Wednesday, October 10, 2007

76. Follow-up on Case 72. The virus deals the card of death.

Wednesday, October 10, 2007 6 p.m

"What are the chances of recovery?" the banker came to visit his Miniature Schnauzer puppy after work. The puppy was lethargic since Sunday. 3 days had passed without full recovery. This evening, the 15-week-old puppy would not greet him but just wanted to be left alone, lying at the corner of the crate. The puppy just did not feel good and did not care about any food or visitor. He was given electrolytes and medication by mouth on a schedule, to keep him alive.

A handsome 'sun-tanned' slim lady in her late twenties and wearing a contrasting pure white dress as if she had come from a big corporate office where every lady dressed to impress or kill, accompanied him to visit the puppy.

The banker did not introduced her to me and she did not introduce herself. This is a common happening in the Singaporean culture. So I presumed she was his wife, working in the same bank.

The gentleman was worried about the sleepy puppy. The puppy wrapped his front legs around his head, as if having a headache and laid against the right inner corner of the crate. The puppy's temperature was 39.2 deg C at the time of visit. But he was not active. He just slept and had not eaten for the past 24 hours.

Yesterday, around midnight, the puppy's temperature was 40.1 deg C. He was given anti-fever medication. At 8 am today, his temperature shot up to 40.9 degrees C. The fever was brought down by bathing and anti-fever medications.

Who was the lady visitor? Impertinent curiosity would not be appropriate at this time.

As if reading my mind, the gentleman banker said, "She comes to visit the puppy because she had purchased a female sibling from the same pet shop. She had also left the puppy at the pet shop for 4 hours waiting for the vet (myself) to do the 3rd vaccination. She was groomed in the pet shop as well. Yet this sibling is in perfect health. How come the male sibling was hovering at death's door?"

"The male sibling could have had picked up a virus or more than one during the four hours inside the grooming room of the pet shop," I said. "The sister could be more resistant to the viral infections and remained healthy."

"Is there any hope and how long will the puppy recover?" the gentleman sat in the air conditioned waiting area as the animal holding area was too warm as he was wearing a long sleeved shirt and tie, as befitting a banker of the financial district of Singapore.

"The puppy's resistance to viral infections is the key to recovery. If the puppy is strong, he will recover." I said. "However, the vet or owner must be able to control the fever. If not, the puppy's brain and internal organs get burned out and the puppy goes into fits and possibly death."

"He had lost a lot of weight," the banker referred to the slim waistline of the puppy earlier.

"This puppy is not thin at all," I said. "The spinal area still had the layer of fat."

The banker asked again, "When will the puppy recover?"

"From past puppy fever cases, it should be 3-5 days after the onset of fever. Today is the 4th day. Wait and see. I will give him the anti-fever injection for the 3rd time since the anti-fever medications work for very short periods of time. Usually I try not to give more than two times the anti-fever injection. The puppy's liver may not be able to handle too much of the anti-fever drug."

There were many things the vet could talk about. The gentleman banker knew a Singapore veterinarian who was also studying in Australia's Murdoch University at the same time. "Now, he makes lots of money in Singapore---like nobody's business," the gentleman said. "He has a big crowd of patients every day."

"How are veterinary students in Murdoch University?" I distracted him from thinking that all Singapore vets mint gold from pets.

"They are a dull lot. Not much of a life. They seem to have no time to play. Their studies take up too much of their time. Unlike Finance and Banking undergraduates, we had much more time to do other things."

"Did you join the Association of Singaporean students or something like that?" I asked.

"No," he said. "A waste of time. I had some Australian friends."

"Do you need a car if you study in Murdoch University?" I asked.

"Yes," he nodded his head emphatically. "For example, I need a car to borrow books from another Australian University. I will copy the book and return them as I can't borrow for a long period of time."

"Do you find pages missing from the text book, such that you can't read or photocopy them?" I asked.

"No," he said.

Text books are expensive in Australia. Cars are relatively cheap compared to Singapore. Do students really need a car? I don't think so as many Singaporean parents have to sacrifice a lot of money just to pay for the veterinary school fees totalling at least A$30,000 - $40,000 a year.

"What do you do with your text books after graduation?" I asked him. I thought he might be able to sell them.

"All books and notes are donated to the ... (name of the Murdoch University Drinking Pub) so that the new students can benefit. That was a great idea for recycling. I wonder if Singapore University does such things.

Next, I talked to the presumed wife. I was surprised to discover that the lady's dad was a Malaysian veterinarian and would take home injured dogs to nurse back to health.

"Very rarely do I meet or know of small animal veterinarians in Malaysia", I said.
"Is he an animal welfare activist, like those at NANAS (Noah's Ark Natural Animal Sanctuary)?" I asked her.

"No," she said. "He's retired at 60 years of age." We talked a bit more into the evening. The banker looked at the puppy after the anti-fever injection was given. No instant leap to activity. The puppy just huddled in a corner of the crate. |

The two bankers had to go home as it was 6.30 p.m and they had been here for at least an hour.

"Going back to see your daughter after a hard day's work?" I asked the lady in the white dress. The gentleman banker had told me he had monitored the puppy's temperature at home on day 1 till 9.30 p.m when he had to tuck his daughter in bed. The puppy did not have a fever on day 1 till the next day. Subsequently, the puppy was warded at Toa Payoh Vets.

"Oh, that's his daughter," the lady with the most beautiful brown complexion pointed to the gentleman banker. Assumptions of martial relationships can be dangerous. So, was this lady his girlfriend?



As for the puppy, I dare not assume that the puppy would recover in the 3-5 day period of time. I told the banker accordingly. For all I know, the puppy could be dead. The only good signs are that he no longer vomited and he did not have diarrhoea or blood in the stools. Whatever virus was attacking him had so far, gained the upper hand.

The viruses had put out the card of death on the table of life and death at 6.00 pm on day 3 of fever. The gentleman banker now took his card---an anti-fever injection and electrolytes given by his veterinarian proxy. Who has the stronger hand?

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