Truffle is a 5 month old and extremely cute Chihuahua. During Truffles first health checks with her primary vets, a heart murmur was heard. A heart murmur is caused by the abnormal flow of blood through the heart, for example, blood travels in the wrong direction.
There are many different types of heart murmur. Sometimes the category of heart murmur can indicate the underlying reason however we can never truly make this diagnosis without scanning the heart. This assesses its structure, function and direction of blood flow.
As Truffle was so young it was important to check for any heart defects that can occur at birth, this is also known as congenital. Truffle was referred to a cardiac specialist. The cardiac specialist scanned Truffles heart and diagnosed her with a Patent Ductus Arteriosus (PDA).
The ductus arteriosus is a blood vessel that should close itself after birth. The vessel connects the aorta and the pulmonary artery. If the vessel remains open, some of the blood which is meant to be carrying oxygenated blood towards the body travels in the wrong direction . This reduces the amount of oxygenated blood the body receives. Initially Truffles body will compensate to cope with this and luckily truffle was coping very well with her heart defect. However, it can eventually lead to remodeling of the heart and congestive heart failure.
Closing the defect at an early age can give an excellent long term prognosis. However, as Truffle was so small this abnormal vessel would need closing surgically. Open chest surgery is very advanced and this would need a specialist soft tissue surgeon and intensive post-operative care. At this point Truffle was transferred to the care of Hollybank Veterinary Centre where a specialist soft tissue surgeon would perform the operation.
The surgery itself would be extremely intricate. One of the highest risks would be bleeding, therefore we had to ensure this was taken into account within our pre-operative plan. If an animal experiences large volumes of blood loss then a transfusion is required. To prepare for this we blood typed Truffles blood. We then collected a donation from one of our matched donor dogs. Truffle was then ready for her operation!
During the surgery it was important to monitor Truffle very closely. Our role was to ensure a stable anaesthetic and provide adequate pain relief. To expose the heart, important vessels and nerves had to be carefully identified and moved to one side, as you can see in the picture. The surgery was a great success and the PDA was closed!
Although the largest part was now over for Truffle, her post-operative care would be just as important. As the surgery was performed in close proximity to so many vital structures a chest drain was placed to monitor for delayed haemorrhage, development of inflammatory fluid and leaking of air. Truffle was hospitalized; her drain, heart rate, respiration rate and general demeanour were checked every couple of hours and her pain relief was provided regularly.
Over the next few days Truffle recovered remarkably well. The chest drain was removed and her surgical wound was healing really well. Most importantly, her heart murmur had now disappeared!
Within 2 days post-surgery Truffle went home with 6 weeks strict rest; her family were extremely pleased to have her home. Despite her tiny size, Truffle made a very big impression on us all at Hollybank Veterinary Centre!