An innovative canine surgery performed at the Onderstepoort Veterinary Academic Hospital has pioneered the use of a technique that, until now, has only been possible at global universities and a few large referral veterinary practices.
During the successful surgery, on the University of Pretoria campus, a balloon catheter was inserted into the arteries of two dogs to correct a heart valve defect.
This is a major development, and great news because South Africa’s only training hospital for vets can now teach this technique. It has also improved the quality of life of the two patients, Daisy and Tallen.
According to veterinarians Drs Ross Elliott and Adriaan Kitshoff both dogs had pulmonic valve stenosis. This means that their heart valves, situated between the arteries leading to the lungs and the heart, were abnormally fused.
The surgery is an alternative to the medication that dogs that suffer from this condition is normally treated with. After the procedure, the dogs wake up less painful and more alert. Generally, they can go home the next day.
Without the surgery, the majority of these dogs will develop heart failure between two- and three-years-old. With the procedure, 70% of dogs will have an increased quality and quantity of life. However, 15% of dogs will have scarring of the valve and require a second procedure if the owners see fit.
A big team was involved in the innovative canine surgery, including anaesthesiologists Drs Abdur Kadwa and Justin Grace, theatre nurse Adele Rossouw, and theatre assistant Mike Shabangu from Onderstepoort.
Rossouw says, “The innovation of the balloon valvuloplasty lies in the fact that the whole procedure is done through a small incision in the neck vein. This means that they do not need to open the chest. Patients show almost an immediate improvement after recovering from anaesthesia.”
Elliot explained that the balloon catheter is a commercially manufactured device, specifically for canines, produced by an American company called Infiniti Medical.
“We ordered these according to the size of the dog’s blood vessel that needed to be dilated.”
As a final year anaesthesiologist, Dr Kadwa also pointed out that, fortunately, there is a lot of literature available on how to do such a procedure and what problems could occur during the operation.
“This, however, remains theory until you know more about the specific dog and start with the actual procedure,” he said.
Rossouw said she had to do research to gain insight into what was expected of her as a nurse during the procedure, especially because she had never seen such a procedure before.
“I mentally played out different scenarios to predict anything that could change or evolve during the surgery and even prepared for the ‘what-ifs’.”
Careful planning for canine surgery
The anaesthesiologists’ main concern was how well the dogs would oxygenate and how the heart would function under anaesthesia.
“We had to do a lot of planning beforehand. In theatre, we don’t only admit the anaesthetic, we also manage a lot of the logistics – from the computer, the fluoroscopy machine and coordinating to see that both dogs perform well on blood pressure, heart function, etc.” said Kadwa.
Thankfully, both dogs were stable throughout the surgery. Only slight modifications had to be made, but a lot was learned throughout.
Both anaesthesiologists mentioned that this was a fantastic learning opportunity.
The hope is that more such procedures can be done to learn from, perfect the technique, pre-empt any complications that may occur, and ultimately improve the success rate over time.
The canine surgery is costly, but the more it is done and the more experience gained, the costs will decrease and it will become more accessible. “It is rewarding to know that the dog’s quality of life is drastically improved by this simple procedure on a vital organ”, says Kadwa.