Buddy, a nine-year-old Havanese dog owned by a family in Dubai, is “like a puppy again, full of bounce and life” after undergoing open-heart surgery at a clinic in Abu Dhabi.
It is a stark difference from the beginning of the year when the much-loved pet was suffering from mitral valve disease, a condition that may have left Buddy with a life expectancy of less than one year.
“There were times of extreme fatigue which caused us great concern and we lived somewhat from day to day, never knowing when to expect the worst,” his owner, an Australian woman in Dubai, told The National.
Buddy was one of three dogs that this year underwent a mitral valve repair operation, a form of open-heart surgery, at the British Veterinary Centre.
New lease of life
It did not take long for the benefits of the complex surgery to become clear. “In an incredibly short period of time after the operation, we noticed a hugely significant change in Buddy – his energy levels changed significantly and continued to do so,” she said.
Buddy was referred to the clinic in Abu Dhabi by vets at Umm Suqeim Veterinary Centre in Dubai. The operations on the three dogs were carried out on different days by Dr Katsuhiro Matsuura, a clinical assistant professor in open-heart surgery at the University of Florida’s College of Veterinary Medicine. He flew to the UAE with his team to carry out the operations.
Dr Martin Wyness, founder and chief executive of the British Veterinary Centre, said the clinic was keen to offer the procedure “because there’s just nothing like it at all” in the UAE. “If people do want that surgery, they have to travel internationally to get it,” he said. “It’s not as if it’s an unusual thing that we’re coming across. It’s the most common heart disease in dogs – we see it every day in patients.”
The disease involves progressive degeneration of the mitral valve, which separates the left atrium from the left ventricle of the heart.
In the UAE, mitral valve repair costs Dh75,000 ($20,420), although this is less than half as much as in the US, where it can cost between $45,000 and $50,000.
When the left ventricle contracts, it pumps oxygenated blood into the aorta, which distributes it around the body.
With mitral valve disease, the valve becomes “thickened and lumpy”, causing it to leak blood back into the left atrium and creating a heart murmur, the UK veterinary charity PDSA said. Drugs can help, but their effects may not be long-lasting.
“When blood gets pumped back the way it came, it stops going round to way it’s meant to,” Dr Wyness said. “The pressures of the heart changes, the shape of the heart changes, the muscle changes.
“The heart adapts a certain amount and the medicines accommodate a certain amount. But overall, as the heart adapts, it’s getting into chronic progression of disease and the adaptations only work for a certain amount of time.”
Smaller breeds of dog, notably the Cavalier King Charles Spaniel, are most at risk from the disease, Dr Wyness said. Dogs will show few outward signs of the condition in the earlier stages, but it becomes apparent when vets listen to the animal's heart using a stethoscope. Other techniques, such as ultrasound, confirm the diagnosis.
As the condition progresses, the dog may become lethargic and there may be breathing problems.
Surgery is crucial
Heart failure or pulmonary oedema – when fluid builds up in the lungs – often develops and, while medicine can increase life expectancy, Dr Wyness said they tended to become less effective over time. Life expectancy could be “very limited”, he added,
“Eventually the drugs stop working,” he said. “We know it’s a progressive disease with an outcome that will be heart failure eventually. That will typically be within a couple of years of diagnosis.
“The surgery is what offers the actual cure. If you get that right you need either no medicines at all thereafter or maybe smallish amounts. The results we’ve had have been phenomenally successful so we’re likely to keep this going and build up case numbers as time goes by.”
One of the three dogs operated on was thought to have less than a month to live at the time because the medication was no longer working. “Within days of the surgery, the energy level was better than ever before and we knew the whole thing was a success. It was lovely to see,” Dr Wyness said.
The operation, which typically lasts at least four hours, involves stopping the heart and tightening and replacing chords that attach the valve to the organ. “The level of expertise to perform this is high,” Dr Wyness added. “It’s not something that you can learn in a short course. It’s something that you need to have done many cases before you are going to be confident enough to do it on your own.”
Team effort
Dr Wyness said the Small Animal Blood Bank in Dubai, run by Dr Dorian Gaeta, played an important role in ensuring the operations could happen. It was a major undertaking for the clinic to offer the surgeries, not least because the project required significant investment in equipment.
“You’re stopping the heart during the surgery with cardiopulmonary bypass and then restarting it once you’ve fixed the valve,” Dr Wyness said. “This requires lots of expertise in terms of our anaesthesia and our equipment, lab equipment, and monitoring.
“Post-op care is extremely important because the first day or two after surgery are crucial. If you get through those, the chances are everything is going to be fine. There’s a tremendous amount of work in these cases. It’s a big job.”
The British Veterinary Centre plans to carry out more mitral valve repair operations this year and hopes more pets are referred to the clinic from the UAE and abroad. Dr Wyness said many of the clinics elsewhere that offered the procedure were oversubscribed.
The PDSA said it was vital that dogs from at-risk breeds or that have mitral valve disease should be kept slim and be taken for regular short walks. The charity advises against taking such pets on longer walks because this could put the heart at risk.
Buddy, who lives with his brother, Dash, from the same litter, is back enjoying life. “He is loving, sweet, obedient and playful,” his owner said. “He is a super special dog, we would have been absolutely devastated if he was not still with us.”
