Jasmine Clinic Webinar

Last year we were honored to attend a webinar Dr. Sayaka Takeuchi, Dr. Masami Uechi and other vital staff at the Jasmine Clinic hosted. They were gracious enough to host and recorded the seminar to educate our Mighty Hearts families on what is canine mitral valve disease (MVD) and repair (MVR).

Topics discussed included:

• Candidacy

• Risk factors

• Steps of the procedure and a visual of the components of the heart and chambers and what the repair surgery entails.

• Most importantly the latest statistics achieved by the Jasmine clinic in 2021, (2024 Statistics remain the same as 2021).

Please watch the video below. We appreciate your support, as we continue to support you and your beautiful family members.

The Mighty Hearts Project Team

The Raw Entrepawneur Interviews Mighty Hearts Project

The Raw Entrepawneur

The Raw Entrepawneur looks at the transformative journey of holistic pet service entrepreneurs, overcoming obstacles, chasing their passion and creating a mass movement. This show is for holistic pet service entrepreneurs who are passionate about their craft and want to create an impact and change the world. To help them learn from other entrepreneurs to give them the confidence to start their own journey of growth, self-discovery and creating a movement that's changing the lives of clients and their pets to create a ripple effect of positive change around the world. A raw uncut look at the journey of fellow holistic pet service entreprenuers – their successes and failures.

I was honored to recently be interviewed by Amrys Wang from The Raw Entrepawneur where we discussed how Mighty Hearts Project came to fruition and about my daughter Zoey Marie Estes’s two mitral valve repair surgeries. This is our journey, I hope you enjoy it.

Nate Estes

Zoey Marie's Second MVR Surgery

In this video you will see Nate Estes's daughter Zoey Marie Estes undergo her second Mitral Valve Repair surgery procedure. Nate Estes is one of the original...

I wanted to share Zoey’s second mitral valve repair surgery video. Thank you to Dr. Masami Uechi, Sayaka Takeuchi, Ayaka Chen and the entire Jasmine team for your unbelievable dedication towards saving my daughters life not once but twice. You all have saved so many lives of dogs suffering with mitral valve disease and for that we are forever grateful and hold you all dearly in our hearts. Below is Zoey’s brave second journey story.

Zoey’s second surgery journey

Just after two years since having her first mitral valve repair surgery in France by Dr. Masami Uechi and the Bozon’s team we noticed Zoey was again progressing from this dreadful disease at each checkup things kept looking different. I was actively working with the clinics in France and Japan to understand what was going on with Zoey to cause this. After a few difficult months of piecing it together we realized Zoey may have torn a major artificial chordae that was placed during her first surgery in France in 2016.

Proactively I already started the Japanese quarantine process which is a six-seven month waiting period proving rabies immunity before you are allowed to enter the country. We found ourselves yet again facing the possibility of doing another bypass repair surgery on Zoey, otherwise she probably wouldve only had a year left to live as she was already moving towards congestive heart failure (CHF), she was only seven years old now.

So we prepared for Japan per Masami Uechi’s request. The day came to embark on our second mitral valve repair journey, this time a different continent. Much like the first, we were prepared for what lies ahead. We arrived a week early to acclimate Zoey and had our pre-op surgical appointment with the wonderful Sayaka Takeuchi. We were faced with the scary truths about the risks involved in this second surgery and needed to make a heavy decision on whether we would again proceed. Obviously with Zoey quickly advancing and knowing the road that was ahead we placed our unwavering faith in Dr. Masami Uechi and his team and our faith in god and decided to proceed ahead to save our little daughter again.

We were told second surgeries were rarely performed and they weren’t even sure on how successful it could be. They were not sure why this happened to Zoey as it’s not very common unless a dog was to active early on in the recovery process causing a chordae to detach before allowing them the required three months time to scar and bond over the repair to the heart further reinforcing the repair. Was it a weak heart muscle or stress we will never know. All I know is here we are again faced with the same fears a little over two years ago.

Surgery day came and I won't lie that I was a complete wreck internally, outwardly I was holding it all together for my family that needed me to be the rock. As they took Zoey away from me yet again, a wave of calmness went through my body because I knew I gave Zoey’s little body the best chances at fighting this again and I knew the team cared deeply about us and would save my daughters life again, I had no doubts in my soul.

Surgery started, sitting again in that lobby, knowing my daughter was clinically dead for the second time was the most difficult thing I had to witness for the second time in my life. As you sit in the lobby you find yourself reading each doctors reactions as they come and go gauging how it’s going inside the surgical room. It’s such a heart-wrenching feeling. Sitting in the lobby waiting and seeing how many more dogs are coming in to be examined as future patients is devastating and makes you realize how much of a problem this disease is worldwide.

Finally

Dr. Masami Uechi comes out to bring you back to the surgical theater to explain to you how it all went “heart sinking” he tells us all went as planned and Zoey is off the bypass machine and being closed up by the team. As Dr. Uechi shows us the repair results we are crying in relief and amazement of what this beautiful man and team just did again saving our daughter.

We are lead to the back of the room to see Zoey being stitched up and Dr. Uechi is explaining what the vital signs on the monitor means, blood pressure, heart rate, etc. We are thrilled yet worried as the recovery is just as crucial as the surgery. They did their job and now Zoey’s body and the recovery team start theirs. What a roller coaster and miracle.

As Zoey was moved to recovery and we were able to see, I again had to be the rock holding us all together to see her through this. As the days went on we strengthened Zoey with proper nutrition to get her numbers to improve from the natural bodies inflammation response to this intervention. Zoey did remarkably well and eventually was able to check out of the clinic and come back to our Airbnb. She did have to go back to the clinic a few times and the amazing team at the Jasmine clinic were able to get Zoey’s numbers yet again stabilized.

Headed home

Zoey persevered through all the obstacles against her for the second time and we got to go home. After a much needed rest at our home in the US, we went for our checkup with Dr. Emily Chapel at Access Specialty Animal Hospital and she was so impressed with how well Zoey was doing since the last time she saw Zoey before going to Japan for surgery. You always find yourself at each cardiologist appointment holding your breath because we’ve been here before and you never know what they are going to say in the future towards this progressive disease.

It’s been quite a life-changing journey for us and the immense support from the Mighty Hearts MVD Community was just amazing and a remainder of why I helped to create and continue to maintain this important resource. This experience has only further strengthened my determination at dedicating my life to this cause to save more of our babies lives and to continue helping all the families get through this as gently as possible. Mighty Hearts Project needs all of you working together with us for the common cause of advancing this procedure all over the world.

One thing I’ve learned is just how important it is for us to support these doctors learning this surgery. As they make it more readily available throughout the world, we must advocate for them in doing this procedure in the proper manner increasing the lives saved as they all advance in these emerging programs. I truly hate this disease and my resolve is strong to continue to grow our organization towards helping all of those we support. It won’t be perfect and I’m sure many bumps will happen along the way. To learn is to grow and sometimes letting the path lovingly guide you to where it needs you is what I’ve learned.

My little daughter is alive and inspiring myself and many others along the way to never quit in life until your soul is needed elsewhere. I love all of you and and will never quit in my resolve to seeing you all through your difficult journey’s to hopefully come home with your babies on the other side of this terrible disease.

Cindy Dunston Quirk Interview

Interview with Cindy Dunston Quirk (Owner) of Scout & Zoe's to discuss some of the amazing treats that she makes. Cindy will explain the importance of sourcing quality treats for your companion animals. Those that know me understand my passion for animal nutrition.

I had the absolute pleasure of Interviewing Cindy Dunston Quirk (Owner) of Scout & Zoe’s to discuss some of the amazing pet treats she makes. Cindy explains the importance of sourcing quality treats for your companion animals.

I really feel it’s important for pet parents to maximize our pet's health by feeding fresh whole foods and quality treats free from any harmful additives. In today’s market you will find a lot of treat ingredients filled with unnecessary additives like, BHA (Butylated Hydroxyanisole), BHT (Butylated Hydroxytoluene), Ethoxyquin (It’s Illegal to use this in human foods in the US), Food Dyes (Blue 2, Red 40, Yellow 5 and 6, 4-MIE), PG (Propylene Glycol) and rendered fats. These ingredients have been linked to many diseases like cancer, kidney, liver and other organ failures in laboratory animals and humans. So read all your treat labels carefully and know your sourcing. Only use companies that are a hundred percent transparent in the making of their products or I personally wouldn’t use that company.

The industry regulators (AAFCO, FDA) aren't doing a good enough job protecting our pet's from these unsavory ingredients and have allowed these companies to use these harmful products on our pets to avoid proper disposal in a landfill. It’s common sense that a poorly sourced diseased animal in the making of these products will not yield optimal health in your animals so we must be very careful when selecting the brands we choose for our animals because the big industry has led us astray. We must all do our own research and become our pet’s advocates to ensure they live long, rich fruitful lives they so deserve.

Cindy is a beautiful example of what a reputable and responsible company should do in the sourcing and manufacturing of a product for our companion animals. I wanted to highlight companies like Scout & Zoe's because a change is needed in an out of control industry that’s only getting worse. I hope you enjoy the information we have provided. #KnowBetterDoBetter

Interview with Dr. Judy Morgan, DVM, CVA, CVCP, CVFT

In this interview we discussed the importance of proper pet nutrition, supplementation in regards to heart disease specifically related to mitral valve disease (MVD). We also briefly covered the controversial DCM issue.

I had the pleasure of interviewing Dr. Judy Morgan, someone I deeply respect in the holistic veterinary community. Dr. Morgan received her Doctorate of Veterinary Medicine degree from the University of Illinois College of Veterinary Medicine in 1984.  Dr. Morgan is also a certified and accredited veterinary acupuncturist, chiropractitioner, and food therapist.  She offers an integrative approach combining holistic medicine with traditional Western techniques. 

An integrative approach combines the use of traditional veterinary medicine with complementary therapies. It involves minimizing the overuse and misuse of conventional medications. Integrating therapies like chiropractic, acupuncture, physical therapy, cold laser, nutritional therapy, and Chinese or Western herbal therapies may allow the use of far fewer traditional medications.

As part of her holistic practices Dr. Morgan provides such treatments as chiropractic, acupuncture, food and herbal therapies, all are utilized alongside conventional medicine to provide a full range of veterinary treatments.  In addition to all these amazing achievements Dr. Morgan is a best-selling author of four books on holistic pet care and feeding, hundreds of online and print magazine articles, and hosts her own Naturally Healthy Pets radio show.  Dr. Morgan’s goal is to change the lives of pets by educating and empowering pet owners worldwide in the use of natural healing therapies, minimizing the use of chemicals, vaccinations, and poor quality processed foods.

In this discussion we talk about the importance of proper pet nutrition, holistic supplementation in regards to heart disease and heart disease specifically related to mitral valve disease (MVD). We also briefly covered the controversial DCM topic. I hope you enjoy this important information and learn just how vital proper health and nutrition is for our companion animals lives. We must do better by advocating for our animals so they may have happier, healthier fuller lives by minimizing the amount of environmental toxins they are exposed to on a daily basis. Consider the products you use at home and look into safer alternatives. My favorite saying is, know better do better.

Zoey's MVD Journey

Zoey’s Mighty MVD Journey

Me and my wife’s journey as pet parents began back in April of 2011. That was the day Zoey Marie came into our lives. You see, Zoey was our first adult companion animal. Boy were we in for a lesson in parenting. I realized taking care of a puppy was a lot like taking care of an infant human child. I did everything right, we immediately purchased pet insurance and took her for her wellness exams, she was always fed fresh foods. Unfortunately, Zoey had early onset patella issues and at the age of two needed corrective surgery for her grade four patella.

Zoey bravely recovered through these procedures and continued on to better days, runs in the park, beaches and many family outings. Then everything changed back in July of 2016 when at our routine vet visit Zoey was diagnosed with a grade four heart murmur. The vet did a series of X-Rays and noticed her heart was very enlarged. They recommended we see a Veterinarian Cardiologist to further investigate her issue right away. This was when our lives forever changed towards the path we now live today.

At our cardiologist appointment Zoey was given the diagnosis of Myxomatous mitral valve disease (MMVD). Let’s just say we were told no surgeries worked in the USA in the past and that our best options were to medicate Zoey with the intent of delaying congestive heart failure (CHF) which would ultimately lead to her early death. Zoey was just five years. I remember that day so well. My cardiologist drawled on the whiteboard Zoey’s prognosis. By his estimate she had about three months before congestive heart failure and maybe a year total. I took a picture of that and look at it almost every day to date. We departed the clinic with new medications in hand crying as we left with no hope in our hearts.

 It was then after days of crying, researching, crying some more I found the hope I was looking for. We found the one silver bullet option we needed to believe in when nobody else around would. I found an article written by a writer from Cornell University about a man named Dillon Raskin and his dog Esme. In this article I learned Dillon found a man by the name of Masami Uechi who invented and pioneered mitral valve repair surgery in dogs and was performing this surgery in Japan and France at that time. Needless to say, I found hope in my darkest moments.

After contacting this author my phone rang and to my surprise Dillon was calling me after the reporter reached out to him. Naturally I asked Dillon a million questions like we all do and eventually I was able to figure out how to contact the clinic in France where Masami Uechi and his team from Japan were performing his surgery in collaboration with a French team at their clinic called Clinique Veterinaire Bozon. Finally, I found hope and a path other than watching my daughter deteriorate in front of my eyes.

I just missed the surgery in France as they performed them every two months, typically about 5-6 dogs each time. After confronting my cardiologist about this surgery, he admitted it did exist and didn’t know much about the surgery’s success (We immediately looked into a new cardiologist). Now after being in touch with the French team we had a surgery date scheduled and starting down the road to saving my young daughters life. After many personal bank loans, personal sacrifices and reassurances through reputable veterinarian schools this was all legitimate we wired the funds and were well on our way towards Zoey’s mitral valve repair surgery in France. After a few thousand dollars of tests to see if Zoey was a candidate, we had a scheduled surgery date of October 26th, 2016, a three month wait.

The day came for us to travel after all the test, export paperwork to leave the country with a dog we were well on our way. After arriving in France and going to the clinic for our first pre-op appointment to assess Zoey before surgery the only way I can tell you how that feels is like open the gates of heaven and you’ve arrived home to the one place that never gave up on you and your dreams of saving your child. During this emotional roller coaster, we found strength in others like us that have also traveled from all over the world to save their children.

As we bonded with complete strangers over dinner with our pups we talked about our similar experiences and struggles, we found support and comfort in each other that we were not alone anymore. It was then through this experience the meaning of Mighty Hearts Project was created in my heart and soul. I found myself compelled to helping these brave people that would fly to the ends of the earth as I did for their children. As each surgery day arrived, I needed to be with them easing their minds from the pain and the worry of what’s taken place in the next room. You see as they were performing surgery, they would update you periodically as to how it was going, they would send you pictures from the operating room of your dog’s heart being sutured.

Slowly as each dog was saved and now my day was next. A part of me wanted to run away and take my daughter far away like she’s healthy and doesn’t need this surgery. I composed myself taking a deep breath, I gathered my senses and said goodbye to Zoey with the fear of never seeing her alive again. Now I became the one who was the supporter needing the support. My wife and my newly found families were there for me throughout Zoey’s surgery and made the waiting bearable. Then I started to receive picture updates on my phone of my daughters’ actual heart, I was falling apart inside thinking why does such a beautiful soul have to go through this. Finally, Dr. Sabine Bozon came out to tell us Zoey made it, her heart restarted via a pacemaker and she’s now off the bypass machine and being slowly woken up. The feeling I felt describable. My daughter is alive!!!

I was able to see Zoey soon after that from another room near the operating theater. Seeing these heroes repaired that repaired her heart when nobody else in the world could I wept. An hour later we saw Zoey in recovery and each day she slowly improved until a week later she finally came home to our temporary apartment. We finally came home back to the US after a post-op appointment to verify Zoey was fit to fly home and followed the required three months post-op of no running and jumping. We did it, we saved my daughter’s life when everyone in the US I spoke with said it wasn’t possible.

Zoey’s second repair surgery

Sadly, just after two years from having her mitral valve repair surgery in France with Dr. Masami Uechi and the Bozon’s team we noticed Zoey was again progressing from this dreadful disease at each checkup things kept looking different, her valve sizes were increasing as well as the regurgitation from moderate to severe. I was actively working with the clinics in France and Japan to understand what was going on with Zoey to cause this. After a few difficult months of piecing it all together we realized Zoey may have torn a major artificial chordae tendineae that was placed during her first surgery in France in 2016. It seemed to have torn away from her heart muscle wall.

Proactively knowing what the only thing we could do; I started the Japanese quarantine process which is a six-seven month waiting period proving rabies immunity before you are allowed to enter the country. We found ourselves yet again facing the possibility of doing another bypass repair surgery on Zoey, otherwise she probably would’ve only had a year left to live as she was already moving towards congestive heart failure (CHF), she was only seven years old at this time and very healthy otherwise.

We prepared for Japan per Sayaka Takeuchi and Masami Uechi’s request. The day came to embark on our mitral valve repair journey, this time a different continent. Much like the first surgery, we were prepared for what lies ahead. We arrived a week early to acclimate Zoey to the new environment and we had our pre-op surgical appointment with the wonderful Sayaka Takeuchi. At the appointment we were once again explained and faced with the scary truths about the risks involved in this second surgery and that we needed to make a heavy decision on whether we would again proceed. Obviously with Zoey quickly advancing and knowing the road that was ahead we placed our unwavering faith in god, Masami Uechi and his entire Jasmine team and decided to proceed ahead to save our little daughters life again.

We were told second surgeries were rarely performed and they weren’t even sure on how successful it could be. Again they were not sure why this happened to Zoey as it’s not very common unless a dog was very active early on in the recovery process causing a chordae to detach before allowing them the required three months’ time to scar and bond over the repair of the heart further reinforcing the repair. Most likely as this is a progressive disease and surgery can’t cure the disease maybe it was a weak heart muscle as she did develop this disease at the early age of five or maybe it was stress induced because Zoey is very high strung, we will never know. All I know is here we are again faced with the same fears we experienced a little over two years ago.

Surgery day came and I won't lie to you that I was a complete wreck internally. I cried when I was alone and never outwardly showed it as I needed to be the rock for my family that needed me more than ever now. We departed for the Jasmine clinic and dreadfully arrived. After checking into the clinic, the doctors came out to get Zoey. As they took Zoey away from me yet again a wave of calmness went through my body because I knew I gave Zoey the best chances possible at fighting this again and I knew the team cared very deeply about us and would save my daughter’s life again at all cost, I had no doubts in my soul in their abilities whatsoever.

We were told not long after surgery started. Sitting again in that lobby, knowing my daughter was clinically dead for the second time because they would induce her heart to stop under bypass was the most difficult thing I had to experience again in my life. As you sit in the lobby you find yourself reading each doctor’s facial expressions as they come in and out of the area trying to gauge how it’s going inside the surgical room. It’s such a gut-wrenching feeling to be sitting in the lobby waiting, feeling helpless and seeing how many more dogs are coming into the clinic to be examined as future surgery patients. It is devastating and it makes you realize how much of a problem this disease is worldwide.

Finally, surgery results

 Zoey made it through her second mitral valve repair surgery. Dr. Masami Uechi comes out to bring you back to the surgical theater to explain to you how it all went “heart sinking” he tells us that everything went as planned and Zoey is off of the bypass machine and being closed up by the team. As Dr. Uechi shows us the repair results on the monitor in the little waiting room we start crying in relief and amazement of what this beautiful man and his team just accomplished. Again, they saved our daughter.

We were brought to the back of the surgery area to see Zoey being stitched up in the next room over and Dr. Uechi is explaining what the vital signs on the monitors means overhead, blood pressure, heart rate, etc. We are thrilled yet worried as we know the road to recovery is just as crucial as the surgery. They did their job and now Zoey’s little body and the recovery team start theirs. What a roller coaster ride and a true miracle to witness.

As Zoey was moved to recovery, we were able to see her again. As the days went on, we visited Zoey every day and we watched her getting stronger and stronger. Me knowing she wouldn’t eat for days I was prepared and feed Zoey with good proper liquid nutrition to get her numbers up to improve from the natural body’s response to inflammation after this intervention. Zoey did remarkably well and eventually was able to check out of the clinic and come back to our Airbnb. She did have to go back to the clinic a few times as her left lung collapsed and she also had a re injure of her left leg patella. The amazing team at the Jasmine clinic were able to get Zoey stabilized yet again.

Headed home

Zoey persevered through all the obstacles she faced against her for the second time and after a final check up we received the all clear to go home back to the USA. After much needed rest at our home in the US, we went for our checkup with Dr. Emily Chapel at Access Specialty Animal Hospital and she was so impressed with how well Zoey was doing since the last time she saw Zoey before going to Japan for surgery. You always find yourself at each cardiologist appointment holding your breath because we’ve been here before and you never know what they are going to say in the future towards this ever-progressive disease.

 It’s been quite a life-changing journey for us to undergo. The immense support from the Mighty Hearts MVD Community was just amazing and a remainder to me of why I helped to create and continue to maintain this important cause and resource for others to utilize. This experience has only further strengthened my determination and resolve at dedicating my life to seeing more of our babies’ lives saved. I will continue helping families get through this as gently as possible. Mighty Hearts Project to me is always and will forever be the embodiment of a group of brave loving beautiful people that come together for the common cause of helping others through this difficult disease. We hope to help advance this procedure by making it more widely available all over the world.

One thing I’ve learned is just how important it is for us to support these doctors learning this surgery. As the doctors work hard to make it more readily available throughout the world, we must also support them and advocate for them in this procedure so others can learn this in the proper manner increasing the lives saved as they all advance in these emerging programs. I truly hate this disease and my resolve is strong to continue to grow our organization towards helping all of those we support. It won’t be perfect and I’m sure many bumps will happen along the way. To learn and grow sometimes we must let the path lovingly guide us to where it needs us to be at that moment is what I’ve learned through all of this.

My little daughter is alive today because of this surgery and inspiring myself and so many others to never quit in life until your soul is needed elsewhere. I promise to always be that beacon of hope and I will never quit in my resolve to seeing you all through your difficult journey’s to hopefully come home with your babies on the other side of this terrible disease.

How to use the 711 ATM's in Japan

Here is a very quick video on how to use the ATM machines in japan when going to a 711 store. 711’s are literally everywhere and tend to have a much better exchange rate than other stores. It’s best to exchange your foreign money at the airport when arriving for the best exchange rates. As many of us will be in Japan for at least three weeks you will most likely need to pull cash at some point during your stay so hope this video is helpful.

Japan Pet Taxi Service

While traveling to Japan for my surgery I used a wonderful pet taxi service called  Yako doghouse that specializes in picking up pets and families from local airports (Haneda and Narita).  I must say it was a great and affordable experience.  The taxi fit three people and our dog on our lap as well as three large suitcases and a large dog stroller very comfortably.  Izu was the drivers name and he was very nice and offered to workout even taking us to our exportation appointment before leaving Japan,

“ The purpose of the exportation process is to have your pet inspected by the Japanese animal quarantine services ten days or less before your departure from Japan so they can be sure your dog is free of any signs of rabies.  You will be given a special certificate allowing you to show the airlines so your dog can be exported out of Japan properly, when arriving into Japan you will have a chance to setup that appointment while checking in with the animal quarantine services”

If anyone is interested in using this service here are pricing examples and booking instructions according to the website.  Please book a reservation before your arrival into Japan as well as pay in cash which is in the form of Japanese Yen, no credit cards are accepted and they will never asked for your credit card information when booking your reservation.

Yako Doghouse  - Japan Pet Taxi Service

Tel & Fax: (045) 573-0507

Facebook page

https://m.facebook.com/yakodoghouse/

Website

http://yakodoghouse.com/english/

I emailed and primarily used Facebook messenger with Izu and he sent me an agreement to fill out via email to officially book the reservation. Izu was at the airport holding my name up as soon as I departed customs.  I let him know via messenger when I arrived and when I was clearing customs.

Pricing information according to his website, 

Estimate to Tokyo,

7070 yen = 65.00 US, Cash only

Here is his about section of the companies website,

We offer the most effective, affordable and professional pet transportation alternative in Tokyo.

Our goal is to provide safe, reliable and stress-free transportation for your pets to and from appointments, the kennel or the airport (and more) we give you peace of mind.

Our staff can pick up your pet, take them to their appointment, and bring them home when they are done. Please contact the following e-mail address for an estimate inquiry.  Feel free to contact us with any questions or comments, we are always glad to here from you.

Special Price,

Haneda AirPort to Narita AirPort 20000yen (Highway fee Incl)

For example

Haneda AirPort to Tokyo Minato-ku Area 5520yen

(Highway fee Incl)

Haneda AirPort to Yokohama Station 6120 yen (Highway fee Incl)

Contact information

Yakodoghouse (Pet Taxi)

Hours：AM 08:30〜PM 18:00

(Please contact us for other than operating time)

info@yakodoghouse.com 

Lots of luggage space

Interview with Dr. Karen Becker, DVM

https://healthypets.mercola.com/?utm_source=youtube&utm_medium=video&utm_campaign=Content_NathanEstes Dr. Karen Becker interviews Nathan Estes from the Might...

I had the privilege of being interviewed by Dr. Karen Becker to discuss mitral valve disease. Dr. Karen Shaw Becker is the most followed veterinarian in the world. Dr. Becker believes in a deliberate, common sense approach to creating and maintaining vibrant health for companion animals and an unconventional, integrative approach to addressing disease and re-establishing health in ill pets. This refreshing, proactive approach that intentionally focuses on creating or restoring well-being has been embraced by millions of pet lovers around the world.

 Dr. Becker’s integrative approach to internal medicine and her passion for clinical pathology (tracking disease processes in the body), as well as her array of progressive diagnostics and innovative treatment protocols have earned her recognition as the world's most sough-after resource for proactive, integrative pet owners as well as the leading authority on animal nutrition and general well-being of pets.

Dr. Becker lectures internationally and writes about species appropriate nutrition on many platforms. She has co-authored the Whole Dog Journal’s Best Homemade Diet Book of All Time award, “Real Food for Healthy Pets.”  Dr. Becker consults for a variety of health and wellness companies, including www.healthypets.mercola.com, the largest pet wellness website on the internet. In her spare time she enjoys formulating fresh pet food recipes for transparent, ethical pet food companies and developing pet health products to improve the well-being of companion animals worldwide. 

I hope you enjoy the interview and please follow Dr. Becker and friends on all social media platforms to continue to learn more about her integrative approaches and modalities. Your companion animals with thrive from it.

Dr. Masami Uechi Interview

In April of 2018 the Mighty Hearts Team traveled to visit the state of the art Jasmine clinic in Yokohama Japan. Our mission was to further educate ourselves to better serve our community members. Drs. Masami Uechi and Sayaka Takeuchi were very kind to take time out of there busy schedules to allow us to interview them so that we may bring you the latest information about this amazing mitral valve repair surgery.  We tried to cover all the important topics, if you still have questions please leave them in the comments below.

Travelling by train in Japan using PASMO

PASMO

The simplest and easiest way to navigate the public and private transportation systems is to sign up for a PASMO card.  You can get one at any train station, but it is recommended to get one at the airport when you arrive as you will have a better chance of getting English speaking assistance there.

For those of you that will be traveling to the JASMINE clinic in Japan for your dogs Mitral Valve Repair Surgery we put together two videos on how to purchase a new PASMO card and how to recharge your card.

The video tutorial below will help guide you in the purchase of a new PASMO Card. You may also refer to the PASMO website for further documented instructions on how to purchase your card by clicking on this link, Purchasing a new PASMO card.

This next video will guide you on how to recharge your PASMO card when the card credit is low or empty. For additional step by step instructions please visit PASMO's website by following this link, Recharging your PASMO card.

When entering the train station gates simply touch your PASMO card to the reader to enter the station.  In the examples below, when a blue led light is displayed and you hear 2 beeps, you are clear to proceed.  When a red led light is displayed and you hear four beeps, this indicates your card wasn't read properly or you ran out of credit.  Simply go to the nearest machine and refill your card.  It's always a good idea to check your balance when leaving the gates.  Your balance is displayed on the LCD panel every time you leave a gate.

NOTE:  You can also use your PASMO card to purchase goods and services from retail stores that accept electronic money payments.  Look for the PASMO logo at checkout.

References

• What is a PASMO

• How to use a PASMO

• Buying a PASMO

• Renewing your PASMO

• PASMO FAQ

Requirements to become a surgical candidate for Japan

We all have been there… you bring your dog to the vet for a routine checkup or for what you suspected was a minor issue, only to be sent to the cardiologist and given the dreaded diagnosis of Mitral Valve Disease (MVD), possibly even Congestive Heart Failure (CHF), which lead you to research the disease and ultimately brought you to this site… If you have decided to have your dog evaluated for surgery with Dr. Masami Uechi at the Jasmine Clinic in Japan, please read on.

The first thing to understand is that over the past few years, there has been a spike in demand for the Mitral Valve Repair surgery from overseas clients, mostly from the US. There is currently only one fluent English-speaking vet at the Jasmine Clinic (Dr. Sayaka Takeuchi).   Dr. Takeuchi is responsible for coordinating surgeries for all foreign potential candidates. She corresponds with all foreign clients via email and by phone, compiles all the medical records, and evaluates each patient for surgery (new cases can take many hours to review). In her final steps, Dr. Takeuchi presents each case to Dr. Uechi for his final approval before recommending the surgical intervention.

Dr. Takeuchi then schedules surgeries for all foreign dogs, assigns each foreign dog to a primary recovery vet, and participates and translates in all foreign dogs’ surgeries and pre-op/post-op appointments. This is a tremendous amount of work for one person, particularly now with the dramatic increase in overseas interest. Therefore, email correspondence will take more time, as you can imagine. If your local cardiologist thinks your dog is likely going to be a candidate it is recommended starting the Japanese quarantine process while you wait for the final approval from the Jasmine clinic, (Your local vet office should know this process).

In order to expedite the evaluation process to get your dog closer to securing a surgery date, the following is a list of all testing needed:

Appointment #1 (with Cardiologist)

• Echocardiogram

• Chest X-ray (regular vet can perform)

Note: Each echocardiogram should always include an echo report, images, and still videos. Videos and still images are best delivered in AVI or DICOM format (via dropbox or google drive would be fine)

The following views are the most important to the Jasmine team when assessing for surgical appropriateness. While these views are standard to anyone trained in echocardiograms, occasionally some are missing from echo reports, delaying your candidacy review.   

• Right parasternal long-axis 4 chamber view

• Right parasternal long-axis 4 chamber view - color Doppler

• Right parasternal short-axis view papillary muscle level (M mode)

• Right parasternal short-axis view mitral level

• Apical 4 and 5 chamber view (with and without color Doppler)

• Have you Cardiologist email the files to Jasmine with you CC’d. jasmine.cardiology@gmail.com

Appointment #1 or #2

To be performed early, once it has been determined that your dog is a surgical candidate

• Full abdominal ultrasound: used to rule out potential surgical risks (This can be done by your local vets office and not a specialist, only the report is needed).

• Blood type (DEA 1.1 antigen): Needed in order to prepare donor blood for surgical patients 1 to 2 months prior. The common blood typing test for dogs is DEA 1.1 antigen (+) or (-). Negative type blood donors are not common in Japan and would require advanced planning to coordinate donor blood bank supply.

Appointment #3

To be performed 2-3 months before surgery

• Inulin clearance test or SDMA

• Blood test: CBC Chemistry Electrolytes, CRP

• Urine test: UPC, UAC, in-house urinalysis including USG

Appointment #4

To be performed 2-4 weeks prior to surgery

• Coagulation profile: ACT, Fibrinogen, AP, APTT, Antithrombin III (ATIII is mandatory)

• C-Reactive Protein test is done to measure any possible inflammation in the body prior to traveling (this is a mandatory test)

"Only if indicated" (At your veterinarian’s discretion, the following remaining test below can take place as needed at any or additional appointments, based on any possible abnormal findings)

• Blood test: Canine SpecPL, T4, TSH, 4DX, ACTH stimulation test, Low dose dexamethasone test

• Urine culture (sample obtained by cystocentesis)

• Fecal (culture, occult blood, parasites)

Note: The above appointment schedules, have been categorized by the recommended timing of each test.  Some tests can be combined for consolidation purposes and for convenience, at your Veterinarian's discretion. 

Tips to Expedite Surgery

• Include your dog’s name in the title of your first email message

• Always reply to the same email thread rather than starting a new message. Whether you decide to send these test results yourself or have your veterinarian send them, it is important that you and your vet continue to reply to the same email thread (have your vet cc you in his/her email so you’ll have access and will be able to reply). This keeps all medical records together so Sayaka will have quicker access to your dog’s medical records when performing her evaluation, or when answering questions, you or your vet may have.

• Some families have started the quarantine process for Japan before confirming their dog was a surgical candidate. Doing this allowed them to enter Japan much sooner rather than later, as time for some patients is very critical. This is a separate process which can be managed by a general vet, though the blood drawn for the rabies titer should be performed by a vet accredited by the USDA. After completion, the quarantine paperwork is valid for two years.

• At this point please be patient. Once you’ve started the quarantine process, you will have at least six months to get all the testing completed and make your travel arrangements.

This article was intended to be a guide to navigating the extensive list of medical tests needed to determine if your dog is a candidate for Mitral Valve Repair surgery at the Jasmine clinic in Japan.  It is subject to change and will be updated as needed.

Navigating the Japan Trains

Click to link to Japan Travel app

Navigating the Japan train systems for the first time can be stressful. This guide was put together to help others.

A great App to use when traveling in Japan and navigating the train systems is Japan Travel – route, map, JR by NAVITIME JAPAN CO, LTD.

As seen in the first screen shot, enter your ‘From’ and ‘To’ destinations to run your search. The results are then displayed in the second page example indicating train lines by the color cars, additional route options, and typical cost for each option.  The third screen shot is the Jasmine clinic stop.

This example shows that I started on the green line and transferred to the blue line. All throughout the ride, I opened up Apple maps to see when the next stops were coming so I wouldn’t miss my stop or connection. Therefore, as side note, it is important to have a stable WiFi connection and phone battery life.

There are stairs and escalators to navigate throughout each station. If you’re close to the Jasmine clinic, consider taxis when transporting your dog prior to surgery and on the day of for peace of mind and less stress on your pup.

“It’s also a great way to save on transport costs while your dog is recovering in the hospital by utilizing the extensive, affordable, and reliable train systems. This method worked for me flawlessly as I’m the get-lost-everywhere type of person and I pulled it off using this method.”

— Nate Estes

MVD Studies From Around the Country

Spironolactone Study at Virginia Tech

This study is looking at whether adding spironolactone (a diuretic commonly used in human medicine) to conventional therapy for congestive heart failure will improve pulmonary hypertension caused by mitral valve disease. There’s also a bit more information on our website: http://www.vetmed.vt.edu/clinical-trials/current-studies/spironolactone.asp.

Dogs must be seen at the Veterinary Teaching Hospital here in Blacksburg, VA. There are required follow-up visits at Day 7 and Day 30 after enrollment, so it’s probably not a practical study for anyone outside of easy driving distance.

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Entresto Study at Auburn University

"Entresto, a highly effective drug used in treating human heart patients, is being evaluated at Auburn University’s College of Veterinary Medicine for use with dogs.

A clinical trial for the drug is underway in the Cardiology Service at the Wilford and Kate Bailey Small Animal Teaching Hospital. Pet owners can begin registering to participate in the two-year study that costs nothing but a $75 screening and examination fee, says Dr. Daniel Newhard, a cardiology resident at the college and chief physician conducting the trial. Although the entire trial is a two-year program, each dog participates for only 30 days, he notes."

Continue reading about the study here. 

To inquire or to register for participation in this clinical trial, call (334) 844-4690, or contact Dr. Newhard by email at dkn0004@auburn.edu.

Turgon's Surgery Story

Today is a special day for me and my family. One year ago today we received a devastating news as our friend had mitral valve disease (MVD) at a very advanced stage (5/6 murmur, dilated atrium and ruptured chords). How it could be possible? He went from nothing to probably one year left. Our cardiologist was, as I was, aware of the surgery.  When I asked about it she did not agree and finally added 'It depends on the size of your pocket'. This was the last time we went to see her.

Two months later Turgon had an appointment with Dr. Sabine in Versailles. She is so kind and competent! As we expected, Turgon was at C stage, but he never fully went into congestive heart failure thanks to proper treatment (pimobendan, benazepril and diuretics).

Tania with Turgon at the JASMINE clinic

We contacted Japan for the surgery and Dr. Sayaka gave us a date - October 3rd. I remember those months waiting as a really hard time. We also received a message that as Turgon was so big (18 kg), there was not going to be sufficient blood in case of acute hemorrhage. This was of course a concern for us, and we moved earth and sky to find a donor in Japan, but without success. So we moved forward to surgery knowing this risk. I remember that day of surgery, I held my breath for 7 hours. Dr Uechi confirmed us how bad his valve was, as he had 4 ruptured chords. I visited my boy after surgery and I was so happy this first step was finally behind us.

During his stay, Turgon developped anemia, he was not eating so they asked us to come to the clinic 3 times a day to give him some food. So we did, and 3 days after he was feeling better... so much better that it was impossible to keep him in the hospital any longer. He had a lot of energy and was continuously trying to get out of the oxygen cage. We were asked to take him home and come back to the clinic everyday to check his vitals.

After the 6th day, Turgon developed acute hepatitis. We were very scared after they told us his liver numbers were sky high (more than 100 times normal values) and it was maybe a toxic reaction to a drug or the effect of bypass. We went to the clinic for 6 more days so that Turgon was able to receive intravenous liquid. We stayed with him in a separate room for 12 hours a day. Three days after they started the treatment, his liver values started decreasing, a sign that he was responding well. Finally we could got to take him home two days before our departing flight to return home.

We managed to keep him calm most of the time during the first three months and he slept most of the day (~20 hours a day). One month after the surgery his liver values were normal, his lungs clear, his regurgitation now mild-to-moderate (25-30%) and heart murmur of 3. Three months after surgery the ventricle of his heart was normal, and the atrium significantly decreased. However, Turgon has developed a significant cough that was misinterpreted by his regular vet on x-rays as pulmonary edema.  Dr. Sabine, who is following him thinks it could be bronchitis. He is on medication for this, and his cough went from wet to dry. Today my boy is not on heart pills or diuretics and we are patiently waiting for his 6 month check-up.

Turgon at home!

I have learned a lot during this past year, about me, about my family, about friends. I would like to thank from the bottom of my heart the people that stayed close to me during these hard months: Kaori, Nate, Marla, Desiree and very specially Madeline and Carol. If distance was not a barrier, I would hug them for a long time. Also, If I have not published this before it is because of the immense respect and love I have for friends who have lost their soul mate. May their love never leave them.

Thanks again to all the doctors who made this surgery possible.  Dr. Uechi and his team in Japan, and Dr. Sabine for following my boy with so much love in her heart. May this week be filled with successful surgeries and smooth recoveries.

Kind regards,
Tania

Lessons From Zoey's One Year Checkup

UC Davis Veterinary Medical Center in San Diego, CA

Zoey’s one year checkup was done October 28th 2017.  Zoey’s cardiologist (Dr. Hodge) was a bit worried Zoey’s left atrium and left ventricle (LA/LV) numbers were increasing after each checkup.  According to Dr. Hodge, Zoey’s pressure and her regurgitation were shown to be the same since having her surgery a year ago.  Naturally We were concerned about the increasing LA/LV values and sent the records off to Dr. Sabine and Dr. Uechi to review them.

Dr. Timothy Hodge evaluating Zoey

I’m delighted to say that It was great news. Dr. Sabine and Dr. Uechi compared Zoey’s numbers from her surgery echos to her 3, 6 and one year checkups and the values appeared to be the same since she had her surgery in 2016. It was extremely important for me to learn exactly why it was being seen differently with my doctor and share with you all what I’ve come to learn. 

Basically Zoey has a larger than normal pulmonary vein (ostium) since before her surgery and standard measuring practices can give false numbers if you don’t account for these results.

According to Dr. Sabine, the 1st reconstruction is of the Long axis LA diameters in telesystole at 3-6-12 months. Measured 2, 1.84 and 2 cm, basically they are the same measurements ; the SAX measurements are somehow difficult with Zoey because she has a very large pulmonary vein ostium compared to other dogs. As noted, (Zoey had this before her MVR surgery)

Echocardiograms showing Left Atrium (LA) measurements at 3 months, 6 months, and 12 months post operatively

The 2nd reconstruction is of the long axis LV diameters in telediastole at 3-6-12 months. They measured 2, 2 and 2 cm = same.

Echocardiograms showing Left Ventricle (LV) measurements at 3 months, 6 months, and 12 months post operatively

The 3rd reconstruction is of the long axis view of the mitral regurgitation color flow map at 3-6-12 months = same ; so there isn’t any chance for the LA pressure to increase considering that the 12-month MR is the same as the 3 month and the 6 month post-op checkups.

Echocardiograms showing regurgitation at 3 months, 6 months, and 12 months post operatively

This is the manner in which Dr. Sabine uses with Dr. Uechi to review the cases post-operatively. 

Zoey with Dr. Timothy Hodge at UC Davis

It’s very important to note, all operators can cut a heart a little differently and measure slightly differently during the same examination or during different examinations a few months apart. Some other factors like Zoey's large pulmonary vein ostium can make the measurements difficult to compare. Also, after surgery, some hearts have mild different anatomy because of the sutures, or because it has possibly turned a little in the thorax etc... Zoey is doing very well and there is no need for concerns.

Zoey is still off all her medications and doing quite well.  I write this in hopes you all understand how important it is to have the doctors review your records after each checkup and assess.  My doctor wasn’t doing anything incorrect and I completely trust him.  The surgery repair is just widely unknown and many don’t understand the long term results. As more of us return to the US with our babies we all can help play a vital role in educating everyone, awareness is very important.

Zoey with her favorite person on the planet, daddy Nate

Post-Op Activity

Recommendations for Open-Heart Surgery Post-Operative Activity

 The importance of post-surgery healing process 

For the first, second- and third-month post-op, you would have been given guidelines by your surgery team on what to avoid, what movement is acceptable and how much exercise your dog is recommended. It’s vital that given guidelines are followed to allow a successful healing process to take place. 

The first three months is the most crucial time in the healing process as the heart is remodeling itself. By helping your dog to eliminate certain movement you are supporting the foundations for a stronger healthier heart muscle. It is therefore essential that certain movement is avoided or eliminated from daily life and activities. By planning, preparing and preempting situations, you will make way for a successful healing process. This is not to take place of the advice of your dog’s Cardiologist. 

Surgery recovery postop month 1-3 

•Patients should be kept under strict rest.•No jumping up / No jumping down•No stairs•No abrupt starts and stops.•Please keep your pets separated from other animals in the home. This will avoidplay and other movement that may disrupt healing of repair.•Set up a pen area as this is a great way to keep dog at rest. This will ensure thedog stays calm and resting when you are not around.•Block off furniture - Please keep dog off bed/sofa, so your dog is not tempted tojump off.

Shampoo or grooming 

• No shampoo until 1month post-surgery.

• If skin/hair gets dirty, you may wipe him/her down with a wet towel.

Walking instructions 

• Specific instructions may be given depending on your dog’s post-op condition.

After 3 months: 

• keep dog on leash (even when in yard/garden/walks)

• Allow dogs to meet and greet in controlled environment.

• Begin walking your dog, on lead for 20-30 minutes twice per day.

• No running

• No Jumping

• No stairs

• No abrupt starts and stops.

• Please continue to keep dog off bed/sofa, do not allow them to jump off anyfurniture.

• No frantic play, No zoomies, no chasing wildlife, or animals

• You can allow gentle play interaction with other dogs.

After 6 months 

• Please continue to keep your dogs on lead during this time, due to risk of high energy play with other dogs.

• After 6 months, you may use a ramp when needed, in place of stairs.

• No wildlife and/or animal chases, avoid high energy play, avoid high energy dog sports such as agility.

Remember that you have made an incredible journey by choosing open-heart surgery for your beloved dog, so please take care of the repaired valve as best as you can so that you can enjoy quality time with your pup!

Please contact your surgical clinic for the latest updates in post-op care or if you have additional questions

The Mighty Hearts Project team

Moni and Prudence

Fred: A Different Open Heart Surgery

“I feel a little bit as an outsider because my Fred does not have Mitral Valve Disease and Congestive Heart Failure.”

— Raya

Fred, an 1 year old purebred standard schnauzer, has a large atrial septal defect (sinus venosus), not amendable to trans catheteral closure with an amplatzer device.  In layman's terms, this means Fred has a hole in his heart and the typical procedure developed to treat this issue will not work in his case. 

Because of the atrial septal defect, Fred has already developed moderate pulmonic stenosis and right-side heart hypertrophy. Without an open heart surgery to patch the defect he will develop congestive heart failure (CHF).

Fred was brought home on the day of one year anniversary of the terrible loss of his owner's first standard schnauzer, Peter (aka Petya). Peter was battling two types of cancer during the last year of his life- going from radiation to surgery, and than to chemo.  Nothing helped. Raya and her family were devastated. Learning Fred's diagnosis has only added to their stress.

“We were emotionally and financially drained after our first dog’s illness. Fred is our family now. We love him. We will do everything to save him.”

When their cardiologist, Dr. Dennis Trafny, from Animal Medical Center told them that Dr Uechi is the person who could help them, they immediately started looking for a way to get to France.  Raya wrote to the clinic and heard from the Bozons a few days later.  Dr. Sabine consulted with Dr. Uechi, and he is confident he can fix Fred's heart defect. There is a Jewish saying, if problem can be fixed with money, than it's not a problem, it's an expense.  Fred's open heart surgery at the Bozon clinic in Versailles, France is scheduled for September 2017.

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At Clinique Veterinaire Bozon in Versailles, France, Dr. Jean-Hugues Bozon is a highly skilled surgeon who can perform techniques to correct many heart-related conditions including pulmonic stenosis, valvular aortic stenosis (excluding subvalvular), ventricular septal defects, atrial septal defects, tricuspid dysplasia, mitral dysplasia, patent ductus arteriosus, and fallot tetralogy.

Levi's Surgery Story

Kim, Ginny, and Levi. Photo taken by Carolyn Scott Photography

The biggest unexpected surprise for our family came in July of 2016, when we took Levi in for a routine physical exam prior to having his teeth cleaned.  Dogs have to go under anesthesia to have their teeth cleaned, and Levi has traditionally had some issues related to anesthesia and we wanted to be safe.  His last checkup was in April 2016; he went in for an ear infection and at that time, he was in perfect health (except for the ear infection, of course).  So it came as quite a shock when the vet announced that he heard a heart murmur level 4/5 for the first time in Levi's life.

A lot of small dogs develop a gradual heart murmur that starts low and builds as the dog gets older.  We would not have been surprised if, at 9 years of age, that Levi had a minor heart murmur.  But to go from zero murmur in April to a level 4/5 in July is alarming. 

Heart murmurs in dogs can occur for many reasons, but the most typical of which is degenerative mitral valve regurgitation.  The mitral valve is a flap in the heart that allows blood to pump into the ventricle, but not backwards towards the lungs.  As a valve should work, it allows one-way movement.  Degenerative mitral valve disease causes the thickening of the valve to the point at which it does not close properly and blood moves back and forth ineffectively in the heart.  In response, the heart enlarges to allow for a larger capacity of blood pooling and to keep blood pressure in the body stable.  Eventually, the excess fluid will back up into the lungs causing congestive heart failure.

We went to the cardiologist at the earliest possible moment.  He confirmed that Levi did indeed have a level 5 murmur caused by degenerative mitral valve disease exacerbated by a chordae tendonae rupture.  There are chords in the heart (literally what country singers croon about when they sing about heartstrings) that help coordinate the movement of the mitral valve flaps.  If they break, the effectiveness of the valve is compromised significantly.  That explains why it was not a gradual increase in murmur grade, but all at once.

We were devastated by the news, and we were further shocked when we were told that Levi had 6-9 months before he experienced congestive heart failure, and possibly a year left to live.  We left with this news heavy in our hearts.  Our devastation turned to anger and frustration.  Why is there nothing that anyone can do to correct this issue in dogs?  Humans have open heart surgery to repair the heart valves all the time - it's practically routine!

We emailed veterinarians at UC Davis, Cornell University, and several other highly respected veterinary schools in the US, along with one point of contact we found for veterinary surgeons in France.  We heard back from the French doctors - they asked for more information about Levi and his results from our cardiologist. 

We sent them, and held our breath. 

We found more information about the doctors in France, and other dogs and owners from the US who had gone there to have the repair done.  We called.  We coordinated.  We kept researching.  No veterinary team in the US performs this procedure.  Only one surgeon in the world - renowned Japanese surgeon named Dr. Masami Uechi - performs these operations currently in Japan, Singapore, and France.

Levi was in the loving care of Dr. Jean-Hugues Bozon and Dr. Sabine Bozon during his surgery and recovery

When we finally got word from the Clinique Veterinaire Bozon in Versailles, France that Levi was a candidate, we were still in a little bit of disbelief that this was possible, that this was actually something that we could and possibly WOULD do.  Were we crazy?  Would other people think we were crazy?  Can we logistically pull this off?

Maybe we are crazy, maybe we just love our dog.  We stopped caring what anyone thought of what we were doing.  And yes, we logistically pulled it off . . . one day at a time, one piece at a time, one foot in front of the other.  When you want to do something that seems impossible in foresight (and hindsight), you have to know that the little steps in between to make it happen just come as long as you keep moving.  We never lost faith, even when it was tested over and over again.  I was taught that my heart and my hope are infinitely bigger than I ever realized. 

It was unexpected.  All of it.  The diagnosis.  The plan of action.  Even the result.

Levi with Dr. Neal Peckens at CVCA

We expected resistance and judgement anytime we talked about cardio-pulmonary bypass surgery for our dog . . . in FRANCE.  But, everywhere we turned, friends and family knew exactly what Levi meant to us, and agreed we were doing the right thing for him.  Our vets Dr. Carole Richards and Dr. Chris Vanderhoof at Caring Hands Animal Hospital, and Dr. Neal Peckens at CVCA, were 100% on board with us when we made the decision to go forward with it.  They ran tests, and re-ran tests, and asked questions, and cared for us as owners.  They cheered us on, and helped Levi recover when we got back.

We knew before we even went to France for the surgery, before we even knew Levi would live through it, that we wanted to be of service to Dr. Sabine and Jean-Hugues Bozon.  We didn't know how, but we felt so inspired by what they are doing.  When we met them, saw their clear vision of the future, learned about the many leaps of faith they took to get where they are, and witnessed the loving care they put into every living being that they touch, it was very clear to us and a few owners who came before, that we would need to take our own leap of faith to help them, and to help this cause in some way.  And that is one of many reasons that Mighty Hearts Project was born.

Though most of all, it was unexpected what two people with love and hope in their hearts can accomplish together.  I do mean Ginny and myself; however, we saw it in Dr. Sabine and Jean-Hugues as well.  Their love for each other and their love for saving animals is unparalleled.  Dr. Sabine taught us not to ever lose faith in something that is important to you.  If the solutions presented to you are unacceptable, find new solutions.  

We are currently on a mission to find new solutions for dogs in the United States.  We will not lose faith.

Levi, sitting up in his oxygen recovery cage just a few hours after his mitral valve repair surgery at Clinique Veterinaire Bozon in Versailles, France

The LOOK Study: ACVIM Conference 2017

The Longitudinal Outcome of Canine Mitral Valve Disease (LOOK-mitral) - by Dr. Michele Borgarelli, DVM, PhD, DECVIM-CA

This is a study being performed with the collaboration of Virginia-Maryland College of Veterinary Medicine, where Dr. Borgarelli does his research, and one of the largest veterinary cardiology practices in the United States, CVCA. The purpose of the study is to assess the natural history of mitral valve disease (MVD) in a large referred population of dogs, assess the prevalence and effects of co-morbidities on the natural history of the disease, and to identify risk factors for progression and death.  Collected data includes physical exam, radiographic findings, ECG findings, presence of co-morbidity, laboratory results and treatments.

Since October 2015, vets from CVCA have been submitting information from a large population of dogs with MVD to the LOOK Study.  This is strictly an observational study.  Inclusion criteria for study enrollment is a diagnosis of MVD confirmed by echocardiographic exam. Dogs are enrolled in the study at the time the diagnosis is confirmed by a cardiology specialist. 2,053 dogs have been observed as of April 30, 2017, and new dogs can continue to be submitted to the study until September 2017.  Data on the dogs enrolled in the study will continue to be collected until it concludes in October 2020 or until the death of the dog.

The current population of dogs in the study represent 104 different breeds.  The largest segment being mixed breed at more than 300 dogs, second highest is CKC, then Chihuahua.  48% of dogs are female, and 52% are male, and for both male and female, approximately 90% are neutered/spayed.  The median age of all dogs is 10.3 years, but it was noted that the average age for the CKC is much younger than the median.

57% are Stage B (75% of which are B1, 25% are B2), 39% are Stage C, and 4% are Stage D.  During the current 20 months of the study, only 4.5% of dogs have passed.  It was noted that this could be because most dogs being submitted to the study were new cases presented at CVCA which typically occur at the earlier stages.  

Some of the preliminary findings of the study so far are:

• Echocardiogram results are more important than the observation of a heart murmur, as more than 4% of dogs with the disease had zero murmur.  In high risk breeds, this suggests that regular preventative cardiology exams with echocardiogram are warranted rather than waiting until the onset of symptoms.
• Nearly 80% of dogs are referred to cardiologists due to the presence of a cough.  
• Most concomitant disease is chronic respiratory disease.

Additionally, at the conclusion of the conference session, Mighty Hearts Project participants were able to inquire with Dr. Borgarelli on whether dogs who have had an intervention, such as Dr. Uechi's Mitral Valve Repair surgery, were noted and being tracked within the study with this information in mind.  Dr. Borgarelli confirmed that is correct.  One dog that we know of being tracked as part of the LOOK study is Levi, who has had a successful mitral valve repair since his initial diagnosis.  Levi is seen by Dr. Neal Peckens at CVCA in Virginia.