Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Friday, August 8, 2014
Thursday, August 7, 2014
TALK TO FINAL YEAR VET STUDENTS - YESIN VET UNIV, MYANMAR - AUG 15 2014
YOU CAN BE A VERY GOOD VET IN MYANMAR
- Belief, Passion, Drive, Perseverance and Focus.
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Founder of Toa Payoh Vets, www.toapayohvets.com
40 years ago, I was a final year veterinary student like all of you. I had to buy veterinary books and subscribe to veterinary magazines to acquire skills and knowledge to be a competent young and inexperienced vet. Now, you have online sources of information and much more distractions like online gaming, online movies, Facebook, Instagram and Twitter taking up your free time.
Veterinary medicine and surgery is too large a subject compared to human medicine and surgery as there are so many animals involved. The people expect you to be able to diagnose, treat, X-ray and perform surgeries in all animals unlike the general practitioner who refers difficult cases to the specialists.
So, how can you be a good small animal vet? Or a very good vet in Myanmar? My opinion is that you must have at least 5 attitudes - Belief, Passion, Drive, Perseverance and Focus.
BELIEF. A feeling that something is good, right or valuable.
PASSION. A strong enthusiasm or interest for something or about doing something.
DRIVE. A determination to always try very hard to achieve something and be successful.
PERSEVERANCE. A continued effort to do or achieve something despite difficulties, failure or opposition.
FOCUS. To concentrate on something and pay particular attention to it
All these 5 attitudes must be present to achieve success and be a knowledge-able vet..
Some examples from my past years are
1. The military German Shepherd Guard Dog with a heart problem. Mentor.
2. The racehorses are not in good form. Adding value to your employer.
3. The dog breeders want more than cheap Caesarean sections. Probity.
4. The internet opens doors to all vets. Proximity and competition from groomers.
5. Intense competition. Strong financial investors set up more veterinary clinics. Financial knowledge of young employee vets. Niche marketing. Social media marketing.
6. Increasing number of complaints on negligence and incompetence. Bad-mouthing the vet through social media.
7. Self discipline and common sense. Wearing slippers to work. AWOL. .
8. Hard work and work-life balance. No hunger in the young generation of Singaporeans..
FOCUS
Need to focus on the bigger picture.
End of the day, nobody in Myanmar know who you are if you are still young.
Office politics. Need to gain skills and experience. Not a household name unless well financed vet.
Client education e.g. Depo-M injections no longer used in other countries. -- pyometra
Stay the course to be a small animal vet Engage children to be kind to pets. What is your mission?.
BELIEF
Something you believe in and you know you want to do and do it well.
You believe you can help in curing diseases of animals and you want to do it well. Money is secondary. Playing politics with the officers and head nurse.
What goals do you set for yourself in 5 years' time? Get married to a rich spouse. Be a homemaker? Open up your own practice - >60 vet clinics in Singapore. Rich parents. 100 in Yangon?
PASSION
Motivation (internal or instrumental?)
Internal - self motivated.
Instrumental - make more money.
PERSEVERANCE
Secrets of success. Persevere. Attracts referrals. Intense competition from deep pocketed, big practices. Your reputation of delivering results and good outcomes (e.g. no dogs dying under anaesthesia during spay) and referrals over many years sustain your practice.
DRIVE
Energy. Marketing. Pleasure enjoyment. Research read. Healthy. Social media. Pet owners will mature and gain knowledge from the internet. ,.
-----------------------------------------------------------------------------------------------------------
1. Practise in Niche areas like hamsters and terrapins as most vets are too busy with too many dogs and cats
1.1 HAMSTERS
1.1.1 A You Tube video on lateral ear canal resection in a dwarf hamster with ear warts by Dr Sing Kong Yuen
http://www.youtube.com/watch?v=fxJ2AH0raKk
1.1.2 Show actual video from laptop at the talk, as the internet may not be stable.
1.1.3 Background to surgery
As the ear warts are deep inside the vertical ear canals, I advised opening up the lateral (side) wall) of the ear canal. This will provide access to removal of the warts and provide ventilation and drainage. The two lady owners are happy with the outcome as the hamsters have recovered fully, without any more ear scratching.
Lateral ear canal resection is a very rare surgery in dwarf hamsters. The danger is a high anaesthetic risk as the hamster is very small in size. The vet needs to be very alert and careful not to kill the hamster with anaesthetic as owners will not be happy with this death outcome and bad-mouth the vet.
1.2 TERRAPINS
1.2.1 A You Tube video on ear abscess drainage under anaesthesia in a terrapin performed by Dr Daniel Sing of Toa Payoh Vets.
http://youtu.be/fj_eBwMGtns
1.1.2 Show actual video from laptop at the talk, as the internet may not be stable.
1.1.3 Background to surgery
The slim lady owner googled for "ear abscess terrapin" and came to Toa Payoh Vets to get her terrapin's ear abscesses treated. She saw a similar case done in Toa Payoh Vets.
This video shows the treatment of the ear abscesses by Dr Daniel Sing of Toa Payoh Vets Zoletil IM was given and isoflurane gas top up enabled the abscess to be drained without the terrapin struggling.and withdrawing his head inwards. It is not possible to lance the ear abscess and drain all pus properly in a terrapin without anaesthesia as the terrapin will be in great pain and withdraw his head under the shell..
The You Tube Toa Payoh Vets ear abscess terrapin seen by this lady is at:
http://www.youtube.com/watch?v=TtbQ0ZJDoCo
As at August 7, 2014, I googled "ear abscess terrapin" and the results are as follows:
Toa Payoh Vets appear in the top 3 rankings:
About 114,000 results (0.33 seconds)
Search Results
A terrapin has a painful right ear abscess - YouTube
Sep 4, 2013 - Uploaded by Kong Yuen SingHow to treat an ear abscess in a red-eared slider (terrapin). A "Be Kind To Pets" Veterinary Educational ...The terrapin ear abscess surgery - Part 2 - YouTube
Jan 9, 2014 - Uploaded by Kong Yuen SingUnder anaesthesia, the terrapin does not struggle and his left and right ear abscesses are lanced, drained ...
Wednesday, August 6, 2014
Tuesday, August 5, 2014
Haematuria - blood in the urine - in a 16-year-old Shih Tzu - penile fracture
Blood in the urine in a male dog - instant diagnosis is urinary stones as this is top of the list in so many cases of haematuria. I got the dog X-rayed today at 9 am.
Practise evidence-based medicine. X-rays are taken to check for radio-dense stones.
Is there something wrong with the kidneys, the kind vet nurse told me. There appears to be a radio-opaque kidney shaped area in the sublumbar region where the kidneys are located. I kept an open-mind. Certainly, it looked odd.
Yet based on the fact that the dog is eating like a horse, I discounted that "kidney" problem.
I would say that there is the fracture of the os penis. I passed the urinary catheter. No problem passing into the bladder. Urine collected was clear. Still I had to get urinalysis done to check for UTI and stones.
I gave an enema as I believed that this dog could not poop owing to the painful fracture of the os penis. He passed out the stools and should feel better with pain killers and antibiotics.
In a thorough physical examination, I protruded the penis to check for pain and bleeding. The prepuce was swollen but the dog did not feel any pain. Only the penile tip was inflamed dark red.
VIDEO. Graphic images warning.
Sunday, August 3, 2014
1437. Poodle with elongated pelvic bones bites when anal sacs are touched
Sunday Aug 3, 2014
Poodle, MN, 4 years. Home breeder used him to produce 4 litters but did not take good care of him..Bites anybody. Finally a couple adopted him from SOSD (Save Our Singapore Dogs).
"Can't stop scootering," the man had googled "Toa Payoh Vets" and so found me.
A simple case, I thought.
"Sedation is required," I advised as the dog objected strongly to his anal sacs being touched.
"The other vet expressed his sacs last month," the wife said. "We could hear loud screaming inside he room."
"What did the vet tell you about the amount of anal sac oil?" I asked.
"Just fishy smell."
With permission, I sedated the 7 kg dog with Zoletil 100 at 80 mg. Not good to traumatise the 4-year-old again by grabbing him and expressing his glands..
He vomited 10 minutes later and kept moving his tongue in and out of his mouth. He salivated and vomited again, being fed fully.
I was surprised to see the poodle's anal area being 3 cm shorter than his pelvic bones. Dogs do have undershot or overshot jaws but pelvic bones being longer backwards than usual are rare.
I showed the couple how to express since the dog now trusts them and does not bite them.
Or will he?
Thick dark brown oil oozed out. Smelly. Around 2 ml. Not much. Still the room stenched. I switched on the fan. Red, dark red skin seen after expression. As if this is badly infected skin.
As for surgery to anal sac removal to resolve this problem of intense scootering, I advised that the anal sacs may be much sunkened in an difficult to remove. The pelvic bones stretched back by 3 cm, depressing the anal area. There is a concave depression between the anus and the lower pelvic bone jutting caudally. So, surgery may be challenging as other normal dogs have anal sacs in line vertically with the posterior edge of the pelvic bones, not 3 cm forward. A rare case.
Medication to resolve the problem. No surgery to be advised as the sacs may not be easily located and the problem will remain.
Poodle, MN, 4 years. Home breeder used him to produce 4 litters but did not take good care of him..Bites anybody. Finally a couple adopted him from SOSD (Save Our Singapore Dogs).
"Can't stop scootering," the man had googled "Toa Payoh Vets" and so found me.
A simple case, I thought.
"Sedation is required," I advised as the dog objected strongly to his anal sacs being touched.
"The other vet expressed his sacs last month," the wife said. "We could hear loud screaming inside he room."
"What did the vet tell you about the amount of anal sac oil?" I asked.
"Just fishy smell."
With permission, I sedated the 7 kg dog with Zoletil 100 at 80 mg. Not good to traumatise the 4-year-old again by grabbing him and expressing his glands..
He vomited 10 minutes later and kept moving his tongue in and out of his mouth. He salivated and vomited again, being fed fully.
I was surprised to see the poodle's anal area being 3 cm shorter than his pelvic bones. Dogs do have undershot or overshot jaws but pelvic bones being longer backwards than usual are rare.
I showed the couple how to express since the dog now trusts them and does not bite them.
Or will he?
Thick dark brown oil oozed out. Smelly. Around 2 ml. Not much. Still the room stenched. I switched on the fan. Red, dark red skin seen after expression. As if this is badly infected skin.
As for surgery to anal sac removal to resolve this problem of intense scootering, I advised that the anal sacs may be much sunkened in an difficult to remove. The pelvic bones stretched back by 3 cm, depressing the anal area. There is a concave depression between the anus and the lower pelvic bone jutting caudally. So, surgery may be challenging as other normal dogs have anal sacs in line vertically with the posterior edge of the pelvic bones, not 3 cm forward. A rare case.
Medication to resolve the problem. No surgery to be advised as the sacs may not be easily located and the problem will remain.
Saturday, August 2, 2014
1436. TALK TO FINAL YEAR VET STUDENTS - Belief, Drive, Passion, Perseverance, Focus
DRAFT
YOUNG & INEXPERIENCED VETERINARIAN
FOCUS
Need to focus on the bigger picture.
End of the day, nobody in Myanmar know who you are if you are still young.
Office politics. Need to gain skills and experience. Not a household name unless well financed vet.
Client education e.g. Depo-M injections no longer used in other countries. -- pyometra
Stay the course to be a small animal vet Engage children to be kind to pets. What is your mission?.
BELIEF
Something you believe in and you know you want to do and do it well.
You believe you can help in curing diseases of animals and you want to do it well. Money is secondary. Playing politics with the officers and head nurse.
What goals do you set for yourself in 5 years' time? Get married to a rich spouse. Be a homemaker? Open up your own practice - >60 vet clinics in Singapore. Rich parents. 100 in Yangon?
PASSION
Motivation (internal or instrumental?)
Internal - self motivated.
Instrumental - make more money.
PERSEVERANCE
Secrets of success. Persevere. Attracts referrals. Intense competition from deep pocketed, big practices. Your reputation of delivering results and good outcomes (e.g. no dogs dying under anaesthesia during spay) and referrals over many years sustain your practice.
DRIVE
Energy. Marketing. Pleasure enjoyment. Research read. Healthy. Social media. Pet owners will mature and gain knowledge from the internet. ,.
Networking with successful and more hardworking entrepreneurs
Spend more time out rather than at home to watch Korean soap operas and gaming.
Attend courses, travel to broaden your mind
Training
Networking. Make friends. Expand your interpersonal circle. Buy lunch for people who are richer than you, more knowledgeable than you or have had helped you in your career. Do that every month. After one year, big circle of valuable friends.
Continuous Learning. Buy books to read about lessons and strategies of success, selling, marketing, social media etc. Spend money to attend training courses.
Library books
Internet
Reward yourself. Travel at least once a year cheap hostel. Many countries and different experiences.
Save. Do part-time jobs. Sales. Improve you skills. Art of selling. All successful entrepreneurs are good salespersons.
Always make yourself useful.
When you are poor, spend more time outside, spend money on others. When you are rich, stay at home more.
You need not be afraid of being poor. You need to know how o invest in yourself and increase your wisdom and stature.
.
FEAR OF TECHNOLOGY
PROBITY
Professional misconduct
1. Obstetrician offered tampered records. The Straits Times Aug 2, 2014 Home B4
Dr Lee did a Caesarean section on a woman. She screamed when he made a cut on the patient's abdomen at around 8.20 am. .
Dr Lee asked the operating theatre manager to write the words "patient is in supine position after epidural anaesthesia at 0800 hours" on a copy of the nursing record. He offered this record as evidence.
Anaesthetist said that the epidural was given at 8.10 am. It would take at least 15 minutes to take effect.
The Court of Three Judges find that Dr Lee lacked probity. The contested time was of "secondary importance." Dr Lee was guilty of professional misconduct as he did not check whether the epidural had taken effect. 5-month suspension and a $10,000 fine. The Singapore Medical Council Disciplinary Committee had handed a 9-month suspension and a $10,000 fine but Dr Lee appealed.
2. Royal College of Veterinary Surgeons disciplinary cases - suspend, warning, de-licensed.
Protect the welfare of the animals and uphold the reputation of the profession.
2.1 Violent, aggressive and intimidating behavior --- fitness to practice?
2.2 Falsely testifying the test results. Sign false certificate for sheep meant for export. In Singapore, rabies vaccination not done 30 days as required. Certificate following clinical examination of a horse for a prospective purchaser.
2.3 Drunk-driving. Criminal conviction. Disqualified. Still drive employer's car.
2.4 Treatment short of standard to be expected in the profession. Had not removed a of glass inside the dog's stomach, abdominal contamination.
2.5 Illegal tail docking.
2.6 Failure to provide adequate and appropriate veterinary care or treatment. Motivated by financial gain. Caused actual serious injury to 4 animals over a prolonged period of time.
2.7 Clinical incompetence during the treatment of the CKC.
CHEAP CAESAREAN SECTIONS FOR DOG BREEDERS
University professor has no time to teach you the details of handling post-Caesarean puppy not breathing. What to do?
http://www.bekindtopets.com/dogs/20091194Distressed_Maltese_Pup_ToaPayohVets.htm
Case diary for every C-section done in 2004 - 2006. Take images. Now I take videos..
http://www.bekindtopets.com/animals/20081201PAGE2_Dog_Surgery_Anaesthesia_ToaPayohVets.htm
Acquire theoretical knowledge.
Read/buy/borrow books, borrowed from the National Library. Internet.
to be able to offer value-added services e.g. swinging the distressed puppy and save lives. Not just do the C-section and don't know what to do with the respiratory-distressed puppies after that.
OFFICE BEHAVIOUR
Smile and Greet "good morning" when you see your boss on reaching the office. but none do. Maybe the Asian culture
Myanmar Vet assistant and staff wearing slippers and clogs when I was on leave but turned up at the office. POOR IMPRESSIONS TO CLIENTS. Some interns wear shorts and T-shirt.
HUMILITY AND HARD WORK - Ask head nurse or senior vets for help but make sure you do your research and reading first. It is hard work reading the vet books and magazines as young people prefer online gaming and texting. Pleasure is more important than pain of reading widely.
WORK LIFE BALANCE
NOT SO BUSY TIMES
The vet will watch online or streamed movies etc but not spending the hours paid to do office work. No consultation, so watch online movies or text or facebook. Bad attitude. Learn how to use Excel or read vet magazines, but this is hard work and a pain. So pleasure comes in. Time goes by. Still as ignorant as before.
--------------------------------------------------------------------------------------------------------------
2014Travel_Myanmar_Feb
1. 20140209Hinthada
MVI_1667
bride & bridegroom monastery wedding 0.03 - 0:50
MVI_1903 4:18 - 6:34
How to give I/V drip to a dog. Dr Thein Tun Aung. Few thousands of dogs IV experienceclip, IV catheter, plug, tape No. 1 over catheter, put in IV drip, bend catheter, tape No. 2, adhesive tape.
MVI 1905 0:42 - 1.31
PASSION IN THE JOB?
A TRISHAW RIDER GOES TO MARKET
MVI_2013 0:00 - 0:17 Smiles to photographer. Enjoys his work.
DRIVE & DO CASE STUDY ON EVERY ONE OF THEM WITH CAMERA TO DOCUMENT
FOLLOW UP ON POST-OP. Build a portfolio like the artist in the TP website. Complaint to vet authority -- promoting C-sections!
7 DAYS A WEEK
$300 caesarean section for 2 yearsYounger vet cheaper at $250 or less
YOUNG GENERATION USES SMARTPHONES TO RECORD 3RD EYELID FLAP BY DR AUNG - A cat clawed his own eye causing a descemetocoele.
http://youtu.be/C2OPnin1Oj4
Subscribe to:
Posts (Atom)