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. 

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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

Trinka Silvoso

Our Trinka is now a healthy, happy 13-year-old miniature schnauzer thanks to Dr. Brockman of the RVC and the Mighty Hearts Project team.  

At age 10 which she developed a heart murmur which worsened over the next year.  The night of August 22,2022 she had labored breathing, and we took her to the Emergency vet.  She was in heart failure with severe mitral valve regurgitation.  She had x-rays which showed that she was in pulmonary edema and had an enlarged heart.  The Dr told us that she may have ruptured some chordae tendineae (the ligaments that attach the valves to the heart.) 

We took her home and she slept with us as she always does. I cried long into the night.  A wonderful veterinary internist, Dr. Gary Anthony, did an echocardiogram the next day.  He talked to us with a solemn expression and said she did indeed have ruptured chordae tendineae and that she would live 9 months to a year.  He started her on Pimobendan, Enalapril, Lasix and Spironolactone.

Shortly after she started on the meds, she started having more problems.  The heart meds were stressing her kidneys and creating a medication related kidney failure.  Her creatinine and Bun levels (blood values that are indicative of renal function) soared.  Because of the elevated kidney values, she lost her appetite.  She wouldn’t eat anything.  We tried to feed her boiled chicken and steak and other delicacies. She turned up her nose at everything. 

They gave her fluids twice to try to bring her kidney values down.  I thought, “She’s in heart failure, kidney failure and she won’t eat.  This could be the end.”  But I was in warrior mode.  I continued my research, found amazing Mighty Hearts, and discovered that there were 3 places in the world at the time where you could have a mitral valve repair done - Royal Veterinary College in England, Dick White Referrals, also in England, and Jasmine Clinic in Japan.

There is no veterinary cardiologist in our town, so we took Trinka to the LSU Veterinary Hospital in Baton Rouge, Louisiana.  The wonderful doctor MaGee did another echo on her. She also took her off Enalapril and put her on Benazipril, a med with a similar action but which is less toxic to the kidneys.  Doing this totally cured her medication-induced kidney failure, which, in turn, cured her appetite.  Dr Magee’s office took responsibility for submitting all Trinka’s medical records and echocardiogram to all 3 of the places that performed mitral valve repair.

It wasn't long before we heard from RVC in England that she was a candidate for surgery. We were thrilled and immediately accepted. Not long after. We heard that DWR, and Japan also had accepted her.  We went with RVC. Her surgery was scheduled for June, but they were able to move her up to April 24.

The thought of my baby girl having heart surgery and being on a heart lung machine terrified me and my resolve wavered a few times.  But I forged ahead with the protocol, working with our great local vet, Dr Bridges.  So many times, I thought, “Oh how I wish this was behind us and we were on the other side with a successful result!”

We went to England in late April of 2023. Her pre-op appointment with Dr. Brockman was on Thursday. April 20.  After meeting him, we felt a sense of peace and that we had done the right thing. He exudes a sense of capability and kindness. We expected to fall apart when we dropped her off for surgery, but we didn't. Doctor Brockman took her back in his arms and we left with a sense of calm that we were doing the right thing.  

She did beautifully during the surgery and Dr. Brockman called us right afterward and said she had done very well. He cautioned us that there were still post operative hurdles still to be gotten through.  He kept in close touch with us throughout her recovery and we got to see her daily starting the 2nd or 3rd day after surgery.  We were very fortunate that Trinka turned out to be a model patient with no complications other than a picky appetite right after surgery.  I knew she had turned the corner when they told us she had begun wolfing down her meal.  We picked her up exactly 1 week after her surgery.  It was so wonderful to get her back to our apartment!! 

They aren’t supposed to overexert themselves for a while, so we barricaded off the couch and beds at Harpenden House where we stayed.  Trinka and I slept in the couch/cage.  We enjoyed taking her around Harpenden in her stroller.  We did have one scary stroller incident.  My husband was pushing her stroller, and we had the lid zipped closed so she wouldn’t try to jump out.  Trinka was getting hot, so we headed back to Harpenden House. 

My husband was walking at a fast clip when he tripped over something.  He took a hard fall and basically tackled the stroller on the way down.  It broke the plastic piece that was holding the pet carrier portion in place, and it went flying with Trinka inside and landed on the sidewalk!!! Definitely not what the Dr. ordered!  Her sutures were fine, she was fine, and her echo was fine! Thank God!! A testimony to Dr. Brockman’s sturdy repair!

She is 13 and 4 months old now and looks and acts 10 years younger than that.  She is off all meds, her post op echo looks great, her kidney values are great, and her heart has returned to normal size.  Dr. Gary did her post op echo and this time, when he talked to us, he had a big smile!!  I have to pinch myself every so often to realize we did it, she’s doing great, and we did make it to the other side!

Thank you and God bless you, Dr. Brockman, Mighty Hearts Project, Nate and Isa, the Facebook support community, and our local vets and cardiologist, Dr Magee!! Also, a big thanks to Harpenden House and Manor Cars.

Trinka with Dr. Brockman

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Breed: Miniature Schnauzer
Age at surgery: 12
Diagnosis: Stage C
Surgery Date: April 24th, 2023
Hometown: Little Rock, AR USA
Owner: Karen Silvoso
Cardiologist: Dr. Aliya Magee
Repair Surgical Team: Dr. Dan Brockman, RVC

Lucas Bustillos

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.

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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.

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

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.

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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

Yuzu Tamaki

Yuzu was first diagnosed at 4½ years old with a very mild murmur June 2017. We caught it early with annual exams. No enlargement was observed, and her heart was still very strong. I was devastated it was early onset MVD, as that had a higher chance of progressing into heart failure much sooner. I did a lot of research about holistic approaches to delay the progression as much as possible. I added D-ribose, CoQ10, Omega 3, Vetri-Science Cardio Strength, Vetri-Science Cell Advance 880.

Fast forward 3 years, to June 2020. It was the first time her echocardiogram showed heart enlargement. I truly believe the supplements and raw diet kept the disease at bay for so long. Her echo 3 months prior to this appointment still showed no enlargement, but there was a sudden progression, most likely due to a ruptured chordae tendineae. She developed 3 jets, a prolapse and a mild tricuspid regurgitation. I was so glad I had Yuzu checked by a board-certified cardiologist every 3 months instead of the recommended 6 months. Yuzu was put on pimobendan for the first time. I contacted JASMINE at this point and although Yuzu was a possible candidate, we were suggested to wait another month to see if the medication would help shrink her heart a little bit.

1 month passed and Yuzu had another cardiologist appointment. The pimobendan did not help her heart decrease in size and JASMINE determined Yuzu will need surgery soon. She was stage B2 at this point and also developed a type of arrhythmia called premature atrial complexes. We were finally given the surgery date of March 2021.

Come February 2021, Covid-19 was still surging, and travel restrictions were in place. Japan was not letting any visitors in and unfortunately our surgery day got postponed to June 2021. Yuzu was coughing a lot more followed by gagging. Her heart kept getting bigger and we didn't know when she would go into heart failure. She was advanced B2, very close to C. Her heartbeat didn't sound like beats anymore, just a lot of whooshing and it was scary.

Around March 2021, we found out Japan started to issue special circumstance visas. I was lucky to be a child of a Japanese father, and with a lot of paperwork, I finally had my visa May of 2021.

June 2021, we were finally in Japan! We flew Delta and Yuzu as my emotional support animal (no longer allowed), she slept throughout the flight on my lap! She earned the Mile High Peepee Pad Club status as well 😂 Because of Covid, we had 2 weeks of mandatory quarantine in our accommodation with daily government app tracking and video calls. Yuzu on the other hand enjoyed every second of it because we were always together.

Our pre-op exam at JASMINE was our first day out of quarantine. Thorough exam was once again done on top of the complete exam done in the US. The echocardiogram confirmed how close she was to heart failure. It was a miracle we made it with dates being postponed and the hurdles in between.

June 21, surgery day was here. I kissed Yuzu on her cute little forehead and excitement and fear kicked in as JASMINE took her in to shave and prep for surgery. A few hours passed and received a call that surgery was successful without any complications and Yuzu was resting in ICU. I was dying to see her but was not able to see her until the next day.

Visitation the next day, Yuzu was still sleeping and was too weak to get up. I visited her every day and each day she looked much better. Her numbers steadily improved and on day 5 post-op, she was discharged. Echocardiogram showed minimal regurgitation and reduction in size within normal range! She was also off Pimobendan. She does not do well being apart from me, but JASMINE had the most wonderful care team that spoiled her to death!

The next week at home was difficult as Yuzu was feeling amazing. The hardest part was keeping her calm and keeping up with how well she was spoiled at JASMINE!

One week passed and we were at the post-op appointment. Echo showed a setback. Her inflammation numbers increased along with her regurgitation. Turned out she was moving too much but I was reassured, it will improve with stricter restrictions and adding pimobendan back to her routine. The plan was to stay on pimo for 3 months.

Another week passed and had our last post-op appointment before our flight home. Her numbers looked much better, and her regurgitation improved as well. We got cleared to fly on two days and were ecstatic.

Fast forward 3 months, Yuzu's follow-up appointment with her local cardiologist showed significant improvement. Her LA/Ao before surgery was 2.24, now it was 1.37. Her regurgitation decreased even more. We stuck with the plan to be on pimobendan for 3 months and now we were ready to try a full month off meds.

Her exam a month later (November, 2021) didn't give us good news. Her LA/Ao increased from 1.37 to 1.57 and her regurgitation slightly increased. JASMINE reviewed her records and concluded Yuzu needs pimobendan to help her little heart. Her activity level did increase as well after her 3-month recovery period and the sudden increase most likely added to it as a result.

It is now almost 7 months post-op as I write this, and Yuzu is still doing amazing! Yuzu celebrated her 9th birthday this January 17th! The pimobendan is truly a miracle drug that is keeping her heart the way we want it to be. She will have another exam in a month and we will be crossing our fingers for good news.

Thank you Mighty Hearts, everyone at the JASMINE clinic, and the whole Mighty Hearts MVD Community for helping us through this crazy journey. We are forever grateful!

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Breed: Cavalier King Charles Spaniel
Age at surgery: 8
Diagnosis: Stage B2
Surgery Date: June 21st, 2021
Hometown: Roseville, CA, United States
Owner: Rie Tamaki
Cardiologist: UC Davis, Dr Kaplan
Surgical Team: Dr. Masami Uechi & Team at,
Jasmine Cardiovascular Medical Center

Chloe Perry

Chloe Perry was 8.5 when she was diagnosed with a heart murmur by our local vet’s mobile echocardiogram machine, they determined she had mitral valve disease.  Our local vet said that a cardiology consult was unnecessary since the medical treatment is straight forward. Three weeks later I opted to get a cardiology consult with a well-known expert, Dr. George Kramer in Bohemia, Long Island, NY. Dr. Kramer informed me that Chloe’s heart was very large and verified she had MVD. Chloe also had severe pulmonary hypertension. He changed her medications accordingly. 

  On the second visit I asked him about the Mighty Hearts Project and Nate Estes. He said he was very familiar with the cause and had sent 17 dogs to Dr. Masami Uechi for mitral valve surgery in Japan. He said he would be totally supportive and help us get Chloe’s medical records reviewed by the JASMINE Clinic, I am glad I did.  I learned a ton of information from the Mighty Hearts MVD Community Facebook group.  I’m extremely grateful for the support I received from this group.

In February of 2021, Chloe’s condition rapidly deteriorated. She spent several days in Dr Kramer’s hospital with congestive heart failure. Although her pulmonary hypertension was under control the mitral valve disease worsened and her heart grew rapidly. Her LA:AO was 2.65 which is very large. Her trachea and bronchioles were getting crushed, and the coughing and panting were hard to manage. The Jasmine clinic gave us a surgery date of 7/6/21.

With a timeline in sight, Dr Kramer’s objective was to keep her stable to make it to Japan. He changed her diuretic to a stronger brand called Torsemide. After this change we had to carefully monitor her kidneys values.  With the assistance from the Mighty Hearts Project family, I was able to obtain a travel visa and maneuver through the newly established pandemic requirement rules for Japan.

The day came to finally travel to Japan. Dr. Kramer gave me emergency Lasix syringes and medication for the flight. Traveling solo to Japan and having to quarantine for 14 days wasn’t an easy task. My first text in Japan was from my wife and second from Dr Kramer requesting an update. He was very concerned that Chloe couldn’t hang on until surgery.

Dr. Sayaka Takeuchi was Chloe’s treating cardiologist in Japan. She was amazing and provided me daily updates while I was quarantined in my Airbnb apartment because of the Covid requirements. Dr. Takeuchi said that Chloe’s mitral valve was in extremely poor condition and her heart size may not shrink too much. Chloe had her surgery and remained in the hospital for 7 days and had the best cardiology care in the world.

Chloe was released from Jasmine, a few days later we had our final checkup before leaving Japan after spending 21 days in Japan.  After arriving back home we saw Dr. Kramer for her one-month post op visit. Dr. Kramer and his staff were so happy to see Chloe.  Dr. Kramer told me to discontinue several of her medications, Chloe’s regurgitation was mild, no more pulmonary hypertension and her LA:AO heart size was 1.4. The hardest part at home was keeping Chloe’s activity restricted for the 90 days of recovery. It is important after surgery to restrict activity as the heart heals. We see Dr. Kramer next month for a 3-month post op visit.

It’s a truly amazing experience that we took a dog to Japan in Stage D heart failure, panting, bluish tongue, at the end of her life and now she’s been given the gift of time. She is happy, frisky and like her old self again. We are extremely fortunate to have stumbled across the Mighty Hearts Project organization, to have consulted with Dr Kramer and are now able to share our journey!!! We hope many others will be able to receive this incredible medical care and successful outcome.

Brad & Chloe

Myself & Chloe with Dr. Kramer

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Breed: Cockapoo
Age: 10
Diagnosis: Stage D
Surgery Date: July 6th, 2021
Hometown: Long Island, New York, United States
Owner: Brad Perry
Cardiologist: Dr. George Kramer, Atlantic Coast Veterinary Specialist
Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center