Transdiaphragmatic Pacemaker in Dogs

A pacemaker is a device used to regulate the heartbeat of an animal by delivering electrical shocks directly to the heart muscle if it should start to beat out of time, thereby 'resetting' the rhythm of the heart and ensuring that it pumps effectively. A 'trans-diaphragmatic' pacemaker runs the length of the dog's diaphragm, with parts of the implant being located towards the hindquarters of the dog. In cases where the heart is not pumping blood with a regular heartbeat, the dog can suffer from poor circulation - potentially leading to damage to the tissues in its extremities or even to more serious heart problems and death. In such cases, the vet will typically recommend the use of a pacemaker to ensure that the dog can resume a somewhat active lifestyle.

Before the surgery can begin, the dog will be sedated with a general anesthetic before the vet shaves and disinfects a patch on the animal's abdomen. In most cases, the incision will be relatively small compared to other forms of chest surgery, with the surgeon making a lengthways cut just below the ribcage. They will then insert the main body of the pacemaker into the lower half of the chest cavity. The contact probes meanwhile, will be threaded through the chest and over the diaphragm before being anchored in place on the surface of the heart. The surgeon will then ensure that the pacemaker's software is running properly before suturing the incision shut. The dog will then be allowed to awaken before being placed in confinement for monitoring.

A pacemaker is a very good way to deal with an irregular heartbeat, allowing the dog to move around and exercise without experiencing unpleasant side effects. However, some owners may feel reluctant to have surgery conducted on their pet and may seek different methods of dealing with the problem. Alternative treatments are available, with drugs such as diuretics and beta-blockers commonly being prescribed by vets for dogs with heart problems. These drugs are used to prevent the buildup of excess fluid in the chest cavity (diuretics) and to block the nerve signals that can commonly result in a bout of arrhythmia or a heart attack (beta blockers). However, the dog's continued dependence on these drugs to live a normal life can mean that the pacemaker is a more practical (and in the long run cheaper) option for such animals.

Following the completion of the surgery, the dog will need to be confined for roughly a week in order to establish a baseline resting heart rate for the pacemaker to be calibrated against and to get through the first stages of the healing process. The vet will also typically recommend that their exercise levels be kept relatively light for a few weeks, so that they do not over-exert themselves or damage their surgical wound. The dog will also need painkillers and antibiotics to be administered to it (usually in pill form) until the incision has healed. The vet will schedule several follow-up appointments, in order to perform further calibrations of the pacemaker, with additional checkups being conducted every few months or so.

Successfully implanting a pacemaker takes a fair degree of skill on the part of the surgeon, as well as a fair amount of technical expertise in order to calibrate the hardware itself. Additionally, the cost of the pacemaker unit will make up a substantial portion of the final price, with most owners being able to expect a bill of $2,500 to $4,000. On the other hand, alternatives such as diuretics and beta blockers can be much less expensive in the short term, with pills typically costing under a hundred dollars. However, in the long term this will add up to quite a considerable sum, making the pacemaker implantation more financially viable.

Despite the effectiveness of a trans-diaphragmatic pacemaker in correcting a dog's irregular heartbeat, there are some concerns that owners commonly bring up. The first of these worries is a perceived risk of infection caused by implanting such a seemingly large object into the animal's chest. It is important to bear in mind that all implants are carefully sterilized before being placed into the body, meaning that in conjunction with antibiotics, there is virtually no risk of infection occurring due to the implant itself. The second issue that is often raised is the chance of the risk of respiratory collapse posed by the use of general anesthetic, though the vet will make their own evaluation of the dog's suitability for this method of sedation as every case is different.

It is important for owners to pay attention to sudden changes in their dog's behavior and exercise patterns, as these can betray the presence of a developing heart problem. By catching a condition in its infancy, there is a greater chance that the vet will be able to resolve it via relatively simple means such as steroid injections to strengthen the heart muscle or a dietary change. In any case, it is important for owners to ensure that their pet enjoys a good quality diet and regular exercise, as these two factors are the cornerstones of good circulatory system health.