Kirin: Liver Shunt Surgery

4 months ago, a kind act by rescuer Benji and Purely Adoptions got a very sick puppy off the streets. Treatment and surgery by Dr Dennis Choi and Dr Nathalee Prakash provided the best chance for a long healthy life. Top it all off, Dr Gloria Lee and Victor changed Kirin’s future by giving him the best home any street dog could ask for!

When Kirin was found in a car workshop, he was very weak and showing signs of respiratory distress.

portosystemic or liver shunt

Our liver plays a role in most of the metabolic processes in the body. Normally, blood from the abdominal organs flows to the liver via the portal vein. The blood brings the liver nutrients and is cleansed of toxins and impurities.

In a puppy like Kirin, a portosystemic or liver shunt is an abnormal blood vessel that diverts blood around the liver instead of into it. The liver is deprived of necessary nutrients and fails to grow normally. Congenital shunts can be extrahepatic (outside the liver) or intrahepatic (inside the liver).

With Purely Adoption’s support, rescuer Benji took Kirin to Mount Pleasant Vet Centre (Mandai) for treatment.

Clinical Signs and diagnosis of Liver Shunts

Common clinical signs include stunted growth, poor muscle development, mental dullness, reduced appetite, vomiting, diarrhoea, blood in urine. Hepatic insufficiency combined with toxin build-up can result in hepatic encephalopathy – affecting the brain and causing neurological signs such as  ataxia, seizures, head pressing and behavioural changes.

Common clinical signs of liver shunts include stunted growth and mental dullness

Kirin was referred to Mount Pleasant (Gelenggang) for a full diagnostic work-up including blood work, urinalysis, liver function tests, ultrasound and CT scan with contrast to confirm and locate the portosystemic shunts.

medical management Before Surgery

Before surgery could be performed, Kirin was managed by veterinary specialist Dr Nathalee Prakash. The aim was to reduce the amount of toxins produced and improve Kirin’s health  to decrease the risk of anaesthesia and surgery. Kirin was placed on an appropriate hepatic diet, antibiotics to reduce intestinal bacterial overgrowth, and lactulose to encourage rapid transit of faecal matter and bacteria through the intestinal tract.

Kirin with veterinary specialist Dr Nathalee Prakash at Mount Pleasant (Gelenggang)

liver shunt Surgery 

Once Kirin’s condition is stable for general anaesthesia, surgeon Dr Dennis Choi performed a challenging procedure to close the shunt. The abdominal cavity is opened and the liver shunt identified. An ameroid ring constrictor is then carefully placed around the shunt, allowing it to close progressively over time and restore normal blood flow to the liver.

Gradual occlusion is important to prevent excessively high portal system pressure, called portal hypertension, which can result in death.

Dr Dennis Choi assisted by Dr Korn

After locating the shunt, Dr Dennis Choi prepares to place the ameroid ring constrictor around it.

Over the next few weeks, the casein absorbs fluids from the body and swells inwards, gradually compressing the shunt to restore normal blood flow to the liver.

Kirin was hospitalised for a few days and closely monitored

Kirin at his post-surgery review. Surgical site healing very well.

Kirin with Dr Korn, Victor, Dr Dennis Choi, Dr Gloria Lee

A month and half after surgery, Kirin is a healthy 19kg, playful and active.

post surgery care

It takes time for liver cells to regenerate and regain normal function as the shunt slowly closes in the weeks following ameroid constrictor placement.  Kirin  will continue on a hepatic diet and medications while returning for regular blood tests to monitor his recovery. Meanwhile, this sweet little boy is bright, active and happily annoying his big brother Tully — enjoy the video below!


We welcome medical stories of your animal friends to educate and inspire others. Email us at comms@mountpleasant.com.sg and be part of Mount Pleasant community over at our Website and Facebook.

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Coco: IVDD

Intervertebral disc disease (IVDD) or ‘slipped disc’ is most commonly seen in short-legged breeds such as Corgis and Dachshunds. It can be a very painful condition resulting in limb weakness or paralysis.


30 Jan 2018

Coco suddenly lost the use of her hind legs.

Our dog’s spinal column is made up of a series of bones called vertebrae and intervertebral discs which act as ‘shock absorbers’. When the discs degenerate, the inner contents (nucleus pulposus) herniate and press against the spinal cord or nerve roots, causing limb weakness or paralysis.
Neurological exam, myelogram and CT scan help our surgeon Dr Dennis Choi locate the ruptured disc and plan for surgery. For ruptured disc in the thoracic (mid back) or lumbar (lower back) spine, a specialised procedure called hemilaminectomy is performed to access the vertebral canal and remove the disc material compressing the spinal cord.

An incision is made along the back -> a ‘window’ is drilled through the vertebrae -> the extruded disc material is removed. The incision on Coco’s back healed very well.

While conservative management may be acceptable to treat patients with mild neurological deficits, dogs with paralysis or loss of pain sensations require prompt surgery for a positive outcome. After a week of close monitoring, Coco was discharged for home care.

15 Feb 2018

Following a delicate spinal surgery by Dr Dennis Choi, Mount Pleasant Vet Centre (Gelenggang), and strict home rest, Coco improved day by day. Gentle controlled exercise and physiotherapy will be gradually incorporated to help Coco build up strength and regain normal motor function.

“Coco is a sweet girl with a mild temperament. She loves Lele and always wants to be with him. Coco is coping much better than the humans. Her independent character makes her crate rest and recovery much easier for us. She doesn’t whine while being crated. She doesn’t complain about anything, she’s the best patient.️” ~ Coco’s family (Photo: @corgiandachshund)

“We learnt a lot about IVDD from IG furiends. Some recovered, some are on wheels permanently. Coco doesn’t jump on furniture at all. They have ramps to access the couch and bed but only Lele uses it. We place dog beds everywhere so they can stay comfortable on the floor. We have taken precautions but some things just happen. Here are some advice:

  • Discourage jumping up and down furniture.
  • Crate your dog and go to the vet ASAP if you suspect IVDD.
  • Crate rest after surgery, 6 to 8 weeks recommended.
  • Use a sling support to help your dog during toilet breaks.
  • Each dog’s recovery differs. Be very patient and do not rush your dog to walk.
  • Keep your dog at a healthy weight to reduce stress on spine and legs.
17 mar 2018

6-weeks post surgery review with Dr Dennis Choi and Coco’s recovery is excellent!

Coco used to go on adventures with Lele and we know she can’t wait to get out there and explore the world. So long as it is nothing strenuous or competitive, Coco can gradually resume normal walks and outdoor activities. As Dr Dennis Choi says, “Ultimately we want to live our life. And we want to be happy.”

Coco’s excellent recovery from IVDD is possible with a successful spinal surgery, wonderful home care by her family & moral support from Lele who always looks ‘deep in thought’ but is actually a very happy boy! 🙂


We welcome medical stories of your animal friends to educate and inspire others. Email us at comms@mountpleasant.com.sg and be part of Mount Pleasant community over at our Website and Facebook.

Sarge: Lung Lobe Torsion

When 3-year-old Sarge lost his appetite and started panting for two days even in an air-conditioned room, he was referred to our specialist surgeon Dr Patrick Maguire.

X-rays and CT scan revealed pleural effusion (fluid accumulation in the chest cavity) with a right lung lobe torsion (twisting). This is a life threatening condition that requires immediate stabilisation and surgical intervention.

Lung lobe torsion

When a lung lobe twists, it causes obstruction of the bronchus and vessels. The torsed lobe is identified through a lateral intercostal thoracotomy and surgically removed with a stapling device. 

Thoracotomy (open-chest surgery): performed by Dr Maguire via an incision on the side of the chest to visualise the affected lung lobe.

Lobectomy: the affected lung lobe is surgically removed and sent for histopathology and bacterial culture.

After the torsed lung lobe is surgically removed, a chest tube is placed to allow for removal and evaluation of fluid and air from the chest cavity during post-operative period.

Recovering at home

Don’t think Sarge enjoys this channel

“Sarge is doing great and back to normal. He coughs sometimes but otherwise everything is good.” Grateful for families who do all they can to give their best friends the best chance at health and happiness. Sarge is back to fun and games with his sweet little missy!

If your dog has a sudden episode of respiratory distress, please go to the nearest vet clinic immediately. For after hours and emergencies, take your pets to our Mount Pleasant After Hours Clinic located at 232 Whitley Road.

Flat-faced dogs such as Bulldogs and Pekingeses are at risk of upper airway abnormalities such as stenotic nares and elongated soft palate. More about brachycephalic airway obstruction syndrome (BOAS). 

We leave you with this super adorable photo taken by our vet nurse Gerren. You are a brave boy Sarge!


We welcome medical stories of your animal friends to educate and inspire others. Email us at comms@mountpleasant.com.sg and be part of Mount Pleasant community over at our Website and Facebook.

Cutie: Flash Glucose Monitoring System For Diabetic Pets

Joette with Cutie

how did cutie come into your life?

I was leading a busy and stressful life in the corporate world. The only thing I loved to do was visit the pet farms during my free time. I saw Cutie during one of my visits. She was at the back of the viewing room – her eyes so sorrowful. We both looked at each other for a long time. I could not stop thinking about her. Two weeks later, we brought Cutie home.

living with skin problems

When Cutie developed skin problems, we went to the vet very often but it just got worse. Then I met Dr Simon Quek at one of his talks. We did a skin allergy test to find out what Cutie was reacting to (e.g. pollen, dust mites, tobacco). It can be difficult to avoid exposure to certain environmental allergens. We started Cutie on immunotherapy and it has been working well.

living with blindness

Last year, Cutie was diagnosed with diabetes. Her condition worsened rapidly and within a month, she developed cataracts in both eyes. Cataract surgery was successfully performed by Dr Heng Yee Ling but unfortunately, Cutie developed glaucoma.

It was a very painful and difficult decision to go ahead with enucleation to remove both her eyes. You will find this silly – I actually let Cutie choose from 2 pieces of paper: ‘keep’ or ‘take out’. She kicked the paper with the words ‘take out’.

“We got the Muffin’s Halo to help Cutie get around. Now she is familiar with the surrounding – we do not move or add in new furniture – she can find her way around and even climb up and down the stairs. I guess she ‘activates’ her other senses and decided to move on with life.”

“I learnt something from Cutie: We don’t need a pair of eyes to see the world. We just need a heart to feel it.”

living with diabetes

We are very fortunate to meet Dr Nathalee Prakash and her team – their dedication, patience and commitment. To reduce stress in Cutie, Dr Prakash introduced us to a glucose monitoring device that is implanted into Cutie’s neck – no more poking of needles to draw blood.

Application of the sensor is relatively quick, painless and well-tolerated by diabetic patients.

“Now we can monitor Cutie’s blood glucose with ease at home. Cutie is the first dog to use this sensor!”

flash glucose monitoring system 

Effective blood glucose (BG) monitoring is essential for the management of dogs and cats with diabetes mellitus. BG readings can be affected by stress, food consumption and exercise. BG testing in a vet clinic can be stressful for our pets, especially cats. Under stressful conditions, the values obtained may not be an accurate reflection of the BG curve on a typical day.

A novel Flash Glucose Monitoring System is now available to measure interstitial tissue glucose levels every minute via a disposable sensor with a small catheter inserted under the skin. It can be worn for up to 14 days and eliminates the need for repeated blood tests at the vet clinic. The readings are collected, registered and stored automatically. Email mpvc@mountpleasant.com.sg or call 6251 7666 to find out more.

For patients living with diabetes, consistent, unchanging and constant are keywords to remember for lifestyle, diet and treatment.

Ideally, a diabetic dog or cat should be fed the same type of food, same amount, at the same time each day. A regular schedule will help minimise fluctuations in blood glucose so that the amount of insulin needed remains the same. Once the diabetes is properly regulated, our diabetic pets like Cutie can live relatively normal lives.


We always welcome medical stories of your animal friends which can educate and inspire others. Email us at comms@mountpleasant.com.sg if you have a story to share. Meanwhile, be part of Mount Pleasant community over at our Website and Facebook.

Happy Father’s Day Joel!

Our parents influence not only our life journeys but possibly the journeys of our children. If there is one lesson we can impart to our kids and them to their kids, let it be “Families stick together. We look out for one another.” Congratulations Joel on your first baby to come – Happy Father’s Day!

Why do you choose to work with animals?

I have various animals since young. From fishes, rodents,  dogs to cats, birds, turtles. I have reared chickens, goats, cows and pigs back in the Philippines too. The feeling that animals project towards me is very satisfying. They teach me to be patient and caring. I also learn to be an innovative and analytical thinker to make their lives more comfortable.

“In our line of work, it is not all cuddles & kisses with our furry friends. Things can go downhill in an instant, thus, every shortcoming is an opportunity for improvement for the team.”

“Our clients’ satisfaction & compliments fuel me to strive harder to provide better care & service to their pets.”

“The continuous knowledge & enhanced skills set I gain motivate me to perform better & give my best in times of crisis.” Read more about Blood Donation for dogs & cats.

“I feel elated whenever we discharge healthy & happy patients. Knowing you have contributed to their recovery & well being is always the best takeaway from my job.”

A weekend of diagnostic imaging with Dr Cathy Beck from University of Melbourne. As Joel says: “The good teacher makes a poor student good and a good student superior.”

Brian Herbert once said “The capacity to learn is a gift; the ability to learn is a skill; the willingness to learn is a choice”. I believe education is a continuous process. It does not stop at the four corners of our school but rather, every day is a learning experience.

Joel & Shella

“I am so ecstatic & looking forward to fatherhood. We have been praying for this blessing for years since we got married. We are thankful that we have been blessed.”

With Cake, the super duper adorable adopted Pug.

“I have been a fur daddy for so long. Now we will have a little human as an addition to our family!”

What are the important lessons from your father that will help you be a good dad?

I have a very religious family and we are inculcated since young to be family-oriented. My father taught me a bible verse that stayed with me while I was growing up: Proverbs 22:6 says “Teach your children right from wrong and when they are grown, they will still do right.”

Being the eldest child, my father always says I am responsible for my siblings while they are away. I take this task very seriously. I learnt a lot from keeping my siblings in line and teaching them the right ways in life.

Super Mommy Jia Hui: Happy Mother’s Day!

“We all have to juggle and maintain a balanced work and family life. For me, I always prioritise my baby. She comes first.”  Because there is no replacement for a family lost. Happy Mother’s Day Super Mommy Jia Hui. May you always have time for the people you love and the ones who love you FIRST! 

why did you choose to work in a vet clinic?

It has always been a dream job of mine. Since young, I’ve liked animals. Being able to interact with them everyday is such a joy!

Working at the front desk, the greatest joy is to hear clients coming back to the hospital because they are satisfied with our customer service. It is very important that the frontline is excellent.I’m very close to some of my clients. When their pets pass away and they grieve, I still feel that tug in my heart. Sometimes I’ll tear a little even though I have worked for many years and seen many deaths.

With @RaphaFluffyButt at Mount Pleasant (Gelenggang)

what’s the toughest part of being a working mom?

When your child is sick and you’re at work but you have to go pick her up. Or when my child is sick and I’m the only one capable of taking care of her. I have to take leave to nurse her at home. In order not to affect my work performance, I try to give my 200% at work. I’m very passionate about my work – my clients are my testimonials. 😉

Jia Hui with Katrina and Mittens

Mittens is a rescued cat & also our Mount Pleasant Hero!

what are your sweetest memories of motherhood?

The sweetest memories were when I was pregnant with Katrina. I loved the feeling of being pregnant. You instantly feel prettier and have that glow. And of course, when your baby is born, every single bonding session builds a stronger connection between mother and child.

Whenever I hug my child, I make sure it’s from my heart & we will always exchange an “I Love You”.

any advice for working moms?

Many working mums tend to be very stressed about work and about affecting their work performance. You have to have a company that really understands you and doesn’t see having a child as a cause of poor performance, so long as you give it your all at work.

But don’t get too engrossed in work & forget your children. They will grow up real quick & be very independent by the time you realise it.

Every moment with your child is going to be a precious memory.

We all have to juggle & maintain a balanced work & family life. For me, I always prioritise my baby. She comes first.

Corkscrew Tail Amputation

Note: The following surgery images may be unpleasant for some readers.

Ingrown or corkscrew tail is an abnormal inward growth of the tail commonly seen in brachycephalic or flat-faced dogs such as Pugs and Bulldogs. Due to the tight and deep folds, a corkscrew tail often results in repeated skin infection that leads to irritation, pain and odour.

Dog breeds with corkscrew tails include Boston Terriers, Pugs, Bulldogs & French Bulldogs like 5-year-old Boris.

Dogs with screw tails are prone to itchy & painful skin infections, especially where the curls are very tight & the folds are deep.

The deeper the folds, the worse the skin fold dermatitis which typically manifests as moist, inflamed & painful skin. Mild dermatitis can be treated with daily cleaning & antibiotics. However, the warm moist conditions are a breeding ground for bacteria, making the infection difficult to treat medically.

If the case is severe & there is constant itch, pain & odour, amputation of the affected tail is necessary. Dr Dennis Choi, Mount Pleasant (Gelenggang), proceeds with a surgical resection of Boris’ infected corkscrew tail.

The tail & infected tissues are carefully removed.

Sufficient skin is left for the area to be stitched up properly.

Post-surgery: No more constant tail cleaning or bacterial infections to deal with.

2 months after surgery, the surgical site has healed nicely & fur has grown back. Boris is healthy & well with a clean rear end – no more itchy irritated butt – thanks to his family’s decision & good care!

Boris with his lovely guardian Zoan. We love the cheerful playful nature of Frenchies! However, many are predisposed to health issues such as brachycephalic airway obstruction syndrome due to their flat faces & pinched nostrils. Fortunately, Boris does not have breathing problems. If you are intent on purchasing a Frenchie puppy, choose only responsible breeders who understand the underlying health issues of the breed. Consider adoption.

Thank You Wei Juan & Madeleine!

At Mount Pleasant Vet Centre (Gelenggang), we see many patients who require intensive and palliative care which makes it an emotionally challenging place to work in. Today we say THANK YOU to Wei Juan and Madeleine, two strong ladies who see the good in every journey!


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“I’ve been an animal lover since young. Always have that special interest & love for anything that involves animals – articles or variety shows. I chose to study Diploma in Biotechnology – Vet Science in Temasek Polytechnic to gain more knowledge about animals.” ~ Wei Juan

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“I did my student internship at Mount Pleasant in 2008 & have been working with Mount Pleasant since then. It is very rewarding when sickly pets get nursed back to health & seeing them discharged with wagging tails, or seeing happy ‘parents’ bringing home their meows. It really makes my day.”

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“If I have the ability to fund my studies, I would still pursue my dream of being a vet.” With Dr Sophie Cho & Jia Hui.

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Happiness is contagious! Bee Hong, Wei Juan, Jia Xuan.

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“One thing few people know about me? I may be gentle to the furballs but I am an aggressive gamer! Strategic games are my favourite. It helps to keep my brain alive.” With Benjamin our senior vet tech.

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“A quote that motivates me: Where there’s a will, there’s a way. This has somehow pushed me to never give up & keep on trying.”

“There are many happy new beginnings but also moments when you know the end of the journey is near and you have to let go of your loved ones. For our clients who lose their beloved pets, I comfort them by reassuring them that their babies or kiddos are no longer suffering nor in pain. That they have not really left us. They are up in heaven watching over us right now. Everyone, including me, need time to heal our broken hearts.”


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“I joined Mount Pleasant in January 2015. Growing up, I was surrounded by animals but working with animals wasn’t always a priority in my life.” ~ Madeleine with Tiger the Irish Wolfhound

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“It wasn’t until the death of our family dog Sundae that I felt a strong need to care for animals.”

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Volunteering at the old premises of SPCA

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“The most rewarding part of my job is being able to learn new things & successfully applying them at work.” With Renga, a rescued German Shepherd whom we found out was lost for 7 years.

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“There are many careers out there that I would love to experience. If I could be anything, I wish to be an animal behaviourist or a singer.”

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“I have a Labradoodle named Cosby, four guinea pigs & a betta fish so I never feel alone. It’s like a sleepover in my room every night! When I had a bad day, I would usually go home & Netflix & catch up on sleep to destress. Having something to look forward to also encourages me to keep going on.”

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“Mental health is very important & often overlooked. We should not be afraid to speak up or seek help. I recently volunteered for World Suicide Prevention day organised by the Samaritans of Singapore.”

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“I get inspired by everyday things such as people I meet or things I read. I love the Latin quote: ‘Ad astra per aspera’ which means ‘through hardships to the stars’. Through all the difficulties I am facing, I believe I am able to get through them & get to something even better at the end, like I always did. I like the quote so much, I have it tattooed on me!”


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Part of our big Mount Pleasant (Gelenggang) family!

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Twinkle: Feline Eosinophilic Gastrointestinal Sclerosing Fibroplasia (FEGSF)

Vomiting frequently, growing weaker and losing weight, Twinkle was a far cry from her chubby cheery self. At her lightest, she was 2.92kg. Twinkle’s family fought alongside her, through sickness and surgery, until she was fit to go home.  

“One night 11 years ago, we were driving when a kitten dashed across the street. My husband got out immediately and found the kitten huddling in a drain. We are not cat people but we just had to take her home. It was difficult caring for Twinkle initially but we learnt along the way.  A year later, Heidi joined our family. Like ebony and ivory, Twinkle and Heidi live together in perfect harmony!” ~ Julie

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Few months ago, Twinkle started vomiting frequently (vomiting is the primary sign seen with a variety of diseases affecting the GI tract). She was losing appetite & losing weight.

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A naso-esophageal feeding tube is passed through the nose into the esophagus. Only very liquefied food, water & some medications can be given through the narrow tube. An Elizabethan collar is necessary to prevent Twinkle from interfering with the tube.

feeding tubes are useful for animals who are ill & have lost their appetite

The sight of your cat or dog with a feeding tube might be unpleasant. However, feeding tubes are useful for animals who are ill and have lost their appetite, or are keen to eat but have difficulties swallowing or keeping food down. 

13 september 2016 – consult with dr nathalee prakash

Twinkle was referred to Dr Nathalee Prakash, veterinary specialist in canine medicine, at Mount Pleasant Vet Centre (Gelenggang). Cat physiology is  different compared to dogs or humans. The consequences of not eating are much more significant. If your cat does not eat for forty-eight hours, she can develop a potentially life-threatening form of liver malfunction known as hepatic lipidosis.

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“Twinkle has always been healthy. When she started losing weight, we have to find out what was wrong & do whatever we can to help her get better.”

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Twinkle’s body condition score was 3/9. Upon palpation, a mass was detected in the mid-abdominal region. Exploratory laparotomy was advised, with a possibility that surgical intervention could help Twinkle.

15 september 2016 

Dr Patrick Maguire performed exploratory laparotomy to examine Twinkle’s abdominal organs. A mid-jejunal mass was identified, measuring 1 to 2cm in diameter, which appears to be causing partial obstruction. A jejunal resection and anastamosis was performed – fully excising the diseased section of the intestine and suturing the remaining sections together. The mass was sent for histopathology examination, together with the mesenteric lymph node and a section of the liver. 

Note: The small intestine is the major digestion and absorption site. It is divided into three sections – duodenum, jejunum and ileum. The jejunum is the longest section of the small intestine.

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To provide nutritional support, an esophagostomy feeding tube is inserted when Twinkle was still under GA. This tube is slightly larger than a naso-esophageal tube & enters the esophagus through a small incision in the neck.

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Back home with Heidi

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The larger diameter of the esophagostomy feeding tube allows thicker food to be fed, in lesser time & with fewer clogs.

proper nutrition is critical for successful recovery from any disease

If your cat refuse food for more than two days, consult your veterinarian immediately. Force-feeding is unpleasant for cats. There is an increased risk of your cat inhaling food into the trachea or windpipe and developing aspiration pneumonia.

how to encourage your cat to eat
  • Slightly warm the food prior to feeding.
  • Offer frequent, small meals of odorous, highly palatable food.
  • Hand feed or gently place small morsels of food on your cat’s tongue.
  • Feed in a quiet and comfortable area.
26 september 2016 

Twinkle is eating about 20g of kibbles on her own daily, supplemented with tube feeding.

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The area where the tube enters the skin should be checked every day to make sure it is not clogged Any sign of infection (e.g. pus-like discharge or foul smell) requires veterinary attention.

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Histopathology revealed feline eosinophilic gastrointestinal sclerosing fibroplasia (FEGSF), an uncommon inflammatory disease affecting the stomach or intestines.

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FEGSF is treated with steroids and antibiotics to control inflammation and prevent recurrence.

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“Twinkle is family. When we choose to welcome an animal friend into our lives, we have to commit to the animal for the rest of his or her life.” ~ Mr Chia & Julie

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One of her favourite spots

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Still thin but we will get there!

18 October 2016 – recovering well

Twinkle now weighs 4kg (up from 2.92kg). She is eating about 80g of dry food on her own in addition to 4-hourly liquid food and medication through tube feeding.

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“Twinkle has started to venture out of our study room/recovery room to the living room & various favourite spots.”

24 october 2016 – off with the feeding tube

Twinkle returned for review and ultrasound. The feeding tube is removed as her appetite is good and she is eating well on her own!

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Well done Twinkle. Keep getting stronger!

Before (right) and After (left)

Beautiful Twinkle in May 2018

In the earlier days…..
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Ebony & ivory

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Twinkle’s 1001 positions!

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“It fits I sits”

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“Let me out. I smell dinnerrrr!”

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“Let meow help you…”

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Twinkle & Heidi living together in harmony

Stenotic Nares In Flat-Faced Dogs

Brachycephalic dogs and cats such as Pugs, Bulldogs, Pekingeses and Persians are bred to have flat or short faces which puts them at risk of airway obstruction, heat stress and even death.

Brachycephalic airway obstruction syndrome (BAOS) refers to the upper airway abnormalities that affects brachycephalic dogs. They include stenotic nares, elongated soft palate, hypoplastic trachea and everted laryngeal saccules.

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Mon Mon, 2-year-old Pekingese: A dog with stenotic nares has abnormally narrowed nostrils that restrict the amount of airflow into the nostrils, making it difficult to breathe.

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Rasping breath and snoring is not always “cute”. Families with flat-faced dogs must be especially vigilant in our hot and humid climate, to catch the first signs of heat stress and respiratory distress.

Air passes from the nostrils through the nasal cavity and back of the throat, and into the trachea via the larynx. A dog with stenotic nares has abnormally narrowed nostrils that restrict the amount of airflow into the nostrils, making it difficult to breathe. Over time, increased airway resistance can cause the larynx to collapse.

Pinch your nostrils slightly with your fingers – experience how difficult it is to breathe. Then imagine breathing this way, 24 hours a day.

SIGNS OF STENOTIC NARES
  • Noisy breathing 
  • Snoring 
  • Disrupted sleep
  • Exercise intolerance
  • Cyanosis (blue gums due to lack of oxygen)
  • Occasional collapse especially after activity/excitement/excessive heat

The increased effort required for breathing can eventually put a strain on the heart.

keep dog at healthy weight
  • Dogs with mild symptoms can be managed by keeping them at a healthy weight
  • Avoid hot and humid conditions
  • Avoid situations of high stress and excitement
  • Use harnesses instead of collars to lessen pressure at neck area
“nose job”

If the stenotic nares are severe, rhinoplasty (“nose job”) can be done to widen the nostrils. A wedge of tissue is surgically removed from the walls of each nostril to open up the nasal passage.

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Dr Patrick Maguire, Mount Pleasant Vet Centre (Gelenggang), performed stenotic nares repair & soft palate resection on 5-year-old Barney the Frenchie. As seen in the photos, his nostrils are widened to improve airflow & help him breathe better.

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A wedge of tissue is surgically removed from the walls of each nostril to open up the nasal passage. (Ref: vet4bulldog.com)

Milton the Bulldog – another happy patient after successful stenotic nares surgery. “Milton recovered well & is obviously panting lesser.”

soft palate resection

Breathing difficulty in brachycephalic dogs or cats can also be caused by an elongated soft palate which obstructs the opening to the larynx.

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Your bulldog’s palate is located at the roof of the mouth – the front part is the “hard palate” & the back part is the “soft palate”. In brachycephalic dogs, their upper jaw has been shortened, forcing the tip of the soft palate into the laryngeal area & partially obstructing the airway. (Image Ref: veazievet.com)

Signs of elongated soft palate
  • Noisy breathing
  • Retching or gagging especially while swallowing
  • Exercise intolerance
  • Cyanosis (blue gums due to lack of oxygen)
  • Occasional collapse especially after activity/excitement/excessive heat

This condition can be corrected by a soft palate resection to remove excessive tissue and allow better airflow from the nose to the windpipe.

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“Mon Mon was not able to breathe properly when the weather is hot. She couldn’t go out for a walk even if it’s just 5 minutes. When she played with her mate, she was panting a lot. Few weeks ago, she was again struggling to breathe, her tongue turned pale. I rushed to the nearest vet where she received oxygen therapy. The vet advised us to bring her for a surgery which can help her breathe better. I took Mon Mon to Dr Dennis Choi.” [Evaluating the soft palate]

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After stenotic nares surgery & soft palate resection

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“I know Mon Mon definitely has to go through this surgery (to widen her nostrils) sooner or later or else, one day she might just passed on if she can’t catch her breath. She is recovering well. Now, she can play with her little boyfriend Fibio at home!”

Many brachycephalic animals experience significant improvement in their breathing and overall wellness after surgery.

Stenotic nares and elongated soft palates are congenital malformations. Dogs requiring surgery to correct airway obstruction should not be used for breeding. We recommend that these dogs be neutered or spayed during the surgical correction. 


We welcome medical stories of your animal friends to educate and inspire others. Email us at comms@mountpleasant.com.sg and be part of Mount Pleasant community over at our Website and Facebook.