PDA

Patent Ductus Arteriosus (PDA)

 Jamie was a 6 and a half week-old puppy when she was first brought to Dr. Chuck Noonan at Animal Doctors of Weston. She was acting normally and seemed to have had no issues in her first weeks of life. Dr. Noonan examined her and listened to her heart only to discover a significant heart murmur that was continuous throughout her heartbeat cycle. Dr. Noonan astutely recognized that this was likely a very significant heart defect that she was likely born with and recommended that Jamie’s mother take her to a veterinary cardiologist.

A week later, Jamie was seen by Dr. Mandi Kleman, a board-certified veterinary cardiologist at Cornell University Veterinary Specialists. Dr. Kleman performed an echocardiogram (ultrasound of the heart), which revealed a structural abnormality called a patent ductus arteriosus (PDA). A PDA is a congenital cardiac abnormality in which a connection exists between the aorta (the major systemic artery) and the pulmonary artery (the major vessel to the lungs). This abnormal connection results in the heart becoming overloaded by recirculating blood and typically results in heart failure within the first year of life. It was imperative, therefore, that we correct Jamie’s PDA.

There are 2 ways to correct PDAs. The first is via open chest surgery, to locate and ligate (tie off) the abnormal PDA vessel. This is the traditional method. The second option is to occlude (close off) the PDA vessel via an Interventional Radiology technique. Interventional Radiology is a method of surgery that uses video xrays (fluoroscopy) to allow the surgeon to see into the body and manipulate structures. This is a new technique in veterinary medicine, available at few academic and specialty institutions, including Cornell University Veterinary Specialists. The advantages of these techniques are that they are less invasive; there is no open surgery and thus, less pain and a faster recovery. For PDA correction via Interventional Radiology, an Amplatz ductal occluder or embolic coil can be inserted via a blood vessel until it is placed across the abnormal PDA vessel. The device then causes obstruction of blood flow across the PDA.

Here, at CUVS, both techniques are possible. In Jamie’s case, however, it was decided that surgery was her best option given her very small size. Dr Oli Morgan, staff surgeon at Cornell University Veterinary Specialists, performed the surgery - a left lateral thoracotomy via the 4th intercostal space. The PDA was carefully dissected and ligated, restoring normal blood flow. Jamie recovered smoothly in the Intensive Care Unit. Her heart murmur resolved. That evening she was already standing and eating! The next day, she was giving kisses and behaving like a puppy again. She was discharged to her owners care for at home recovery. After two weeks of exercise restriction she was healed. Her prognosis is excellent with a normal life expectancy.

Dr. Oli Morgan joins CUVS

CUVS Welcomes Dr. Oliver Morgan, VMD, DACVS, on board as our new staff surgeon!

As we bid a sad farewell to Dr. Alon Kramer, who has moved back to Portland with his family, we are excited to introduce Dr. Oliver “Oli” Morgan as the newest member of our medical team. We are so lucky to have found a surgeon of his calibur, and his communication skills and core values lend themselves very well to our atmosphere here. We're thrilled to have him on board, and he is undoubtedly a great match for our team here at CUVS!

We had a chance to catch him in the middle of a busy day here to ask him a few questions:

Q. Where are you coming from - where did you work before CUVS?

A. I am moving from Los Angeles, California where I worked at a large multispecialty referral hospital (Advanced Critical Care at the City of Angels Veterinary Specialty Center).  I am returning to Connecticut where I grew up with my wife and 1 year old son not only to work at CUVS, but also to be close to family.

Q. How have your first few days been here at CUVS?

A. My first few days at CUVS have been great with everyone being extremely welcoming.  The atmosphere within CUVS for both clients, patients, and new doctors is very similar it seems!

Q. How is CUVS different? What do you like about working here?
A. CUVS represents a new paradigm in veterinary medicine that is directed at providing a mix of the best of private practice with the best of academia.  I am so excited to be working in an environment with specialists that both love what they do and are excellent at what they do with a central dedication to client service and to our referring veterinarians.  The technicians and staff are excellent and also clearly have a deep-seated dedication to the care of our patients and that carries through in all their interactions with our patients.

We're so happy to have Dr. Morgan on board and are looking forward to a great future with him as part of the family. Welcome!

Casey's Abdominal Surgery at CUVS

   Casey is a mixed-breed spayed female dog owned by Suzanne, who is the Senior Client Service Representative at Bull's Head Pet Hospital. Casey was referred to CUVS from Bull’s Head after Dr. Nolan Zeide diagnosed her with a large abdominal mass, hemo-abdomen and a fever.  Casey was admitted to CUVS for observation, supportive care and a further work up under the care of Dr. Rousseau, DVM, DACVIM, DACVECC.

An ultrasound at CUVS revealed a large mass potentially originating from the liver, an abnormal spleen and a probable left adrenal mass. Casey underwent abdominal exploratory surgery with Dr. Alon Kramer, DVM, DACVS, during which a large, ruptured splenic mass and a ruptured liver mass were found. A splenectomy, a liver lobectomy and an adrenal biopsy were performed. (Her spleen and part of her liver were removed.) Casey also received a blood transfusion during surgery, a routine part of splenectomies as it combats anemia.

Post surgery, Casey stayed in our ICU for four days for pain relief and continuous monitoring. Attentive post-surgical monitoring is important for splenectomy patients to make sure that there are no complications. Lab results came back showing liposarcoma of the intermediate grade in the spleen, hepatoma in the liver and suspected pheochromocytoma in the adrenal gland.

Once Casey was stable enough for travel, she was sent back to Bull’s Head so her regular veterinarian could continue caring for her. Casey was a lovely patient for us and although we are happy she was discharged from CUVS, we were sad to see her go!

Lipton: First Emergency and First Surgery at CUVS

Lipton in the ICU of CUVS

Lipton was Cornell University Veterinary Specialists' first emergency case on January 14th, 2011. She was referred to us by a local veternarian because she was lethargic and had collapsed on more than one occasion.

Upon examination, our criticalist Dr. Sergi Serrano, LV, DVM, DACVECC, suspected a possible hemoabdomen (blood in the abdominal cavity). Our team began stabilizing Lipton and performing diagnostic tests, which included bloodwork, abdominal ultrasound, thoracic radiographs and echocardiography. These tests confirmed the hemoabdomen and Lipton was rushed into surgery with Dr. Alon Kramer, DVM, DACVS. 

Dr. Kramer and Dr. Serrano perform surgery on Lipton

Exploratory surgery revealed multiple splenic masses, one of which had ruptured and was actively bleeding. Dr. Kramer performed a splenectomy (removal of the spleen) and Lipton was then admitted to ICU for recovery and monitoring. Lipton stayed in our ICU for three days, during which she received a blood transfusion to treat her anemia. Attentive pain management and lots of love from our staff made Lipton's extended stay at CUVS as comfortable as possible.