Tuesday, January 16, 2018

Companion Animal Hospital Takes on Rare Case

Companion Animal Hospital takes on rare case with successful outcome

As a Veterinarian you will always have those cases that stick with you and remind you even on the toughest day that I love what I do and grateful to have the opportunity to work with caring people and great owners."Queen" White is one of those cases....

The Problem    
Queen was a 8 week old female German Shepherd puppy that presented for vomiting/ regurgitation.  She had been drinking her mother's milk but as soon as she went over to solid food the episodes started and we saw her two days after the vomiting had started.  Queen had a sweet disposition was incredibly adorable.  Dr. Johnson recommended radiographs to look at her gastrointestinal tract which looked somewhat abnormal, so we pursued doing a barium study which highlights different areas of the gastrointestinal tract and is able to pick up strictures and other abnormalities that a normal radiograph could not.  As we looked at the radiographs during barium study, my heart sunk because I could see the problem immediately.

The Diagnosis     
Queen had a persistent right aortic arch which left untreated would mean death.  This congenital abnormality occurs when the right aortic arch which normally regresses during development does not and wraps/ compresses the esophagus.  This causes the esophagus to stricture down at the site of the irregularity and severely distend in front of it collecting food and then causing regurgitation.   We typically will see this problem in very young puppies because milk or watery substances can pass much easier then solid food. 

There is a surgery to correct the problem but usually handled by a Boarded Surgeon because of the delicacy of working in the thoracic cavity.  This is a costly surgery and some puppies do not recover even with the surgery.  As I presented all the options to the client, Mr. and Mrs. White really wanted to give Queen a chance and were willing to pay for the surgery even with an unknown outcome.



The Plan
I called Dr. Hammer at Companion Animal Hospital of Norridge, a Boarded, skillful, experienced surgeon to see if they would see the White's and Queen for a surgical consultation.   Dr. Hammer not only saw them he performed the surgery a few days later.  The surgery involves going in to the thoracic cavity and removing the persistent right aortic arch segment by ligating both sides and removing the part that is compressing the esophagus.  He also went in a ballooned out the strictured area to try and open it up more.  Queen recovered from the anesthesia and surgery well.

   Little Queen is a fighter and with patience and small meals frequently throughout the day, she will continue to thrive and get in to trouble as every puppy should!

Queen's case stayed with me is that this type of congenital abnormality is pretty rare.  I had heard about it during Veterinary School and read about it, but honestly I never thought I would get to see, diagnose, and treat a case.  We call these the ZEBRA cases.......rare cool cases.

Queen's story continues and her recovery again reminds me of my love of this field.

Written By:
Megan Moser DVM
Companion Animal Hospital of Skokie

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