Emma

April 2008:

Emma is a petite 5 month old Westie girl who came to Canine Friends Foundation on 2/7/08 when she was 11 weeks old. She was relinquished to rescue by a commercial breeder who had taken her for a "well puppy" vet check where it was discovered she had a Grade II/VI heart murmur. Since she could not sell her, the breeder contacted me to see if I wanted to take her into rescue before she euthanized her. This breeder was aware that CFF rescued Robbie and Roy (both grateful Westie Med alumni) who were diagnosed with heart murmurs caused by pulmonic stenosis last year.

I picked Emma up the next day and was shocked by her small size and thin frame- she only weighed three pounds! Based on her poor condition, it was obvious that the breeder had just stuck her in a cage and neglected her after the diagnosis. However, that did nothing to stop this little girl's sweet and spunky attitude and indomitable spirit! Upon her arrival at my house, she was welcomed with kisses and "let's play" doggie bows by the resident Westies- Rowdy, Katie, Darby and Robbie.

I immediately took Emma to my vet, Dr Ted Foster, who agreed that a referral to VA Tech Veterinary Teaching Hospital's Cardiology Dept headed up by Dr. Jonathan Abbott was in order. She was scheduled for a cardiac evaluation and echocardiogram for 4/7/08. Since the appointment w/Dr Abbott was nearly two months into the future, we began working on Emma's body building and weight gain program. Needless to say, she has certainly enjoyed all the play time and scrumptious food and treats she has been allowed to have for the past several weeks, in addition to the countless hugs and kisses and constant attention!

Emma arrived at VA Tech VTH on 4/7/08 where she had a physical exam followed by an echocardiogram. It was found that her heart murmur had worsened to a Grade IV/VI and that she had pulmonic stenosis-narrowing of the outflow tract of the pulmonic valve on the right side of her heart caused by abnormal pulmonic valve development. Pulmonic stenosis makes her heart work too hard when it pushes blood from the right ventricle of her heart into her pulmonary artery. Her heart will gradually become enlarged from overuse and will progress into congestive heart failure and death without surgical intervention.

The severity of the pulmonic stenosis is determined by the pressure gradient between the right ventricle and pulmonary artery. Balloon valvuloplasty is recommended for dogs w/pressure gradients greater than 80 mmHg-Emma's gradient was 85-90mmHg-thus she needs to have the procedure done as soon as possible. Balloon valvuloplasty involves dilating Emma's narrow pulmonic valve with a balloon, which will stretch and open it up, reducing the pressure gradient between the right ventricle and the pulmonary artery and decreasing the amount of stress on her heart. The procedure has a good success rate and I am hoping that with the surgery, Emma can continue to grow up like any other healthy Westie and lead a long and happy life.

I am deeply grateful to Westie Med for providing the financial support needed to proceed w/scheduling Emma's surgery and giving her a chance. She is currently scheduled for June 23, however Dr. Abbott is working on getting that date moved up since Emma's pressure gradient is already so high.

Emma has touched everyone she has met w/her outgoing, bubbly personality--she is absolutely beautiful both inside and out and quite the little charmer! Hugh and Colleen Pettis, a retired couple from Staunton, VA and lifelong Westie lovers/owners, fell head over heels in love with Emma when we stopped by their home to visit them and their 8 yr old Westie girl, Silver Lining-adopted from CFF and who had been rescued along w/Emma. They want to adopt her (of course) and they are praying for the success of Emma's surgery so she can soon join their family and become their beloved and totally spoiled little Westie girl.

With many thanks and deepest appreciation to Westie Med,
Susie Branham, Cofounder, Canine Friends Foundation and Emma

Update June 1, 2008:

Emma returned to VA Tech's Veterinary Teaching Hospital  for her recommended pulmonic valvuloplasty on 5/28/08 after I received a call from Dr Jessica Gentile, cardiac resident, that they had a procedure cancellation for 5/29. I was very relieved, as Emma had started coughing when she awoke in the morning and I was concerned she was going into the early stages of congestive heart failure.

Upon arrival, Emma and I were met by her senior veterinary student, Michael Hickey, who would be in charge of her care for the next two days. Emma's outgoing personality and charm quickly won him over and they became fast friends.  Dr Gentile joined us, advising they planned to do an echocardiogram that afternoon to determine if there had been any change in Emma's pressure gradients since her 4/7/08 appointment. The results of the echocardiogram showed the pressure gradient between the right ventricle of Emma's heart and her pulmonary artery had worsened from 85-90 mmHg to 100 mmHg over the past 7 weeks. This information confirmed Emma's pulmonic stenosis was worsening and that she would eventually develop congestive heart failure and die without surgical intervention.

Emma's surgery started at 9 a.m. on Thursday morning, May 29. A catheter with a small inflatable balloon on the end was placed in Emma's jugular vein through a small incision in her neck. The catheter was guided to the narrowed pulmonic valve and the balloon was then inflated several times, opening up the valve and decreasing the pressure gradient across it. This allows the oxygenated blood to pass more freely between the right ventricle of Emma's heart and the pulmonary artery and means her heart no longer has to overwork itself to maintain the correct blood oxygen level for her to survive.

I waited all morning w/my heart in my throat, saying little prayers for Emma, until Dr. Gentile called me at 11:40 a.m. to advise Emma's surgery had been "textbook perfect" and she was just waking up. A call from Mike, senior vet student, later in the afternoon revealed Emma was awake, alert, hungry and ready to play!!

Emma's post surgical pressure gradient was evaluated Friday morning w/a repeat echocardiogram. Her pressure gradient was found to be 30mmHg and her heart murmur was reduced from Grade 4 to Grade 2-3/6, which is a dramatic improvement according to Dr. Gentile. Emma was her usual outgoing and happy self when she was discharged late that afternoon by Mike and Dr Gentile, who were still elated by the overwhelming success of her surgery. Everyone who participated in her surgery came in to say goodbye before we departed and Emma distributed sweet Westie "thank you" kisses to all without reservation!

Emma must remain quiet while her neck incision heals. This is probably going to be the hardest part of the process, since she feels so good. We will return to Blacksburg for another echocardiogram in three months to ensure the pulmonic valve remains open and her pressure gradient remains low, since pulmonic stenosis can never be truly fixed, just reduced through stretching the narrowed valve with balloon valvuloplasty. Her chance at living a normal Westie lifespan has been dramatically increased w/this procedure. If her pressures are stable at her follow up appointment, she will be ready to go to her new adoptive home, where Hugh and Colleen Pettis and Silver Lining the Westie (now known as Cupcake) are eagerly anticipating her arrival.

Again, WestieMed has provided financial support and helped save the life of one of CFF's precious rescued Westies. It is hard to believe that breeders routinely kill these little ones with heart murmurs without giving them a chance. Emma and her foster brother and best friend, Robbie, (Westie Med alumni March 2008), have brought much fun and laughter to this foster home and their antics and natural charm never cease to make me and all who meet them stop and smile!

I am deeply thankful to WestieMed and VA Tech's cardiology department for their help in the effort to save the lives of sweet Emma and CFF's other two pulmonic stenosis diagnosed Westies, Robbie and Roy, this year. CFF would not have been able to fund these major surgeries without the assistance of WestieMed--THANK YOU for being there for these little ones!

Gratefully and joyfully from the bottom of our hearts,
Susie Branham, Canine Friends Foundation, and Emma