Nathan Estes 10/30/23 Nathan Estes 10/30/23

Lucas Bustillos

Breed: Pomeranian - Chihuahua Mix
Age at surgery: 11
Diagnosis: Stage: C
Surgery Date: November 22nd, 2022
Hometown: Alexandria, Virginia, USA
Owner: Dilianna Bustillos
Cardiologist: Kendra LaFauci DVM
Surgical Team: Dr. Masami Uechi & Team at,
Jasmine Cardiovascular Medical Center

I adopted Lucas when I was 22, right out of college. He quickly became the love of my life. Over the last 12 years, Lucas and I have been through everything together.

I adopted Lucas when I was 22, right out of college. He quickly became the love of my life. Over the last 12 years, Lucas and I have been through everything together. Lucas helped me get through a divorce, a layoff, grief over the loss of a loved one, heartbreak and many, many, panic attacks. He has been my protector since day 1, barking at anything that came near me in that funny, ferocious way only chihuahuas know how to :)

Lucas was a relatively healthy dog up until December 2021 (he started getting yearly seizures around the time he turned 6, but luckily, they were mild and very sporadic). On December 29th, 2021, we had the worst night of our lives as a family. The situation that was unfolding required me to quickly reverse roles with Lucas: He was the one who needed saving that night.

Earlier that day, we had arrived in Telluride, Colorado. We were a few hours into our vacation when we noticed our little guy wasn't breathing properly. He was panting and walking around aimlessly, he was dazed and confused. Lucas wasn't himself. I called his ER vet and sent them a video and they told me he needed to get to a hospital ASAP. They told me he seemed to be in respiratory distress.

After a 2 hour panicked drive to the nearest ER in Grand Junction, CO we were given the news: Lucas was in congestive heart failure. It was a huge shock. Lucas seemed to be doing so well for his age before that night. We had even proactively taken him to the cardiologist a few months before and they had only seen a level 2 murmur. They didn’t start meds then, because they told us he didn't need them - he didn’t have heart disease. How could everything have changed so quickly?

My husband and I didn't sleep for the next 3 days. Lucas had to be put in an oxygen chamber and was started on furosemide. We were told he had skipped from Stage B1 of MVD all the way to CHF... Likely an acute tear of his chordae tendineae at high altitude... But they couldn’t know for sure. He was discharged on NYE. I spent all of January 2022 taking him to different cardiologists in the greater Denver metropolitan area. We went to 3 specialists in fact - and it was very confusing because one cardiologist told us she didn't think he had ever really been in CHF and that it may have been something else (and proceeded to lower his furosemide dosage)... two days later another cardiologist told us he was indeed in CHF and it was getting worse, re-upping his meds. Eventually the consensus was CHF with a few months to a year on average left... I was devastated, confused, frustrated and exhausted.

Nevertheless, something inside of me pushed me to get one last opinion. Don't ask me why... I had a feeling everything wasn't set. So, at the recommendation of a friend, I drove almost 2 hours to Fort Collins, CO to the CSU Vet Cardiology department. There, one of the residents on their staff finally mentioned the Mighty Hearts Community... my reaction was one of both relief and shock: "WHY DIDN'T ANYONE TELL ME THERE WAS A REPAIR OPTION BEFORE THIS APPOINTMENT"? The anger turned into hope. There was no time to waste being upset or looking for blame. I went home and started the process to get Lucas to Japan right then and there.

The following 6+ months would have been impossible without the Mighty Hearts Community. Their website and their Facebook MVD Community group held answers to nearly all of my questions surrounding the actual repair procedure and the process to get to Japan and secure a surgery date. They helped me every step of the way - from the moment I introduced myself in the group all the way up to the week prior to travel where I was panicking to make sure I had all of Lucas’ documentation in order to get into Japan. Not only would they answer my questions via FB, many many times the amazing volunteers in this community made themselves available over the phone as well - reassuring me even when things looked really tough and convoluted.

Lucas had successful surgery on Nov 22nd, 2022. As you can imagine, we had a ton of ups and downs along the way. The process was arduous. It tested my husband and I and pushed us to be the most organized we had ever been... about anything in life. But we made it and Lucas made it. He recovered so well from surgery - we were in awe. Day 2 he was already wagging his tail and trying to bark at the nurse when he caught a glimpse of me on the other side of the room. The team at Jasmine was incredible - everyday we went to visit Lucas post-surgery, we had the opportunity to see up close the state of the art facilities and care they apply to each dog that is recovering from this life-saving procedure.

Unfortunately, a few months after Mitral Valve Repair surgery, Lucas was given a few unnecessary vaccines at his primary vet in DC (at District Vet, for those wondering) without our consent (the vaccines included ProHeart12 and a rabies booster he wasn’t due for). Those errors set off a series of events that ended up with him having to get Ventral Slot surgery at VRA Gaithersburg with Dr. Kaiman - we still don’t know exactly what happened, but we know he wasn’t the same after those shots… he could barely walk and was yelping in pain for almost a month before we were told he needed spinal surgery. For a second time, we were faced with the need to trust our furbaby to the medical experts, only this time we had a bit of PTSD given what had happened with his vet in DC to get us here.

The surgery thankfully went well and Lucas was back to his normal self the next day. However, it made us realize how important it is to continue to advocate and be on top of his care even after successful mitral valve repair surgery. We realized we couldn't lose our focus now that we were back home. At the end of the day, we each know our furbabies best - advocate for them as much as you can and trust your gut. That would be my main recommendation to anyone reading our story. It is possible for you and your beloved pets to live longer, happier lives... but it does require patience, research, time, energy, focus, care and above all unconditional love.

Lucas is doing great btw! we are almost a year out from his MVR surgery and 4 months out from his spinal surgery and he is acting like he is a puppy - getting zoomies, eating treats and playing with his sister Mila everyday. Thank you to this amazing Mighty Hearts community, to the entire team at Jasmine and to Dr. Kaiman at VRA Gaithersburg - words cannot express how grateful I am to still be enjoying quality time with the love of my life.

Nathan Estes 10/16/23 Nathan Estes 10/16/23

Emma Ibrahim

Breed: Chihuahua
Age at surgery: 11
Diagnosis: Stage C
Surgery Date: November 7th, 2022
Hometown: Ontario, Cananda
Owner: Nancy Zhang
Cardiologist: Dr. Lichtenberger, Dr. Pires
Repair Surgical Team: Dr. Dan Brockman, RVC

Emma is a fiery, sock-loving, and (now) well-travelled little dog. She was from Texas and came to Canada when she was five. She always had a cough when she drank water

Emma is a fiery, sock-loving, and (now) well-travelled little dog. She was from Texas and came to Canada when she was five. She always had a cough when she drank water or got excited, but this was chalked up to tracheal collapse and her checkups were always fine.

Feb-March 2022 we noticed the cough was more frequent and lasting longer. Her vet heard a new heart murmur. She was started on Furosemide while waiting for the echo, then Pimobendan when the diagnosis was confirmed. We knew surgery existed, but our (and our vets) impression was that it was rarely done and quite risky. Emma was doing well and was active as ever. In hindsight we should have looked into it sooner.

Everything fell apart July 2022. One night, Emma got too excited and collapsed. When she came to, her breathing rate shot up to the 80s. She was rushed to hospital and admitted for heart failure. A few hours later, her heart stopped. Thank God for her amazing team - they jumped into action and brought her back. The vet said that life expectancy was 6 months to a year, if she makes it through this exacerbation.

After that worst night, things started to improve. Emma responded to treatment. More than that, she started acting like herself again. She ripped out her IV, refused to eat anything except chicken and cat food, and relentlessly bullied her cardiologist. She was medically stable after a week in ICU and was allowed to come home. She was now on heavy doses of Pimo, furosemide, plus Benazepril.

Knowing the progressive nature of the disease, we planned for surgery. We were referred to RVC in early August, spoke with Dr. Brockman in September, and got our surgery date for November 7th. We were lucky to get off the cancellation list so quickly, and I am forever grateful to the family that had postponed their own surgery.

We started the quarantine process for Japan, but in my gut I knew we were going to RVC. Japan’s success rate was slightly higher, however it did not outweigh the risk of waiting six months. We knew from the literature that surgery done in Stage C had markedly lower complication rates and mortality than Stage D. There was also concern that if we wait too long, it would be too late. Emma did not meet the minimum weight for DWR.

We decided to fly Emma to France as a “pet-in-cabin”, then rent a car and drive to UK via the Eurotunnel. We needed an Animal health Certificate for Great Britain and a In-Transit paperwork for France. The forms had to be completed less than 48 hours before our flight (not the usual 5 days). Emma was tiny enough to fit under the seat of the plane.

Our last night in Canada was Halloween, and we set off the next day. She had a dose of trazodone before the flight. Emma used a diaper on the plane. We also had some spironolactone that we could start in case her symptoms worsen before surgery, and extra emergency doses of furosemide. We had all our paperwork (originals and photocopies) on our person. Fortunately we didn’t have any issues getting across the boarders.

We stayed with the famous Tony at Harpenden House. He greeted us with a Mighty Hearts blanket and a custom dog bowl with Emma’s name on it. The next day, we met Dr. Brockman at Emma’s pre-op appointment. We spent the next few days checking out the town and learning to drive on the left side of the road. The UK was much more dog friendly than Canada - we got to take Emma into the pub!

Emma’s surgery went well. Her heart shrank and her cough improved significantly. Emma’s furosemide and benazepril were stopped. She is now classified as stage B2. There was some residual regurgitation, so we are continuing the Pimobendan at 1/3 her precious dose. In total, we went from seven pills a day to just two. Functionally, Emma is more energetic and full of life than ever. She recovered quickly and grew very attached to Dr. Brockman.

We got daily updates from him and got to visit every other day. She was discharged from hospital after a week and cleared to fly two weeks after. The night before our flight home, Emma started coughing a more. Dr. Brockman squeezed her in the next morning for an appointment and thankfully everything was fine. We can’t say enough about the kind and attentive care Emma received from RVC.

We didn’t realize we also needed an “Export Health Certificate” in order to leave the UK, so the last few days were a scramble. We used PetAirUK’s “Official Veterinarians” for the paperwork (they were more knowledgeable than the airlines). It was expensive, but I didn’t have time to shop around.

The 3 month minimal activity was a challenge. Instead of using the pillows we painstakingly stacked for her to get up, she would walk around them and hop onto the couch. She hated being crated and would shake, cry, and bark, and we couldn’t have that. We ended up blocking off her access to the living room (so she couldn’t jump on her beloved couch). We also took off our bed frame and slept on the floor for the next three months. We became the top 1% listeners for Dog Music Dreams and Relaxmydog on Spotify.

It’s crazy to think that we flew our chihuahua to the UK for open heart surgery, but we’re so glad we did it. The surgery is a gift of time - not only did Emma pass her “six months to a year” prognosis, she is thriving. This dog has now been in the US, Canada, France, and the UK. She is now making friends with cats - something she’s never done before. She was described as “very feisty for eleven”, and I couldn’t ask for anything more.