1181. How to remove maggots efficiently?

Each vet has his or her own way of removing maggots from the dog's anal area.
Some take a very long time as they don't have good planning. A video will be produced soon.

How to remove maggots efficiently?
Each vet/vet assistant has his or her own way of removing maggots. I notice many tend to take a longer time to do it. Time could be spent on other work as there is a lot of administrative work to be done.

To remove them efficiently and properly without the owner needing to return for a second operation, there must be a systematic process.

PLANNING WHAT TO DO

Tools of the trade - chloroform, curved tipped forceps, cotton buds (not swabs), kidney dish, 20-ml syringe and water. Tip of cotton buds with chloroform is inserted at 12, 3, 6 and 9 o'clock for 2 minutes. Maggots will crawl out for fresh air. Pick them out with forceps and put into the kidney dish.

PAIN RELIEF

Pain relief enables safe removal of maggots as the dog may bite the staff. It is a painful process.
In this 14-year-old dog with heart disease, I used 25% of calculated dose. Not sufficient to knock out but there was pain relief.



TABLE TOP
Put dog on table top to make work easier for the staff rather than bending down

HANDING OVER CHECK
360-degree scan before handing over. Dead maggots may be there. 

Medication and anti-fly powder. Groomer to clip hairs short.

1180. Incredible Singapore story: Mum's ultimatum to the stray kitten

Sunday Oct 5, 2013 8.50 am

Bright sunshine day. An adult couple with an older woman from Tampines brought the cat for her vaccination at 8.50 am today. I was surprised as most pet owners don't come so early.
"This is the growling cat," I had recorded in my case sheet in July 12, 2009 when she was brought in for spaying. She had caterwauled 7 days ago, displeasing the neighbours. But today, this cat no longer growls. "She dares not go out of the house," the older woman said. 


"How does the cat pee and poop?" I asked. Many cat owners used litter boxes."
"She just goes to the toilet floor near the drainage hole and pee and poop there. When she came on the first day, I talked to her. Pee and poop here or you will not be adopted. The kitten went to the toilet to pee and poop."

"Really?" I asked the adult daughter whose husband was with her.
"Yes," she confirmed.
I find this story to be incredible. A stray kitten of 3 months of age, living in a car park, could understand human talk and complied to avoid being homeless.

Well, it was possible that she had been to such concrete floor in the car park as a stray kitten and so this was a coincidence. 
"In Buddhism, there is the belief in re-incarnation. Are you Buddhist?" I asked the mum.
"Yes," she said. "The previous person was bad and was reborn as a kitten!"
"How about the cat scratching the furniture?" I asked.
"Seldom, she's is afraid of me. I bought her a scratching post."
"Why didn't you tell the cat that she would be homeless if she scratched the sofa?" I asked.
"Well, scratching is not as serious as urination and passing stools in the apartment."

It was good to see this cat growing up to 4 years of age and looking very healthy. Her tongue was very pink. Her white nose was pinkish and her yellow eyes were bright. She had those leopard spots in mid-abdomen behind the chest and black long vertical stripes of the zebra. She had greyish green spots and was much loved.    

The owners lived in Tampines and as there are several vet clinics nearer to her home, I was surprised that they made an appointment and brought the cat to Toa Payoh, driving all the way. This cat was vaccinated annually in 2009, 2010, 2012 and now. 

1179. Two grandmothers' burden

Yesterday Saturday, Oct 4, 2023, one grandmother showed me her mobile phone image of a backside wound of the 14-year-old Retriever X and requested some medicine as the wound was so smelly and she did not want to spend money on treatment. Her 2 adult daughters had wanted her to get the dog treated but she would be the caregiver.

"The maggots tunnel deep into the muscles," I said. "Antibiotics will not remove them. They need to be taken out by a person!".  I gave her the dog transport man's phone number and the dog was treated.

The other grandmother who had silver hair and is slim had her Sheltie sent in for maggot wounds which had eaten up over 10cm x 5 cm of the peri-anal skin. She had a grandson to look after as her daughter had divorced the abusive husband. "He even hit her when she was pregnant but luckily, there was no miscarriage!"   At 70 years of age, she had much responsibilities to care for her grandchildren and the dog too.    

1178. Images Perineal hernia Yorkshire and quadraparesis Pom for video production

1177. Perineal hernia surgery - images

1176. Transparency of medical charges

The case of Dr Susan Lim v Singapore Medical Council (SMC)
The Court of Appeal delivered a verdict on Jun 28, 2013 ruled that Dr Susan Lim overcharged a member of the Brunei royal family supporting the SMC's charge of professional misconduct leading to her suspension.
The Court did not define "ethical limits" as regards overcharging.


1. His peers must decide that a fee is excessive
2. A fee that is absurd or unconscionable.

The listing of charges should provide transparency and let patients make informed decisions and uphold the honour, honesty and integrity of the profession. Charges must be accurate and detailed as possible and include the complexity of care, the doctor's experience and the cost of the service rendered. Some hospitals list the doctor's fees separately from the hospital charges.

Posting of prices online by public and private hospitals on procedures will be best.
   

1175. Self-publishing on CreateSpace at amazon.com

Here is an overview of our professional services we offer for book publishing if you'd like our team of publishing professionals, including our editors, book graphic design artists, and marketing experts, to take your book to the next level to publish a polished, paperback version.

You have the option to build out your own publishing package as I can help you select your services.

We offer your choice of professional editing services for any genre: https://www.createspace.com/pub/services.home.do?tab=EDITING

If you need help with designing a stand-out cover using a Custom Cover option or want to simply submit your Word document for book layout, below is a quick overview of our Cover and Interior options to publish a book with us as. You can elect to use our editing services and/or cover and layout services or do your own book cover and interior page layout.

Cover Options: https://www.createspace.com/Products/Book/#content2
Interior Options: https://www.createspace.com/Products/Book/#content3

Also, included in every signup package:
- An ISBN
- A bookselling page on www.Amazon.com and Amazon EU channels with a free Look Inside! feature
- Industry-leading discounts when you purchase copies of your book
- Flexible pricing that allows you to determine the royalty you receive and allows you to receive industry leading Amazon.com royalties:
https://www.createspace.com/Products/Book/#content6
==>CreateSpace authors pay only $3.25 for a 200 page BW paperback per unit! With a $15 list price on Amazon.com, earn $5.75 per retail order!

You'll be pleased to know we offer a Satisfaction Guarantee on our Professional Services: https://www.createspace.com/Special/Help/Rights/Guarantee.jsp

When you first sign-up for your account and title, you'll see your Member Dashboard and experience our Do It Yourself tools. To receive full support through our paid-services mentioned above, I'll need to set-up a service order and process payment to refresh your account so that your account is refreshed with the paid, service-specific instructions. You will then be assigned a Publishing Project Team who will provide you with online instruction and support throughout the process.

Let me know if you'd like to connect to pick out your custom package of services.


---------------------------
Email from amazon.com  Oct 4, 2013

Hi Kong Yuen Sing,

We do not charge per page for editing nor book design.

CreateSpace charges per WORD if you would like a line-editing service. See the Editing Levels and service fees here:

https://www.createspace.com/pub/services.home.do?tab=EDITING

And, the fee for Interior Page Layout is $679 for Complex books with text and graphics as it includes custom page-by-page layout with up to 50 images (and extra images are $15 each) and charts or tables or diagrams can redesigned at $25 each if you cannot submit them as JPEG graphics for insertion in your page formatting.

See more here: https://www.createspace.com/Services/ComplexCustomInterior.jsp

And here are the different Cover Design fees: https://www.createspace.com/Products/Book/#content2

I hope this helps you better understand our fee structure.

Basically, you pay for what you may need as one-time fees for:

-Editing: Charged per word. So a Comprhensive Copyediting service is $0.021 per word. If you have 50,000 words, then the cost is $0.021 x 50,000 = $1,050.00

-Book Interior Layout: Complex Custom Interior $679

-Custom Cover Design Premier $599 (Or pick another cover design level based on your needs)

Total: $2,328.00

------------------

EMAIL REPLY DATED OCT 5, 2013

Yes, you can do all your own book interior page formatting using these guidelines and specifications:

Free Do-It-Yourself Option

Whether you have a print-ready pdf, or a Word® .doc, docx, or .rtf file, it's easy to upload your file and get it ready for publishing for free.

Interior Reviewer presents your file as an online virtual version of your book. You'll be able to see formatting issues highlighted visually to find and address formatting issues fast.

Start creating your title

Download the CreateSpace PDF Submission Specification.

Learn more about Interior Reviewer

Print-ready PDF files created through desktop publishing software offer the most control over the appearance of your book.

Learn how to create a PDF to match our Specifications

Get more free resources for Formatting

(If you cannot create the PDF print-ready files, then you can provide us with your manuscript in Microsoft Word as we’ll do the custom book interior page formatting for you using our Complex Custom Interior service at $679 and recommend the best layout choices for book size, typography, text and graphic formatting- https://www.createspace.com/Services/ComplexCustomInterior.jsp)  

And, yes, you can purchase any of the Cover Options as seen here: https://www.createspace.com/Products/Book/#content2

What would you like to see on your cover?

------------------------

OCT 9, 2013 REPLY FROM AMAZON

I’m happy to call you and review our options further with you. Basically, you have the option to submit a PDF for printing/publishing of the interior pages if you are confident in the interior page layout and they meet these outlined specifications:

https://www.createspace.com/Products/Book/InteriorPDF.jsp

If you are providing us with a PDF, we review it to ensure it meets the outlined specifications for printing and use it as-is.

If you would like CreateSpace to do any professional line-editing or do the professional layout/design of the interior pages for you, then we require a Word document for editing and/or book interior page layout.

Choose to submit your own cover, use the FREE Cover Creator templates, or have us design a Custom Cover (fee-based): https://www.createspace.com/Products/Book/#content2

Choose to submit your own PDF print-ready files (per our submission guidelines) OR you will need us to do the interior page PDF layout for you using your Word document and images: https://www.createspace.com/Products/Book/#content3

If we do the book layout and design for you, we will need 5-6 weeks for book layout and design. Add 2-3 weeks additionally if you would like us to do any editing work for you.