A Living Legend Because of a PDA

May 6, 2015
Molly, a Ganaraskan and AMC Living Legend

Molly, a Ganaraskan and AMC Living Legend

Molly is a cute fluff ball of a Ganaraskan. Although her name sounds like she belongs in a Tolkien novel, the Ganaraskan is a modern dog breed, developed only a few decades ago in Canada near the Ganaraska River in Ontario. The originators of this breed set out to develop the ideal therapy dog from English Cocker, Bichon Frise, Poodle and Miniature Schnauzer stock. Molly is typical of the breed – curly coated, anxious to please and weighing just about 20 pounds. But Molly is anything but typical; she is a legend in her own time a survivor of a major cardiac procedure necessary to save her life.

An Early Beginning of a Legend
Molly’s story starts when she is just a young pup and is diagnosed with a heart murmur at ten weeks of age. An echocardiogram did not identify a cause for the murmur and since the murmur was not very loud, no treatment was prescribed. Two years later, Molly came to The Animal Medical Center for evaluation of a fractured tooth. Dr. Stephen Riback, one of The AMC’s dentists, heard the murmur and recommended an echocardiogram.

The “Heart” of the Problem
The echocardiogram, performed by one of The AMC’s board certified cardiologists, Dr. Dennis Trafny, revealed an enlarged heart and a 4mm (1/8 inch) wide abnormal blood vessel known as a patent ductus arteriosus (PDA). Normal before birth, the PDA typically closes shortly thereafter. In Molly, the PDA did not close, allowing blood to traverse between two major blood vessels, the aorta and the pulmonary artery. The abnormal blood flow caused the heart murmur. But the murmur was just a harbinger of a future, more serious problem – the potential risk of heart failure if the abnormal blood flow was not halted.

The first technique available to veterinary cardiologists for repairing PDA’s in dogs required a thoracic surgery to ligate the PDA vessel using suture material. The incision scar was the size of your hand on the dog’s chest. Now, veterinary cardiologists use fluoroscopy, a special video x-ray machine, to guide a special catheter with a disc occluder up through a blood vessel in the leg, into the heart and right to the site of the PDA. When the disc occluder was deployed on both sides of Molly’s PDA, it corrected the abnormal blood flow. All it took was an incision the size of your fingertip on the inside of her leg and a highly skilled team of AMC veterinarians and medical staff.

Screen Legend – A Movie of Blood Flow
The video clips of Molly’s procedure come from The AMC’s fluoroscopy machine. It is a special x-ray machine which makes a video x-ray of a procedure. In the first video clip, before the PDA was occluded, the rapidly moving black material is a special contrast agent administered intravenously to highlight the PDA. The contrast agent should all stay in the big blood vessel (aorta), but instead it circulates throughout the lungs and the blood vessels highlighted by the contrast agent represent blood vessels in the lungs.

In the second video clip, you can see the PDA has been closed off with a disc occluder. It blocks the blood flow through the PDA. You see the blood does not circulate abnormally through the lungs like in the first video.

Two weeks following surgery, Molly’s cardiac size decreased by 25% and she is doing well today. She is no longer at risk for developing heart failure and is expected to live a long, full life!

If you liked Molly’s story, you might want to hear other stories of medical triumphs at the 7th Annual Living Legends Luncheon on May 12th. Learn more about this event.

Blueberry: An AMC Living Legend

April 12, 2012

Blueberry in a stabilizing neck wrap. Photo: Dr. Joshua Gehrke

Blueberry, a 2 year old fawn and white Chihuahua, was rushed to The Animal Medical Center one night after having what his family thought might be a seizure. When he arrived at The AMC and was under observation by the ER staff, Blueberry had another terrible episode of pain which appeared to be originating from his neck. The astute observation of excruciating neck pain coupled with weakness in all four legs helped the ER staff to formulate a short list of possible diagnoses for further investigation.

Drs. John McCue and Joshua Gehrke and The AMC’s Neurology Service consulted on Blueberry’s case and confirmed the list of possible diagnoses: a disk extrusion in the neck pressing on the spinal cord, cranial occipital malformation syndrome or an atlantoaxial luxation. Later that same day, under general anesthesia, an MRI was performed to determine the diagnosis.

Using The AMC’s 1.5 Tesla MRI, the strongest magnet in use for veterinary patients in the New York Metropolitan area, The AMC’s radiologist confirmed one of the potential diagnoses, atlantoaxial luxation, a common condition of toy breed dogs. In addition, The AMC radiologist also noted that Blueberry’s spinal cord had kinked, resulting in a hemorrhage in the spinal cord.

Immediately, Blueberry was wrapped in a stabilizing neck splint and prescribed cage rest until surgery could be performed. The AMC neurology service was unsatisfied with the standard techniques often used to repair the alignment of the first and second neck bones. Current techniques were fraught with potential complications and Blueberry’s small size made many of these risky. A dorsal (top) stabilization was considered the best approach. Stabilizing the bones from the top requires a wire be passed over the spinal cord and anchored into the spinous process of the second cervical bone; sounds tricky and it is.

Radiograph taken after placement of Kishigami device (fishhook-like image). Blueberry's head is on left, neck to right.

For Blueberry, the Neurology Service recommended a state of the art repair technique using the Kishigami atlantoaxial tension band. The technique was developed 25 years ago by a Japanese veterinarian, but the procedure was not widely utilized. In 2010, a group of French veterinarians published the results of using the Kishigami technique in eight toy breed dogs and The AMC Neurology team was anxious to use this improved procedure in a dog with an atlantoaxial luxation. To repair Blueberry’s neck, the special device had to be purchased and shipped from Spain since a Spanish company currently is the only manufacturer of this device. Due to difficulties in purchase and transport of the Kishigami device, Blueberry waited one month after his diagnosis for surgery wrapped in a neck stabilizing bandage resembling a cocoon to prevent further damage to his brain stem.

At his three month post-operative check, Blueberry was given a clean bill of health by Dr. McCue. “Blueberry is completely back to normal.” Dr. McCue told me. “Even better, the Kishigami device holds Blueberry’s first and second cervical vertebra in perfect stable alignment and he should continue to do well on a long term basis.” Based on the success Blueberry enjoys with his Kishigami device, a box of the devices are sterilized and ready to go so no dog will have to wait for this repair again.

Blueberry will be honored as an AMC Living Legend at the Fourth Annual Living Legends Luncheon on May 9th. Blueberry’s is being recognized for his patience during a month long hospitalization and for his pioneering spirit in being the first AMC patient treated with the Kishigami technique.

Amos, a 5 Year Old “Living Legend”

April 25, 2011
Every year, The Animal Medical Center honors “Living Legends,” patients who have survived what seemed to be insurmountable odds. Unlike most living legends, who have distinguished careers and are silver haired recipients, the 2011 AMC Living Legends are two youngsters who both have long lives left to live because of the care given at The AMC. Today, I am writing about Amos, a 5 year old Burmese cat. Our other living legend is Herbie, who I have written about previously.

Amos as a kitten

Amos’ story starts in early 2007, when he was just 10 months old. After a normal kittenhood, he began vomiting and his regular veterinarians determined he had developed a gas-distended and inflamed esophagus and stomach. It seemed nothing was going out of the stomach and everything was coming back up. Pretty much all cats vomit, but poor Amos was losing weight and was down to barely six pounds.

Amos came to The AMC when treatment elsewhere was unsuccessful. Dr. Janet Kovak McClaran of the Surgery Service performed a Bilroth I surgery. Named after a 19th century human surgeon, the Bilroth I performed on Amos removed a thickened part of his stomach which was blocking the exit of food into the intestine and reattached the stomach directly to the small intestine. Within three weeks following surgery, Amos was a new cat. He was not vomiting and had gained one pound on his way to being an eight pound cat.

Amos snuggles with a friend

But the story doesn’t stop here. Eight months ago, Amos returned to The AMC. This time he was critically ill, requiring urgent, emergency surgery. Dr. Sarah Petre was the emergency surgeon on call. The AMC veterinarians were concerned for an intestinal blockage or worse, leaking intestines. What they found during an abdominal exploratory surgery was an eight inch segment of intestine twisted upon itself and deprived of its blood supply, but unrelated to the previous surgery. Amos underwent a second remodeling of his intestine to remove the twisted segment and reattach the ends. Without this surgery, Amos would have certainly died.

Both Amos and our other Living Legend, Herbie, will be attending The AMC’s Third Annual Living Legends Luncheon. If you would like to attend the luncheon and meet these incredible animals click here for more information.


This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

%d bloggers like this: