Bane is a Yorkshire Terrier that was first presented when he was 6 months old. He was a happy, active puppy but the owners observed him having a syncopal (fainting) episode while he was playing. They immediately brought him to NIVES for an evaluation.
On examination, Bane was bright and alert but had a grade 5 of 6 continuous heart murmur. The emergency clinician was concerned about a congenital heart defect and recommended radiographs (x-rays) to evaluate his heart size and lungs. Radiographs were done showing marked heart enlargement.
The following week, Bane was evaluated by the cardiology department. An echocardiogram (ultrasound of the heart) was performed to identify the cause of the heart murmur and heart enlargement. The echocardiogram showed the presence of a patent ductus arteriosus.
What is a Patent Ductus Arteriosus (PDA)?
During development, all dogs have a blood vessel called a ductus arteriosus. This vessel allows blood to bypass the lungs when the puppy is still developing in the uterus. Shortly after the puppy is born, the dynamics of the cardiovascular system change and blood starts flowing through the pulmonary artery to the lungs instead of being shunted through the ductus arteriosus. The ductus arteriosus will naturally close off because it is no longer needed. In some puppies (and less commonly kittens), the vessel remains open (patent) causing increased work-load on the heart, progressive heart enlargement, and risk for congestive heart failure (up to 60% of dogs with a PDA will develop heart failure before a year of age).
Treatment for a PDA patient is to close the vessel to prevent permanent heart enlargement and heart failure. This can be accomplished through open-chest surgery or with a catheter-based technique. Both procedures provide successful closure; however, a dog’s size must be taken in to consideration when determining the best option.
Bane was only 3.5 lbs! He was too small for the catheter procedure so open chest surgery was recommended. An incision was made between his ribs on the left side of chest to visualize the PDA. Two sutures were placed around the vessel to stop the flow. This resulted in immediate resolution of the murmur. Bane did great during surgery and was monitored overnight in the intensive care unit.
The following morning, Bane was acting like a normal puppy again! He was discharged on oral pain medications with the plan to recheck his heart size in 1-2 months.
Bane did great after surgery! He had a recheck echocardiogram showing permanent closure of the ductus and significant improvement in his heart size! He did not require long term cardiac medications and should have a normal life expectancy for a Yorkie.
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