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

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

---

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.

View fullsize

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.

---

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!

---

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

---

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

Madison Lawson-Fairfield

In May 2019, Madison went to her primary vet, Dr. Katrina Johnson, for a routine visit and I was shocked she discovered a heart murmur. I was shocked to say the least. I was there 2 weeks prior for a cyst on her back, and there was no mention of a heart murmur.

Immediately my heart fell! Dr. Johnson took x-rays and performed a few other tests. Madison was only 8 years old. How could this be so? I knew I had to see a cardiologist.

There are not very many cardiologists in the Chicago area. I scheduled an appointment to see Dr. Luethy at Medvet of Chicago. He determined Madison was B1 and stable without medication.

Shortly after her initial appointment with Dr. Luethy, I saw Madison start a downward pattern of coughing while excited, often being tired and panting after a short visit outside. All these changes happened rather quickly. I moved her appointment sooner and found out just shy of 3 months, Madison had moved to B2 and started vetmedin.

The very next day, I started the quarantine process. I did have a phone consult with RVC in England and was advised that since Madison was B2, she could be bumped for a more severe dog. At the same time, I also had my cardiologist send my records to the Jasmine Clinic.

Shortly after, I receive a March 2020 surgery date from the Jasmine Clinic. As weeks went on, Madison continued to go downhill, and her heart murmur was 5/6. I asked Jasmine to please move my date sooner and was advised their English-speaking surgeon was out of the office until March. I told them I would use an application for translation, and they agreed to the February 24, 2020, surgery date. My case manager was Dr. Chen.

I watched Madison continue to decline and suffer during the hot summer months. I was so scared and nervous and just prayed that we could keep her stable until our arrival date for surgery. Nate was so kind to help with diet changes and provided so much help, support and guidance.

Madison had cardiology visits every 2 months and moved to moderate B2, with her heart pressing on her trachea. Finally it was time for our travels to Japan. I knew about the Covid virus and armed myself with plenty of masks and hand sanitizer.

We arrived in Japan on February 18, 2020, and Izu picked us up from the airport. I do recall going past the Diamond Princess ship that was offshore Japan with many covid passengers. That felt so leary to me, but here we are. Izu dropped us off to Atsuko's Azumino apartment. Atsuko gave us a tour and we settled in.

Finally. our pre-op visit was 4 days later, and Dr. Chen advised that Madison's valve was severe. I just burst into tears. She performed an echo and all bloodwork, and I signed all appropriate paperwork for Madison's surgery. I knew Madison was in the best hands possible.

Madison in the final stages of heart repair surgery, closure.

February 24th arrived, and we were the 3rd surgery of the day. We arrived and they shaved Madison and brought her back out to me for a while. Surgery time arrived, and I knew it wouldn't be long until I saw her again. I kissed her goodbye and told her that mom will see her in just a little bit.

We went to a local restaurant close-by and was given a time to come back to the clinic. Madison was out of surgery after 3.5 hours. 7 chordae were replaced, and she did well during surgery. They did allow me back to see her and I knew the worst part was over.

We took the train daily to visit Madison and her numbers improved day by day. We brought her cooked chicken breasts daily, feeding her, and spent a little time with her. They released Madison from the clinic after 5 days. She was so excited to be released to me and it was so hard to keep her calm. Madison's heart returned to normal size by the time we left japan.

Madison Is released from Jasmine

We continued with our follow-ups until the day arrived for us to fly back to Chicago. By this time, covid took hold in the US and flights were being shut down. We arrived home just in time.

Madison continued to improve leaps and bounds every single day. Our cardiology visits were great and Dr. Luethy could barely hear a murmur.

Madison stopped all heart medications after her surgery in Japan. Here we are, almost a year and a half later, with no heart medications needed. She has remained stable, and all cardiology visits remain positive.

First and foremost, I thank God. I also thank Nate, Dr. Chen, Dr. Masami and his team. I thank Dr. Luethy and my vet, Dr. Johnson. We all worked hand-in-hand for a successful surgery for my precious baby Madison.

Breed: Shih Tzu
Age: 9
Diagnosis: Stage B2
Surgery Date: February 24th, 2020
Hometown: Crete, IL, United States
Owner: Michelle Lawson-Fairfield
Primary Vet: Katrina Johnson VCA Forest South Animal Hospital
Cardiologist: Michael Luethy MedVet of Chicago
Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center

Snickers Kay

December 2019, I noticed our 11-year-old chihuahua was breathing very fast. I asked my fiancé James if this was normal, he quickly answered no. We immediately rushed Snickers to the nearest emergency veterinarian hospital. After multiple tests the doctor came and informed us that Snickers has mitral valve disease. My heart sank to the floor. I could not believe this was happening. She proceeded to tell us that his prognosis was approximately 8-10 months maximum to live. Unfortunately, I knew this fact all too well. You see, my first dog, Coco, also had this horrible disease and ultimately died from it.

James asked the doctor if there was anything or anyone that could help Snickers. We were desperate and willing to do anything to save him. She mentioned a doctor in Japan, but said it was very expensive and does not know anyone who ever followed through with it. As we left Snickers in the ER the tears streamed down my face. James looked at me and told me “I promise I’m going to save him.” I wanted to believe him, but I did not know how he was going to make that happen. That evening, when we got home, James searched google for hours. That is when he came across Mighty Hearts Project. We joined the Facebook MVD Community group and then received a call from a gentleman by the name of Nate Estes. Nate shared with us his personal experiences with Might Hearts. In that moment, I finally felt a huge sigh of relief, finally a glimmer of hope.

After Snickers came home, we took him to a to local veterinary cardiologist who recommended we take him off furosemide. Shortly after, Snickers quickly went into his second heart failure episode. As we sat waiting and praying that Snickers would stabilize, James did what he does best, more research. The more posts we read, the more we kept seeing the name Dr. Simon Swift in Gainesville, FL. This seemed to be where he was practicing, only a 4-hour drive from our home. On Christmas Day, we emailed Dr. Swift begging him for help because he could be Snickers last resort. Dr. Swift responded requesting us to bring him in to assess him. We waited until Snickers was once again discharged and drove to meet Dr. Swift, the man who would save his life.

I could write a novel about Dr. Swift...his demeanor, his presence, his empathy, his knowledge. Dr. Swift saved Snickers. I know what you’re thinking, Dr. Uechi saved Snickers, and he did. But Snickers would not have made it to Japan without Dr. Swift. The importance of a GREAT cardiologist was so evident. We went every 2 months to go see Dr. Swift for over a year. February 2020, we scheduled a call with Dr. Brockman and scheduled Snickers for surgery on May 28th. We were over the moon; we were going to save our baby. One week after our call we got the email the RVC was suspending their heart surgery program due to staffing. We were once again crushed but hopefully this would be temporary.

Snickers 3rd heart failure episode happened on July 4th, 2020. This one was bad. Snickers was coughing up blood and they called us to come say our goodbyes. I begged the young doctor not to give up. I told him Snickers was going to have heart surgery and to do whatever he had to stabilize him. That’s where Dr. Tucker comes in. Dr. Tucker had been an emergency room veterinarian for over 20 years. When she heard the young doctor calling us to say there was nothing more that could be done, she took over. Dr. Tucker told us that this will be a slow process, but she believed we could get Snickers out of heart failure. Four days later, she did. At this time, we knew we could not continue to wait for RVC and started the 180-day Japanese quarantine. Only problem was we were in the middle of a pandemic. Japan was only allowing Japanese nationals. Snickers 4th heart failure episode happened when we tried to control his coughing. He was waking up in the middle of the night coughing and gasping for air. Our hearts broke knowing he wasn’t comfortable. He was prescribed prednisone by another doctor and immediately went into heart failure.

By this time we knew this pandemic was here to stay and we needed to think outside of the box if we were going to save Snickers. James joined a group on Facebook called ‘Return to Japan’ and messaged over 100 Japanese nationals asking if they would take Snickers from the states to Japan for three weeks. I’ll be honest, I think most people thought he was a crazy person. A man offering to pay for your flight, hotel, and compensation for taking his chihuahua to Japan for a lifesaving surgery? Hmm....I think I’ll pass. Enter Haruno. Haruno was a member of the group and had responded to another person’s question about the restrictions. James sent her a private message explaining our situation and she responded that she had a sister that lived in NY who was a Japanese national. She said she would speak to her sister and get back to us. Three days passed and James sent a message asking if she wanted any documentation to prove this was a legitimate trip. She asked us for email correspondence with Jasmine clinic. After she saw emails dating back to December 2019 she agreed on a zoom call with her, her sister Kotono, James and myself. After speaking for 10 minutes and explaining everything we asked Kotono to think about it and get back to us. The next morning, she agreed to take the lifesaving trip with Snickers from NYC to Japan.

The next 150 days was a series of what can go wrong will go wrong. From the wrong forms being submitted to Japanese Quarantine to having to sedate Snickers most of the day in order to preserve his health. We flew to NYC to meet a total stranger who was going to take our Snickers on a 14-hour flight to another country. We were terrified saying goodbye at the airport knowing this could be the last time we see Snickers alive. The difficult path continued to the last day when Japan announced that anyone flying from the states would need to take a 72-hour PCR test prior to getting on the flight. This news wouldn’t have been a big deal if it wasn’t announced as we were at the airport sending Snickers and Kotono off. We received a panicked call from Izu telling us that Kotono would be taken from the airport to a government hotel and separated from Snickers.

Oh no! Snickers would never survive this! But, by the grace of God with every roadblock was a path to success and Florida did not have this restriction go into effect until 3 days after the announcement, we were safe. Snickers had surgery at Jasmine Clinic on January 12th, 2021, with Dr. Uechi. We received the call from Sayaka that surgery went well, and Snickers was stable, thank God! Fast forward five months...Snickers murmur went from a grade 6 to grade 3, his heart shrunk to pre-disease size, his respiration is 12 bpm, and most importantly he gets to enjoy sprinting without coughing when he sees a squirrel he wants to chase.

If you told me back in December 2019 that we would find a stranger to take our chihuahua from the states to Japan for a lifesaving surgery in the middle of a pandemic. I would never have believed you. But none of this would have been possible without Nate, Dr. Swift, and Dr. Uechi. This experience showed me that miracles can happen and there is truly good in the world. Never give up, the path isn’t easy...it’s full of roadblocks. But the end result, man the end result is so beautiful I couldn’t even put it into words.

Lots of love from the Kay family.

A beautiful video of Snickers seeing mom and dad back in the US after surgery.

Breed: Chihuahua Age: 12 Diagnosis: Stage D Surgery Date: January 12th, 2021 Hometown: Boynton Beach, Florida, United States Owner: Jennifer and James Kay Primary Vet: Dr. Michele Tucker, VCA Cardiologist: Dr. Simon Swift
Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center

Dumpling Yean

It all started when Dumpling, just turned ten years old. He was due for a full annual exam, I noted that he had a cough. My vet noticed a heart murmur that was never detected before (when we were living abroad in France), she referred me to the cardiologist for further diagnostics. July of 2019 Dumpling was sadly diagnosed with mitral valve heart disease. It was determined he was at stage B2. His left side of his heart was visibly enlarged. Immediately he had to start taking two different kinds of medicines, Vetmedin to keep his heart pumping more effectively, and Hydrocodone to help suppress his cough.

I discovered a group by the name of Mighty Hearts Project on Instagram where I learned of the cardiac surgery group in Japan led by Dr. Masami Uechi (Jasmine) where they have shown successful outcomes (>90% success rates) in dogs undergoing mitral valve repair for degenerative mitral valve disease. The surgery is a complete valve repair!

Immediately I began the preparations for Dumpling to get on the surgery waitlist, since this is a highly specialized surgery and only a few teams in the world perform it, all based off Dr. Uechi’s technique. Dumpling was deemed too early the first time we tried looking into surgery back in September of 2019, we were told to try again after another six months had passed by doing another echocardiogram. In the meantime, we started his 180-day quarantine to get into Japan.

April 2020, we did another echocardiogram and submitted the results to Dr. Takeuchi in Japan. This time, she said his heart has degenerated to a point where he was eligible for surgery. Unfortunately, she was right and on July 3rd Dumpling had his first check-in to the emergency room, due to congestive heart failure - his heart condition had slipped into stage C quickly! Time was of the essence. We had to get to Japan for his life-saving surgery right away.

Jasmine’s first opening was in the fall of 2020. We scheduled surgery around Thanksgiving/December of 2020, the first appointment we could get. In the meantime, the entire world was dealing with the Covid-19 Pandemic and travel bans, but I did not lose hope and thought things would open up for us.

In September the Japan Animal Quarantine Office granted him clearance to come into Tokyo after I submitted his Rabies Titer information after completing the 180-day waiting process. This was one hurdle completed but I was still not granted the temporary visa to get into the country yet. I went to the Japanese Consulate and submitting many documents for the visa, and it was denied in September, (they did not even want to submit it formally as it would mean I was banned from Japan for six months if rejected formally), as I am American and not a Japanese national. The rejection was a crushing blow and super stressful, we did not give up. I went back in the middle of October to apply again for a medical or tourist visa, unfortunately I was denied the visa and asked to retract my application again, cases of Covid-19 were too high and they couldn’t risk letting in any foreigners now. Of course, this blow was heartbreaking.

Due to the lack of a visa I had to reschedule Dumpling’s surgery from the week of Thanksgiving to January. For the next two months I checked with the Japanese Consulate with hope and diligence that they would accept my application and grant me the visa. I also had my Japanese friend call the Tokyo Visa office, and we tag teamed both of them from the USA and Japan offices to try to get them to accept my application, they finally did and granted me my visa in the final hour, week of Christmas! At the same time, I had to deal with the new legislation that took away the rights for ESA animals to travel in the cabin. Through much discussion and help with the great team at ANA, they decided to honor my original ESA pet in-cabin booking as it was made before the U.S. law took effect in January. Again, crisis averted. We did have a slight wait but no problems getting Dumpling’s forms for export with the USDA office.

On January 4th we were on our way to Japan. Upon check-in at LAX, the airline told me that my visa was no longer valid as new restrictions were placed on tourists due to the two new strains of COVID-19. I pleaded my case and after calling Japan she agreed to let us board on the condition that I sign a contract to see if I was denied entry to Japan and had to turn back, I would be responsible for all charges. When we landed that is when the nightmare began. Unexpected hurdle number two, apparently while I was in-flight Japan issued a new law that placed California on a new red list. The officer explained it was mandatory that I had to stay at a government hotel to self-quarantine, no exceptions, and pets were not allowed. No matter how much I tried to reason and plead it was no use this time...I was so sad realizing Dumpling and I had to be apart for two crucial weeks of pre and post surgery.

I had to pivot and quickly book Dumpling to be boarded at a friend’s vet in Tokyo and arrange him to be driven there alone with the Pet Taxi service, I was not allowed to go into Tokyo with him. The customs officers escorted me to my bus to go to the quarantine hotel after we separated at baggage claim. I was very sad and scared for Dumpling to be apart from me after such a long flight.

On January 7th I took Dumpling's pre-operative appointment via video from my quarantine hotel. Since we were apart, I had to make sure I was communicating with everyone on the ground (his pet taxi driver, his local vet boarding, and Jasmine) remotely. Mr. Izu, Dumpling's Pet Taxi driver kindly took a picture of the Jasmine building for me, and it is quite impressive, it’s a huge animal hospital! I met with Dr. Takeuchi over ZOOM and was so happy to see my little boy in the frame doing well. I took a little screenshot of Big D in the carrier, and he seemed content, he was grooming and burrowing in the blanket. Dumpling was tested for his blood work and overall heart check with x-rays and echocardiograms. He was cleared for his surgery in 5 days.

By January 10th the Japanese authorities surprised me by letting me out of the Quarantine hotel early, as I tested negative three times in a row. I had to sign an honor contract that let them track my whereabouts in Japan and had to report my temperature on a government APP daily for the rest of my two-week quarantine period, but was free to go to my AirBNB. I was thrilled to leave and was able to spend the 11th with Dumpling, a full day before his surgery. Last night I had Dumpling sleep with me and I cuddled with him, prayed, gave him a lot of soothing kisses and pep talks. He knew something big was coming up!

January 12th was his Heart Surgery Day. It was a hopeful, grateful, and nerve-wracking day. Mr. Izu picked up Dumpling at 6 am to take him on his solo ride to Jasmine (I was still in quarantine and was not allowed to go). He was so nice to help us take a picture together, as well as gave me a gift - a small calendar that had chihuahuas on it, just so kind! My heart hurt when I saw them drive off without me. Jasmine and I had a pre-surgery zoom where I met Dr. Uechi. We had a translated conversation together where he told me that Dumpling looked good for surgery. I thanked him and wished him good luck on the surgery.

After his 5 hour long surgery, I received communication from Jasmine. I was so anxious. He finished surgery and was now in the ICU. The surgery went well without any major complications. Bleeding was as expected for a cardiac surgery. Dumpling’s heart had 2 to 3 major chords that were broken and the rest were stretched. Today he has 7 new chords placed with goretex sutures. The goal of the new chords are to allow the leaflets to close better to reduce the regurgitation volume. It’s a miracle, a 1.5 year journey to get this done. I believe in science and the power it has to heal and save lives. I am beyond grateful for this blessing.

I was not allowed to see him during his week in ICU for recovery post surgery. The first three days were crucial to his recovery. Jasmine updated me a few times each day. He had anemia, low blood platelet count, and typical bruising. They tried to keep his inflammation down and stop blood clots from forming. I was also shocked to learn he had a partial seizure on the 15th. On the bright side he still had a hearty appetite and was strong enough to walk outside. Within that week his vitals all improved. The 19th was the big day. Time for Dumpling’s discharge from the Jasmine clinic and into my home (Air BNB) care. It was my first time seeing him post-surgery.

It was also the day that I was officially off the 14 day quarantine with the Japanese government. Seeing Jasmine in person was a wonderful moment - the crescendo of 1.5 years of hope and work towards Dumpling’s journey. It is brand new, big, and clean - a totally impressive new place where they do life saving work for dogs. The lobby was spacious and Covid-friendly. There were a few local Japanese patients, all little fur babies waiting patiently inside their carriers. Exactly as scheduled, Dr. Takeuchi opened the patient room door to welcome me. Dumpling was there and so shocked to see me. We had an amazing reunion where my little guy showered me with tons of kisses. He looked visibly tired and a little skinnier but all in all so good. He was ready to go home.

Her directions to me were clear, limited exercise and activity for the next three months. Feed him nutritious food (his appetite was hearty), and watch out for his heart and breathing. His vitals were improving and he was going to the bathroom regularly. He is down to one medication a day (blood thinner) instead of four. He had huge stitches and lots of deep colored bruises, but Sayaka told me it did not cause him pain. All good signs.

We did one last echo before his discharge and did not yet see his heart shrinking, she explained this process fluctuates in the next three months after surgery as his heart hopefully learns to be small again. Sayaka explained some dogs hearts never get small again, it depends on the muscle’s response and tissue reactivity. Because this was a repair, and not a replacement, the regurgitation will always be there a tiny bit. The heart will still continue to age, there are still the aortic and tricuspid valves that can leak, even if we repaired the main one, the mitral valve. We have added more years to Dumpling’s life and hopefully we won’t have to worry about the mitral valve ever again.

Friday January 23rd Dumpling had his last appointment at Jasmine. Dr. Takeuchi was able to remove the stitches that were on his neck and chest, his skin had healed nicely. Two thirds of his dark red bruising healed. She also did his bloodwork and another echocardiogram. Good news is that his anemia improved and his platelet counts were up. Bad news is that his heart size has not decreased yet, and she says it is because he is moving too much. Dumpling made a point to say hi to everyone in the staff, I think he knew he was thanking them and saying goodbye. So thankful for this incredible team at Jasmine Animal Hospital and Dr. Uechi and Dr. Takeuchi. They are such experts and so caring. Once I got their blessings and strict instructions (3 month recovery), we gave our kind goodbyes and I hope we never have to come back in Dumpling’s lifetime. Izu from the Pet Taxi drove us to the airport the very next day and we had a nice, uneventful flight on ANA back to Los Angeles, the crew was so nice to us. Our Japan journey was officially over and a success.

It is with gratitude and love that I can say Dumpling has recovered well from his surgery at Jasmine and is flourishing. His 12th birthday was spent on the beach in March. As we approach month five post-op, he had the green light from Jasmine and my cardiologist Dr. Emily Chapel to do 20 minute walks again and his heart has shrunk back down to the size of the beginning size of B2, which is quite significant for a brave boy his advanced age. He still has his coughing due to his collapsed trachea condition, (common in small dogs) but the coughs sound different than before the surgery, where it was due to his heart disease. He takes Vetmedin twice a day now to keep his heart pumping optimized, but no longer needs any other meds like Furosemide or Enalapril. He now has a bit of separation anxiety and is way more loving and close to me than before. I give him extra cuddles and kisses everyday, I am so thankful and really enjoy each day that is bestowed upon us. It’s such a gift from the amazing mitral valve surgery by the amazing Dr. Uechi, Dr. Takeuchi, and the wonderful team at Jasmine.

Dumpling and I LOVE you all and THANK you for supporting his surgical journey. He will forever have a place in his heart for you all and Japan in his little mighty heart.

If you have any questions about the surgery, Japan recommendations or need any support whatsoever please feel free to reach out to me on Facebook and IG.

Dr. Sayaka Takeuchi with Eva & Dumpling

Breed: Chihuahua Age: 11 Diagnosis: Stage C Surgery Date: January 12th, 2021 Hometown: Los Angeles, CA, United States Owner: Eva Yean Primary Vet: Dr. Jeff Werber Cardiologist: Dr. Emily Chapel, Access Specialty Animal Hospitals Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center

Hazel Radon

Hazel is a brilliant, attentive, and shy Cavachon. She gets a lot of attention but has somehow managed not to get spoiled or pick up too many bad behaviors. When Hazel was 5, her vet noted a slight heart murmur during a routine check-up. Barely audible.

 In the summer of 2018 at the age of 9, she had an infection which the vet mistook for congestive heart failure. Our vet sent us to Veterinary Cardiologist Consultants (VCC) who assured us it wasn’t congestive heart failure. Her murmur was moderate and although her mitral valve was leaking, it was minimal. VCC asked us to bring her back in a year.

 Six months later, in late Feb of 2019, Hazel had another cough. We made a vet appointment for a Saturday morning. Early Saturday morning we woke up to find Hazel panting, coughing, and her heart racing. We spent 10-15 minutes trying to see if we could calm her down. When that didn’t work, we snapped a video and rushed her to emergency. They whisked Hazel off, got her in an oxygen chamber and tossed every treatment they had at her. It was dicey, but she recovered over the weekend and we were allowed to bring her home.

 A later echocardiogram would confirm that several chordae tendineae had ruptured. Her cardiologist at the time, Dr. Christian Weder, let us know that Hazel had suffered a catastrophic failure. A failure that’s usually fatal. We were informed that dogs who survive an incident of this magnitude often do better, and on medication she might live for 9-12 months.

 That same day, with a lot of new medications in hand, we started to research. I found references to mitral valve repairs in various journals. Then, I found Mighty Hearts Project and realized that people were actually going through with these surgeries.

 Unsure of the efficacy, we immediately sent Dr. Weder an email and asked him what he thought of Mighty Hearts Project and the MVR surgeries. Dr. Weder replied early in the morning the next day. We read the email and cried with hope. Dr. Weder had studied with Dr. Uechi at Cornell. Furthermore, he had a patient (JoJo) returning from RVC after a successful surgery. We were told if we went that route, chances were very good that Hazel could live symptom free for the rest of her natural life.

 The next few days were a whirlwind. Dr. Weder connected us with JoJo’s owner. We asked to get on RVC’s waitlist. We put together a project plan based on the guidance from Mighty Hearts Project. We signed up with the Facebook MVD Community group to find how people were handling travel.

 On March 15th, 2019, Hazel was given a surgery date of June 4th. Timing wise, Hazel was extremely lucky. RVC had just doubled their capacity and were able to get us in much quicker. Her surgery threaded the needle between increased capacity at RVC and the suspension of the surgeries at RVC and furthermore, COVID-19.

 We began training Hazel to fly. We practiced using a stroller and travel carrier. We obtained some anti-anxiety medication for her to reduce all of our stress. Hazel did fantastic on the flight. She refused to go on the pee pads and at the very end of the flight ended up peeing on a blanket we had for her, but otherwise did great.

 During the surgical process, we stayed in Harpenden. The apartments there had an interesting vibe. It felt like a tiny dog heart surgery community. People brought food to one another, shared tips, shared rides, and just generally took care of one another.

 Hazel had her surgery on schedule and recovered without incident. I was able to work remotely while overseas. The time difference was very useful. I was able to spend mornings with Hazel in recovery and work in the afternoons and evenings. Once Hazel was released, she had some pretty bad indigestion. Enough that I took her back to RVC one evening to receive fluids. The bypass machine can be pretty rough to recover from and they’ll give the dog anything to keep them eating in recovery.

 The flight home was largely uneventful. My wife had been home for a few weeks during Hazel’s recovery and had prepared the house. Baby gates on the stairs. Furniture she could jump on moved into one room and gated off. Mattress on the floor. Ramp down our front steps. Those steps made the recovery much less stressful. The 4th of July was just a few days after we arrived back home. Hazel is terrified of fireworks, so we booked a hotel far away from any neighborhoods or planned shows.

 As of October 2020, Hazel is now 1 year and 4 months post-surgery. She’s doing well entirely without medication. Her checkups have shown no change in heart size or valve function for the past 6 months. The only lingering symptom is a cough after drinking and occasionally choking on her food. We believe that to be from the time she spent with an enlarged heart pressing on her trachea and esophagus. Raising her bowls (at the recommendation of her cardiologist) and using a slow-feed bowl have eliminated the incidents of choking.

 In the end, we feel extremely lucky to have her well past her initial prognosis. She’s happy, healthy, and very lucky.

Breed: Cavachon Age: 10 Diagnosis: Stage C Surgery Date: June 4th, 2019 Hometown: Novi, MI, United States Owner: Jonathan Radon Primary Vet: Dr. Gorbea, Plymouth Veterinary Hospital Cardiologist: Dr. Weder/Dr. DeSana, Veterinary Cardiology Consultants Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow