Lulu is a big bundle of soft, black fur who is full of happy energy despite having been born with a heart defect. The four month-old lab mix was recently transferred to the Humane Society for Southwest Washington (HSSW) from a shelter in Southern California.
As part of the Animal Shelter Alliance, HSSW makes a temporary home in their shelter for several hundred out-of-state animals each year. The majority of those animals have health issues.
Dr. Lauren Overman is the managing veterinarian at HSSW. With more than 5,500 animals entering their shelter each year, her team does a lot of spay and neuter surgeries, but they also diagnose and treat a wide variety of health issues. In a routine exam, prior to Lulu’s spay surgery, Dr. Overman discovered a loud heart murmur, so she referred Lulu to the OSU Veterinary Teaching Hospital for evaluation.
The Lois Bates Acheson Veterinary Teaching Hospital at OSU is equipped with a state-of-the art, 3D echocardiograph that allows doctors to view the inside of a patient’s heart in real time, as it is beating and pumping blood.
An echocardiogram of Lulu’s heart revealed a small hole between her aorta, the main artery in the body, and her main pulmonary artery. The hole is known as a left-to-right shunting patent ductus arteriosus (PDA) and is a normal vessel in a fetus, but should close within twenty-four hours of birth. That did not happen with Lulu.
In a healthy heart, blood returning from the body is pumped from the right side of the heart to the lungs to pick up fresh oxygen and then returns to the left side of the heart. The left side of the heart pumps the oxygen-rich blood out the aorta to the body. In Lulu’s heart, the PDA allows blood to flow from the aorta into the pulmonary artery, creating a ‘short-circuit’ or shunt from the systemic to the pulmonary circulation. As a consequence, the lungs and the left side of the heart see an increased amount of blood. This often leads to congestive heart failure before a dog is one-year old.
Dr. Courtney Smith is in her final year of a three-year cardiology residency at the hospital, and was assigned to Lulu’s case. She and the entire cardiology team, including Drs. Katherine Scollan, Nicole LeBlanc, and Julia Treseder, decided that Lulu was a good candidate for corrective surgery.
The funding to cover Lulu’s surgery was provided in combination from the College of Veterinary Medicine’s Olive K. Britt Hope Fund and the HSSW’s Chopper fund. The HSSW Chopper Fund was created to help shelter animals with costly medical issues and is supplied through the generosity of the society’s donors.
Amazingly, the surgery on Lulu’s heart was done without having to open her chest. First, a tiny incision was made on the inside of her right back leg, and a catheter was passed from the femoral artery into the aorta and across the PDA. This was done with the aid of a fluoroscope and echocardiography, which allowed Dr. Smith to view the interior of the heart on a screen as she operated. Once in place, the catheter was used to guide a specially designed wire mesh cylinder, called an Amplatz canine ductal occluder, into the open PDA. In a few seconds, blood began clotting within the occluder, and very quickly created a solid plug that stopped the blood flow through the PDA.
Lulu came through the two-hour surgery with flying colors. Chest x-rays and a recheck echocardiogram showed proper blood flow in her heart with no residual flow through the PDA. However, her caregivers will need to restrict her activity for one month while her device permanently adheres in place.
Meg Turnquist and Lucie Crane, fourth-year veterinary students on cardiology rotation, were assigned to Lulu’s care. In addition to monitoring her post-surgery condition and vital signs, they gave her lots of hands-on attention. “She already wants to run and play,” said Turnquist. “She’s mad at me because we have to keep her quiet in the kennel.”
Complex surgeries like Lulu’s are a valuable learning experience for veterinary students. Lucie Crane was pleased to be involved: “It was interesting to be able to hear that very classic heart murmur, and then to observe the procedure by which it was fixed. It was very rewarding to follow the case to completion.”
Lulu went home the next day to her foster family. “They will have their hands full trying to keep her from not being such an active puppy, now that she feels better,” says Dr. Overman.
Lulu’s prognosis is excellent. She will return to OSU in a month for a checkup, and then, if Dr. Smith gives the okay, she can return to normal puppy activity and be placed on the HSSW website where her darling face and sweet, loving personality will find her a forever home.
