PET DOCS: New procedures offer better prognosis for cardiac patients
- Pet Docs
- Posted: Sunday, August 12, 2012 12:01 a.m.
Just like our human counterparts, veterinarians are constantly improving what we can offer our animal patients.
Cardiac patients who in the past would have had dramatically shortened lives now can live a decade a more thanks to newer, minimally invasive procedures, which are available to treat myriad conditions.
Pulmonic stenosis is one of these. Dogs with this condition are born with a narrower pulmonary artery, which takes blood from the right side of the heart to the lungs. This will eventually cause the right side to fail, resulting in fluid accumulating in the abdomen, fainting and exercise intolerance.
Using fluoroscopy, which is a radiograph in real time, a veterinary cardiologist can guide a balloon down a vessel and to the narrowed area.
When in place, the balloon can expand the narrowed area allowing blood to easily pass through.
The earlier these are corrected, the better patients do as, over time, the heart changes may not reverse even after treatment.
Another congenital defect that can be corrected with this technique is a patent ductus arteriosus. In the womb, a puppy does not need blood to pass through its lungs. The ductus arteriosus allows blood that would have gone to the lungs instead to be diverted to the aorta.
At birth, this vessel should close so blood will fill the lungs and be oxygenated.
A PDA occurs when the vessel remains open (patent). Over time, this abnormal flow of blood taxes the heart resulting in heart failure.
Using the fluoroscope, a cardiologist is able to pass an occluding device down a vessel and into the PDA and close it off. The ability to do this means we no longer have to go into the chest cavity to tie this PDA with suture. This, too, should be corrected at an early age to prevent irreversible cardiac changes.
Heartworm disease is an ever-present problem for dogs in South Carolina.
Most dogs can be treated with a medication that kills the worms.
Occasionally, a dog will have so many worms that it cannot wait for the medication to work.
Here again the cardiologist can pass a grasper down the jugular vein and into the heart, using the fluoroscope as a guide, and extract the worms.
This does not remove every worm but decreases the worm burden enough to where the dog can tolerate the medication to kill the remaining worms.
While working in our North Charleston practice recently, I (Dr. Perry Jameson) received a call that I was needed at the Mount Pleasant hospital to assist in putting in a pacemaker.
Three years ago, I would have been trying to stabilize this patient myself and then send the family to the veterinary school in Raleigh, N.C., hoping the dog would survive the trip.
This time, however, our cardiologist, Dr. Ryan Baumwart, only wanted me to provide an extra set of hands.
He had a 1-year-old Labrador/chow mix that was collapsing every 5 to 10 minutes.
Her heart was either stopping because of 10-15 seconds of sinus arrest or racing with episodes of ventricular tachycardia.
We had to try to get her heart beating at a normal rate and rhythm soon.
He made a small incision in her neck to expose her jugular vein. He then inserted the pacemaker down this vein and into her heart. During the mere minutes it took to get the pacemaker in place (it felt more like an hour), she was going in and out of her arrhythmias.
Once it was in place, Baumwart connected the pacemaker, and her heart rate immediately normalized. It took about another 15 minutes for my heart rate to get back to normal.
About an hour later, this dog that could not go five minutes without fainting was up wagging her tail and barking for attention.
“Without the pacemaker, she would have died. We really had no other choice,” Baumwart said following the procedure.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.