4176 Meridian Street
Bellingham, WA 98226
(360) 758-2200
24/7 Emergency Care
Bellingham, WA 98226
24/7 Emergency Care
Patient
Name: Agnes
Breed: Dachshund
Age: < 1 year (female)
Service & Date
Surgical correction of a congenital heart defect, performed at Boundary Bay Veterinary Specialty Hospital (BBVSH) – Bellingham, following referral from a traveling veterinary cardiologist working in collaboration with local practices.
Quick Facts
Care Team Perspective
Agnes’ case reflects the strength of community-based veterinary collaboration, as well as the value of having advanced surgical expertise available locally. Early recognition by a mobile cardiologist, coordination with primary care, and timely intervention by Dr. Milan Milovancev, whose experience with congenital heart surgeries made correction possible in a very young patient, allowed Agnes to receive definitive care without delay.
Agnes was still a young puppy when a heart murmur was detected during a routine examination. Because congenital heart defects can progress rapidly in growing animals, she was referred for further evaluation by a traveling veterinary cardiologist who serves the local community and works closely with Boundary Bay.
Advanced cardiac assessment revealed a serious abnormality in her blood vessels. While Agnes had not yet shown outward signs of illness, the defect carried a significant risk of rapid progression to heart failure within her first year of life.
Her family was faced with a timely decision: pursue corrective treatment early or risk the condition worsening beyond repair. With guidance from the cardiologist and Boundary Bay’s surgical team, they elected to move forward with definitive treatment while Agnes was still young enough to benefit fully.
Cardiac evaluation confirmed that Agnes was born with a congenital heart defect involving an abnormal blood vessel. This vessel allowed blood to bypass the heart’s normal circulation pattern—creating an improper “detour” that reduced the heart’s efficiency.
Before confirming the diagnosis, the care team discussed a differential diagnosis list, a structured approach used to evaluate possible causes of a heart murmur in puppies. Differentials included benign puppy murmurs, other congenital cardiac anomalies, and conditions that might resolve naturally with growth.
Echocardiography clarified the problem and confirmed that Agnes’ defect would not resolve without intervention. Without correction, approximately 90% of puppies with this condition develop heart failure within their first year of life.
Final Diagnosis:
Congenital heart defect involving an abnormal blood vessel causing improper blood flow and high risk of early heart failure.
After diagnosis, treatment options were discussed with Agnes’ family. In some cases, congenital heart defects can be corrected using minimally invasive intravascular (catheter-based) techniques. However, Dr. Milovancev explained that not all patients are suitable candidates. Puppies may be too small, too large, or have anatomy that makes catheter-based approaches impractical or unsafe. In these situations, surgical correction remains the most effective option and requires specific experience with delicate cardiovascular procedures.
For Agnes, surgical correction was the most appropriate and reliable approach. Dr. Milovancev has performed this procedure many times over the years and recommended proceeding promptly.
Surgical Procedure
Agnes was taken to surgery, where the abnormal blood vessel was carefully identified. Using a piece of surgical silk, Dr. Milovancev ligated (tied off) the vessel, permanently closing the abnormal pathway. This redirected blood flow back through the heart’s normal circulation routes, allowing the heart to pump more effectively.
Post-Operative Care
Agnes recovered smoothly from surgery. Follow-up evaluations by the referring cardiologist showed:
Although technically demanding, this is a procedure Dr. Milovancev has performed many times, with excellent outcomes in young patients.
Agnes’ outcome was excellent. Post-operative follow-up confirmed that her heart is now functioning normally, with no residual murmur and no need for continued cardiac medication. Most importantly, she now has the prognosis of a normal lifespan and quality of life.
Dr. Milovancev noted that without surgery, Agnes likely would not have survived her first year. With timely intervention, she now has the opportunity to grow, mature, and enjoy life without the burden of heart failure.
Her case highlights the importance of early detection, collaboration across the veterinary community, and access to experienced surgical care close to home.
Prognosis & Takeaway:
Early diagnosis and coordinated specialty care can completely change the trajectory of congenital disease. Agnes’ story demonstrates how experience, collaboration, and timely intervention can give even the smallest patients the chance to thrive.
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