Tracheal Stent Placement & Laryngeal Sacculectomy: Cookie

13-year-old Cookie was referred to our specialist Dr Nathalee Prakash with a history of stertor (noisy breathing), coughing and voice change. She had been admitted to After Hours Emergency for recurring episodes of respiratory distress and cyanosis.

* When there is not enough oxygen being carried to the body by red blood cells, the skin and mucous membranes can turn a bluish or purplish colour. This condition is known as cyanosis. 

Thoracic radiographs showed markedly narrowing of the cervical trachea to the extent of the thoracic inlet. Tracheal collapse syndrome is a debilitating condition common in small breed dogs. Intraluminal tracheal stenting is a minimally invasive procedure that can improve the quality of life for dogs like Cookie with severe TCS.

Cookie had been admitted to After Hours Emergency for recurring episodes of respiratory distress. Intraluminal tracheal stenting is a minimally invasive procedure that can improve the quality of life for dogs with severe TCS.

what is tracheal collapse SYNDROME?

The trachea, or windpipe, is a tube that delivers air to and from the lungs during respiration. There are small rings of cartilage along the tracheal wall to maintain the tube shape and keep the airway open. If the cartilage becomes weak, the tracheal rings flatten, making it difficult for air to get to the lungs. Signs of tracheal collapse include coughing, noisy breathing, exercise intolerance. Some dogs turn cyanotic when stressed or excited.

A self-expanding nitinol tracheal stent was deployed under fluoroscopic guidance to hold Cookie’s trachea open and help her breathe again. Watch fast-motion video below.

After tracheal stent placement by specialist Dr Nathalee Prakash and Dr Anthony Goh, assisted by vet tech Marco, laryngeal sacculectomy was performed by Dr Dennis Choi to help Cookie breathe more easily.

Laryngeal sacculectomy (surgical removal of laryngeal saccules) is often required for dogs experiencing compromised upper airway flow. The soft tissue masses protrude into the airway just in front of the vocal cords and obstruct proper airflow.

Both procedures were successful. Cookie was closely monitored in our hospital for a few days before discharge for home care.

Post-procedural medication included a broad-spectrum antibiotic, corticosteroid, anti-tussive and bronchodilator therapy. One month post-stenting, Cookie is doing well. She coughs when excited and sometimes at night. There is no stertor or episodes of fainting. Cookie continues to enjoy family activities with her sister Baby – bike rides almost every evening!

cookie and her wonderful family – a chance meeting

A meeting purely by chance. About 10 years ago, Cookie ran out of her house on one occasion and was found by Karen’s family. That was how 2 families got to know one another. When Cookie’s family had to relocate and couldn’t take their dogs along, Karen’s family decided to adopt both Cookie and sister Baby.

It is wonderful the 2 closely-bonded sisters can continue to stay together when their first family was relocated, all thanks to big-hearted folks like Karen and family.

“Besides her collapsed trachea, Cookie is generally healthy for her age. We decided to let Cookie go through tracheal stenting so she can live longer. She and Baby are always a part of our family activities. We are glad to find out about this procedure that can help her.” ~ Karen

A family that exercises together stays healthy together! Karen’s family takes Cookie and Baby on bike rides almost every evening. When she is not out and about, Cookie enjoys sitting by the full-length window and watch the world go by. #KeepingFamiliesTogether


Intraluminal tracheal stent placement is a palliative, minimally invasive procedure to restore an obstructed or narrowed tracheal lumen.
  • TCS is common in small breed dogs. These patients usually present with a distinctive honking cough and may show signs of breathing difficulty, cyanosis and fainting episodes during stress.
  • Diagnosis of TCS can be made by chest radiographs but as the collapse is dynamic, fluoroscopy and endoscopic examination may be required in some cases.
  • Management of TCS consists of weight loss, use of harnesses instead of collars to reduce tracheal pressure, limiting exposure to respiratory irritants (e.g. smoke, dust).
  • The stent reduces but does not resolve coughing completely. Concurrent conditions such as bronchial collapse, chronic bronchitis and congestive heart failure should be evaluated and managed to optimise success post-stenting.
  • Intraluminal tracheal stenting can result in rapid and significant improvement of clinical signs in patients with severe TCS. However, it should be considered as a palliative procedure and reserved for dogs who do not respond to medical management.

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.

Advertisements

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.

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.

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

img_5246

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.

img_5273

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.

img_1875

“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.”

img_1861

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.

twi1

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.

twi2

Back home with Heidi

img_5641

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.

img_6087

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.

img_6088

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

fullsizerender

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

img_3416

“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

img_5624

One of her favourite spots

img_5672

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.

img_6098

img_6101

“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!

img_7806

Well done Twinkle. Keep getting stronger!

Before (right) and After (left)

Beautiful Twinkle in May 2018

In the earlier days…..
to-update-001

Ebony & ivory

tw1

Twinkle’s 1001 positions!

img_2370

“It fits I sits”

img_3543

“Let me out. I smell dinnerrrr!”

twi4

“Let meow help you…”

twi3

Twinkle & Heidi living together in harmony

Bam Bam Says “Thank You Dr Nathalee Prakash”

bam bam

Bam Bam  is fighting a brave battle against kidney disease. He’s not out of the woods yet. But with such a band of brothers alongside him, he’s already a winner. These boys are so so loved. (L-R: Luke, Bacon, Astro, Bam Bam)

Bam Bam and Family would like to specially thank Dr Nathalee Prakash for all her care and meticulous attention and most importantly, her never give up character. Thank you!

And we would also like to thank all the nurses and vet techs who have helped us in so many big and small ways. It means alot to us. Also thank you for taking care of Bam Bam when he was hospitalised. Thank you. You all are awesome.

Annie Ho and Bam Bam

Elvis The Maltese: Thoracotomy (Open-Chest Surgery)

Note: The following images may be unpleasant for some viewers.

16-year-old Elvis the Maltese had been losing weight despite a normal appetite. He was also generally quiet and showing signs of respiratory distress with a grating cough throughout the day. 

Echocardiogram (ultrasound of the heart) and CT scan revealed a large mass in the right caudodorsal chest.

IMG_1819

A thoracotomy (open-chest surgery) was performed by Dr Patrick Maguire, Veterinary Specialist (Small Animal Surgery) & Dr Dennis Choi, Mount Pleasant Veterinary Centre (Gelenggang), to excise the mass which was compressing the right main bronchus & oesophagus. Following anaesthetic induction, a ventral midline approach was made to the thoracic cavity.

IMG_1814

A saggital saw was utilised to perform a caudal sternotomy – making an incision in the centre of the chest to separate the sternum (chest bone) & gain access to the heart & nearby organs.

IMG_1822 copy

Upon entering the thoracic cavity, a large, slightly irregular but seemingly well-encapsulated mass was identified, associated with the right caudal lung lobe. [The colour in this photo has been toned down]

Elvis

The mass was removed from the thoracic cavity & sent to the laboratory for histological examination. A chest tube was placed to drain air or fluid from the thoracic cavity before the surgical site is closed.

“Histopathological findings are consistent with a pulmonary carcinoma in the lung lobe, and based on morphology of the neoplastic cells is most consistent with papillary variant of pulmonary adenocarcinoma. Pulmonary adenocarcinoma is associated with mucus production by neoplastic cells. Clinical signs include cough, pneumonia, dyspnea, cachexia.”  ~ Excerpt from lab report by Dr Ong Chee Bing

* Dyspnea: difficult or laboured breathing
* Cachexia: weight loss in patients with cancer or other chronic diseases

IMG_3481

Elvis may have been diagnosed with cancer but this little trooper is making every day count. Few hours after his major surgery, Elvis was eager to have a good dinner.

IMG_3483

Elvis during one of his reviews with Dr Sebastien Monier, 6 weeks post surgery.

IMG_3482

Elvis continues to be on medication for his existing bilateral uveitis (inflammation in the eye) & heart condition.

IMG_3480

“I was very apprehensive about putting Elvis through surgery until I spoke with Dr Sebastien to understand how he’d be carefully monitored under general anaesthesia. Elvis is happier & more active after surgery. He coughs much lesser & it’s not the grating painful cough he had before. His coat is also healthier & he has a good appetite. We celebrated his birthday on 10 November. He is 16 now.” ~ Justine Duerden

Helping Nala See Again

Cataract is the leading cause of blindness, especially in senior dogs. Once a cataract has developed,  no eye drops or medication can reverse it. Thankfully, surgery can remove cataracts and help blind dogs see again.

what is a cataract?

The lens is a clear structure inside the eye that focuses light and images on the retina. It is made up of clear protein surrounded by a very thin and elastic capsule.  A cataract is an opacity or cloudiness that forms within the lens.

 dog_eye_health

Very small cataracts would not affect vision too much. However, as the cataract progresses, it can cause uveitis (inflammation in the eye), retina damage or glaucoma, leading to permanent blindness. Signs of uveitis include increased eye redness, squinting, excessive tearing and light sensitivity.

WHAT IS NOT A CATARACT? 

Senile Nuclear Sclerosis is commonly seen in dogs 7 years and older. Lens fibers are continuously being produced. As older fibers are compressed in the nucleus, the lens take on a bluish-grey hue. No treatment is required as light can pass through a sclerotic lens. The cloudiness does not impair vision.

Mount Pleasant Newsletter - Apr to Jun 2015

IMG_6149

Coco the Jack Russell Terrier, 5 years old. When the cataract is mature, the lens becomes opaque. It is like looking at the world through frosted glass.

DSC_0473

Bebe the Poodle, 8 years old, adopted from SOSD. Poodles are prone to retinal detachment if the cataracts have been present for a long time.

FullSizeRender

“We adopted Nala 6 months ago. Because of her cataracts, she knocks into things, especially white walls or chairs, and when she gets excited playing ball.” ~ Rachel Tan

What Causes Cataracts?

When cataracts occur in younger dogs (less than 6 years of age), it is usually hereditary. Cataracts can also develop from:

  • diabetes: early detection and surgery is especially important with diabetic cataracts which can progress rapidly
  • old age
  • nutritional deficiencies
  • toxins
  • trauma
IMG_6222

If your dog’s eyes look cloudy or bluish-grey, have her examined by a veterinary ophthalmologist. A series of diagnostic tests will be performed (e.g. check tear production, measure intraocular pressure (IOP), stain the eye with a fluorescein dye to evaluate ocular surface).

 

DSC_0542

Advanced testing may include electroretinography (ERG) to evaluate the electrical activity of the retina. If the retina is not functioning properly, cataract surgery will not visually benefit your pet.

IMG_6087

Nala the Dachshund, 3 years old. Her cataracts developed when she was just 1. A year later, she was blind.

“My mom insisted on Nala having cataract surgery. It is costly. But knowing Nala will regain her vision is more important to my family. My mom, sis and I saved over 6 months for this surgery.”

DSC_0510

“We started performing cataract surgery once a week but due to an increase in demand, we have to create more slots for surgery. Many of our patients are Toy Poodles and Miniature Schnauzers.” ~ Dr Heng Yee Ling

Preparing The Eye For Cataract Surgery  

Under general anaesthesia, the eyeball usually rolls back into the socket, making it inaccessible to the surgeon. An intravenous nerve block is administered which makes the eyeball rotate to the centre.

Staining The Lens Before Phacoemulsification

A small corneal incision is made to gain entry into the eye and a blue dye injected to stain the lens to make it clearly visible. Then a small window is created in the lens capsule through which the cataract is broken apart and removed via a procedure called phacoemulsification.

http://www.youtube.com/watch?v=KC6bTpOamq4

Inserting The Intraocular Lens (IOL)

Once the cloudy lens material is removed, the capsule is cleaned and polished. An artificial replacement lens is then inserted into the lens capsule. This will improve the vision of the patient tremendously.

http://www.youtube.com/watch?v=rj09QI1yf6E

Ref: discovery eye.org

Suturing The Corneal Incision

After the corneal incision is closed up with absorbable sutures, the patient is monitored closely as she recovers from anaesthesia. Post-operative eye medications are administered. Intraocular pressure (IOP) is measured at regular intervals to ensure it is within normal range.

http://www.youtube.com/watch?v=7rTBpgPyyfs

how do i Care for my pet after surgery?

Vision usually improves within 24 hours and continues to improve over several weeks. Your pet will require the following:

  • oral medication
  • medicated eye drops
  • an Elizabethan collar to prevent self-trauma to eyes
  • re-examination of the eyes within 1 to 5 days, then 1 week after surgery, and again 2 weeks after surgery. Thereafter, the schedule for reviews is determined by the vet and progress of your dog’s recovery.
Before & after cataract surgery. Rachel & family has not only given Nala the gift of a new home, they have given her the gift of sight. We will follow up to see how Nala progresses over time!

Before & after cataract surgery. Rachel & family has not only given Nala the gift of home, they have given her the gift of sight!

“When Nala got home last night, she started barking at everyone, probably because she has never seen us & our house before. We comforted her with our voices which she is familiar with. Today, she is much calmer.” ~ Rachel

FullSizeRender-6

Teamwork at Mount Pleasant Animal Medical Centre (Farrer)

robin stanley jp

Whether it is Xiao Hei the bunny, Noah the Cocker Spaniel, Nala the Dachshund, Bebe the Poodle, Ming Ming the Chihuahua or Coco the JRT, there is something comfortingly the same – you can feel it in the air. The guardians love their pets. So very much.

No matter what our pets are living with, Dr Stanley says it beautifully: “We humans may feel sorry for ourselves. These animals, they just make the best of every situation.” But what a wonderful gift it is, to be able to help the blind see again!


Dr Heng Yee Ling, Mount Pleasant Animal Medical Centre (Farrer), graduated from the University of Edinburgh. During the course of her studies, she realised her interests in soft tissue surgery and in particular, veterinary ophthalmology. In 1997, she completed the Post Graduate Foundation Course in Veterinary Ophthalmology and has been performing cataract surgery for the past 3 years.

Dr Robin Stanley graduated with first class Honours from the University of Melbourne in 1984. He undertook an ophthalmology residency from 1987 to 1989, and in 1990, obtained his Fellowship of the Australian College of Veterinary Scientists in the field of ophthalmology. Dr Stanley is registered as a veterinary eye specialist and works in a dedicated ophthalmology-only practice in Melbourne. He consults and performs eye surgeries at Mount Pleasant Animal Medical Centre (Farrer) every quarter. Contact 6271 1132 for more info.

Does Your Pet Need To See A Specialist?

A veterinary specialist is a veterinarian who has completed advanced training in the form of a 3-year residency under a registered specialist in an accredited institution. They would have had to demonstrate their expertise in the area of specialisation by examination and publication.

There are currently three veterinary specialist clinicians in Singapore.

tate and me

Dr Nathalee Prakash, Veterinary Specialist in Canine Medicine, Mount Pleasant Veterinary Centre (Gelenggang)


Dr Nathalee Prakash
graduated from Murdoch University in 2002. She obtained her membership in Canine Medicine in 2008 with the Australian and New Zealand College of Veterinary Scientists (ANZCVS) and completed a three-year residency in Small Animal Medicine with the University of Melbourne in 2014.

In the same year, she obtained her specialist qualifications with the ANZCVS and is aiming for Board-certification with the American College of Veterinary Internal Medicine (ACVIM) in 2016. She has published in the area of veterinary gastroenterology and immunology and is currently completing her PhD on inflammatory bowel disease in dogs.

12540514_465460130327362_8453079025692756242_n

Dr Patrick Maguire, Veterinary Specialist in Small Animal Surgery, Mount Pleasant Veterinary Centre (Gelenggang).

Since he joined Mount Pleasant in October 2015, Dr Patrick Maguire has been kept busy. One of his first patients is 16-year-old Elvis the Maltese who needed an open-chest surgery.

Dr Maguire is a Veterinary Specialist in Small Animal Surgery. He graduated from University of Sydney in 2006 with first class honours and worked 9 years in the USA, where he completed 2 years of surgical internship training and a 3-year small animal surgical residency programme at a veterinary referral centre in New York. In 2015, he obtained his specialist qualifications with the American College of Veterinary Surgeons. His areas of interest include trauma and reconstructive surgery, orthopaedics, soft tissue surgery and neurosurgery.

Dr Maguire lives with his wife, a specialist in exotic companion mammal medicine, two children and a parrot named Tweety!

REFERRAL SERVICE FOR INTERNAL MEDICINE

We provide a referral service for internal medicine, which focuses on the diagnosis and management in areas of cardiology, endocrinology, gastroenterology, haematology, infectious disease, medical oncology, nephrology and neurology.

REFERRAL SERVICE FOR SURGERY

Our surgical team works with state-of-the-art surgical equipments and facilities including Synthes® (Swiss precision instruments) orthopedic and neurosurgical units, Valleylab® electrosurgery unit, operating microscope and a Cardell® multifunction digital anaesthetic monitoring system. We are also equipped with digital radiography and a CT( computed tomography) scan unit for better surgical planning and access to top of the line 3 Tesla MRI.


You may be referred to a specialist if your pet’s health problem is more complex and requires additional expertise and/or specialised equipment. Your pet may be referred for a diagnostic procedure, or for both investigation and treatment.

The aim of our referral service is to complement or be an extension of veterinary care already provided by your veterinarian. As we do not replicate services of your regular veterinarian, specialists do not usually provide basic care such as vaccinations, spays or neuters, etc.

IF YOU WOULD LIKE A REFERRAL, PLEASE SPEAK WITH YOUR VETERINARIAN.

Your pet receives the best care when you, your regular veterinarian and the veterinary specialist communicate and work together.

We will communicate with your regular vet regarding our clinical findings and ongoing treatment for the referred problem.

Dr Nathalee Prakash and Dr Patrick Maguire are available for referral at Mount Pleasant Veterinary Centre (Gelenggang). If you have any queries, contact our centre at 6251 7666.

Dr Nathalee Prakash: Be Thankful

There is no fast track to true success and that is a good thing. Because along the journey, we grow through lessons of faith, courage, sacrifice. And maybe, most important of all, gratitude. 

Love what and who you have. Be thankful for everything in your life. 

I WANTED TO BE A VET AS IT COMBINED MY LOVE OF PROBLEM SOLVING & PASSION TO WORK WITH ANIMALS.

Now I am thankful that I am able to care and give back to the animals that do so much for our society. Being a veterinarian is not just another job. It is a vocation.

Later, when it became a serious consideration, I chose to pursue a veterinary degree because I enjoyed problem solving.

I spent my childhood trying to convince my parents it was feasible to have a horse tied to a tree below my apartment block.

My parents finally allowed us to get a dog when I was 17. Ember loved to swim in the ocean, destroy walls, furniture and paper, and steal food off tables. He had eaten things he shouldn’t have including clothes pegs, porcelain figures, pencils and Chinese herbs, all of which fortunately passed out uneventfully.

IMG_5751

“Ember was a free-spirited & rambunctious Cocker Spaniel.”

I got Tate, my second Cocker, after I started my residency in Melbourne. An accident as a pup resulted in three surgeries on his leg and residual joint issues. Tate has been by my side throughout my residency – sitting patiently under my desk and sacrificing his walks and beach outings whilst I studied for exams.

sitting on beach_colour

“I love being around water. I unwind by going to the beach or to the lakes for walks & watch Tate run like a crazed nut. “

IMG_5748

“Unfortunately, he also loves mud & rolling in smelly things!”

IMG_5752

“Participating in Obedience & Rally-Obedience with Tate allows us to work as a team. It teaches me patience, trust, discipline & understanding. Tate won his first ribbon in 2012!”

I chose to do a residency & PhD to further develop myself in the area of veterinary medicine I was interested in, particularly gastroenterology, neurology & urology.

Internal medicine provides the intellectual challenge of problem solving, as well as the ability to develop a relationship with owners and their pets. It involves further training in various medical sub-specialties including cardio-respiratory medicine, endocrinology, immunology, nephrology and urology, gastroenterology, neurology so that we can assess our patients holistically to make appropriate recommendations for each individual.

IMG_5749

With the team from Mount Pleasant Veterinary Centre before leaving for a 3-year residency in the University of Melbourne. [Dr Dennis Choi, Dr Anthony Goh, Dr Nandini Mudeliar, Dr Nathalee Prakash]

DSC_0319

“My aim was to essentially become a good clinician & provide the best standard of care I can.” Dr Nathalee Prakash is a Veterinary Specialist in Canine Medicine & is available for referral at Mount Pleasant Veterinary Centre (Gelenggang).

Being good at something requires sacrifice.

I had to sacrifice money, time with family and friends, and the opportunity to do surgery, which I used to enjoy. Preparing for Board exams is a stressful process. But in return, I gained friends, created wonderful memories and have been given opportunities I never would have had as a non-resident.

IMG_5747

“I draw strength from family & friends in Singapore & Australia, resident mates & supervisors. I would not be where I am today without them.”

Music has always been a part of my life.

I enjoy concerts and playing duets and trios with friends. I was in the band in secondary school and college and have been studying the flute since I graduated. This has been put on hold due to residency and exams but I will be picking up on my passion next month!

tate-ragamuffin-September_14(54)-2

I focus on goals rather than tasks. So if there are road bumps along the way, I won’t lose sight of where I’m headed.
tate-ragamuffin-September_14(73)-2

“Many have gone before me & succeeded. I really have no excuse. I remind myself to be thankful & not take for granted the things that are going well in my life.”