Lily the Border Terrier
Davies Veterinary Specialists
14th November 2019
Four-month old border terrier Lily receives treatment for severe pulmonic stenosis
On assessment before the procedure Lily was bright and alert. The only relevant finding on physical examination was a heart murmur that was characterized as a 4/6 holosystolic murmur most audible over the left base and irradiating to the right. An echocardiographic examination was performed and confirmed the presence of severe pulmonic stenosis with cusp fusion (type A) which had been diagnosied initially by Lily’s primary care practice. Additionally, a very small ventricular septal defect with left-right shunt was suspected.
The degree of obstruction across the pulmonic valve was severe with a transvalvular flow gradient of approximately 140-150 mmHg (severe > 80). Unfortunately dogs with severe pulmonic stenosis are at risk of sudden death or heart failure at some point in their lives.
Under general anaesthesia, the right jugular vein was used for cardiac catheterization. Angiography and pressure measurements were performed. Two dilations were performed with a 12 mm high pressure catheter. A significant reduction in the degree of obstruction was achieved with a reduction in the right ventricular pressure from 95 to 26 mmHg (normal 20-25) during the procedure.
This was later confirmed via echocardiography on the following day with a reduction of the transvalvular gradient from 140-150 mmHg to 22 mmHg (conscious) (mild < 50; severe > 80). We were very pleased with these results.
A percutaneous approach was used which meant that there was no particular care necessary after the procedure. Lily was discharged the following day and should now be able to lead a normal life without any medication. We will see Lily again for a re-examination in three months.
For more information about pulmonic stenosis in dogs, click here to read our fact sheet.
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