Veterinarian and Heart Surgeon Team Up to Save Lab Puppy With Heart Defect

Story at-a-glance -

  • A chocolate Labrador puppy named Shamus was born with a serious heart defect called a persistent right aortic arch, or vascular ring anomaly
  • This congenital abnormality affects the heart’s blood vessels, causing a complete ring to form around the esophagus, which means food cannot be properly swallowed
  • Thoracic surgery costing $5,000 was the only solution to save the dog’s life, and when the breeder was unable to afford it, a veterinarian offered to do the surgery for free and even enlisted the help of a human heart surgeon for the procedure
  • Shamus bounced back with vigor after the surgery and is expected to live a normal life; a veterinarian at the animal hospital has since adopted Shamus, bringing this happy ending full circle

By Dr. Karen Shaw Becker

A chocolate Labrador puppy named Shamus was born with a serious heart defect called a persistent right aortic arch, or vascular ring anomaly. This congenital abnormality affects the heart’s blood vessels, causing a complete ring to form around the esophagus. This, in turn, narrows the passage and causes it to become compressed, which means food cannot be properly swallowed. In addition, it leads to dilatation of the esophagus, or megaesophagus.

In megaesophagus, there are issues with nerve and muscle functioning that cause a motility problem. The esophagus stretches out and muscular contractions aren't efficient. As a result, food doesn't always reach the stomach. It can build up in the esophagus, which eventually will cause the dog to regurgitate.

Regurgitation can occur within minutes of swallowing food, in which case the food looks exactly as it did going in. If regurgitation occurs hours after eating, the food reappears in a tubular or sausage shape (food regurgitated due to vascular ring anomaly will be undigested). In Shamus’ case, his breeder brought him into Hyannis Animal Hospital in Yarmouth, Massachusetts for what was believed to be a gagging problem. He was just 10 weeks old.

When it turned out a heart defect was to blame, thoracic surgery costing $5,000 was the only solution to save the dog’s life. When the breeder was unable to afford it, veterinarian Kevin Smith offered to do the surgery for free — after he studied up on how to perform it — and even enlisted the help of Cape Cod Hospital heart surgeon Dr. Paul Pirundini.1

Signs and Symptoms of Vascular Ring Anomaly

Dogs may be born with vascular ring anomaly, which leads to symptoms such as regurgitation of undigested solid food in dogs less than 6 months of age, malnourishment and gagging. According to Wag Walking,

“In the fetal stages of development, there are aortic arches (blood vessels) that encircle the esophagus and trachea. In some instances, arches can form in an abnormal way or location, resulting in pressure on the esophagus and trachea, which can cause a narrowing of the organs and subsequent regurgitation of solid food as a puppy is weaned.”2

Certain breeds, such as Boston terriers, German shepherds and Irish setters are more likely to be born with vascular ring anomaly. Dogs may also experience stunted growth and constant hunger and appear emaciated.

Constant regurgitation, which may occur minutes to hours after eating, also predisposes these animals to aspiration pneumonia, which occurs when a dog inhales during an episode of regurgitation, bringing food into the lungs. This can cause a terrible, potentially life-threatening infection.

Imaging, such as thoracic x-rays, are typically required to diagnose this condition, and surgery is required to cut the ligament that’s closing off the esophagus. The earlier the surgery is performed the better, as permanent damage to the esophagus can occur, in some cases requiring ongoing treatment for megaesophagus.

For instance, pets with megaesophagus tend to do better with small, frequent meals fed out of elevated food bowls or by hand, with the head in an elevated position. With the body elevated, which means in a vertical position, gravity can do some of what the esophagus isn't doing.

Many owners of dogs with megaesophagus encourage their dogs to hold a sit position for 10 minutes after eating or drinking anything, to allow the food and water to eventually reach the stomach with the effect of gravity.

Some pet owners also use a "Bailey Chair," which is a piece of equipment that functions like a high chair for dogs, keeping them in an upright position during meals. You can maintain a dog in the Bailey chair for 10 to 30 minutes after a meal, allowing gravity to move the food down the esophagus and into the stomach.

A Combined Effort Between a Veterinarian and Heart Surgeon

To save Shamus, Smith and Pirundini worked together during the 1.5-hour procedure, which took place in January 2018. The teamwork reportedly helped them complete the surgery faster, reducing how long the pup was kept under anesthesia.

After a 24-hour observation period, Shamus bounced back with vigor and is expected to live a normal life. Cape Cod Times noted, “After having stitches removed … Shamus ran around the veterinarians’ office, chasing water bottles, sniffing boots and shoes and trying to steal another dog’s blanket space under a desk.”3

A veterinarian at the animal hospital has since adopted Shamus, bringing this happy ending full circle. In dogs suffering from megaesophagus following surgery for vascular ring anomaly, thickening agents may be added to water to reduce the likelihood of recurrent aspiration episodes. Finding the best form of food to feed and method for feeding it is usually mastered through trial and error, so don’t give up.

In addition, acupuncture can sometimes be used to stimulate esophageal motility, and chiropractic care may help remove disruptions to the nerves in the esophagus.

Further, there are some traditional Chinese medicinals as well as homeopathics that have been used to stimulate esophageal tone, as well as nutraceuticals such as choline and whole food organic minerals that have proved to be somewhat beneficial for the megaesophagus patient.

However, if vascular ring anomaly is caught and correct early on, as it was in Shamus, your dog can often live a long and healthy life with no lasting complications.

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