Urinary stones in Singapore
dogs
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case 1 was recorded in 2008. Case 2 was recorded in 2010.
Saturday
06 September, 2010 |
 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
Case 1:
2010 - The Shih Tzu keeps passing blood in the urine every day
X-rays and blood tests would be best
but sometimes it is not possible due
to economic reasons. The vet has to be
compassionate when the owner request
least-cost surgery. However the
diagnosis must be spot-on and the
surgery must be planned to ensure
survival of a dog during anaesthesia.
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"Your Shih Tzu needs
an operation to remove the big bladder stone I felt," I
advised the young man whose female dog passes blood in
the urine for the past 2 months. I could feel the
creptitus (gas-like feeling) in the bladder. But the
owner did not want an X-ray nor surgery. He wanted
drugs. |
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One
month later, his dog had not stopped
passing red blood. He requested surgery,
but no blood tests or X-rays. I was OK
with this request. |
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"It is an
open-and-shut case," I thought when I saw one stone
coming out. "This was the big stone I had palpated.
Stitch up the bladder and go home. |
Another big stone was
stuck partially in the urethra as my catheter could not
pass through. What to do?
The stone was stuck fast. Finally the forceps managed to
grip one end and pull it out |
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Smaller stones spilled
out like small bombs when the bladder was flushed. |
Catheter was earlier
passed
out via the vagina |
No more urinary stones
after irrigation of the bladder |
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Day 3 after surgery.
There has been difficulty in passing urine but the dog
eats and has no fever. Antibiotics and pain-killers are
given. I phone the owner that the dog can't go back
today Sep 6, 2010 as the dog has dysuria. |
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Case 2:
Employee Vets That Discourage Referrals
E-MAIL TO DR SING dated
Sep 5, 2010
Hi Dr Sing,
Just a quick line to let you
know that I have finally
returned to Singapore and
just started work at (Name
given). I am returning to
Perth from 16th to 19th for
my graduation. If you want
me to carry anything for
(Name given), I will be glad
to. The other reason for
this email is Dr (Name
given) heard that (Name
given) might have been badly
injured in a car accident in
Perth on Friday night/
Saturday... is this true? If
so, I hope all is ok with
her... we are concerned
about her welfare.
E-MAIL FROM DR SING dated
Sep 6, 2010
Thank you for email. (Name
given) is my
god-daughter. She passed
away on Sep 3, 2010 due to
an accident as the other
driver of an on-coming car
overtook a car and smashed
into her car.
In your new job, I hope you
will present a kindness
towards "smaller practices"
as I have had nasty
experiences of three vets
from your practice when
cases were referred to them.
I gave you 3 examples in the
hope that you would be
kinder now that you have had
started practice with them.
1. One vet demanded over the
phone that I should call him
first but I told him that
his receptionist said he was
busy and it was my client
who wanted the case to be
sent to him. So I extended
the courtesy to phone him.
2. Another vet said I should
fill up a form if I wanted
to refer any animal to him.
3. The 3rd vet refused to
give the X-ray of the
bladder stone to a small
animal practice vet. I shall
name him as Vet X. His
practice had fed your new
employer with numerous cases
over the last 20 years. Vet
X's receptionist had a dog
with haematuria. The dog was
referred to your employer
for an X-ray.
Vet X's mother had asked me
to mentor her son in
surgery. This was his first
case of urinary stone
removal from the bladder. I
asked him to get the X-ray.
It would be good to have an
X-ray but since the vet did
not want to release it, he
could do nothing.
I said it was OK since I
could palpate the bladder
stone and in fact X-rays are
not necessary if one is
confident of the diagnosis
based on clinical signs and
history. Vet X operated
under my supervision and the
dog is still much alive and
well when I saw the
receptionist recently.
Best wishes to your new
career.
|
 A
code of honour is needed to manage employee vets if a practice
wants to be a champion referral centre (thereby increasing its
customer base and its own profitability). The culture of
wanting to be champions must be in
the team. Otherwise, you'll get
vets who discourage referrals.
Reference: The ABC's
of Building a Business Team That Wins - Blair Singer, Sales
Communications Specialist |
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More
info at:
Urinary Tract Infections and Stones in the dog in Singapore.
To make an appointment:
e-mail
judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326 |
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
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PAYOH VETS
