Dec 31, 2014
I was still in the surgery at around 5 pm. The rabbit had suddenly stopped eating and the lady owner came as her vet must have closed shop on this last day of New Year. Enjoyment was in the air and so many shop owners close early.
This was a new owner who had given critical care to this anorexic rabbit as I noticed some wetness in his mouth. She did not want any injection and this is a mindset of some of the younger generation pet owners and vets as regards injections of rabbits and guinea pigs, thinking they will suffer death.
They would dictate the type of treatment and had researched the internet..
"I am a doctor," she said when I explained that the rabbit would recover faster from injection.
"You heard a squeak when I palpated the abdomen," I explained that the rabbit had a swollen stomach which was painful on palpation. "As a doctor, you would know that it is best not to give oral medication to an upset stomach whenever possible. The stomach would get further irritated."
She reluctantly agreed to the injections which were 0.1 ml of baytril and 0.1 ml of painkiller meloxicam added to 0.4 ml of saline and given subcutaneously via fine needles. There was no painful squeal from the rabbit on injection.
"I want some antibiotics," she said.
"Be patient," I said. "Tomorrow morning, New Year's Day, I will be working in the morning. Giveme a phone call if the rabbit has not started eating. Antibiotics may irritate the stomach and intestines now inflamed."
Now it is 10.30 am on New Year's Day and no news from her.
This is a strange case in the sense that she lives in Toa Payoh but had never come to Toa Payoh Vets. So proximity was not her concern. She liked the service of the other vet south of Toa Payoh. This rabbit has a habit of licking wall paint and biting things compared to the other two roaming ones. So, the stomach could be upset by chemicals from the paint.
"Strict monitoring of the rabbit outside the crate would prevent a 4th occurrence," I said.
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I was at the pet shop to buy hamster food and had a chat with the operator. Her Primary 6 daughter had helped her in the shop. "I listened to what you said about having my children learn about the pet shop business," she told me. "So this 2nd daughter is here. The one in Seconday 1 will come another day."
"If you shield your 5 children from working in the shop, thinking that they better stay at home, you are bringing up your children to dislike the pet shop business and succeeding you later. You think you are protecting them from the smells and dirt of the pet shop animals. But this is a mistake. They will grow up self-centered and not assisting you at all, to keep their hands clean."
Thursday, January 1, 2015
1163. INTERN. SCRIPT. A dwarf hamster has an itchy lower elbow wart
The mother and pre-teen daughter complained that this 2-year-old dwarf hamster had a red bald patch on the right backside area and was itch scratching continually. I observed the hamster and saw the scratching (video) mainly on the right side.
Some vets perform physical examination which does not involve picking up the hamster to examine his lower body. After all, this is such a small creature and everything can be seen at one look.
I picked up this hamster. Surprisingly, there was a hidden lower elbow wart! This could be the irritating inflamed growing wart that caused the right sided itchiness including right ear scratching and the left backside biting wound. Biting and scratching provide instant temporary relief of pain. This was my hypothesis.
If my hypothesis is correct, electro-excision of this ventral wart would resolve the problem.
Now how to excise this wart which extends the whole width of the lower elbow? It is a gigantic wart if you imagine your lower elbow's width being occupied by a large wart. Should the vet use scissors to excise it and how to control the post-op profuse bleeding?
The hamster is aged, being 2 years old and has around 6 months of life generally. Would the hamster die under anaesthesia and therefore damage the vet's reputation?
What to do to resolve this problem without killing the hamster? Reputational risks are more important for a private vet. Nobody will refer cases to him if he or she has hamsters dead on the operating table.
I decided to give the hamster only isoflurane gas anaesthesia. I used the circular electric loop wire to electro-excise the wart in a split second when the hamster was just anaesthesized by the gas. I used forceps to lift up the wart and excise under it. There was some normal skin. The wart came off and there was just a 3 mm wound. Blood-less. See video.
The hamster went home on the same day and the mother and daughter were happy and satisfied.
In conclusion, if the vet does not examine the underside of the hamster, he or she would mis-diagnose as environmental cause of itchiness and this would not resolve the itchiness problem.
TIPS
Always examine the underside of the dwarf hamster by picking up the hamster and turning him upside down. This elbow wart would have been missed as it was not protruding. A correct diagnosis resolves the client's problem and bring in more referrals than slick advertising. Vets have to deliver results and perform like any service provider.
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Jan 3, 2015
COMMENTS ON VIDEO PRODUCED BY INTERN JIA LING
1. A fast-paced concise video
To improve the quality of production
1. Not to publish the title of video as this is unnecessary
2. Subtitles to be on white text on a black band. White text not easily read in this video.
3. Subtitles are too rapid to be read
4. The BKTP image is flashed by too quick to be read
5. Weak concluding frames - same videos of hamster still scratching. Should have a post-op video or something similar rather than repeat the opening
6. The backside wound - main complaint was not emphasized.
7. Credits -- more videos at www.toapayohvets.com/videos.htm
Some vets perform physical examination which does not involve picking up the hamster to examine his lower body. After all, this is such a small creature and everything can be seen at one look.
I picked up this hamster. Surprisingly, there was a hidden lower elbow wart! This could be the irritating inflamed growing wart that caused the right sided itchiness including right ear scratching and the left backside biting wound. Biting and scratching provide instant temporary relief of pain. This was my hypothesis.
If my hypothesis is correct, electro-excision of this ventral wart would resolve the problem.
Now how to excise this wart which extends the whole width of the lower elbow? It is a gigantic wart if you imagine your lower elbow's width being occupied by a large wart. Should the vet use scissors to excise it and how to control the post-op profuse bleeding?
The hamster is aged, being 2 years old and has around 6 months of life generally. Would the hamster die under anaesthesia and therefore damage the vet's reputation?
What to do to resolve this problem without killing the hamster? Reputational risks are more important for a private vet. Nobody will refer cases to him if he or she has hamsters dead on the operating table.
I decided to give the hamster only isoflurane gas anaesthesia. I used the circular electric loop wire to electro-excise the wart in a split second when the hamster was just anaesthesized by the gas. I used forceps to lift up the wart and excise under it. There was some normal skin. The wart came off and there was just a 3 mm wound. Blood-less. See video.
The hamster went home on the same day and the mother and daughter were happy and satisfied.
In conclusion, if the vet does not examine the underside of the hamster, he or she would mis-diagnose as environmental cause of itchiness and this would not resolve the itchiness problem.
TIPS
Always examine the underside of the dwarf hamster by picking up the hamster and turning him upside down. This elbow wart would have been missed as it was not protruding. A correct diagnosis resolves the client's problem and bring in more referrals than slick advertising. Vets have to deliver results and perform like any service provider.
------------------------------------------------------
Jan 3, 2015
COMMENTS ON VIDEO PRODUCED BY INTERN JIA LING
1. A fast-paced concise video
To improve the quality of production
1. Not to publish the title of video as this is unnecessary
2. Subtitles to be on white text on a black band. White text not easily read in this video.
3. Subtitles are too rapid to be read
4. The BKTP image is flashed by too quick to be read
5. Weak concluding frames - same videos of hamster still scratching. Should have a post-op video or something similar rather than repeat the opening
6. The backside wound - main complaint was not emphasized.
7. Credits -- more videos at www.toapayohvets.com/videos.htm
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