CSU veterinary heart specialists pump up the volume for rescued beagle

The peek of health: Lilly makes sure the coast is clear outside the Critical Care Unit at CSU. (Photo by John Eisele/CSU Photography)A rescued beagle from Iowa survived to mark her first birthday after cardiac surgeons at Colorado State University's veterinary hospital repaired a congenital heart defect that more often afflicts human babies than canines. 

Lilly Rose was born with tetralogy of Fallot, a set of four structural heart abnormalities that's uncommon in dogs and is often fatal before the age of 1.

In humans, the condition often is called “blue baby syndrome” because the heart problems prevent oxygenated blood from properly circulating through the body, giving the skin a bluish tinge. The disease, occurring in about five of every 10,000 babies, is typically caught and successfully treated. Case in point: Shaun White, the snowboarding superstar and two-time Olympic gold medalist, was born with tetralogy of Fallot and underwent two open-heart surgeries as an infant.

It is not likely that Lilly will catch big air any time soon, but she does have one thing in common with White and other survivors of this condition. 

“The dog came here blue and is going home pink,” Christopher Orton, DVM, PhD, DACVS, a professor of cardiology at CSU, said when Lilly left the James L. Voss Veterinary Teaching Hospital after the second of two operations in July.

Lilly's lifesaving operations

Critter Crusaders, a pet rescue organization in Cedar Rapids, Iowa, took in Lilly Rose when her owner surrendered the sickly puppy. The group finds medical attention for homeless animals and sought a surgical solution that could give Lilly a normal life.

Lilly ultimately underwent two procedures. During the first, in September 2014, CSU veterinarians performed a balloon valvuloplasty. In this minimally invasive procedure, a thin catheter is inserted into the heart and a balloon at the tip is inflated to stretch open a constricted heart valve. This improves the flow of blood to the lungs for oxygenation. 

The valvuloplasty bought time until doctors could perform heart surgery to install a shunt that further increases blood flow from the heart to the lungs for life-giving oxygen. Called a modified Blalock-Taussig shunt, the device is a small, artificial tube that diverts blood-in this case, for the purpose of recirculating through the lungs to pick up more oxygen before it travels into the body to enliven cells and tissues.

The shunt connects a systemic artery, which carries oxygenated blood to the body, to the pulmonary artery, which carries deoxygenated blood to the lungs.

“Dr. Orton uses synthetic tubing to connect a branch of the aorta to her pulmonary artery. This gives the blood a second shot to pick up oxygen,” said Marisa Ames, DVM, DACVIM (cardiology), a CSU assistant professor of clinical sciences. “This is blood that has already gone through the entire heart. But we're saying, ‘Let's take one more spin through the lungs and pick up more oxygen.'”

Orton performed the three-hour surgery in July, assisted by Ames and a team of veterinary residents. 

A second chance for survival

Lilly's treatment is palliative-not a cure. But the two operations have improved her quality of life and her chances of long-term survival.

“Lilly is a trendsetter-we were able to palliate her disease with the valvuloplasty and give her time to grow up prior to the surgical procedure,” Ames said. “Our senior cardiology resident, Dr. Christian Weder, is writing up her case, so her story will hopefully help other dogs. This sequence of treatments has been described only once in veterinary literature, yet no follow-up information is available.”