10/29/24 – Please welcome Blue! Blue has been passed around between three homes over the last two years for various reasons before finally making his way to us. He came in with an upper respiratory infection. Once we get it cleared up we will more forward with surgery.
11/7/24 – Blue had surgery today and this did not go well. We where able to finish his neuter but had to wake him up quickly because his blood pressure dropped.
11/15/24 – Blue saw the cardiologist today for an echocardiogram. He has been diagnosed with a third-degree AV block, and they are recommending he get a pacemaker.
11/19/24 – Blue underwent general anesthesia for placement of an epicardial pacemaker. This permanent pacemaker was placed on the surface of Blue’s heart by entering the abdomen, chest (thoracic) cavity, and pericardium surrounding the heart through an abdominal incision and small incision through the diaphragm. The pacemaker generator containing the battery was placed under the internal musculature of his abdomen on the left side. Blue was woken up from anesthesia with no complication and monitored in ICU overnight in an oxygen cage. He has done well since his pacemaker implantation and the pacemaker is functioning properly at this time. Blue was transitioned to minimal amounts of treatments prior to the time of discharge as he was breathing comfortably, his pain was well tolerated and he was eating well on his own.
The type of pacemaker Blue has now provides a variable heart rate with an average of 60 beats per minute, which varies to adapt during physical activity. His pacemaker is currently set so that his heart may not get below 60 beats per minute. The life of the pacemaker battery depends on how much he needs to use the pacemaker. Blue needs a recheck in 3 months to test the pacemaker and determine if we can decrease the voltage thereby extending the battery life. We will likely be able to maximize the battery life at his 3-month recheck when we optimize the pacemaker’s settings. It takes about 3 months for the heart to completely heal after implantation and the settings of the pacemaker to be adjusted. The pacemaker should not override the ability of Blue’s heart to function normally on its own. If his intrinsic heart rate is appropriate, the pacemaker will simply listen in the background and only provide paced beats when needed. The pacemaker should work in conjunction with his heart, providing assistance if the heart rate is not high enough while letting his heart generate the beats if it is functioning normally.
He will see the cardiologist again in med February to have his pacemaker adjusted. At that time we hope he is cleared to have surgery. We think he would benefit from having his palate shortened and his nares widened.
2/17/25 – Blue had his pacemaker adjusted today and all went well!
2/20/25 – Blue had surgery today and all went well! He had his palate shortened and his nares widened. We started him on apoqeul to help with his allergies. He will need to see the cardiologist again in 6 months for a recheck and adjustment on his pacemaker but we expect him to live a long normal healthy life with no heart issues. He seems a bit weak in his back end so we are working on at home therapy to help him with this.
7/30/25 – Plus saw the dermatologist today because of his history of infection and inflammation around his face, paws and body. Based on his history and exam, the dermatologist suspect the thickening and bumps appreciated around the face/muzzle, on the chin and paws is due to folliculitis and furunculosis. This is inflammation and rupture of the hair follicle, leading to a foreign body reaction and commonly secondary infection. Long term, the skin becomes thickened from scar tissue. There are many reasons for this type of skin lesions, including allergies (due to licking or rubbing and inflammation), bristle-like haircoat, abnormal weightbearing typically due to orthopedic abnormalities and arthritis, an overweight body condition, mites (demodex) and hormonal abnormalities (decreased thyroid hormone). It is likely Blue has underlying allergies leading to his itch and skin inflammation. Based on his response to diet changes and increase in itch after being outside, it is likely he has a combination of pervious food and environmental allergies. We discussed performing a diet trial to confirm a food allergy but since he is doing well with no stomach upset on his current diet of Hills Biome, we will continue this diet for now. For environmental allergies, we will continue using apoqeul. We will continue with all current maintenance topical therapies (Zymox ear cleaner, Douxo Pyo Shampoo for body, Douxo Pyo wipes for face folds, chin and paws).
08/21/25 – Blue saw the cardiologist today for a 9 month follow up and pacemaker interrogation after his 3 month recheck on 2/17/25.
On presentation, he was bright, alert, responsive, and otherwise hemodynamically stable. Blue’s pacemaker was interrogated and is sensing and pacing appropriately. There were no concerning high-rate episodes, lapses in pacing or concern for fracture along the lead at this time. We did slightly increase the amplitude of his pacemaker today.
We also performed an echocardiogram on Blue today. Blue’s left ventricle is still enlarged. As we discussed, it is possible Blue’s left ventricle enlarged due to his bradyarrhythmia. However, his heart should be remodeling (repairing) these abnormalities since the pacemaker has rectified his arrhythmia. It is possible another condition could be causing the dilation of Blue’s ventricle. We discussed things such as dilated cardiomyopathy, which can be associated with diet, endocrine diseases like hypothyroidism, or can develop without a known cause (idiopathic). We ruled out hypothyroidism. His echocardiogram was otherwise static, which is great!
The type of pacemaker Blue has provides a variable heart rate with an average of 80 beats per minute, which varies to adapt during physical activity. His pacemaker is currently set so that his heart may not get below 80 beats per minute. The life of the pacemaker battery depends on how much he needs to use the pacemaker but we expect it to last 9.5 years. We can optimize pacemaker settings to help allow for the longest battery life possible while still providing a safe heart rate. The pacemaker should not override the ability of Blue’s heart to function normally on its own. If his intrinsic heart rate is appropriate, the pacemaker will simply listen in the background and only provide paced beats when needed. The pacemaker should work in conjunction with his heart, providing assistance if the heart rate is not high enough while letting his heart generate the beats if it is functioning normally.
9/24/25 – Blue had dental surgery today to address his gingival hyperplasia and all went well! All teeth where cleaned, he had handful of teeth extracted, Gingivectomy/gingivoplasty to remove extra tissue around a most of his teeth, sublingual chewing granulomas removed.
approximate age: 4 – DOB 8/4/21
approximate weight: 25
likes dogs: he does not mind them when out and about and has a few friends he likes to play with but would be happiest as the only dog living in the home, or perhaps living with another dog as long as they do not get near his food bowl
likes cats: we have not seen him around cats
likes kids: he is ok with older kids that give him space and do not touch his food
food: Hills Biome prescription food for his sensitive stomach
lifelong medications: allergy medication, tacrolimus eye drops for dry eye, over the counter medicated shampoo, over the counter medicated wipes
Likes: attention, bones, soft beds, back scratches, sunbathing
dislikes: being left alone (we are working on his separation anxiety), thinking dogs or people are going to take his food from him, sharing attention with other dogs all the time
ideal home: he would do best in a home with no other dogs, someone to spend time with him more often then not, someone willing to work with him on his separation anxiety, someone willing to do follow up visits with a cardiologist once a year to be sure his pace maker is working as is should
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