Saturday, October 21, 2017

3159. Royal Asia Veterinary Surgery, Yangon, Myanmar

1 June 2023.


Dr Sing Kong Yuen, BVMS (Glasgow) is the veterinary consultant for Royal Asia Veterinary Surgery, Yangon (RAVS). He had been the consultant since the founding of RAVS over 15 years ago.

RAVS is a thriving practice under Dr Thein Tun Aung who had worked in veterinary practices in Singapore for over 15 years and is able to communicate well in English. RAVS is considered a top veterinary surgery in Myanmar as Dr Thein performs various types of surgeries not available  at the other clinics.

Many cases such as rabies, parvovirus and distemper which can be prevented by vaccination can be seen in Myanmar. These are rarely seen in Toa Payoh Vets or Singapore's veterinary practices in 2023, as almost all puppies are vaccinated. Some 15 years ago, Dr Sing has seen distemper, kennel cough and other viral diseases in puppies.


Dr Thein Tun Aung (left)


Veterinary Reception Area


Veterinary Reception Area

The address is:
 Royal Asia Veterinary Surgery
 296A Than Thu Mar Road
 South Okkalapa township
 Yangon, Myanmar
 Tel: 01-85007115
 Emergency Tel: 09-4210-66887

Interesting case studies in the videos were seen during Dr Sing's visits pre-Covid 19 pandemic are:

 https://www.youtube.com/watch?v=DaeMBn66jmk

 https://www.youtube.com/watch?v=LV0Z2lgptsA

 https://www.youtube.com/watch?v=CDAXZPBljJg

 https://www.youtube.com/watch?v=P-Jofu1cXa0

 https://www.youtube.com/watch?v=kEB_Kak9uME

Perineal urethrostomy surgery in the cat
 

Thursday, October 19, 2017

3158. A 10-year-old Shih Tzu had eye problem for 4 days.

"She is very thin and sick," I examined the lethargic and recumbent Shih Tzu with the swollen prolapsed eyeball with corneal ulcerations and descemeotocoele. "I need to do a blood test to check the health."

The daughter had surfed the net and asked to see me.  
"Vet 1 had done the blood test  2 days ago and said the report showed kidney failure,"  the mother had consulted Vet 1 who prescribed eye drops, antibiotics and stesolid enema. 
"Vet 1 advised an MRI scan and CT scan," the mother said. "I cannot afford it."
"Why would Vet 1 want an MRI scan for eye problem?"
"I complained about the dog being giddy."


 BLOOD TEST DONE AT TOA PAYOH VETS ON 17.10.17
Liver ALT 225 (less than 59), AST 398 (less than 81) -- suggestive of liver disorder.
Kidney urea 40.4 (4.2-6.3)
             creatinine 189 (89-177).

Haemoglobin 7.2   (12-18)
Red cell count 3.4   (5.5 - 8.5)
Total white cell count 27(6-17)
Haematocrite (PCV) 0.20   (0.37-0.55)
Platelets 46  (200-500). Platelet clumping noted.

Later in the afternoon, the dog passed away while beingiven IV drip.

3157. 2-year-old Corgi had 2 mummified foetus and one small live pup

Oct 19, 2017

"Corgis are hard to breed," the breeder said. "Hence the pups are expensive, over $10,000".

Record: Mated on Aug 17, 2017. One mating only if there is a tie, the breeder said.  So, this would be 62nd day of gestation. Black vaginal discharge seen today. The breeder went to Vet 1 to scan as the dam was overdue 2 days.

He used stethoscope. "Only one pup had heart beat. Do Caesarean section fast!"

The breeder thought the dam was short of 2 days but she was overdue by 2 days. Vet 1 had never performed Caesarean before. 2 vets were on leave. 1 had resigned. So the breeder came to Toa Payoh Vets as he did not want sn inexperienced vet to do the surgery. The fees are much lower at Vet 1.

"What happened to the 6 big healthy Dachshund puppies I did Caesarean section some weeks earlier?" I asked.
"3 died," he said sadly.
2 were bitten by the dam at 2 days of age. 1 died by itself."

Sunday, October 15, 2017

3156. A love bird, budgie and 2 cockatiels live in harmony

Sat Oct 15, 2017

The 4 birds were perched inside a carrier in harmony. They were less than 1 year old and were raised together at a young age by this lady owner.






3155. A rabbit stops eating suddenly - molar spurs and tongue plaque








The owner came early for treatment a few hours after the rabbit stopped eating.
"Likely to be dental problems," I pried open the front lips. "The front teeth are normal and not overgrown. I suspect the problem is molar spurs which are sharp edges of the cheek teeth cutting the underside of the tongue. I need gas anaesthesia to examine the cheek teeth."

The owner gave consent and signed the form.  "I detect a small lump of around 4 mm in the abdomen and this could be hair ball. Has the rabbit been grooming excessively?"  The owner was not sure.

Gas anaesthesia. Dental instruments. Molar spurs on the lingual side of the tongue on both left and right cheek teeth. I got them filed.

The next day, the rabbit eats and poops. The 3rd day of inpatient, the rabbit is OK and eating and pooping. Sent home. Evidence of more than 20 faecal pellets and the above images sent to owner. .

Saturday, October 14, 2017

3154. Rabbit hip dislocation X-rays & cat and dog hip dislocation

Will a femoral head osteotomy work in rabbit hip dislocation? This case did not have the surgery.


TP46483
Rabbit. Peanut.  3 yrs old. Left hip dislocation



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A 3-month-old rabbit hip dislocation. No surgery.








-------------------
TP50133

In the dog, the operation is generally successful in permitting the dog to walk almost normally as seen in the video of Kobe post op some months later.





Oct 13, 2017. Surgery on Aug 7, 2017.  The happy owner sent a video to Toa Payoh Vets on Oct 13, 2017 as follows: 

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Cat hip dislocation. Closed reduction. The owner does not come back for review.

 Case at:

http://2010vets.blogspot.sg/2015/08/a-cat-has-dislocated-right-hip.html














-----------------------------------------------------------------------------
TP 43447
Left hip pain






3153. My family dentist. Molar amalgam fell off on Oct 12, 2017

On Oct 12, 2017, I felt a large hole inside my left upper molar. This was due to the falling out of the mercury amalgam covering my large cavity over 50 years ago. I could feel the sharp edges and a large hole, but no pain. This meant that the pulp cavity was not there or the tooth was "dead."

On Oct 13, 2017, I walked in to my family dentist who said: "Your cavity is large and challenging. I will do my best to plug it. If you feel the pain later, you will need a root canal treatment. I will refer to you a specialist in Takashimaya Shopping Centre as I don't do this treatment."

I sat on the dental chair. The dentist educated me on the anatomy of the tooth by showing me a chart of illustrations. "The pulp is where the nerve is," she said. "If my treatment of plugging up the cavity cause pain later, that means there is pressure on the pulp and you will need a root canal treatment."

"Why don't you extract the molar since the crown is 90% cavity?" I asked.
"It is best to save the tooth," she said. "Hence the root canal treatment. Do not worry."

Some drilling of the tooth. Suction. Rinse my mouth. More drilling. Only a short time of mild pain during drilling, all to my surprise. Is the tooth dead?

"It has been some years since 2009 since I saw you," the dentist checked the records. "If I depend on you for dental services, I will need to close down," she joked. Two new dental clinics have now opened.

"How many dental clinics are there now?" I asked.
"When I started, it was 300," she reminisced. "Now there are over 1,000."

"I ask my children not to go into private medical practices," she said. "The big private medical groups need to make more money every year. It is better to work for institutions."

She advised me not to go to private practices as they need to justify their bottom lines and therefore will recommend unnecessary treatments to generate revenue. Large groups are now formed from mergers and acquisitions of smaller groups and so they must make more money for the shareholders. That means more unnecessary treatments.

"The younger generation is not loyal," my dentist said.
"Most of the young is time-pressed and wants convenience of proximity, immediacy and low price," I said. "So, there is no loyalty. 

We spoke on family. Her son is a medical undergraduate overseas. "The senior consultant is good," she said. "He has many important clients. That day, he told the other younger doctor to get out as this doctor came to work without a tie."

She is pro-family as she said that a married couple should have children soon after marriage. "Some wives may want to achieve success in their new careers and motherhood meant being side-tracked," I said.

"The Chinese saying: ''Suffer hardship early (in life), enjoy sweetness later (in life)," she told me that I was westernised in advocating a married woman's right to choice of career over motherhood.  If the wife is ambitious in being top in her profession, let her do it. It is not possible to have both although there is "work-life" balance being advocated and there are domestic helpers to look after children.  It is her personal choice and the husband has better accept it.

"What would you do if you have a person who says he has no money but insisted vehemently to be treated by you?" she had such a male aggressor. "If he was poor, I can reduce the charges." This person just wanted free services by being aggressive and hope to get away with it.

"There are such people in life," I said. "Some years ago, I have a case when a young couple had no money for deposit. I did a Caesarean section for their Jack Russell and never received a cent from the couple!"



My filling needed two tubes. I had to bite on some paper tissues to confirm the grip. Then I was not supposed to eat or drink for 2 hours. No hot and cold food and drinks for 2 months. Is my tooth dead?  Will I need root canal treatment which will be costly if down by the downtown specialist whom she says is good and has excellent bedside manners, from her feedback?  Only time will tell.

On Oct 19, after Deepavali, I have a 8.30 am dental scaling appointment with her. She is busy but not overwhelmed nowadays. The two new competitors open till 8.30 pm but she closes in the evening. So, it is her choice for family and to bring up the children well.  .

The two children are now undergraduates overseas and they prefer to come home rather than going around Europe during holidays. "They want the family to holiday together," she told me. It is such a joy to to have such filial children, well brought up and able to study to university level.