Emma Ibrahim
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.
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
