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Poco Gets a Pacemaker

March 28, 2009
Poco

Poco

 

“The Tell-Tale Heart”

 

Poco’s Story

 

 

 

 

 

 

Thursday: Jammin’ around the house, as usual, with six rambunctious Australian Shepherds, ranging from 2 to 14, under foot. I casually noticed that Poco was down on the kitchen floor. Odd, I thought. Perhaps the youngsters had knocked her over. Later, she was down in the hallway. Very unusual, but I was busy. Then, getting her out of the van from a trip to town I noticed she was a bit unsteady. I was starting to take notice. That night, on the couch, she suddenly quivered all throughout her body. Oh no, I thought –not seizures!

Friday: I got her into my vet, Dr. Glenna Hopper. It was late in the day. We lifted Poco up on the examination table and Glenna began to take her pulse. Almost immediately she let out a “Oh, my God!” Not a good sign coming from your vet! Approaching panic, I asked, “What is it?” She returned that Poco’s heart rate was at 40! (Between 80 to120 beats per minute is normal.) Next, she took some blood but the test results wouldn’t be back until tomorrow. She suspected low thyroid, gave me some medicine and asked me to come back on Monday.

Saturday: Between 2:00 and 2:55PM Poco collapsed three times. Panic, indeed, was setting in. I called Glenna and rousted her out of her day off and we agreed to meet at her clinic in ten minutes. My husband, Hans, came with me. Poco’s heart rate was now a scant 44 bpm. Obviously the medication hadn’t worked. The results of her thyroid test showed low but not by much. What was going on? Glenna took x-rays. Thank God, no tumors. Next, Glenna put Poco on an EKG and there it was. Poco’s heart was only firing at every other beat. She then scattered her medical books around the examining room and, after a while, looked up and said, “What Poco needs is a pacemaker!” In the back of my mind I heard a little voice say “Yeah, right!?*!” contemplating the impossibility.  And then, Glenna got on the phone with CSU (Colorado State University Veterinary Teaching Hospital) and their Cardiology and Cardiac Surgery Unit and, sure enough, they did the surgery necessary to implant pacemakers in dogs. I was reeling; I never dreamed it was possible! Next Glenna said, with a tone of dread, to take Poco home, give her absolute rest, and IF she made it through the weekend, to get her to CSU immediately on Monday.

Monday: Poco was still with us. We were lucky to get a 1:00PM confirmed appointment, as the hospital was unusually busy that day. We packed ourselves up and headed south. It was blizzarding. Great!*?! After a tense hour and a half drive we arrived in Fort Collins just on time to be met by a cracker-jack cardiac staff. Initial observation concluded that indeed Poco needed a pacemaker but first they had to determine whether she was a good candidate at ten years old. An hour and a half of tests later showed that Poco was good to go. Surgery was scheduled for 2:00PM the following day. Driving back without her was heavy on our hearts. All that afternoon we had learned of the new procedures and strides made in veterinary cardiology. Our heads were swimming in all this new technology while only days before we would have never thought that these procedures were possible. Yes, both dogs and cats can now receive pacemakers – but there are risks.

The diagnosis, explained to us in layman’s terms, is this. Imagine your typical Valentine’s Day heart. Next, think of it divided into four quarters, two up, two down. Now imagine a node (we’ll call it Node A) in the upper right quarter. Now imagine Node B somewhere around the middle of the heart. What was happening to Poco was not seizures at all. Our poor Poco was fainting and collapsing from lack of oxygen. At CSU, they found that resting, Poco’s heart was actually only firing every third or fourth heartbeat. (What Glenna saw as every other beat was because Poco was stressed by being at the vet.) What they explained was that Node A would send a signal to Node B to tell the bottom of the heart to contract but Node B was only receiving the signal on every third or fourth beat. Thus, the heart was not contracting properly to send the necessary oxygen out into the bloodstream. Poco was in heart failure. Unequivocally, only a pacemaker would save her life.

The actual surgery required only two small incisions. First, they obtain what is referred to as an “expired” pacemaker. This is one that is normally used for humans but the normal human life span has “expired” leaving only five to ten years left on the functioning unit. Because a dog or cat’s life expectancy is so much less than ours, these expired units fit the veterinary requirements at a greatly reduced price. The first incision is made on the upper right side of the neck. Fatty tissue is removed from this area to make a platform large enough for the pacemaker’s implantation. Next, the second incision is made lower down on the throat where the pacemaker’s wire is navigated down through the right jugular vein all the way down and imbedded into the heart. The pacemaker is then programmed for the particular patient’s heart rate. Although this procedure sounds simple enough there are many risks, including lethal blood clots. If there are no complications, once recovered from the surgery, the patient may go home the next day. Absolute bed rest is needed for at least two full weeks. This time allows the wire to safely imbed into the heart. (Without rest, the wire may not connect properly and then the surgery would have to be repeated.) Constant monitoring of the heart is recommended throughout this time with a home stethoscope. If the heart rate should drop significantly the animal needs to get back to the hospital immediately. After six weeks, a non-invasive post-op exam is required to check the programming of the pacemaker.

Wednesday: Poco had recovered from Tuesday’s three-hour surgery well and spent the night in a sealed cage with infused oxygen. We were told that while she was a sweet and excellent patient, during the night she barked at everyone passing by. They all took this a good sign that she was ready to go home. Hans and I arrived at the hospital at 2:00PM, less then 24 hours after surgery, to go through the release procedure. Poco came into the examination room walking steadily and bright-eyed with her vigilant vet tech, Nate. What a joy to behold – our miracle! We were then educated about her home care with bed rest and that now Poco could never wear a traditional collar again, never have an MRI and blood could only be drawn from the left side as her right jugular now housed her heart wire. Not a bad prescription, considering. 

Poco, now three weeks later, is running along side her Aussie family with the best of them. She is bouncy and exuberant for life. We were told that one day Poco will leave us but it will never be from her Tell-Tale Heart!

Heart disease is now the second most common cause of death in dogs and cats. This had led CSU’s cutting-edge Cardiology and Cardiac Surgery Team to explore, research, educate and provide the most state-of-the art cardiology care in all species of animals in an accessible and compassionate environment. Among its many achievements, this world-renowned team was the first to develop an open heart surgery program and pioneer pacemaker implantation and surgical valve repair in animals. Additionally, the team collaborates with cardiologists at other institutions, both nationally and internationally, sharing their knowledge and expertise to create innovative treatments for human cardiac patients, as well. One such collaboration is with Children’s Hospital in Denver providing revolutionary treatment for infants with life-threatening cardiovascular disease. This team’s mission is to expand the universe of cardiac knowledge, research, technology and treatment for animals from all over the world. Presently this team includes cardiac surgeons Dr. Chris Orton, Dr. Jan Bright (Poco’s surgeon) and Dr. Leigh Griffiths along with the team’s residents, students and staff at 300 W. Drake Road, Fort Collins, Colorado, 970-221-4534.   

  
Poco 24 hours after surgery!!!

Poco 24 hours after surgery!!!

 
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