Sibling, 1.5 years old. Small tumour became large. Her previous hamster died under operating table at the 3rd surgery to remove the chest tumour.
"Why don't you come earlier?" I asked the sales girl. "Now, the tumour is over 1.2 cm in diameter in the right armpit area. It is very risky to operate."
"I have to wait till I earn enough," the girl said. "Now, my hamster does not want to eat much and walks with difficulty. So,I brought in for surgery."
Wednesday, May 5, 2010
52. CASE STUDY: HOUSE BREAKING Toy Poodle
Problem: Not house-trained after 2 months with owner.
Dog: Male, toy poodle, 5 months. Thin.
Owners: Young man in late 30s, elder sister and parents
Housing: Apartment - Free to roam but crated at night. Eliminates everywhere.
Consult Vet: Pimples on flanks and thighs 5 days after proheart vaccination. "Is it due to the proheart injection?" the young man asked. "No," I said. "Puppy skin is easily infected by bacteria s it is not mature. Happens in many puppies."
"What is the medical condition?" the young man asked me.
"Is it Impetigo?" the young man showed me the name in his smartphone screen. He had researched the internet well.
House-breaking
"My friend told me it takes 1 month to house-train a puppy," the young man said. "Now, it is 2 months and the puppy pees and poops everywhere."
Confinement
"You let the puppy out after the first night," I said. "
"Yes," the young man replied. "He was barking and barking and may upset our neighbours."
Dog: Male, toy poodle, 5 months. Thin.
Owners: Young man in late 30s, elder sister and parents
Housing: Apartment - Free to roam but crated at night. Eliminates everywhere.
Consult Vet: Pimples on flanks and thighs 5 days after proheart vaccination. "Is it due to the proheart injection?" the young man asked. "No," I said. "Puppy skin is easily infected by bacteria s it is not mature. Happens in many puppies."
"What is the medical condition?" the young man asked me.
"Is it Impetigo?" the young man showed me the name in his smartphone screen. He had researched the internet well.
House-breaking
"My friend told me it takes 1 month to house-train a puppy," the young man said. "Now, it is 2 months and the puppy pees and poops everywhere."
Confinement
"You let the puppy out after the first night," I said. "
"Yes," the young man replied. "He was barking and barking and may upset our neighbours."
Monday, May 3, 2010
51. The guinea pig with two loose front teeth
I was shocked. The young lady closed her eyes and lowered her head as I took her guinea pig to the operating room. This young lady was extremely upset as she did not accept my explanation that her guinea pig would not die on the operating table under gas anaesthesia. Her other 2-year-old guinea pig who was following her mum around every day had died despite treatment by Vet 1. The guinea pig was not eating and just died. Some causes of death are unknown unless autopsies are carried out and this was not done. So, she imagined the worst for this guinea pig.
She had heard so many stories of anaesthetic deaths and this 2.5-year-old guinea pig needed some gas anaesthesia. "The guinea pig always bite the BBQ wire fencing every morning to ask for her breakfast. Today, a loud banging noise frightened her and her teeth was broken when she tried to run off."
"Isoflurane gas anaesthesia is very safe for guinea pigs," I explained to her. She would not accept my explanation and wanted to be present. "No," I said. "You will stress yourself and everybody by being present at the operating room. I have to focus on the anaesthesia and you will be a great distraction."
So, the young lady had to wait in the waiting area. The guinea pig squealed when I touched her. My assistant took out the face mask as this was the standard procedure. He was on auto-pilot. "No face mask," I said. "The guinea pig has two loose front teeth and they are loose and bleeding. The usual small face mask will cause pain as it will touch the teeth. The best method is to use a bag and put the guinea pig inside this bag. Go and get a bag" Teaching my Myanamr vet assistant is part of my contribution to society. Once he is good, he will be in great demand and goes away. This can't be helped. In fact, competitors have tried to lure him away from my practice as he has 2 years of experience at Toa Payoh Vets. I accept that he needs to secure for himself a better future. No employee works long in a place and two years were great. What he needs is another 2 years and he can open his own vet practice in Myanmar, after learning the tricks of the trade from me and my assistant Dr Jason Teo. He could also learn by job-hopping. Maybe.
I made my assistant think. He went to look for a plastic bag. "Take this narrow vertical plastic corner and put the guinea pig inside," I showed him the gadget which was wide enough to fit the small guinea pig. It was slightly longer than the length of this little pig and was open at the top. I found this narrow transparent plastic container shop and knew it would be useful as an anasthetic chamber for the anaesthesia of guinea pigs and rabbits. Plastic bags are poor alternatives.
"What to do with the open top?" I asked my assistant. He got some towel tissue, made a central hole and taped the tissue at the sides, thereby covering the open top. It was OK. The hole would be where the endotracheal tube would be inserted to pipe in the isoflurane gas. This was what we do for hamster anaesthesia.
I was thinking too. Is there an alternative to this paper-top cover up which appeared flimsy? "Just get a thick white towel to cover the top," I said. At the side, put in the gas.
We did that. The guinea pig turned her head away from the incoming gas. But since the whole container was covered, she breathed the 5% isoflurane gas. Suddenly, the whole floor of this transparent container had a milky white discharge. She had peed. Within 5 mintues, she was dazed. I took her out, examined the front teeth. They were loose. I just extracted them and presented them to the happy lady.
Since I was free, I gave her a ride to Agnes' pet shop where she had bought her guinea pig and wanted to buy some hay or "emergency diet for guinea pigs". I don't sell pet food and so I drove her to Agnes and at the same time, see the new pet shop set up by Agnes.
Agnes had not told me about her new pet shop. Since she had no more rabbit scabies problems for the past 6 months, I did not have any referrals from her. I thought she had closed her half-shop in Ang Mo Kio as I just can't figure how she could survive.
This new pet shop set up one month ago was bright and pretty. Guinea pigs, hamsters and rabbits were sold here. In clean plastic containers. No puppies or kittens. I was glad that Agnes had prospered as I know that the pet shop business is a cut throat underpricing business in Singapore.
"The guinea pig's teeth will grow back in two weeks," Agnes said. "Use a file to file the lower teeth every day." This filing system was what I advised the guinea pig owner now that the two upper front teeth was broken at the gum level and the lower front teeth would grow and grow. I was told that the guinea pig's tooth grows 1 mm per day. In 14 days, it should be 1.4 cm if what I was told was correct.
"You don't think that guinea pigs are dumb creatures," Agnes implied to me when I told her that the dead guinea pig of the lady owner used to follow the mum around every day and was said to be more intelligent than the one with the loose front teeth. "I have a client who spends a lot of time with her guinea pig. When my client says 'bang' and points her forefinger and thumb, the guinea pig falls to the side and plays dead." Certainly, Agnes is an authority on guinea pig behaviour.
I was admiring the new pet shop. Suddenly, a mother and daughter came in with a scratching rabbit. The story continues
She had heard so many stories of anaesthetic deaths and this 2.5-year-old guinea pig needed some gas anaesthesia. "The guinea pig always bite the BBQ wire fencing every morning to ask for her breakfast. Today, a loud banging noise frightened her and her teeth was broken when she tried to run off."
"Isoflurane gas anaesthesia is very safe for guinea pigs," I explained to her. She would not accept my explanation and wanted to be present. "No," I said. "You will stress yourself and everybody by being present at the operating room. I have to focus on the anaesthesia and you will be a great distraction."
So, the young lady had to wait in the waiting area. The guinea pig squealed when I touched her. My assistant took out the face mask as this was the standard procedure. He was on auto-pilot. "No face mask," I said. "The guinea pig has two loose front teeth and they are loose and bleeding. The usual small face mask will cause pain as it will touch the teeth. The best method is to use a bag and put the guinea pig inside this bag. Go and get a bag" Teaching my Myanamr vet assistant is part of my contribution to society. Once he is good, he will be in great demand and goes away. This can't be helped. In fact, competitors have tried to lure him away from my practice as he has 2 years of experience at Toa Payoh Vets. I accept that he needs to secure for himself a better future. No employee works long in a place and two years were great. What he needs is another 2 years and he can open his own vet practice in Myanmar, after learning the tricks of the trade from me and my assistant Dr Jason Teo. He could also learn by job-hopping. Maybe.
I made my assistant think. He went to look for a plastic bag. "Take this narrow vertical plastic corner and put the guinea pig inside," I showed him the gadget which was wide enough to fit the small guinea pig. It was slightly longer than the length of this little pig and was open at the top. I found this narrow transparent plastic container shop and knew it would be useful as an anasthetic chamber for the anaesthesia of guinea pigs and rabbits. Plastic bags are poor alternatives.
"What to do with the open top?" I asked my assistant. He got some towel tissue, made a central hole and taped the tissue at the sides, thereby covering the open top. It was OK. The hole would be where the endotracheal tube would be inserted to pipe in the isoflurane gas. This was what we do for hamster anaesthesia.
I was thinking too. Is there an alternative to this paper-top cover up which appeared flimsy? "Just get a thick white towel to cover the top," I said. At the side, put in the gas.
We did that. The guinea pig turned her head away from the incoming gas. But since the whole container was covered, she breathed the 5% isoflurane gas. Suddenly, the whole floor of this transparent container had a milky white discharge. She had peed. Within 5 mintues, she was dazed. I took her out, examined the front teeth. They were loose. I just extracted them and presented them to the happy lady.
Since I was free, I gave her a ride to Agnes' pet shop where she had bought her guinea pig and wanted to buy some hay or "emergency diet for guinea pigs". I don't sell pet food and so I drove her to Agnes and at the same time, see the new pet shop set up by Agnes.
Agnes had not told me about her new pet shop. Since she had no more rabbit scabies problems for the past 6 months, I did not have any referrals from her. I thought she had closed her half-shop in Ang Mo Kio as I just can't figure how she could survive.
This new pet shop set up one month ago was bright and pretty. Guinea pigs, hamsters and rabbits were sold here. In clean plastic containers. No puppies or kittens. I was glad that Agnes had prospered as I know that the pet shop business is a cut throat underpricing business in Singapore.
"The guinea pig's teeth will grow back in two weeks," Agnes said. "Use a file to file the lower teeth every day." This filing system was what I advised the guinea pig owner now that the two upper front teeth was broken at the gum level and the lower front teeth would grow and grow. I was told that the guinea pig's tooth grows 1 mm per day. In 14 days, it should be 1.4 cm if what I was told was correct.
"You don't think that guinea pigs are dumb creatures," Agnes implied to me when I told her that the dead guinea pig of the lady owner used to follow the mum around every day and was said to be more intelligent than the one with the loose front teeth. "I have a client who spends a lot of time with her guinea pig. When my client says 'bang' and points her forefinger and thumb, the guinea pig falls to the side and plays dead." Certainly, Agnes is an authority on guinea pig behaviour.
I was admiring the new pet shop. Suddenly, a mother and daughter came in with a scratching rabbit. The story continues
50. The rabbit 's neck became bald suddenly
I was at a pet shop when a mother and her pre-teen daughter came in with a 3-month-old rabbit with no more hairs on the neck between the shoulders.
"The rabbit keeps scratching the back of the neck non-stop," the mother had bought the rabbit recently. Agnes, the pet shop owner whom I knew for some years and had excellent working relationships introduced me as a vet. "Do you have a name card?" the mother asked. Before I could take one out, the guinea pig owner whom I treated her guinea pig for loose front teeth and had driven her to this pet shop where she bought the guinea pig, handed my namecard to the lady. I was surprised.
"It is best to bathe the rabbit," I advised Agnes. "But rabbits at 3 months of age should not be bathed or they will die."
"They will not die," I told Agnes who had applied a spot-on insecticide on the neck between the ears behind the neck and between the shoulders. "You need to wash off the spot-on insecticide as it is irritating the rabbit. Use very warm water."
"The owner can bathe the rabbit at home," Agnes was reluctant to do it. I asked her to do it as there was an opportunity to rectify what went wrong. The mother and daughter were first-time rabbit owners and would not be able to bathe it. "The rabbit may fracture its legs too, if the owner does it". I could take over the bathing but that would not be the right thing to do as Agnes could easily do it.
"Why don't you bathe the rabbit and if the rabbit still scratches the neck with its hind legs, I will treat it," I said to Agnes. Veterinary costs are much higher and I know most Singapore owners have this culture of "seeking the groomer first." Groomers are more affordable.
Later in the day, the mother and daughter came to see me. "Is there less scratching now after bathing?" I asked. "Yes," the mother said. "I paid $30 for the bath which took half an hour. But the rabbit is still using the hind legs to scratch the neck."
I gave an anti-inflammatory injection subcutaneous and tried to provide the least veterinary cost to the owner. "Let me know if the rabbit still scratches," I advised the stressed mother. No complaints for the last 2 days. I presumed all are back to normal.
P.S
Hypersensitivity to spot on insecticides may occur in animals. The rabbit had been bathed with an insecticide powder but since it was still shaking its head, Agnes applied a spot-on insecticide.
"The rabbit keeps scratching the back of the neck non-stop," the mother had bought the rabbit recently. Agnes, the pet shop owner whom I knew for some years and had excellent working relationships introduced me as a vet. "Do you have a name card?" the mother asked. Before I could take one out, the guinea pig owner whom I treated her guinea pig for loose front teeth and had driven her to this pet shop where she bought the guinea pig, handed my namecard to the lady. I was surprised.
"It is best to bathe the rabbit," I advised Agnes. "But rabbits at 3 months of age should not be bathed or they will die."
"They will not die," I told Agnes who had applied a spot-on insecticide on the neck between the ears behind the neck and between the shoulders. "You need to wash off the spot-on insecticide as it is irritating the rabbit. Use very warm water."
"The owner can bathe the rabbit at home," Agnes was reluctant to do it. I asked her to do it as there was an opportunity to rectify what went wrong. The mother and daughter were first-time rabbit owners and would not be able to bathe it. "The rabbit may fracture its legs too, if the owner does it". I could take over the bathing but that would not be the right thing to do as Agnes could easily do it.
"Why don't you bathe the rabbit and if the rabbit still scratches the neck with its hind legs, I will treat it," I said to Agnes. Veterinary costs are much higher and I know most Singapore owners have this culture of "seeking the groomer first." Groomers are more affordable.
Later in the day, the mother and daughter came to see me. "Is there less scratching now after bathing?" I asked. "Yes," the mother said. "I paid $30 for the bath which took half an hour. But the rabbit is still using the hind legs to scratch the neck."
I gave an anti-inflammatory injection subcutaneous and tried to provide the least veterinary cost to the owner. "Let me know if the rabbit still scratches," I advised the stressed mother. No complaints for the last 2 days. I presumed all are back to normal.
P.S
Hypersensitivity to spot on insecticides may occur in animals. The rabbit had been bathed with an insecticide powder but since it was still shaking its head, Agnes applied a spot-on insecticide.
49. Mind Your Own Business
Chinese Wedding dinners are very boring obligations unless one sits with a talkative group. A vet whom I still remember as a primary school boy in his mother's practice was hosting a wedding dinner and his mum invited me. I had asked to sit with a group of friends so as to enjoy my dinner. The bridegroom's brother was very helpful and found me a table with 5 people though it was meant for 10. A Myanmar vet technician who told me he was sitting in this table suddenly disappeared but there was Mr Goh, a veterinary drug salesman I had known for over 30 years. Mr Goh, another vet and her friend were good conversationalists and we had some laughter when my old friend, a retired vet called Dr X, came to sit beside me. I had not seen him for several months and it was good to catch up with him. Soon a Filipino vet technician joined us. For some unknown reason, Mr Goh, asked Dr X to give a lift back home in front of everybody. Dr X said in his usual quiet voice, "OK". While Dr X went back to his table where his wife was seated, the veterinary technician who had left as his wife was at another table, came to our table again. Mr Goh asked the waiter for a glass of brandy for him. A second glass was drunk.
For some unknown reason, Mr Goh bragged about his doing a good service of getting a free ride for the technician. The technician announced calmly, "I will be taking a taxi with my wife home after the wedding dinner. We have to go somewhere."
Mr Goh said, "Where do you want to go with your wife after the wedding dinner? It is already 11 pm?" This is where Mr Goh should mind his own business.
The technician raised his voice, "You think that Filipinos can't afford taxi fares and must take lifts home! In the Philippines, I can afford a Mercedes."
Dr X who agreed to give him a lift home drove a Mercedes. I minded my own business and kept mum. Mr Goh could not keep his mouth shut, "Dr X is going home in the same area as you live." This was a fact.
The technician's eyes looked bigger and he stood up and shouted as loudly as he could, "You will not survive if you live in the Philippines." The wedding dinner crowd was not the hard-drinking noisy type.
The bride had changed from her white wedding dress to red and was going round the tables to take pictures. As the crowd was the conservative type, there was not much cheering and toasting the wedding couple. So the technician's shouting could be heard distinctly.
Suddenly the technician's wife came over and spoke to him. Her forehead wrinkled and she pulled him away from the table. This was an unforgettable incident and reminded me that it is best to "mind your own business."
I can't figure out why the drug salesman would impose on Dr X to ask him to give a lift home to the veterinary technician, causing the latter to feel that he was penniless and could not afford taxi fares.
Dr X was a retiree and was most hospitable and happy when he came to chat with me and those at the table. Resentment surfaced in unexpected situations and one should mind one's own business as there are better and less stressful things to do in life than doing "match-making" car rides.
Sunday, May 2, 2010
48. Puppy playpen + 2 pee pans bought. What to do?
SUNDAY'S CASE
Pembroke puppy brought in for examination as the pet shop seller gives a 24-hour guarantee.
1. If the puppy is medicated against diarrhoea or kennel cough, the disease of parvovirus and kennel cough cannot be seen sometimes. The owner must be aware of this fact. Parvoviral diseases take several days to show the symptoms. A parvo-viral faecal test may be done.
2. Pembroke Corgi with long tail. This is normal, I said to the owner.
3. House-training. The pet shop sold the owner a playpen which can enclose a pee pan and a bottle of puppy training liquid. He also sold another pee pan. "What advices did the Seller give you?" I asked. "Why is there an extra pee pan?".
It is a pity that Puppy Sellers in Singapore don't co-operate to provide detailed information on how to use the tools sold to house-train the puppy. Puppy house-training books written by Caucasians are many but they seldom have the detailed relevant explanations as for this case.
This will be an opportunity for vets to create goodwill by providing the information but this is seldom done too as it takes around half an hour to explain how to do it and a long queue is waiting on a busy Sunday. Use drawings.
4. I had taken a photo of my illustrations and explanation. Will upload at www.toapayohvets.com later. Maybe a book will be better. But is there a demand for such a book?
Pembroke puppy brought in for examination as the pet shop seller gives a 24-hour guarantee.
1. If the puppy is medicated against diarrhoea or kennel cough, the disease of parvovirus and kennel cough cannot be seen sometimes. The owner must be aware of this fact. Parvoviral diseases take several days to show the symptoms. A parvo-viral faecal test may be done.
2. Pembroke Corgi with long tail. This is normal, I said to the owner.
3. House-training. The pet shop sold the owner a playpen which can enclose a pee pan and a bottle of puppy training liquid. He also sold another pee pan. "What advices did the Seller give you?" I asked. "Why is there an extra pee pan?".
It is a pity that Puppy Sellers in Singapore don't co-operate to provide detailed information on how to use the tools sold to house-train the puppy. Puppy house-training books written by Caucasians are many but they seldom have the detailed relevant explanations as for this case.
This will be an opportunity for vets to create goodwill by providing the information but this is seldom done too as it takes around half an hour to explain how to do it and a long queue is waiting on a busy Sunday. Use drawings.
4. I had taken a photo of my illustrations and explanation. Will upload at www.toapayohvets.com later. Maybe a book will be better. But is there a demand for such a book?
Scratches mouh and saliva-stained front legs
SUNDAY'S INTERESTING CASE STUDIES
Mar 16, 2010
A young couple brought their dog came in for consultation of skin lumps on the back spinal area.
Why did this 12-year-old male Shih Tzu have purplish stains on the upper part of his front legs? Bad breath, Thin. Treatment with antibiotics and anti-fungal wash. Advised dental 7-10 days later as this would be ideal time as dog had antibiotics and his mouth would be free of bacteria.
May 2, 2010 (Sunday)
No saliva stains. I was surprised to see pure white hairs on front legs now. So, the dog had not been rubbing his painful mouth with his front legs. Dental scaling and extraction.
ANAESTHESIA
All 12-year-old dogs are high anaesthetic risks. Blood tests advised but not accepted. This must be recorded. Isoflurane gas anaesthesia is the safest method.
TEETH
15 loose teeth extracted. Dog goes home. Should be living longer now.
CONCLUSION
It is best to get your dog dental scaling from 2 years of age and every year or two, rather than live with bad breath and saliva-stained front paws. After the dental, he permitted his mouth to be opened as there was not much pain now.
Mar 16, 2010
A young couple brought their dog came in for consultation of skin lumps on the back spinal area.
Why did this 12-year-old male Shih Tzu have purplish stains on the upper part of his front legs? Bad breath, Thin. Treatment with antibiotics and anti-fungal wash. Advised dental 7-10 days later as this would be ideal time as dog had antibiotics and his mouth would be free of bacteria.
May 2, 2010 (Sunday)
No saliva stains. I was surprised to see pure white hairs on front legs now. So, the dog had not been rubbing his painful mouth with his front legs. Dental scaling and extraction.
ANAESTHESIA
All 12-year-old dogs are high anaesthetic risks. Blood tests advised but not accepted. This must be recorded. Isoflurane gas anaesthesia is the safest method.
TEETH
15 loose teeth extracted. Dog goes home. Should be living longer now.
CONCLUSION
It is best to get your dog dental scaling from 2 years of age and every year or two, rather than live with bad breath and saliva-stained front paws. After the dental, he permitted his mouth to be opened as there was not much pain now.
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