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

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

Bixby Morton

On one of his regular checkups the vet told me Bixby had a low-grade heart murmur. To be honest I didn’t think much of it as my brother had one for years with no issues. Dumb, I know, dogs are not humans. The vet said not to worry as Bixby was at a 2 out of 6. So, I didn’t worry. When he went in for his next well check on July 1st, 2019, the murmur had progressed. At this visit Bixby got a rabies vaccination and was also given some new heartworm injection. Within two days Bixby’s breathing became rapid and he started coughing.

My vet recommended Bixby get an echo with the mobile cardiologist that visits their office periodically. The echo showed significant enlargement and the cardiologist prescribed pimobendan and Lasix with a repeat echo in a month. The repeat echo showed continuing fluid buildup and the cardiologist told me to monitor his breathing but nothing else. In fact, the mobile cardiologist wouldn’t speak to me directly at all, let alone meet with me. At this point, I was very concerned that since he wouldn’t talk to me and just prescribed meds, I really didn’t know what was going on. I insisted on another cardiologist referral and that’s how I found Dr. Sarah Miller at Blue Pearl hospital in Irvine. I was familiar with Blue Pearl because Bixby had been treated by Dr. Barry there for about 5 years for epilepsy. I was able to get an appointment the first week of September. By then Bixby had 2 torn chords and his heart had weakened significantly.

Bixby was losing a lot of weight and I was fretting every day to find something/anything he would eat. Thankfully, when I walked into the examination room there was written on a whiteboard, “if you are interested in surgery for mitral valve repair for your pet please ask us”. Suddenly, there was hope! Dr. Miller told me of Mighty Hearts Project that day. I looked it up and called Nate right away. It was like giving a drowning person a lifeline. Nate took a lot of time walking me through the process, referring me to places for information and generally calming me down. What a godsend!

Sean Pador who was an intern at Blue Pearl started Bixby on his journey to recovery. He forwarded all of Bixby’s records to Japan and the RVC in London. By September 13th, 2019 Bixby had been accepted to japan and London for surgery. This really took a team effort. A vet tech, named Meg at Estrella got all of their records together and helped me navigate all the paperwork. Japan warned me that Bixby’s epilepsy could worsen from the surgery but Dr. Brockman at RVC was not as concerned.

Unfortunately to get everything done for Japan would put surgery off until March of 2020. The Royal Veterinary College, (RVC) was scheduling in February 2020 and having great results with Dr. Dan Brockman so I went with them. His first scheduled available date was February 17th. The challenge was to keep him stable until then. Bixby was on 6 different medications, not eating, epileptic, and by early October had tested positive for Cushing’s. It just kept getting worse.

Bixby was taken off spironolactone to see if his appetite increased in mid-October. He seemed perkier and ate a little more but on October 22nd Bixby was hospitalized with azotemia. He was treated and released after 2 days. The balancing act of cardiac drugs and kidney failure would continue until his surgery. I took Bixby to a nephrologist in November. Drs Miller and Pador notified the RVC of the kidney failure issue and the RVC was able to give me a moved-up surgery date of December 3rd which was only a week away from the time they notified me. My excitement was soon dashed when I discovered that the requirement to enter the UK of a dog being microchipped BEFORE the rabies vaccine that would be used to count days before entry into the country was a hard and fast rule without exception.

Bixby had to be revaccinated (which I hated), to start the countdown to RVC. They then gave me the date of January 6th for surgery. I got all the paperwork together while every day I was praying Bixby would make it to surgery. His breathing kept getting worse and he had lost 6 of his 22 pounds.

On December 27th, 2019 Bixby passed out. At the time he was on spironolactone (restarted after his kidney failure), vetmedin, mirtazapine, zonisamide (for seizures), norvasc, furosemide, and Rena Kate gel. His breathing during this time was 40-50 and coughing a lot. His breathing would get up to 90 at times. Dr Miller who was in Portugal) recommended that I get X-rays done. They showed increased fluid buildup in the lungs. Bixby had to get a furosemide injection as it responds quicker in removing the fluids and then switch to torsemide, a stronger diuretic that is even harder on the kidneys. His spironolactone was also increased on December 29th.

I was trying to keep my panic level manageable by this time as I left on New Year’s Eve for London with Bixby. I had Valium for Bixby which he had to take 3 times on the flight. He was quite agitated without it and peeing so much he went through 10 diapers (which he had never used). When we checked in to RVC on January 3rd they told me they were shocked to see how friendly and perky Bixby was. In fact, they honestly said they didn’t think he would make it. Bixby’s personality is such that he loves meeting new people and I think going out to the pub and the Italian restaurant in Harpenden before surgery made him happy.

Mom visiting Bixby in recovery

His surgery was January 6th. I did not leave the hospital until I heard he made it! Then I went out and had a lot of wine. He is his friendly happy robust self now and I count each day as a bonus day with him. Dr Brockman, Alison and Sarah at RVC are amazing people. I only wish everyone who needs this surgery had access to it. Just a couple weeks after Bixby’s surgery sadly the program was stopped because of staffing issues. A great loss to this community and I hope it restarts in 2021.

With all of the obstacles we encountered, we never gave up hope because of the support I got from my family, the doctors, support staff and especially Nate Estes. Without Nate and this group Mighty Hearts Project I would not have my little man today.

Breed: Bichon/Poodle mix
Age: 11
Diagnosis: Stage D
Surgery Date: January 6th, 2020
Hometown: Dana Point, California, United States
Owner: Diane Morton Primary Vet: Dr. Ryan Bloese, Estrella Veterinary Hospital
Cardiologist: Dr. Sarah Miller, Blue Pearl Pet Hospital, Irvine Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Kobe Wong

Kobe is a loving Maltese who wants to constantly be around people, he was formerly named after Kobe Bryant (NBA player). He enjoys watching TV and barking at dogs and cartoons that show up on all the channels. He loves belly rubs, eating chicken and sleeping on pillows like a human. When we first got him as a puppy, he was the only one that sat there and did nothing while all the other adorable puppies were running around like crazy. Even since then, we knew he was the one!

When Kobe's birthday came in January 2019 when he was ten years old, he went completely deaf. The doctor said he had a low grade heart murmur but I never fully comprehended what that meant. Fast forward to June 1st 2019, my parents were watching Kobe for a few weeks as I often work. This day was special as it was our wedding date. Kobe wore a tux to the wedding and he looked very cute. We always envisioned him being at our wedding! Later that day, my parents took him home, but I said to drop him off at my sisters apartment as I wanted to watch him since it's been a few weeks.

Kobe was acting relatively normal at my sisters apartment. Later that evening, while we were driving him home he was breathing quite rapidly. All night his breathing rate was intense and he did not look the same. We were concerned if he got sick and trying to understand what exactly happened. We took him to the vet the next morning and they found that he had fluid in his lungs. The vet told us to see a cardiologist. A few days later after a cardiologist appointment, he was diagnosed with mitral valve disease and that he developed congestive heart failure as a result. We were told he had only 6-12 months to live and that there's nothing we could do to correct this.

We spent the next few weeks crying and feeling sorry for Kobe. I had so many regrets not spending enough quality time with him. I researched mitral valve disease (MVD) and came across the Mighty Hearts Project organization while google searching. Nate Estes was kind enough to speak to me for over an hour and was extremely compassionate. I quickly realized that there was a chance if we flew to London or Japan then Kobe could have a chance.

The financial toll is extremely frightening and my friends and family cautioned against this. Within a few days, I already knew my answer. Kobe has been there for me so many times during many low points in my life. I had to repay him the favor and save his life! Within a few days, I made a website and a gofundme page and was able to raise a few thousand dollars from kind friends and family. We were so blessed to get donations that it gave me enough motivation to fight for him. On December 4th,

Kobe in recovery after MVR surgery

We flew to London for his surgery at the Royal Veterinarian College (RVC). We took him to a winter festival and the Camden market nearby. This was his first vacation ever and gave us quality bonding time together. I was lucky enough to be able to work at my companies London office. Kobe’s surgery was on December 10th where he survived open heart bypass surgery and recovered very well! By the time he was discharged, I was shown a final echo of his heart and it had already returned to its normal size! The staff at the RVC is so compassionate, Dr. Dan Brockman and his staff are truly amazing.

We finally were heading home after a post-op checkup at the RVC to get the all clear to fly home. When we flew Kobe back home, he literally barked at every person at Heathrow Airport, that's how I knew Kobe was getting back to his normal self. After safely arriving home Kobe was quarantined at my parents house for three months and was recovering well. When he finally finished his quarantine three months later, COVID-19 had hit the United States and then we were being quarantined! It was an opportunity for us to spend even more additional time together and he has been attached to us at the hip ever since!

Breed: Maltese
Age: 10
Diagnosis:Stage C
Surgery Date: December 10th, 2019
Hometown: Staten Island, New York, United States
Owner: Matthew Wong
Cardiologist:: Dr. Joshua A Morgenstern, Veterinary Medical Center of Long Island
Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Chockie Deglow

Up until November 15, 2018 Chockie had pretty much been the healthiest dog I’ve known. That is the day everything changed for us. I couldn’t understand why Chockie was coughing... I don’t take him to parks, kennels or around other dogs, so not kennel cough. I knew to count his respiratory rate but didn’t know why or what it meant. I only knew it should be under 30 and his was near 60. I was so lucky that Torrey Pines Animal Hospital got us in same day. I was shocked when Dr. McClellan told us he had a grade 5 heart murmur (from no heart murmur the previous May 2018), his heart was enlarged and he had fluid in his lungs.  This was his first episode of Congestive Heart Failure. Luckily we were able to easily get him out of this episode of CHF. Looking back I felt so naive, uneducated, even stupid. I feel like I’m pretty dog savvy, I ran the Southern California Section of Italian Greyhound Rescue for years, but I had no idea what this was or what I was doing. Chockie was started on Pimobendan and a low dose of Lasix. 

Chockie had his first Echo on November 20, 2019. At that time, on the referral of our vet, we used a mobile cardiologist who came into our vets office. He told me he expected his echo to be much worse with the symptoms Dr. McClellan and I had described. He said Chockie had a murmur is V/VI, severe degenerative mitral thickening but mild leak, mild left cardiac enlargement, normal right heart size and intact atrial septum. The treatment was to add Enalapril, continue the Pimo and the Lasix at a reduced dose or we could go off if we felt his respiratory rate was ok (I later found out we probably shouldn’t have been doing this). He suggested to follow up with a renal panel in one week, chest X-rays and echo in six months and to continue to monitor his respiratory rate.

Chockie held fairly steady until Mid-March 2019. One morning I left for work, Chockie was happy and normal. I came home 4 hours later and immediately new something was wrong, his respiratory rate was between 60-75. I was able to take him into Torrey Pines Animal Hospital for chest X-rays and they confirmed another episode of CHF and he was given a Lasix injection. At that time we also increased his Lasix dosage a bit. We kept having to increase his Lasix dosage for the next few weeks.

Chockie’s six month follow up was April 5, 2019, which could not of come at a better time. Still being naive about all of this I thought his condition would be status-quo.  The cardiologist called and told us he had very bad news, that his valve had completely torn (this is what I heard, not sure if this is what he really said) and he probably had six months to live and to keep him comfortable. We were not expecting this news, I remember this like it was yesterday, we were so depressed. The echo report noted: Severe mitral valve regurgitation and flail leaflet. Moderate left atrial hypertension. Recent congestive heart failure. The left heart size continues to grow larger. Today left atrial pressures are increased. The flail anterior mitral valve leaflet likely occurred recently causing progressive leak and clinical signs of CHF. In addition to lasix, Pimo and Enalapril the cardiologist added Amlodipine. We were told to just keep him comfortable.

After the cloud of depression finally lifted I thought to myself they fix people, why can’t they fix dogs? And that’s how I found Mighty Hearts. I had everything ready to submit to the RVC except for the echo videos and unfortunately my cardiologist didn’t keep them. I was able to get Chockie back in for another echo on May 7, 2019 to get the videos and was able to submit everything to RVC on May 8th, I got a response from RVC on May 9th, and we had our call on May 15, 2019. Everything was still so new to me, I asked Dr. Brockman what stage Chockie was in and he told me B2. We got our surgery date of September 23, 2019. We thought that is far away but he’s stable so this will be no problem. I can’t tell you how wrong we were.

I started having a really hard time getting Chockie to eat, he became very finicky and wouldn’t eat out of a dog bowl.  He would eat something one day so I would run out and buy a bunch of it and the next day he would run away from it.  This frustrated me to tears, I would spend 2.5 hours in the morning and evening trying to get him to eat. Some days he would just eat plain pasta and I thought it was better than nothing. I later found out they start doing this when they can’t breathe.

June 1st - 5th. Leading up to June 1st, in addition to Chockie losing interest in eating he also had another Lasix increase. I noticed a change in his breathing and it started to get upwards of 50. I took him to the ER, hoping we could just have a lasix injection and go home. They did X-rays, put him in oxygen and gave him a lasix injection. I begged the ER vet, Dr. O’Donnell, to let me take him home where he would be much more relaxed. I think she felt there was enough improvement that she discharged him. 

The next day, June 2nd, I monitored Chockie like crazy. He didn’t want breakfast and his respiratory rate ranged from 30 and crept up to the 60’s. I took him to the ER at 8:15PM, this time thinking they would want to hospitalize him and I would allow it. It was a different ER vet, he did chest X-rays, oxygen therapy and a lasix injection and didn’t feel it was necessary to keep him because he didn’t hear much crackling in his lungs. I still kick myself for believing that vet that Chockie was ok. When we got home around 10:30PM I didn’t feel there was any improvement. Between 11PM and 4AM on June 3rd his respiratory rate got up into the 90s. At 4AM I took him back to the ER, they immediately put him in oxygen and admitted him. I later found out his respiratory rate was over 120 when I brought him in. It took him 10 hours in oxygen with lasix injections to get his respiratory rate into the 80s. Dr. Botha and Dr. Itsvan were the critical care specialists looking after him and took amazing care of him. They along with my cardiologist couldn’t understand why his respiratory rate was so high when his lungs were pretty clear.  Chockie stayed in the hospital until June 5th. During that time there was a veterinary cardiology convention and the two cardiologists that are attached to the hospital were away at the convention and no one was available to do an echo. They finally got him stabilized and on June 5th he was discharged. They increased his Lasix again and added Spironolactone. At this point he was on Lasix, Pimo, Enalapril, Amlodipine and Spironolactone. 

On June 7th I was able to get Chockie in for an echo with my cardiologist. He told me it was bad, that he actually saw a ruptured chordae this time. He noted: “Severe mitral valve regurgitation and flail leaflet/ruptured anterior leaflet chordae tendineae. Mild to moderate left atrial and pulmonary hypertension. Recent return of congestive heart failure. The mitral valve is unstable and I assume the recent mild interstitial pattern was refractory pulmonary edema.”  He asked if there was anyway we could get moved up because he didn’t believe he would live to September. I asked him if he could live another month and at first he was hesitant and then said yes. On this day I actually lost hope for a little bit, I felt so helpless and I didn’t know how we would make it to his surgery date of September 23rd, it seemed like we were at the end.

I was so hopeful that Chockie would get his surgery date moved up as I had seen happen to many others. I was keeping in very close contact with RVC and even called them, I was so desperate.  We got his surgery date moved up by two weeks to September 9, 2019 but that would be it as the team was going on a break from mid July-September 2.

June 9th-10th. On June 9th Chockie was very restless, wouldn’t eat, didn’t pee or drink since 9:45am and his respiratory rate was upwards of 60 so at 7PM back to the ER we went. The next morning June 10th, the ER vet called and said he was the same as last night, he was not in oxygen, kidney values were the same, still wouldn’t eat and they were waiting for a cardiology consult (the cardiologists were back, thank god!). Around 2PM, Dr O’Donnell one of my other favorite critical care specialists told me she talked to Dr. Orvalho, one of the cardiologists attached to the hospital, and as soon as they could squeeze him in for an echo he was stable enough to come home.  

Dr. Orvalho (UC Davis Vet Med) called late that evening to go over his findings and he restored my hope. He said if he didn’t know Chockie’s history he would not of thought that Chockie was in as bad of condition as he was in. He said based on his echo he felt his heart was stable today.  The valve was prolapsed and flailing which likely meant there was a chorade rupture (as our other cardiologist saw on June 7th). 

Dr. Orvalho said that we needed a plan/protocol for Chockie. He told me I was chasing his heart failure and having to be reactive because I didn’t have anyone to really follow up with.  Which is true, I did follow up with my vet and cardiologist but obviously my vet is not a cardiologist and I was having to go through my vet to get cardiology info. We talked for 30 minutes and went through all Chockie’s meds and he made a few adjustments. He was concerned with Chockie not eating and his kidneys, his BUN is just a bit high and when I took him for a follow up they would do a more detailed renal panel with SDMA. Dr. Orvalho was so incredibly helpful. He gave me so many suggestions on how to get Chockie to take his meds and said there were still more meds we could play around with.  I told him of my concerns on Sunday, that he didn't out of his bed from 9:45 until 5:30PM, I thought he should at least of been peeing or drinking. He said he is probably very tired and their bladders grow so he was not concerned.  I told him about how restless he is at night and he said they do feel worse at night, just as humans do. We talked about his surgery date in September, I asked if he could make it. He didn’t say yes, but didn’t say no like our other cardiologist did. Dr. Orvalho asked how long he’s had MVD, I told him November 2018 and he said dogs usually live 12-18 months and he thought Chockie would live 18 months so it sounded like a yes to me. He also said that we need to get him stable and in good shape for surgery. I felt so good after this conversation, I felt so hopeful and knew there were still more meds that could help him. 

Dr. Orvalho told me everything happens for a reason. He said obviously if you can get an earlier surgery date that would be ideal but sometimes we are under pressure to do a procedure and we don’t have the exact team we would have wanted and something goes wrong. This really stuck with me and maybe I was just trying to convince myself that we will make it to our surgery date and everything happens for a reason.

July 16th-17th. With the help of Dr. Orvalho we were able to keep Chockie out of the hospital until July 16th with yet another episode of heart failure. He had an overnight stay in oxygen with lasix injections. The next day July 17th, Dr. Orvalho performed an echo and didn’t see any changes from the previous echo, his lungs were significantly better than the day before and almost clear. I asked what brought this on and he said probably from the worsening of the disease.  At this time he switched him from Lasix to Torsemide, Chockie had dosed out on Lasix and was getting it three times a day. The Torsemide would be just twice a day.

Toresmide is supposed to be something like 10 times as strong as Lasix but I didn’t feel we were seeing the results that we were supposed to. Since the switch to Toresemide I noticed his breathing pattern had been quite different. While he was awake it was 40-50’s and dropped drastically when asleep to 20-30’s, while on Lasix there wasn’t such a big fluctuation and it always stayed in a similar range, awake and asleep. It didn’t feel right to me and I scoured the internet to try to find something similar to what was happening to Chockie but I couldn’t.  

July 25-29th. On the evening of July 25th Chockie was back in the hospital because his respiratory rate was upwards of 88.  The next morning Dr. Hodge, the other cardiologist, called me to tell me he had taken over Chockie’s case. He heard a bit of fluid in his lungs but his respiratory rate was sill too high. They were switching off between additional doses of Lasix and Torsemide. He felt that his blood pressure, for his condition was too high and added an additional dose of Amlodipine. The afternoon of July 26th Dr. Hodge called and said Chockie was still in oxygen, his breathing had gone down from high 80’s to 60’s and he still heard some abnormalities in his lungs. On the morning of July 27th Dr. Hodge said his lungs sounded better and his respiratory rate was going down at night but pretty high when he’s awake, like I had also observed. He said they were working on weaning him off oxygen.  When I picked Chockie up at 1PM to bring him home, Dr. Hodge said he increased his Amlodipine to twice a day and started him on Hydrochlorathiazie. While we were going through Chockie’s discharge instructions I didn’t think he was quite right but I thought once we got home he would settle. He did not settle at home. He couldn’t get comfortable, was very lethargic and wanted to be carried to go in and out to potty, something he never did and his respiratory rate was 60 asleep and wake. So at 6PM back to the ER we went. The morning of July 28th the ER vet said his respiratory rate was “mildly elevated” 50-60. Later that morning Dr. Itsvan, one of our favorite critical care specialists, called and said his respiratory rate was still high they were going to start him on Lasix injections (not sure why they didn’t start on them the previous night). She said his disposition was ok he sleeps most of the time. She said he would not pee for them and thought it would be good for us to come take him out to empty his bladder. This was news to us and empty his bladder he did when we went to visit! On July 29th Dr. Orvalho was back in the office and said he seemed to be doing better, respiratory rate was now in the mid 30’s, his heart and lungs sounded better, still a little crackly but not too bad. He said his renal panel was significantly worse and that his SDMA went from 10 to 19 but he had been hospitalized with Lasix injections, new meds and he had not been eating so hopefully when we brought him home it will improve. I asked Dr. Orvalho why his breathing pattern had changed and he told me honestly that the Toresmide 2 times a day was probably not enough and that we would increase it to 3 times a day and also supplement his potassium. I had been starting to think is this fair to Chockie to keep him alive for this surgery and will he make it to his surgery date of 6 weeks from this very day.  I decided I had to ask Dr. Orvalho two realistic (dreaded) questions:

Is Chockie suffering? Will Chockie make it to surgery 6 weeks from this date?

He said Chockie was not suffering but when he is having a hard time breathing he is uncomfortable but not suffering. He said if Chockie was stable he would say yes he could make it to surgery but he was worried given the pattern he had lately.  He said Chockie has not given up yet. This was kind of a low point for me and I started to question what we were doing. I really didn’t want Chockie to suffer.

From the time we picked Chockie up from the hospital on July 29th, when his Torsemide dose was increased, until his surgery date of September 9th he started to stabilize and thankfully his kidneys stayed ok. His respiratory rate was 20-30 and only a few rare occasions of it spiking but no more hospitalizations. We stayed in very close contact with Dr. Orvalho and went in every other week if not every week.  Chockie had an echo a few days before we were due to fly. I was so nervous I could have thrown up, I always felt like we were getting bad news. Dr. Orvalho asked me how I thought Chockie was doing. I told him he seemed ok, his respiratory rate was pretty steady now. I was waiting for Dr. Orvalho to drop the bomb of bad news but he didn’t, Dr. Orvalho said his heart had shrunk not a ton but it shrunk a little bit, I could not believe it. This is where I can look back now to what Dr. Orvalho said - everything happens for a reason. We were desperate to get an earlier surgery date but we didn’t. We had to wait our turn and in return Chockie got stabilized on Torsemide and we could fly with a little less worry. When we left for surgery Chockie was on the following meds: Torsemide, Pimobendan (Vetmedin), Spironolactone, Enalapril, Amlodepine, Entyce, Cerenia and Potassium.

At Chockie’s pre-op appointment Dr. Anne Kurosawa told us she saw two ruptured chordaes and he was stage D but stabilized as if he was stage C.  She told us it’s very good he’s at his best for surgery as they were very worried about him. At a later time they all told us they never thought they would meet him. Chockie had surgery on September 9th, the most nerve wracking day of my life! The surgery and repair went well and by the evening he was sitting up looking around. The next day we were able to briefly see Chockie, Dr. Dan Brockman said he didn’t hear much of a murmur anymore, he was stable and out of oxygen, drinking lots, not eating yet, the fluid coming out of his chest dried up and they were able to remove the chest tube. We visited Chockie everyday. On September 12th (Day 3 Post-op) Dan told us he was still not eating (which is normal) and was feeling more comfortable so they were going to pain score him instead of continuing with pain meds. He told us he could not hear a murmur but his echo showed a very small leak in the mitral valve which is very common. Day 4 Post-op Chockie ate some turkey breast we brought. He had just had an echo and they saw tricuspid leak so they started him on Sildenafil.  We noticed his respiratory effort was greater than the prior day and they felt it was partly because his red blood cell count was still low and felt he had a little bit of what they called the “Friday Blues”.

September 14th (Day 5 Post-op). When we went to visit Chockie the nurse told us they had put him in oxygen overnight because his respiratory rate was high but had weaned him off that morning and he was back in the ICU. He ate a little bit for us but his respiratory rate still seemed very high, he seemed very tired but could not get comfortable to lay. He did not seem right to us so I went to get a nurse and magically Dan happened to be in the hospital even though it was Saturday.  He watched him and said he doesn’t seem as perky. After listening to his heart he said it doesn’t sound the same, I hear a murmur, maybe there is a clot on his valve.  He took him straight back to oxygen and to do an echo. That afternoon he called and said Chockie is a paradox. The repair looked the same as the previous day, a little more leakage and they were putting him on Lasix for the next few days.  He said this could be caused by anemia or a clot. He said the change in the pulmonary hypertension from the previous day could also be from a clot in his lungs. He said his pulses feel good and his pressures are ok. His lab work came back as expected so no transfusion was needed and they didn’t feel he had an infection.  They increased his Heparin dose. Dan felt like there might be a clot interfering with his valve. I did find out much later that Chockie did have a clot or lesion on his valve, you will see Dan’s email to me below. So much happened during Chockie’s post-op recovery I asked Dr. Brockman to summarize it for me when we got back to San Diego.

September 16th (Day 7 Post-op). Chockie lost the use of his right front leg, presumably due to a clot. He was holding out his leg straight and would not walk, only sit. It was heartbreaking watching him be so uncomfortable. He ate quite a bit for us and his respiratory rate and effort seemed to settle but when we tried to get him to lay and relax with us he couldn’t.  He was rolling around on this back, which was not normal.  Dan visited with us and said his murmur had gone down since September 14th but that he probably has a few clots that should resolve themselves. Dan updated us later that day and said he was bright, eating and drinking. They started physio on his leg and Dan was personally massaging it. He was out of oxygen, they were considering stopping the Lasix, the pulmonary hypertension had gone down.  His WBC had gone down significantly and RBC had gone up, indications that things were improving.

The next couple of days Chockie continued to improve. He was walking better, breathing better, his pulmonary pressures were mild on the meds, they stopped the Lasix injections, his mitral valve was stable, his regurgitation had reduced from when the valve reopened on September 14th but still more regurgitation than straight after surgery. His murmur was a 4, the echo showed the regurgitation was hitting in one spot so that might of made it sound louder. There was probably still a clot on the valve and hopefully the body will start reorganizing it.

September 19th (Day 10 Post-op). My heart sank when Dr. Tom Greensmith a Critical Care Specialist, called to tell us he had something to discuss with us, we thought we were going to bring Chockie home the following day. He said he ate a little bit, he was a bit quiet, he was walking but over night he had a fever and his heart rate spiked. Tom he told us all of Chockie’s blood work came back as expected except his CRP (C Reactive Protein a marker of inflammation) had shot back up to 120 then 132, that coupled with the fever, spike in heart rate and clot on his valve were all signs were pointing to an infection and they had started aggressively treating him for Endocarditis (an infection on the valve). They started him on IV antibiotics, Amoxiclav and Baytril and if he didn’t show signs of improvement in 3 days they would get special permission to get him on a very strong one.  They were also culturing his blood to see if anything would grow, this was going to take 3 days if anything would grow at all. 

Thankfully for the next few days Chockie showed signs of improvement.  His temperature and heart rate had gone down to normal. The cultures hadn’t grown anything and they continued on with the IV antibiotics. We brought out his Froggie and he was so excited to see it, he started beeping it and shaking it.  He slept for us, devoured his food and seemed to be responding to the antibiotics. 

September 22 (Day 13 Post-op).  When we came to visit Dr. Inaki Checa told us around 3AM Chockie started to have increased effort in his breathing but his respiratory rate as ok. They put him in oxygen from about 3AM-8AM and gave him a Lasix injection. After doing an echo they saw he had pleural effusion (fluid in the chest, outside the lungs). That was the only change they saw; his heart, valve and pulmonary pressures were the same. His temperature and heart rate were normal so they didn’t feel it was chest infection. Since Chockie was still on Heparin they did not want to take a sample and did not want to stop the Heparin in case he was still going to throw clots. They decided to just monitor it for the time being. His demeanor was the same to us, he ate, walked and played with his Froggie. We felt his respiratory effort had increased but his respiratory rate was about the same as the previous day. 

September 23 (Day 14 Post-op). They gave Chockie his last IV antibiotics, removed his catheters and started him on oral antibiotics that he would be on for the next 6 weeks. They also stopped the Heparin and reduced his aspirin back to normal dosage to see if the pleural effusion would resolve. Dan said his murmur was also reducing and really wanted him to do some more walking and take deep breaths. This was the first time in MONTHS he had eaten out of a dog bowl and didn’t give up on trying to get the pieces of food out of the bowl. The plan was for us to bring him home the following day. 

September 24 (Day 15 Post-op). Anne called and said the pleural effusion had gotten worse, they saw more fluid in Chockie’s chest cavity and he was more symptomatic.  During his echo he went blue, he had not been fighting it rather he was just laying there. They decided they needed to sedate him and drain the fluid. Anne said she got about 20mL of fluid out of him and was not blood, which was good. There was still another pocket of fluid but it was close to his heart so she didn’t want to mess with it. They had sent it off to cytology and to be cultured. He had been coughing a little bit that day and he had crackling in his lungs, which they thought might have been pneumonia. He still eat really good for us.

September 25 (Day 16 Post-op).  Anne called in the morning and told me they kept Chockie in the ICU overnight and they had called her a couple of times over night about his effort as it had gotten worse. She scanned him and saw he had accumulated more fluid. The cytology came back as inflammatory cells so it was consistent with pneumonia or inflammation from the surgery. Tom tapped his chest and they got about 10mLs of fluid out but there was still more in there. They had put the IV catheter back in and had started him back on the IV antibiotics. I met with Anne before my visit with Chockie, she said after my visit they planned to put the chest drain back in. They were hoping once all the fluid was out from around his lungs they could then re-xray them and see how they compared from the previous x-rays.  His murmur was about a 2-3 and his heart size had not increased.  I saw Chockie for about 2 minutes in the ICU as I wanted to close the door to his oxygen cage because he couldn’t breathe, he was gasping for air, IT WAS ABSOLUTELY HEARTBREAKING. His effort had most definitely gotten much worse. This was probably the worse I’d ever seen him during our whole journey, before and after surgery.  When I got back to the apartment I completely lost it, I was hysterical.  It was the first time while being in the UK I felt like that. I am not an excitable person and usually do very well in emergency situations but this day was such a roller coaster.  Shortly thereafter, Anne called and said when they put the drain in they got an additional 120 mLs of fluid out and he immediately stopped gasping for air and ate a bunch of chicken. Talk about an emotional roller coaster.

September 26 (Day 17 Post-op).  Dr. Anne called in the morning she said clinically Chockie looked really good. He went running to the front of his cage when she went to see him, he ate really well again for Sarah.  At 2:45 AM they drained an additional 60 mL of fluid, she said he still had a little bit of effort but nothing like yesterday. They kept him in oxygen overnight night, the x-rays of his lungs showed the right one looked ok but the left one was very diseased, not as bad as she thought it would be though. When I went to visit Chockie Anne had just scanned him and she said no new fluid had accumulated since they removed the 60mL at 2:45 AM and they would probably remove the drain that afternoon. His pulmonary hypertension was still stable, no coughing, the cultures hadn’t grown anything and he was breathing much easier. Anne went to go get Chockie for me, she came back and she said I swear he was doing so good all day but all of the sudden he started having an increase in his effort. They took me back to the ICU to see him, he was sleeping but when he realized it was me he was very excited. We took him out for a a quick walk and then took him back to ICU. When he saw Sarah and Alison getting his food bowl out, he started barking and demanding his food! I fed him everything in his bowl, he SCARFED it down. I went to wash my hand and when I came back to say goodbye I knew he was going to start screaming, luckily he kept it down and when I looked back to him, he was craning his neck to see me. These were all very good signs from him, his personality was coming back, what a change from the previous day.  Anne called me that evening and said she had just scanned him and there still no fluid in his chest so they were removing the chest drain. She said they discussed Chockie at their meeting and since he still has effort and was oxygen dependent (he was in at 60%) they wanted to give him Lasix to see if it was pulmonary edema. My heart sank when I found out he was going back on Lasix but I told myself if this is was going to make him feel better then so be it!

September 27 (Day 18 Post-op).  This was my last day in the UK, I had extended my trip from 3 to 4 weeks and needed to get home to our other dogs. The plan was for my husband to stay in the UK with Chockie because we weren’t sure how much longer he would be in the hospital. Anne called in the morning and said Chockie’s demeanor was good, he ate, he was running to the front of his cage, playful and barking. After giving Lasix there were no more crackles, his lungs had cleared up and they were switching him to oral Lasix.  She had scanned him and there was no more pleural effusion,  his heart has shrunk being on the low dose of Lasix and the pneumonia had cleared up but he was still oxygen dependent at 60%. All his blood work looked good, his CRP was normal, the x-rays showed his lungs almost clear so it was pulmonary edema, the clot/lesion on his valve had caused him to go back into CHF.  Anne agreed to meet with me before seeing Chockie so I could see his echos through this whole process.

Echo prior to surgery - obviously massive leakage and huge left atrium.
Echo right after surgery - showed very little leakage. Echo 10 Days Post-op (9/19/19) - The left atrium was large and the leakage was much worse mostly likely due to the clot/lesion that formed. Echo 15 Days Post-op (9/24/19) - The left atrium was still large and there was still a lot of leakage. Echo 18 Days Post-op (9/27/19) - The left atrium had shrunk significantly on Lasix so he was responding very well to it. His pulmonary hypertension has improved as well.

September 28 (Day 19 Post-op) After my husband dropped me off at Heathrow he went to RVC to visit Chockie. Joon was on that weekend and told Alan that Chockie was out of oxygen, all his meds were oral, his temperature and appetite were good and he was very perky.  They had kept him in the ICU because they all knew him too well.  When Alan saw him he knew he was better, he was demanding to be stroked. Two hours into my flight I got a message that Chockie was going home and Anne had approved! They said he was stable and doing really well and thought it would be better for him to be out of the hospital.

Chockie did really well being with Alan out of the hospital. At first his respiratory rate was a bit high 32-38 but it slowly started going down, it wasn’t until he was back in the US for a week or two that it went down to the low 20’s. On September 30th Chockie went in for a recheck.  His lungs were still clear, his heart has shrunk more, his slight cough was either from his trachea or his virus (he had a collapsed trachea a couple weeks prior surgery), they lowered his dose of Lasix to see how he would respond.  This was the first time we really felt he made it! He was feeling so good, demanding attention, very alert with his supersonic vision and hearing. All the things he used to like to eat but started turning his nose up at were interesting again. 

October 3 (Day 25 Post-op) This was Chockie’s final discharge appointment, I woke up at 3AM so I could be a part of it. Anne was very pleased with his progress she said his heart had shrunk, his murmur was a 2-3, his pulmonary hypertension was gone and they had already previously stopped his Sildenafil so the Lasix also cleared that up, his leakage was mild to moderate compared to when his valve re-opened and the leakage was severe. The plan was to reduce his Lasix to once a day once he was back and settled in San Diego and have an echo with Dr. Orvalho on October 17th. 

Chockie came home on October 5th and he was like a new man with so much energy and a new zest for life. He had more energy than I ever remember him having, even as a puppy. He wanted to  run laps with his froggie in his mouth, he had never been that kind of dog prior to having MVD.  When we were home and settle I emailed Dr. Brockman to get clarification on what had actually happened during this crazy journey and this was his response:

“To answer your question, I understand that a lesion was identified on his valve.  If you recall, I was concerned that his murmur got much worse on the Saturday after surgery and suspected a clot (thrombus) on his valve.  I recall a “lesion” was identified at that time and at that time too, he lost the use of his leg (associated with lower blood pressure in the artery of that leg), thankfully only for a very short time.  The “circumstantial evidence” for a thrombus on the valve and thrombus affecting the front leg is pretty convincing. The only evidence that we have for an infection anywhere was a mild increase in body temperature and an increase in inflammatory markers (C reactive protein and white cell count) but we were unable to document bacteria anywhere.  He was given antibiotics as a precautionary measure and that, along with Anne managing his fluid build up was coincident with his recovery. 

Bottom line, in my opinion, he didn’t have an infection on his valve ever.  He may have had inflammation elsewhere (lungs, bladder) that was clinically unapparent that responded to antibiotics but we did not confirm that suspicion with any of the fluid/urine/blood samples we submitted.  Frustratingly, there are a lot of aspects of his clinical progression we don’t understand.  The most pleasing thing, of course, is that he is clinically much better.”

On October 17th we saw Dr. Orvalho for his echo. There was no fluid anywhere, no pulmonary hypertension, no arrhythmia, murmur was 3-4 and leakage was moderate. Dr. Orvalho said his left upper chamber was smaller but still enlarged, he said he was pleased with Chockie’s progress especially with all his post-op complications.  We did a renal panel and his kidneys looked good. At this point Chockie was still on Lasix once a day, Pimo, the 2 antibiotics (which were almost done), aspirin and Plavix. Anne reviewed his echo and felt it was similar to when he left although his heart was still a little large.  The plan was stay stay on the Pimo because of his heart size, stop the Lasix completely and have an echo recheck in one month.

We stopped Chockie’s Lasix on November 6th and other than GI Issues he was doing great! His respiratory rate stayed a steady 18. During this period of time Chockie started having severe upper GI issues, in addition to his lower GI issues. He would eat and then sit up for at least 2 hours after he ate, if he even wanted to eat. Without any invasive diagnostic testing I felt he was developing an ulcer. I discussed this with our primary vet and he advised giving him Prilosec.  We had Chockie’s follow up echo on December 3rd (which also coincided with Chockie being 3 months post-op) we finally got some good news with actual improvement.  Dr. Orvalho said his heart has shrunk; his leakage was mild compared to his echo in October it was still classified as moderate and he felt his murmur is right around a 3 compared to a 3/4 in October. Chockie’s progress was very slow but I was so happy he was progressing in the right direction. I spoke to Dr. Orvalho about the upper GI issues and he felt it was the Aspirin so we increased his Prilosec until RVC was able to review Chockie’s echo. When I sent off his echo images to RVC I asked them if we could stop the blood thinners as we were almost at the 3 month mark. This was Dr. Brockman’s response “Thank you for the update after Chockie’s latest echo with Dr Orvalho, we are please he’s doing so well at home and is full of energy! We have looked at his images as a team and are happy to report there are no signs of any clots and you can stop both Aspirin and Clopidogrel now.” This was the first time I felt like we made some real medical process.

Chockie has never been more full of life! You can just tell he feels so good, his eyes are full of life again and is back to doing everything he used to do before having MVD - making scandals, sleeping comfortably on his back, being the king. We are still dealing with some lower GI and eating issues which I have pinpointed to the US Vetmedin. We are lucky enough to have family in the UK and are able to get it there. Our next echo will be March 3rd and we will see if his heart has shrunk further and if he can go off the Pimo.

From all of this I learned a lot but the two important things are:

Everything happens for a reason. When we were so desperate to get Chockie’s surgery date moved up, he would not of been fit enough to fly. While we waited for his surgery he actually stabilized.  You know your dog best. If you feel something is off with them take them to the vet or if they are in the hospital, be pushy about it. It makes me very uncomfortable to be pushy but I realized I know all Chockie’s little idiosyncrasies and this helped us in his recovery.

Update,

Chockie had his 6 month echo last week, Dr. Orvalho said his heart looked almost identical to his previous echo. I heard back from Dr. Anne at RVC today and she said he Chockie could stop his Pimo. I am going to do an echo in 6 weeks for my own peace of mind since he had so many post-op complications. He is completely off all meds now and I'm hoping his GI issues continue to improve.

Breed: Long Haired Chihuahua
Age: 10
Diagnosis: Stage D
Surgery Date: September 9, 2019
Hometown: San Diego, California
Owner: Megan Deglow & Alan Walton
Instagram: chockietherussian
Primary Vet: Dr. McClellan & Dr. Tannler, Torrey Pines Animal Hospital
Cardiologist: Dr. Orvalho, UC Davis Veterinary Medical Center San Diego
Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Bella Phillips

Bella has been in my life now for almost five years as of May 2020. When I first knew Bella was going to be mine permanently I took her to a regular vet for a basic checkup. Right away the first thing they noticed was Bella had a heart murmur. My Vet took X-rays and explained that she had an enlarged heart and in the future it would eventually cause her to have more issues. A few years went by with no issues and one day everything changed. Bella was getting out of bed and suddenly fainted and began to urinate as she was gasping for air. This lasted for about 5 seconds and then she slowly came to. Bella acted normal as if nothing ever happened. It was a very scary thing to witness.

I took Bella right away to my vets office and they explained to me it was from her heart. I thought it was from having a seizure. The doctors prescribed her a medicine called furosemide and eventually took her off after a few months. Bella was doing well and about 4 months later she had her worst episode to date which ended up being full blown congestive heart failure (CHF). She was very lethargic and started drooling heavily, she was even having difficulties controlling herself from pooping. It was extremely scary to see her in that condition. I rushed her to the emergency room right away and they immediately began to give her diuretics via an IV drip to drain the fluids from her lungs. We stabilized her and checked out of the clinic. Now she was prescribed furosemide again indefinitely.

I made an appointment with a veterinarian cardiologist, Dr. Mikaela Mueller from Seattle Veterinary Specialists. Dr. Mueller explained that Bella was in stage C of her heart disease and that her mitral valve was failing. Bella was officially diagnosed with mitral valve disease (MVD). Dr. Mueller prescribed two more medications in addition to the furosemide, Bella was prescribed Pimobendan and Enalapril. Dr. Mueller explained that Bella would need to be on these meds for the rest of her life (Bella now was given 6 months to a year to live). Dr. Mueller did tell me another option was available, a mitral valve repair surgery in Japan and London (RVC).

I decided to have Bella’s records sent to the RVC to see if she qualified for the surgery and I received word back shortly after that Bella was a good candidate! From there I booked the closest date I could and went through all the hurdles of getting Bella ready to go to London which included the following steps,

1. Registration as an ESA animal

2. Getting an updated rabies shot

3. Getting a health certificate so she’s allowed in the UK

4. Booking a flight that allowed ESA animals to fly into London

5. Book lodging accommodations

I then was told about a Facebook group called Mighty Hearts MVD Community and was introduced to Nate Estes who was a life saver on guiding me through the entire process which allowed me to get everything done. Eventually our date came up and we made it safely to the UK (which was such a blessing but that’s another story all together). Finally Bella got to meet Dr. Dan Brockman and his amazing staff who were very so nice. I felt good about the surgery after my pre-op appointment because they made me feel so comfortable with the procedure by clearing explaining everything.

During my time I met a few other families who were also having the same surgery and I was relieved to see their dogs made it through the Initial procedure. Bella’s surgery day came and she did great. I was so nervous, finally Dr. Brockman gave me the call after Bella made it through the first stage of surgery and her heart was beating on its own. Then I was told Bella was moved to recovery. Bella recovered really well, each day getting better and better. Bella was even released a day early! We stayed for another week as many do to make sure she was going to be ok. Bella was placed on aspirin, blood thinners and continued to stay on pimobendan until they felt her heart was strong enough to not need the meds anymore. Bella had a small blood clot that eventually went away on its own.

We finally made it back home to Seattle and continued to follow the three month recovery instructions given to us by the RVC. I’m happy to say five months later Bella and I received the best news ever at her recent checkup. NO MORE MEDS are needed! Bella is now doing wonderful and plays nonstop like a puppy. This experience was life changing and has given me lots of new perspectives on life. It’s a stressful process to get through no doubt, but in the end it’s worth every step.

Love Nolan & Bella

Breed: Chihuahua/Jack Russell Age: 11 Diagnosis: Stage C Surgery Date: September 16th, 2019 Hometown: Seattle Washington, USA Owner: Nolan Phillips Primary Vet: Afford A Vet
Cardiologist: Dr. Mikaela Mueller Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Luna Brice

Luna was diagnosed with mitral valve disease (MVD) September of 2019 after a very touch a go episode of congestive heart failure on that fateful Friday the 13th. The diagnosis came as a real shock to myself and the RVC team given Luna’s breed (Labrador) and her only being four years old. Nonetheless this was the hand we were dealt and we needed to deal with it. , Luna was diagnosed with MVD, stage C. Our only option for a long term survival was for her to have the mitral valve repair surgery at the RVC..

Luna pulled through that episode and I knew I had to do everything in my power to make sure she could have that surgery at RVC by the amazing Dr. Dan Brockman and his wonderful team. We were on the wait list and received the good news that we had a date of January 21, 2020. Only now do I realize how incredibly lucky we are to have had that date given the programs suspension as of Jan 24th 2020.

Luna has now had her surgery which consisted of the replacement of 5 chords and an annuloplasty. She is currently 8 days post surgery and doing well so far. I don’t like to be too overly optimistic as I am a bit superstitious about these things but all signs are pointing towards a good recovery. She will head back to RVC in a week for a blood test and then in another 2 weeks for her 1 month post op echocardiogram. Fingers crossed for a positive outcome and my thoughts are with everyone who is going through this, especially those waiting for this life saving surgery. To Dan and his team - we are all so incredibly grateful to you and hope the program resumes soon as it’s very much needed as many are waiting to be saved.

Update - We’ve just comeback from our Monday RVC follow up appointment and we are happy to say all of Luna’s blood work looks excellent, kidney’s look very good now.

Lara & Luna

Breed: Labrador Age: 5 Diagnosis: Stage C Surgery Date: January 21, 2020 Hometown: Esher, Surrey, United Kingdom Owner: Lara Brice Primary Vet: Beech House Cardiologist: Dr. Inma Cerrada Serra, Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Bailey Grimshaw

Bailey entered our hearts and lives on July 13, 2010 at the age of nine weeks. She was an adorable, but difficult puppy. She had little respect for our house, but we quickly fell in love with this adorable little girl. She is the most special of all of the dogs we have ever had, and that is saying a lot. We cannot imagine our lives without Bailey.

Bailey is a quiet girl, and likes to spend time with us and sometimes plays with her toys. One time she is not at all quiet is when she wants something, and if she feels that she is being ignored, she begins to howl. In fact she just began howling at this very moment. Her howl sounds like a woman screaming, and we actually had someone come to the door one day thinking that something terrible had happened. The gentleman was very surprised when I told him that it was our dog making that terrible racket.

Bailey loves to go for rides in her dad's car. She rides in the back seat, in her special car seat that allows her to look out the window. She does show great concern when he backs up, and keeps her eyes on the rear tire to make certain that he is doing it correctly. She loves traveling under 35 miles per hour, but usually naps during higher speeds.

Bailey has had reasonably good health, but had calcium oxalate bladder stones at the age of two years that required surgery. She has them again, but because of her heart disease, surgery has been put on hold. She shows no signs of them causing any concern at this time.

We decided over two years ago that we would no longer board Bailey, so now we plan vacations that include her. We have always believed that she would not handle flying well, so we drive to our destinations, and we often discuss places that we want to take her. The United Kingdom has never come up during those discussions.

We have had times when Bailey refuses to eat. We always fed her food that her veterinarian recommended, and often prescription diets. She refused to eat in March while we were on vacation, and Ed found information on a raw diet. We switched her to that diet, and she has been excited about every meal since we made the change. Her overall health has also improved.

Bailey was first diagnosed with a heart murmur on July 25, 2018, when she was taken to the veterinarian for a suspected urinary tract infection. She did not have an infection, but Dr. Joel Conn at Pismo Beach Veterinary Clinic noted that she had a grade II/VI systolic heart murmur. The technician had listened to her heart prior to the doctor entering the exam room, and found no sign of the murmur. The doctor spent extra time listening to Bailey's heart. Her murmur could have very easily been missed without Dr. Conn taking extra time on this part of the examination.

Bailey was seen by Dr. Thomas Morrison at Coast to Coast Cardiology on August 2, 2018, who confirmed Dr. Joel Conn's finding. Bailey was diagnosed with Degenerative Mitral Valve Disease, stage B2 at that time. She was prescribed Pimobendan. We were devastated by this report, and believed that our time with our precious girl was going to be much shorter than we had hoped. She was prescribed Furosemide during a subsequent visit.

Ed did a great amount of research, and found that mitral valve surgery was a possibility. Mighty Hearts Project provided a wealth of information, and we were impressed that Nate Estes, the president of Mighty Hearts Project, was available for telephone consultations. We began the process to learn if Bailey was a candidate for surgery, and sent all required information to Royal Veterinary College (RVC).

Bailey was evaluated by Dr. Reid Nakamura at Veterinary Specialty and Emergency Center in Thousand Oaks, on March 23, 2019, where a recheck echocardiography examination was performed to send to the surgical team at Royal Veterinary College. Dr. Nakamura gave Bailey 12 to 18 months to live, and was very negative that surgery was a viable option. We both firmly believed that he was wrong.

We received an email from the RVC stating that Bailey was a candidate for surgery on April 11, 2019, and that a telephone conference was scheduled for 8:30 AM on April 16. We eagerly awaited the call, and spoke with Dr. Poppy Bristow. Following that call we waited to be assigned a surgery date for Bailey. We received an email on April 23 scheduling Bailey's surgery date for September 9, 2019. On July 5, we received a letter giving Bailey a surgery date of September 2, which we accepted. Waiting for the surgery date was difficult because Bailey's heart disease was advancing rapidly.

Bailey was seen by Dr. Emily Chapel at Coast to Coast Cardiology on April 12, 2019, and was now in stage C. Benazepril and Spironolactone were added to her medication regimen. Bailey was seen by Dr. Jordan Vitt at Coast to Coast Cardiology on August 1, who determined that she was now in Stage D, and changed her diuretic from Furosemide to Torsemide . We were very grateful that we were close to her surgery date.

We are very fortunate that Bailey happened to see Dr. Kayla Walti at Pismo Beach Veterinary Clinic during this process, and Dr. Walti became her primary care doctor. Dr. Walti did an excellent job of making certain that Bailey had everything in place in order for her to travel to the United Kingdom for her September surgery date. This doctor even came in four hours early on the morning that we were leaving on a trip so that she could see Bailey before the three of us left town. She also came in on her day off to see Bailey prior to our trip to the United Kingdom. Needless to say, we feel truly blessed to have such a dedicated doctor on our side.

Ed did an amazing job making all of the preparations for our journey to the United Kingdom for Bailey's surgery. I was preoccupied with family members who needed my help, and did not have much extra time to spend assisting Ed with this sometimes frustrating process. Mighty Hearts Project and the Mighty Hearts Facebook Group were very helpful during this often confusing process.

We were very nervous about the flight with Bailey because she had never flown before, and also the fact that she was on a diuretic (Torsemide) made us very concerned. Bailey handled the flight like a seasoned traveler, and had no accidents during our flight. She even used a potty pad for the very first time. Previously, she just tore them to shreds.

We finally arrived into London and settled into our accommodations. We were very concerned about Bailey when we got up the first morning in Harpenden. She was unresponsive, and at first appeared that she might require immediate medical intervention. She was on the floor at the foot of our bed, and did not respond to us when we spoke her name. We stroked her, and still there was still no response. Even gently shaking her brought no response.

Bailey had an appointment at RVC that afternoon for her surgery pre-op, but we considered taking her there immediately if she did not begin to respond. After what seemed like hours but was only a few minutes, she began to respond. She improved gradually, but was fine after a couple of hours. We could only attribute this issue to the stress of the very long travel day that she had experienced. Bailey had completely recovered by the time of her pre-op appointment, much to our relief.

The morning that we dropped Bailey off at the hospital for surgery was a very difficult one. We knew that she was in good hands, but we also knew that the surgery had its risks. We were very relieved when we received the call from Dr. Dan Brockman that surgery went well, and that he would call again later that afternoon. Bailey's recovery was for the most part uneventful, but she did develop a hematoma during surgery, and also developed arrhythmia following surgery for which Sotalol was prescribed. The level of care that Bailey received after her surgery was outstanding. Dr. Brockman, Alison and Sarah provided expert, loving care for our little girl.

We had our last appointment at the RVC before we prepared to depart home, we were all cleared for travel. It was a wonderful flight home with our precious girl. During the flight home we thought so much about the fact that we had no assurances on the flight to the United Kingdom that Bailey would be with us on the return flight, we felt so blessed. It has now been three months since Bailey's surgery, and she is doing well. It was noted during her echocardiogram at Coast to Coast Cardiology in October that she does have regurgitation of the tricuspid valve, and slight enlargement on the right side of her heart. We were assured that it was not of concern to the doctors, and is somewhat common after this surgery. We just had another recheck recently and we are thrilled to report Bailey is off all medications.

Bailey is more alert than she has been in more than a year, and definitely has more energy. We are very grateful to the surgical team that extended her life, and for the encouragement that we received from the members of the Mighty Hearts Facebook Group. Most of all, we are forever indebted to Mighty Hearts Project for the education that we received about mitral valve disease. We thank the president of Mighty Hearts Project, Nate Estes, for his guidance and direction while we were on this journey. It was the road less traveled, but it was definitely a journey worth taking that we will hold dearly in our hearts.

Love,

The Grimshaw Family

Breed: Pomeranian Age: 9 Diagnosis: Stage D Surgery Date: September 02, 2019 Hometown: Arroyo Grande, CA Owner: Ed & Jacklyn Grimshaw Primary Vet: Dr. Kayla Walti, Pismo Beach Veterinary Clinic Cardiologist: Coast to Coast Cardiology Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Spatas Rocky Holm

Our little boy Spatas was born on the 16th of January, 2008 in Vilnius, Lithuania. And his Mommy is a banking consultant and was travelling for assignments before settling down in Denmark, Spatas has had his share of travel and relocation. He enjoys seeing in new places and is extremely easy to travel with, he’s a natural born globetrotter!

For the past 4 years he has lived in Copenhagen, Denmark and calls it his home, though he gets to travel quite a bit to visit his both sets of grandparents that dote on him and spoil him rotten. He has two big human siblings, a 10 year old brother and a 16 year old sister, and enjoys being the only pup in the family, as he loves being spoiled and hates sharing attention and especially food!

Spatas has always been a very healthy boy and as he is inherently a slow and relaxed guy, he has never suffered any major injuries. In 2016 after an episode of pain in his hips he got diagnosed with hip dysplasia, but after a round of anti-inflammatory medication he got better and it has not bothered him since. We know it is a congenital defect and it has not disappeared, so we do our best to keep his little hips warm and avoid swimming in cold water, which, living on an island is sometimes hard to avoid.

On the 4th of May, 2019 Spatas woke up struggling to breathe. He was sitting in our bed and breathing really rapidly, though the weather was cool and he was certainly not overheating. We got really worried, as Spatas is not a morning person, and until we call him for walkies he usually rolls in bed or naps on the sofa, yet there he was, wide awake and struggling to breathe. The day before we had taken him to his “happy place” which is an old military fortress in a shape of a pentagon called Kastellet in Copenhagen. It’s around an hour’s walk and he enjoys it immensely, but in hindsight the exercise might have caused one of his chords to rupture.

As it was a Saturday and we had never had any pet related emergencies, we panicked that our family vet may not be open yet, so we called the only 24/7 pet hospital we found online, which was a 15 mins drive away. While getting there Spatas was sitting on my lap and I could feel he was struggling to breathe and his heart was beating super fast and I already suspected it was heart related. The moment we walked in the hospital’s door, a nurse came and took one look at his gums and scooped him up and ran away. We were left standing knowing that something very bad has happened to our baby boy. We stood in the corridor waiting for someone to come out and tell us what was going on and I was hoping and praying it was something treatable, like pneumonia or infection, but deep in my heart I knew it was his heart.

Spatas spent 36 hours in intensive care as it was weekend and they could only release him on Monday after a full checkup by cardiologists. He was diagnosed with MVD on Monday, the 6th of May, 2019. The doctor prescribed Cardisure (pimobendan), furosemide and Cardalis (Benazepril hydrochlorid/spironolactone) and gave him 6 to 12 months to live. To say we were devastated would be an understatement. This disease hit us completely unexpectedly and we just couldn’t believe that medication is the only thing they can offer us and that we’re running out of time with our sweet and lively baby. That’s when we started searching online for treatment options for MVD and stumbled upon the Mighty Hearts Project page on Facebook and learned about surgery options. The very afternoon we emailed our cardiologist and told him we want to pursue the option of having Spatas operated on and asked him to contact RVC. We got a date for surgery (19th November, which was later changed to 21st of October) on the 25th of May, so there were only 19 days between the devastating diagnosis and receiving a surgery date and finding hope. 

Two weeks before the surgery Spatas had whole body scan and required blood tests. They found that he had some elevated tests numbers (45 while the norm is up to 25) CRP marker (C-reactive protein) and our cardiologists were not sure RVC would still accept him for surgery. We were super stressed as we had no idea what was causing the inflammation as our baby looked happy and healthy and had no diseases or injuries that could explain it. Thankfully, when we repeated the test in 10 days the marker was back to normal and we got the green light to come to RVC for surgery.

We arrived to Harpenden on the 16th October, Spatas met Dr. Dan Brockman and the crew during his pre-op exam on the 17th and we delivered him for his surgery in the early morning of Monday, the 21st of October. Both our cardiologists Jakob and Anders flew in from Copenhagen to observe Spatas’ surgery as our little boy was (and still is) the only Danish patient to ever get this surgery. It was really nice to have them there and know that in case Dan or others are missing any information about Spatas or his condition, our wonderful doctors that diagnosed him will be there to provide it.

Spatas surgery went without complications and he recovered very smoothly. The only hiccup in his recovery was a mild case of diarrhea that resolved itself within a few days. We went home on the 1st of November, Spatas was taken off pimobendan at discharge, as his heart had returned to its normal size. We had our 1 month post-op checkup two weeks ago, which confirmed Spatas has a grade 2 murmur, which is normal and expected, and is otherwise healthy. The only problem we currently have is a mild separation anxiety that Spatas started displaying after we returned from London. After a consultation with a dog behaviorist we have adjusted our daily routine a little and provide him with more mental stimulation and structure and he has started showing improvement.

We couldn’t be happier with the outcome and will be forever grateful to Nate and the Mighty Hearts family for their guidance and support. We’re sure that without Mighty Hearts we would not be where we are today.

 Best regards,

Egle & Spatas Holm’s

Breed: Longhaired Dachshund & Beagle mix Age: 11 Diagnosis: Stage C Surgery Date: October 21, 2019 Hometown: Copenhagen, Denmark Owner: Egle Holm Primary Vet: Østerbro Dyreklinik, Copenhagen, Denmark Cardiologist: Dr. Jakob Willesen & Anders Simon Schrøder, Frederiksberg Small Animal Hospital, Copenhagen, Denmark Surgical Team: RVC, Drs. Dan Brockman & Poppy Bristow

Sally Fiksman

After a routine check-up, about 3 years ago, meaning Sally was about 5 years old, the doctor heard a heart murmur. The Doctor advised me to take Sally to the veterinarian Cardiologist, he was the one who indicated her pathology. Sally was diagnosed with MVD in B2 status.

Her cardiologist put her on a treatment regimen of (Vetmedin) and explained the disease process. About a year later, I started giving Spironolactone and a few months later, also Amlodipine. All this at the same time deteriorated her kidneys so I also had to change her diet. It was not easy since they had warned me that the disease continued its progress and that at some point some determination would have to be made.

It was at the end of 2018 when Dr. Carpenter already told me that the time had come. Sally was still in stage B2 but the progression of her illness already indicated the ideal time to operate on her.  With my veterinarians and Nate's help, I was able to do all the necessary paperwork for admission to both Japan and the Jasmine clinic. We completed the quarantine process after 6 months.

 We arrived in Japan on June 25 2019 after a long trip from Miami. On the 27th I had a pre-op appointment with Dr. Sayaka Takeuchi and after seeing Sally and how she was doing so well compared to most others Jasmine said the risks outweighed the benefits to the surgery because surgery wouldn’t change her current condition by much as she was asymptomatic. I decided at that time, with the jet lag and as I was very nervous to not operate on Sally. The funny thing is that I paid for the operation even thinking that I would not operate on her at that time.

 Again with the help of Nate who is always so patient and the "mom" of another newly operated dog in japan, I finally decided that proceeding was the best option for us. As many may understand this disease is very unpredictable. Sally was only 8 and the chances of her progressing were immanent.

 Finally, they operated on July 2, 2019. My nerves are not the purpose of this text but for those who want to know, it is not easy. They were days of great anxiety and anguish. I recommend not being alone in your journey, I had the help of my sister and it was a great support.

 Sally survived the surgery and did great. The surgeons actually found a few torn chordae tendineae and were very surprised she didn’t progress further before surgery or show any signs. Sally did not eat until after 6 days of the operation. This also made her not recover as fast as other dogs but she slept in our rented apartment on the fifth night as Jasmine thought this was better for Sally, we would have to come to Jasmine daily for her rechecks.

 Little by little she regained her strength and was eating much better. eventually we made it to our last appointment to verify Sally was good to go back to Miami. On July 13 we were already flying back to Miami. After a month I could say that things were already back to normal as before the operation. Sally was acting very vital and happier, so much that she had to be stopped so that she did not run since she was still in the 3 months of post-op.

At her recent checkup review they were all normal values and the heart was no longer so big. Sally is exactly the same as before her operation in every way, except that the disease is now controlled. Doing this surgery was the most difficult experience of my life yet I have my Sally back for many more years to come thanks to these amazing team of doctors that dedicate there lives to our animals and to the Mighty Hearts Project team and the community that helped us to get to surgery and offer us so much support.

Sincerely,

Fernando & Sally Fiksman

Breed: Beagle Mix Age: 8 Diagnosis: Stage B2 Surgery Date: July 2, 2019 Hometown: Miami Beach Owner: Fernando Fiksman Primary Vet: Dr Covadonga Talavera, VCA South Dade Cardiologist: Dr Carpenter, Jupiter Pet Emergency & Specialty Center Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center

Toto Ardila

We rescued Toto when he was about 1-2 years old, Toto is the best chihuahua you’ll ever know. He doesn’t fit the stereotype of a chihuahua, he’s calm, kind, gentle, super clingy and he’s the sweetest boy. He’s a favorite patient according to his doctors. Toto was healthy for all of his life, but on July of 2018 he developed a cough. We didn’t think much of it, but after about a week or so he was still coughing, which is when we decided to take him to a doctor. He was treated for kennel cough first and after that did nothing to his cough. We decided to go back to the doctor’s clinic. After performing x-rays we found his heart was so enlarged that it was pressing on his trachea and that was causing the cough. We were told there wasn’t much we could do and the doctor said that heart medications are bad, so she sent him home with no prescriptions (this was a different doctor not Dr. Dauguette).

What the doctor told us didn’t sound right to me at all, which is when my inner Sherlock Holmes kicked in. I spent hours researching and came to the conclusion that Toto needed to see a cardiologist ASAP. It turns out Dr. Culwell, his current cardiologist is the only board certified cardiologist in the area. I scheduled the earliest appointment they could give us. On August 30th, 2018 the scariest thing happened. Toto had a syncope episode in the middle of the night. He cried out and peed the bed and was not responsive. He was rushed to the ER where they were able to stabilize him with oxygen and he was prescribed Pimobendan (Vetmedin), and diuretics.

In September, 2019 Toto was finally seen by a cardiologist, this is when we got the devastating news and all the details of his heart condition. Toto was officially diagnosed with degenerative valve disease severely affecting his mitral valve, he had developed pulmonary hypertension. The hypertension in the lungs is what caused his syncope episode. We asked the one question no one wants to ask. How long does my dog have to live? “6 to 18 months is his prognosis” said Dr. Culwell. This was a very sad day for me, I cried so much at the doctor’s office. It was very surreal because no one ever thinks this could happen to their beloved pet. Toto was prescribed additional medications to help with his condition: Enalapril, Sildenafil (for his pulmonary hypertension), Spironolactone, Pimobendan, and Furosemide.

I never lost hope after hearing my dog was dying and I’m so glad I didn’t because I continued to do my research and that’s when I found the wonderful Mighty Hearts Project MVD Community. I joined late September 2018 and quietly followed many cases of dogs who had the surgery in the UK as well as Japan, some were successful and others were not, and it was based on that we made the decision to go to Japan to Dr. Uechi who is the person who pioneered mitral valve repair on dogs and has the highest success rates to date.

Toto’s surgery was successful, but he continues to have some issue on the right side of his heart (Tricuspid Valve) this is what’s preventing him from coming off the Pimobendan, but other than that he is doing fantastic and we’re so happy he’s still with us and hope he can live many many more happy years next to us.

Breed: Chihuahua Age: 9-10 Diagnosis: Stage C Surgery Date: April 30th, 2019 Hometown: Dallas, TX Owner: Karen Ardila Primary Vet: Dr. Dauguette, Crossroads Animal Clinic Arlington, TX Cardiologist: Dr. Nicole Culwell, Medvet Dallas Surgical Team: Dr. Masami Uechi & Team at, Jasmine Cardiovascular Medical Center

Newton Chorin

Newton's doing extremely well one year + post-surgery. By the time we arrived in Japan, he was in very bad shape, after having gone into CHF briefly the month before. I had kicked myself for not starting the Japanese quarantine process as soon as he was diagnosed with mitral valve disease, as the disease initially seemed to be moving slowly. But it progressed rapidly in between two checkups, one of which I delayed. The regurgitation after his surgery was virtually nil, but within a few days it had reappeared, albeit at a much lower level than pre-surgery, which caused concern. Jasmine thought it was because of over-exertion after surgery - but certainly there were no dramatic incidents. Tranquilizers are contra-indicated but there are herbal supplements that help Newton (my holistic vet has a tincture that works very well), and it would have been super helpful to have those with him (along with a large crate) during my travels.

Keeping Newton calm at Jasmine was difficult from an excitement point of view. Within a few months, however, the trend towards heart chamber shrinkage resumed, and continued through his recent one-year post-op exam. On the recommendation of his holistic vet I have been giving him low sodium and fresh-frozen foods, along with Omega 3 / fish oil and Standard Process Cardiac Supplement. I'm convinced these supplements help, and he's done super well on this food, particularly after surgery. I am so grateful for the care of Jasmine, and have absolutely no regrets about going through the procedure, which I knew was no guarantee. The people I met through Mighty Hearts Project provided an invaluable support. There are many, and increasing options for treatment of MVD, and the effectiveness varies greatly.

Do your research on different programs' success rates and costs, and plan early. I really believe (and this seems to be supported by the literature) that a fresh diet can greatly slow the progression of the disease in some cases. Most dry food is downright bad for your dog's health. As with everything medical, the more research you do, the better. Another bit of advice, when traveling with an MVD dog and/or one with a partially collapsed trachea, it REALLY helps, where possible, to fly on a plane like the 787 which is pressurized to a considerably lower altitude, and has an air system that is humidifying. He had no problems getting to Japan, but did have coughing problems on short flights prior, on older planes. Mighty Hearts Project does a great service. I'm happy to reply to anyone with questions: chorined@gmail.com

Breed: Age: 12 Diagnosis: Stage C Surgery Date: August 7, 2018 Hometown: Northern California Owner: Ethan Chorin Primary Vet: Dr. Anne Reed, All Paws Holistic Veterinary Clinic Cardiologist: Dr. Catherine Gunther-Harrington, UC Davis Small Animal Clinic Surgical Team: Dr. Masami Uechi, Jasmine Cardiovascular Medical Center