How risky is heart surgery for puppies?

April 27, 2012 11:00 AM

What are survival rates like for dogs or puppies undergoing heart surgery?

We have a newly acquired (from a rescue organization) Bichon Frise puppy who has a pronounced heart murmur, and a slightly enlarged heart. The vet who has provided us this information is by his own testimony not an expert on cardiac problems, and in order to get a more precise diagnosis we'd probably have to travel at least 4 or 5 hours away. The puppy has no other symptoms of trouble...no trouble breathing, no fainting, no failure to grow, no lack of energy, no lethargy, good appetite, etc.

In the event that we do travel for a more specific diagnosis, virtually everything that the problem might turn out to be can be corrected only via surgery. So...how risky are cardiac-related surgical procedures for puppies?

posted by Ipsifendus to Pets & Animals (4 answers total)

I had a dog that had a heart murmur. She was a Rat Terrier. She was the most athletic dog I ever owned, until I got my Vizsla. She was monitered when we went for vet visits, but over all, it was not a big deal. Keep their heart and body as healthy as possible and they will live a long life. My girl died from other causes, but at that point she was 12. My personal opinion, which was my vets opinion also was to "let them run until the end" even if that means she had a heart attack, I would know she had a full and happy live.
posted by brinkzilla at 11:54 AM on April 27, 2012

My dog underwent open-heart surgery at 14 months. We were advised that survival rates are "very high," but success rates (ie, effectiveness of the procedure) were 80 percent or less.

You don't have to make the decision about surgery until you've visited the cardiologist and have a better understanding of the defect and the risks involved.

We were fortunate to have a qualified cardiologist local to us who could perform the necessary tests (several sonograms, basically) and offer a diagnosis. We drove from Long Beach, CA to Fort Collins, CO (Colorado State Veterinary Teaching Hospital) for the surgery.

Doughty's surgery cost just over $5k -- a little more than expected due to minor post-operative bleeding. Had the surgery required the use of a heart-lung machine (needed for lengthy stoppages of the heart), the cost would have tripled.

Here's my writeup, with way more details than necessary:

Pulmonic Stenosis is a congenital obstruction in the right heart that restricts the flow of non-oxygenated blood out of the heart, into the pulmonary artery and on to the lungs for oxygenation. The condition leads to an enlarged heart (“hypertrophy”) and eventually failure and sudden death. The degree of obstruction is determined by measuring the pressure gradient on either side of the obstruction using echo-cardiogram. A normal pressure gradient in the area is 4 mmHg (“millimeters of mercury”). A moderate obstruction reads 4-50 mmHg, and is not considered dangerous. A gradient of 50-80 mmHg warrants treatment with medication. At 80 mmHg, surgery is considered.

At nine months, Doughty measured 90 mmHg. At 13 months she measured at 124 mmHg. Monday October 12th, the day before surgery, she measured at 151 mmHg. Obviously, this wasn’t moving in the right direction.

She was 14 months old.

Here’s an abstract of a journal article that describes a procedure similar to the procedure my dog underwent, written by the surgeon who did both. Basically, Dr. Orton pre-positioned a 1 1/2″ by 3″ Gore-Tex patch over the obstructed area and then stopped the flow of blood through her heart (“inflow occlusion”). With blood flow blocked, he made an incision under a gap he left during pre-positioning of the patch, closed the gap and restarted blood flow. Blood flow was stopped for about a minute. From beginning to end, the surgery lasted almost three hours.

“Very smooth,” he said afterward. “Usually it’s a fire drill during occlusion.”

The patch will become the new “wall” of the right ventricle outflow tract. The dog’s tissue will intertwine with the Gore-Tex fabric and eventually cover it altogether. The surgeon did not remove the obstruction; he increased the circumference of the outflow tract, obstruction and all, creating a bigger channel for blood to flow through. A preliminary echo done the day after surgery measured a pressure gradient of 40 mmHg. It was a good result — much better than expected. A second echo two days after surgery showed 36 mmHG. We’ll need to do another echo in December to confirm the result.

Dogs recover from major surgery much quicker than people do. Doughty was out of the hospital the next day, in fact. She looked like hell all shaved and stitched (“Franken Terrier”) and she probably felt that way, but less than 48 hours after surgery, she was already back to fetching and barking at strange noises. They are durable little creatures. We were cleared for the long drive home on Friday October 16th, three days after surgery.

Doughty's still with us, nearing her fourth birthday. The surgery did not correct the defect as well as we'd hoped. Her past several pressure gradient tests have been in 90-100 mmHG range. High, but holding steady. And, so far, hypertrophy (enlarged heart) is not apparent.

Good luck to you and your pup.
posted by notyou at 12:05 PM on April 27, 2012

It is really going to depend on the surgeon, the anesthesia used, the monitoring and concurrent adjustments needed to medications/fluids/oxygen/etc., and the condition of the dog. If you have a university with a veterinary program within a day or two's drive, that would be my suggestion to you for best possible outcome. Keep in mind that many heart conditions can be managed very well medically with some of the newer drugs available to us.
posted by biscotti at 6:41 PM on April 27, 2012

Oh, and obviously the primary consideration is the actual diagnosis!
posted by biscotti at 6:41 PM on April 27, 2012