117. Don't take my picture!

"Don't take my picture! No...no..." the Golden Retriever shifted and lowered and turned his head as his young lady owner tried to pry open his left eyelid for me to take a photograph of the bleeding conjunctiva for my educational purpose in the "Be Kind To Pets" community education project.



A gentle big dog. His lady owner could not position the eyelid, exposed it for me to photograph a wide bleeding strip of conjuncitiva -- reddish and swollen from 11 o'clock to 5 o'clock.

"I'll take the picture for you," the young man said. OK, it was best not to stress out this gentle giant who was attacked by a Border Collie. Two pictures were taken. One was good enough. Beggars can't be choosers! Thanks to the young couple. The dog was treated and should recover with nursing and medication!

Now, why would a Border Collie attack him? Dogs have nemesis too!

116. Words don't come easy.

Tips for asthmatic suffers

"If you have to go, you have to," the young man said but his mum said, "This is not the order of life. Parents die before their children."

This young man, at around 21 years of life feel incredibly invincible. He ran the army marathon and got his award. He partied till the early hours of the morning though he was not seen intoxicated and drunk.

A few young men in Singapore had crashed the cars in the early hours of the morning and caused immense grief to their parents as they perished.

But this young man had a guardian angel. He escaped death in one car he drove at 4 a.m after driving friends home. The car did a somersault as it hit the central fencing separating two roads.

The car flew up, crossed the central fence, did a U-turn and landed upright on the only side of Thomson Road. A big hole in the roof and dented front door. The car was even facing the right direction. It did hit and dented the bumper of a taxi but the taxi driver was not hurt.

This young man did not have one wound. The police did not find him drunk. The car was a write-off. Nobody was killed. What an incredible tall tale, you would say. Yet it is true.

This young man ought to be dead. Crushed inside a burning exploding car. A young promising life snuffed out in a car accident involving young men who feel they are masters of the universe.

Yet he was much alive. If there was a guardian angel or God, he would be blessed with a new lease of life.

Now, he could not breathe well. Coughing non-stop for the past 2 days at least. The general practitioner had given him some tablets for his sore throat. Flu was suspected. Now, he could not sleep as he could not breathe.

Could he wait till the morning to see the doctor? It was 4 am and his mum was barely alert, being a night owl like him.

"Where's your inhaler," I asked him. The inhaler delivered drugs to open up his breathing airways. But he did not carry one with him although he was asthmatic and advised by me. After all, he did not suffer any ashtmatic attacks for some years. He won an award at the army marathon and he was invincible.

His mum fished out an inhaler kept for him. Mums are always a boy's best friend. He put the inhaler into his mouth and sucked in two puffs of the medicine. No effect.

"Well, the inhaler has expired in 2005," I said. I doubted that even a non-expired inhaler would be effective at this late stage of acute respiratory distress. It is best he gets to the Emergency Ward of the Hospital before he dies.

Can a young man die so easily? Yes, if his parents ignore his acute difficulty in breathing.

"It will be a very painful death as you can't breathe when all the airways have had shut down due to your asthmatic attack." I said to the young man. He ought to take personal responsibility of his health and carry the inhaler with him at all times. But he did not do it.

"I read in the newspapers that a qualified doctor had an asthmatic attack in an aircraft and died. All that was needed was the inhaler and she did not have it with her."

Mum would rather sleep. I beckoned to her to get up and get dressed. This young man was still standing and there would be some hope. It was fortunate that he was not in the cruise ship or airplane. What he needed was the emergency nebuliser with oxygen mixing the anti-asthmatic drugs and that was found in the hospital.





To make a long story short, this young man survived. This was his second lease of life. He has to be personally responsible for his own health and learn from this experience.





"When you have to go, you have to go," are brave words of masters of the universe. Try not to tempt fate, young man. Words don't come easy from your parents. This story is written for you. To ask you keep an updated inhaler by your side always and not cause intense grief to your mum when your life is cut short due to a lack of an inhaler and early use of it.

115. Neuter, microchip and vaccinate at one time?

E-MAIL QUERY TO DR SING

----- Original Message ----
From: ...@yahoo.com.sg>
To: judy@toapayohvets.com
Sent: Friday, 28 December 2007 11:41:28
Subject: Services Enquiries

Hi,

I came across your website from the Spore Vet site. I just inherited a 4 year old wire-haired male fox terrier and would like to enquire some stuff. It has not been sterilised. Is it too late to sterilise him?

Is it ok to do sterilisation, mirco chipping and vaccination in one go? It'll be very inconvenient to bring him more than once as i dont have my own car.

How much would it cost to arrange for return transport?

Many thanks,
Name given



E-MAIL REPLY FROM DR SING

It is ok for a normal dog to get neutered, micro-chipped and vaccinated at the same time. Transport costs around S$50 depending on distance.

Some reasons for neutering a male dog is to prevent anti-social behaviour like urine-marking, gripping people's legs, humping onto pillows and mattresses, wanting to go out, aggressive behaviour and unwanted breeding.
Urine-marking behaviour may not be completely eliminated after neutering since your dog is now older.

114. Pus oozing out of an unopened puppy eye.

Very unusual case. The young man who was on a break from his studies in Australia must have kept a close observation on the 6 Siberian Husky puppies. Most likely his maid. But he quickly consulted me about some pus in a puppy's eye.

Now, the puppy does not open their eyes till they are 10-14 days old. So, how could the eyes be infected?

I pried open the eyelids as the puppy's eyes were still not opened naturally. Swollen red conjunctiva. Thick creamy pus accumulated in the right eye. Wiped off the pus. Put eye drops. This puppy should have no loss of eye sight.



One would have thought that unopened eyes of a puppy ought not get infected. But there are always exceptions to the rule.

113. Toilet training: 5-year-old and 15-month-old apartment dogs

Paper training an apartment puppy

Many Singapore apartment owners do not realise that the new puppy must be confined to a small room or crate for 2-4 weeks to achieve some hope of success in paper training.

The puppy at 2-4 months is at an impressionable age and can be paper trained if there is some consistency, perseverance and time spent in training it. As he grows older, it becomes more difficult as the hormones kick in and the older puppy rebels.

Parents with adolescent children who prefer not to be seen with the hand that feed them for the past 15 years will understand what I mean. Young adults, if not brought up with sound values experiment with alcohol and drugs and bring much grief and sorrows to the parents.

Toilet training of puppies use the same principles as bringing up a child. Time is needed. A sound knowledge is also required.

For puppies, toilet training begins when they are brought home at around 2 to 3 months of age in Singapore. They are easily toilet trained if time is spent with them and they are confined for 2-4 weeks.

We examine the 2 dogs in this case study.

Russell, Miniature SchnauzerXChihuahua, Male, 5 years, not neutered

Initially kept in a playpen when bought. Stepped on stools. So, let out of playpen after 2-4 weeks of no success in paper training. He was praised and rewarded with treats when he peed and pooped on the floor of the balcony which became the toilet and sleeping area for the past 5 years. Poop cleared using plastic bags. Floor of balcony flushed with water to clean it.

The dog never goes outdoors. At 3 to 4 years of age, he starts urine marking on vertical surfaces in the apartment. 2-3 times a day or sometimes not doing urine marking. Spanking him is ineffective.

Miniature Schnauzer, Female, 15 months.
"Not so intelligent," the owner said. "She pees and poos in the living area or bedrooms during daytime. She does not go to the newspapers in the daughter's bedroom to eliminate."

There are no newspapers in the living area.

During the initial 2 weeks, sleep in the daughter's bedroom. No crate or playpen. Newspapers on bedroom floor. Occasional elimination on newspaper. Bring her to the accident area where she had peed, said "No,", spanked her backside. But she would pee and poop on the newspapers sometimes. At night, sleep in one of the two beds in the balcony. Eliminate more onto the floor of the balcony now. Had been with the owner for the past 1 year.

Advices
1. Neutralise the urine smell in the living area with white vinegar:water 1:3.

2. Urine marking behaviour of the male dog onto furniture is difficult to eliminate. Neutering was an option but it might not be effective. If breeding is desired, no neutering is advised.

3. Paper training is too late now. The strong urine smell on the balcony floor far away from the beds may be the toilet area.



4. I forgot to advise that the pee pan with newspapers + urine smell be put on that area if the owner wants to do paper training and has less cleaning work to do. As the female dog is now a "young adult", it is much harder to paper-train her. She had used the same toilet area as the male dog. The male dog is a distraction in paper training a female dog.

As the mother and her daughter seem happy with the two well looked dogs, the toilet location will be the edges of the balcony floor. In retrospect, the male dog should have been paper-trained on a pee pan (with newspapers) and confined to the playpen and kept in the balcony for the first 2-4 weeks. He was in the bedroom at that time. He kept stepping on the stools because he wanted to get out and had no sense of cleanliness. So he needed bathing every day. The owner let him out of the playpen early and he eliminated everywhere in the apartment. Till one day, he went to the balcony floor and was not scolded. He was praised and given food treats and therefore he used the balcony floor (with no newspapers) as the toilet location.

Now, you can see that the sleeping area is kept clean by the dogs as they eliminate as far away as possible from their beds in the balcony.

112. Vet Ethics. Ambulance chasers for vets.

"Sending condolence cards to dog owners whose dogs had died was a very good idea (to build up good will)." the 4th year Massey University vet student recalled a dog owner who mentioned about a vet who performed this practice. I was discussing with her the highly competitive nature of all Singapore businesses as Singapore becomes developed. The veterinary practices are not immune to competition. Price under-cutting by being the cheapest vet in Singapore is one strategy to capture more clients and increase turnover. The student mentioned condolence cards as one method.



"Yes, sending condolence cards is a good idea but it is better for a vet to send birthday cards for dogs" I said. "Have you heard of ambulance chasers?"

She shook her head.

"In the legal profession, there are laymen who specialise in informing the lawyer (for a commission) when there are traffic accidents. These ambulance chasers will go to the hospital and sign up the injured to get legal advice.

"From what the dog owner said, it seemed that the vet who sent condolence cards had excellent knowledge of any dog that had died and had been sent for cremation.

"The owner was saying how come the vet knew about dogs that had been cremated? He had no veterinary crematorium. The owner guess it must be his connections with the dog transport man.

"When the dog transport man sends the dead dog for cremation, he informs the vet and gives him the address of the dog owner. The vet sends a condolence card to the grieving owner.

"Is this a veterinary equivalent of ambulance chasing? In this case, the dog that was not under the vet's care had died. So I would not want to send condolence cards to such owners.

"The vet who sent the condolence card might not have paid the dog transport man for the addresses but if the transport man was not given a commission or payment, why would he bother to divulge such details to the vet. Is this ethical or not?"

It is good to discuss with 4th year vet student as they are more mature and had seen various practices. So they are able to discuss various aspects of the veterinary profession.

Out of this discussion with her, I said to the vet student that sending doggie birthday cards to my dog clients would be an excellent idea. Now, I must get on with the execution of this idea. It is not a novel idea in the sense that the NTUC Insurance Company sends birthday cards to their insured clients regularly! I wonder whether the vet who sent condolence cards do send doggie birthday cards as well?

111. Toilet-training a small breeds - Small breeds get away with murder.

All over the world, small breeds get away with murder. What do I mean?

This little puppy had been given to the owner for the past one month. Pees and poops everywhere inside the apartment. As small breeds eliminates in small amounts, there is not much pressure or stress to the owners.



"How's the toilet training?" I asked the lady in her forties. Her husband was waiting outside the surgery, ready to pick up the daughter.

"Pees and poops everywhere," the lady said. "My husband is not so happy with the puppy."

Neither would I. This is what I mean. Small breeds get away with murder. I asked if she had time. Pulled up a chair opposite me across the consultation table. I attempted to give a quickie lecture and photocopied my scribblings in the picture below.




I hope the puppy can be paper-trained fast. Presently, the bedroom doors are locked to prevent accidents. Once paper-trained, the puppy can be trusted not to soil the whole residence! If only a dog manual on paper-training a puppy is available whenever a puppy is sold or given away, there will less problems for puppies.

110. A gigantic breast tumour in a dog

E-MAIL TO DR SING DATED 4 DEC 2007

----- Original Message ----
From: ...@yahoo.com>
To: Dr Sing KY
Sent: Tuesday, 4 December 2007 12:50:40
Subject: Re: Please help the dog

Hi Dr. Sing,

I am Ms Ng here. So did you manage to talk to the dog`s owner?
How is it?



Did she agree to let the dog does the op? If yes, pls let me know the time? Thanks.


Regards,
....

E-MAIL REPLY FROM DR SING

No tel call from the owner although his friend who was present at the Surgery would have informed him of the high anaesthetic risk of surgery.

I did not tel the owner to talk to him because he will only think of one thing: The vet (me) is a salesman trying to sell my services.
Therefore I don't phone owners as they feel pressured to make a decision.

If the tumour is not removed, the dog is likely to die a slow painful death due to bacterial infection of the big tumour and the bacterial toxins inside this huge tumour affecting his heart over some weeks. If surgery is performed, the 20-year-old dog may die on the operation table.

The ill will created by a dog's death invariably harms a vet's reputation built up with great difficulty over the years. In my experience, when there is a death of a pet, the owner or his family and friends in Singapore usually blame only one person - the veterinary surgeon. They bad-mouth the vet for all who care to listen.

Seldom do they blame themselves for belated treatment. Some write malicious false allegations to the veterinary authorities to solicit and get an investigation. Some get lawyers to sue.

Personally, I had never seen or talked to the dog owner in person. I assess that the 8-year-old dog with mammary carcinoma bigger than the feet of an adult man has less than 50% chance of not dying under general anaesthesia.



Hence, I do not tel the owner to get the surgery done. This is a matter for the owner to decide as there is a very great anaesthetic risk of the 20-year-old dog dying on the operation table.

Singapore does not have a charitable animal foundation like the PDSA (People's Dispensary for Small Animals) in the UK. In the PDSA, low-income dog owners can get their dogs treated at low fees.

I distinctly remember the PDSA for one reason --- a Jaguar. No, they were not treating the big wild cat!

I was seeing practice with an Englishman, a private vet. He offered his services once a fortnight as a volunteer. He drove me to the PDSA. I was a fourth-year vet student. That was in 1973.

A big Jaguar car drove up to the PDSA clinic. The driver brought in a dog for treatment. The English vet told me that the PDSA was meant for disadvantaged families. Maybe your foundation may look into starting a similar project like the PDSA.

If this 8-year-old dog had been spayed and her mammary tumour removed earlier, she would be living a better quality and pain-free life now.


Best wishes to you.

109. Seeing practice: Can't force a horse to drink

"Where would you incise the skin when you spay a cat?" I asked two vet students who had completed their first year at Murdoch University. They had passed some Anatomy tests on muscles and nerves and were back in Singapore.The girl would score high marks in Anatomy as she was very interested in Anatomy, the young man informed me.

So I expected the girl to give me the correct answer. The classmates hesitated. "Make a guess," I encouraged. "That is how you learn, by being hands-on." And making mistakes.

Spays are the commonest operations and both had seen cases of spay. So, this should be an easy question.

The girl whom all mothers would want as a daughter-in-law had a wind-swept natural brown hair parted with no fancy styling or make up pointed to the most posterior part of the cat's body off the midline, nearer to the tail area.

The classmate with the ear stud and reddish brown hair to make himself stand out from the crowd, pointed similarly but to the other side of the midline. They surprised me as they were miles off target and had just completed some Anatomy studies.

"The incision is about 1.5 cm from the umbilical scar," I showed them the almost invisible white spot on the cat's belly. Their incision would be 15cm away! I hope they learnt something.



The young man said, "Why do vets incise the linea alba during surgery?" This was an examination question in Anatomy.

The linea alba has no blood vessls and therefore no bleeding when incised," I said.

The young man was elated as he had got the correct answer. He would get 1 mark.

"1 mark out of 20?" I asked.

"No, no," the young girl sabotaged him from giving me a good impression. "1 out of 200 marks!"

I did not comment. This was a happy couple but they were just friends if you know what I mean. I continued my surgery. I said, "This is a human trachea hook to fish out the ovaries after the incision. I had just bought this hook as the usual veterinary spay hooks are hard to find in Singapore."

Unfortunately, I kept on hooking up the omental fat and the students were not impressed. The human tracheal hook is smaller and the hook is shorter too. I quickly changed to the cat spay hook and was successful in fishing out the right ovary.

Seeing practice can be quite boring if you don't know how to make the best use of the time by recording what you saw for your future years. Keeping a journal would be best.

I suggested taking pictures of the cat spayed for future reference. The girl did use her camera phone to take some pictures although the young man had to configure for her how to take pictures. If she could keep proper records of the good visual images, they would make her textbook studies come alive.

As for the young man, he was not that keen. One can bring the horse to the water but can't force it to drink!

I had a great roasted duck rice lunch with the couple at Blk 124 Toa Payoh. The young lady had a makansutra reference book with her and she drove us to this place. The young lady was as thin as a rake and enjoyed the duck rice while she chattered away about relationships. This was a new world to me as I had a glimpse into first year undergraduate life of young adults.

The young lady ate all the crispy duck skin, meat and poured the remaining black sauce onto her duck rice. Full of oil and cholesterol I presumed. As for me, I had to controlled my impulse to devour the crispy duck's skin, leaving them on the plate. I avoided pouring the black sauce onto my rice. The Singapore Health Promotion Board seemed not to have got its health prevention anti-cholesterol and anti-hypertension messages to the young chatterbox.

108. Follow-up to 103. .

What's wrong with the Angora rabbit?

1. FIRST CONSULTATION:
Tuesday, November 20, 2007
Copy of Case 103. The bony Angorra rabbit will not eat.

"My rabbit has not been eating for the past 2 days," the first-time rabbit owner took leave to seek veterinary treatment. "She just sits around and will not greet me when I come home."

"Has she got diarrhoea?" I asked. "This Angorra has a beautiful coat which camouflages her lack of weight gain. She is as extremely thin and can die anytime due to lack of health." I taught her how to feel the spines of the thin rabbit. Sharp spinal process poked at her index finger as she felt the whole length of the spine. There was no fat layer.

The lady said, "My rabbit eats all day. At times he has loose stools. Why is he not putting on weight?"

"Much depends on the quality of food and the rabbit's lifestyle of gnawing at objects that may cause watery stools. Did you smell the rabbit pellets to get an impression whether they were of poor quality?". A smelly pellet or hay pieces may indicate something is wrong. You will need to know how to judge by the smell.

I tried to take the temperature. A few pellets of stools and some wet faeces matted the swollen anal area. The rabbit disliked this handling. So, I stopped taking the temperature from the rectum.

This is the type of case where the rabbit appeared healthy and alive. If the vet gave an injection and the rabbit dies due to pre-existing diseases, he gets the blame. The owner needs to be warned.

I gave the rabbit an antibiotic and dextrose saline injection and asked the owner to hand feed the rabbit with rabbit food pellets slowly as whole pieces or wet ones.

"Hand feed?" the career lady queried me. "I don't know how to do. In any case, my rabbit does not stay still."

"Put the rabbit on the table. Grip the upper jaw with your left hand. Push a small pellet inside his mouth." I said. "Do you have any pellets?"

"No," she said. I saw the teacher with her pet rabbit of around 4 months in the waiting room. She might have some. She took out a small plastic bag of pellets to help me out as I did not have any. That was kind of her.

I demonstrated to the Angorra rabbit owner by pushing a pellet into the mouth, close the jaws and tilt the head. The rabbit wrinkled her lips and swallowed it. Now, it was the lady's turn. The rabbit was held but she was wiser. She would have none of the nonsense of being force-fed. She just turned his head away and would have stomped her foot if she was well.

"Let her smell the pellet," I advised. The rabbit was not interested in food and just turned his head.

Now, will the rabbit die if she does not eat for another day? She would have a gut infection or intoxication. I gave her the injections of antibiotics and dextrose saline and advised the owner to tel me if the rabbit did not eat the next day. Hand feeding was out of question.

Early the next day, she text messaged me "this morning she goes back to be an active hungry rabbit as usual. I will monitor her condition and will give her another 2 days antibiotics. Thank you very much."

That was good news. Seldom do I get feedback. Text messages are best and effective. As to the cause of the suspected fever, it would have to be something upsetting the rabbit's gut.





2. SUBSEQUENT CONSULTATIONS BY SMS, E-MAILS AND TELEPHONE

E-MAIL TO DR SING DATED NOV 21, 2007
Hi Dr Sing

> > > Here are a few of Rabbit's photographs for you.


E-MAIL FROM DR SING DATED NOV 21, 2007
> > --- Dr Sing KY wrote:
> > > Thanks for very beautiful pictures of the rabbit.
Thanks for report on progress of Royal. Most owners have no time to do it. Stop medication now. She is fully recovered. Looks like she has all the good housing and
food. Can't understand why she gets loose stools or get sick. Unless she gnaws at some toxic objects like plastic spoon (the other rabbit owner who gave
you the rabbit food at the clinic) gave a plastic spoon for the rabbit to gnaw.

Thanks again.

3. E-MAIL TO DR SING DATED NOV 25, 2007

> > Hi Dr Sing
> >
> > Apologize for unable to reply earlier. Was quite
> > busy for my handover of work scope to my people
> > last week,as last Friday was my last day in that
> > Company,didnt have much time to login to my email.
> > Tomorrow will be starting in the new Company.
> >
> > Rabbit's cage is a 3ft(L) x 2ft(W) x 2ft(H), I
> > guess thats the largest size in the market so
> > far I see. Yah, I always have her cage clean
> > every once a week, I also dont understand why
> > this rabbit is having weak stomach..very poor
> > thing. Yesterday till today, I notice Royal's
> > appetite seems starting to reduce again 3 days
> > after her injection, again heard some grinding
> > of teeth occasionally, hmm..my worry comes back.
> > Moreover, starting on my new job, I will not be
> > able to apply urgent leave to bring her to you
> > during daytime, and what timing I will be able
> > to leave work is still unknown...
> >
> > Rabbit dont have habit of chewing plastic, as I
> > dont see her biting her plastic house. There's
> > no other plastic items in the cage.
> > There's no way she can chew on any newspaper too.
> > I am also still thinking what had she took to
> > upset her stomach, hope its not due to more
> > complicated illness.
> >
> > I really appreciate you for helping to get
> > Rabbit well. It heartpain me to see her
> > suffer, keeping her & she's just like one
> > of my family member,if I dont love her, who will?
> >
> > Have a nice Sunday.
> >
> > Thanks & Regards
> > ...

E-MAIL FROM DR SING DATED NOV 25, 2007
>
> --- Dr Sing KY wrote:
>
> > 1. Quickly change the food as your food may be contaminated. Buy a fresh batch.
> > 2. Check the water quality.
> > 3. I don't see any water bottle in your pic.
> > 4. Give me an sms if he gets stomach upset again.


E-MAIL FROM DR SING DATED NOV 26, 2007

--- Dr Sing KY wrote:

> As there are many factors involved and there are
> many questions not able to be covered in text
> messages, it was good that we spoke by phone.
> From your email I can suspect that the new hay of 3
> weeks old may be contaminated.
> As we spoke yesterday, stop all hay. Just feed
> pellet and let me know.


E-MAIL TO DR SING DATED NOV 28, 2007

Hi Dr Sing

Thank you so much for your attention on Rabbit's
condition.

She's mischievous and playful now when I
reach home and play with her. Just appetite
is not high.

I will continue to monitor her till
this weekend and will update you on her condition.

Once again thank you.





Most likely, there may be something contaminated/toxic in the hay which was purchased 3 weeks ago. Since you stopped feeding hay for past 2 days, she seems to be more active. Toxins can make the rabbit inactive and pass loose stools. For 3 days after treatment, the rabbit ate and was active. After 3 days, she had good appetite because of the injections. After 3 days she was inactive. This led me to suspect that you had fed food of poor quality and I suggested no feeding of hay. Now, after another 3 days, there was some good news. Her appetite will return.

Thanks for your pictures of Royal zipped to me. I note that there is a lot of hay on top of one bowl, with the pellets below he hay.
I presume she eats more hay than pellets for the past months. Pellets are important in nutrition. If she eats hay mainly, she cannot put on weight. Therefore she is extremely thin when I examined her.

Separate pellets from hay in 2 different bowls to observe the rabbit's eating habits. Get rid of the blue litter tray so as to give the rabbit more space to exercise. I know you had told me you had done it as the rabbit does not use it as a toilet area. A good bed if the rabbit does not gnaw on it. Tel me if you can about any changes. Your generation loves thumbing text messages and they are great. Though detailed, a telephone call can answer more questions and give us a fuller picture of the management of your rabbit as a rabbit's life is at stake.

Best wishes.





> >

Rabbit presumed OK after the hay was not given to the rabbit. No news as at Nov 30, 2007 9 p.m.

107. Summer jobs: Love is A Butterfly

Saturday, November 25, 2007


The personable Filipino waitress in her twenties, held a pad and pen and stood beside the young man who had completed his first-year veterinary studies in Australia and arrived home today.

From across the table of four, the white words on her pure black T-shirt sang to me:

LOVE IS A BUTTERFLY
Which when pursued is just beyond your grasp
But if you will sit down quietly
It may alight upon you.


The first line was in bigger fonts and was easier to read. I could read the following 3 lines while she took the orders with a smile. She was one of those fortunate girls who are born with a happy countenance, unlike her lady boss whose facial lines tell of a thousand worries and stress.

"Is love like a butterfly or is love a butterfly?" I asked her. She did not reply but her eyes sparkled as she took the orders.

The boy's mother admonished me: "It is not nice to stare at a lady's chest." Prim and proper.

I had not thought of the sexy implications and the waitress was not Dolly Parton whose bosom demanded attention. I said, "I was reading the words of a poem."

It is always good to make a happy connection with the serving staff as they work very long hours. She could be a student who needed to work. How do I understand their working life?

Well, I was a waitress during the 3 months of summer holidays during my first year veterinary studies in Glasgow University in 1969. I could not go back to Singapore unlike this young man I was dining with. My parents had no money. It was out of question.

At that time, the University bookshop had notices of summer jobs offered. I got a job as a waiter in an upscale hotel opposite St Andrews' Golf Course. After 2 days, I got the sack. Probably too slow to serve or not up to the mark, I guessed in retrospection.

I went back to the University bookshop and applied for another job. A small hotel catering to tour groups accepted me. A small seaside town called Dunoon, in Scotland. I had never worked before I went to Scotland on this veterinary scholarship. In a way, I was like this young man I was dining with.

After the termination of my first job, I decided to work harder. Worked 7 days a week and overtime. The tour groups would come in for breakfast, lunch and dinner and the waiters and waitresses would have to rush in and out fast to serve them. Then they would go out on their tours.

Now, how to serve fast for a table of 10 people? The British way of dining is so much different from the Chinese way which is a communal way of dining. For the British dinner, for example, there was the soup first. Then the main course followed by the dessert.

Each person had his own bowl or plate. So, 10 people would need to be serve 10 plates of the main course. And we had to serve fast as they needed to go for their tours.

The head waiter taught us how to balance the plates for the main course on our left hand. The waiter bent his elbow to hold one plate and his right and left hand hold two plates. A total of 3 plates. That meant rushing up and down to the kitchen 4 times to serve 10 plates per table. Some tables have more than 10 diners and we had to service more than 1 table.

Remembering my premature job termination, I resolved to work harder and smarter. All waiters and waitresses were of my age and undergraduates from various places in the U.K. We improved our serving technique to serve much faster.

After some time, we challenged each other as to how many plates we could serve at one go. We were young and energetic. Do you know how many big plates holding the main course could be served by a waiter?

Give me a number. Say it loud. Write it down.

Now, it is 2007. Almost 38 years had passed. I wonder whether the Glasgow University bookshop still exists and whether there are still vacancies for summer jobs.

The young undergraduate I had dinner was really fortunate that he did not have to work during his 3 months of summer holidays and could come home. His mum missed him a lot, so if I advised him to stay back to work in Australia to understand more about the Australian way of life would cause disharmony with his mother.

Back to the number of plates I could carry. It was 7. Two hands held 2 plates. Of the remaining 5, the left hand's elbow area held 3 plates in tiers. The right hand's elbow area held 2 plates. When I reached the table, the diners would help me to unload. Two trips would do for each table. The customers sometimes clapped their hands. I didn't know my fellow waiters and waitresses and I were so entertaining to them. The folks were the heartlanders and very kind. There was interaction between the customers and the staff and we did some tips at the end of each week.

Occasionally one of us dropped a plate during the rush, but that was not common. In that 3 months of summer job, I went out with my colleagues to the pubs. I witness one young man called Bill.

Once after our drinking at a pub, he stole a traffic hazard warning light and brought it back to our hotel accommodation. A blonde undergraduate waitress taught me what "mascara" meant when I asked her what she was applying to her eyelashes as all of us went to the pub. She would hum to this top of the pop song starting with the lyrics: "They paved paradise and put in a parking lot...".

At that time, I could not understand the slang of the singer till some years later. Sometime to do with yellow taxi and old man dying and taken away.

Recently, the young man's radio played this song which has the "Save the environment" theme. Which brought me back some 3 decades ago to this blonde undergraduate girl.

If you need to know, she was friendly but I did not date her. Love is a butterfly but it did not alight upon me in Dunoon.

106. The best spay I had - a smooth operator

When the dog owner is well informed, a spay operation in the female dog can be a very smooth operation taking less than 30 minutes.

Today was such a day. The Miniature Schnauzer, born in Dec 3, 2005 was on heat 4 months ago. She was spayed today Nov 23, 2007 as the owner was advised to do so 3-4 months after heat.

My assistant Mark talked to the dog as he put the face mask over her muzzle. She did not struggle and went to sleep under 8% gas anaesthesia within 10 minutes. No tranquilisation. I inserted the endotracheal tube to connect her lungs to the anaesthetic machine, maintained the anaesthesia at 1.5%.

Incision was 2.5 cm from the umbilicus. 1 cm incision cut. The spay hook was inserted towards my right at 45 degrees posteriorly. It hooked out the left uterine horn. I pulled the left ovarian ligament. Pulling caused the dog to breath much faster as he felt the pain.


I increased the gas to 8% for a minute so that he had more gas. The minimal amount of gas given will lead to no deaths and that was why I used 1.5%.

No more rapid breathing observed. I cut the ovarian ligament with the scalpel. Clamp the ovarian stump. Ligate the stump.



Pulled the left uterine horn out of the body and saw the right uterine horn at the uterine body junction popping out. Use forceps to pull it out.

Then I pulled the right ovarian ligament and repeated the same procedure. No bleeding but the blood was normal red with oxygen. The dog was breathing regularly. The uterine body was pulled out and clamped.

The skin and muscles were stitched up. Anaesthesia switched off as I stitched the skin. No bleeding from the ovarian and uterine tissues at all as the dog was no longer on heat.

The dog woke up smoothly after 3 minutes. An Elizabeth collar was given to prevent licking of wound.




QUESTIONS THE OWNER ASKED:

1. Bathe the dog? Yes, but make sure the plaster is not wet.
2. Can the dog eat any food? Yes.
3. When to come back to remove the stitches. No need. The absorbable stitches will dissolve and fall off in 14-28 days.
4. When to remove plaster? 7 days later.
5. Can give antibiotic tablet crushed and mixed with water inside a syringe? Yes. 7 days. Normally I don't give antibiotics but lately, I do so as the dog may lick her wound or irritate it.

Overall, this was a most satisfying spay I had ever done. I had time for the first consultation at 10 a.m

105. Green vaginal discharge, no puppy seen. What to do?

"My Labrador Retriever passed green discharge all over the kitchen floor. What to do?" the teenaged girl asked me. The female dog had no active contractions and half a day had passed with no puppy seen.

I said, "Wait, the puppy should be out within 30 minutes of the rupture of the water bag."

She did not know what I was talking about. All she knew was that there was green discharge all over the floor.

Telephone diagnosis is best avoided. Normally all Retrievers can give birth naturally. However, in this case, a green discharge meant that the placenta had separated and the puppy had not passed out. There might be some problem.

In such situations, if I advised waiting for an hour or more and if all the puppies die, I get the blame. I had encountered such a situation before from an unknown caller.

The person complained to the veterinary authority about me as one puppy or more had died. He had a Caesarean done at another vet surgery.

"Did you ask about the green vaginal discharge?" the authority called me by phone telling me there was a complaint about my phone advices.

So the best advice is to get the dog down to the surgery for observation or necessary Caesarean. Do not assume that every Retriever would give birth naturally. In this case, the girl was told to contact the parents. I got the dog transport woman to go to the house after talking to the mother.

When the transport woman reached the house, one puppy was born. Another came out within 30 minutes. The father asked me why I sent the dog transport woman to the house? The dam was suckling the 2 puppies!

I advised "wait and see" and asked the dog transport woman to leave. It was a very stressful situation for the teenaged girl as this was her first time. I should expect the Retriever to give birth naturally as almost all do so.

However, in life, there are always exceptions to the rule and the vet should not be too complacent.

104. BIOLOGICAL OR EMOTIONAL? Submissive urination in dogs - is there a cure?

"Must I put a parking coupon?" the young lady asked me. It was 10.30 am on a weekday and she had to get her Maltese vaccinated the 2nd time.

In the past month, the car park wardens had "thought out of the box" and had came for surprise booking of cars without parking coupons at 9 a.m. They tried to sneak in from various ends of the road and did have some successes. Previously they would come at 5p.m. They were out-sourced private corporate "wardens" and the office must have a brain-storming to get more bookings.

"The car park wardens don't come at this time," I assured the lady. She brought the puppy into the consultation room.

"My puppy pees when I pat her head or when friends come to visit me," she said. "Is there something wrong with her?"

"This is a case of submissive urination or excitation urination," I said to the surprise of the young lady who replied, "I do not know there is such a condition."

Yet this puppy did not pee on the examination table when my assistant Mark held her for vaccination. I have had submissive urination cases of puppies dribbling urine at the Surgery as well as at home.

"Is there a cure?" she asked.

"You have to train her to be confident," I said. "This condition is reported to be hard to cure."

"How do I train her?" she asked.

"When you go home, ignore her for a while. When your friends visit, ask them not to greet her. Do not pat her head or you will reinforce this submissive urination. Bring the puppy out to socialise with people and other dogs. It takes a long time to cure and many grow up without being cured."


IS SUBMISSIVE URINATION A BIOLOGICAL OR AN EMOTIONAL DISORDER?

Autism is believed to be a biological rather than a mental disorder. Is Submissive Urination a biological disorder?

Are there therapies that can help? So far, the dog books do not advocate more than what I had told the lady.

Today, I read in alternativemedicine magazine April 2006 issue about APPLIED BEHAVIORAL ANALYSIS (ABA) which appears to work well for children who have Asperger's syndrome (a form of autism).

ABA is a set of behavioral modification techniques. Teach the child to learn the real world by breakind down tasks in simple steps. Reward the child with the tiniest success. Slowly the therapist weans him from the rewards as he succeeds in each task. The disadvantage is that ABA is time-intensive and very expensive.

For submissive urination in dogs, the owner may use alternative treatments such as the ABA's methods to see whether it is successful to cure submissive urination in the dog.

You will need to spend a lot of time gaining the trust of the dog and making her or him self-confident. Praise and rewards for small successes. Keep accurate records of the dog's response (no drops of urine). It is a trial and error as each submissive urination puppy is different. I don't know whether ABA's methods will work in the dog.


Autism Resources:
www.autismwebsite.com
www.autismtreatmentcenter.org

103. The bony Angorra rabbit will not eat.

"My rabbit has not been eating for the past 2 days," the first-time rabbit owner took leave to seek veterinary treatment. "She just sits around and will not greet me when I come home."

"Has she got diarrhoea?" I asked. "This Angorra has a beautiful coat which camouflages her lack of weight gain. She is as extremely thin and can die anytime due to lack of health." I taught her how to feel the spines of the thin rabbit. Sharp spinal process poked at her index finger as she felt the whole length of the spine. There was no fat layer.

The lady said, "My rabbit eats all day. At times he has loose stools. Why is he not putting on weight?"

"Much depends on the quality of food and the rabbit's lifestyle of gnawing at objects that may cause watery stools. Did you smell the rabbit pellets to get an impression whether they were of poor quality?". A smelly pellet or hay pieces may indicate something is wrong. You will need to know how to judge by the smell.

I tried to take the temperature. A few pellets of stools and some wet faeces matted the swollen anal area. The rabbit disliked this handling. So, I stopped taking the temperature from the rectum.

This is the type of case where the rabbit appeared healthy and alive. If the vet gave an injection and the rabbit dies due to pre-existing diseases, he gets the blame. The owner needs to be warned.

I gave the rabbit an antibiotic and dextrose saline injection and asked the owner to hand feed the rabbit with rabbit food pellets slowly as whole pieces or wet ones.

"Hand feed?" the career lady queried me. "I don't know how to do. In any case, my rabbit does not stay still."

"Put the rabbit on the table. Grip the upper jaw with your left hand. Push a small pellet inside his mouth." I said. "Do you have any pellets?"

"No," she said. I saw the teacher with her pet rabbit of around 4 months in the waiting room. She might have some. She took out a small plastic bag of pellets to help me out as I did not have any. That was kind of her.

I demonstrated to the Angorra rabbit owner by pushing a pellet into the mouth, close the jaws and tilt the head. The rabbit wrinkled her lips and swallowed it. Now, it was the lady's turn. The rabbit was held but she was wiser. She would have none of the nonsense of being force-fed. She just turned his head away and would have stomped her foot if she was well.

"Let her smell the pellet," I advised. The rabbit was not interested in food and just turned his head.

Now, will the rabbit die if she does not eat for another day? She would have a gut infection or intoxication. I gave her the injections of antibiotics and dextrose saline and advised the owner to tel me if the rabbit did not eat the next day. Hand feeding was out of question.

Early the next day, she text messaged me "this morning she goes back to be an active hungry rabbit as usual. I will monitor her condition and will give her another 2 days antibioitics. Thank you very much."

That was good news. Seldom do I get feedback. Text messages are best and effective. As to the cause of the suspected fever, it would have to be something upsetting the rabbit's gut.

102. "Buy a new dog!" the daughter said.

I can remember this dog. He bit me towards the end of surgery to remove his lip and face wart. So did groomer Mark who had also been bitten last year. Now the tumours had regrown and are bigger. Much bigger than last year. The girl's mother wanted surgery now as the dog kept pawing the tumours and they bled all over the floor.

"This must be the oldest English Cocker Spaniel in Singapore," I said. "Cocker Spaniels seldom live past 12 years of age. He is overweight and may not survive anaesthesia this time, so you have to take the risks if you want to operate."

We did not talk about the cost of surgery.

"Just buy a new dog!" a young girl of around 12 years old suddenly interjected. Mum was shocked at this discard the old and buy a new one consumerism. She was shell-shocked at the young girl's remarks, so was I. She responded: "It is my obligation to get him treated."

What happened to this little girl? Why did she said to get rid of the old dog? He can still eat and walk. Sometimes he leaked urine.

"He coughs at night last year," the mum said. "Like old people. I presume it is normal for old dogs to cough at night."

"It is not normal for old dogs to cough at night or at any time," I advised and checked his heart.

"Why don't you just use gas anaesthesia like the last time," the mum recalled. "No tranquilisation injection. He survived."

"OK," I said. I put the dog on antibiotics so that the wounds would heal well. The surgery would be next week.

The mum has a name card

The Shih Tzu came for his annual vaccination booster during lunch time as the neighbour referred the mum to me. The mum had got a vaccination reminder card from a vet clinic and came here with her daughter. Referral clientele are the most precious and hard to get.

"Two front teeth dropped off as he bites iron gate," mum laughed. "What can be done?"
I said, "I don't think Singapore has the capablility to put on 2 false teeth for him." I checked his other teeth.

This 4-year-old Shih Tzu weighs 8 kg. Not obese. Yellowish white tartar accumulates on 4th premolar.
No bad breadth and no loose decayed dark brown teeth. Dog had been fed on dry dog food and the best steamed fish and chicken.

"Best to get a dental scaling done," I advised. "The tartar brings in bacteria to the gums and then the roots get decayed. After scaling, brush the teeth or give him some ropes to chew or dry dog food."

With yearly dental check up, the teeth can last till he is 15 years old.

The daughter worked in a bank. "Banks pay the most nowadays according to the Straits Times. Change job and get $1,000 pay rise. Change jobs a few times a year and get more pay. Do you have any name card? I asked.

The daughter apologised for not carrying one.

"Do you have one?" I asked the mum. She was conversant in the sale of funds as she was doing it. I was impressed.

Her son qualifies as an accountant, did not practise but works in the hedge fund.

"He is earning at least $10,000 a month," I said.

"More than that," Mum said. I ought to have studied finance and banking. It is too late but young people choosing their degree course ought to go for finance and banking studies if they want to earn much more than a professional.

Paper training --- One month later. What to do?

Nov 16, 2007. Case study. Vaccination 3rd done today.

Questions asked by a young couple:

1. Should we restrict the feeding amounts? The pet shop seller advised leaving the food all day as the Shih Tzu was small sized.

2. How many times a day should we feed?


PUPPY
Shih Tzu, Male, Born Aug 2, 2007. 2.4 kg. Now 14 weeks old. Small sized. Pet shop puppy seller advised to leave feed bowl for 24 hours. Active.

HOUSING
Playpen.
1. Lower left quadrant --- Pee pan with newspaper. Urine spray liquid at one end (left most).
2. Front middle --- Water bottle. Middle because water seepage will go onto tray instead of the floor.
3. Upper right corner. Feed bowl. Feed topped up. Free feeding.
4. Upper left quadrant. Basket bed --- sleeps in bed or corner of bed outside at night.

POOPS 3x/day. No specific time. Poops onto pee tray as well as lower right corner. Pees many times on tray and on lower front half of the playpen.

"Did you change newspapers every day and regularly?"
"Once a week," the young man said.

I repeated my question.

"Once a week," the young man said. "Sometimes we change papers after 3 days."

"The puppy likes a clean newspaper to eliminate," I explained. "He will poop on the lower right corner or pee throughout the lower half of the playpen to avoid stepping on the soiled newspapers if he can help it."

Change newspapers daily or more often.



CONCLUSION
1. It has been one month. The puppy was not paper-trained as soiled papers were not replaced regularly (several times a day).

2. At one month, the puppy would be paper-trained if it has access to clean papers and the playpen could be removed. The puppy should go to the pee tray's newspapers to eliminate.

3. Give sufficient feed 3x/day. Remove the feed after 10 minutes. This encourages the puppy to poop after eating (in many cases). Do not distract the puppy before he poops.

4. Exercise. Evening outdoors. The puppy will eliminate downstairs. Get a fixed timing. Let it eliminate on newspapers after dinner before going downstairs.

5. A time-table for feeding and exercise is necessary for early success in paper-training. Pee tray is a good idea as this prevents the tiled floor of the living area from being soiled. But the puppy does not go into it if the papers are soiled. Changing papers a few times a day and praises and treats on successful elimination on newspapers are needed for early success.

99. The Pom's face wound would not heal --- Oronasal fistula.

"Why didn't you come for the surgery?" I gently admonished the lady owner of the Pomeranian. "You wasted more money buying antibiotic powder to dust onto the facial wound after consultation."

Her dog had a weeping wound of around 5 mm in diameter below the left eye, above the maxillary 4th premolar tooth. It did not heal over the past weeks despite various medications and powders she had sprinkled on. Pet shops sell wound powders.

Some 14 days ago, I had patiently explained to her that there was an infection from the root of the maxillary 4th premolar. The infection went through into the nose below the eye. The bacteria from the decayed roots of this premolar attacked the nasal bone area and made a hole. This was an oronasal fistula and surgery to remove the infected premolar would resolve her Pomeranian's non-healing wound problem once and for all.

I guessed she could not understand how a rotten tooth inside the left upper jaw could be related to a hole on the skin below the left eye. Her husband thought, "This doctor is nuts. Mouth and nose. So far apart. How could there be a connection?"



"Surgery was to be done 7 days ago after antibiotics were given but you did not turn up till today --- 14 days later. Why spend more money on wound powders when they don't work?" It was not good for the dog. The anaesthesia and tooth surgery was $200 which was affordable for most pet owners. If it was $2,000, it would be high.




Sometimes it is good bedside manners not to elaborate in such situations and just simply accept the case. There was an optimal time to do extraction of the infected and decayed tooth. It was after 7 days of antibiotics and she had been given an appointment. She did not turn up and now the effects of antibiotics were no more. The bacteria in the infected teeth had returned.

The lady smiled sheepishly. "My husband wanted to use the $200 for the anaesthesia and surgery to go to India lah!"

Now that the dog is no longer on antibiotics, should I operate? There was no urgency in the sense that it was an emergency.

But it would be in the best interest of this poor dog to be cured as soon as possible.

The decayed 4th premolar and lst molar were loose as their roots had shrivelled from bacterial attack. They were extracted.





The wound should heal and the Pomeranian should have a face with no wet weeping hole.

98. The big-eared dwarf hamster

"The hamster is sleepy now," my assistant said as the owner and myself were observing the hamster inside a transparent anaesthetic container in the surgery room. This was part two of the procedure. In part one, the owner was absent and the large lump beside the hamster's left ear had been removed. Now, the owner was present for the stitching of the wound as he was interested in seeing it.




This container had a hole through which a breathing tube carrying anaesthetic gas was pumped in. The hamster breathed the gas and would fall asleep, permitting me to operate. The problem with anaesthesia of the dwarf hamster is that the vet needs to be very careful. A bit too much or a few seconds more of the anaesthetic gas means that the hamster dies.

No second chance. No cardiac massage or emergency resuscitation unlike the dog or cat.

The hamster closed his eyes. I picked him up to stitch the wound of his left ear area. A big fat tumour, globular in shape and 5mm in diameter had been removed some time ago. There was now a big gaping hole of around 8 mm exposing the pink flesh. Bleeding was profuse but had stopped.

The young entrepreneur in his thirties was in the operating room as he wanted to watch the surgery after I had removed the tumour.

His wife waited outside as she could bear to see blood spurting over the hamster's head. She would not want to see the hamster bathed in red blood covering his whole head and neck.

I picked up the hamster and put him on a face towel held by the owner. This 'portly' hamster was tame and did not bite me. As I put in the first stitch, the hamster squeaked and moved. The pain of the needle had wakened him from his drowsiness.

How could that be? The hamster had been in the gas container and should be anaesthesized. I ran through my check. My assistant James had switched off the oxygen which would have mixed with the anaesthetic gas to make the hamster sleep. He was 71 years old but had not done this before. The presence of the owner had distracted him and me.

"Damn it, the gas was not given," I said. I apologised to the owner. It is important that the owner not be present during surgery as he could be distracting as in this case. It could be humiliating and humbling too.

The hamster was put back into the container to breathe the gas. Then as his eyelids closed, I took him out, placed him on the towel held by the palm of the owner and stitched him. 3 fine stitches of 5/0 absorbable. He squeaked at the prick of the needle uniting his torn skin. He was fine and alive.



I taught the owner how to wipe off the blood from the hamster's body. "Use a cotton bud and do it slowly so as not to stress the hamster."
"What about the ear lump?" the owner asked.

"If it grows so big and so fast in the last 5 days," I said, "It would be cancerous and would re-grow." I did not suggest sending the lump for histopathology to confirm whether it was malignant or not as total costs would add up and the results would not help the hamster to survive longer. Cancer treatment for a dwarf hamster is out of question.

The histopathology analysis of a tumour would cost over $200. The hamster's operation and anaesthesia was kept as low as possible at $75.00. Now, the cost of a new hamster would be around $10.00.

The owner and his wife appeared satisfied as they packed the hamster in his cage to bring home to their daughter. From this experience, it is best not to permit owners to observe surgery as they can be distracting to the assistant.

97. The teacher's pet

Dr Sing Kong Yuen
www.toapayohvets.com


“My rabbit keeps biting his toes,” the young teacher cradled her 3-month-old Netherlands dwarf rabbit in the nook of her left hand. “What is the cause?”

“Put the rabbit on the table so I can examine properly." I advised.

The young lady took out 2 bottles of medicine from her plastic bag, “As you were on leave, I consulted a vet when my rabbit leapt and then limped. The vet diagnosed a leg sprain.”

“The rabbit looked thinner since I saw him 6 days ago.” I encircled the rabbit with the fingers of my left hand as he tried to scamper away. The teacher’s pet was fighting to be slimmer than the teacher.

“He’s very picky and eats only the green dry food,” the teacher laughed. “I don’t know what to do to make him eat more.”

The rabbit’s crusty toes caused by the scabies mites, except for two, were now normal skin. That was good news as the scabies mites had stopped multiplying and burrowing under the skin of the toes. The scabies mites caused considerable itchiness in the rabbit, leading to licking and biting to relieve the itch.



“But why was the rabbit still biting his toes?” the teacher asked when I declared that his mite infestation was no more.

I removed a scab on the right fore paw. There was a red 4-mm diameter wound. I pressed the lower part of the skin below the wound. Thick creamy pus oozed out. The rabbit squealed suddenly. The teacher uttered a sharp cry as if she was stabbed. Sometimes it is best not to have owners around but their presence and interaction educate them more on pet care than talking and books.

“It is best to clip off all the hairs of the paws,” I advised. “In this way, we can examine all toes thoroughly. Can you do it?” Most Singaporeans of her generation do not have contact with Nature and animals and she was not able to restrain the rabbit, afraid of hurting the little one. The teacher, in her early thirties cradled the rabbit. She scissored the paws in vain. The rabbit shifted and withdrew his paws.

“Grip the skin with the fingers of your right hand,” I demonstrated. “The fingers curl onto the scruff of the neck. Hold the rabbit upside down, like what his mother would have done to carry him. He would be quiet.” The rabbit appeared ‘hypnotised; as I snipped the hairs off the paws.

“Can you do it?” I asked the teacher. She tried but the rabbit would move. “It is cruel,” she must have thought. Her groomer would take care of the entire nail clipping and grooming.

To save time, I cut off all the hairs. There were 2 more abscesses with pus.

“What do secondary school children read nowadays?” I asked. “Do they read books about animals as I am thinking of writing one for the children and want to know the prospects of sale?”

“I doubt my students read. The English teacher gives them books to bring home to read. They return the books. No questions asked. I teach Mathematics and Chemistry and so do not know about their reading habits. But I know many spend lots of money to buy gaming books.”

Maybe there is no audience for the animal story books for children in Singapore.

“Thank you for your feedback. Fiction like ghost stories seems to be preferred by the Secondary school students.”



I advised observation of the rabbit’s appetite, daily cleaning of the wounds, removal of the chewed-out plastic spoon and stopping the medication meant for another 6 days.

The thin rabbit must eat good food. So should this ultra slim educator but it would be rude of me to say so.

"No plastic spoons as the bits and pieces of gnawed plastic ingested will kill the rabbit," I reiterated. The teacher's pet was not thriving.

In the 1960s, a student who carried books for the teacher to the common room to mark was called “the teacher’s pet.” Was it a privilege? What do you think? I was proud to be a teacher’s pet in primary school.

Do secondary school students carry books for this teacher in 2007? I did not ask her. I hope she learnt something today on rabbit care and that the dwarf rabbit would eat all day to gain weight and thrive.

96. Follow up on 94. The stars of timing.

"The vet must guarantee that the dog will not die under general anesthesia," the owner of the Yorkshire Terrier told the pet shop girl who had referred the case to me. Should I handle this case or not?

If the dog has an inherited poor heart condition and dies under anaesthesia, the owner is sure to tell everybody about the vet. No doubt about this.

Anasesthetic death opens the door to litigation and demands for explanation from the veterinary authority should a complaint be made. So much emotions are involved in an anaesthetic death. Family members may want to sue.

Why risk my reputation built over a life-time? Just pass the case to another veterinarian. This should be a wise decision. Pass the buck of potential death.

Yet this Yorkshire Terrier was young, active and examined. He was apparently healthy. Still, there may be hidden heart arrhythmias or ventricular tachycardia which manifests during general anaesthesia resulting in heart failure and death.

I did not pursue the matter as I asked the pet shop girl to let the owner decide. Maybe she had her own vet.

The owner decided to operate on an auspicious day and time and told the pet shop girl. I had never met the owner.

This auspicious day would be a Sunday and the pet shop girl made an appointment. Sunday is a busy time for vets as most Singaporeans are free. I did not object to surgery on a Sunday. But the Sunday happened to be busy and I could not finish the cases before noon.

"Doc," the owner said to me as I was in the middle of consultation. "I understand that you have to clear your consultation cases. Please make the first incision before noon."

Her adviser had given her the safest time for surgery of her dog. It ought to start before noon and on this Sunday. Wow, I did not know about the time.

It was obvious to her that I could not complete my morning consultation in time to start surgery.

"It is best you postpone the surgery to another day, after consulting your adviser," I said to the owner. She had this kind and pleasant personality when we talked. I would sense that she was not the litigious type.

But the stars of timing are now against me. I don't want to claim to be superstitious but it is best not to antagonise the stars of timing.

"Why not wait?" I asked the owner.

"It will be 2 weeks later," she sighed. She decided on the operation in the afternoon. She did not tell me then but she was worried that the leakage of "mercury" from the defective chip would kill her dog if she waited much longer. She had already two weeks of worries and hassling the pet shop owner to get remedial action.

The pet shop girl had warned about the "lighter patch" of hair colour for the Yorkshire Terrier at the surgically shaved area. So, the owner asked me not to shave too much of the hair so that the new hair colour patch would not be so obvious.

"No," I said. "I need a large area to operate to remove the chip fragments. If I cut a small area, I may stitch the hair into the wound. The best is to shave the whole body bald and the new hair growth would be of the same colour."

The owner agreed. I asked my groomer Mark about the pricing. $60.00 was too much for her. So she drove to her pet shop to get it done. When she came back, it was still before noon, but the Surgery was crowded.

I must say that not all my Sundays are bustling and I could complete the cases before noon on most Sundays. This Sunday was an auspicious operating date for the owner of the Yorkshire Terrier. Many Chinese pick auspicious dates for marriages too and so I am not a bit surprised that operating dates must be auspicious for the best result of the Yorkshire Terrier.

"My mother's poodle died under anaesthetic at the vet," the owner explained to me although I never asked her as to why she wanted a guarantee that the vet who operated on her Yorkshire should guarantee against any death. "She still keeps the dog's accessories and renew his dog licence."



I did not comment as anaesthetic deaths happen to all vets for various reasons. Now, I am in this situation where the auspicious time had passed. I should not operate. Choose another day.



But the owner had concerns about the toxicity of the fragmented microchip. Not one hard lump under the neck. Two lumps. And 2 weeks had passed. She had not told me about her concerns nor did I have much time to talk to her on this Sunday morning as I was busy with cases.

I did not have any prayers to any God as I operated during lunch time. Used gas only. Intubated the dog in case of the need to give emergency oxygen should the heart fail. Nothing eventful. The lightest anaesthesia was given. The dog woke up before the last stitch was inserted.

The dog came around 3 pm. She was the happiest pet owner in the world as she held her dog up for me to take a picture.

95. The hatchet man

"My son told me he got 16 out of 20 marks for his essay, no thanks to you," the mum spoke to me as a matter of fact. "You had severely criticised his writing when he asked you to review his essay."

Mother Juliet is a very good people manager in a corporation. I believe the her subordinates love her and wants to work with her when she is transferred out of the section.



As for me, I don't have time for being nice to students who need to complete their writing project. I just have little time for myself.

Juliet's son had not written an essay which was easy to read. I said it was written as a quick draft and needed to be re-written with more references.

Why not let Mum Juliet review his essay? She would not do it. So, the hatchet man gets the blame and no credit for his success!

In another case, a mother asked me to help her polytechnic son who wanted to profile me as a "successful" professional. The son had to write on "industry, person or company" success story. The poor teenager, probably around 17 years old interviewed me. We went to a puppy pet shop. I read his second draft after a good lunch treat from the mother and met the family at Crystal Jade in Toa Payoh. The mother had presented me mooncakes and a nice grasshopper present.

Still the poor boy's draft of me was not reading smoothly. I had to tell him to re-write the 3rd time if he wanted good marks. He is still at it. I spent some few hours with him.

Writing is hard work. A hatchet man's job for students of writing is even harder and time consuming!

94. The petshop girl was between the devil and the deep blue sea.

"It was silly of her to tell the dog owner that she had micro-chipped the dog," Mark said to me.

"It is good for her to be honest. If she said a vet did it, the owner would sue the vet or ask for clarification and she would be found defective in her character." I said. "I believe there is no legal requirement that vets must do the microchipping."

Now that the owner was vigorously pursuing this matter of the big lump and the dog crying all the time, the pet shop girl had to do something. She consulted a vet, namely me.

"She is between the devil and the deep blue sea," I said to Mark. Meaning that she had to decide to tell a lie or a truth. They were both difficult choices for her.




I had told the pet shop girl that the big round 0.5 mm swelling at a grain of rice was a microchip which had caused reaction after implant into the dog. The owner had complained that the dog was crying all the time after micro chipping as the dog had a big lump under the skin above the shoulder area.

I examined the active dog. There was no fever or pain in the area between the shoulders.

"The microchip scanner did show pick up the digits," the pet shop girl told me. "When I asked the seller about defective chips, he said I ought to scan first before implant."

"Well," I said. "My scanner cannot show the digits. It is most likely a defective chip but was it defective before the implantation or after?"

"Oh, this dog moved quite a bit during implantation" the pet shop girl said.

"It is possible that the microchip was not intact or well manufactured. After implantation, the body tissue fluids leaked inside the wall of the microchip and so the chip was spoilt. The scanner would not be able to scan it."

She had not thought of the "after implantation" possibility although she did mention about the chip breaking up during implantation.

So there were 3 possibilities of defects - before, during and after. It was good to brainstorm.

But now the owner was not happy. What should the vet advise?

"It is best to remove the big lump," I said. "Though the dog appears healthy today, what happens if he dies in the next few weeks. The owner could attribute to the toxic release of the substances inside the defective chip. Soon you would be sued."

The pet shop girl was vacillating, "I have to pay for the surgery. How much is it?"

"$150 is the cheapest I can offer to help you," I said.

"Can you do it now?"

"Better ask the owner first," I said. This is a potential litigation case. Mark volunteered to talk to the owner.

"It is best that the pet shop girl talk to the owner," I assessed the situation correctly. "Otherwise, the owner thinks there is something she is hiding."

The pet shop girl nodded her head. She had an half-an-hour teleconversation with the owner while I cancelled my lunch appointment! All because of a microchip!

The pet shop girl said gravely, "The owner wants you to guarantee that the dog will not die during the anaesthesia and surgery to remove the chip. Otherwise she would sue your pants off. I told her no vet in the world can guarantee that!"

So that was part of the long teleconversation she had with the owner.

I felt sorry for the dog owner, the pet shop girl and the dog.

I would like to help out. Another case of "Fools rush in where angels fear to tread"? This seems to be such a case. I should opt out. Where taint my reputation for $150 and a potential litigation.

"Chances are good that this young active dog would not die during anaesthesia," I said. "I will use just gas anaesthesia and no tranquilisers. It is much safer." There was an excellent pet shop girl-veterinarian relationship and I would help if I could.

The pet shop girl was "between the devil and the deep blue sea", I think. It was no longer a matter of her paying for the operation. It was whether the dog would die under anaesthesia or should the dog not be operated and die later and get sued for alleged intoxication from leakage of the microchip.

I was encountering a case of "Fools rush in where angels fear to tread".

"Let the owner think about it," I said. "In any case, the dog had eaten and would not be suitable for the anaesthesia. It is best to starve the dog 12 hours before anaesthesia. I want to maximise my chances of success."

So, the pet shop girl reluctantly went back and would let the owner decide. An hour was spent for this matter! The pet shop girl text-messaged to me that I had not charged her for the consultation. Now, how much should I charge for an hour of worries - of the dog owner, the pet shop girl and the vet? Life is full of problems and is not a matter of dollars and cents sometimes!