Oliver Richmeir
I have been blessed to have a dog or multiple dogs in my life since I was 2 years old. And yet I knew absolutely nothing about heart disease in dogs. So, I was completely taken aback when I was told that Oliver (10.5 y/o) was in heart failure and that, hopefully, with medication he could live another 12-15 months. The ER cardiologist (Dr Andrew Waxman, now practicing in upstate NY) who treated him mentioned a surgical option in Japan but indicated that it was cost prohibitive and left me with the feeling that it wasn't really an option for me. This is not to slight Dr. Waxman in any way. He's an excellent cardiologist.
In February of 2021 at his annual exam, his vet said that she was hearing a murmur that she hadn't heard before but “not to worry as it could be nothing”. They had a tech come in every other month to perform various diagnostics. She'd already been there that month, so I made an appointment for an echo to be done in April. In March upon returning from a trip to Oregon, Oliver started coughing that night. I knew that he had eaten some grass after getting home & I thought he'd gotten it stuck & was trying to dislodge it. He coughed the entire night & continued to cough the next day. I finally realized that he was no longer just coughing, he was starting to struggle to breathe. I took him to the ER. These were the COVID days when you had to stay in the parking lot, as they wouldn't let you enter the building. When I called the ER ahead of time, they were telling me that they had a 3-5 hour wait time.
Luckily, they were assessing patients, in the car, as they arrived. Upon assessment, they immediately took him from me into the hospital. They told us to go home as he'd have to stay in oxygen over night. I had no idea what was going on. Dr. Waxman arrived the next morning & diagnosed him as being in CHF. He was put on Pimo & lasix. I only got to see Dr. Waxman twice more, as he was planning to move from CA to upstate NY. In retrospect, knowing what I know now, I believe that a deep powdery snow the day before we left Oregon caused one of his chords to rupture and thus for him to go into CHF. The next big challenge was getting in with another cardiologist, as there were only 2 others practicing in the area and they were overwhelmed with patients. I got in, thankfully, with Dr Kate Woodruff (now in SFO). As his condition worsened, Oliver was also put on enalapril & amlodipine.
Besides not knowing anything about canine heart disease, I didn't participate in social media. I had no idea that helpful groups such as Mighty Hearts Project existed on Facebook. Surgery wasn't really on my radar. Then, one night, while watching the local news, they did a story on a military vet & his service dog that needed MV repair surgery & he was trying to get to Japan to do it. They (shockingly) included his email in the story & I emailed him to see if he'd gotten the surgery & how did it go? He'd said due to COVID, he'd been unable to get to Japan as of yet. He told me about Mighty Hearts Project & that I should get in touch with Nate Estes. *Had it not been for me seeing that story on TV and for Jason telling me about Mighty Hearts, I would have never known that they (MH) existed & I would not have known about or had a pathway to surgery.* After connecting with MH & reading about steps to surgery, I then immediately got Oliver a 2nd rabies vaccine & got the titer test on “the off chance” that I'd be able to make getting him to surgery work. It was now August 2021. Around this time, I was trying to initiate contact with Jasmine.
Although, I was now connected to MH & receiving copious amounts of invaluable information, I felt like I was trying to “jump through every hoop”, but still not really knowing if I could go through with it. Doing this during the pandemic made it especially difficult. Having to secure a special circumstance visa in order to enter Japan was beyond daunting in and of itself. Had it not been for others in the group, who'd shared their knowledge, we would have shown up unprepared & likely been declined our precious visas.
Up until the time that we went to Japan, Jasmine had been following the government rules with regards to quarantine, but they suffered some illness & increased their clinic quarantine from 1 week to 2 weeks. So-not only did we need to be there 2 weeks post op, but we also now needed to be there 2 weeks pre op. We were in JP from February 15th through March 17th, I almost mistakenly arrived 1 day prior to Oliver’s eligibility to enter the country as it was, we entered exactly 6 months to the day after his 2nd rabies & titer test (not planned-just fortuitous). His surgery was scheduled for March 1st, 2022, one year after his CHF diagnosis. Pre surgery testing showed that Oliver had/still has kidney stones, bladder stones, collapsing trachea & most disconcerting splenic masses. However, Jasmine was still willing to do his surgery.
His surgery was scheduled for 8:30 am. They called me an hour and a half later to tell me that he'd done well & hadn’t needed a blood transfusion. I'd made the difficult decision to “visit” Oliver every day, post op, but not to let him see me. I couldn't believe that in less than 2 hours of coming out of surgery, he was standing, alert, and wagging his tail-it was amazing! He did really well for four days post op & then he suffered some setbacks and ended up staying in hospital for a full 7 days. He did really well post op, up until the day we were to fly out. I took him out to potty & he just laid down on his side on the asphalt. We rushed him, via train, to Jasmine & they said he had pancreatitis. They gave him steroids & antibiotics & thankfully were still able to fly out that night.
Weirdly, after a year post op, Oliver started having syncope episodes, this was not a pre surgery issue. I did my own research and as a result asked if he could come off of the Pimo. My current cardiologist, Dr Sara Johns, conferred with Dr Sayaka Takeuchi and a little more than a year post op, it was agreed that he could be weaned off of Pimo. This was May of 2023. I don’t know whether or not it is coincidental, but we have not had any more syncope episodes as of yet since stopping the Pimo.
We see the cardiologist every 6 months for follow up echos. Upon returning from Japan, my other dog (Oliver's mother, Penny) was also diagnosed with a heart murmur during her annual physical, she too goes to the cardiologist every six months as well. She's B2 and holding steady 2 years later. Five months post op, Oliver suddenly developed glaucoma in his left eye and his collapsing trachea has worsened, but to look at him you would never that know he's almost 14 now (11.5 y/o at time of surgery) and has so many issues. He's a happy & curious little guy. I try to savor each & every day that I have with them and I try to always take them both wherever we go.
I have to thank Nate Estes for the research that he did to find this surgery for his precious Zoey and for realizing that this was something really important that he could share with the world to help countless others try to save their dogs from this horrible disease that takes way too many lives way too soon. By creating the Mighty Hearts Project, he created a forum filled with invaluable information that has allowed so many of us to save our dogs, when otherwise we would have had no idea that this surgery even existed, nor all of the many, many complicated, overwhelming & necessary steps it takes to get our loved ones to surgery. Thank you Nate!
Secondly, I have to thank Michelle Lawson Fairfield for all of the energy and effort that she put in to guide those of us needing “special circumstance visas” to enter Japan. As I mentioned this was a very daunting process and if you got denied you had to wait, I believe, 6 more months to reapply, during which time, your dog could likely not survive the additional time. She was also very helpful with directing me to all of the Mighty Hearts resources so that I can safely make it to Japan during the difficulties of covid travel, Thank you Michelle!
And lastly, but not least, I need to thank Isa Randle. As I have said before, Isa ended up being my personal guiding “Angel” in this endeavor. I had reached out to her after seeing her posts on MH about her dog, Lucky, going to surgery in Japan (and this was before she became a group moderator). She made it her business to become extremely knowledgeable about the surgical process while she & Lucky were going through it themselves. She seemed to always be available to answer my questions & more than anything she always provided me with an encouraging and positive perspective. Thank you Isa!
I never got to meet or communicate with Dr Uechi in any way due to the strict covid protocols, but I am so thankful that he recognized the need for this surgical procedure and then pioneered it and over the years of doing it, has perfected it to the point of a 98% success rate! Dr Sayaka Takeuchi is so great at making sure that you are aware of all of the risks pre surgery & post-surgery allows you to know what is worrisome and what not to worry about as there is a lot. Her calm demeanor imparts a confidence that is so very appreciated under the stressful circumstances. I also had the opportunity & pleasure to work with their Oncologist, Dr Omski with regards to Oliver’s splenic masses. The level of expertise and care is exceptional to the point that I have never experienced anything even close to it here in the United States, unfortunately. Jasmine Clinic and their doctors have my highest regard.
Getting Ollie to surgery, during the height of Omicron, to one of the most locked down countries in the world was a huge endeavor & a yearlong labor of love. One that I will never regret & will, forever, have both fond and stress fraught memories of and would have never been able to do without Mighty Hearts & so many of its wonderful Facebook group members. I & Oliver thank you Mighty Hearts & so many of your wonderfully kind & generous members (you know who you are) who answered all of my questions and concerns along the way which ultimately enabled me to successfully get Oliver to Japan for his life saving surgery. I am & will always be eternally grateful.
Breed: Pomeranian
Age at surgery: 11
Diagnosis: Stage C
Surgery Date: March 1st, 2022
Hometown: San Ramon, CA, USA
Owner: Kim Richmeier
Primary Vet: Dr. Elisa Dowd
Cardiologist: Dr. Sara Johns
Repair Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center
