As a puppy, Rudy preferred a secluded place to hide from his raging littermates. When Jill and Chris Carter saw Rudy in the adoption home, he ran out of hearts.
“His brothers and sisters wouldn’t allow him to hide,” recalls Jill. “Chris noticed that he was torn from hiding by his tail and was forced to attend the puppy fun festival.”
The couple from Rochester, Minnesota adopted Rudy and his sister, whom they named Holly. Two weeks later, when the Carters picked her up, the differences were noticeable. Rudy weighed 5 pounds while Holly had grown to 11 pounds. And Rudy looked bloated. Her vet recommended deworming, which didn’t help. “Holly was growing like a weed, but Rudy was rounder and wasn’t really growing,” says Jill.
A trip to the emergency room confirmed a significant amount of abdominal fluid. Liver problems were the suspected cause. Abdominal CT eliminated this theory. Rudy’s liver struggled, but in good shape. However, on the verge of the scan, the radiologist discovered abnormalities with his inferior vena cava – the vessel that returns blood from the lower and middle parts of the body to the right atrium of the heart. A chest CT showed a membrane separating Rudy’s right atrium into two chambers. The faulty atrium had caused the incoming inferior vena cava to gush out as blood pooled.
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The condition known as cor triatriatum dexter or CTD occurs when an embryonic structure persists after birth to form the membrane. The rare abnormality is well documented in humans and other animals, and patients often have other heart defects. The poor blood circulation leads to a blockage as fluid builds up in the abdominal cavity.
“The vet told us we were lucky because the University of Minnesota had a cardiologist who specializes in CTD cases,” says Jill. An appointment was made with Chris Stauthammer, DVM, Diplomat ACVIM (cardiology) and a treatment plan was developed.
“Our typical method is to use a catheter to insert a device into the atrium to either stretch the membrane or to perforate it to increase blood flow throughout the atrium,” says Stauthammer.
The day of surgery came and the Carters were nervous. The operation was canceled after seven hours because the “usual” intervention did not work. Rudy’s blood pressure dropped.
“We were heartbroken,” says Jill. “We brought Rudy home thinking he only had one month left in his short little life.” A few days later, Stauthammer called and said he was ready to give Rudy another chance to develop.
Stauthammer had found a Colorado-based company willing to donate a transseptal needle to the College of Veterinary Medicine. The device uses radio frequency energy to pierce thick membranes safely and in a controlled manner without using force to push through the tissue. Rudy had few options left, and Stauthammer’s review of human cases in the medical literature showed a positive track record.
“The transseptal needle was a logical choice because it has proven to be safer, more efficient, and faster, especially in cases like Rudy’s where the membrane is thick,” says Stauthammer. “This procedure also seems to reduce the need for second attempts, which would have been dangerous for Rudy.”
Stauthammer recommended a second operation, and the Carters agreed. It would be the first documented use of the device and procedure on a veterinary patient.
Rudy’s second chance operation went smoothly. After a few bouts of constipation, Rudy began to thrive. Jill says, “We had a healthy little puppy who could finally keep up and play with his sister.”
In October 2020, Rudy’s exam at Stauthammer at the Veterinary Medical Center was a breeze compared to previous veterinary appointments that Carterr remembered. By age two, Rudy became the brave, vocal member of her family – he is the first to go outside at night looking for scary things for his sister Holly. He greets the Carters at home with a playful bark. The greeting brings tears to Jill’s eyes as she imagines her house without Rudy.
“We will forever be grateful to the university for not giving up on Rudy,” she says. “They exceeded all expectations to make sure we had two dogs to cuddle with.
“Every aspect of Rudy’s treatment seemed to have its obstacles,” adds Carter. “It was reassuring to work with the university staff who made us feel we were in the right place from our first visit.”
Chris and Jill Carter enjoy spending time with their Labradors Holly and Rudy. Photo credit: Steve Woit