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SURGERY HOURS:
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*10 a.m - 5 p.m (Mon - Sun,
except Sat). Dr Sing Kong Yuen. By Appointment Only.
*6 p.m - 10 p.m (Mon - Fri). 10am - 5pm (Sat). Dr
Jason Teo. House-calls available.
Appointment preferred.
Tel: 6254-3326, 9668-6469 |
EMERGENCY
11 p.m to 6 a.m
Dr Teo
Tel: 9853-1315,
9668-6469, 6254-3326 |
judy@toapayohvets.com
Fax: +65 6256 0501 |
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Toa Payoh Vets
Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures |
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CASE 1.
Pictures of a lateral ear resection surgery in a Miniature Schnauzer
performed by Dr Sing Kong Yuen |
The left ear. No ear problem on the left ear in this old dog. The ear
canal consists of a vertical and a horizontal canal joined
together. |
The right ear. Infections of ear for four years lead to thick growth of
skin blocking the vertical ear canal. The canal is very narrow and
smelly now. |
An operation is needed to open up the vertical ear canal to drain the pus,
debris and water from the vertical canal (forceps inside the vertical
canal). |
A rectangular piece of skin is cut out from the side of the ear.
The vertical ear canal is seen after the skin is removed.
The outer half of it has been cut and discarded leaving a big gap. |
The horizontal ear canal can be seen as a circular hole at the bottom of the
ear.
The vertical canal's side wall has been removed. Therefore, the ear now has
open ventilation and does not trap water and dirt now. |
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The vertical ear canal opened up. The stitches hold the side of the vertical
canal to the skin. |
First day after surgery. Swelling of tissues but no paralysis of the eye
lids or lips. The vet has to be careful of the facial nerve is near the
horizontal canal. |
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An Elizabeth collar to prevent ear scratching. Went home as owner did not
want the dog to be warded. |
Wound cleaning. 5th day after surgery. Cotton bud shows the
horizontal canal opening. |
14th day after wall of ear canal has been removed. Stitches taken out.
Tumours inside the ear canals are due to many years of irritation and
infection. |
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Follow up. No more consultation
from the owner. I presumed his problem has been resolved to his
satisfaction. Ear surgery done at a younger age would have given the
dog many years of freedom from ear pain, foul ear discharge, ear shaking and
daily ear scratching! Maybe the younger generation of dog owners are
more educated and aware of the surgical alternative for dogs with chronic
ear infections compared to the baby-boomer generation. |
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CASE 2.
Pictures of a lateral ear resection surgery in a Cocker
Spaniel performed by Dr Sing Kong Yuen
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Left ear before surgery.
Every day for many years, a yellow white ear discharge
oozes out of the right and left ear canals. Head shaking, ear
scratching. Seen a few vets. A very busy owner.
This uncle had no time to clean and check the ears daily
or weekly. He decided. Get the dog put to sleep as the ear
stench was persistent and unbearable even after bathing.
The niece was against the action and took the dog to
consult me. I recommended a lateral ear resection as a
long-term inexpensive solution rather than ear
drops and cleaning every week for the life span of
this dog. |
Left ear prepared for surgery. General
anaesthesia gas. The side wall of the vertical canal is
the rectangular area to be cut away. It is best to mark
the surgical site before surgery. A hole will be
seen at the completion of the surgery. This is the opening of the horizontal canal
after the removal of the side wall (cartilage and
skin). |
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Left ear after
surgery. 7 days after surgery and more drug
treatment, cleaning and washing. The owner may not
be able to nurse the dog if sent home immediately. This
would be one reason for "unsuccessful" ear operation.
Therefore it is mandatory that the dog be retained for
observation for 7-14 days. Cleaning and nursing at the
Surgery rather than permit the dog to go home after
surgery will lead to more satisfactory outcome for the
dog and the owner. |
Right ear before surgery. Cocker Spaniel
warded for 2 weeks of treatment before the ear surgery
can be done. The skin was intensely red, wet and soft,
unlike what you see now. Full of yellowish white raw
skin of infection. Not advisable to operate immediately.
2 weeks' antibiotic and cleaning treatment is the
minimum. |
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Follow-up. The Cocker Spaniel led a ear pain-free
life to old age. Some 2 years later, the
young lady who rescued this dog from death by lethal
injection brought the dog in
for some horizontal canal cleaning.
Other than that,
this dog had no more ear pain, itchiness and scratching
of the neck, face and ears and was no more in pain when
his ears were touched. Nor was he having bad body odour
- I mean ear odour. He lived to an old age
with no painful ear shaking and scratching. Of course,
no more business for the veterinarian too.
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Right ear after surgery. Yellowish white
raw skin areas finally gone away. More normal skin
grows to replace ulcerated skin. At least 4 weeks of
stay at Toa Payoh Vets before the dog can be sent home
in this case. The owner does not know how to take care
of the ears post-operation. |
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COSTS OF
ANAESTHESIA AND SURGERY
At Toa
Payoh Vets, the cost of surgery and general anaesthesia for both ears is
estimated to be around S$600. Total costs will be around $800
- $1,000 at the Toa Payoh Vets for small breeds like the
Miniature Schnauzer, inclusive of post-operative care (10
days), antibiotics and pain-killers.
In the long term, the owner will find that the surgical costs are
much cheaper than several years of ear plucking costs and the ear
canal infection. Shop around and get the best quotation for
the ear canal resection surgery for your dog. Be Kind to Pets.
Chronic ear infections may lead to painful cries, deafness,
head tilt and tumour formation. Consult your vet early.
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CASE 3. Real
Estate & Veterinary Relationship - Is Image Everything? Educational stories for startups
by asiahomes.com.
Tips for the new
asiahomes realtor.
Written 6 August 2002 for new partners of
www.asiahomes.com. |
Real Estate
& Veterinary Relationship - Is Image Everything?
There are four legs to
establishing a solid relationship in any business, whether veterinary, investment
banking or real estate. These are:
1. A continuity of relationships and trust built over time. This will take
many years. Unfortunately, for various reasons, many startup realtors and
some private veterinarians, being self
employed, do not have the money to last that long.
2. Being able to offer a wide range of products and services.
One-man-operators (OMO) in real estate and veterinary surgeries
cannot compete effectively with bigger firms as he or she does not have a
wide range of products and services. Setting up practice away from the big
firms and opening long hours till past midnight may be a solution as
Singaporeans prefer convenience. However, your Landlord will want to
increase your rental, take over your premises to get the higher paying
tenant. The big firms may set up next door to you as you have been
successful.
3. Provide an excellent personal relationship. This may involve entertaining
clients to a round of golf or treating clients to Starbucks coffee after house-hunting for
realtors. Vets seldom build this relationship traditionally as they
don't take clients out for the whole day (to view houses as rental
realtors do). They need to clear the day's surgeries but they can spend
more time getting to know the pet owner and his children during
consultation. Some Singapore pet owners are in a great hurry to rush off and they
are more time-pressed than the veterinarian.
4. Being able to give advice, solve problems and find solutions. I consider
this to be most important of the four factors. If you can't cure the dog or find a house
the expatriate likes, the client goes to somebody else.
Therefore image is almost everything. Your client's perception of you can make or break you.
If the vast majority feels you are impatient and hard selling, then it is unlikely that
you will get referrals. In the end, it may be better to be an employee or be
unemployable.
A veterinary example of "Is Image
Everything?"
The 10-year old dog had excessive wax in his right ear around 4 years ago. I advised
ear drops to be given to clear the infection and regular ear cleaning as the
first step in the treatment. This would be the least expensive
veterinary treatment and most of the time, the advice worked. The brown smelly ear discharge indicated
bacterial and possibly fungal infections.
As I did not solve the problem of
excessive ear wax production immediately, the owner went to consult other vets.
Doctor hopping is common in Singapore and probably all over various urban
areas in the world.
Now the owner consulted me 4 years later. I guessed that the other vets did not solve
his problem too. In the meantime, the right ear canal's skin
had proliferated with big lumps which covered the whole canal. The dog could not stop
scratching the ear daily.
 In this case, image could be
everything. Bigger veterinary firms and newer firms with modern
premises have better images compared to a 20-year-old veterinary surgery which
looked dated. The glitz and newness attract the internet generation
and Toa Payoh Vets' premises were a dinosaur in appearance (picture of
dated premises, left) in 2002.
However, image is not everything.
The important point was that I did not solve the problem of this dog owner
4 years ago. The long-standing ear canal infections meant frequent
ear pain, ear scratching and head shaking.
With the passing of years, the ear canals react to irritation by forming
growths dotting the side walls of the ear canals. The canals became narrowed
with large numbers of skin growths looking like ear tumours.
The
dog could not sleep properly as the moist ear ulcerations and white fungal
plaques inside the ear caused intense pain.
The solution was to open up the ear canals
to permit proper drainage and ventilation. But was it too late?
The dog was operated with the lateral ear canal
resection surgery (See Case 1).
I could only assume that the problem was resolved as I did not see the
owner anymore. A healthy dog could live up to 15 years and I hope this dog
was all right.
Image is not everything. But first impression counts a lot. Being
able to solve problems is a skill that is very hard to teach. Some people
have it naturally. Others don't have it at all. However, read
widely business articles and talk to many people including strangers on
various ways they resolve their work problems.
Surprisingly, some of the solutions are applicable to your work as a
housing agent or for me, as a veterinary surgeon.
Educational stories for startups
by asiahomes.com
Tips for the new
asiahomes realtor.
Written 6 August 2002 for new partners of
asiahomes.com.
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 Toa
Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures |
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