1110. Myanmar stories - The pretty girl

TOA PAYOH VETS toapayohvets.com Date:   01 September, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits Myanmar stories - The pretty girl     Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   01 September, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Friday, August 30, 2013 Friday Aug 30, 2013 I visited Khin Khin Employment agency at 3 pm as I am off work during the weekday afternoons and wanted to help organise her management of this business which was not my cup of tea. I have no share in this business but it has many management lessons for my veterinary practice. . "No internet connections," Khin Khin complained. "Singtel pushes us to contact the modem maker who passes the buck to Singtel!"  She needed the internet to connect with the Ministry Of Manpower to submit forms for job applicant.  Owing to her persistence and aggressiveness, the Singtel girl phoned back and said they would send somebody the next day. This was a problem as she could not wait. I had a little knowledge of modem. I advised "switch off and on" for the modem or "reset".  My advise was useless.  Her manager put a pen into the "reset" point but there was no effect. The "red" light still remained. "It should be green if the modem is working," he said to me. So, nothing could be done. "Check the network connections," I said. "Done. No use." the manager said. He liked to tell me he is a computer graduate from Myanmar and he does know much more about setting up websites than me. "Try again," I said. He clicked the various names of wireless network source. The neighbours had security password and so there was no hope of connecting to the internet without knowing their password. But there was one called "Gateway". Clicking on it connected the computers to the internet. So work could be done. As to who "Gateway" was, we don't know. Somebody who had not inserted a security password to log on or a hacker? A second problem came as I was advising Khin Khin's manager to keep proper records. Next year, the MOM wants all accounts to be audited. More money for the auditors and economic hardship for the employment agencies as the bureaucrats demand more compliance and dictate the amounts of fees to be charged to job applicants instead of letting the free market work. The manager did not know how to devise an Excel formula for the balance of profit and loss in the accounts. I asked him to check the internet forum. No use. Finally I asked him to subtract the "sum of column of profit from the sum of column of expenses". The formula worked.  "The loss figure is in 'brackets'" I told him as he expected a "minus" sign. Read widely about financial statements and you will know that bracketed figures represent "minus" or loss in accountancy. Suddenly a stocky Myanmar man in his 50s, looking like one of those cooks came with a bag of goods. "What's inside this bag?" I asked Khin Khin. "They are presents for the 'pretty girl,'" she said. Khin Khin knows I have difficulty remembering Myanmar names and so called her the "pretty girl". She is in her mid 20s and dresses quite well whenever I met her. I had mentioned about her in one of my previous Myanmar stories. Khin Khin and she had gone to the famous temple to thank the Gods for her getting employment successfully. She lost the job subsequently and went back to Myanmar. But she  found a better one. The employer was setting up an office in the Philippines and wanted her to go there. She found another good employer working 5 days a week. She is staying with Khin Khin sharing the house with other Myanmar people. I believe she is a draughtswoman. Her conversational English is good. I believe she is hard working as well as being good looking and so the boss likes her. Good looks are unfair advantages in the office if the employee is industrious.   "This man does not charge for the courier services because she is a pretty girl," Khin Khin said to me. "Yesterday, I had free dinner as the other tenant cooked for the pretty girl." "How come you have to pay for courier charges to send things to Yangon?" I teased her as she seems to fixate on looks and condemn those Myanmar job applicants who are not in good physical shape. "I am old and ugly," she remarked. Actually this man is a sailor and collected the goods from the mother of the pretty girl.  Unlike many Singaporean mothers, this mother wanted her to work in Singapore. "Why?" I asked Khin Khin one day as Singapore mothers will not want their daughters to be away from Singapore if given a choice. "So that she will not be near the man whose family quarrelled with her mother. This man is very persistent and wants to marry her. But her mum will disown her if she does that." It seems Myanmar mums are quite strong personalities. Khin Khin would take all her husband's salary when he was working in Singapore and dole him an allowance.  How many Singapore husbands  will do that I wonder. Probably none. The pretty girl's mother was said to make several thousands of dollars on flipping properties in Myanmar as presently there is much asset appreciation in Yangon. "If it is so easy to make money," I said to Khin Khin. "Why don't you sell your apartment in Yangon and make money instead of struggling in Singapore? Now your office of 250 sq ft is reduced by 50% as you rent to another sub-tenant. The office now is so crammed that 5 people would fill up the room!"   This Friday was memorable in that I felt dizzy at around 8 pm as I sent the two RI interns to the Bishan subway and nearby apartment. I quickly drove home thinking I would be getting a stroke. Fortunately, it was food poisoning as I had diarrhoea with lots of gas and recovered the next day. The two RI interns had produced an excellent movie on the 15-year-old closed pyometra and uterine torsion case as they enacted the true story well. It is difficult to produce the dialogue but they did it. See: Video Part 1: Closed pyometra & uterine torsion - Part 1 Video Part 2:  Closed pyometra & uterine torsion - Part 2   Updates will be on this webpage: www.sinpets.com/F6/20130901pretty_girl.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: September 01, 2013 Toa Payoh Vets

 

1109. HOW YOUR OLD DOG CAN LIVE LONGER. Follow up: Westie with bladder stone - 26th day post op

Saturday 31 Aug 2013  9.38 am

Wife who loves this 10-year-old Westie much more than husband came to get stitches out.
"26th day after op," she said. "Stitches still there."  These absorbable PDS sutures are really lasting. Seldom dissolve early. The dog was active. Stitches taken out. A small skin haematoma at one end expressed. Video image.

The dog vomited on Day 16 to 21. The couple was much concerned and wanted antacid as he read on the internet that his dog was suffering from stomach ulcers. "It is hard to tell what he is suffering from without tests," I said. I gave him the antacid and changed antibiotic tablets to Vibravet paste.
"Stop the dry U/D diet."
No more vomiting two days later and today the stitches are taken out.

"He is still urine-marking a lot when outdoors," she said. "Every few spots, he will lift his leg. At home, he does it 3-4 times a day if he is not outdoors."

"Male dogs do that," I said. "Neutered ones may do less times or not at all. Holding back urine causes bacterial infection and then stone formation, leading to blood in the urine or difficulty in urination."
"Is it too risky to neuter him now?" she asked.
"Based on his blood test and examination, he is fit for anaesthesia. Neuter and dental scaling 3 months from now will be best. Get urine tested 3 monthly to check for infection of the bladder"

The owner wanted 24 cans of U/D and went home quite happy with this dog who keeps looking for the canned food by tapping on the feeding area. He has a voracious appetite and is now 8.1 kg making him heavy to be carried.

TIPS
Besides proper care of the older dog, get him health screening and urine tested. Prevent urinary stones by urine testing +/- X-rays regularly. In any case, urine test 3 monthly.  To prevent urine marking, neuter him when he is around 6-8 months old so that the male dog does not retain urine, causing stagnant urine favouring bacterial infection and stone formation. Some dogs don't drink much water. 


RETROSPECTIVE REVIEW OF CASE
TP 45123
Westie, M, Not neutered, Born Nov 16, 2003
Wanted 3rd opinion as Vet 1 took blood test for suspected poisoning and Vet 2 diagnosed bladder stones based on X-ray.
Blood test unremarkable
X-ray bladder stones
Urine test calcium oxalate crystals
Owner does not want stone analysis owing to financial constraints.
Bladder stones removed. Calcium oxalate.
On U/D diet.
As at 26th day after surgery, no complaint of surgical outcome.
Vomiting reported

UPDATE ON WESTIE
The wife came to buy 24 cans of U/D yesterday Sep 5, 2013 and said that the Westie is OK.

1108. Relocating from Ireland to Singapore - dog

Hello,

 

I am helping a client of mine who has just relocated to Singapore from Ireland. They are looking for a veterinarian for their 23 kg setter. I had a few questions about your office.

• How soon are you making appointments for new dogs?
• About how much does a general checkup with vaccinations cost?
• Is there anything they should know about moving their dog to Singapore?
• They are looking for dog boarding facilities as well, do you offer that service or could you recommend someplace?

I am so sorry for all of these questions. Thank you so much for your time. I look forward to hearing from you and referring your office to the family.

 

Sincerely,

Margaret Hoffman

 

Margaret Hoffman | Resource Specialist Direct 314.523.7547 | Main 314.576.0010 MHoffman@vandover.com | ighr.com

EMAIL REPLY DATED AUG 31, 2013

I am Dr Sing Kong Yuen from Toa Payoh Vets

Thank you for email. My replies are respectively:

Appointments can be made 24 hours earlier in general.

General check up is around $65 - $75. Vaccinations are $40 for 9-in-1 vaccine, $70 for proheart vaccination, $40 for kennel cough vacc.

A rental house with a garden will be best for the dog. For families, a ground-floor condominum with private garden. Get copies of the dog's medical records from previous vet including health screening.

Get import licence from the Singapore Government's Agri-Food & Veterinary Authority  www.ava.gov.sg
.

We don't have boarding facilities. Phone Pet Hotel +65 6582 2222 for boarding.

Script for intern - Kidney disease

Date: Aug 30, 2013  

TP 43996
Miniature Schnauzer
Black, F, spayed, 9 years


A vomiting and diarrhoeic dog.
8.8 kg, 38.4C.

Recent History
2 weeks no appetite
2 days of vomiting and diarrhoea
No abdominal pain


A simple case of gastro-enteritis?
Some injection and medication.

Not so fast. Review the previous history.
"Bladder stones removed 3 times", the owner said. "The first two times were in October 2010 and October 2011."
"How do you remember the dates so well?" I asked this groomer.
"October is her birthday and she missed the celebrations. I was happy to celebrate her October 2012 birthday. But she had the 3rd bladder stone surgery in January 2013!"
"Miniature Schnauzers are a breed prone to bladder stone formation," I said. "Struvite stones were analysed in Oct 2010. Did you still continue feeding the dry dog food after surgery?"
"Yes, but now I feed home cooked food, vegetables, rice and sometimes canned food"

Almost all Singapore dog owners do not follow up after bladder stone surgery as regards urine testing, X-rays and special diet for prevention of the struvite stones. So, the stones return and in this case, the dog had 3 bladder stone surgeries!

Blood test, urine test and X-ray advised.

Blood test was done in Jan 2013 and Aug 2013

INTERN TO HAVE  DISCUSSION WITH DR DANIEL SING ON KIDNEY DISEASE.

.

Images for closed pyometra & uterine torsion video

Images

1105. Stray cat from Hougang drain

Video movie of uterine torsion & closed pyometra

The patient bites and so the interns were frightened. However, we need to wrap up the video making today as it is 7th day post-op. I got a lady who is not afraid of dogs to bathe, dry the dog and bring it into the consultation room for last video section. 

So much time had been spent with the 2 interns to shoot this video and re-do. I hope it will turn up educational and fun.

1103. Untreated generalised scabies in a Cocker Spaniel - images

1102. Follow up: The old Maltese with uterine torsion & closed pyometra still snapped at the vet

Aug 27, 2013.

The dog is alert and is hosptialised for 7 days after her surgery.

She ate all a/d. Still she would snap at my hand should I go near her. She never forgives or forget.
At 15 years of age, her blood test results were unremarkable. Except for a decrease in creatinine and an increase in neutrophils, she has normal values. No increase in total white cell count unlike other closed pyometra cases I encountered despite such a gigantic womb and being so old.

Around 90-100 years old in human age. Still strong and alert.

1101. Stray cat activism. Soft masses inside abdomen in a stray cat

The kind teacher brought one of these stray cats that had lost weight and was not eating for the past 2 months to Dr Daniel on Aug 19, 2013.

Blood tests were unremarkable. X-rays show a circular mass in the abdomen. Exploratory laporatomy showed the lumps which are sent for histopathology.

"There seems to be a stalk," Dr Daniel said.
"They appear to be encapsulated abscesses, peritoneal tumours or some worm masses e.g. round worm larvae migrating from the mouth to the intestines causing such reactive masses."

Mine was all speculation. Histopathology may enlighten me. Stray cats eat hazardous materials as part of their life-style. Did this cat swallow fish bones and perforated her intestines. Then such masses form to wall off the holes in the intestines?