers. http://www.youtube.com/watch?v=L0f0ZTKlS6U The following is how I teach my vet interns in video production. The same principles of a compelling story applies whether you produce a veterinary education video or a dance video. HOW DID I PRODUCE THE VIDEO ABOVE? Hook - Protagonist -- An attractive woman with flowers in her hair. She loves dancing and found a capable dancer hopefully. Is she a Nonya? Is he a Baba? I don't know them. Introduction - Crowded dance floor. Focus on this Protagonist whenever possible as a story is all about people and a character. . Middle - Antagonist -- Another good-looking woman who loves dancing too came into the scene. Would she be a better dancer? Who is her beau? Is he a good dancer? Is he a first romance? Will she fall in love again? To break the boredom of just showing dancers, I angled the zooms lens vertically. Not a good idea as conventional movies don't do it. Who is the singer? Is he Cliff Richard? My lens zoomed on him. A camera man went into the dance floor and blocked my view. I was hand-holding my camera and moved elsewhere. A steady hand to produce good video with focus. I zoomed back to the Protagonist as she is a good dancer. But more dancers blocked my view. The Antagonist is hearing some conversation but the music is loud. What did she hear? Other dancers. Too soon, this 1-minute video had to end with the end of the song. Ending - Quite abruptly. Without a visual impact. This is my first video and I have much to learn. The website and updates will be at: http://www.kongyuensing.com/folder5/20130112video_first_romance_toapayohvets.htm Conclusion: Is this video capturing the attention of viewers? I think so. But it is up to the general viewer to judge. Tips & Advices: Join the fun rather than just eat and watch the poor quality TV screens of the dancers at the dining table. Get up. Take your camera. Go and see the real people and appreciate life. If you know how to dance, find a partner from your group of friends. There are many women who know how to dance well. I thought the song was "First Romance" but could not find it in You Tube. I grow up listening to Cliff Richard's songs but there are so many other singers. At that time in the 1960s, there were no distractions like coloured TVs and the internet or mobile phones. The song was "Falling In Love With You" by Cliff Richard and they are at: http://www.youtube.com/watch?v=QRq642i-VVA http://www.youtube.com/watch?v=SB_fTsVcv24 http://www.youtube.com/watch?feature=endscreen&v=dEeP42flo6o&NR=1 http://www.youtube.com/watch?v=hp1ZLjavWd8 includes Mean Woman Blues http://www.youtube.com/watch?v=qEz3emlyZhs (with lyrics) Song: The Young Ones: http://www.youtube.com/watch?feature=endscreen&v=5Tmv7YMcdXc&NR=1 Apache http://www.youtube.com/watch?feature=endscreen&NR=1&v=bNAyPK2O4fk These songs are for baby-boomers who grow up with music of the 60s. We still get the screaming girls in 2013! I would be going to Cliff Richard's performance in Singapore in Feb 2013 and the audience would be mostly in their late 40s and the screaming girls have had grown up with responsibilities. They would be more controlled in their emotions. I hope most of them have not fallen out of love. I just booked the seats today Jan 13, 2013 but the good ones are booked. Although Cliff Richard is 72 years old, I am not expecting him to be at his peak. Just enjoy the music. After all, the baby-boomer generation has matured too and the younger generation has taken over. Update and webpage is at:http://www.kongyuensing.com/folder5/20130112video_first_romance_toapayohvets.htm | ||
Saturday, January 12, 2013
Create veterinary videos to educate and entertain
|
Veterinary videos by
interns Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS First written: 9 January 2013 Date: 12 January, 2013 |
toapayohvets.com
Be Kind To Pets Veterinary Education Project 2010-0129 |
|
"It is better to create 3 imperfect video rather than
create one perfect video as you are doing hands-on
learning as an intern," I said to the girl who produced 3
videos for me and told me she might edit it if I find some
major flaws. "It takes too long for an intern to produce a
video as they are not professionals. Once the video is
done, no editing will be done. Producing veterinary videos
is part of the experiential learning for an intern at Toa
Payoh Vets ." She produced 3 videos for me as follows: http://www.youtube.com/watch? http://www.youtube.com/watch? http://www.youtube.com/watch? |
|
Friday, January 11, 2013
Be proactive and create
|
||||||||||||||||||||
1237. Industrial dogs in Singapore dying from distemper
Jan 11, 2013
I had a chat with a lady who cycles to feed industrial dogs in the evening and nights and had adopted two.
"Do you know that industrial dogs are dying of distemper?" she asked me.
"No," I said. Many industrial dogs had been culled by the authorities and so there are few seen at Toa Payoh Vets.
"They lie down, shivering. Their muscles start twitching," she said. "The vet said nothing can be done to cure it and put them to sleep."
"Is it an infectious disease to all dogs?" she asked.
"Yes," I said. "The virus attacks the brain cells and other parts of the body. There is an effective vaccination."
"Factory owners don't vaccinate the dogs," she said. "How come in a group of dogs, not all will die?"
"Some dogs will be resistant to the distemper viral infection. These will not die. It is like drinking a small potion of poison. You will not die unless it is a lot or very potent. If the dogs are dead, how come you are still feeding the industrial dogs?"
"Another part of the industrial estate," she laughed.
She continues her cycling to feed the stray dogs her home-cooked food.
"It is fortunate that your husband does not mind you adopting the stray puppy," I said and found that she adopted two.
"He nags and nags," she said. "I am looking for homes for them."
ADVICE
All Singapore dog owners should get their dogs vaccinated against distemper yearly but sadly, many don't bother. Dogs at dog parks, boarding and grooming should ensure protection from distemper by just taking time off to see the vet and get the dog vaccinated.
I had a chat with a lady who cycles to feed industrial dogs in the evening and nights and had adopted two.
"Do you know that industrial dogs are dying of distemper?" she asked me.
"No," I said. Many industrial dogs had been culled by the authorities and so there are few seen at Toa Payoh Vets.
"They lie down, shivering. Their muscles start twitching," she said. "The vet said nothing can be done to cure it and put them to sleep."
"Is it an infectious disease to all dogs?" she asked.
"Yes," I said. "The virus attacks the brain cells and other parts of the body. There is an effective vaccination."
"Factory owners don't vaccinate the dogs," she said. "How come in a group of dogs, not all will die?"
"Some dogs will be resistant to the distemper viral infection. These will not die. It is like drinking a small potion of poison. You will not die unless it is a lot or very potent. If the dogs are dead, how come you are still feeding the industrial dogs?"
"Another part of the industrial estate," she laughed.
She continues her cycling to feed the stray dogs her home-cooked food.
"It is fortunate that your husband does not mind you adopting the stray puppy," I said and found that she adopted two.
"He nags and nags," she said. "I am looking for homes for them."
ADVICE
All Singapore dog owners should get their dogs vaccinated against distemper yearly but sadly, many don't bother. Dogs at dog parks, boarding and grooming should ensure protection from distemper by just taking time off to see the vet and get the dog vaccinated.
Referral is best but the vet must deliver
| |||||||||||||||
Wednesday, January 9, 2013
1236. Not recognised vet degree
Nobody can "influence" the AVA on your behalf unless you are the son of a
big important person, things may be reviewed again. That is a fact of
life.
I have given your resume to an employment agent. It is NOT possible for you to be a vet in Singapore due to AVA's licensing requirements of accredited vet universities for practising vets and your degree is not recognised by the AVA. .
But if you are flexible, you may get other industry jobs or even in Yangon. But the pay is not what you expected and if you are agreeable, you may get a job e.g. in a vet pharmaceutical company that is looking for a vet to provide after-sales services for its veterinary products to vets in Singapore and the region..
I am really sad that you are in this situation but life is full of ups and downs. Whether you can be resilient or not, it is up to you.
I have given your resume to an employment agent. It is NOT possible for you to be a vet in Singapore due to AVA's licensing requirements of accredited vet universities for practising vets and your degree is not recognised by the AVA. .
But if you are flexible, you may get other industry jobs or even in Yangon. But the pay is not what you expected and if you are agreeable, you may get a job e.g. in a vet pharmaceutical company that is looking for a vet to provide after-sales services for its veterinary products to vets in Singapore and the region..
I am really sad that you are in this situation but life is full of ups and downs. Whether you can be resilient or not, it is up to you.
House-call to vaccinate 2 cats
On Tue, Jan 8, 2013 at 8:37 AM, Daniei@gmail.com> wrote:
Thank you for your email. House-call will be $250 and 2 vaccinations will be $70. Total $320.
Hi. I live near Orchard and my two cats need their annual
vaccinations. Can you tell me how much it would cost to get these
vaccinations done via a house call?
Thanks,
Dan
Thank you for your email. House-call will be $250 and 2 vaccinations will be $70. Total $320.
Tuesday, January 8, 2013
1234. Anaesthetic risks for the young rabbit and the old cat
Jan 8, 2013
Recently Dr Daniel and I had 2 cases of high anaesthetic risks - the very young and the very old patient. Every vet will inform the owner of the high risks. Invariably, the owner would not want the operation. So, the disease progresses as in the following cases:
Case 1. Rabbit, F, 3.5 months
The lady bought 2 siblings at 1 month old at Farm Mart which is in Chua Chu Kang. This patient had a twisted leg but the appetite was "good." Over the next 2.5 months, her sibling doubled in size while this rabbit started to hide in a corner.
"She refused to move as she grows older," the lady had phoned me for the fees for amputation. "The two vets in the same practice wanted to charge $1,000 to cut off the leg. I have already spent over $1,000 treating this rabbit!"
"I have to examine the rabbit in order to quote you," I said. "If the surgery is short, the fees are lower."
The lady came while I was out. Dr Daniel advised amputation. "She wanted to try TCM (traditional chinese medicine)," Dr Daniel said when I asked why he had bandaged the leg.
I spoke to the owner as she was paying the bills after consultation with Dr Daniel and not accepting amputation as the medical advice. The rabbit's leg had swollen at least 3 times and multiple yellow abscesses flowered inside the leg. "Do you know that this rabbit's life is endangered as his leg will become gangrenous and septic, spreading bacteria to her whole body and killing her? I have already given you a below cost fee to amputate her twisted leg. Yet you want to try TCM."
"I tried TCM in the sibling which was similarly lame and he recovered," she said.
"The sibling did not have the same condition of fractured lowered leg that became twisted and infected," I had not seen the sibling but it is highly improbable that both siblings suffered fractured legs. The sibling was probably weak in his hind limbs but the fact is that he is a thriving rabbit, double the size now.
Recently Dr Daniel and I had 2 cases of high anaesthetic risks - the very young and the very old patient. Every vet will inform the owner of the high risks. Invariably, the owner would not want the operation. So, the disease progresses as in the following cases:
Case 1. Rabbit, F, 3.5 months
The lady bought 2 siblings at 1 month old at Farm Mart which is in Chua Chu Kang. This patient had a twisted leg but the appetite was "good." Over the next 2.5 months, her sibling doubled in size while this rabbit started to hide in a corner.
"She refused to move as she grows older," the lady had phoned me for the fees for amputation. "The two vets in the same practice wanted to charge $1,000 to cut off the leg. I have already spent over $1,000 treating this rabbit!"
"I have to examine the rabbit in order to quote you," I said. "If the surgery is short, the fees are lower."
The lady came while I was out. Dr Daniel advised amputation. "She wanted to try TCM (traditional chinese medicine)," Dr Daniel said when I asked why he had bandaged the leg.
I spoke to the owner as she was paying the bills after consultation with Dr Daniel and not accepting amputation as the medical advice. The rabbit's leg had swollen at least 3 times and multiple yellow abscesses flowered inside the leg. "Do you know that this rabbit's life is endangered as his leg will become gangrenous and septic, spreading bacteria to her whole body and killing her? I have already given you a below cost fee to amputate her twisted leg. Yet you want to try TCM."
"I tried TCM in the sibling which was similarly lame and he recovered," she said.
"The sibling did not have the same condition of fractured lowered leg that became twisted and infected," I had not seen the sibling but it is highly improbable that both siblings suffered fractured legs. The sibling was probably weak in his hind limbs but the fact is that he is a thriving rabbit, double the size now.
Subscribe to:
Posts (Atom)