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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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