Sunday, October 13, 2013

1188. Adding value to your customer service - "Harvard University educated" tourist group

Oct 13, 2013

Holiday Inn Express Quebec City (Sainte-Foy) Room 201

Visited Harvard University's Admin campus. There are chairs for the group travellers to take a group photo with the buidling in the background, creating a memory of having been to "Harvard". Unfortunately my tour guide did not do this. Each tour guide has his or her personal handling of the packaged tour. I think it is an excellent idea for the Singaporean tourists who will never meet again.  This will be what I mean as adding "value" to your service. 

The Harvard Shop we visited must be the most productive as it is a small shop of around 300 sq ft, managed by one salesperson. A young Singaporean lady said that the Facebook "likes" for a 10% discount when shown in the mobile phone was not operational. For most tourists, they are older and not able to do it. This is a good marketing method using multi-media.










Saturday, October 12, 2013

1187. Customer service is part of the DNA of this airline

Oct 12, 2013
Holiday Inn Boston-Bunker Hill
USA

More than 20 years have passed since I last visited the USA. My children had grown up. SIA has very strong competitors like Emirates. There is a new advertising video of the SIA girl in some tea plantations.

The culture of excellent customer service is in the DNA of this airline at the passenger level in my recenr experience of being offered eye cover on my after midnight flight from Singapore to Frankfurt without me asking for it and the recommendation of spicy tomato juice from the cabin crew. The food is much better now.  The food cabinet spilt scrambled egg as 3 trays slid out just beside my seat, making the Frankfurt-New York journey memorable. "Why don't you vaccum it off?" the American woman asked. "Why not use the broom?" I asked as the male steward used tissues to clear the spilt scrambled eggs. I put a piece ofl tissue to cover it as the cabin crew worked fast to serve brunch to other passengers.








The culture of excellent customer service is in the DNA of this airline. It is team work.
    

1186. The dwarf hamster may lose his right ear

TOA PAYOH VETS
toapayohvets.com

Date:   01 November, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
A dwarf hamster keeps scratching his right ear    
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   01 November, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Saturday, October 12, 2013

1186. The dwarf hamster may lose his right ear

Case written on vacation in the USA
Dr Sing Kong Yuen
Oct 12, 2013  5.50am
Holiday Inn Boston-Bunker Hill Room 300, USA

A DIFFERENCE OF VETERINARY OPINION

My opinion was that the ear might have to be removed with the ear wart and I informed the owner early. It would be too late during anaesthesia to phone the owner as the Zoletil anaesthesia given IM would last less than 5 minutes. The wart might recur in trying to save the ear if it was malignant.  

The husband was much worried. A hamster is family and losing one ear would disfigure this family member.

I assigned the case to Dr Daniel who said the ear might not need to be cut off.  He excised the wart and put in 2 stitches. The intact ear was happiness to the couple. To save the couple money, no histopathology of the wart was done and so I don't know whether it is malignant or not. Only time will tell as malignant tumours recur.

Update on Nov 1, 2013. No complaint from the couple. No news is good news.
 
Anaesthesia Post-op recovery Ear wart excised. Goes home
Excision of the big wart in the left ear resolves the problem of the hamster continually scratching his ear.
Updates will be on this webpage:
www.sinpets.com/F5/20131101hamster_wart.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: November 01, 2013

Toa Payoh Vets

1185. Ear warts are quite common in the older dwarf hamster

In this case, the hamster kept scratching his left ear and came in for surgery on Oct 9, 2013. From my observation, I told the husband that the ear might need to be cut off. Dr Daniel handled the surgery and removed the wart, putting in two 4/0 nylon stitches.  Sedation with Zoletil IM. The hamster woke up 30 minutes later. Image of him on a "mouse" was taken 15 minutes after surgery.

Will the hamster still scratch his left ear? There are 2 stitches. As each vet has his or her own approach to surgery, I would not say my approach would be the better. In my approach, I would excise the wart and used KMnO4 powder to cauterise the wound. Or I would use electro-cautery. That would mean no stitches which could irritate the hamster again and would need removal in 10 days' time.



Thursday, October 10, 2013

1184. Review of TP 40729. Maltese, 10 years old, M, kidney stones

Today Oct 10, 2013, I phoned the busy lady owner of the Maltese as she returned my call. She said the dog is OK, with no blood in the urine and is fed the special diet.

I review the medical records relevant to the case

Dec 6, 2009. 6 years old. 3 kg. Very thin. Treated for vomiting & diarrhoea
Jul 10, 2010    Dental scaling & extracted  teeth

Oct 3, 2011     Bloody urine recorded by associate vet. UTI?  Urine test - black & turbid. Blood 4+. White blood cells 1620, Red blood cells >2250. Too turbid to perform biochemical tests. Blood urea 6.5 (4.2-6.3), creatinine 85 (89-177). No increase in total WCC or other values.  X-rays

Jan 27, 2013. 10 years old. 3.3 kg. Vomiting & diarrhoea today. I palpated very painful abdomen. Blood test -  liver enzymes elevated. Urea 11.2, Creatinine 88. Advised X-ray.   

Jul 7, 2013. Blood in the urine 2 days. X-ray shows small kidney stones. X-rays given to owner.
Urine pH  8.0  SG 1.044,  Blood 4+, amorphous phosphate +,
http://www.kongyuensing.com/laws/20130725kidney_stones_Maltese_M_10years_haematuria.jpg


I recorded the following:
S/D for 1-3 months. The owner bought 12 cans of S/D and no more news from her.
urine test monthly.

As at Oct 10, 2013, the lady owner told me that there is no blood in the urine. However, she did not submit any urine for testing and said she bought  the "special diet" to feed her dog. This case study was made into a video by interns during the first episode of turbid blood in the urine. See:

http://www.youtube.com/watch?v=HvV-00dDRg4


Wednesday, October 9, 2013

1183. $46,000 fine for abetment

From what I read in the newspaper, the pet transport man was given $5.00 for every cat he brought to a lay person (a young lady) who would spay or neuter them. I met him at another vet practice recently and asked about his side of the story.

"I did not take any money," he said. "There was no mention of the $5.00 in the first police statement she made. It was in the second statement. I paid $46,000 as a fine for abetment. My lawyer is pursuing this matter. Why would I take $800 over the two years to ruin my reputation?"

Singapore has many caregivers who feed stray cats and get them sterilized and returned to their original premises. The pet transport man is paid to trap and ferry them to and from the vet who will sterilize them. The vet will claim the discounted fees from the Cat Welfare Society or some humane organisations. In this case, the Cat Welfare Society noted a discrepancy in the stamping of the claim forms - two different forms of the chop. The vet practice confirmed that there was a fraudulent stamp.

The young lady worked for a veterinary practice and had gone to Australia to study to be a vet. However, her father passed away soon and she could not continue her studies. She was arrested.

"There are still people who asked me to send the cats to her for sterilization," the transport man said. "Her surgical skills in closing the wound are excellent. Small wounds well stitched up."

"How come you got fined $46,000, an amount similar to hers? It is a large amount of money" I asked.
"For abetment. She got fined another $2,500 for other charges."
"Why did you help her if you don't profit from it?"
"After her father passed away, the Australian vet faculty gave her one month to return back and to pay the fees. She had no money and so the university terminated her place. She needed money to help her family as her father had died."

It is hard for this transport man to defend himself as the newspapers had stated he had accepted $5.00 per cat ferried for the sterilization!      

Monday, October 7, 2013

1182. Continued from 1181. Handing over inspection of maggot wound in the dog

There should be a systematic process in the treatment of maggot wounds efficiently.


There should be the final inspection for dead maggots. Although the wound is closing by >50%, there may be dead maggots inside. I advised my assistant to use the curved forceps to check. He disbelieved my suggestion that there might be maggots since the wound had closed by over 50%.

He did the 360-degree scan twice using the forceps. 4 dead maggots were extracted. The dog went home.  The wound should close uneventfully. Dead maggots would have delayed closure.




The dead maggots were black. Compare to the live ones taken out earlier in the image below.