1413. Sunday May 12, 2013's interesting cases. The senior citizen man has a swollen foot

Sometimes, the vet has to care about the client's health although this is the domain of the medical doctor. The couple brought two Bichons with itchy necks and rashes all over the body for consultation. 

As there are over 50 vet practices now, I rarely get cases from Tampines which is near Changi Airport and is a half-hour's drive to Toa Payoh Vets and so I was surprised to see this couple. They wanted to buy a bottle of multivitamins in the belief that this would cure the itchiness. They had bought Neoderm cream which was effective.

"It is best to see the dogs," I explained to the couple. Times are hard for senior citizens and if the skin diseases cannot be cured after two consultations, then self-treattment is usually done by many Singaporean dog owners.

Both Bichons had extensive redness below the neck and on the face. Rashes scattered all over the body except the ventral part. The dogs wore clothing to prevent scratching but this was futile. From the signs, the main cause would be ear itchiness leading to continuous hind leg scratching and scratching of the flanks and self-inflected biting of the back and body. 

"The skin has been injured by the daily scratching. Skin wounds and rashes become infected over the months. To the owner, it seems that the skin is badly infected and he buys oil,cream and shampoo over the counter to treat the disease. Without success if it is a fungal and bacterial and yeast infection."

I had the dogs clipped bald, the excessive ear hairs plucked. As the gentleman was wearing slippers with straps over and across the foot, I noted that the left foot was much swollen. The swelling under the cross straps was absent due to the pressure. "I can't wear shoes and these sandals are useful as I can adjust the width as my foot swells."

"You will lose your foot if you continue," I said. "How long and have you seen a doctor?"
"Just 8 weeks. The doctor said I could have gout or arthritis and gave me some medication."
"I think it is likely a tumour - a nerve sheath tumour at the ankle growing and obstructing blood flow," I said. So, the fluid from the blood vessels of the obstructed area spills out and accumulate under the skin, leading to such a swollen foot. If you delay further, you lose this foot and will be hopping around on one foot. Have you got an MRI  or CT scan of the foot?"

He had not. He would go to the polyclinic to get an appointment to see the specialist. "By the time the specialist sees you under this system, it will be a few months. Your foot may become gangrenous and need to be amputated."

I advised him to see a private specialist at the Singapore General Hospital. "How long do you think you will live?" I asked this 65-year-old man.
"Men live up to 85 years."
"Men live shorter lives than women," I said. "Many have died before they reach 60 years of age, owing to poor health."
He agreed to see the private specialist next week as he said: "I believe the swelling has a more sinister cause." I guessed his wife was grateful for the advice. Men are inert when it comes to their health and in this case, an MRI would have detected the cause and he might save his foot.

1412. Email query: Neuter of male hamsters and outcome of surgery

On Sun, May 12, 2013 at 10:54 PM, J@gmail.com> wrote:

> Good evening,
>
> I am keen to get my male hamsters neutered because I want to keep all of
> them with their partners.
> I do not want them to keep reproducing and end up selling them away due to
> space constrains.
> I have a total of:
> - 1 male at 8 months old.
> - 2 males at 5-6 months old.
> - 1 male at 2 months old.
> - a few newborns (still have not determined their sex yet) at around 1 month
> old.
>
> I want to know about the pricing as well as what are the chances of a
> successful operation.

--------------------------------------------------------------------
Neuter of male hamsters cost around $75 for anaesthesia and surgery. Pl make appointment at 6254 3326. The earliest age to neuter will be around 3 months of age.

Chances of a successful neuter are 100% at Toa Payoh Vets for the normal healthy hamsters as anaesthetics used are safe and effective. Sick hamsters are not neutered. .

1411. Follow up: Cat with bladder stone surgery & owner's preferences of vets

TOA PAYOH VETS toapayohvets.com Date:   11 May, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits The vet said that the cat would die   Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   11 May, 2013  toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Friday, May 10, 2013 1411. Follow up: Cat with bladder stone surgery   Friday May 10, 2013 "Remember the cat? You said it would die under surgery!" the busy gentleman drove over to buy the C/D dry food and canned food for his cat after ensuring that these were available. He had ordered earlier and deliveries by the Science Diet supplier arrive only on Thursdays of the week. His cat had run out of the canned food. "Yes, I remember your cat" I said. Cats with bladder stones are relatively a rare occurrence in Singapore and this was one with impending kidney failure according to the vet who had taken blood test. The owner wanted an immediate surgery since his vet who diagnosed the condition would not do it owing to lack of experience while the senior vet had a full schedule of surgery. It is best not to operate on a cat with impending kidney failure as the cat would die. I waited one day so as to give antibiotics since the other vet did not do it. The cat die not die under surgery but the owner never forgets the "cat will die if operated upon" informed consent. "How's the cat?" I asked. "Put on weight. Back to his naughty pesky self now, as normal." he said. "Can I keep the prescription diet inside my car as I cannot go home immediately?" "No," I advised finding a covered car park. He was such a busy person but he took time off to buy the special food for his cat before the stock runs out. His cat eats one can per day. Most Singaporean cat owners will not be bothered. He told me his cat will eat the canned food whether it was refrigerated and cold and also any brand of cat food. This is surely an unseal cat as most cats are fussy. I am glad his cat is normal and there is the chance to follow up with him. I told him that the supplier will deliver to his home if he pays me first for the next order.  "The supplier does not want the hassle of collection," I said. He would transfer the money to my account electronically first. Actually he could have bought the food from the vet nearby but he did not do so. The vet was the one who diagnosed the bladder stone and I am sure she would just sell him the special diet. Pet owners have their preferences of vets and it is up to the vet to build up the relationship of trust and goodwill as there is nowadays a vet round the corner. Owners have to make an extra effort just to go to a vet "far away" just to buy the special diet which is easily available at most vet practices in Singapore.   Calcium oxalate bladder stones in a much loved cat An informed consent must be given prior to anaesthesia and surgery. It should be in writing but in this case, I emphasized orally the high risks of death since the cat has kidney disorders based on blood tests and surgery could not be postponed for a week. I suspected the cat could suffer from a bacterial nephritis based on high total white cell count so a pre-emptive antibiotic injection which the other vet did not administer would increased the chance of success. In this case, the odds were in my favour after a Baytril antibiotic injection SC 24 hours ago. The cat survived the bladder stone removal surgery. Unfortunately for me, the owner never forgets my warning that "the cat will likely die during the anaesthesia and surgery" and will remind me whenever possible. Many vets will suffer my situation when the cat they say will die from a serious disease lives up to a ripe old age! He had Hobson's choice and I had been fortunate that the cat did not die on the operating table and the fact that this owner detected loss of appetite in less than a week. Many cat owners wait and see for several weeks before they seek vet consultation. No vet can predict the surgical outcome in taking on high-risk anaesthetic cases. Use evidence-based medicine always but sometimes the owner's financial situation prohibits blood testing and in this situation, it is difficult. In such situations, use minimal injectable sedatives, use IV drips and isoflurane only.    Updates will be at: Calcium oxalate bladder stones in a much loved cat. More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: May 11, 2013 Toa Payoh Vets

1410. To publish*****: Myanmar Stories - The maid ran away again

TOA PAYOH VETS toapayohvets.com Date:   11 May, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits The maid ran away again   Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   11 May, 2013  toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Thursday, May 9, 2013 1410. Myanmar Stories - The maid ran away again The following are text messages from Swee Swee, a 27-year-old Myanmar maid to her employer, Mrs Robinson and her employment agent, Aunty Khin: Message 1 I went to kill my self .I wernt to die mardam.Please i went to stay along .Icamback later .Not finish rezult .please sorry nor i very sorry. Yes i go  aunty khin office. (From: Mrs Robinson to Khin Khin -  This is a message from Swee Swee!) Message 2 Unty ye,u went to inform police me i go ready .But now  i have very inportant problem .This one finish i can go.I went to die .Iwent to run away . Everybody cant help me . I went to killy self . (From: Khin Khin) Message 3 later i comong ur office. I explain  all unty .I coming rearly.Now i go hospital waiting me .nor unty. (From: Khin Khin) Message 4 Ko gyi i coming now . Now i    near sea.I went to die. (From: Khin Khin) --------------------------------------------------------- I had met Swee Swee 3 months ago when she got the job as a domestic worker through Khin Khin Employment Agency. I was visiting Khin Khin at her office. Swee Swee had worked for a Singaporean employer before and her conversational English was good. The new employer, Mrs Robinson was a very kind Caucasian lady who paid Swee Swee $550/month, one Saturday off per week and some time off during the weekdays. There was another senior maid who took off on Sundays. The job was to look after the aged mother and do house-work. The Caucasian couple travelled overseas most of the time and so there was practically much free time for two maids. Singaporean employers typically pay around $300/month with only one day off per month. The asking salary nowadays is now $450. So Swee Swee had a higher salary, a dream job and she was most happy. She earned more than her mother who worked as a teacher in Myanmar. But love came in like a ferocious lion. From what I was told, Swee Swee thought she was pregnant. She had at least one male friend in Singapore. "But the friend she named as responsible for her pregnancy said it was not him," Khin Khin told me. "He said Swee Swee was having menses last month and so he could not be the father!" Khin Khin advised Mrs Robinson to terminate Swee Swee's services in order not to lose the bond. Employers have to pay $5000 if the maid disappears. Swee Swee came back and Mrs Robinson forgave her and said: "After all, she is young and young ones make mistakes. We were all young once." But 5 days later, Swee Swee disappeared again. It was hard to contact her as she would not answer her handphone. This time, Mrs Robinson reluctantly terminated her services. I had come back from a holiday in Europe and visited Khin Khin at her office on May 10, 2013. "Lots of problems in the office," Khin Khin always complain about problems. I always say: "If an employment agency is so easy to operate, why are so many people employees? All Singaporeans will open employment agencies instead of working for others since there are no problems. All business owners have work and staff problems till they go bankrupt or die. Why don't you just go back to Yangon and retire as a lady of leisure? You don't need the money." Three months ago, Swee Swee had shown me her phone images of her family, her friends and house in the Irrawaddy Basin when I first met her at the employment agency. She was a personable short delicate-framed lady, the type of personality and  happy facial features that everybody likes. "The man does not love you. Now you lose your job," I said to her as she, Khin Khin and the manager sat in my car on the way back to Mrs Robinson's condo in the prime district 9 of Singapore. Swee Swee rubbed her nose and shook her head saying: "I don't care." She must be glad as she was not pregnant. She had asked Aunty Khin for money to buy the pads earlier in the day, speaking Myanmarese. She was wearing shorts as is the common practice with the young ladies of Singapore.  "Go and ask Aunty May for a longzhi (sarong)," Khin Khin gave her ten dollars." "Aunty May will charge her," I know Aunty May needs to charge for services since her business of employment agency and organising meetings and publishing were not making much money and rentals had gone up. A few businesses including employment agencies, trading companies and the seamstress shop had closed in this mall. "No," Khin Khin said. As I was going back to the Surgery at 5.30 pm to continue my consultation, taking over Dr Daniel, Khin Khin, her manager and Swee Swee hitched a ride from me to Mrs Robinson's condo.  The storm clouds had burst as if the skies were weeping for the runaway maid who lost a very good job in the name of romantic love. Black clouds poured buckets of water on my windscreen. Visibility was 1 metre ahead but I knew where the condo was as I had been in this Cairnhill Road condo built some 20 years ago. "You have such a large maid's room in this type of old condo," I said to Swee Swee. "Other maids have to live with the family members or in a small utility room just enough for a bed. In Hongkong, some live in the living room." "She even has a big LED TV inside her room," Khin Khin laughed. This was a luxury job at $550/month, one Saturday off/week and freedom to go out after work to visit Aunty Khin. But materialism lost to romanticism just after 3 months as a maid in Singapore.   The next day, she would be escorted back to the airport by Khin Khin's manager on a one-way ticket to Yangon. She would then take a bus to the Irrawaday village and be welcome home. For young ones with family support especially for Singaporeans from the middle- and higher- income families, the motivation to earn more and be independent is not as much as for those who are hungry and ambitious to make a living and become an expert. The same situation applies to other countries too and much family funds are wasted sending the young ones overseas to work or study to improve their station in life. P.S. Many Singaporean employers may sound heartless as they only permit their maids out once a month as they will lose their $5,000 bond if the maids run away. There are men who befriend such maids on their days off and so it is hard for the young maids to resist when love comes out of the blue. Many have lost their jobs in the name of love.             Updates will be at: http://www.sinpets.com/letters/20130511 pregnant_maid_toapayohvets.htm More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: May 11, 2013 Toa Payoh Vets

1409. Animal activism - the young Singaporean lady

TOA PAYOH VETS toapayohvets.com Date:   10 May, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits A stray dog got pregnant young   Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   10 May, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 1406. Animal activism. A pregnant stray dog has a black tongue May 7, 2013. I reached Changi Airport from Amsterdam at 5.30 am Singapore time and arrived at the Surgery at 9.10 am to check on the administrative processes and cases done while I was on leave for 12 days. It is part of the responsibility and good management. If the leader (vet) is lazy and come late to work, don't expect the staff to be hardworking -that applies to all businesses. As expected, my assistant turned up at 9.14 am thinking I was still overseas. I had spoken to him about work attitude but some young people lack self discipline. It should be 3.15 am now in Amsterdam and I ought to be sleeping. The first phone call I answered was from a young lady asking whether the vet does house-call and how much. I said we do house-call and the fees start from $250 but not every dog can be treated on the premises. "A pregnant black cross female dog at the Ang Mo Kio factory is walking here and there," she said. "Can a vet do the check up? The side of her tongue is black." I wanted to give her the dog transport man's phone number. She was hesitant as this might upset the dam. "You can accompany her," I said. "Some dogs do have black tongues from birth. Some black pigments on the tongue," I said.    "Is the dog eating and drinking normally?" I asked. "Yes," "Is she peeing and pooping normally?" I would say that the black tongue was natural since the dog did not show any signs of salivation, bleeding ulcerations and was eating. "Yes." "Is she active?" "Yes," the young lady said. "How long has the dog been pregnant?" "2 months ago," she replied. "Did you see the mating?" "No, I know it is 2 months. Everybody loves her. She is a friendly dog." "She may be giving birth soon" I did not explain that the pregnancy is 60 days as nowadays, the young lady Singaporeans are well informed by researching the internet on canine gestation.  I just read the Sunday Times dated yesterday on the Singapore Airlines flight back that there are 30 animal welfare groups as compared to many years ago. Some female Singaporeans go on animal care tourism e.g. panda parks. "Find a big box, towels and newspapers. Put the box in a quiet place e.g. the landing between floors to provide privacy for giving birth." It was not practical advice as this was an industrial park and no privacy in between floors would be available to give birth. The lady said so accordingly. "How about near the Security Guard house?" I asked "No, the guard will not permit it esp. during daytime." Where to place her for birth? The young lady came to the conclusion that the dog was wandering around to seek a private space. So this young lady is an animal welfare activist. Her action reminded me when I was in the Bukit Merah Primary School. I used to bring bread and food to a nursing female dog on the first floor of the landing of the Redhll flat. That was 50 years ago. Now, there will be a few hundred young female Singaporeans taking care of the disadvantaged dogs. Men are fewer. As for this pregnant dog, I told the young lady that a house-call was not needed. She thanked me. P.S. The lady send an image of the dog to my iPhone the next day. The dog is a cross-bred and looks like a one-year old based on her snow-white teeth.  I asked the young lady to contact the dog transport man who will bring a microchip scanner to find out if the dog has a microchip. She suspected that the dog could be lost or abandoned. I would hazard a guess that this is a stray dog that survived being captured by the authorities and pest control contractors hired by town councils to get rid of stray dogs and cats, through the kindness of the young Singaporean workers in the industrial park and non-protests from the older ones. She got pregnant young and is looking for a den to give birth. Recently, I read 3 newspaper reports of two stray dogs being captured and put to sleep by the authorities causing distress and protests from the animal lovers in the neighbourhood. A member of parliament who adopted one black stray dog also lost it as she wandered out of the house and disappeared.  In 2013, stray dogs are quite rare unlike 20-30 years ago when one could see them around coffee-shops. As a country advances, the strays get easily trapped and eliminated by the authorities or are protected in safe havens.  Updates will be at: http://www.sinpets.com/F5/20130509pregnant_stray_dog_toapayohvets.htm More info at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research

Copyright © Asiahomes All rights reserved. Revised: May 10, 2013 Toa Payoh Vets

1408, Internship - Republic Polytechnic

I am Dr Sing Kong Yuen from Toa Payoh Vets. Thank you for your email.
Pl come for an interview, with your resume and testimonials, at 10 am on a weekday or Sunday. Phone 9668 6468 for the date.

On Thu, May 9, 2013 at 2:17 PM, A...@hotmail.com> wrote:
> Dear Sir/Mdm,
>
> Hi, my name is A... I'm a student from Republic Polytechnic currently
> doing my Diploma in Biomedical Sciences. I am in my 3rd year now and I'll be
> having my internship this coming October. So I would like to inquire in
> advance about the internships/attachments you have available.  I would like
> to work and get the experience working in a veterinary clinic and learn
> about the procedures and how animal patients are being cared there.  I
> really have a great interest and passion in helping animals and I would like
> to further my studies by doing Veterinary Science after graduating from
> Poly. I do not have any experience in studying veterinary or animal science
> currently, but I would love to learn and gain my experience from working
> with the doctors and animal patients  there. I have had experience in caring
> for birds and animals at the SPCA and at home likewise. So is this possible
> for me, even though I'm not a vet student?
> Thank you for your attention, I hope to hear from you soon.
>
>
> Yours Sincerely,
> A..

1407. Internship plan for RI students - July 29 - Aug 9 and Aug 19 to Aug 30, 2013 (2 weeks)