Maggots In Pets

Maggots are fly larvae (an early stage of fly development). Flies are usually attracted to animals by their odour, especially for animals with urine or faecal staining (e.g. from diarrhoea), skin folds, severe skin problems, wounds, infected ears, hot spots etc. Weak and debilitated animals and those kept outdoors are at higher risk of maggot infestation.

Flies reproduce by laying eggs on the skin or wounds. When maggots hatch, they feed on surrounding tissues by producing proteolytic enzymes. These enzymes cause an enlargement of the wounds. As a result, surrounding tissues become severely inflamed, uncomfortable and painful for the pet. The maggots can also burrow underneath the skin.

Community cat Tiger was rescued with a huge maggot wound on his head.

In severe cases, surgery may be necessary under local or general anaesthesia.

Reconstructive surgery was performed by Dr Lesley Teo of Mount Pleasant Central (Whitley) with a single pedicle advancement flap elevated from the neck skin to stretch over the big wound.

Maggot wounds are common in warm and humid environments

These wounds are often noticed only when the animal shows discomfort or pain. Owners usually notice discharge and/or foul smell from the wounds, which frequently have a small circular opening with surrounding tissues becoming red and swollen.

If you find maggots on your pets, we recommend veterinary attention as soon as possible to shave and clean the affected area, remove the maggots, followed by topical wound treatment and oral antibiotic therapy, if required.

Maggot wounds can be prevented
  • Keep the environment clean and dry to prevent flies.
  • Keep your pets indoors if they have a tendency to attract flies.
  • Check your pet’s body regularly for any external wounds.
  • Clean up any parts of your pet’s body with discharges or staining.
  • Keep your pet’s coat short to prevent matting and soiling.

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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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.

Kuro: Mast Cell Tumour

“Kuro is quite adventurous – he loves going out! As soon as he sees his leash or knows he’s getting into the car, he gets ULTRA excited.”

“He literally quivers with excitement thinking we are going to the park or beach. So naturally he was upset when he realised it’s the vet instead!”

“The first time we saw the growth, it was about the size of his nipple. We didn’t think much of it as Kuro has a history of sensitive skin. We thought it was a reaction to some environmental irritant. However, it continued to grow and started to look red and angry.” ~ Denise

WHAT IS A MAST CELL TUMOUR?

Mast cells are present in large numbers in the skin and play a role in inflammatory and allergic responses. When they replicate in higher than normal numbers, mass cell tumours can develop.

  • Mast cell tumours (MCTs) are common cutaneous (skin) tumours in dogs.
  • Usually occur as solitary lumps, and occasionally as multiple masses.
  • Range from low grade (low rate of metastasis or spread) to high grade (malignant with an aggressive rate of metastasis).
  • Vary in appearance – just a raised bump or a swollen ulcerated mass
  • Vary in size –  from a few millimetres to a few centimetres in diameter.

MCTs vary in size and appearance. Kuro’s lump measured 10x5mm.

Fine needle aspirate and cytology: A sample of the cells is taken with a very fine needle and examined under a microscope to identify mast cells.

SURGical excision IS THE TREATMENT of choice FOR MASS CELL TUMOURS

Excision with wide margins to completely remove the tumour and surrounding neoplastic cells. The mass will be sent for histopathology for grading and to confirm if the tissue margins are clean and ‘free from cancer cells’. Dogs with low grade MCT have very good prognosis and further treatment is typically not necessary.

“Knowing that Kuro required surgery, we turned to Dr Sandhya Nair (Mount Pleasant North) as she has been taking care of Kuro’s surgeries since he was a puppy. She was professional and in-depth with her diagnosis, and clear in the steps we needed to take. It eased some of our worries.” ~ Denise

Kuro came back for suture removal. “The surgery went well and the lab result confirmed the tumour as Grade 1. We will monitor Kuro closely for any abnormal lumps.”

Chemotherapy

If the MCT is high grade, complete surgical excision cannot be obtained, or there is evidence of spread to lymph nodes or other tissues, chemotherapy may be recommended. Dogs and cats appear to tolerate chemotherapy better than humans. Side effects (such as vomiting, diarrhea, appetite loss) are minimal.

The goal of treatment is to kill and slow the growth of cancer cells, produce minimal negative effects on normal cells, and allow our patients to lead a good quality life for as long as possible.

EXAMINE YOUR DOGs REGULARLY FOR LUMPS & BUMPS

Run your hands all over your dog’s body, feel for unusual lumps and bumps and look out for fur loss, redness or swelling. Lumps and bumps, especially fast-growing ones, should be assessed by a vet. Dogs with a history of MCT should be rechecked regularly.

“Kuro is super stubborn. He doesn’t like people telling him what to do but will do anything for food.”

“For months, Kuro would just sleep on the floor next to the dog bed we bought. After surgery, the bed came in handy when he needed to rest on a comfy place. From then on, Kuro sleeps on his bed every night.”

“Kuro farts a lot, loves human company (doesn’t care about dogs or at least pretends he can’t be bothered), and communicates through snorts! He only barks at the vacuum cleaner or people coming through the gate and it’s literally just 1 bark. He’s very selfish with his barks!”


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.

Femoral Head Ostectomy (FHO)

The hip consists of a ball-and-socket joint. A normal hip joint is held in place by muscles, a deep socket and strong ligaments.

  • The ball or femoral head is the top part of the femur or thigh bone.
  • The neck is the narrow portion just below the ball.
  • The socket (or acetabulum) is the concave portion on each side of the pelvis.

Several conditions of the hip, e.g. canine hip dysplasia, can be corrected by a surgical procedure called Femoral Head Ostectomy (FHO). Hip dysplasia is caused by abnormal growth of the hip during puppyhood which results in looseness of the joint & development of painful arthritis.

Baby the Japanese Spitz had been limping & “bunny hopping” due to hip dysplasia – the ball of her femur did not fit properly into the hip socket.

signs of hip pain
  • Decreased tolerance to exercise
  • Stiffness
  • Limping
  • “Bunny hopping”
  • Difficulty climbing stairs
  • Difficulty lying down or standing up
  • Reluctance to run or jump
  • Shifting of weight to fore limbs
  • Loss of muscle mass on hind limbs
Physical Exam and x-rays

In severe cases, your vet can feel the hip “pop” in and out of the socket during a physical examination. X-rays will help to:

  • diagnose hip dysplasia, dislocation or fractures
  • identify if the acetabulum is shallow
  • check for bone spurs (a sign that the hips are degenerating)
  • determine if surgical correction is required
FEMORAL HEAD OSTECTOMY (FHO)

FHO is a surgical procedure to remove the femoral head – the ball and neck portion of the joint – to alleviate the pain of bone rubbing on bone. During healing, scar tissue will form and act as a “false joint”. The surrounding muscles continue to support the hip joint.

Dr Estella Liew proceeds to surgically remove the femoral head.

With the femoral head removed, your dog will no longer suffer the pain of bone rubbing on bone. During the healing process, scar tissue will develop to form a functional pain-free “false joint”.

After FHO, strenuous exercise is restricted but your dog is encouraged to use the limb as soon as possible, in a controlled manner. Your vet will advise on a strict physical therapy programme to ensure a good range of motion in the affected hip. Most dogs will start using the surgery leg within two weeks.

WATCH BABY’S VIDEO HERE.

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.

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 & snoring is not always “cute”. Your dog may be suffering from 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
  • 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
  • If your dog is only mildly affected by stenotic nares, the condition can be managed by keeping him at a healthy weight as obesity worsens the symptoms.
  • Keep your brachycephalic dogs away from stressful situations and avoid exercise in hot humid weather.
  • They may also do better with harnesses instead of collars to avoid putting pressure at the 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)

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. So 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 the surgeries. 

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

Kenny: Total Ear Canal Ablation (TECA)

Despite chronic ear infection and a foreleg crushed by a forklift, Kenny is such a dear boy. Today, his entire diseased ear canal is removed by Dr Simon Quek @ Mount Pleasant Animal Medical Centre (Clementi) in a procedure called TECALBO. A very rewarding surgery that offers Kenny a pain-free and better quality of life! Thank you Noah’s Ark CARES for watching over him.

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Chronic ear diseases can be very painful and extremely challenging to manage. When the condition is recurring or has become difficult for topical medication to be administered, surgery is recommended to remove the ear canal entirely.

What is a Total Ear Canal Ablation?

Total Ear Canal Ablation or TECA involves the removal of an infected ear canal when other treatment methods have failed. The full name for the procedure is Total Ear Canal Ablation with Lateral Bulla Osteotomy (TECA + LBO). 

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The moist and warm environment within the ear canal provides an ideal environment for bacteria and yeast to grow. Cocker Spaniels, with their long pendulous ear flaps, are very prone to ear infections. Image ref: willows.uk.net

WHAT ARE THE SIGNS OF EAR INFECTION?
  • Ear scratching
  • Shaking of head
  • Sensitivity to touch
  • Thickened ear canals
  • Foul odour from ear
  • Discharge from ear canal
  • Head in tilted position

If you notice these signs, have your vet examine your pet’s ears before the disease becomes chronic and irreversible.

WHEN DOES MY DOG REQUIRE TECA?

  • Severe or recurrent infection/inflammation of the ear canal (otitis externa) or  middle ear (otitis media) which is non-responsive to medical treatment
  • Narrowing of ear canals due to chronic ear disease (certain breeds like the Shar Pei and Bulldog tend to have narrow ear canals, predisposing them to ear infections)
  • Difficulty in administering ear medication (due to dog’s behaviour or owner’s time constraint)
  • Tumours in the ear canal
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As infection and inflammation progress, the walls of Kenny’s ear canal thicken, ossify (turn into bone) and become irreversibly narrowed. Topical medications can no longer reach the diseased portions. His middle ear chamber is filled with infected material.

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Contact or food allergens, parasites and foreign objects can cause inflammation of the external ear canal (otitis externa) which may lead to secondary infection of the middle ear cavity (otitis media). Image ref: willows.uk.net

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Robert and Cheryl prepare Kenny for TECA procedure

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Dr Simon Quek carefully dissects the soft tissues close to the ear canal, avoiding trauma to important structures such as the facial nerve. The entire diseased ear canal is then surgically removed.

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After removal of the ear canal, the tympanic bulla (middle ear chamber) is exposed by removing part of the bony wall. Any remnants of infected tissue attached to the bulla is removed. After surgery is completed, there will be no opening into the ear canal.

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The incision is flushed with sterile saline before closure and the area protected with a light bandage. Kenny will be hospitalised for a few days with antibiotics and pain relief medication.

can my dog still hear after the procedure?

Most dogs undergoing TECA already have reduced hearing due to severe changes in the ear canal so owners do not notice a significant difference in the dog’s hearing after surgery.

What we often do notice is a positive change in the dog’s behaviour and energy level after the infected ear canal is removed. No longer living with chronic pain, your dog will have a more active and  better quality of life.

** Kenny currently stays at an industrial area. Please contact noahsarkcares@gmail.com if you can give this sweet and undemanding boy a foster or forever home. Read Kenny’s rescue story

Qian Xun Says “Thank You Dr Germaine Lee & Dr Lesley Teo”

Qian xun

Deepest thanks to all the wonderful and passionate doctors, nurses and staff at Mount Pleasant (Whitley) for saving our dearest Qian Xun’s life. Especially Dr Germaine Lee & Dr Lesley Teo.

Despite all the risks and fearing the unknown, we placed Qian Xun’s life in your hands and with caring arms, you’ve brought him back to us, healthy and happier! Is time for 千尋 to say tHAnk yOu 🐾🐾

Watch Qian Xun’s video.

Wendy Tang and Qian Xun

Capers: Juvenile Pubic Symphysiodesis

Capers is a super happy 5 months young Labradoodle puppy. Recently, his family noticed he was bunny hopping (taking short, hopping steps) more frequently, especially during faster gaits. There was also stiffness in his hind limbs.

X-rays were taken and Capers was diagnosed with mild hip dysplasia. A surgical procedure called Juvenile Pubic Symphysiodesis (JPS) is recommended to prevent the development of painful arthritic hip degeneration. Treated early, Capers can continue to live an active and full life!

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“It was mixed emotions for us. Our perfect little puppy being unwell so early. The decision to proceed with surgery was easy. I was open to whatever was needed to give Capers many many great years ahead.”

what is hip dysplasia?

In a normal hip joint, the femoral head (ball) fits snugly into the acetabulum (socket). In dogs with hip dysplasia, there is abnormal looseness between the ball and socket. When these two structures do not fit smoothly, the femoral head slips in and out of the joint (subluxation). Over time, the bones become deformed, resulting in inflammation, lameness, stiffness and pain.

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Ref: vetsurgerycentral.com

how is hip dysplasia diagnosed?

A puppy’s hip dysplasia is usually detected during the second or third vaccination appointment when the vet performs a physical examination and gait evaluation. X-rays are necessary. In order to get the best diagnostic view, the dog is sedated or anaesthetised for proper positioning with the hips distracted (femoral heads “distracted” or pulled out of the acetabula as far as they will go) so that any looseness between the ball and socket can be seen.

Symptoms of hip dysplasia 

  • Bunny hopping
  • Stiffness
  • Limping
  • Swaying gait
  • Difficulty getting up and lying down
  • Reluctance to run, jump or climb stairs/slopes
  • Shifting of weight to forelimbs

DID MY PUPPY GET HIP DYSPLASIA FROM HIS PARENTS?

Genetics do play a part. Puppies diagnosed with hip dysplasia should be neutered or spayed to prevent the breeding of dogs who carry the gene for hip dysplasia. Dogs used for breeding should have their hips evaluated by vets.

Although there is a genetic influence, hip dysplasia can be caused by other factors:

  • Body weight – Overweight puppies and larger breeds who grow rapidly are at greater risk of developing hip dysplasia.
  • Nutrition – Puppies must receive good nutrition to grow but they should not be overweight. Speak with your vet about proper nutrition and supplements.
  • Exercise – Avoid over exercising your puppy and high impact activities like jumping, leaping for balls, running up and down the stairs. Take your pup for a few short walks daily instead of one long walk/run. 
  • Environment – Puppies who frequently walk on slippery surfaces or have access to stairs at a very young age have a higher risk of hip dysplasia.

What can be done?

* Early intervention is critical. If the diagnosis is made at an early age, a minimally invasive surgery known as Juvenile Pubic Symphysiodesis (JPS) is recommended.

If the diagnosis is made at a later stage, Triple Pelvic Osteotomy (cutting the pelvic bone in three places and rotating the segments to improve coverage of the ball) or total hip replacement surgery is required. These are major surgical procedures. If surgery is not an option, the dog may need lifelong pain relief medication.

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Puppies with hip dysplasia may have weak upper thighs that lack muscle mass.  They may also take short, hopping steps especially when running fast.

WHAT IS JPS surgery?

In JPS surgery, the goal is to achieve a better congruency (fit) of ball and socket. This is done by “fusing” the growth plate of the pubic bone to limit the growth. The hip socket is forced to rotate over the ball (femoral head) as it grows.

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A small incision is made between the hind limbs to expose the pubic bone of the pelvis.

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Image 1: The growth plate is cauterised (burn with electrocautery) to stop this part of the pelvis from growing. Image 2: As the remaining parts of the pelvis continue to grow, the hip sockets rotate over the balls (femoral head) resulting in a more stable hip & less chance of future arthritis. (Ref: vetsurgerycentral.com)

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Dr Patrick Maguire, Veterinary Specialist in Small Animal Surgery, Mount Pleasant Vet Centre (Gelenggang) performed the surgery on Capers. JPS is more successful when there is significant potential for growth & thus, the opportunity to alter the hip growth. It is ideally performed at 16 weeks & no later than 20 weeks of age.

should my puppy be neutered at the same time?

Puppies should be spayed or neutered at the same time as JPS surgery, to prevent the breeding of dogs that carry the genes for hip dysplasia.

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Capers waking up from surgery. Exercise is restricted & we will see him in 2 weeks’ time for review & suture removal.

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.

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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.

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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.

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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]

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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

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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.

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

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

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“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