Next stop was a complete checkup by Dr. Jeffrey Bryan of Irving Street Vet Hospital (now studying for an oncology specialty at the University of Missouri).  My Westie-mate, Brad, was telling Dr. Bryan about Annie’s new pack when his eyes (Dr. Bryan’s!) got large and he hushed the audience comprising me and the other three Westies. He noted a dramatic heart arrhythmia called sick sinus syndrome (defined as a group of abnormal heart beats presumably caused by a malfunction of the sinus node, the heart’s “natural” pacemaker).  Annie’s heart would beat for a bit and then go silent (asystolic) for a bit and back and forth with the heart not beating as long as it was beating during those intervals.  Dr. Bryan referred Annie to the cardiologists at UC Davis for evaluation at age 12 (estimated since she is a rescue).

 

Annie was quite the star that day at UC Davis. All of the students and residents were called in to listen to her heart.  You know there is a problem when your dog becomes a must-see sensation at a vet school.  She loved the attention as they studied her.  At that time they decided that since she had not yet fainted and her EKG resumed a normal pattern when she was injected with atropine, the illness was in the early stages and she did not need a pacemaker until it worsened.

 

Fast forward 3 years to 2004…Annie still had not fainted although she was very quiet, slept a lot, was anxious, panted frequently and overall seemed to be failing.  She had also been diagnosed with Westie Lung Disease (pulmonary fibrosis) during the past year and had an enlarged heart.  On August 16th she was sleeping on a sofa by my patio door while I did yard work.   I heard a crash and found Annie collapsed on the floor and she was not breathing.  Fortunately, I had attended the CPR/Safety lecture given to SFBWHWTC Westie Club members by President Lisa Blutman in 2003.  I was unable to clear Annie’s airway as she had also vomited during this event.  I resorted to the last resort and picked her up by her back legs and swung her back and forth.  Annie reacted with a gasp on the fourth swing.  She had blue gums and tongue and was stiff and dazed. 

 

My neighbor, Ken, responded to my plea for help, looked at Annie and decided she would never make the 15-minute drive to Irving Street Vet Hospital.  Ken took us to his vet, Dr. Linda Hunt at Sunset Vet Clinic, only 5 blocks away.  Annie was immediately placed in an oxygen cage and stabilized.  I was sure I had broken her legs swinging her around but, thankfully, all were intact.

 

After the crisis passed Dr. Hunt said she thought Annie’s heart was the primary issue.  Dr. Craig Maretzki of San Francisco Vet Specialists, Annie’s primary care giver, referred us to UC Davis cardiology.  Sandy Gilmer (one of our club’s rescue coordinators and my great go-to-friend for all matters Westie) told me that club member Kathy Kelley has a Westie, Maggie, who recently had a pacemaker implanted at UC Davis.  She stated that Kathy would be happy to share her experience with me.  Kathy was nothing short of a cheerleader for Westie pacemakers as her Maggie, who is 15 years old, is a new dog and has significantly benefited from the procedure.

 

Annie went to see Dr. Sarah Miller at UC Davis who expedited our appointment on August 26.  She and her senior student assistant, Debbie Chou, examined Annie and said her heart rate, which should be 120 beats a minute, was never over 50 beats per minute and was intermittent.  Dr. Miller and a heart squad of about 7 others performed an ultrasound of her heart and other organs and strongly recommended that Annie get a pacemaker.  We left Annie in their care and her pacemaker was implanted the following day.  And what a long day it was!  We held our breath that the Westie Lung Disease would not cause her to have complications.  They talked to us 3 times -- first to report that a temporary pacemaker was in place, second to say surgery was complete and she was recovering in their Intensive Care unit (just a precaution because of her lungs) and finally to tell us that she was awake and alert.

 

When we arrived the next day to get Annie, we were quite surprised.  Annie walked out to greet us and was missing a bit of her lovely fur coat.  See the pre-surgery photo of Annie above with her pal Tessa before you look at her post surgery photos.  They placed the pacemaker on her back (see Photo 2) where it could not be reached by paws or teeth and introduced the pacemaker lead through her left carotid artery.  She also had bruising and swelling in her neck and front which is rare but previously observed with this surgery (see Photo 3).  In her discharge instructions was the note “She was a wonderful patient and an adorable dog.”  I agree.

 

                         Photo 2                                              Photo 3

 

Note that Annie’s skin is spotted.  When she was originally groomed in 2001, I noticed her Dalmatian-like skin and she became known as Annie Dot (after JennyAnnieDots, one of T.S. Eliot’s magical cats).  In only 5 days after surgery the bruising and swelling had disappeared.  I was to take her pulse each day for a month to make sure she did not come unplugged.  As she recuperated we were finally getting to meet the ‘real’ Little Annie – the heart-beating-at-120-beats-per-minute Annie Dot.  What a thrill to see her develop into an active, ornery and vibrant dog with all the requisite Westie enthusiasm.

 

Today is her first month anniversary.  Those defining spots on her skin are covered with white peachy fuzz and our Annie is a new little girl.  The instructions to limit her activity were greeted with “no problem -- she never runs or jumps anyway.”  Well, this new Little Annie now runs, jumps, plays and nips at my ankles if I am too slow preparing her dinner.  She eats better, she sleeps through the night, she is less anxious, she plays with Skyrin and the best bonus of all -- Annie is more affectionate.  Sandy Gilmer came over to see Annie and was showered with kisses by the Westie girl who previously only gave out one kiss per month.  She was giving Sandy the kiss of February 2005 in short order.  I think Annie knows Sandy is into rescuing Westies like her.

 

A big thank you to all of you in our Westie Club who entrusted Annie’s care to me. Thanks to Sandy and Jim for delivering her to my home that important day in May of 2001 and thanks to Kathy Kelley for her encouragement.  Many kudos to the UC Davis cardiology staff -- Dr. Sarah Miller and Debbie Chou made Annie their VIP client.  And thanks to Dr. Maretzki for keeping her, her compromised lungs and her enlarged heart well enough to take this important step to being a successful pacemaker girl.

 

And now a plea to all cardiologists who treat both 4-legged and 2-legged patients…

 

Please give animals like Annie a pacemaker before they collapse and offer humans the same courtesy. Annie and I have the same brand (Medtronic) and model of pacemaker and we both had to collapse to get them.  So, readers and Club Members -- do not hesitate to get a pacemaker for you and your Westies.  Annie would have had three more healthy and active years because she needed a boost for her ticker which will now also allow her enlarged, overworked heart to return to normal size and I might not have a brain injury from the falls during my collapses. My gratitude is also extended to the pacemaker manufacturers like Medtronic who donate pacemakers to vet schools after their shelf life precludes human implantation.  My unit cost about $30,000 and Annie’s was free!  Her surgery costs were very reasonable ($1,800), especially since she was in the ICU and had constant care.  Also, those of you with pacemakers may donate them using your organ donor card from the DMV.  Pacemakers implanted in humans frequently have many useful years left when we, uh, are done with them.  Of course Annie could have had that expensive version if she needed it since she deserves the very best and gives back that and more.

 

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