Dec 31, 2013
Last case of 2013.
I had operated on this 8-year-old cat that had a bladder stone. Now she comes to me with a bald tail, side flanks and belly.
"After your bladder stone operation, the belly area never produce hairs!" the gentleman told me as I advised clipping the cat bald as she had too many fur mites irritating her. The owner decided to take the Samsung smartphone video of this mite under the microscope.
"The whole tail is bald," I am surprised. "This could be due to the anal sac infections." I pulled up the tail and some light brown oil was expressed by the fingers releasing the oil. The cat turned his head and hissed at me
"The bald belly area will be due to the cat's continual licking daily," I said. "So no hairs can grow. As for both flanks being bald, this could be due to a hormonal imbalance condition called bilateral endocrine alopecia. Only that, the tail is not balding in such conditions."
As I looked closed at the upper neck area, there were specks of 3mm x 3 mm seen. Some specks were alive and kicking. So there were fur mites. The
What is the treatment for this cat?
An insecticidal wash in a bath tub after clipping off the contaminated coat.
"What if the hairs don't grow after clipping?" the owner asked.
So I dared not clip off the whole coat. I would sedate the cat and bathe him. The owner will need to decontaminate his big cage and the whole room. As to the source of the mites, the cat loves to lie down on cardboard boxes from China, stored in the room. This cat does not go out of the house or go boarding kennels.
"I live on the 17th floor and no stray cats ever visit him," the gentleman snapped video of the moving mite. Did the fur mites cause hair loss so extensively? What species are they? I need to identify them by doing some research.
I took a video of the species for further research. 6.40 pm Dec 31, 2013. Will close shop to celebrate New Year.
Tuesday, December 31, 2013
1282. Urethral obstruction in a young male dog
Monday Dec 31, 2013
Last day of 2013. The old cat with difficulty in urination and treated by Dr Daniel who had flown off to HongKong today is more lively (Blog 1281).
Suddenly an older Indian owner of a 3-year-old male Jack Russell that could not pee came into the Surgery. He had been boarded a few days ago as is the case with Blog 1281's old cat. Now he could not pee.
A 2nd case of urethral obstruction but in a dog. Same procedure. Owner permitted X-rays and blood test. I got 20 ml of air pumped into the bladder. No radio-dense stones are seen. "Some stones are not seen on X-rays," the short and slim nurse at the vet practice reminded me.
Blood test and urine test are done.
Last day of 2013. The old cat with difficulty in urination and treated by Dr Daniel who had flown off to HongKong today is more lively (Blog 1281).
Suddenly an older Indian owner of a 3-year-old male Jack Russell that could not pee came into the Surgery. He had been boarded a few days ago as is the case with Blog 1281's old cat. Now he could not pee.
A 2nd case of urethral obstruction but in a dog. Same procedure. Owner permitted X-rays and blood test. I got 20 ml of air pumped into the bladder. No radio-dense stones are seen. "Some stones are not seen on X-rays," the short and slim nurse at the vet practice reminded me.
Blood test and urine test are done.
1281. Urethral obstruction in an old male cat
Rex, male, neutered cat, 11 years. Usually inactive, plump at 8.1 kg. Only active when given treats.
When young kitten, not active. Grouchy towards other cats.
Ate dry food since young
Boarded 6 days. On lst day home, went to cat litter, not much urine seen.
On 2nd day, did not want to eat treats or wet food. Recently tends to eat less dry food.
For next 3 days cannot pee. lethargic, anorexic.
Dec 29, 2013 See Toa Payoh Vets. Mango-sized bladder palpated.
Urethral obstruction first time, after boarding for 6 days -- FLUTD. Change of environment.
Had not been to boarding for the last 5 years except recently.
Blood test - urea and creatinine very high urea 119.0 (7-11), creatinine 2321 (71-160).
- glucose high 11.8 (3.9-6.0)
- total white cell count and neutrophils high, platelets low.
Urine test - glucose negative.
- bacteria +, protein +, blood +, crystals nil, white blood cells 15, red blood cells >2250,
Dr Daniel had to sedate the old cat called Rex to insert the IV drip and take blood from the jugular vein. With the IV drip and medication, the cat responded well the next day. He sedated the cat, flush open the urethra, sucked out the urine, irrigated the bladder (Intern Clara to insert video clip - VIDEO 1)
Both cats were boarded but the 2-year-old male neutered cat is OK.
Dec 31, 2013 is day 3. The owners ( a lady and gentleman in their late 30s) came today. The cat greeted them and her eyes were bright and alert. The
owners commented on the brightness of the eyes (I took an image and video (VIDEO 2),4 pm Dec 31, 2013).
CONCLUSION
Since the cat was eating,drinking, pooping and peeing as normal
before boarding, this problem would have been avoided if the old cat was not boarded. The couple had to go overseas and the mother could not take care of two cats - this old Rex and the young cat. So both were boarded.
Rex will be warded for 3 more days for antibiotic injections & drips to flush out the toxins from the blood via the bladder. He should recover. No more boarding days as some cats cannot adapt to new environments and develop FLUTD (Feline Lower Urinary Tract Disease) which has many causes..
When young kitten, not active. Grouchy towards other cats.
Ate dry food since young
Boarded 6 days. On lst day home, went to cat litter, not much urine seen.
On 2nd day, did not want to eat treats or wet food. Recently tends to eat less dry food.
For next 3 days cannot pee. lethargic, anorexic.
Dec 29, 2013 See Toa Payoh Vets. Mango-sized bladder palpated.
Urethral obstruction first time, after boarding for 6 days -- FLUTD. Change of environment.
Had not been to boarding for the last 5 years except recently.
Blood test - urea and creatinine very high urea 119.0 (7-11), creatinine 2321 (71-160).
- glucose high 11.8 (3.9-6.0)
- total white cell count and neutrophils high, platelets low.
Urine test - glucose negative.
- bacteria +, protein +, blood +, crystals nil, white blood cells 15, red blood cells >2250,
Dr Daniel had to sedate the old cat called Rex to insert the IV drip and take blood from the jugular vein. With the IV drip and medication, the cat responded well the next day. He sedated the cat, flush open the urethra, sucked out the urine, irrigated the bladder (Intern Clara to insert video clip - VIDEO 1)
Both cats were boarded but the 2-year-old male neutered cat is OK.
Dec 31, 2013 is day 3. The owners ( a lady and gentleman in their late 30s) came today. The cat greeted them and her eyes were bright and alert. The
owners commented on the brightness of the eyes (I took an image and video (VIDEO 2),4 pm Dec 31, 2013).
CONCLUSION
Since the cat was eating,drinking, pooping and peeing as normal
before boarding, this problem would have been avoided if the old cat was not boarded. The couple had to go overseas and the mother could not take care of two cats - this old Rex and the young cat. So both were boarded.
Rex will be warded for 3 more days for antibiotic injections & drips to flush out the toxins from the blood via the bladder. He should recover. No more boarding days as some cats cannot adapt to new environments and develop FLUTD (Feline Lower Urinary Tract Disease) which has many causes..
Saturday, December 28, 2013
1280. How ro be an excellent tour guide
Dec 28, 2013
I toured Turkey from Dec 17 to 26, 2013 on a packaged tour. Packaged tours tend to be quite boring as tourist sleep while the coach passes various towns and villages as the Singaporean tour leader would not have comments nor knowledge of the places passed by.
However, this tour to Turkey was unusually fun as the Turkish tour guide, Mr Serkam could connect with the Singaporeans and gave comments on the cities passed such that one Malay mother with a 26-year-old career daughter who is still single told me that she had "no time to sleep during the journey."
Here are the best practices of Mr Serkam
1. Greeting the tourists every morning in their languages - Malay, Chinese and other foreign languages.
2. Diction. Use of a microphone and speak clearly in English.
3. Making eye contact with the tourists is important to him. Towards the end of the travel, our Singaporean tour leader slipped and hurt his knee and was sitting down on the front of the coach, obstructing his eye contact with the back of the coach. After enqniring about his injury, the Singaporean tour leader sat down on the aisle to ease his pain. He politely asked him to walk to the back so that Mr Serkam could see the tourists.
4. Getting up to point out various characteristics of towns and villages. For example, heavily polluted industrial area in Turkey where people are not expected to live past 65 years of age. A corporate logo of Noah's Ark on the side of a wall belonging to a corporation. Taxi drivers being ex-criminals and not to be honked at. The coporate SASA logo of the richest man in Turkey, Salt Lake's dimensions much bigger than the State of Singapore. This was why the travellers had no time to doze off for long periods of time as for other packaged tours led by Singaporean tour laaders.
5. Informing the travellers that the whole journey was 3,000 miles.
6. Recap the places visit at the last day. This seemed to be appreciated by Mr On who mentioned this to others. Mr On is the "vocal minority" who filled up the tour feedback forms for his Hokkien group
of 14 senior citizens.
7. Cracking numerous jokes at the expense of his Singaporean tour leader who did not mind.
Two videos of his jokes is uploaded. Some tour guides can't joke as it is not part of their personality and so the tour is serious and the travellers just sleep. No person can sleep when he cracks relevant jokes.
8. Connecting with the travellers by applying "organic olive oil" personally to moisturise their hands at the start of each day's journey. The other coach's tour guide did it once only. This daily contact with the travellers put them in a good frame of mind. So his optional tours are highly subscribed to as compared to the other coach. However, in the other coach, the large proportion of travellers were senior citizens with at least 14 of them being Hokkien speaking friends including Mr On. Mr On and myself were allotted to the first coach where our Turkish guide was not cracking jokes as that was not his character to do so.
It so happened that Mr On and I decided to pay $55 for the optional tours. We had to join the other coach led by Mr Serkam as there were around 8/35 opting for such tours. The others in the 2nd coach not opting for the tours came over to take our seats. As explained by our Singaporean tour leader, there were two coaches and so optional tours could be conducted. If there was one coach, there needed to be 100% opting in or no optional tours as in previous single-coach packaged deals.
"$55 is worth it," Mr On kept telling anyone who will listen to how he got a fun journey with Mr Serkam. He is 63 years old and has travelled much in his retirement years. He commented on one China Tour where the Chinese tour guide would not speak to Singaporeans if they didn't patronise the souvenier stalls. One had told me that he would not be able to make it up the high wall of a place. So he bad-mouthed this Singaporean travel agency.
He was the type who would share his views. He told us to claim back the over-charging of $35 in airport tax by our tour company. He had done so before the trip. It is not right for the tour company to keep quiet as airport tax is not part of the packaged tour cost. On returning home, I discovered that he was correct and the company agreed to give back the excessive paid. It is surprising to me as I trust this travel agency and did not query when asked for payment of the airport taxes.
9. Communicating well with travellers is not easy as it is part of the DNA of a service provider. There are doctors with excellent bedside manners and there are others who can't please the clients no matter how he or she tries.
10. "The other tour guide is old and therefore tired," Mr On was frank in his perception of the oldies. There will be such comments from a group of travellers. Such comments can influence the silent majority. In this first coach, the tour guide with 20 years of experience did his best, in my opinion. It would be out of his character to joke and he had no "clown" in the Singaporean tour leader who was only one instead of two for two coaches. This gives the impression that our company is trying to make more money by not providing one tour leader per coach of over 35 people. So, the one Singaporean tour leader in the first 3 days was absent as he decided to stay one day in one coach. Later, he decided to spend half a day in each coach and that would be better than being absent for the whole day.
From Day 3-10, Mr On and I had opted for the 4 optional tours and so was in the 2nd coach of Mr Serkam. We did not opt for the 5th optional tour - air balloon led by Mr Serkam but he had quite a good number. There was the optional Bosphorous River Cruise which Mr On and I subscribed to
and had another 8 of the Hokkien group from Coach 1 deciding to join.
11. Optional tours provide additional income for the tour guides. By getting the travellers in a right frame of mind to buy the tours, Mr Serkam was very successful in getting a coach full, not an easy task with previous tour leaders of single coaches.
One successful strategy used and encountered by me in a European tour was to thrown in another "free tour" if the whole coach agreed to the optional tour or letting the Singaporean tourists know that they would just be loitering in the shopping mall if they don't opt 100% for such tours. The optional tours permit the guide to earn some income as many are free lancers but some guides just can't sell the optiional tours. Some can do it as they are able to earn the trust and get the traveller in the buying frame of mind by communications. Life is unfair if the service provider's personality is such that he or she is not able to connect to close sales.
12. Providing statistics to tourists. Mr On asked the other coach friends whether the guide mentioned about the dimensions of the Salt Lake. He said Mr Serkam said it was of dimensions that are bigger than the State of Singapore.
13. Language barrier. Also Mr Serkam had better English diction but Mr Serkam had studied in the US for one year, in my talk to him.
14. Stereotypes of the old being tired and not energetic. Unfortunately this stereotype of the worn out oldie is quite common. Mr Serkam is in his late 30s and is deemed energetic.
15, Telling personal life stories. This can be difficult for some tour guides but those who do it, get some attention. The average people like gossips of lifestyles of the tour guides too. So, gigolo jokes from Mr Serkam about his Singapore counterpart, Sebastian, being a busy "gigolo", caused much laughter in the coach. I had a short video clip on this joking laughter in one of the 3 videos posted below.
14. Be proactive. Mr Serkam chartered the whole boat for the Bosphorous River Cruise and personally pointed out the various interesting aspects of the European side and the Asian side of the River. This is better than the usual taped recording of Boat Cruises on the River Seine in Paris.
3 videos to illustrate what I mean about being an excellent tour guide:
I toured Turkey from Dec 17 to 26, 2013 on a packaged tour. Packaged tours tend to be quite boring as tourist sleep while the coach passes various towns and villages as the Singaporean tour leader would not have comments nor knowledge of the places passed by.
However, this tour to Turkey was unusually fun as the Turkish tour guide, Mr Serkam could connect with the Singaporeans and gave comments on the cities passed such that one Malay mother with a 26-year-old career daughter who is still single told me that she had "no time to sleep during the journey."
Here are the best practices of Mr Serkam
1. Greeting the tourists every morning in their languages - Malay, Chinese and other foreign languages.
2. Diction. Use of a microphone and speak clearly in English.
3. Making eye contact with the tourists is important to him. Towards the end of the travel, our Singaporean tour leader slipped and hurt his knee and was sitting down on the front of the coach, obstructing his eye contact with the back of the coach. After enqniring about his injury, the Singaporean tour leader sat down on the aisle to ease his pain. He politely asked him to walk to the back so that Mr Serkam could see the tourists.
4. Getting up to point out various characteristics of towns and villages. For example, heavily polluted industrial area in Turkey where people are not expected to live past 65 years of age. A corporate logo of Noah's Ark on the side of a wall belonging to a corporation. Taxi drivers being ex-criminals and not to be honked at. The coporate SASA logo of the richest man in Turkey, Salt Lake's dimensions much bigger than the State of Singapore. This was why the travellers had no time to doze off for long periods of time as for other packaged tours led by Singaporean tour laaders.
5. Informing the travellers that the whole journey was 3,000 miles.
6. Recap the places visit at the last day. This seemed to be appreciated by Mr On who mentioned this to others. Mr On is the "vocal minority" who filled up the tour feedback forms for his Hokkien group
of 14 senior citizens.
7. Cracking numerous jokes at the expense of his Singaporean tour leader who did not mind.
Two videos of his jokes is uploaded. Some tour guides can't joke as it is not part of their personality and so the tour is serious and the travellers just sleep. No person can sleep when he cracks relevant jokes.
8. Connecting with the travellers by applying "organic olive oil" personally to moisturise their hands at the start of each day's journey. The other coach's tour guide did it once only. This daily contact with the travellers put them in a good frame of mind. So his optional tours are highly subscribed to as compared to the other coach. However, in the other coach, the large proportion of travellers were senior citizens with at least 14 of them being Hokkien speaking friends including Mr On. Mr On and myself were allotted to the first coach where our Turkish guide was not cracking jokes as that was not his character to do so.
It so happened that Mr On and I decided to pay $55 for the optional tours. We had to join the other coach led by Mr Serkam as there were around 8/35 opting for such tours. The others in the 2nd coach not opting for the tours came over to take our seats. As explained by our Singaporean tour leader, there were two coaches and so optional tours could be conducted. If there was one coach, there needed to be 100% opting in or no optional tours as in previous single-coach packaged deals.
"$55 is worth it," Mr On kept telling anyone who will listen to how he got a fun journey with Mr Serkam. He is 63 years old and has travelled much in his retirement years. He commented on one China Tour where the Chinese tour guide would not speak to Singaporeans if they didn't patronise the souvenier stalls. One had told me that he would not be able to make it up the high wall of a place. So he bad-mouthed this Singaporean travel agency.
He was the type who would share his views. He told us to claim back the over-charging of $35 in airport tax by our tour company. He had done so before the trip. It is not right for the tour company to keep quiet as airport tax is not part of the packaged tour cost. On returning home, I discovered that he was correct and the company agreed to give back the excessive paid. It is surprising to me as I trust this travel agency and did not query when asked for payment of the airport taxes.
9. Communicating well with travellers is not easy as it is part of the DNA of a service provider. There are doctors with excellent bedside manners and there are others who can't please the clients no matter how he or she tries.
10. "The other tour guide is old and therefore tired," Mr On was frank in his perception of the oldies. There will be such comments from a group of travellers. Such comments can influence the silent majority. In this first coach, the tour guide with 20 years of experience did his best, in my opinion. It would be out of his character to joke and he had no "clown" in the Singaporean tour leader who was only one instead of two for two coaches. This gives the impression that our company is trying to make more money by not providing one tour leader per coach of over 35 people. So, the one Singaporean tour leader in the first 3 days was absent as he decided to stay one day in one coach. Later, he decided to spend half a day in each coach and that would be better than being absent for the whole day.
From Day 3-10, Mr On and I had opted for the 4 optional tours and so was in the 2nd coach of Mr Serkam. We did not opt for the 5th optional tour - air balloon led by Mr Serkam but he had quite a good number. There was the optional Bosphorous River Cruise which Mr On and I subscribed to
and had another 8 of the Hokkien group from Coach 1 deciding to join.
11. Optional tours provide additional income for the tour guides. By getting the travellers in a right frame of mind to buy the tours, Mr Serkam was very successful in getting a coach full, not an easy task with previous tour leaders of single coaches.
One successful strategy used and encountered by me in a European tour was to thrown in another "free tour" if the whole coach agreed to the optional tour or letting the Singaporean tourists know that they would just be loitering in the shopping mall if they don't opt 100% for such tours. The optional tours permit the guide to earn some income as many are free lancers but some guides just can't sell the optiional tours. Some can do it as they are able to earn the trust and get the traveller in the buying frame of mind by communications. Life is unfair if the service provider's personality is such that he or she is not able to connect to close sales.
12. Providing statistics to tourists. Mr On asked the other coach friends whether the guide mentioned about the dimensions of the Salt Lake. He said Mr Serkam said it was of dimensions that are bigger than the State of Singapore.
13. Language barrier. Also Mr Serkam had better English diction but Mr Serkam had studied in the US for one year, in my talk to him.
14. Stereotypes of the old being tired and not energetic. Unfortunately this stereotype of the worn out oldie is quite common. Mr Serkam is in his late 30s and is deemed energetic.
15, Telling personal life stories. This can be difficult for some tour guides but those who do it, get some attention. The average people like gossips of lifestyles of the tour guides too. So, gigolo jokes from Mr Serkam about his Singapore counterpart, Sebastian, being a busy "gigolo", caused much laughter in the coach. I had a short video clip on this joking laughter in one of the 3 videos posted below.
14. Be proactive. Mr Serkam chartered the whole boat for the Bosphorous River Cruise and personally pointed out the various interesting aspects of the European side and the Asian side of the River. This is better than the usual taped recording of Boat Cruises on the River Seine in Paris.
3 videos to illustrate what I mean about being an excellent tour guide:
Friday, December 27, 2013
1277. Create a fun experience to close sales
It is difficult for a doctor to create a fun experience to close sales as medicine is a serious matter. For the Spice Market salesperson in orange uniform, the competition is intense. By creating a fun experience, the Singaporean tourists stay longer and he closes sales. His boss will find him a high performer
Tuesday, December 24, 2013
1276. Travel Stories - Matching civilian and military fashion - Turkey
A rare image
We had to alight from the coach and walked through the X-ray machine minus our metallic objects left inside the bus. Then we would go up the bus. "Yet the coach is not searched," our guide said. Our coach's gear level suddenly froze and the driver could not move it. So fortunately, there were 2 coaches in this tour and the other coach driver picked us up to drive to the Museum. The luggage compartment of our coach was opened and the problem was resolved. Some tied up mechanical problem fixed at the luggtage area to free the clutch which was a long "manual" type lever unlike modern ones with short lever as in the other Mercedes coach. Ours was a Mitsubishi or some model.
Dec 24, 2013
Koru Otel
Small room, elevator has a door which opens outwards, but internet connections in the room excellent compared to other modern 5-stars
Changing of the guard at the Ataturk Museum, Turkey
attracts some tourists to pose with the soldier. One Asian tourist told another that the soldier
would feel irritated by their posing. What do you think? I think it is a peaceful distractionWe had to alight from the coach and walked through the X-ray machine minus our metallic objects left inside the bus. Then we would go up the bus. "Yet the coach is not searched," our guide said. Our coach's gear level suddenly froze and the driver could not move it. So fortunately, there were 2 coaches in this tour and the other coach driver picked us up to drive to the Museum. The luggage compartment of our coach was opened and the problem was resolved. Some tied up mechanical problem fixed at the luggtage area to free the clutch which was a long "manual" type lever unlike modern ones with short lever as in the other Mercedes coach. Ours was a Mitsubishi or some model.
Dec 24, 2013
Koru Otel
Small room, elevator has a door which opens outwards, but internet connections in the room excellent compared to other modern 5-stars
Sunday, December 22, 2013
1274. Travel Stories: Efes, Turkey
Dec 21, 2013
I visited the of the Virgin Mary and saw this squirrel who was being hand-fed a piece of bread by a person familiar to him. As a young tourist girl from Singapore walked towards him within 0.3 metre foot, he grabbed the bread and scootered up the tree for safety.
-------------------
Pictures with explanation. My favourite is the one with "sunlight in her hairs"
I visited the of the Virgin Mary and saw this squirrel who was being hand-fed a piece of bread by a person familiar to him. As a young tourist girl from Singapore walked towards him within 0.3 metre foot, he grabbed the bread and scootered up the tree for safety.
Location plays a great part in getting customers. This stall is located next to the zebra crossing where the tourists, after visiting "Seven Sleepers" site in Efes (Ephesus) will walk to, to wait for their coach. So this stall gets all the business of my tour group buying pomengranate juice while the other 2 competitors on the left are quiet.
Once in a while, I get a picture I appreciate. The sunlight is good. The modern Japanese or Korean woman faces the same way as the ancient woman or goddess. Much has changed for the better for women in many countries.
My Turkish tour guide was quite frustrated with the Singaporean tourists who are more interested in taking pictures of the approved 180 street cats than listening to the wonderful history of the old days. This feline distraction is common with other Asian tourists esp. the young ladies as in this photo of a Japanese or Korean girl eyeing the cat. Usually these cats have their left ear edge snipped or tipped to indicate they are "sterilized". The cats add colour to dead archeological monuments. I doubt 5% of the Asian tourists are interested in the Ottoman or Roman imperial history.
-------------------
Pictures with explanation. My favourite is the one with "sunlight in her hairs"
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