Nov 19, 2014
Two interns from RGS, Sec 3 and 4 on their 3 day of internship to produce this video.
REVIEW OF SKIN DISEASES
A monthly review is important but many clients do not turn up. Some will go to another vet when the skin diseases still prevail.
In this case, the couple did turn up for a review at 9 am today via SMS to me.
The neutered black and white American Cocker Spaniel was muzzled as he will bite anyone, except the couple, who touches him or pats his head. Some friends had ignored the couple's warning and were bitten. It was kind of the couple to adopt this 4-year-old as normally he would be put to sleep for biting over 10 people in the past. Yet, with love, this dog would not bite the couple and even shake hands with the owner (video) at the end of consultation.
HISTORY
In June 2014, the couple consulted a vet twice in May and July for the skin disease on the top part of the body. There was hair loss and some flakes. Skin cytology revealed bacterial cocci and yeast. The vet prescribed anti-fungal tablets for 20 days, antibiotics and a shampoo.
But there was no improvement and so, I was consulted in Oct 2014. Ultraviolet light showed fluorescence of the bald circular skin patches but microscopic exam of the hairs were negative for ringworm as the dog was under treatment. VIDEO MAY BE AVAILABLE SHOWING UVL EXAM. Check hard-disk
Generalised ringworm and bacterial infections are very difficult for the owner to treat. I had the dog's clipped bald from head to toe under sedation. Daily anti-fungal washes for 1 month. Anti-fungal medication for one month
MONTHLY REVIEW
Today, the owner came as scheduled. There was sparse hair growing on the back spinal area. The head and legs were full of hairs. Generalised ringworm need to be treated thoroughly by clipping the coat of the whole dog to get rid of infested hairs, preventing re-infections from the combs, brushes, towels and harness and reviewing the skin one month after infection.
TIPS
Client Education & Correct Diagnosis.
The vet must spend a lot of time educating the owner on how to wash the body and to advise a monthly review. Negative findings for ringworm in this case would not mean no ringworm as the owner had used her over the counter cream (black circular spots) before seeking vet treatment.
Cocker Rage
In my experience, there are some male Cocker Spaniels who will bite anybody except the owners. This behaviour has been mentioned as Cocker Rage. We have road rage in some Singaporeans who will look for a fight with the other driver or swerve in front of the other driver and brake suddenly to teach the latter a lesson. "Count to 10," is my advice. "If I count to 10, the other driver would have driven away!" the person said to me.
Wednesday, November 19, 2014
Tuesday, November 18, 2014
Saturday, November 15, 2014
1104. An 8-year-old Shih Tzu vomits after eating and drinking
TP 45665
"My dog did eat a squarish piece of bone," the lady owner told me it was around 2.5 cm x 2.5 cm. The dog had been vomiting after eating and drinking during the past 3 days.
There was sore throat but no abdominal pain. X-rays were taken. There could be a bone fragment but it was not obvious in the intestinal tract full of gas.
The owner did not want a blood test which would be very useful in finding a cause. She just wanted the dog treated. I put the dog on a IV drip with antibiotics and anti-spasomgesic for one day. The dog went back the next day with I/D canned food and medication.
BLOOD TEST RESULT ON NOV 14, 2014
I did a blood test which showed a blood borne bacterial infection with total white cell count 26.9 (6-17), neutrophils 89% (60-70) and absolute neutrophil numbers 23.94 (3-11.5).
Liver enzymes were up. SGPT 109 (less than 59), SGOT 111 (less than 81).
FOLLOW UP
Phoned 15.11.14. No more vomiting. The owner was quite happy.
Based on the blood evidence, the cause of vomiting could be due to hepatitis and gastritis due to swallowing of a piece of bone. After 2 days, the dog started vomiting again. The dog had diarrhoea. According to the owner, the dog did not eat the squarish bone but ate other small bone fragments.
It is best to diagnosed based on medical evidence of blood test but many Singapore owners do not want to pay for the test.
"My dog did eat a squarish piece of bone," the lady owner told me it was around 2.5 cm x 2.5 cm. The dog had been vomiting after eating and drinking during the past 3 days.
There was sore throat but no abdominal pain. X-rays were taken. There could be a bone fragment but it was not obvious in the intestinal tract full of gas.
The owner did not want a blood test which would be very useful in finding a cause. She just wanted the dog treated. I put the dog on a IV drip with antibiotics and anti-spasomgesic for one day. The dog went back the next day with I/D canned food and medication.
BLOOD TEST RESULT ON NOV 14, 2014
I did a blood test which showed a blood borne bacterial infection with total white cell count 26.9 (6-17), neutrophils 89% (60-70) and absolute neutrophil numbers 23.94 (3-11.5).
Liver enzymes were up. SGPT 109 (less than 59), SGOT 111 (less than 81).
FOLLOW UP
Phoned 15.11.14. No more vomiting. The owner was quite happy.
Based on the blood evidence, the cause of vomiting could be due to hepatitis and gastritis due to swallowing of a piece of bone. After 2 days, the dog started vomiting again. The dog had diarrhoea. According to the owner, the dog did not eat the squarish bone but ate other small bone fragments.
It is best to diagnosed based on medical evidence of blood test but many Singapore owners do not want to pay for the test.
Friday, November 14, 2014
1102. SCRIPT FOR INTERNS RGS. Ear tumours. Recurring ear canal tumour in an old Jack Russell
Nov 14, 2014
In old dogs, some tumours are malignant. However, many owners do not want to pay for histology to check whether the tumours are malignant. In this case, the tumour at the entrance of the vertical ear canal had been excised by another vet. The tumour came back and grew much bigger.
Vertical ear canal ablation, ie.. the removal of the vertical ear canal is the best option and was done by Dr Daniel.
Ear tumours at the entrance of the vertical canal can become infected or obstruct the ventilation of the ear canals. The dog keeps scratching and the infections cause a bad smell.
Ear canal tumours are not common. This is the second case in 2014. In the first case, the old Husky had a smelly itchy ear. Vertical ear canal ablation by me resolved his problem. Video produced.
In old dogs, some tumours are malignant. However, many owners do not want to pay for histology to check whether the tumours are malignant. In this case, the tumour at the entrance of the vertical ear canal had been excised by another vet. The tumour came back and grew much bigger.
Vertical ear canal ablation, ie.. the removal of the vertical ear canal is the best option and was done by Dr Daniel.
Ear tumours at the entrance of the vertical canal can become infected or obstruct the ventilation of the ear canals. The dog keeps scratching and the infections cause a bad smell.
1101. Internship and experiential learning
Nov 14, 2014
Hi Dr Sing,
We have come to the end of another cycle of our Gap Semester and once again, I would like to thank
Toa Payoh Vets for allowing our boys to be attached to you.
We
asked the boys about the programme and they were very positive about
their experience with you. We hope they have not caused you and your
colleagues too much
trouble.
FEEDBACK FROM BOYS
I
have attached some feedback from the boys. Included are some words of
appreciation which they had submitted on their own accord.
LOOKING TO 2015
We hope to continue this partnership with you next year.
Possible dates:
Currently, the possible blocks of dates for next year are:
Block 1- 2 to 15 Aug (2 weeks)
Block 2 - 16 to 29 Aug (2 weeks)
Block 3 - 13 to 26 Sep (2 weeks)
Number of boys
This year, we had vacancies for 4 boys (2 in Block 1 and 2 in Block 2).
Can we continue with the same number/dates or will you like to offer more vacancies and choose a different block(s)?
Description
Based on this year, the description of the Work Attachment is as follows:
Career Field/Interest
|
·
Interest in Veterinary Medicine
|
Pre-requisites/ Expectations
|
·
Minimum GP of 4.0 for Biology
·
Must love/want to work with animals
·
Preferably able to do/learn simple video production using Windows Movie Maker
·
Willing to work in an environment which requires you to come in direct contact with animals and animal wastes.
|
Description
|
·
Students will be shadowing a Veterinary doctor
·
They will be observing
and working in a real environment dealing with animal healthcare.
Hence, students must not have an aversion to the sight and smell of
blood and must be comfortable in handling animals.
·
As part of the
attachment, students will be tasked to do simple video recording and
production for educational and research purposes.
|
Would we be able to proceed with this arrangement for next year?
------------------------------------
Thank you for your interesting feedback. Most of the
young interns want are to see all the cases and then go home
happily. If there are two at one time, they prefer to chat and do their
own things. As they do not work long hours or weekends, they have little
time to create videos of their cases or do research. So they have to do
time management and not see every case. Seeing is more fun. Writing is a
chore for the young generation.
Case recording and then video production of the case is an important part of experiential learning (if I have got the spelling correct). I improve my skills and expertise by doing this as I will do more research on the particular disease to create quality content in my case report on my blog or video.
Video creation takes too much time as there is a need for me to teach and revise many of the interns' drafts and edit their grammatical errors.
Case recording and then video production of the case is an important part of experiential learning (if I have got the spelling correct). I improve my skills and expertise by doing this as I will do more research on the particular disease to create quality content in my case report on my blog or video.
Video creation takes too much time as there is a need for me to teach and revise many of the interns' drafts and edit their grammatical errors.
Many interns e.g. Intern G was given the least video work compared to his counterpart when I assess they are not so capable of video creation. He still has not edited the video I had asked him through you as he had not contacted me. Once the interns leave with uncompleted work, they seldom bother to complete.
I will be available in the mornings from 9.30 am to 11 am on weekdays. Pl tel me 9668 6468 one day in advance to meet.
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