Thursday, January 17, 2013

1248. Two interns: Electro-excision tumours in 2 dwarf hamsters

TOA PAYOH VETS
toapayohvets.com

Date:   17 January, 2013  
 

Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Electro-excision of a large ear wart or tumour in 2 hamsters 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   17 January, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
CASE 1. Ear wart or tumour

Nowadays, Singapore's pet owners are much more sophisticated and educated. I got an e-mail (below) with 4 images of the hamster's ear wart or tumour from the young couple in a yellow car.
 

...i@gmail.com>
12/9/12
 
to judy
 
Dear Sir/Mdm,

I have just discovered a tiny growth on the ear of my hamster. Attached are the pictures for your reference.

I would like to know if there is any treatment for my hamster and the cost of it.

If so, pls advise on an appointment date and time. Thank you.

Regards,
Name of owner

 
Kong Yuen Sing <99pups gmail.com="gmail.com">
12/9/12
 
 
 
I am Dr Sing from Toa Payoh Vets. Thank you for your email. The "tiny" ear tumour needs to be removed by surgery and under anaesthesia. The ear canals need to be examined for other growths.

The approximate cost is $150-$200 for consultation, anaesthesia, surgery (+/- stitching) and medication. Appointment is by phone 6254-3326.

Bring hamster at 9.30 am and it goes home by 4 pm usually. Best wishes.  

 
Sent from my iPhone
Although it is troublesome to set up the electro-surgery equipment just to excise a "small" ear wart, I am in favour of using electro-excision as the cutting needle is much more precise in cutting the skin. It takes time to sell my idea to Dr Daniel as he said it would be easier to snip off the wart with a scalpel. We did electro-excision and he is quite convinced it is a useful method as bleeding is minimal.

In retrospect, I would have used the circular electrode needle to go under the ear wart and slice it away. The straight needle electrode was used in this case but both achieved the same results in taking out the "small" ear tumour.

   
Image from hamster owner in the e-mail   Remove distracting objects (right) to avoid wasting time on cropping the image   Cropping required to take out the distracting object
   
The rule of thirds for better image. The hamster's eyes or body should be at the intersection of 1/3 of 3 horizontal and vertical lines to produce interesting images for the viewer
     
Straight needle electrode used. I should have recommended a  circular one to loop off the tumour   Very little bleeding and more precise cut when electricity has been use to cut off the ear tumour

CASE 2. A DWARF HAMSTER WITH A GIGANTIC TUMOUR NEAR THE LEFT HIP

Yesterday, Jan 16, 2013, two older women from "Street 12" came with a 64-g female dwarf hamster aged 1 year and 6 months. She had a gigantic tumour near her left hip. "She's biting the lump", one woman said to me. There was a scab of 2 mm x 2 mm due to the hamster's bite.

ANAESTHESIA & SURGERY
Dr Daniel seems convinced that electro-surgery is useful and efficient as he  used electro-excision of the skin. He excised the tumour which had some abscesses. I weighed the hamster after surgery. She was 50 kg. A heavy weight had been taken out. It was a high risk anaesthesia as the hamster was quite plump and the tumour was massive. However the hamster was still eating.

3 drops of Zoletil 50 was insufficient. "Don't use a large volume of normal saline to top up the syringe," I said to Dr Daniel. "The back muscles of the dwarf hamster is very little. It will be like the doctor injecting 20 ml of liquid into you back muscles. I usually top up the 3 drops of Zoletil up to 0.05 ml in the 1-ml syringe with normal saline before injecting the back muscles of the hamster (see video).

I had to use the mask to gas the hamster with isoflurane gas as the Zoletil 50 was insufficient in this plump hamster. Possibly 4 drops would be more effective in a 64-gram hamster or it could be too much and causes death. Much depends on the vet's judgment and experience.

This is where the risks of death increase because it is not possible to monitor the hamster's breathing and heart rate (ECG etc not practical in a dwarf hamster).

Any overdose of the isoflurane gas meant instant death. No such thing as resuscitation. So, I monitored the anaesthesia top up while Dr Daniel operated. It was touch and go. I had to make sure that the hamster was just below the surgical anaesthesia stage and so you would see some leg movement during stitching. It is NOT possible to achieve the ideal surgical anaesthetic stage as in the dog and cat.

The dwarf hamster is so small. "Surgery must be speedy," I said to Dr Daniel. "Undermine the skin, isolate the tumour, clamp the base with a curved forceps, excise the lump and stitch the skin with 6/0 interrupted sutures. All these to be done in less than 3 minutes."  The slower the vet operated, the more the anaesthesia had to be given and this is where the hamster "dies" on the operating table.  

CHECKING THE ACCURACY OF OWNER'S ADDRESS.
The had written "Street 12" in the address. I asked whether she had left out "Bishan Street 12"? Vets must check the records of addresses. She said "Pasir Ris Street 12". I asked an intern to do this case study. She did a video and case report.    

CONCLUSION
The hamster took some time to wake up. Two female interns were present. One of them was a single child. She spent much time with this hamster. "Look, she is vomiting the seeds," this lady intern said to me as she observed the surgery and did some video filming of the operation. "The hamster is dislodging the food from her cheek pouch as she is stressed by the surgery and anaesthesia," I told her. "This is a common occurrence. She is not vomiting." Her parents allowed her to keep one cat. Yesterday I told the parents whom I knew from 20 years ago that this daughter  should adopt more stray cats in her apartment. The mother wanted to kill me. "Don't you dare to suggest this," the mother said to me.

Many Singapore parents dote on the single child and will tolerate them bringing home stray dogs and cats or buy a puppy. In the end, it is the parents who have to care fore them. Yet yesterday, I met an aged mother, an old client, slim woman with white hairs at the side, from Bukit Panjang. Her 15-year-old Maltese X bought by her daughter long ago is so precious to the mother. The dog came in as she behaved aggressively when carried. The mother knew it was due to false pregnancy. Lots of white milk were present in the dog's swollen mammary glands. This dog still had estrus bleeding 2-3 months ago. At the age of 15 years which is equivalent to 105 years in a human being . This is in contrast to menopause in women at the age of 50 - 60 years. I asked permission for my intern to take pictures for her case study and she said OK. My intern would have written the case in 2013Vets blog.  

"Don't feed her," I said to the single child as the hamster wanted to store the seeds. The plump hamster laid on her back and sipped water from the water bottle while lying on her back. The owner came in the afternoon to take the hamster home. The vet must deliver a hamster alive at the surgery. The anaesthesia is the killing part and this is where a vet's reputation is smeared if the hamster dies on the operating table. No deaths should occur if the anaesthesia is minimal and the surgery speedy, but this cannot be guaranteed.

EDUCATION VIDEO ON ELECTRO-SURGERY IN THE HAMSTER
I can't link this webpage to the video taken by the intern as the video is in another blog called 2013Vets. See www.toapayohvets.com for the link to 2013Vets and get the video.   

Name of webpage:
http://www.kongyuensing.com/folder7/
201301117electro_surgery_hamster_toapayohvets.htm
 
More info at: Dogs or Cats
To make an appointment:
e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research

Copyright © Asiahomes
All rights reserved. Revised: January 17, 2013

Toa Payoh Vets

1247. Miccroscope to show images on laptop screen to client

The instructio​ns for the microscope
Inbox
x

These instructions are important for the vet. It is good to show the images to clients but the vet sometimes don't bother as it is too troublesome..  
Connect the microscope using the USB cable to the USB port
Start
Programs
ScopeTek
ScopePhoto
Acquire
Live Capture
ScopeTek DCM310

---------------------------------------------
 
To take a photo:
Top left corner, click 'capture a frame' and another window box will appear. Click the red X on the new window and a pop up saying 'image has been modified. Need save?' Click yes.

To view one of the shots previously taken, click file on the top left hand. Click open image and then choose which image you want.

1246. Animal activism. An abandoned animal shelter

Straits Times Jan 11, 2013 report: 31 dogs rescued from 'abandoned' animal shelter.

In Singapore, the government had designated some land in Pasir Ris as spaces for dogs. Entrepreneurs bidded for the land and build the kennels or tanks to house the approved species of animals like dogs, cats and fishes. They developed the land and rent out the kennels to private individuals, some of whom operated animal shelters.

However rentals are very high compared to other countries with lots of land. Hence some animal activists find that they can't sustain their operations as they board more homeless dogs. After some years if they don't have financial donations if they could not manage their operations. This would be probably what happened when volunteers at Madam Yap's Shelter in Pasir Ris had not seen its operator for many week and 31 dogs were 'abandoned'.

In animal shelters, the dogs needed to be vaccinated against the serious viral diseases of distemper and parvoviruses. They needed heartworm disease and tick prevention. However, it is extremely difficult to do all these preventive disease program if the shelter has insufficient funds.

A few days ago, I met an animal activist who rented Pasir Ris kennels for $8,000 per month. She had given up this shelter and relocated the dogs or rehomed them.She said Pasir Ris kennels would be taken back by the government in 2014.

Madam Yap's shelter is reported to cost $4,000 a month to operate. This included rent, utilities and a full-time worker but not food and treatment for the sick dogs. Save Our Street Dogs has taken over the place. Their email is sostreetdog@gmail.com 

There is another shelter called Madam Wong's shelter which is still operational, according to my intern who visited Pasir Ris last Sunday, being driven there by her father who doted on her. I had asked her to write an essay on "Animal Activism in Singapore".

 



Wednesday, January 16, 2013

1245. Recurring FLUTD in a cat



tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   16 January, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
REVIEW
A CASE OF A RECURRING FLUTD IN A CAT

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   16 January, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Jan 15, 2013
Recurring FLUTD (Feline Lower Urinary Tract Disease) can be very distressful to the cat and the owner. In one sad case, a couple’s cat with recurring FLUTD of more than 2 times died at a veterinary practice and the wife was very sad. This case was recorded reported in:
http://www.sinpets.com/F6/20120218FLUTD-cat-death-toa-payoh-vets_Singapore_ToaPayohVets.htm

The cat becomes more aggressive as he knows what the vet is going to inject and catherise him again and again. This was what happened to this 3-year-old, male, neutered cat. The brown-striped cat hissed at me as the lady owner placed him on the consultation table.

His spinal hairs rolled upwards making a ridge. However, Dr Daniel appeared not to distress him as he spoke to him while the lady owner kept a close watch. Then he held the cat by the scruff of the neck while I injected his back muscles with xylazine and ketamine to sedate him for a proper examination without stressing him more. The cat was catherised and urine was collected. He was X-rayed as Dr Daniel wanted to eliminate the presence of bladder stones. 

FOLLOW UP

I phoned the young lady owner today at 11 am to remind her that the cat’s diet must be strictly canned C/D for the next 4 weeks to prevent recurrence of blood in the urine and difficulty in urination.

DIET & URINATION
“What did you feed him before his urination problems?” I asked the young lady who returned my phone call.
“Dry cat food. Sometimes canned food mixed with dry food once a week.”
“Do you feed cat treats?”
“Yes, he loves them. I give him alternate days. Some reddish pellets. I can’t remember the name.”
“Does he drink water?” I asked.
“He seldom drinks. He will run away when I try to give him water.”

URINE ANALYSIS & X-RAYS

Date April 7, 2011
(22 months ago)
Jan 11, 2013
URINE ANALYSIS
Urine colour Red, turbid Yellow, turbid
Urine pH 8.0 8.0
Urine SG 1.021 1.026
Urine Protein + + +
Blood in urine 4+ 4+
White blood cells in urine 50 30
Red blood cells in urine >2250 1359
Bacteria in urine Occasional Occasional
Crystals in urine* Nil Nil
X-RAYS
X-rays Not done No radio dense stones
Outcome Treated by an associate vet of my Surgery. Given 2 cans of C/D. No complaint for the next 22 months Recovered as at Jan 15, 2013. Fed canned C/D for next 4 weeks and review. No treats or dry food strongly advised by me.

CONCLUSION
* No crystals in the urine does not mean there are no Struvites or other bladder stones inside the bladder. The cat was sent home on the same day after catherisation and irrigation of the bladder. The cat tore out the urinary catheter at home on the second day. On the 3rd day morning, the owner phoned me saying the cat had difficulty peeing. In the evening, the cat was normal and there was no blood in the urine. Owner compliance with the vet's instructions on medication and prescription diet is invariably poor and so the FLUTD recurs in many cases. 

Is this case of FLUTD a case of interstitial cystitis (painful bladder) similar in human beings since there is apparently "no struvite stones" inside the bladder? The presenting sign was the cat having difficulty in urination but no urethral abstraction.

Will hydro-distension of the bladder, DMSO and other drugs supplied into the bladder resolve the problem of recurrent FLUTD? Nobody knows as the causes of FLUTD in a cat are numerous.
ADVICES
1. Owner adds 2 tablespoons of water into the C/D food. Cat does eat C/D but will not drink water given by the owner. “When he was sick in Jan 11, 2013, he drank a lot of water,” the lady said. “But now he turns his mouth away when I give him water!”

2. Continue C/D canned food for at least one month. Water added to the canned food.

3. No dry food and no cat treats anymore.

Webpage:
http://www.kongyuensing.com/folder5/
20130116Recurring_FLUTD_cat_3years_toapayohvets.htm
 
More info of interesting case studies at: Dogs or Cats
To make an appointment:
e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research


Sunday, January 13, 2013

1243. Mum's favourite dog died at the Surgery.

The "7-year-old" Silkie had difficulty breathing for the past 4 weeks. X-rays showed an enlarged heart. Two years ago, I had recorded harsh lung sounds on the right side of the lungs. Dental scaling and extraction of several loose teeth were just done in March 2012.

The dog wanted to bite me 4 days ago when she was put back into her carrier and the mum took her home after a day's stay in the Surgery for treatment of the lung condition. 1 day ago, the dog could not breathe normally again and was treated. For some unknown reason, the mum decided that the dog would be hospitalised. The dog was quiet and did not attempt to bite me when I checked at 8 pm. The next morning, the dog had passed away.

"I should have taken her home," the mum repeated. "He died of fright as he had never been away from hom at all."

"I did not expect him to pass away," I usually sent the dog home if I think the dog is very ill. "She died of heart failure as you can see the tongue is purplish."

This dog was mum's favourite, one son told me. "He would bite any one who goes near the mum. He is more than 7 years old as my brother got him back as an adult dog."
"Was she having difficulty breathing in the past months?"
"Yes," the girlfriend said. "She would be breathless when walked a short time."  

The dog's teeth were dark yellow and most were gone. So, this dog could be older than 7 years.

1242. A caterwauling and anal sac marking male cat

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@" 

   

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.
    

1240. How to create an interesting video?


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   13 January, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
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?v=kWkbYU0dZwM

http://www.youtube.com/watch?v=ODSUlKygenc

http://www.youtube.com/watch?v=BKuotAsSRAA

Friday, January 11, 2013

Be proactive and create









Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
First Romance or Fall In Love With You? 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
For the past 20 years, I have been writing text and inserting images.

Now I 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 at Malacca in late 2012. There were around 700 participants from Malaysia, Singapore, Indonesia, Thailand and Australia. I am not a Peranakan (Straits-born Chinese adopting the Malay culture), Instead of sitting down with strangers making small talk, I took my camera to the dance floor and tried to do some videos. One video may be of interest to viewers.
http://www.youtube.com/watch?v=L0f0ZTKlS6U
HOW DID I PRODUCE THE VIDEO ABOVE?
Hook - Protagonist -- An attractive woman with flower in her hair. She loves dancing.
Introduction - Crowded dance floor. Focus on this dancer if possible.
Middle - Antagonist -- Another good-looking woman who loves dancing too. Unable to video protagonist as the dance floor is crowded.
Break boredom of viewer -- I angled the zooms lens vertically. Not a good idea.
Zoom on singer
A camera man went into the dance floor and blocked my view.
Steady hand to produce good video with focus
Back to protagonist
Antagonist is hearing some conversation but the music is loud.
Other dances
Ending - End of song

Is this video capturing the attention of viewers? I think so. But it is up to the general viewer to judge.

Join the fun rather than just eat and watch the poor quality TV screens of the dancers. See the real people and appreciate life if you know how to dance!

I thought the song was "First Romance" but could not find it in You Tube. I grow up listening to Cliff Richard's songs. At that time in the 1960s, there were no distractions like coloured TVs and the internet or mobile phones.

I presume 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=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. Unfortunately, the young generation seldom hear them as the baby-boomer generation was too busy building up their careers working long hours. I may go to the Cliff Richard's performance in Singapore in Feb 2013.

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.  

Referral is best but the vet must deliver

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date: 11 January, 2013

Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Referral is best but the vet must deliver Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 9 January 2013
Date: 11 January, 2013
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129

Wednesday, January 9, 2013

The 14-year-old Burmese has 3 large abscessed mammary glands

Yesterday, Wednesday Jan 9, 2013, I phoned the gentleman to follow up on a hissing 14-year-old Burmese cat brought in on last Saturday and advised by Dr Jason Teo to operate.

So on Sunday, Jan 6, 2013, I phoned the owner to tell him the high risks involved. "Your cat may just die on the operating table," I said. "She has fever and infections of the ulcerated breast lumps - half as big as fish balls and very smelly."

"I will ask my mum first," he later phoned me to give consent. I decided to get the cat operated on Sunday, 24 hours after admission and after antibiotic injections given. The cat was angry and so she was still in good "health" for one with such smelly mammary ulcers. Dr Daniel would operate. This needed to be a fast operation. The problem was the dosage of anaesthesia. How much that would be effective and not kill the old dame?

"Give xylazine 0.1 and ketamine 0.4 ml IM," I said to Dr Daniel. Clip the hair and bathe the cat after sedation as this is an angry cat."

Dr Daniel had used electro-excision to remove the 3 tumours. I had one young lady intern with top academic results waiting to study vet in Australia. She put a finger to cover her nose. I was surprised. "My father is house-proud," she said when I asked whether she lived in a fragrant household with aromatherapy. Definitely no smells of infection and sick animals.

"Not cutting well," Dr Daniel said as the long elliptical incision of the skin to remove all 3 tumours by the needle electrode did not seem to be effective. "Well, the contact with the skin of the inguinal area is not there," I pressed the soaked saline gauze and folded the return plate so as to close the circuit for the electricity to cut through and return back to the equipment. Mr Min was monitoring the gaseous anaesthesia and he was good at this.

AN INTERN CAN'T STAND THE SMELLS

The young intern was really feeling nauseous as the wisps of smoke on flesh and the putrefying smell of the ulcerated mammary glands filled the operating room air.

"You better go outside," I wondered how she would be able to pass out as a vet. The next day she wore a mask. Another day, she wore one glove when she handled a skin-diseased dog so as not to infect her own cat. She would wash her hands after touching a dog and her mum would remind her. "I can be a hygienic vet," she said to me. Top grades from a top class in a top school and money of $300,000 or more to fund her veterinary studies- what more does a 19-year-old scholar desire?

I did not expect this 14-year-old cat to survive the anaesthesia. She was thin. She was bright 12 hours after surgery after fluid therapy and antibiotics and pain-killers. I phoned the son to take her home as cats usually don't eat at the surgery.

As a follow up with trepidation, expecting bad news, I phoned the owner yesterday which was Jan 8, 2013 at 5 pm. "My cat is very active. Eats a lot. Walk here and there! My mum is very happy as the cat was not eating."
"Did she lick the stitches?" I asked.
"She has an e-collar and could not lick." Actually it was the tolfedine pain-killers that made her so normal post op.
"How did you give her the tablet medicine?" I asked.
"Just crush the tablet and mix it inside her food - canned food. No problem."

CATERWAULING
As this cat was never spayed, I enquired how he coped with angry loud meowing which could be misconstrued as beating up the cat in some cases of caterwauling.
"No problem of noise nuisance due to her being 'bising' (noisy)," he said.
"Does she still do it? At this age? "
"She does it 3-4 X per year. But not nosily."

PRE-OP CONDITION
I asked about the cat before op as this was a first-timer and Dr Teo was consulted. I worked from 9 am to 11 am on Saturdays usually and the client came later.

"Day by day, she lost appetite," the son related the history of his cat during this follow-up call. "She became very weak. My mother wanted the cat to be cured but at the same time did not want to lose the cat (to death on the operating table). Yet my cat will suffer more if no operation is done."

"How long were the lumps present?'
"The lumps were small some weeks ago but started to grow bigger and bigger recently," the owner said.
According to the operating surgeon, these could be abscesses. To save money for the owner, no lumps were sent to the laboratory for histology to check whether they were breast cancers or not. The owner confirmed that he had this cat as a kitten and therefore she was 14 years old.

STITCH OUT IN 14 DAYS
I advised stitch out in 14 days as most cat owners don't come and the knots get buried into the skin and cause stitch abscess and irritation to the cat some months later. The Monosyn stitches used look like nylon and are absorbable..



REFERRAL
He lived in Tampines, near the Changi Airport. This is a 15-minute drive to Toa Payoh Vets and there are several vet clinics closer to him.

"Why did you come to Toa Payoh Vets when there are vets nearby?" I asked this filial son. "My friends in Bedok refer you to me."

I guess these friends were the two Malay ladies with cats that I had vaccinated some weeks ago as I seldom have any clients from Bedok. Proximity is the choice of pet owners as most Singaporeans are time-pressed and so the majority of clientele for me would be around a 5-minute drive to Toa Payoh Vets.

Referral is best as the client trust is there. But the veterinary surgeon must deliver. Nothing less than a live 14-year-old cat at the end of surgery and being alert and hungry at home after surgery. Essentially, this means assessing the anaesthetic risks such that the minimal dose is given without killing the cat. How do you do it? This depends on the good judgment of the individual vet.

In this case, Dr Daniel asked me and I judged that this 4-kg Burmese cat should be given xylazine 0.1 ml and Ketamine 0.4 ml IM and it was effective and safe. "Do a fast surgery in an old cat," I advised. "Electro-excise the 3 big lumps as fast as possible. Ligate the main vessels. There were no big blood vessels to ligate as I expected some from the caudal superficial blood vessels. Perhaps the tumours were necrotic and septic and the blood supply was being terminated or damaged.

UPDATE AS AT JAN 11, 2013
As at Friday, Jan 11, 2013, no news from the owner. In this case, no news is good news.  


Some problem with blogger.com's alignment of text. URL is at:
http://www.kongyuensing.com/folder7/20130110burmese_cat_breast_tumours_toapayohvets.htm
 

 

A case study of recurring urolithiasis in a Miniature Schnauzer - Struvites Video: Kidney & bladder stones
More info of interesting case studies at: Dogs or Cats
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Clinical Research

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.

House-call to vaccinate 2 cats



On Tue, Jan 8, 2013 at 8:37 AM, Daniei@gmail.com> wrote:
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.