Our Community

Brendan was still young when his vet picked up a loud heart murmur during a routine appointment at his daytime family practice.

An echocardiogram (ultrasound scan of the heart) was performed, which identified the thickening of the heart wall muscle on the right side of Brendan’s heart, known as right ventricular hypertrophy. This usually occurs due to high pressure inside the right-heart chambers.

At this point, Brendan wasn’t showing any obvious signs of cardiac disease and was being carefully monitored by his family. A couple of months later, his carer noticed that Brendan’s tummy was distended (bloated), and that he was struggling to exercise. Brendan’s family took him back to his daytime family practice to investigate this, and his distended abdomen was found to be filled with fluid (ascites) due to the development of right-sided heart failure.

Brendan was immediately started on medication (diuretics) to help remove excess fluid from his body and was referred to The Ralph’s Cardiology Service for further investigations and management of his heart condition.

Our Cardiology team performed a full examination, including measurement of his blood pressure and a full echocardiographic assessment, which confirmed that Brendan was affected by a severe form of pulmonic stenosis, complicated by congestive heart failure. 

Pulmonic stenosis is one of the most common congenital (present since birth) cardiac defects in dogs. It is caused when one of the major valves in the heart – called the pulmonic valve – does not form properly and is therefore narrowed. This obstructs the flow of blood from the heart to the lungs. 

Dogs with this condition do not always show symptoms, but are at risk of developing exercise intolerance, syncope (fainting), congestive heart failure and, in some instances, sudden death. Pulmonic stenosis can be seen in any dog breed but Bulldog breeds, Beagles, Samoyed, Fox Terriers, Miniature Schnauzers and West Highland White Terriers are all predisposed to the condition.

Typically, pulmonic stenosis is treated using a minimally-invasive cardiac intervention called balloon valvuloplasty. Interventional cardiac procedures use advanced techniques via a “key-hole” approach to allow access to the inside of the heart and great vessels using a series of wires and catheters passed through arteries and veins. This approach removes the need for open-chest or open-heart surgery.

However, because Brendan’s pulmonic stenosis was associated with a hypoplastic pulmonary artery (where the main artery from the heart to the lungs is underdeveloped), Brendan required a relatively new and minimally invasive interventional procedure called transvalvular pulmonic stent angioplasty. A stent is an expandable metal mesh tube that, when left inside the artery, helps keep it open.

Check out these fluoroscopy stills from Brendan’s procedure…

 

This procedure is currently only performed by very few centres in Europe and our cardiology team here at The Ralph is proud to be one of these experienced groups.

Brendan’s procedure was a success! 

After a smooth recovery, Brendan stayed in hospital overnight and was discharged home the next day for a couple of weeks of rest.

Brendan returned to see our Cardiology team for a check-up 6-weeks later, and his family reported a huge improvement in his energy levels and symptoms.

Follow-up echocardiographic assessment showed the stent to be in the correct position and functioning well to alleviate the obstruction to blood flowing to Brendan’s lungs. Brendan is now a happy and playful chap, and we can’t wait to see him again for his next check-up in a couple of months; stay tuned!

Brendan’s mobility has greatly improved since his surgery and it’s lovely to see him gently jogging.

Thank you for reading Brendan’s incredible story. For more information about our Cardiology team and the services we provide, head to our Cardiology Service page!

Take care,

Team Ralph 🐾