64. Veterinary Anatomy and an "MRT spay"

THE BOY WHO WANTS TO BE A VET


"A bone has so many prominences and holes and I need to know and identify the various apsects," the first-year veterinary student was trying to tell what he was studying to his mum. Mum had managed to get him away from his girlfriend to have dinner with her. She said to the boy who wanted to stay trim and slim and was careful of his intake of calories, "A bone is just a bone. Eat the last pork rib."

Veterinary Anatomy studies can be a very boring subject to the first-year veterinary undergraduate.

But it is a matter of life, death and sound reputation to a practising veterinarian.

Last week, I was vaccinating puppies at a Pet Shop. For want of some common topics to converse with her, I asked her whether she would refer her clients' dogs for spays to me. The recent law that Singapore dogs caught with unlicensed dogs would be fined $5,000 had led to an increase in spay operations for vets. A sterilised dog's annual licence fee is $14.00 compared to $70.00.

Do I sound a bit desperate by soliciting from the pet shop? Or is it good business practice?



The pet shop girl arched her eyebrows and frowned, "I never recommend any of my customers to a vet for spay. One of my customers was so angry recently. She kept complaining to me that the veterinarian had cut a very long wound on her female dog. She said that it was an MRT (subway) line! So, I don't refer any customers to any vet."

At least I know her position and policy. I must work harder to build my practice on my own merits.

"Sometimes, a very long incision into the skin may be necessary. There may be bleeding or some complications of surgery and a long skin incision is needed to locate the bleeder. If not, the dog bleeds to death after the spay." I replied. Every vet would encounter this situation once in his career.

The pet shop owner had her reputation to protect, "This customer was still angry yesterday, at the extremely long incision on her poor dog---an MRT line. Kept moaning about it.

"By the way, how long an incision you cut during spay?" she asked me.

I replied, "Usually 1.5 to 2 cm long if there are no complications like bleeding. I usually advise 3 months after the end of heat so that the ovaries and womb are not fragile and bleed easily. It is much safer."

The pet shop girl was not convinced about my experiences or lack of. I could not convince her.

"Is there a portfolio of spay done?" Vets usually do provide portfolios of work done like models or plastic surgeons.

I said, "Maybe you can see some pictures at my website." She was surprised I had one.



I was there for the vaccination and microchipping of puppies and some free consultations. Nowadays, I seldom provide such services as they are time-consuming. But it is good to get out of the surgery to feel the 'pulse' of the pet market place.



Veterinary anatomy is a very boring and difficult subject for the first-year student because they don't see the relevance. A sound knowledge of veterinary anatomy is essential as the veterinarian is also a surgeon.



I hope this story will make the study easier and have included pictures of the anatomical positions to spay a big Golden Retriever and the follow-up.

63. A Jack Russell made the bean curd man smile

No doubt, he made excellent bean curd and I had patronised his stall many times. He has a steady stream of buyers. He closes the stall in the afternoon.
Each time he or his wife would ask what I would be ordering. No smile and no remembrance of my order. I was a non-entity to him. Faceless and nondescript.

A slim man in his fifties. His wife was slim too. No small conversation as he dispensed the bean curd in a bowl and collected his 40 cents. Another customer would be waiting. Most would buy the bean curd home. He dispenses the bean curd into plastic bags, pour in the syrup and twist the rubber band to seal the bags.

One weekday morning I asked him, "Why do you open your stall half a day?"

The bean curd man said, "I start work at 2.30 a.m. I have to grind the Canadian-imported beans to prepare the bean curd. It is too tiring to work the whole day."

"How long since you open this stall?" I asked this man as I perceived that he was in a rut and was not enjoying his trade.

"Since I completed my National Service full-time some 30 years ago!"

I was impressed that he stuck to this trade for so many years.

"Why don't you do other business?" I asked.

He said, "I did MLM (Multiple Level Marketing) selling health products. I could earn as much as $4,000 a month but my downline of agents were not productive. So I gave up the MLM as it took a lot of time."

I doubt that honest money can be earned so easily but I did not say so.

"What business are you in?" the bean curd man suddenly asked me.

I said, "I am a veterinarian in Lorong 8 Industrial Park in Toa Payoh."

The bean curd man smiled, "Do you remember vaccinating a Jack Russell? My second son brought the dog to your Surgery."

"Sorry, I can't remember as there are too many Jack Russells. Did he cycle to the Surgery as that was one young man who did it.

"No," the bean curd shook his head.



"How did you all toilet train the puppy?"

"This puppy is just too active," the bean curd man's eyes widened and shone, "Running in and out. Here and there in the apartment like a sports car. He was peeing all over the apartment during the first few days. We put him inside the crate with pee pans below the flooring.

He paused and his facial muscles relaxed into a smile. "Later on, he went to the newspapers on a pee pan and pee there." the bean curd man recalled the actions and nonsenses he had to put up with the high dynamo.

That was good news. The bean curd man had 2 sons and they were working. The younger one was the one who bought the Jack Russell puppy. The bean curd could not talk more because more walk-in customers came in. It was the antics of a Jack Russell puppy that brought out his smiles of happiness when we talked.

62. Can't hold a candle

"They can't hold a candle to you" I said, not quite sure whether this fair lady would understand the English idiom involving candles. She was a healthy young woman in her late twenties. Slim and a wash board tummy that did not need hours of gym workout. Not a gram of fat like so many Singapore girls before marriage.

A pair of large brown eyes that sparkled when she talked to you. A pair of reddish brown rectangular framed spectacles illuminates and magnifies the friendliness of her eyes. A lovely small sharp proportioned nose like some English belles, so unlike the usual rounded-ended ones of most Chinese women. An oval face so much desired by the Chinese. A sharp chin and lips that are not too large. Shoulders that were not too broad and masculine.

I elaborated without flattery, "I mean you will not lose out (in beauty) to the starlet or the daughter of the owner of Hartman's International Jewellers. It is just that you don't dress up or use make up." These were her two significant rivals.

"I used to dress up during work," the fair lady with the fairest complexion of which the China's Swatow girls are famous for, said. "But many men come into the shop but they do not buy anything. They just waste my time chatting to me. So, nowadays, I just dress casually."

Whenever I went to her shop, she was shabbily dressed. What's wrong with being dressed to kill and attract moths to the candle? Increase the walk-in traffic. Men with ulterior motives are always a nuisance and a health hazard of beauty. But some men may buy something.

Her fashion boutique shop was profitable probably as it had existed for some years.

"If you procrastinate, he may marry one of them and it will be too late for you," I said. "It is better to be loved than to love. Marrying this man means that you need not work anymore."

She did not respond to my simple outlook about love, materialism and marriage. Financial security and a family were not what she wants, I discovered further into our conversation. It was just that so many marriages ended in divorces and bitterness. That was her main concern.

I had met this boyfriend in her fashion boutique. I shook my head in disbelief as my informant said, "I do not think a young man in his early forties can afford three upscale automobiles in Singapore. Each exotic branded sports car costs over half a million dollars and much more to maintain."

"But it is true," my informant insisted.

I asked the fair lady when I met her in her shop. She affirmed and since I was quite interested in dream cars, said, "The Maserati showroom is just a short drive. Why don't you drop by and see the Maseratis"

Now I realised how provincial I had become after spending so many decades with animals. Why can't a Singapore man be extremely successful financially in his own right when he is in his early forties? There would be many of them that my network had no contact with.

I have no reason to doubt my informant as he had no motive to deceive me.

While I was in the shop, the fair lady answered a phone call "I am busy now. I can't go out." She crinkled her forehead and put down her phone promptly. No 'goodbye honey' and 'I love you' talk as she was not a Caucasian.

"Why don't you close the shop and have dinner with him?" I suggested.

"I have to deliver some wedding accessories after closing the shop," she said sharply.


How could a young man with financial success win the heart of this fair lady? A Maserati might impresss her. A Ferrari did not make her swoon. There are 400 Ferraris in Singapore, a source told me. Perhaps a Lamborghini which is less common would win the heart of this fair lady? A Lotus car perhaps? There are only a handful of such cars in Singapore as they are over a million dollars to buy.

She knew a rising starlet and a jewellry heiress were her competitors in love. How she knew and how many more rivals in love, I did not ask her. She had seen many friends getting divorced over the past years and was now cautious as she approached her thirties.

"How come your marriage can last so long?" she asked me.

"I don't know the secrets," I said. "Maybe my wife and I spent so much time in our careers and bringing up two kids and time just flew by."

This boyfriend is very successful if one measures his material wealth.

"Why didn't he marry you during the early years of courtship?" I asked this fair lady.

"I would have said yes," she said. "But he had his plans to be successful in his business ventures and was not ready to commit." A successful man's secret was perhaps revealed. Make your fortune without the distraction and nagging of a wife first. Then get married. This is too simplistic a statement.

The boyfriend did not strike while the iron was hot. He had good intentions. Now, she was not sure that marriage and children are that great in a Singapore that sees the rising number of divorces every year.

Is it possible that she has other fishes in the pond of love? I dare not ask her as I did not know her sufficiently well.

Perseverance and persistence may yet win the heart of the fair lady. What is that something that can win her heart? I don't know. This fair lady has her worries and if he can address her concerns about the increasing divorce rates in Singapore, he might win her heart.

61. A Dr-Jekyll-and-Mr-Hyde Chihuahua

"Be careful, she bites!" the lady in her forties warned. A small less than 2-kg 5-month-old female Chihuahua with the golden brown coat trembled as the maid held her. The dog's eyes widened and focused on Mark and myself. Her ears folded backwards and her short hairs on her back stood up like soldiers at attention.

"Can you handle her?" I asked Mark who does obedience training of the fiercest dog such as the Rottweiler. I wanted Mark to be hands-on and learn how to restrain this dog. It should be nothing difficult when he is 100X bigger. Hands-on experience under my supervision would be easier for him to learn.

"No," Mark had decided firmly. "I don't want to be bitten." Sharp white canine teeth can tear the flesh of one's fingers and Mark was not going to risk it.

What to do?

"Actually, all you need to do is to wrap the Chihuahua's head loosely with a towel," I said. "I can then vaccinate and microchip her from behind the head. Most likely, she will bite the towel or just keep quiet." From September 1, 2007, all new Singapore puppies needed to be microchipped and licensed. The penalty for disobedience to government orders would be a fine of $5,000. It was no small change.

Mark brought in one big thick cotton bath towel and started covering the face. It seemed to be out of proportion in size for such a small breed. I meant a face towel would do.

The Chihuahua turned and twisted as the maid held her and nothing could be done.



"No need to use the towel," the lady suggested. "The Chihuahua will not bite my maid. She bites only men. At home, she would bark at my husband or son when they go home. Then she runs away to hide under the bed before they can touch her. Why?"

That was a surprise to me. "Most likely she had been abused by a man or boy during her fear imprint period and hated all male members of the human race. She was reared by a home-breeder.

"It will not be the home breeder," the lady said.

"Maybe it is a naughty boy trying to pull her tail or cause her pain and fear," i guessed. "Now, all men are enemies."

"How do you solve this problem?" the lady asked.

"Ask Mark," I said as this was an opportunity for Mark to gain a new client.

"No, ask Dr Sing," Mark declined.

I explained, "Maybe Mark does not want to provide free advice. Dog obedience training is his bread and butter and love."

I could not command Mark to dispense any advice if he decided not to. Much depended on his mood too. Here, I was stuck as the lady looked at me for help while Mark talked to the dog.

This was just a vaccination and microchipping session and not dog counselling.

"Talking to the dog in a low friendly voice to gain her trust is one way to stop her biting," I said. "But your husband and son need to spend time like 5 minutes 4x day doing it."

"They are quite busy," the lady shook her head after considering my impractical advice.

"Any ideas?" I asked Mark but he remained silent. The Chihuahua had been biting male family members for the past 3 months if they wanted to pat her head.

"Well," I said. "The positive reinforcement training method is the best way as in all other aspects of training the puppy."

The lady was perplexed as to what was positive training.

I said, "Basically, the dog is rewarded with a food treat, praise or playtime for performing what is required of her."

The lady asked, "You mean my maid gives the dog a food treat for not barking or biting at my husband and son?"

"No, no," I said. "Your husband or son gives the reward."

"How do they do it? The Chihuahua barks at them when they come home and runs away quickly to hide under the bed!"

"What a clever little rascal", I thought. "Now I have a problem."

I said, "In this case, fence up an area behind the main door so that she cannot run away to hide. When your husband or son comes home, she can bark at them. They give a firm command "No barking" but do not touch her. This is repeated for many days. If she stops barking, offer a food treat.

The lady did not comment but it was "easier said than done."

"You know," the lady said, "The Chihuahua will greet my maid in the morning and pees a bit of urine on the floor. She pees a bit whenever my daughter or I pat her too."

"This is a submissive urination behaviour!" I was surprised that this dog could exhibit fear aggression towards the male members and submissive behaviour towards female members of the family. Dual personalities like Dr Hyde become Dr Jekyl.

I said, "This dog will turn on her back and expose her belly for you to stroke," I said.

"Yes," the lady affirmed and laughed. "If we don't stroke her belly, she will use her paws to hook our hand to do it."

"Well," I said. "If you don't stop this behaviour, she will pee lots of urine as she grows bigger. The bigger the dog, the more urine is peed. The apartment will be most smelly."

"What to do?" the lady asked and answered her question at the same time, saying "When I ignore her, she would not pee a bit of urine."

"The best way is by not petting her or touching her when the maid gets up in the morning."

"Bangun...tidak ..." the lady gave her instructions in Malay to the maid. The maid understood that she must not pat the dog in the morning.

It is believed that if you building self confidence in a submissive puppy while she is still impressionable, the urination will stop. Avoid greeting her when coming home or touching her. Avoid loud commands. Take her out to meet people and other environmental situations like noisy roads etc. With a proactive approach while this puppy is young, the submissive urination behaviour may disappear.

As for the biting of the male of the Homo Sapien species, a positive reinforcement training program carried out persistently at 5 minutes 4 times a day for many days, for example, will help.

This Chihuahua is unusual in that she has a "split personality" just like Dr Jekyll and Mr Hyde in the story written by Louis Stevenson. Most submissive urination dogs are females and do not bite people!

60. "Is my dog going to be all right?" the tall sun-tanned man asked.

"Will my Jack Russell be all right?" the tall sun-tanned blond-haired young man was worried as he checked his dog into the Surgery. "This 7-month-old dwarf Jack Russel is like a son to me."



I was surprised as so far, nobody asked this question. But then, nearly all my clients were non-Caucasian.

"Neuter is a very common surgery," I said. "It takes a short time unlike those complicated surgeries. Normally the dog does not die during anaesthesia." His dog was in excellent body condition and well muscled too.

Xyla 0.2 ml and gas anaesthesia. The dog was put under 1% maintenance although 2% would be better.

Suddenly the dog moved as I incised the skin. I stopped the surgery as he was on the borderline between surgical anaesthesia and waking up. The gas dosage was increased for a minute to 8% and then dropped to 1.5%.

He went back to sleep at 1.5%. No more problem. He woke up at the end of the surgery, as if he had a good nap.



As for the owner, I asked what he was doing in Singapore. His profession of fashion photography must be glamorous---travels and seeing the world and photographing models for magazines like Vogue! This is one lucky dog as he gets to see the world and meet fashion models with his master who cares a lot for him. Mark is supposed to get a "passport" for the Jack Russell.



"Never heard of an animal passport?" Mark shook his head.

"There is such a thing," I said. "Check it out with the dog transport people!"

57. Follow up to Case 51. The stray cat

E-MAIL TO DR SING

...@yahoo.com.sg> wrote:

Hi Dr Sing
so much has happened since our last email. You could say it was a whirlwind. Let me fill you in with what's happened.

On Monday midnite, we were feeding M2 as usual and realised that he wasnt eating or drinking. Actually, he had some sticky film on his lower jaw on Sunday and didnt want to eat or drink either. I decided to monitor him closely to see if it was a toothache/ulcer/glue from rubbish. By Monday midnite, he still had not eaten or drunk (which is highly unusual cos he LOVES his food), the sticky film had now progress to a gooey brown patch on his chin and he wasn't even grooming himself (this was the last straw cos he is very particular about his appearance).

So my hubby and I brought the carrier down and some catnip and cat pheromone spray (yes, we have been prepared for a few years now, just needed M2's consent, heheh). Lo and behold, my fears were unfounded cos in he went! We brought him to the emergency clinic.

To cut a long story short, M2 had a mouth wound and infection which they couldnt really diagnose cos it was clammed shut. But blood tests later revealed that he has FIV. So he was given a jab, and given a course of antibiotics.

Needless to say, it is now Friday and M2 is with us at home. He responded to the meds very very well cos by Tuesday, he wasnt salivating anymore and was able to eat wet foor (handfed by me) and drink water. By Wed he was eating dry food and grooming himself.

Anyway, my hubby and I read up alot on taming and homing feral cats so we put into practise what we had learnt. I must happily report that M2 was a fast learner. He now uses the kitty litter to pee and poo with no messes or accidents. He has found his favourite spot in his own room in our flat. He is also a lot tamer and lovable, wanting us to stroke him, caress his belly and love him. He used to be a wiry and defensive when he was outdoors and would lash out without warning amidst our strokes. But now, he lets us stroke his paw, clean his ears etc.

Well, the vet advised us the precautions of FIV. On the grim side, it's like HIV and life expectancy is short. M2 will be prone to infections, recurrence of mouth wounds etc. But we are determined to keep him and shower him with lotsa love. We were told that he shouldnt be released into the wild again, and that he should be the only cat in the household, all this to avoid infecting other cats. Plus, if we are exposed to other cats, we should wash ourselves before we touch M2.

All this is well and good but I have a problem. When night falls, round about midnite up till 8am, M2 is quite active. He has now left his safe room and begun exploring the living room. All this while, we have kept the windows closed. The window in his room is left slightly ajar and the grills are wiremeshed up. Unfortunately, between midnite-8am, he is very vocal, from mewing to meowing, to yowling, to howling. Usually the yowls and howls will come when he comes to the main door or he catches sight of the outside through the windows.

I know he wants to get out. He misses the blue sky, his night "clubbing".....but I know that if he leaves, he will prob never come back. He might return to his usual routine of waiting for his food but being FIV positive, he can just turn up with a wound and infection again. I can't bear to see that and expenses will be high.

I'm just wondering if the yowling and howling is a phase that will pass or is it gonna be permanent until we give in and let him out? Im afraid that the neighbours might one day complain about the incessant howls. Is there any way to appease him?

Thanks in advance and I apologise for my longwindedness.
Warmest
(Name)

E-MAIL REPLY FROM DR SING

Sat Sep 22, 2007 7.27 am

It is nice to hear good news from you and a well-written report. Every case of handling a feral cat is unique and a learning experience for me too.

I did think of pheromone as it has been used widely in the U.K for dogs, but somehow forgot to mention it.

I just had an owner with a similar situation as your--- a case of the same problem with a male stray cat adopted some months ago.This cat hissed and clawed when brought in for neutering. He was as fierce as a leopard as he was ready to fight his way out.

I believe the reason for your cat's (and most cats') past midnight anti-social behaviour is that he hears the street cats downstairs. In theory, soundproofing his room will likely resolve your problem. I know this is not practical.

The second option will be to neuter him as soon as possible. Pheromones and/or tranquilisers/hormones may help temporarily.

56. Follow up to Case 34: A mother's love

Friday Sep 21, 2007, Bishan Community Library, 8.02 pm.

The mother must have asked her son who is a veterinarian to present me 2 boxes of mooncakes as a gesture of thanks for mentoring her son in the bladder stone surgery. I phoned her Surgery for past 2 evenings but got no pick up. Tonight the son returned my call. Mum was sick due to diarrhoea and so it was not possible to thank her.

"Struvite crystals as analysed by Science Diet," the young man in his late twenties said. A quiet person of few words. Science Diet has a free analysis of bladder stones for Singapore vets. These are sent to the U.S. So, the spiky stones are struvite.

"Is the dog ok?" I was more interested than the nature of the bladder stones.

"Yes," the young man said.

"How do you know?" I queried.

"The dog belongs to the girl working at my Surgery," he explained.

"That's good news and your surgery was good."

It was good to know that the dog no longer passes blood in the urine. It was around one month ago that he had the surgery done.

Bladder stone surgeries in male dogs for young vets are a bit complicated. It is always best done under the guidance of an experienced vet. The alternative is to refer to other vets and not gain any surgical experience. As I said to this young vet, you send the cases to other surgeries---their young vets gain experience and it will always be a one-way street. You never learn anything and you lose clientele too.



In my experience, it will be a rare veterinarian or specialist who will bother to pick up the phone and tell the referring doctor what happen.

In this case, the mum had asked me to mentor her son for bladder stone surgery and Caesarean section. There are not many such cases but if there are, I am most happy to mentor him.

Mothers always love their children---most mothers anyway. They have their welfare at heart even though the baby is a parent and a veterinarian of some years! This mother of the veterinarian is very unusual in that she seeks out a mentor for her son.

55. The inventor of hospital bed lights

2 clear cupped goggles covered his 2 bandaged eyes as he walked to the Head Nurse's station. The man was in his late fifties, of medium height, broad shoulders and receding hairline and was dressed in blue uniform.

The inventor of hospital bed lights had finally made an appointment for me to see the hospital bed lights he had invented and installed in a private hospital. I had known him for over 20 years as he provided veterinary anaesthetic machines for my surgery. He had a workshop at one time and then he disappeared for some years overseas and running an Indonesian restaurant.

Now, he was back in Singapore again and back to his love of making and maintaining medical equipment. A biomedical-engineer type of person, a profession rather rare in Singapore.

What's the big deal in inventing and designing a hospital bed light? I had to see the real thing as his photographs did not impress me. In any case, there is nothing like seeing the real invention. So, he made this appointment for me to see it.

The hospital bed light must be safe for the patient and must be easy to maintain. It has an upper reflection light, a reading light and a night light all in one tube. He had worked closely with the hospital for the past years and finally his invention was approved.

The hospital seemed to be full house. However, he arranged for me to view one light. The man with the space-age eye googles left his bed for a minute for me to see the operation of the light.

"There is a wired remote control too," the inventor's assistant pressed a console and the lights went off. Some gadget similar to the nurse-call light.

"Why not invent a wireless remote control?" I asked the inventor.

"No," he said. "The electrical intereference may affect patients with heart pacemakers."

The lights looked plain but it was what the customer wanted. His manufacturer took his designs to other countries to market and not pay him some royalties. It is the dog-eat-dog world. There was not much he could do.



I said, "From what I read in some business entrepreneur magazines, it is best to let different manufacturers from different countries do certain parts. You then assemble the whole lot."

Manufacturers and/or their staff have no qualms about stealing the designs and making money for themselves. This makes the inventor unwilling to do more research. Setting up his own factory could be an answer but that still would not solve his problem of intellectual property theft.

I asked one intellectual property lawyer who happened to take his dog to me for microchipping. A lawyer will charge a trademark registration cost around S$1,000 but a patent cost at least $10,000 in Singapore. It is just too expensive for a small inventor of hospital bed lights to patent one's invention!

54. Behavioural problems - "sibling rivalry" from a new puppy?

Children less than 5 years old are often hyperactive and inattentive. Some are energetic and outgoing, some are passive and reserved and clingy.

Puppies behave similarly when they are less than 6 months old, depending on breed. Jack Russell puppies are hyperactive compared to the Cavalier King Charles. The latter may follow the owner everywhere, even to the bathroom.

Hyperactivity and distractibility may be also a temperamental trait. If there are communication problems in addition, appropriate intervention and behavioural management strategies from the professionals may be needed.

The 4-year-old girl lifted up her mum's front half of her blouse many times while the vet discussed treatment of her Jack Russell.

"It is not a nice thing to do," she looked at the girl after she failed to stop her by ignoring her. She pointed her finger at the child and said, "Mummy is not pregnant." She was wearing an "empire" blouse or something of that fashion.

The daughter stopped doing it. The mum had to talk to her. I continued discussion with the 17-year-old son on how to care for the puppy's ears and some skin disease leftover from the sarcoptic mange infection of the ears.

I wonder whether this is a case of "sibling rivalry" --- the sibling being a new puppy taking up attention from the mother. Her only son was 25 years old. Yet the mother looked in her thirties.



"What is your age?" Mark asked. She was not hesitant to reveal her exact age. As expected she was young at forty. Full of energy and sociable. She took her daughter to the Supermarket while she worked. The daughter was confident child. But at her age (less than 5 years old children), hyperactivity, inattention and sibling rivalry from a puppy are to be expected. The mother handled her well.

The mother had a top salesperson temperament. High energy as the Jack Russell as she worked hard at insurance and real estate. I expect her to be very successful in her life.

53. Pee off target - clicker training to correct his problem?

Tuesday Sep 18, 2007
NLB 6.34 pm
Dr Sing Kong Yuen, www.toapayohvets.


A VERY COMMON COMPLAINT that is encountered during toilet-training by Singapore pet owners during my case studies:

The puppy steps onto newspapers or pee tray. He pees outside the edges.
Why? How to solve this problem?


Why?
1. Most likely reason. Owner does not change soiled papers frequently. Puppy dislikes being dirty. Puts 2 front legs at clean part of paper. So the back half of the body is outside the papers. Eliminate at outside as hind legs are out of the paper.

2. Peeing liquid sprayed in centre of paper. Puppy smells it, but its body is longer. So back legs are outside the paper.

3. "Wants attention". Owner makes a lot of fuss. Puppy wants attention. Does deliberately.

How to solve this problem?
1. Clicker training. I doubt Singaporean puppy owners have time for such training.
Put pee tray/newspapers between owner and puppy.
Puppy steps onto tray with front feet.
Click. Food treats given to puppy at tray level.
Repeat 4x/day at 5 min duration to train. Not >15 min.

Now, puppy goes inside tray with back legs (front legs may be outside tray now).
Click. Food treats given to puppy at tray level and so on.

Puppy wakes up or after meals. Goes to tray with back legs inside.
Puppy eliminates.
Click. Food treats given to puppy at tray level and so on.

2. I think the simplest method is provide clean tray or newspapers.
Neutralise urine smell outside tray area with vinegar:water 1:3.
Say firmly "Pee here", praise and food treat on success.
Remove soiled papers/clean tray.

3. Urine-marking of male dogs is a separate problem as urine is sprayed onto vertical surfaces like legs of tables or walls! May happen as early as 5 months of age. Neuter early at 6 months of age and not at 3 years of age as habit may be established.

52. Somerset Maugham, Lee Kuan Yew and Raffles Hotel

One August 2007 day, I chanced upon Raffles Hotel's 120th Anniversary advertisement in the Straits Times---120 people would be invited to the 120th Anniversary Celebration if they win the "What Raffles Hotel Means to Me" contest. What attracted me to participate in the contest was a chance to be briefed by the Hotel historian and I thought, there would be a tour of the room that Somerset Maugham stayed or the place where he wrote his stories.

Raffles Hotel was just next to Raffles Institution (now Raffles City Shopping Mall) where I started my Secondary One studies in 1963.

During my Secondary and Pre-University studies at Raffles Institution, the Raffles Hotel was not of any interest to a teenager. The girls of the Convent of the Infant Holy Jesus school (now no more) and the St Anthony's Convent (now no more) were forbidden fruits and much more interesting.

Over the next 5 decades, Raffles Hotel was just a luxury hotel, out of bounds to most Singaporeans. It did not have the tim-sum lunches like Shangri-la Hotel, a place that I could invite a special friend to lunch with and maybe impress her.

However, Raffles Hotel has the historical romance of famous writers like Somerset Maugham and others. I used to read Somerset Maugham stories and so must be many others during my era, as Minister Mentor Lee Kuan Yew mentioned in his speech at the 120th Anniversary Celebrations on Sep 16, 2007.

This is what I believed Mr Lee said.



Those important people who met Mr Lee had asked him to arrange for a drink at Raffles Hotel during the 1980s. "They must have heard of Somerset Maugham and other writers having stayed at Raffles Hotel," Mr Lee said. "This means that Raffles Hotel had a good name. However, I did not recommend them to stay there. Raffles Hotel was in a period of decadence."

He told the management that the government would acquire Raffles Hotel if the management continued their existing way of doing things.

Renovations were done and a piece of land behind the hotel was given to them.

(In 2006 and 2007, it received awards of "Best Luxury Hotel in Asia" and "Best Hotel in Asia" respectively.)

Mr Lee began his speech which captured the attention of the audience crowded inside the lobby. There was a drizzle in the outdoor stage and so all went indoors to the large lobby.

"The reason I am invited is because I got married in Raffles Hotel," Mr Lee said, without the need to refer to written notes. This was the only time I saw him giving a speech in person although I have lived in Singapore for the past 5 decades. Most business people in the audience would have more contacts with him.

This must be the only occasion he got the audience of several hundred people clapping their hands spontaneously at the commencement of his speech and his first sentence. (He was 84 years old on this 120th Raffles Hotel Anniversary Celebration day, according to a Business Times report on the Raffles Hotel Anniversary celebration on Sep 17, 2007, it was also his birthday.)

He ended his speech with an indirect advice to the audience of business people something along these lines of thought: "A famous name (such as Raffles Hotel) is insufficient nowadays with so many top class hotels as competitors. The guest must receive an experience he will not forget while staying at the hotel (so that he will recommend the hotel to others and return to stay)."

To me, this event was very interesting. A guide took us to visit the inside of the hotel. The romantic honeymoon suites which are in great demand, the spas, the swimming pool and its presidential suites at $7,500 per night? The "Original Raffles Hotel" moon-cakes presented to us were the first time I had tasted it. I must say it ranked top, as good as those from Shangri-la Hotel I tasted a few years ago when a client presented them to me.



Now, which room did Somerset Maugham live in when he stayed in Raffles Hotel? That was what I wanted to see. Well, I guessed the tour guide forgot about this most important aspect for the "120 writers" who participated in the writing contest.

Raffles Hotel Singapore has another famous living writer that it ought to consider mentioning in its history book. It was the hotel where this writer had his wedding reception on Sep 16. He went on to manage a country called Singapore, making it world class.



P.S.

"WHAT RAFFLES HOTEL MEANS TO ME" IN 120 WORDS.

“My husband always stays at Raffles Hotel,” the attractive hatmaker had invited me for my first-time tea at Ah Teng’s Bakery in 2006. “One day, I’ll ask my connections to show you where Somerset Maugham and Rudyard Kipling lived!”

I had told her that I enjoyed visiting Shakespeare’s birthplace in Stratford-upon-Avon when I studied to be a veterinarian in Glasgow 3 decades ago.




Her global business expands explosively. I cannot impose on her promise. Raffles Hotel today means more than a memory of a most beautiful hatmaker-veterinarian friendship. Its “Best Hotel in Asia” award and the success of the hatmaker teach me that I must provide the highest quality services or products to be a top dog in my profession.

51. Building trust in an abused cat takes hard work

E-MAIL ON SEP 16, 2007

Hi Dr

I would like to ask you for some advice on how to adopt a feral cat. I hope you don't mind if I give you a history and background of our situation first. It looks pretty long but I believe it will help you better understand our situation. I have been reading your case reports on the website and find them very enlightening and honest. I greatly appreciate that you care to discuss real every day animal cases, both good and bad. Thank you for sharing your knowledge and experience and thank you for your invaluable service to animals.

OKAY, here goes. My husband and I live in an HDB flat and we've been feeding a feral cat called M2 for the past 4 years. Her ear was already clipped when we first met her. Let me give you a little backgrounder on her.

M2 is a feral cat who used to hang around our HDB block void deck. She took to us very well and would wait for us punctually for our regular feeding times. Then with the coming of other more dominant cats, she was eventually chased away from her roost at the void deck. She now naps and hangs out in a little garden patch (next to a power station) of shrubs and roses behind my flat. She doesn't stray far, always within calling distance. She is quite a scaredy cat, easily flustered by the slightest sound, sudden movement and intimidation of other cats. That she makes up for by using her claws in any iffy situation.

M2 can scratch quite vehemently when she's overly excited or agitated.She is a rather skittish cat. We know she has probably been through alot and is just trying to be defensive. We think she may have been roughly Handled by humans last time and hence her insecurity.

Over the years M2 has grown accustomed to our strokes and pets. In the beginning, she would not let us touch her, let alone approach her. Today whenever she see us, she will come to us with an upright tail, roll over on her back, expose her belly and let us rub her. We've been meaning to adopt her but trying to find the right time and not lose her trust.



However, she does not like to be carried at all. Once I carried her and she gave out this yowling meow before struggling out of my arms. We even managed to carry her into the lift and up to the 7 floor where we live. But once the doors opened, she bolted out of my arms and down the stairs.

Seeing that she is such a timid soul and often bullied by other dominant feral cats who usurp her territory and chase her out, we have always wanted to adopt her. Right now, she is at risk of being chased out of her garden patch by a very bossy and aggressive female calico cat who is a "newcomer" with unclipped ears.

A big problem is that if i were to adopt M2, given her temperament and dislike to being carried, how am I going to bring her to the vet for an all-over medical checkup as well as a one-time grooming before she becomes an indoor cat? I played around with the idea of sedating her with tranquilizers. Can I get these over the counter at a vet clinic? Will they sell it to me?

Another alternative people offered was cat trap. But M2 might
completely lose the trust we built over 4 whole years and be mad at
me, and won't come near me at all.

To tell you the truth, I had called a professional cat catcher (recommended by an animal shelter) to try and capture M2 after she had hurt her leg. To cut a long story short, after 5 hours, he failed. He also said when people call him to catch a cat, it's 100% success that he catches them.

Needless to say, M2 recovered from her "injury" and she was so mad
at us (or scared) that she disappeared for 2 wks. When she finally re-appeared, she was so suspicious of us that she didn't come close or let us touch her. She kinda knew we had a hand in the attempted capture even though we didn't personally catch her ourselves. So our 3 years of gaining her trust went down the drain.

As you can see, due to this episode, we are hesitant to use any force on her for fear of another episode.
What should I do? Don't tell me to ignore her or forget about her just cos shes feral, we love her like she was part of the family. We want to give her a home and not relegate her as a statistic. Thank you in advance.

Warmest Regards
Name given


E-MAIL REPLY


Date: Sun, 16 Sep 2007 06:12:18 +0800 (CST)
From: "Dr Sing KY" Add to Address BookAdd to Address Book
Subject: Re: How to take in a feral cat we love so much
To: ...@yahoo.com.sg>


Thanks for your compliments and detailed background of M2. I presume you are a journalist to be able to write so well. Here are some quick suggestions as I have never been asked to resolve this problem by any cat lover.

1. Tranquilisers from the vet. Your vet should be able to help you if both of you have a business relationship of integrity and trust. However, the cat is very smart and will not take the drug if you put it inside the food. There are other ways which your vet will explain to you. Obviously, if you don't have this relationship, it will be foolish of the vet to help you as you may be an undercover journalist interested solely in yellow journalism.

1.1 Tranquiliser dart. This is the best method but there are legal requirements in its use. The AVA may or may not have this dart. The vet in Singapore does not have it. Maybe the zoo vet? This person must be good at it. No second chance of blowing the dart as M2 would have sprinted off.

2. Professional Cat Catcher. I don't know if there such a profession. I will think that the best one in this business is actually from the AVA's dog and cat control unit. If you really spend time with these people, they may or may not be kind enough to help you to trap this cat. This depends on how good you are at people relationships.

3. Cat trap. I doubt M2 will get into the typical cat trap as she is street-wise after so many years of human abuse. Such cages usually smell of 'death' and 'fear' as these cat traps are usually used many times. A cat netting method is probably the best if it can be done by an expert.

4. Trust. During that period of time when the cat trusted you, you did NOT gradually hold her for short periods of time. Put food on your lap and let her eat from there for few days. Then slowly hold her for a few seconds.

Instead, I presume and I may be incorrect in my presumption, you suddenly carried her to your apartment one day? It was as if one is being kidnapped and being murdered. This act triggered in her the recollections of bad experiences with human beings.

5. How much time you have to re-gain the trust of the feral cat? In the final analysis, how much time/day did you spend with M2? Is it 3x per day? Or just feeding time? The more time you spend with M2, as with human relationships, the opportunities for the other party trusting you are higher. The only problem may be whether M2 has time for you? I think she will have.

Lots of time/day spent to gain the trust of a feral cat is probably my answer to your problem. Play time and fun time using toys that the cat likes must be included, not just feeding time.

5.1 Routine and priorities in your day.

My suggestion is that you write a time-table of action and priorities for the day (I sound like a teacher as I often suggest this method to some of my clients as well but they don't do it!). Below are my quick thoughts on this rainy Sunday morning.

You spend 3 or more times a day with M2, if she is available. Do you know where she wanders about? That is what I mean---getting to know her well. I know this is asking for the impossible. Who cares where M2 spends the whole day?
Start playing with her and getting her used to be carried. Feed from your hand and then from a tray (which may or may not evolve into a cat trap or cat net). One of the methods of catching her is a new well designed cat trap set by you, not one from the AVA or others.

I have an inspiration which may sound nutty to you and which I write below:

Feed her from the void deck, moving the food plate to the floor step of the staircase going to the 2nd floor. Then feed on the 2nd step and so on to the first floor. Feed her favourite food and milk, let her go. Repeat many times. Play time and fun time must be included when M2 runs down the stairs. Old cats may not want to play with the "catch the mouse toy" but who knows. Carry her from a low height, not high up standing. Put her down after a few seconds. Repeat and so on.

Feeding continues to the 2nd floor (this will take some weeks I guess). By the time you reach the 7th floor of your apartment and into your apartment, it may be 7 years later!

The above ideas are adapted from the puppy toilet training advices asked by an American yesterday. The American wanted to know how to get the Shih Tzu peeing and pooing from the indoors to outdoors for her adult Shih Tzu. It seems the method for the Shih Tzu can be applied to your case?

The above are my suggestions. Time is of the essence for you now. Let me know if you succeed. Best wishes.

50. The ex-dog breeder shares his experiences

He saw the opportunity in the new microchip law effective from Sep 1, 2007. All Singapore dogs must be microchipped before they can obtain their licence. Otherwise a fine of $5,000 for not possessing a dog licence. Apparently all dogs 3 months and above. Spayed and neutered males are charged around $14.00. Intact ones pay around $75.00.

Now, the dilemma of the Singapore puppy owners is that they can't get the cheaper rate of $14.00 because the puppy is too young to be sterilised at 3 months of age. Maybe they can't find a vet who is willing to do it. So there must be some grumbles at the need to pay $75.00 in this case.

From what I hear from a pet shop operator, they now pay $14.00 from month 3 - 6, get the dog sterilised and extend the "validity" of the licence. Failing to sterilise means that they have to pay $75 at month 6. I don't know whether this is a new policy?

In any case, one ex-dog breeder sourced his microchips and got them approved by the regulatory authorities with letter of proof to show me. He dropped his price lower than his competitors. He went to all pet shops, vets and every relevant prospect.

I had a microchip scanner which could not read. I rushed out to NTUC Toa Payoh and bought a battery. The scanner could not work. The message said "powering down" after one successful scan.

I asked my man to look into it. He sent it to Funan computer centre and was told that the scanner needed to be sent to the U.S as there is no spare part.

The ex-dog breeder was willing to help. He took out his "Made in USA Energiser battery", 9V from his scanner which he also sells. His diagnosis was spot on. There was nothing wrong with the scanner!

"You bought a rechargeable battery," the ex-dog breeder patiently explained. Maybe it was not charged. Buy a 'Made in the U.S' battery similar to mine." A very helpful salesperson. He built a lot of goodwill and it was quite embarrassing.



He was a breeder of 50 dogs 8 years ago but his advices still remain relevant today. These are:

1. Hygiene is paramount. Weekly disinfection of the crates and the floors below because parvovirus are "air borne" in big breeding areas.

2. Crated dogs above ground level. So, easier to disinfect flooring below.

3. Vaccination must be done regularly. Many breeders forget after a while. So more viruses come in.

4. Good quality breeds. No point breeding Jack Russells. Maltese and Shih Tzus of good quality are in demand.

5. 24-hour or very close monitoring of breeding dams 58-60 days. Be available to help the dam not able to give birth. Every puppy lost is money down the drain.

6. "How do you control ticks?" I asked.
Use a brand (name given). Not toxic to dogs and puppies (that what the brand label stated). Wash dog frequently. So tick population reduced. So, less ticks.

7. Crates above floor level is one way to reduce tick population but regular check up is necessary.

49. Spaying an alpha female cat. Does it stop her urine marking?

Sunday Sep 9, 2007

"Queenie is a dominant cat," the young man in his early thirites said. "For the last 2 months after introduction of a young male cat, she started urine-marking. She pees on clothing and furniture. Since you can do spay on a Sunday unlike the other clinic, I want her spayed today."

A cat's urine can be particularly strong in smells.

The young man had 5 cats in the last 2 years as follows:
1. Norweigian, female, spayed, 1.5 years old.
2. Ragdoll, female, spayed, 1 year old.
3. Ragdoll, male, intact. 1 year old.
4. Domestic short haired local, male, 6 months old.
5. Queenie, female, intact, 2 years old. Had a litter. Only sign of caterwauling (noisy meows) was 3 months ago. Had never been pregnant. She would eat first sharing the dual feed bowl with the Norwegian.

The owner put sufficient quantities so that the other 3 cats can eat after Queenie had her fill. 3 times a day he would fill up the feed bowls.

Water bowl is available at all times. There seemed to be no fighting over the water bowl.



Queenie had her litter box since she pees outside the first litter box. 2 scratching posts were provided.

"I guess all your wardrobe and furniture had been scratched by Queenie," I guessed that Queenie would not want to put her mark on the two scratching post.

"Yes," the owner said.

I wonder whether spaying at this late stage would resolve the urine marking problem.
It was surprising that Queenie did not get pregnant with the male Ragdoll being intact. Maybe he was too young or intimidated by her looks?

TECHNICAL DETAILS OF SPAY

Queenie, weighing 4.5 kg looked matronly. She was quiet when taken out of the cage and given the injectable anaesthetic. In this case, xylazine 20 + ketamine 100 at 0.2 ml + 0.8 ml in one syringe IM. Onset of anaesthesia 5 minutes and duration more than sufficient for the 15-minute spay.

Incise at 1.5 cm from umbilicus. Skin incision 1 cm long. Remove white fat of 1 cm thick from subcutaneous tissue. Midline incision. This incision was sufficient to expose ovaries, ovarian blood vessels of over 1.5 cm so that ligation of double sutures was easily done.

Hook up left uterine horn. Left ovary ligated. Repeat with right uterine horn and ovary. In this cat, there was no need to tilt the cat's chest upright from ventrally as the uterine horns were easily retracted at the uterine body junction, unlike another case I described earlier (young female cat spayed). 2 simple interrupted sutures close muscles. 1 horizontal mattress suture closed the skin.



Ovaries golden yellow and granular of 0.5 cm. Ovarian vein 50X thicker than a cat not on heat. Uterine horns thick 0.5 cm diameter but firm, not fragile like some cats in the middle of heat. However, ovarian veins were 50X thicker and needed careful ligation otherwise the cat would die of bleeding.

It would have been better if the cat was spayed when not on heat. However, with 2 males in the apartment, she was probably on frequent heat without the loud caterwauling except at one time 3 months ago.

In retrospect, this cat could be pregnant as the solid golden yellow ovaries could be the corpus lutea of pregnancy.

ADVICES TO OWNER.

1. Feed Queenie separately and in measured amounts. No more dual feed bowl. She must have had eaten more than her fair share to put on so much weight. Otherwise, after spay, she may become obese. The cats liked salmon from Science Diet and Proplan but not Royal Canin.

2. Remove plaster covering wound in 10 days.

3. No need to return for stitch removal.

4. No antibiotics given or necessary.

It would be good to follow up on this case as to whether spaying at late stage would abolish urine marking in the alpha female cat.

48. Is Spaying necessary? E-mail queries.

Sunday, Sep 9, 2007, 7.31 am.
Good morning to you. I am Dr Sing from Toa Payoh Vets. Thanks for email.
See answers in CAPITAL LETTERS below. It is good for me to receive an owner's concerns as regards spaying.



AN E-MAIL TO TOA PAYOH VETS

wrote:

Dear doctor

Good evening to you.

I have a female maltese ard 10 months of age. I believed she is in her heat period now, as she will als 'hump' on my arm. I have a few enquiries to check with you on the spaying.

May I check when is the suitable period for spaying??

3 MONTHS AFTER HER HEAT. EXAMINE YOUR FEMALE DOG FOR SIGNS OF HEAT like vaginal bleeding for around 10-14 days and big swollen vulval lips.

Is it necessary??
YES IF YOU WANT much cheaper dog licensing fees payable yearly and no blood stains in your house and furniture during the female dog's heat. SOME female dogs get unwanted pregnancies --- either having escaped from the house for some time or attracting male dogs to the house. Many owners are surprised at such cases of small Silkie Terriers being pregnant although the male is a big Bull Terrier or bigger breed.

NO IF YOU THINK IT IS CRUEL. Some older spayed dogs have urinary incontinence or hair loss.

As i heard this will improve her quality of life, longer life span...
YES. The probability of getting breast cancer is much lower in a spayed female dog. Infection of the womb (pyometra) is one disease in older some intact female dogs (passing sticky pus from vagina, vomiting, not eating). This is avoided if the dog is spayed as she has no more womb.


How long is the recovery period?? (longer than a male..i guess??)
AROUND 7 DAYS after surgery. Most female dogs recover within 2 days if you observe their interest in eating and being active.

I was wondering if i need to arrange for leave to look after her.
PREFERABLY YOU TAKE LEAVE for at least the first 3 days.

Wats the success rate of the Ops??

1. DEATHS FROM ANAESTHESIA OR BLEEDING.

A FEMALE DOG IN GOOD HEALTH usually will not die under the general gas anaesthesia. Bleeding complications and infections are the main risks but should be rare in Singapore cases being operated.

2. STILL BLEEDING.

IF YOU MEAN whether the female dog will still have vaginal bleeding or attract male dogs after spay, she should not. However if remnants of ovarian tissues are left behind, there may be some problems.
Any dangers on a smaller size dog in compare?

Lastly, the cost??
AROUND S$250 AT TOA PAYOH VETS. I advise that you spay your female dog 3 months after heat as there is little bleeding involved. More information about dog spay is at my website:
www.asiahomes.com/singaporetpvet/031208spay_Cocker_Spaniel_Toa_Payoh_vets.htm


I thank you for your patience and hope to hear from you soon.

Best regards
Jasmine

47. Telephone diagnosis in Caesarean can give the vet trouble

"My husband had ruptured the water bag but the puppy could not come out," the breeder's wife phoned me as I was going out for my lunch appointment. "What she I do?"

I asked: "Are you sure the water bag is broken and it is not the watery discharge before birth?"

"I am sure it was the water bag."

"Normally a Miniature Schnauzer has no problems giving birth," I advised. "You can wait for half to one hour."

"Will this puppy die?" the breeder's wife asked.

"I don't know. Perhaps you can wait half an hour. However, the decision to do Caesarean is up to you. Please note that I can't predict whether the puppy will die or not if you don't get a Caesarean done."

This is the type of telephone diagnosis I presume veterinarians all over the world dislike. If the puppies die, the veterinarian gets cursed for incorrect advice.

I got one bad experience of such telephone diagnosis. This Singaporean caller whom I did not have veterinary relationship with wanted free advice over the phone.

The next morning, the government vet in charge of private veterinary matters phoned me to enquire whether I had given advice such as whether the "greenish vaginal discharge had come out or not?" Such experiences harden the attitude of private veterinarians towards free telephone diagnoses.

The breeder came to the Surgery. A puppy was pulled out. In the midst of anaesthesia, a water bag was seen. With some straining, I managed to take out a second puppy. Now what?

Can I just use oxytocin and/or wait? I don't play God. Breeders want one thing --- live puppies. No explanation acceptable if the puppies are dead or stillborn and worse, if a belated Caesarean is done.

Who knows whether the remaining puppies inside the dam would be born easily? I estimated four or five in total. Two had popped out.

The breeder decided on Caesarean. The anaesthesia was smooth. The dam sleeps peacefully but did not strain to pass out more puppies even though I reduced the anaesthesia to 1% instead of 2%. It could be secondary uterine inertia.

I inserted my right forefinger and third finger into the 3-cm incision of the uterine body. I could cut a bigger incision in the skin and then into the uterine horns. However, it would be best to hook out the puppies.

The puppies played hard to get. The mother had stopped contracting. The puppies hid deep inside the horn, near the ovaries. Should I enlarge the skin incision? Try again. With time, the 2 puppies could be fished out without bigger cuts.

All were vigorous and active.

I wanted to take pictures outside the Surgery as there was better lighting. The breeder's wife took pictures with her handphone. She said to the two kids as we crossed the small road to the other side where sunlight fell onto the walls of the building, "Stay inside the Surgery."

"Go and take the kids out," I said, taking over the wife's basket of 4 puppies. "Let them learn about your business."

The little daughter must have felt nauseous as you can see from a chance picture of her. I appreciate this rare action people and dog photo very much as it is one that tells a thousand words.




"Why don't you dock the tails now?" the breeder's wife asked.

"Better not," I said. "The mother may be upset. The puppies may not suckle or be stressed."

Some advices on how to care for the puppies were given.

The breeders seemed grateful and most happy. This was the first time they encountered their Schnauzer giving birth during the daytime. This Caesarean was without complications.

The breeder's wife phoned some one hour later, "One puppy is not suckling well. Milk comes out of his mouth."

"I don't know what's happening. Is there a hole in the roof of the mouth. Check the mouth." It was difficult for her to know what the roof of the mouth means.

See what I mean? I hate telephone diagnosis. I asked her to bring the puppy for me to check. She did not turn up. I guessed all would be all right with the puppies.

46. "Dr, cut only a small piece of my cat's left ear"

"Doc, please cut a small piece of her ear after spay," the 65-year-old lady with such young looks of unwrinkled forehead and black hair that I could assume she was around 50 years old. "Is it painful for the cat?"

The lady had reared this black cat as a kitten. Now the cat caterwauls. She wanted her spayed, ear tipped by cutting off a piece of the tip of the left ear and put downstairs as she felt that changing of the litter was inconvenient. Her husband had passed away some time ago. Her children had grown up and had their own families.

"It is better to cut a bigger piece," I said. "Otherwise, the cat catcher would not know she had been spayed."

"Yes, it is better," a thin tom-boyish self-employed dog transport woman with crew cut hair interjected her remarks. She had bought in a female dog on heat for spay as the owner wanted a cheaper dog licence. An intact female dog licence is around $70.00 while a spayed one costs $14.00.



I looked at the 65-year-old lady who was accompanied by a much older senior citizen to 'protect her' she had jested. I thought: "This lady would be better off with a cat to keep her company as she was still grieving over the loss of her husband who would not see the doctor for some abdominal pain for one year."

By the time the husband consulted the doctor, he had some pancreatic tumour and passed away soon. The lady had seen me yesterday to spay her cat but the cat had eaten. Spay is recommended when the cat has been starved for the past twelve hours.

The lady said, "Maybe you cut the ear another time?"

I was surprised that she vacillated in her decision to spay and abandon the cat.

I said, "The cat would require some anaesthesia the next time. It would be better to tip the ears today after the spay."

The lady could not decide.

"Do you understand that your black cat may disappear once you leave her out of your apartment?"

"It will never happen," she said. "I see the two stray cats downstairs in the void deck every day."

"There is no guarantee in life that you will always see your cat at the void deck. Government cat catchers had been reported to use nets to trap and remove stray cats. There are town council people who cannot put up with cat complaints and get rid of them. There are pest control and town-council approved contractors who dislike cats being paid by those who dislike cats to capture your black cat. Or simply a naughty man who abuses cat."

The lady was distressed at such possibilities.



"But these are realities of life. If we don't give protection to the animal we love, they are at the mercy of many bad people and environment."

She still loved this cat. Other than the need to change cat litters and the strong smell of cat urine, I don't know why she wanted to get rid of this young cat.
I did not ask more.

As she could not decide, I said, "Let me spay her. When the time comes for you to give her up to fend for herself, let me know. Then I will cut the ear tip. In the meantime, she will stay overnight at the surgery after spay, without charge and go home tomorrow."

She seemed happy at this advice and went back home. This was one of the rare times I had some free time to talk to an owner. If not, it would just be spay, tip the ear and abandonment of this gentle 6-month-old cat.

45. Visiting NANAS by appointment only

"Nobody is permitted to visit NANAS if I am not around," Mr Raymund Wee said over the telephone. "Prior appointments are needed."

I could not understand why. Surely it is in the best interest of NANAS to encourage more visits. It is like the Giant Panda attracting over 40,000 visitors at the American zoo at one time. With exposure to members of the public, it will be good for fundraising. After all, Raymund said that the expenses for the maintenance of 1,000 animal residents come up to $700,000 per year. And there is never sufficient money.

Raymund explained: "There are at least 500 free roaming dogs in NANAS. NANAS does not put dogs to sleep unlike other animal shelters. The dogs get excited if some new person arrives. What if a visitor gets bitten? NANAS may suffer litigation costing millions of dollars".

"Has any visitor been bitten?" I asked.

"No,"



"How do you manage to control the tick infestations of so many dogs?" I asked. This is an important question as Singapore dog breeders do have to control ticks in their breeding farm.

Raymund told me the various names of insecticide used, "I rotate various insecticides as the ticks become resistant to them after a while. Ivomectin injection is the better method to once a month oral but it is too costly to use injections for so many dogs. Furthermore, injection has to be done carefully otherwise ivomectin goes directly to the blood stream. There are certain dogs that will never allow injection.

"Is garlic effective in tick control?" I asked as there were some proponents of the use of garlic for mosquito control in the U.S.A.

"No." Raymund said. "Garlic can be toxic. On the other hand, the sanctuary cannot be totally sterile and free from any disease causing organism. It is not practical and not good for the dogs as they don't build immunity."

"Why don't you plan ahead and employ newly graduated veterinarians from overseas to do sterilisation of dogs and cats?" I suggested in reply to his complaint that experienced veterinarians are not interested in performing batch of sterilisations for 8 hours at a stretch.



This is because each colony of cats is sterilised at one time and returned back. In this way, there is disease control and prevention of viral spread to all cats in other colonies. So, the veterinarian must be able to be productive and competent. Competence comes from experience.

"I thought young graduates would gain considerable surgical experience in NANAS," I said.

"The main problem is that some young vets, being inexperienced, are slow and needs supervision. Some of them leave behind remnants of ovarian tissues and do not ligate tightly, leading to bleeding. Some also do not ask for help.

Sometimes, just make a bigger incision would do. Some vets prefer flank (side of the body) incisions for sterilisation and may not be competent to do it. It is not as easy as midline incisions (middle lower part of the body).

Wow, animal shelter medicine is definitely so much different from my private practice. There must be a way whereby experienced veterinarians are decently paid to carry out animal shelter surgery without being mentally exhausted to do factory production line sterilisations for 8 hours a day.

According to Raymund, at least 85% of the street dog and cat population in a place need to be sterilised before any results can be seen. Can he get government or town council grants to do it? There is no easy answer as governments have their priorities and their public relations advertisments and political show-offs.

44. The Swamp Dogs. Chapters DRAFT

DRAFT
THE SWAMP DOGS OF SINGAPORE
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS

The Swamp Dogs of Singapore - Contents
Chapter 1. Did the Animal Activist Fail in Her Mission?
Chapter 2. A Volunteer with Passion Is worth 40 Merely Interested.
Chapter 3. The Looters Attacked the Pack Leader.
Chapter 4. If Only We Can Turn Back the Clock for the Pack Leader...
Chapter 5. NANAS. Swamp Dogs Saved From Lethal Injections.

43. Veterinary Ethics is such a boring subject?

September 4, 2007

To: A Boy who said to his mum that "Veterinary Ethics at Murdoch University is a very boring subject"

BLACK SHEEP IN THE PROFESSION

"Sign these AVA (Agri-Food & Veterinary Authority) forms to certify that you have had implanted the microchip in the puppies I will be selling. From September 1, 2007, every puppy sold in Singapore must be microchipped before sale," the dog breeder gave me a written list of microchipped numbers.

The AVA form had the following particulars needed to be certified by the veterinarian:

MICROCHIP DETAILS:
1. Microchip Number
2. Date of chip implantation.
3. Chip implanted by:





All I had to do was to copy the microchipped numbers onto the forms and certified that I had implanted them at a fictitious date. If I don't do it, there will be other veterinarians who will oblige. This breeder had 3 veterinarians who had solicited business from him.

There are many ethical issues involved in servicing breeders. This story is one example of the ethical issues I encountered.

I used to service all the big breeders and numerous pet shops in Singapore in 2005 because of an unusual situation in that they lost their vaccine suppliers (believed to be two) whom they bought vaccines wholesale and vaccinated their own dogs.

However, in 2006 and 2007, young and unsuspicious veterinarians and an investor of veterinary clinic solicited business from the breeders. The breeders now had bargaining power and were able to get what they wanted.

However, there was a breeder who hedged his bets by engaging my services regularly.

I knew from my research that he would bid the pricing of one professional veterinarian against another to get the lowest price. I was now getting the crumbs of his puppy vaccination as I could be overpriced in my Caesarean sections. The younger vets charged as low as $150 - $200 per Caesarean section while I was already charging more. He started asking for injectable drugs which he could not obtain himself and I had to say no. Well, there are other veterinarians who are more flexible.

He was a big breeder and knew that veterinarians who desired his patronage would need to be flexible and cheap. Big corporations all over the world do it all the time to bring down their expenses.

If you read widely financial articles and other books, you would know that many big corporations use child labour, destroy the environment, compromise the integrity of professional accountants and lawyers, Chief Executive Officers and other means to achieve their aims of being profitable.

The more the service provider salivates at the prospect of big volumes at low cost, the more demanding the big business is of them, to the extent of compromising their integrity and making them lose their professional licence.

Now, how do I resolve this problem? Sign the forms to certify that I had implanted the microchips. This was false certification and ethically, if not legally wrong. The big corporations exploit the desperation of the service provider to get business.

In my case, I must be desperate. Otherwise, why did I still drive up to his farm to vaccinate a very small number of puppies per week? A young veterinarian was doing the majority of his vaccinations and his work. He could have asked her to sign the forms. How would the regulators know?

"Trust me" is the common statment of people who want their self interest served even if the professional licence may be revoked by the misconduct of the service provider. When you hear "Trust Me," you ought to be very careful.

In this case, I told an intermediary to return the AVA forms to this breeder and to tell him that I would not be signing nor doing business with him.

The breeder phoned me: "Those forms I asked you to sign were the puppies you vaccinated!" This was an intelligent and successful breeder but yet he made such a stupid statement. Should I capitulate? That means signing blank cheques. He obviously had no respect for the veterinary profession.

I had to be frank. "I did vaccinate the 5 puppies. But I did not microchip the puppies. So I will not be certifying that the chip was implanted by me."

Dealing with big business is not a win-win situation if the big business has no respect for the professionalism of the veterinarian. Unfortunately, there will always be black sheep in the profession who are willing to take risks to get their business. So, there should be no problem for the big breeders.



"The best veterinary clientele and those of the highest quality are the individual private pet owners" --- two well wishers advised me some time ago to get away from the big business. They were correct.

CONCLUSION:
I hope you will find Veterinary Ethics really interesting and very useful. Your mum has high hopes for you and misses you a lot.

If you can reduce your online gaming time, as all youths are addicted to and devote much more time to creating, reading and learning new craft and doing veterinary research, you will find that veterinary ethics is a fascinating subject as the big business world is quite devious and has no qualms compromising the ethical standards of a professional.

42. 2.5-year-old Maltese purposely pees outside the kitchen bathroom and drinks urine inside

Monday Sep 3, 2007 6.07 pm

The Maltese stopped breathing just before the spay surgery. Her tongue was a dried maroon blue colour with more red hues. There was time to revive her. I grasped her chest with my right hand. A few breaths. Then no breathing movements. Her tongue was still the same colour. I could feel her faint heart beats.

"Disconnect the general anaesthesia," I said to my assistant. I put the endotracheal tube into my mouth and blew air into her lungs three times and compressed her chest three times. A sweetish smell of anaesthetic gas came out of the Maltese mouth. She was responding slowly. Her breathing started.



The rest of the surgery was uneventful as the dog breathed regularly. I incised the skin about 2.5 cm from the umbilicus. I could see the dark brown lobes of the liver. I inserted the spay hook and hooked out the left ovary. I thanked the owner for presenting a female dog that was not on heat. Spaying a female dog during heat was risky as there would be much bleeding as the fragile blood vessel and womb tissue break when clamped by the artery forceps. Lots of bleeding and maybe death later. But this case was a dream boat. No bleeding.

I reduced the anaesthesia to 0.5% and then to zero 5 minutes before the end of surgery. This was a thin Maltese weighing around 3.5 kg and the usual 2% maintenance dose was not necessary. The Maltese woke up 2 minutes later as if she had a nap.

At 5 p.m, the young lady owner came to pick up the Maltese. I had some time to do some research on how Singaporeans keep dogs and invited the lady to sit down and talked about the subject she loved most, besides her husband.

"How did you toilet-train your Maltese during the first week?" I asked.

"It was so long ago," she said as she took out the puppy papers from a folder. "I put newspapers covering the whole floor of the kitchen and the bathroom nearby. Then I removed the newspapers gradually till only the bathroom had newspapers. I want the puppy to eliminate in the bathroom."

"How long did you take to successfully paper-train her?" I presumed she had success in paper-training.

"Can't remember," the lady said. "Now she is 2 years and 4 months old. She goes to the bathroom floor near the kitchen to eliminate. My maid will then hose the urine away."

The lady made a surprising statement: "The Maltese purposely pees outside the door of the bathroom sometimes. Especially after midnight and when nobody is at home. But this would not be done regularly."

I thought: "This must be urine marking. Female dogs seldom do it but I am sure that some will urine marking. Maybe alpha female dogs?"

Yet this was the only spot that the Maltese would pee deliberately. As an adult dog, I presumed she would know better than to soil the place.

I put a piece of paper for the lady to sketch the floor plan of the bathroom and the kitchen and explained the routine of the Maltese.

Why would this Maltese behave so strangely, especially after midnight? She sleeps in the master bedroom but would never go the the master bathroom. When she needed to pee, she would run out and just pees outside the door of the kitchen bathroom.

Why this unusual canine behaviour?
"I don't think there is much space inside the bathroom," I noted from the sketch and from my visits to the typical HDB (Housing and Development Board)apartment. "Most likely, the dog just did not want to dirty her paws by stepping into the kitchen bathroom which could be soiled with urine at, say, 9 p.m. Do you or your maid hose the bathroom before you go to bed?"

"Too tired to do that," the lady in her late 20s shook her head. She worked long hours as she climbed the corporate ladder of a famous multinational company.

"So, the answer for this 'misbehaviour' could most probably be that the Maltese disliked peeing on the soiled floor. All dogs don't like to dirty themselves if they can help it.

It was a surprising revelation for both of us.

"Use a rag. Dip it in white vinegar:water 1:3 and neutralise the urine smell outside the kitchen bathroom. Hose the floor before you sleep. Do let me know in 3 months' time if you are successful." Case closed. Time to go home.

But there was another strange behaviour of this active Maltese who would not step into the veterinary surgery when she reached the place, according to the owner.

"She drinks her urine for the past 6 months," the lady said. "She had never done it as a puppy."

"That is strange," I said. "I have heard of some puppies drinking their urine during my research in toilet training. Adult dogs eat poo. But this is the first time I hear an adult dog drinking urine!"

Why and when?

"The Maltese goes to the kitchen bathroom before bedtime, around 11 p.m," the lady owner said. "I say 'Go shee shee' and she would go to the bathroom. I close the sliding door. Even if she has no urine, she would try to do it. I could see her licking her urine sometimes. Why would she do it?"

I had no instant answer. This Maltese was obedient.

I suggested, "Place a puppy diaper on the kitchen bathroom floor. This absorbs all urine and she would not be able to lick them. Otherwise she would persist and the vice would be hard to eliminate. A diaper costs money and it may be changed every 2 days in the case of the puppy. But your dog is an adult and may need regular daily changes."

My solution did not seem practical or appealing.

"You could buy those human diapers for incontinent people. They are much cheaper." I said.

"Won't the dog shred it?" the lady asked.

"The puppy diapers with stick-on tapes would be more lasting. They have a urine smell to attract the puppy to pee onto it."

"Oh," the lady remembered. "The puppy training aid (liquid) was so disgustingly smelly that the Maltese hated it when I used it to toilet train her on newspapers!"

Somehow she had gone on a different train of thought. I had better not get distracted too.

"Since the Maltese finds that you scold or get angry if she licks urine, she could be seeking attention. The more she does it, the more she gets scolded. Any attention is better than none since you work long hours." I had another brainwave.

So what's the solution?



No puppy diapers. No scolding. Hose the floor before bedtime. Neutralise the floor outside the kitchen bathroom. Do NOT force the adult dog to go to the bathroom before bedtime.

I don't know how much of my advices will be useful and whether this lady would feedback to me the progress in 3 months' time.

This was an educated and well informed owner. I was glad that her then boyfriend had purchased this Maltese as a birthday present for her. I hope all 3 live happily ever after.