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 and be part of Mount Pleasant community over at our Website and Facebook.

7 Mistakes People Make When Keeping Parrots

By Dr Gloria Lee, Mount Pleasant Vet Centre (Mandai)

Dr Gloria Lee has a special interest and special touch with birds. “Birds are challenging patients. The anatomy and physiology of a chicken is different to that of a parrot or dove. It’s like treating a domestic cat, a lion and a tiger.”

Keeping birds as pets is a popular hobby in Singapore. In recent years, more people have gravitated towards keeping smaller parrots as they can be excellent companions and are easier to keep in a flat or apartment without needing large cages. In this article, I share some mistakes often seen when I consult these birds and their owners.

mistake 1: my parrots are seed eaters

Although parrots are mainly seed eaters, their diet in captivity should include less seeds and more fresh fruits and vegetables and other wholesome healthy human foods. In the wild, parrots fly great distances foraging for fruits, nuts and seeds. A seed-only diet is low in calcium and high in fat, often causing obesity and eventually liver disease.

For small birds, it is important to have a digital gram scale to monitor their weight regularly and ensure they are not losing or gaining weight too rapidly.

  • Commonly eaten fruits are all edible for parrots, except avocado and seeds of certain fruits like apples, pears, peaches and apricots.
  • All vegetables are edible, although some have to be cooked, e.g. broccoli, pumpkin, sweet potato, potato, dried peas/lentils.
  • Other wholesome human foods that are acceptable include hard boiled egg, bread, pasta, rice, egg noodles.

Feed in moderation and in great variety. These foods spoil faster so care must be taken to keep food containers and perches well scrubbed. Dispose uneaten foods within a few hours.

mistake 2: my Parrots need to shower to keep clean

Whilst true, never shower a bird that looks less than healthy, and always make sure they are placed in the sun to preen and dry off. It is unnecessary to hose them wet to the skin. Sometimes, it is adequate to place a shallow bowl of water on the cage floor or use a bottle sprayer. Some birds do not like to shower, and it is a source of stress if they are hosed down strongly. Always watch how your birds react.

mistake 3: Putting my sick birds in the sun will keep it warm

A bird’s core body temperature is 40°C. The environmental temperature in Singapore rarely goes above 33°C. A heating lamp (infra-red or basic non-energy saving light bulb) does a better job at raising the temperature of a hypothermic bird.

To avoid accidentally over-heating your bird, place your hand next to your bird – it should feel comfortably toasty warm. Adjust the distance between the lamp and your bird to get the right temperature. Position the lamp to one side so that your bird can get away from direct light if it feels too hot. 

mistake 4: glucose or honey water is the most important first aid for sick birds

If a bird a very sick and weak, it may not be able to swallow adequately. Dripping water into its beak can cause it to drown as the water gets into the lungs instead. The most important first aid for sick birds is warmth.

After you have raised the ambient temperature to support your sick bird’s recovery, make sure it is getting sufficient food and fluids. You may have to hand feed till it regains a normal appetite. Keep your ill or injured bird quiet, warm and inactive.

mistake 5: It is alright if my bird does not eat for a day

Birds have an extremely high metabolic rate, and a high body surface area compared to body mass. This means they burn up food very fast in order to stay warm and keep their body functioning. They must be checked by a vet as soon as possible if you notice a much reduced appetite. Never leave it for 2 to 3 days – often that may be too late.

During a physical examination, Dr Gloria Lee carefully evaluates the eyes, nares, beak, plumage, vent, legs etc. The heart and lungs are assessed by auscultation with a neonatal stethoscope.

mistake 6: It is cruel to cage a bird – Use a T-stand or allow it to free range

Only acquire captive-bred parrots, never wild-caught ones. They adapt to a roomy cage very well. Cages keep them safe. An untrained bird left to roam or on a T-stand can suffer severe accidents such as fractured legs, poisoning or trauma to the digestive tract when they chew poisonous houseplants or electrical cords etc. I have seen many cases of birds injured from flying into fans – they suffer bad concussions or need to have a wing or leg amputated.

Sparta the Conure had a tiny lump on the leg which progressively grew larger. Lumpectomy was performed by Dr Gloria Lee and the mass sent for histopathology. There was no sign of neoplastic disease or cancer and Sparta recovered beautifully. Parrots are highly intelligent and sociable birds who enjoy human interaction and playtime. Sparta’s favourite toys are balls with bells.

mistake 7: Parrots can be left in their cage the whole day as long as they have food and toys

The term ‘bird brain’ to describe dim-witted people was obviously coined by someone who does not keep parrots. Frustration, stress and anxiety are often felt by parrots, especially those that are hand-raised very well and very tame. Self-destructive behaviour and Obsessive Compulsive Disorders (OCD) are well-recognised psychological diseases which are very difficult to treat.

Do not even consider having a parrot unless you can dedicate several hours to them daily. Since some parrots like the Cockatoo can live to 80 years old, be prepared, like me, to include for their care in your Will.

“Blackie the Palm Cockatoo has a superficial ulcer on his tongue and roof of mouth. We suspect the ulcers are caused by contact irritant, e.g. household detergent or items he shouldn’t be chewing on. Cockatoos are inquisitive and love to destroy things. His owner keeps him in an area free of dangerous items but they can still find ways.” Blackie was treated with a topical spray and has started eating normally again.

“My dad takes Chucky out for evening walks. He is well known in our neighbourhood and has even taken photos with our MP!” Chucky the African Grey developed a fungal infection under his wings. He has healed well with diligent cleaning and medication by his family.

Macaws are magnificent, highly intelligent and inquisitive. Make sure you have time and space to properly socialise and bond with your parrot if you decide to have one. Your parrot’s cage should be as large as possible, with safe and stimulating toys, perches, climbing nets, baskets, swings. Birds are born to fly and thrive with exercise and exposure to outdoor environments. Providing an outdoor aviary will give your parrot a better quality of life.

A healthy bird is active, vocal, bright-eyed with nicely preened feathers. A sick bird will usually fluff up its feathers and huddle listlessly in the cage. If you have rescued or acquired a new bird, isolate it to prevent exposing your flock to possible pests or diseases. The quarantine period also allows your new bird to get used to the environment and humans with less stress.

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

Super Mommy Dr Kitty Huang: Happy Mother’s Day!

With two very young boys who still wake up at different hours through the night, we salute Dr Kitty Huang’s unwavering passion to rescue and foster homeless cats. Many have found happy homes because she never stops what her very own mom has started. Happy Mother’s Day Dr Kitty. We hope you get the gift you really want – SLEEP! 

Why you choose to be a vet?

A major contributing factor is definitely my mother’s influence. She is a passionate stray cat carer and I always enjoyed tagging along with her during the feeding rounds. During one of these feeding rounds, when I was about 10 years old, we came across a litter of kittens abandoned in the refuse bin to die.

We brought the kittens home to foster and tried to nurse them back to health. Unfortunately, their condition worsen after a few days and we had to bring them to a vet. The vet caringly advised that we were not bottle feeding them enough and the hot water bag meant to keep them warm and comfortable was too hot resulting in minor burns on their paws and skin.

Observing how the vet cared for and helped the kittens back to health, coupled with the passion for animals influenced by my mother, I was inspired to be a vet so I can help and care for these little friends.

what’s the greatest joy and challenge at work?

Without a doubt, the greatest satisfaction is to see my patients get better after their treatments and witnessing improvements in their condition. And of course, the joy and smile on the owner’s face.

Dr Kitty Huang with Dr Loh Hui Qian, Mount Pleasant (Mandai), examining some cats rescued by Cat Welfare Society.

Unfortunately, life is never a bed of roses. Due to varying reasons such as financial constraints, commitment towards care, temperament of patient, and differing views from owners etc., we are not always able to proceed with ideal treatment plans.

” It can be frustrating and challenging when the ideal treatment plan needs to be altered. In the end, all we want is to keep our patients comfortable and give them a good quality of life.”

what’s the Toughest part of being a working mum?

Juggling between work and quality family time with my boys and hubby. On top of that, it feels like I am doing After Hours every single night! Waking up multiple times through the night to comfort and make milk for the two boys at different hours is no joke – really tiring!

“I am very lucky to have an understanding boss & supportive team at Mount Pleasant (Mandai). The relatively flexible work shifts definitely help my time management.”

“Most importantly, utmost understanding from hubby and family support in caring for my boys when I am at work or need to work late due to emergencies.”

what’s your sweetest memories of motherhood?

Witnessing all the milestones achieved by my boys and seeing them grow up, mingle and love our resident cats and dogs at home.

any Advice to other working mums?

As much as possible, leave work at work and bring only happiness and positivity back home. Spend quality time with kids and not forgetting the husband! Most importantly, catch up on sleep whenever you can. If I can buy time for sleep – I would!

Fractured Bones In Kittens

When Toby (now named Rooney) was found and taken to Mount Pleasant (Mandai), he suffered from a fractured hind leg. His whiskers looked like they had been burnt with a lighter. Still, he trusts humans and is such a joy to be with. Dr Loh Hui Qian fostered Toby for a period of time before he left for The Cat Museum, Muses & Mansion of Singapore where he met his forever family. In this article, Dr Loh shares about young animals’ higher propensity of healing.

1 Aug 2016: All is well now, Toby. You are safe in Dr Kitty Huang’s hands!

Immature animals heal much faster than adults as the fracture sites have a relatively greater blood supply and more pre-existing osteoblasts (cells with bone-forming potential). Older animals or those with concurrent systemic disease (e.g. renal insufficiency or Cushing’s disease) may take longer to heal than young healthy patients.

week 1

Toby is a 4-month-old stray kitten found with a limp on the right hind leg. Upon presentation, Toby was toe-touching on the right hind leg but he was still very active. Radiography revealed a displaced, simple, complete transverse fracture of the mid femur. There were no radiographic signs of osteomyelitis noted.

At that point in time, first intention healing via surgical correction with either a bone plate or intra-medullary pin was recommended to the stray feeders who found Toby. However cost was a concern for  them and they needed time to consider.

Toby was then placed on strict cage rest. During this time, he was very comfortable with his fractured leg & not reliant on pain relief.

week 3

A repeat radiograph was taken and a big bony callus had developed between the two fracture ends. The option of breaking the callus to realign the femur and inserting a bone plate or intramedullary pin was explored. However this approach seemed too invasive for a kitten and because the stray feeders still bore financial constraints, a decision was made to let the bone callus stabilise the fracture and allow secondary healing.

week 5

A third radiograph was taken and an exuberant amount of firm bony callus had been formed. The callus was drawing the two fracture ends to an even closer proximity. The soft tissue swelling had also completely resolved and Toby was using his right hind leg as per normal with no signs of pain or discomfort.

Toby Superpower! Put together by Ai Lin of Mount Pleasant (Mandai).

Toby’s speedy recovery from a complete femur fracture further affirms that young animals have a higher propensity of healing. Cats are also usually able to compensate for an impaired function very well. Toby is now prancing around happily, just like any other kittens.

Living it up at Dr Loh’s house while she was fostering him.

Hanging out with Rao Rao before moving to The Cat Museum, Muses & Mansion of Singapore where he met his forever family!

“One HAPPY FAMILY!!! Look at cutie Rooney’s face!” Photo & caption from The Cat Museum, Muses & Mansion of Singapore. Thank you Serene, John, Sarah & JK for giving little footballer his very own home!

“You made this house just for me?!!! Love you!” Photo & caption from The Cat Museum, Muses & Mansion of Singapore

Discovering hidden talents? Haha! Photo from Instagram @rooney.thecat

Rooney’s family celebrated his 1st birthday on 1 April 2017 with his favourite can of cake! Photo from Instagram @rooney.thecat

Happy Birthday Rooney! We are so glad you have a wonderful family of your own. Live well & be healthy & happy! Photo from Instagram @rooney.thecat

Dr Loh Hui Qian with Faye Faye our Mandai resident cat who has since crossed the rainbow bridge.

ACS (Barker Road) Student Attachment Programme

We believe in educating our community in animal care and veterinary medicine, especially students who are considering the pathways to be a veterinarian.

In November, a group of Secondary 3 boys from ACS (Barker Road) came to “work” at our clinics. Some are so inspired and eager to learn, they came for extra days!


“I love dogs. Job shadowing in a vet clinic is unique and interesting, not something I can do whenever I want.” ~ Joel Mathews with Mason at Mount Pleasant Central Vet Clinic (Whitley)


“The most challenging part of being a vet, in my opinion, is having patience and perseverance.”


“Having patience in handling pets, especially difficult animals. And having perseverance as the doctors need to take on night shifts and perform surgeries which may take a few hours.”


“The best part of being a vet is the opportunity to work with animals. They bring joy to your working life!”


“I’m an avid animal lover. Becoming a vet is a very natural choice for me, having been surrounded by animals since I was born. Through this job shadowing opportunity, I had a feel of what a vet’s life is like and learnt to be a better companion to my pets.” ~ Leon Saint Claire with Sophie at Mount Pleasant Vet Centre (Mandai)


“Sometimes, vets face problems which they have to resolve quickly. They have to think fast and not hesitate. Another challenge is the difficult decision of euthanasia – a life is on the line, for better or for worse. Hence, I feel that vets cannot crack under pressure. They must make the right decisions for the well being of the animal, and also the owner.”


“Job shadowing strengthened my conviction to be a vet. Seeing an animal’s flame rekindled gives you a sense of satisfaction. You feel joyous for helping the family and improving the life of an animal – be it a bird, cat, hamster or dog. Furthermore, a growing stray population may give rise to more animal abuse. By becoming a vet, I may be able to make a positive difference to this predicament. That’s the beauty of being a vet – it is more than just a job.”


“I chose to job shadow at a vet clinic as I have a strong interest in animals and have dogs since I was born. We had a Maltese. After he passed, we welcomed Bambi and Belle into our family. They are Labradoodles which we personally chose from England after meeting their parents to check for any hereditary issues.” ~ Brandon Au Yong with Guan Wei at Mount Pleasant Animal Clinic (East)


“I love animals and want to help them get better. I have plans to pursue a veterinary degree in Australia. During job shadowing, I learnt how to take better care of my dogs and how to observe their behaviour for signs that they are unwell. I also learnt how various blood test machines work.”


“The hardest part was to witness blood from certain surgeries or teeth extractions as I associate blood with pain. The vets do their best to relieve pain and perform procedures as quickly as possible. The best part of this whole experience – I was able to interact with animals and help care for them as well as interact with vets and technicians to learn about the industry and their work.”


“When I was young, we stayed with my extended family and 10 dogs. I love our dogs and my interest lasted through the years till now when only 2 dogs remained.” ~ Michael Boey at Mount Pleasant Vet Centre (Changi)


“Our dogs are old and have had their fair share of visits to the vet. I’m always interested to learn what goes on in a consultation and when animals are hospitalised. Being a vet is one of my dream jobs.”


“For an animal lover, the contact with animals is possibly one of the best parts of being a vet. I cannot bear seeing any animal sick. I would want to find out what is affecting them and how we can nurse them back to health.”


David with Sophie at Mount Pleasant Animal Medical Centre (Bedok)


Daniel at Mount Pleasant Animal Clinic (North)

Under Mount Pleasant Community Outreach – Education, our programmes include talks at schools and organisations, project collaboration, work experience, student attachments and clinic visits. Email to be part of our outreach! 

Thank You Ai Lin & Dionne!

“We protect only what we love. And we love only what we understand.” To love any person or animal, to create great art of any kind, you first have to be vulnerable. Today we say THANK YOU to Ai Lin and Dionne, two strong and seriously artistic ladies from Mount Pleasant Vet Centre (Mandai) who aren’t afraid to open their hearts and use their gifts. For all to see!


“Animals really capture my heart because they are very pure & true. They always show how they feel & never try to hide any emotions from you.” ~ Ai Lin


“When I was young, I was fascinated with stray cats. But other than the occasional cats I encountered, I did not have much experience with animals. I then forgot about animals & started studying design & animation.”


“When I started working at the Night Safari & was spending more time with animals again, I realise I want to spend the rest of my life around animals. On April Fool’s Day 2013, I joined Mount Pleasant Vet Centre (Mandai), when it was still named AMK Veterinary Surgery.”


“The most rewarding part of my job is when our patients leave our clinic healthy & happy. When stray & lost animals are rehabilitated & find themselves good homes.” With Pickles the 13-year-old Sheltie given up by his family & Faye the resident meow. Pickles has moved to a potential adopter’s home.


With Titbit, a rescued community kitten.

It can be difficult to convince owners that sometimes, euthanasia is the better solution. Many people do not understand and reject the idea immediately, convinced it is a cruel and evil thing to do. They do not understand the pain the animal is going through and how we feel when we see the animals suffering. Every minute and everyday.


“Urbanisation & rapid development have caused a lot of problems for wildlife & stray animals. I think it is only right that, now, we help them as much as we can. If I can do anything in the world, I would work in a wildlife rehab centre. To help wildlife get better & eventually return them to where they belong.”

I am inspired by the quote “We protect only what we love. And we love only what we understand”. A lot of the people I know have gone on to do amazing work helping wildlife and strays in any way they can. Seeing their work inspires me every time.


“I do some crafts on my free time & sell them at DIY markets. The money from my crafts goes to my cats & wildlife shelters.” Ai Lin is gifted at crafts & graphic design. When you visit us at Mount Pleasant (Mandai), you will see this lovely piece designed by Ai Lin at the waiting area. Plus all the awesome handcrafted cat houses for our residents & patients!


“As a little girl, I wanted to be a vet when I grow up. Due to my family’s financial constraints, I moved on to a career in customer service but this dream was always at the back of my mind, bugging me. So one day, some 8 years ago with the passing of my first dog, I decided on a complete career switch & haven’t looked back since.” ~ Dionne with Earl Grey, a rescued community cat who now has a great home.


“One reason was to follow my heart & my childhood dream. The other is – I felt I could’ve been a better owner to my dog, so I was driven to learn more about proper animal care before I have another dog. I wanted to educate owners & help them be better caregivers, reduce negligence & increase the pets’ well-being.” Meepie, one of Dionne’s dogs.


Gino, Dionne’s second dog.


“I joined Mount Pleasant (Mandai) in April 2015. The most rewarding part of my job is definitely when our patients make significant recovery. Especially those  we thought wouldn’t make it & they suddenly perked up & started eating. That’s what drives me. Spending so much time with animals has taught me a lot about gratitude, resilience & the power a little TLC – to transform a petrified inappetent animal cowering in a corner into one who is trusting, flourishing & super affectionate.”


“The most frustrating part of my job would probably be witnessing abandonment & severe neglect on the owner’s part (e.g. ingrown nails, severely matted fur, massive maggot wounds left untreated).”


“These, in turn, contribute to the emotional & mental strain we have to endure. After many years as a vet tech, the physical strain can take its toll as well.”



“If I can do anything in the world, I would still choose to fulfil my childhood passions to be a Veterinary Technician & a watercolor artist, painting pets & wildlife! Both bring so much fulfilment & meaning to my life.”


We have some seriously gifted colleagues amongst us! Half Pint, Dr Gloria Lee’s cat, comes to life under the expressive brush strokes of Dionne.


You cannot create such beauty without love! Appreciate more artwork at Paintings By Dionne Ho.


“I never ever want to stop learning & improving myself. I’ve always believed that nothing is impossible & I could be whatever I wanted to be. If there was something I set my heart on, I would dive straight into it, especially if I see value in how it would enhance my life, well-being & sense of purpose.” At her first painting class.

I read a ton of books when I was young. Apart from my massive Enid Blyton collection, the rest were non-fiction and most were related to Psychology. This year, I decided to pursue my other childhood interest by taking up Diplomas in Positive Psychology, traditional Psychology and Psychotherapy. I’m working towards the Professional Diploma to become a certfied psychotherapist as my way of giving back to society. I had a pretty rough time growing up, so my main field of focus will be on adolescent girls, and both men and women who are struggling with body image issues and eating disorders.

My best friend sent me this quote because it reminded her of me: She believed she could, so she did. ~ R.S. Grey


Part of our Mount Pleasant (Mandai) family!



Formerly AMK Veterinary Surgery, now renamed Mount Pleasant Veterinary Centre (Mandai), this is one of our prettiest clinics which we share with a family of chickens & peacocks. Dr Gloria Lee & team at Mount Pleasant (Mandai) believe in helping community animals & the caregivers who are protecting them.  The clinic also provides medical treatment for exotics & rescued wildlife, especially birds.