Lessons From Zoey's One Year Checkup

UC Davis Veterinary Medical Center in San Diego, CA

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

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

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

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

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

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

Zoey with her favorite person on the planet, daddy Nate