Be Kind To Pets

131. Hamster with rotting skin

2008-02-04T14:34:00.000-08:00

This case illustrates how the internet enables hamster owners to share information
from my hamster cellulitis case photographed 5 years ago.

I have not encountered any more such cases because hamsters in Singapore are low value pets and they seldom receive veterinary treatment.

Yet the owner based in Taiwan managed to ferret out my photograph of 5 years ago and contacted me.

This is the first e-mail from the hamster owner in Taiwan.

>>
>> ----- Original Message ----
>> From: A hamster owner in Taiwan
>> To: judy@toapayohvets.com
>> Sent: Tuesday, 29 January 2008 1:40:49
>> Subject: Hamster Cellulitis
>>
>> Hello,
>>
>> I found your site by searching for hamster symptoms online. One of your sites features a picture of a hamster with yellow/greenish rotting skin on the bottom right of the webpage: http://www.asiahomes.com/singaporerealty/last_word.htm

Picture of a hamster cellulitis case taken by Dr Sing in 2002, 5 years ago!
>>
>> This is the exact same thing that is going on with my hamster right now. Fortunately even though the skin on my hamster looks as awful as that little fella my hamster still looks quite healthy.

>>
>> I live in taiwan and unfortunately do not speak Chinese. The vets we have been going through have not been able to help a lot so far and the condition just seems to be getting worse and worse.
>>
>> They had us soaking the area with saline 3 times a day followed by covering it with iodine. It only seems to be spreading. I'm not sure about what kind of medicine the vet has given us but the hamster will no longer take it even if we try to trick him with treats or the sugar solution they gave us.
>>
>> The doctor just keeps guessing and admitting he doesn't really know what is going on and keeps shrugging it off as cancer but it looks like what your site says is Cellulitis. Is there anyway you could recommend the medicine the hamster should be taking so we can ask the doctor to subscribe it??
>>
>> I am also concerned about the saline since I've read getting hamsters wet can cause wet tail and I've read on another place in your website that iodine can poison the hamster.
>>
>> If you can help out you will be my hero!
>>
>> Your advice would greatly be appreciated! Please help!
>>
>> Catherine

>
> On Jan 29, 2008, at 7:13 AM, Dr Sing KY wrote:
>
>> I am Dr Sing from www.toapayohvets.com IF possible, email me the pictures of the actual infected area.
>>
>>

> ----- Original Message ----
> From: A hamster owner in Taiwan>
> To: Dr Sing KY
> Sent: Wednesday, 30 January 2008 12:42:48
> Subject: Re: Hamster Cellulitis
>

> Dr Sing,
>
> Thank you so much for taking the time to write me. I've attached pictures of the hamster's condition.

>
> It started as a spot as big as a (human) pimple on his left side in a day or two it was as big as a nickel (we took him to the vet that day) and since that time it has grown to what you can see in the pictures. We've been to the vet 3 times so far but no clues and it doesn't seem to be healing well. Some of the skin has broken away but it's hard to say it's getting better.
>
> The area has a really bad odor. The hamster is still eating and drinking and looks fairly healthy even though we're having a hard time giving him his medication. His eyes are a bit sleeping and if he's outside he'll tend to lift up his left front paw.
>
> I really really appreciate you taking the time to write me! You are extremely kind! I had a wonderful vacation in Singapore last year and was amazed at how friendly and kind people are in Singapore. I thought it was just because I was a tourist but I guess I was wrong. Thanks so much!
>
> Happy New Year!
>
> Sincerely,
> Catherine
>

On Jan 30, 2008, at 7:35 AM, Dr Sing KY wrote:

> 1. Thanks for your compliments.
>
> 2. The hamster has a severe bacterial infection that had not been responding to antibiotics (I assume the vet had given antibiotics). Or you may have not given the dosage required.
>
> 3. The infection spreads due to your continual swabbing and the hamster continual licking and biting the sore due to intense itchiness.
>
> 4. Can you locate another veterinarian who has experience with hamsters? Ask your expatriate community or Embassy.
>
> 5. On your side, are you prepared to sleep much less? Intensive nursing is required. Some tips are:
>
> 5.1 Remove dead smelly skin with clean scissors.
> 5.2 Put an Elizabeth Collar on the hamster (like in a dog, but you use a thick cardboard to fashion the Collar) at all times.
> 5.3 Cleanse skin with disinfectant and rinse off disinfectant as often at 10X/day. The disinfectant must be rinsed off thoroughly as it irritates the hamster.
> 5.4 Dry skin with tissue paper after cleaning.
> 5.5 Keep skin very dry and exposed to clean air and oxygen.
> 5.6 Hand feed the hamster by hand as many times as possible.
> 5.7. Ensure hamster drinks and measure amount.
> 5.8 Note stool amount and consistency of hamster. If loose stools, there is a problem.
> 5.9 Give oral appropriate antibiotics and low dose of anti-inflammatory (from the vet).
>
> 6. Can you tel me at +65 9668 6468 to discuss further ?
>
> 7. Pl let me know how you manage to fish out my website on the same hamster condition? What search engine you use and how you do it? I will appreciate this info. Many thanks.
>

----- Original Message ----
From:
To: Dr Sing KY

Sent: Monday, 4 February 2008 11:55:58
Subject: Re: Hamster Cellulitis

Dr Sing,

I apologize for the big gap in my correspondence. I ended up getting a really bad case of food poisoning and ended up in the hospital for a couple of days, and have spent a couple of days recovering.

Thank you SO SO SO SO SO much for your advice. We are FINALLY seeing some improvement in my hamster's condition. We found a vet who specializes in hamsters and she put him on better course anti-biotics and thankfully recognized and gave him the same diagnosis you did. She also told us he's a little under weight right now. She didn't want to cut off any of the rotting skin just yet because she said the area was too wide and it may be more difficult for him to heal.

After we rinse off the disinfectant we've been able to very gently rub some of the top loose stuff away (to his comfort level). We can now see an area in the middle underneath that has healed.

It's been a rough couple of weeks and I was sure it was a death sentence for him but it looks like he will pull through.

The only couple of questions I have for you if it's ok. You mentioned to check his stool. His stool color and consistency doesn't look very healthy but is it possible that this is the anti-biotics? I know in my own experience if I take anti-biotics it can mess up my digestive system a bit.

Also I'm still worried, when you say disinfectant is it still ok to use the iodine if we're thoroughly rinsing it? I forget if it was on your site or another I checked that it can potentially poison them if they ingest it.

As far as your website I found it via google and yahoo. On all of the hamster sites I found it impossible to find a picture of what he has and I really had no clue what it could be. I found different pages of your site on many of my searches like "hamster absess" "hamster cancer" "hamster skin cancer". The key that finally gave me your site was "hamster rotting skin". I figured because of the smell this must be what it was. I believe your site was at the top of the search engine for these key words too. If you would like to use my photos to help your article please feel free.

I also have a recommendation for your site. When I was doing my searches like I mentioned your website kept popping up for variety of keywords and I had a feeling eventually I would find my answer on your site because you had more medical photos and better information than most of the other sites but it was very difficult to navigate to find what I was looking for. I didn't want to have to click through all the vet entries to try to find my specific case because it would be time consuming and because as a non-doctor the photos are very disturbing to look at! :) So I would highly recommend you add a search engine onto your site. I've recently done this on my own website and it works beautifully. Through google you can add a free search engine and specify it to only search your domain or even specify a few domains for it to return search results for. The only branding google puts on it is to put inside the search field "google custom search" but this disappears as soon as you start typing in the field. The code is extremely easy to integrate and it can take as little as two minutes to add it in. Here's the website:

http://www.google.com/coop/cse/

Could you please send me your office mailing address so that I can send you a thank you?

Thanks again and have a wonderful new year!
Catherine

1. Thanks for your detailed reply, permission to use your hamster pictures and suggestions of a search engine. My site is disorganised as I need to use my spare time to edit and write to educate pet owners.

2. It is incredible that you can even locate my hamster picture of cellulitis. That was so long ago. In Singapore, more hamster owners in 2008 are getting the vets to treat their sick hamsters compared to 5 years ago. A kinder younger generation has grown up.

3. To answer your 2 questions (reproduced as follows):

The only couple of questions I have for you if it's ok. You mentioned to check his stool. His stool color and consistency doesn't look very healthy but is it possible that this is the anti-biotics? I know in my own experience if I take anti-biotics it can mess up my digestive system a bit.

ANSWER. Pl give me the name of the antibiotics being used. If the stools are loose, stop the antibiotics for the time being. Otherwise the hamster will get severe diarrhoea and die.

Also I'm still worried, when you say disinfectant is it still ok to use the iodine if we're thoroughly rinsing it? I forget if it was on your site or another I checked that it can potentially poison them if they ingest it.

ANSWER. I did suggest the use of any disinfectant but did not name the type to be used. A very mild disinfectant is to be used and this must be thoroughly rinsed off with clean warm water. The bedding must be clean tissue paper rather than wood shavings for the time being.

I disagree with the vet about cutting off the rotting skin. They contain bacteria and other micro-organisms and being around just simply affect the healing of the wound. That is why I ask you to snip them off.

Let me know the name of the antibiotics used. Thanks for taking so much time to reply to me. Hamsters are low value pets and most Singapore owners seldom bring them to see the vets. I am glad you bother with your hamster and will appreciate some pictures of progress in treatment. I like your blog. Keep up your good work.

130. Follow Up: Successful paper-training a Golden Retriever living in a Singapore apartment

2008-02-04T13:53:00.000-08:00

HISTORY:

July 7, 2006. Golden Retriever, Male, 7 months. Pees and poos everywhere inside the apartment. What to do? Dr Sing advised confinement and paper-training using positive reinforcement training.

Feb 5, 2008. Dr Sing followed up. Owner replied indicated that the dog is 100% successfully paper-trained. I hope this write up will benefit busy urban dwellers and owners trying to toilet train large breeds living in apartments.

----- Original Message ----
From: <...@singnet.com.sg>
To: Dr Sing KY
Sent: Monday, 4 February 2008 11:30:25
Subject: RE: Rocky's Toilet Training

Hi Dr Sing,

Happy New Year.
Please see my reply below.

(Name of owner)

-----Original Message-----
From: Dr Sing KY [mailto:ezyvets@yahoo.com.sg]
Sent: Sunday, February 03, 2008 6:59 AM
To: ...@singnet.com.sg
Subject: Rocky's Toilet Training

Hi
1. Happy New Year.

2. I am Dr Sing from Toa Payoh Vets. You brought Rocky to Toa Payoh Vets around July 7, 2006. I am still doing research on toilet training of puppies in Singapore and need some updates on your success with Rocky to help other dog owners.

3. I hope you have some time to update me on whether Rocky is now paper-trained?
3.1 Does he goes to eliminate on newspapers 100% in the kitchen area ? Or is his toilet area another place?
> Yes he now eliminates 100% on newspapers in the kitchen area only.

3.2 How many times is he fed?
> Twice daily.

3.3 Does he get canned food as well as dry food?
> Mainly dry food. Occassionally (probably once fortnightly) a mixture of dry + canned food.

3.4 What time is he fed?
> Around 7am and 7pm.

3.5 Is the feed given the whole day or for a short time of 20 minutes?
> He finishes up his food within a short time, so we have no problem with this.

3.6 Does he pee and poo within 30 minutes of being fed?
> Yes he does most of the time.

3.7 Does he eliminate outdoors?
> Yes sometimes he does when we bring him out for walks. But we did not intentionally bring him out to train him to eliminate outdoors.

3.8 How many times does he pee and poop for one day (24 hours)?
> Pee 5-6 times. Poop 2-3 times.

3.9 Any accidents - eliminate on non-approved toilet areas?
> No. Only eliminate on newspapers in kitchen. He will not do it without newspapers either. He will wait till the newspapers are laid.

3.10 Does Rocky urine-mark -- pee a bit here and there on vertical surfaces?
> At home, never. I used to see him marking at the beach or park, but I noticed he hardly do it after neutering.

3.11 Is Rocky neutered?
Yes. In Oct 2007.

Your feedback will be most appreciated. Best wishes for the new year!

Conclusion:

A busy working young couple. They take time to train the Golden Retriever.
I advised confinement to a small space (in the kitchen) and praise and give food treats on success. It takes some time (probably 4 weeks) to paper train him but once it is done, he is a great pet to be with.

Fortunately he was not easily bribed by food treats for successfully eliminating on newspapers, according to the owners.

In this case, it will be preferred that the big dog go to the guest bathroom to eliminate. Or a pee tray is used to hold the newspapers in the kitchen. To transfer toilet area to bathroom, slowly shift the papers to the bathroom from the kitchen.

I did not ask the owner why the kitchen was used. Sometimes owners are not aware of the preferred toilet location to be the guest bathroom. Or the bathroom is not available for the dog as there may be guests.

Replace soiled newspapers frequently --- an important factor in successful toilet training as most dogs and puppies dislike dirtying their paws and will avoid soiled papers. Some dogs bark to tell the owners to change. Others bark and get scolded for being a noise nuisance. So they give up communicating with the owner and eliminates outside the papers in the nearby areas.

PREVIOUS POST IN 2006
Toilet Training Your First Puppy in Singapore

The following report from the owner of Rocky confirmed that the "older" puppy (e.g. 7 months old) can be paper-trained if the owner knows how to do it. The puppy is into adolescence and is known to be "rebellious" and has a mind of his own at 7 months of age.

However, with time spent on training him, knowledge that he wants a fresh and clean toilet area, praise and treats, the following case was successfully paper-trained in around 2 weeks.

Basically, the puppy just wants a CLEAN toilet area to pee and poop.

Otherwise, he will avoid the soiled newspapers and poop elsewhere. In the first year of my research, owners complain that the puppy will usually "miss" its target (newspapers) and pee "outside" the newspapers.

The reason is that the papers have been soiled and the puppy is loathe to step onto them unless they are quickly replaced. Some puppies will "bark" to let the owner know that the papers must be changed after elimination, according to owners who tell me.

Some puppies do not provide feedback or the owners are not at home the whole day. Possibly, the owner is inside the crate and has stepped on soiled newspapers (in the petshop -- not sold early or the owner's crate). So, the puppy is used to soiled newspapers after some time.

I have no time to edit, but will do it in the new book.
The e-mail is as follows:

Monday, July 31, 2006

DRAFT - Why the puppy does not poop on newspapers

-------------------------------------------------------------------------

E-MAIL REPLY FROM DOG OWNER --- JULY 10, 2006.

> Dog owner wrote:
>
> Dear Dr Sing,
> We went to your clinic last Friday (7 Jul) with our
> 7-mth old Golden Retriever, Rocky for his 3rd vaccination and sought
> your advice on how to toilet-train him.
> After some thoughts on your suggestions, we decided
> to start off with neutralising his urine and poo smells in the house
> with white vinegar and water.
> On that same evening, we neutralised the entire living room and part of
> the kitchen area, leaving the unneutralised part of the kitchen as his
> intended toilet area (the spot that he frequents most). Then covered
> that area with fresh newspapers and some soiled ones. That weekend, we tried confining him to that specific kitchen area after his meals and monitored him, also tried bringing him
Out for walks and kept asking him to pee/poo, but were not successful.

> He did not pee/poo (on the toilet area)
> as we wanted him to. We gave up, but continued neutralising the floors
> every night as he still eliminates randomly at those 2 areas.
> On Tuesday (11 Jul) evening, > that the methods weren't working, we saw him pee-ing right in the
> centre of the newspapers. We quickly praised him and offered him a
> treat. This time, he took the treat happily and ran off chewing it.
> Initially we thought he had learnt to eliminate there, but later at
> night, we found his poo on the kitchen floor. The following days, as we
> continued with neutralising, we saw some improvement. We observed
> he has stopped eliminating in the living room, and does it only in
> the kitchen area, however, he only pees on newspapers, still poo
> everywhere in the kitchen.
> Last night we've decided not to neutralise the floors. This morning, to
> our surprise, we saw both his pee and poo on the papers. We're very
> happy to see that, and we'll continue to monitor him closely until he's
> really stable and makes no mistakes. Will update you again on his progress.
> Really appreciate your help and professional advice.
>
> Thanks,
Dog Owner.

E-MAIL REPLY FROM DR SING --- JULY 16, 2006.

> Sunday July 16, 2006. E-mail reply from Dr Sing
NLB Toa Payoh Library 10.30am.
>
> My computer is infested with viruses. It shut down and re-started
> several times earlier. After that it shut down completely. So, I am
> using the NLB library to reply to you. It is hard to
> find real computer experts in Singapore who can resolve this problem
> without having to re-format the whole hard disk.
>
> I am very grateful for your contribution to my research and a book on
> Singapore puppy toilet training.
>
> In reply:
>
> 1. My research and reading of other reports. It appears that white
> vinegar is effective only to neutralise the ammonia smell of puppy
> urine. Acid plus alkaline = water (NO MORE URINE SMELL), to put it simply.
> So, the puppy can't find the elimination area with his nose (to detect urine smell).
>
> I presume you used the same mop or had not rinsed off the urine smell
> thoroughly, so the puppy could detect the "accident" areas for the first
> few days. Corners or edges of doors may still have traces of urine. The
> sense of smell is very acute in the canine. However, after a few days of
> your hard work, you probably wiped out all urine
> smell. So, the puppy goes to the newspapers. I presume you did not use
> the soiled newspapers (2nd layer) but the floor is OK too.
>
> 2. White vinegar is said to have no effect on the poop as it does not smell of ammonia.
>
> 3. So your success later may be due to your monitoring and praises. Your
> puppy probably now expecting treat. Some will sit and wait for it after
> peeing. A few owners tell me that some even pee less but more often to
> get treats. I hope your puppy does not think this way.
>
> 4. Poop after feeding times. If you can have a regular schedule of feeding and exercise, without distraction of playing
> immediately after eating, you may be successful. Signs of elimination
> like sniffing, squatting and circling - bring puppy to newspapers.
> Praise and reward.
>
> 5. Will be most grateful if you let me know your progress in the pooping
> training aspect. It is from such case studies that I am able to advise
> as each situation and each puppy behaves differently.
>

E-MAIL REPLY FROM DOG OWNERR --- JULY 2006.
>
July 30, 2006 e-mail to Dr Sing>

> Dr Sing,
>
> We're still working on Rocky's poop training. Did not really have enough time to monitor him for the past 2 weeks due to our work schedules.
> We will continue with your suggestion in Point 4 below.
>
> Thankfully Rocky does not seem to expect treats after peeing. He just
> walks away. He has no problem with peeing on newspapers, i don't
> understand why he could not poo on the papers as well. So far only once or twice he pooped on papers, the
> rest of the times are done on the kitchen floor.
>
> We still do use vinegar to mop the kitchen floor on
> alternate nights. You mentioned in Point 2 that white vinegar has no
> effect on poop. Do you mean that white vinegar can only nuetralise
> urine smell, but not poop smell?
> Is there anything we can do to remove the poop smell?
>
> Hope your computer is fine now.
>
> Thanks,

E-MAIL REPLY FROM DR SING --- JULY 2006.

Date: Mon, 31 Jul 2006 e-mail reply.
04:32:18 +0800 (CST)
From: "Dr Sing KY" Add to Address BookAdd to Address Book
Subject: RE: Rocky's Toilet Training - Pooping on floor.

Thanks for feedback.

1. Most likely reason Rocky does not want to poop on the newspapers more often may be due to at least 2 reasons:

1.1 The papers had not been changed. Most dogs do not like to step on soiled newspapers as they are clean creatures. So, he chose the floor.

1.2 The papered area is too small. I remember he is a Golden Retriever. Correct me if I am mistaken. You may need to have double or triple the areas covered by the
newspapers or buy a big pee pan (to put newspapers on).

2. In many cases, vinegar:water mixture does not eliminate the smell of poop because the poop is not ammonical.

3. In your case, you said you had not much time. I
presume you had no time to change the newspapers more
often and no time to bring him downstairs. There is no
fixed schedule for exercise after eating. If that is
true, then he has no opportunity to poop 15-30 minutes
after eating (as most dogs do) on newspapers under
your training and supervision. You probably had gone
to work or are too tired to bring him downstairs. I do
not know the real situation.

4. If you want your puppy to poop on newspapers, you
need to SPEND TIME to train him to do so. WATCH for
signs of wanting to poop and bringing him to the CLEAN
newspapers for the first 2 weeks. Praise, pat and
reward with treats on success.

Otherwise, it is very difficult for him to know what
you want.

5. Let me know once your pooping training is
successful.

0 Comments:

129. New pup avoids peeing on newspapers of older dog

2008-01-31T13:26:00.000-08:00

E-MAIL NO. 1 FROM OVERSEAS TO DR SING

On 1/23/08, ...com> wrote:

Hi,

I read your notes on paper training more than one dog at a time.
I have a 6 month old American Eskimo who is paper trained in my daughter's room, she also has access to kitchen and my work area in the basement I noticed when she needs to use the bathroom she goes back to my daughters room upstairs and use the paper. She also shows signs of going to the door to go out.

Last week we purchased a Pek-a-poo, 3 months old male, however, he does not want to use the same paper even when cleaned and dry, he wants to do his business around the paper, on the floor under my daughter desk. He is confined to her room. I work from home part-time or 3 days a week. Any suggestions?

REPLY FROM DR SING TO E-MAIL NO.1

Subject

Re: Paper training more than one puppy

Thank you for your e-mail. I just read it today Jan 29, 2008 and hope it is not too late to reply to you with some tips.
Pl e-mail to judy@toapayohvets.com as I seldom access the gmail.com

Pek-a-poo 3 months, male puppy.
1. Do you know where he eliminates in the previous residence? Was his toilet area the tiled floor? If that is the case, he is conditioned to the feel of the tiled floor and
so he avoids the newspaper no matter how clean. Newspaper may feel not right to his paws as a toilet area. He has had never eliminated on newspapers before.

If you want to paper-train him, you will need to confine him in an exercise pen/small area in the daughter's room. Cover the tiled floor with 100% newspapers for around 2-4 weeks. If he does not shred the newspapers,
observe which corner he eliminates. You may also place the 2nd piece of a soiled newspaper with the Pek-a-poo urine to attract him to go to the newspapers in a particular corner.
Reduce the newspapered area to that corner where he eliminates. His clean area will be his sleeping and eating/drinking area which may occupy
50% of the tiled floor exercise pen.

Use white vinegar:water 1 part to 3 to neutralise all urine smell on the tiles of the floor of the exercise pen except for the area he is supposed to eliminate.
Feed him regularly and let him eliminate or poop before you allow him out. No distraction. Success in paper training varies from 2 - 8 weeks in Singapore. Much
depends on the owner being there to change soiled newspapers often and to praise and reward with treats when he eliminates.

Do let me know if you receive this e-mail and also your success result.
Best wishes.

E-MAIL NO. 2 FROM OVERSEAS TO DR SING

To: judy@toapayohvets.com
Sent: Monday, 28 January 2008 11:54:24
Subject: Re: Paper training more than one puppy

Hi Dr Sing, I really appreciate you getting back with me.

After reading several of your articles and suggestions, I realized that my daughter and I needed to replace the soiled newspaper more often. Ginger our White Eskimo has been with us for over 3 months, she is 6 mos old and my daughter was a bit lazy cleaning behind her so the Pek-a-poo decided to go elsewhere on my wood floors. So now that we replace the paper as soon as soiled, the paper is now on a first come first served basis.

My daughter has a extra desk in her room, the Pek-a-poo prefers to go under the unused desk and we don't have a problem. Thank you for your suggestions. Pek-a-poo has only been with us a week this past Saturday.

CONCLUSION

I hope this case write up will be of use to other owners with 2nd puppy.

All puppies by instinct want a clean toilet area to pee and poop.

In some single-puppy house-holds, the puppy may be extremely clean (cleanliness freak?) and will bark till the owner changes the soiled newspapers. Or the owner is aware of the need to change the soiled newspapers after elimination.

In the case when a new puppy is introduced and need to share the same toilet location, the puppy dislikes going to the soiled toilet area no matter "how clean the newspapers look after the urine has evaporated" as the puppy can smell the other dog's urine. Some owners just remove the poo from the newspapers but the puppy does not want to use the same newspapers again.

The puppy just eliminates "outside the edges of the newspapers". He is frightened by the possibility of spanking by the owner if he eliminates elsewhere and so, does it outside the paper edges. If the owner is not around, he may do it behind the sofa or some corners.

127. Animal shelter medicine - NANAS

2008-01-28T01:29:00.001-08:00

On Saturday Jan 26, 2008, I brought two 2nd-year vet students from Murdoch University to visit NANAS during my off-day. I hope that they would learn more about shelter animal medicine and I hope to see Bobby who was relocated from Yishun Fishing Pond to NANAS some months ago by Mr Raymund Wee and Ms Lynda Goh.

Much practical knowledge is transmitted from the older folks to young ones. But they need to record the knowledge rather than be an observer. I seldom see the young ones doing any writing. It is a pity that the two vet students did not bother to write how other vets or senior staff do the work at NANAS.

What drug they use? What is the dosage? How long will the drug take effect? Any side effects?

If they record such "meaningless" data during their visit to NANAS, they record Animal Shelter Medicine and Surgery for their storage of knowledge. When they study veterinary pharmacology in the 3rd year or so, the records will make their lectures alive. Much practical knowledge and short cuts get forgotten in the sands of time. It is quite sad to see young ones not knowing the value of practical knowledge which would help them later in life or in examinations.

I record the following to share with young vets doing animal shelter medicine.

ANAESTHESIA AND SURGERY OF 3-MONTH-OLD KITTENS AT NANAS.

ANAESTHESIA & SURGERY

1. Zoletil 100
2. Xylazine 100 mg/ml 2 ml
3. Ketamine 100 mg/ml 8 ml
Total 10 ml in Zoletil bottle.
Can be used for 50 cat spays and neuter?
0.01 ml /kg recommended? Did I hear this figure incorrectly from Raymond Wee?

In practice, 0.15 ml IM for 1 kg kitten was effective!
5-6 hours after being fed a bland diet.

Compare to my Toa Payoh Vets practice:
Adult cats are starved 12 hours before surgery in my practice. I don't spay cats less than 6 months old. I use xylazine:ketamine IM (0.5 ml IM combination/2 kg kitten). The NANAS combination method uses very little volume (0.15 ml IM/1 kg kitten). It appears economical for mass sterilisation? It seems effective after observing around 8 surgeries.

Milk bladder to empty bladder.
Tongue pulled out. I see that the tongue is bright red in colour with this combination.
Eye ointment applied to eyes.

Onset: If given IM correctly, less than 2 minutes.
Duration of anaesthesia: Said to be 35 minutes.
Spay surgery: Should be done in 15 minutes.

Incision: Anterior and around 1 cm from the last pair of mammary glands. Sort of divide umbilical area to last pair by three 1/3. Use the posterior most 1/3 area to incise the linea alba. This incision is just above the bladder. Therefore and in any case, all muscle layer must be pulled up before stitching. Otherwise, the bladder is punctured by the stitching needle.

In adult cats, the incision is also around that area. It can be quite difficult to ligate the ovarian ligament as the incision is too posterior, in my opinion.
As for me, I incise about 1 cm from the umbilical area and find this spot the best.

ANAESTHESTIC DRUG COMBINATION IF ZOLETIL 50 IS USED.

1. Zoletil 50
2. Xylazine 100 mg/ml 1 ml
3. Ketamine 100 mg/ml 4 ml
I presume this will be sufficient for 25 cat spays and neuter?

PAIN MANAGEMENT

Tolfedine ? I need to check on this drug.

0.3 ml SC given at the end of surgery. Apparently, the kitten or cat eats the next day. No pain. This is a non-steroidal anti-inflammatory.

ANTIBIOTICS
Amoxycillin suspension 0.5 ml SC.
I don't give antibiotics to cats after spay generally and seldom have complaints of fever. Cats eat after 1-2 days usually. But if pain management is used, they may eat a few hours after surgery based on feedback from NANAS?

3-MONTH-OLD PUPPY
Uterine horns will be 1/4 size of kitten of same age.
So, it will be very thin.

Incision should be one finger's width from umbilicus, not so posterior as in the kitten.

Bladder is expressed in a different way, said Mr Wee.

Will need to learn more about the NANAS method which has been shared by various vets from animal shelters in other parts of the world.

E-mail to judy@toapayohvets.com if you have any feedback to give to me.

127. The Golden Retriever puppy vomited and purged over 10X

2008-01-28T01:16:00.000-08:00

"For the past 2 weeks, she was all right. Then on Sunday, she vomited all her food and passed blood in her stools. Later there was no blood but she kept purging more than 10 times. Now she would not eat."

The puppy's stomach and intestine were full of gas.

"No new food or treat were given" the owner was insistent when I asked him many times over the half an hour. "The puppy goes to my office and there is nothing in the room. All my employees know that they don't feed him any chicken rice or any chicken. During exercise in the field, I observe her and she did not eat grass or soil."

Yet the puppy had this serious vomiting and diarrhoea. She was wagging her tail while standing on the examination table. Temperature was 38.8 deg C which was not very high fever.

I asked the owner again, "Any new product you purchased on Saturday or Friday?"

He shook his head. He was so sure that the puppy had gone to the Pasir Ris to play and swim. She had her 3 vaccinations done. Parvoviral infection was unlikely but could not be ruled out.

"Did you introduce new food or something to her?"

Finally, after more than 30 minutes, the owner recalled that the pet people had recommended the rawhide doggy bone. This was because the puppy ate all the previous dog treats.

"The raw hide doggy bone is more lasting and not chewed to pieces," the owner said. "That was on Saturday. The puppy chewed it in the afternoon on Sunday. It was durable, as the seller recommended.

The Golden Retriever had vomiting and diarrhoea a few hours later and on Sunday. He brought her to the vet on Monday morning.

So, the most likely cause of this acute gastroenteritis was the rawhide bone. It took so long to get this info!

126. Toilet training a pup who wants to be clean. Advice from the vet was good.

2008-01-28T01:02:00.001-08:00

The Spitz X does not want to eliminate inside the $400 stainless steel crate with a grating and pee pan. The puppy tries to hold his bladder as he considered the crate as his den (clean area to sleep and eat).

So, after meals, a family member will tether him in the kitchen and wait for him to eliminate. When he shows signs, the newspapers are put under him. However, he will frequently eliminate on the kitchen floor.

"He takes a long time to eliminate," the owner said.

"This is due to distraction," I explained. "Somebody is holding a newspaper and watching him. He can't perform under scrutiny and pressure."

I had an idea, "Why not put newspapers to cover the floor of the common bathroom, tether him inside after meals. At least the kitchen floor will not be soiled and smelly and it is easier to clean the common bathroom floor!"

I did not expect the owner to follow up on this advice. When I met her today as the puppy was having pimples in his thights, I asked about the toilet training. She said that the Spitz was successfully paper-trained inside the bathroom. He is nearly 6 months old and he will be passing a larger amount of poop and pee. So, it is good news that he is paper-trained. A lot of stress for the family if he is not paper-trained as he is much loved.

125. Toilet-training - 2nd pup avoids newspapers

2008-01-28T00:54:00.000-08:00

E-MAIL TO DR SING FROM OVERSEAS

American Eskimo - 6 months. Paper-trained in daughter's room. Will go to her room whenever necessary.

New Pek-a-poo pup - 3 months, male. Avoids newspapers as a toilet area. Elminates outside the papers or on the tiled floor under the daughter's study desk.

How to solve the problem?

1. Check history of Pek-a-poo. Previous owner must have had trained him on tiled floor and other surfaces. Definitely no newspapers. So the new owner is unsuccessful in paper-training him. Furthermore, there is no urine smell to attract the pup to use the new newspapers.

2. To paper-train this pup, need to confine him to a small area or exercise pen in the daughter's room as follow:

124. The dog that the Singapore Tzu Chi Fundation volunteers saved from lethal injection. Follow up to Case 110.

2008-01-25T15:22:00.000-08:00

"Since the dog may die on the operating table, put the dog to sleep," the dog owner wiped tears from his face. I had told him that the dog had less than 50% of surviving the anaesthesia.

The dog had not been eating for the past few days after the first consultation. The dog had been given antibiotics and the owner had not phoned me to schedule the surgery some 10 days later. The surgery and transportation of the dog would be paid by the Tzu Chi Foundation. Yet there was just absolute silence from the family.

The Singapore Tzu Chi Foundation Medical Secretary, Ms Ng had e-mailed to ask whether I had followed up on the case after the first consultation. She was the one who contacted me initially about this dog too.

I told Ms Ng that the family had to decide themselves. I could solicit the family. So, nothing happened on the owner's side. Ms Im and her volunteers numbering more than 10 had helped to bring the dog to the surgery during the first consultation. She and her volunteers contacted the owner and the dog came in for surgery in a worse condition than during the first visit. The dog could barely stand up.

"Are you sure that your over 70-year-old mother had agreed to euthanasia?" I asked. This dog was close to his mum and there was no way I could verify that all family members consented since the mum did not make it to the Surgery.

"I represent the wishes of my family," the man in his fifties was ready to sign the consent form. The Tzu Chi Foundation volunteers were shocked at his decision. Though there was a high anaesthetic risk of dying on the operating table, there was a probability that the dog might survive.

By euthanasia straight away, this dog had no chance of survival at all. One Tzu Chi volunteer, a lady in her late thirties and working for an advertising agency sat beside the dog owner and talked to him.

She talked to me. There was a surgery consent form informing the owner that he knew of the anaesthetic risks. This was a standard surgery form used in all hospitals to confirm in writing that the person had been aware of the risks. The clinical outcome of this case would be so poor that I would rather not risk my professional reputation to operate on this dog. A death of a dog spreads like wildfire to all family members and friends and all Tzu Chi Foundation members. Why take risk of ruining my hard-earned reputation over the years?

The owner agreed to the surgery after much discussion from the Tzu Chi lady. I put it on drips and operated the next day. The dog survived. The Tzu Chi volunteers prayed hard, according to the lady volunteer who spoke to the owner. Killing a life is never an option with the Buddhist volunteers. If there is a chance of survival, take the chance. Some 20 volunteers came to the Surgery to transport the dog back and forth and to see him. These volunteers are not paid by the Foundation. Their intervention save a dog from lethal injection which would have had happened.

Some 6 weeks passed. Did the dog survive after the surgery? I had not phoned the owner. If the dog survived, she could live for a few more years.

I asked Ms Im who reminded me that I had not billed the Foundation for the services. This Foundation is good at accounting and pays for services rendered.

Did the dog survive? Is she fatter? I asked Ms Ng.

Ms Ng said in her e-mail:

Follow-up on Jan 26, 2008

Hi Dr. Sing,

I heard from those who paid visit to see the dog and the owner. The dog looks good and better now. Thanks for your concern.

黄燕芯

慈济新加坡分会

电话：65829958 分机：204

This seems to be an incredible story. When the vet thinks the dog that is emaciated and weak has little chance of survival on the operating table, the dog proves the vet wrong and the owner will remind the vet of his bad prediction. When the vet thinks the dog has no problem under anaesthesia, he dies.

123. Apple cider vinegar to treat kitten ringworm?

2008-01-14T21:55:00.000-08:00

After surfing the internet, the owner of the Ragdoll kitten applied apple cider vinegar all over the tail and infected neck of the kitten, as advised by the internet information. The kitten was furiously trying to groom herself to get rid of the apple cider vinegar and started to lose weight.

Ringworm is a fungal infection of the skin. Itching, redness, peeling of the skin.

1. Ringworm thrives under warm moist condtions. Keep the kitten dry.
2. Clip coat short to discover where the ringworm lesions are.

3. For kitten and cat ringworm, do not use human alternative medicine to treat ringworm. These are:
3.1 Apple cinder vinegar soak. Make sure to dry your infected area with a clean towel.
3.2 Tea tree oil twice daily to the affected areas using a 25%-50% solution of tea tree oil twice daily to the affected areas.
3.3 Garlic, a strong antifungal agent boiled to make a garlic bath or solution. Then soak the fungal area.

4. If the fungal araas become red, hot and swollen or the blisters ooze pus, the areas are infected by bacteria. See the vet for antibiotics.

In the first place, it is best to consult the vet. In the case of the Ragdoll, I had it bathed so that the yellow apple cider vinegar solution was washed off. Treated it with antifungal tablets and wash. The kitten responded well. The owner had been given the drugs earlier but decided to use apple cider vinegar. For ringworm treatment, it takes at least 20 days before you can see signs of recovery. There is no fast treatment.

Negative reinforcement training - puppy toilet training

2008-01-12T16:12:00.000-08:00

Toilet training is a headache for most puppy owners all over the world. So many real-life factors adversely affect the learning of the new puppy.

----- Original Message ----
From: Name given
To: judy@toapayohvets.com
Sent: Saturday, 12 January 2008 7:21:03
Subject: Appointment

Hi,

I chanced upon your website. I would like to arrange an appointment for a checkup for my puppy. I think it has had his last vaccination in November. I believe the dog is about 5mths old now. I would also like to get some de-worm tablets.

Also, I am having some problem with the toilet training. We had initially taken the wrong approach at just scolding the dog everytime it peed, and now it seems to think that it is wrong to pee, and instead of doing it at the intended area, the dog would only do it when we are not around, in secret. Would also like to get some advice on this. Would like to check if you are available on Sunday 13/01/08 for appointment.

Many Thanks,
(Name)

E-MAIL REPLY

This Sunday, I will be on leave. Next Sunday will be good and we can talk about toilet training as regards your puppy. Each case is so much different as the players (you and family) and environment (housing etc.) varies!

121. Intern sprayed water onto client's T-shirt

2008-01-08T13:06:00.000-08:00

The 4th year vet student from Sydney University observed how I flushed out the ear wax from the Maltese ears. The two Malteses were on a grey table outside the Surgery. The lady owner and her 12-year-old talkative son were helping out.

I handed the 20-ml syringe to the intern as I presumed it was a simple matter. She squeezed the syringe perpendicular to the ear pinna. The dog could have moved her head suddenly as the owner insisted that no muzzle be used while she held onto the dog's mouth with her hand.

The 20-ml water squirted and bounced onto her spectacles. Worse of all, the water wetted the white T-shirt of the stern-looking lady owner! It was distressing for her but she was a good sport.

The owner did not complain but she was not smiling. I did not know what to say or where to hide my face.

To irrigate the ear well, the syringe must be held at an angle, not perpendicular to the entrance of the vertical canal.

I just read in a 8-Days Dec 13, 2007 magazine about an expert giving tips on make up. To blend the make up well, most brushes should be held at an angle, and not perpendicular to the face.

Same with the irrigation of the ears of the dog as well!

120. Tethered Silkie not toilet-trained

2008-01-08T12:44:00.001-08:00

The Silkie of 4 months, neutered recently, was tethered to the kitchen sink pipe but could not be paper-trained and is not putting on weight. Why?

There was no problem with the weight. The puppy was not thin. The tether method was not successful in this case for the following reasons:

DISTRACTION
Too much distraction from the family members wanting to play with him. He wanted to play and is let free in the apartment. So he does not know why his toilet location should be.

NO FIXED ROUTINE
The puppy was fed various brands of food as he is picky. When he stops eating a brand for a day or two, the owner buys another brand. Then he stops eating again and is offered another type.

PROPOSAL
Buy a crate with wire flooring and pee pan below and confine the puppy for 2-4 weeks. Feed regularly 3x/day and take away the food after 20 minutes. I doubt this puppy can be paper-trained so easily. Will follow up.

119. Follow up on 108: An excellent vet-client relationship is important

2008-01-08T12:12:00.000-08:00

The Angora Rabbit keeps losing interest in food. After the veterinary treatment, ate for 3 days and then stopped eating. Why?

Nothing specific during the consultation. Thin as a rake, loose stools, teeth grinding. Something had affected the digestive system. The rabbit was not losing hair. Just very thin and not eating much.

I had presumed that the rabbit would be eating hay and food pellets as other rabbit owners but I was mistaken. I asked the owner to send me some pictures of the rabbit at home.

The young lady sent some pictures of the rabbit's housing via e-mail as requested by me. From the pictures, this rabbit was very well cared for. It appears that the lady in her late twenties piled hay on top of the pellets in one feed bowl. So, the rabbit ate mostly hay and no pellets or little pellets. Over some months, this could be an imbalanced diet and there also could be toxins in the hay? Toxins not enough to kill the rabbit but did cause some loose stools.

Dec 22, 07
The owner noticed that the rabbit was not eating again. She text messaged for appointment. The rabbit ate a bit and she might sms to cancel the appointment.

The rabbit came the next day. She was warded for one day for observation and fluid therapy. The rabbit was given pellets and vegetables. She liked the leafy kangkong vegetables.

The owner was advised to give her a variety of diet and to get new hay from another brand. She bought the branded hay. The hay has to be put in a separate bowl.

"Pesticide free vegetables are best," I said. "Only certain supermarkets sell them and you need to look for them."

The rabbit was given a variety of food including apples. "Apple skin only," the lady said when I sms her one day. "She gets diarrhoea if given the apple itself."

"Apple skin may contain pesticide," I advised her not to give the skin as apple growers nowadays spray insecticide all over the apples to prevent insect damage. I did not know what she would be doing to source the pesticide vegetables. Christmas and New Year passed by fast. Then I got an sms from her on Jan 5, 2008.

Jan 5, 08

Sms from the owner.

Hi Dr Sing, how hv u been? To update u, I hv been feeding (name of rabbit)with pesticide free lettuce leaf n a mini carrot daily. She continues wif her new pellet n hay diet. She improves a lot n now i can feel her little tummy. She looks good. Thank you so much for your continuous care & attention.

It is important for the vet to follow up in cases where the pet is eating less and less everyday. The feeding management of the pet might be at fault rather than the disease.

With text messages nowadays, it is much more convenient rather than phone calls.

As this young lady owner has an excellent professional veterinary-client relationship, it was easy to follow up via sms. Sometimes I had to phone her for more details as sms can be quite brief.

If this case was not followed up by the vet and the owner had not bothered to e-mail pictures of the rabbit housing, the rabbit probably would have had died as she ate less and less.

This rabbit does not suffer from anorexia nervosa unlike young Singaporean girls. Most likely, the hay was toxic and the variety of diet was not eaten.

118. Hamster tumour - Teaching the intern

2008-01-03T15:01:00.000-08:00

"No anaesthesia?" the 2nd-year Murdoch Univ vet student asked me. All animals must be anaesthesized before surgery to avoid causing pain. This is generally observed by all vets as we don't want the animal to suffer.

However, in this case, the hamster was thin and not eating a lot. She had this glistening big skin tumour for some time and was not eating when brought to the Surgery. A dose of anaesthetic gas might kill her. Could not walk properly as the tumour irritated her. Probably could not sleep well too.

All clients want a live pet back after treatment. Death of a pet ruins a reputation of the veterinarian whatever the explanations.

In this case, the risk was extremely high. I noted a short stalk attached to the "tumour after 3 days of hospitalisation. A small scissor with curved blades snipped the tumour off in less than 1 second. The hamster would still be alive.

After snipping, blood splashed covering the whole area of more than 2 sq cm. What to do? This tumour had a large blood vessels connected to the skin. Would the hamster die? The young student held the hamster in the towel while I pressed a piece of tissue paper to stop the bleeding.

Bleeding is quite common in tumour removal of hamsters. They looked profuse and a lot because the hamster is so small, unlike a dog. It was not possible to clamp the stalk of the tumour as the tumour itself was small. The stalk was about 2 mm in width and because the tumour was no longer inflamed, I could see it.

If I had operated on day 1, I would not have had seen it. The hamster might not have survived as she was in a poor condition. Never operate on a pet that is not eating. Minimise the risk of death due to stress from surgery.

"The fastest way to wash away the blood was to flush the blood off under a tap. Just the area of surgery and not the whole hamster", I said to the student who had not spoken one word throughout the surgery. He must be wondering how I could wipe the messy bleeding as the hamster struggled to get free.

I don't know whether the young man learnt anything from this case as he was starting his second year. Did he learn something about the anatomy of the hamster's reproductive system.

"Is the tumour an enlarged clitoris?" I asked him.

"No," he said. He was correct. From close observation, it was a skin tumour very close to the vulval lips but definitely not the clitoris.

Is he the observant type I wondered? Why was the tumour located in relation to the vulva?

I asked him to illustrate the process of cutting the tumour as he saw it so that he could learnt something by participating in the whole procedure. He was a good illustrator.

The young man drew the tumour at the right side of the vulva.

"No," I said. "The location is not correct." I let him see the wound as he held the hamster. The location was now correct and he drew the illustration for me to include in the case study.

Hamsters are beloved family pets and the family was most happy to see her alive and without the tumour.

117. Don't take my picture!

2007-12-29T15:18:00.001-08:00

"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.

2007-12-29T13:45:00.001-08:00

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?

2007-12-28T19:54:00.000-08:00

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.

2007-12-18T15:30:00.000-08:00

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

2007-12-18T14:52:00.000-08:00

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.

2007-12-08T15:36:00.000-08:00

"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.

2007-12-04T14:03:00.000-08:00

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

2007-11-30T03:45:00.000-08:00

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

2007-11-30T03:09:00.001-08:00

"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. .

2007-11-28T15:23:00.001-08:00

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

2007-11-24T16:13:00.000-08:00

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.

Subject:	RE: 2007 Update:: Rocky's Toilet Training - Pooping on floor.
Date:	Wed, 6 Jun 2007 00:48:17 +0800