Bobo, a 4-year-old dog, was referred to Southpaws Malvern with a congenital heart condition that had gone undetected far longer than usual. His referring veterinarian had identified a loud heart murmur, and an echocardiogram revealed a Patent Ductus Arteriosus (PDA). Despite his age, the cardiac changes were relatively mild, making him an excellent candidate for definitive treatment.
At Southpaws, Dr. Stewart Ryan successfully closed Bobo’s PDA using a minimally invasive transcatheter approach with the Amplatz Canine Ductal Occluder (ACDO). The procedure was supported by advanced imaging from Dr. Aisha Young of Vet Waves diagnostic imaging and expert anaesthetic care from our specialist anaesthesia team. Bobo went home the day after surgery with a completely closed PDA and an excellent long-term prognosis.
This case highlights both the value of referring dogs with heart murmurs — even older patients — and the expanding capabilities of interventional radiology at Southpaws Malvern.
What is a PDA and why does it matter?
A Patent Ductus Arteriosus is a blood vessel that should close shortly after birth. When it persists, it creates a left-to-right shunt, allowing oxygenated blood from the aorta to flow back into the pulmonary artery. Over time this leads to volume overload of the left heart, progressive chamber enlargement, and eventually congestive heart failure or pulmonary hypertension.
Without treatment, more than 60% of affected dogs die from heart failure by one year of age. Most cases are diagnosed in puppies under six months old during routine vaccination visits because of the characteristic continuous “machinery” murmur. Late presentations like Bobo’s are uncommon but increasingly treatable thanks to modern techniques.
Why Bobo was still a good candidate at four years of age
Bobo’s referring vet’s ultrasound showed only mild cardiac remodelling despite the long-standing shunt. This is the key point for referring clinicians: age alone is no longer a contraindication for PDA closure. With the availability of a low-risk, minimally invasive option, dogs with relatively preserved myocardial function can still achieve an excellent outcome even when diagnosed later in life.
The shift from open surgery to minimally invasive closure
Traditionally, PDA ligation required a thoracotomy, careful dissection around the great vessels, and manual ligation of the ductus. While effective, it carried the risks and morbidity of open-chest surgery in a young or small patient.
Southpaws now offers transcatheter PDA occlusion using the ACDO device — a self-expanding nitinol mesh occluder specifically designed for canine ductal anatomy. Dr. Stewart Ryan, who already performs a range of interventional radiology procedures including intrahepatic portosystemic shunt embolisation and tumour embolisation, has added PDA closure to the service.
Bobo’s procedure – step by step
Pre-operative planning began with a detailed echocardiogram performed by Dr. Aisha Young (Vet Waves). She confirmed the PDA, measured the ductal dimensions at multiple levels, assessed shunt direction and velocity, and documented left atrial and ventricular size plus valve function. These measurements are critical for accurate ACDO sizing.
On the day of the procedure, Bobo was anaesthetised and monitored by our specialist anaesthesia team. Vascular access was obtained via the femoral artery in the groin. Under real-time fluoroscopic guidance, a series of guidewires and catheters were advanced from the femoral artery through the aorta to the level of the PDA.
Once the ductal anatomy was fully characterised with contrast angiography and precise measurements, an appropriately sized ACDO was deployed across the ductus. The device was released only after positioning was confirmed to be optimal. Post-deployment angiography and echocardiography demonstrated complete occlusion of the shunt with no residual flow.
The entire procedure was performed percutaneously. Bobo recovered smoothly, spent one night in hospital for monitoring, and was discharged the following day. No thoracotomy, no rib retraction, and minimal post-operative discomfort.
Prognosis and long-term outlook
Dogs whose PDAs are successfully closed — whether by traditional ligation or ACDO — have an excellent prognosis and normal life expectancy, provided there is no significant pre-existing myocardial damage or pulmonary hypertension. Bobo’s mild pre-operative changes put him firmly in the best-prognosis group.
Fixed-price packages and support for referring practices
Southpaws Malvern offers fixed-price packages for PDA closure and several other common surgical and interventional procedures. These packages provide cost certainty for your clients and streamline the referral process. A short video showing Bobo’s pre-procedure echocardiogram and the fluoroscopic steps of ACDO deployment is available for you and your clients to view (embedded below).
When to refer a dog with a suspected PDA
We encourage early referral of any puppy or dog with a continuous heart murmur. Even in older patients, echocardiography can quickly determine whether the ductus remains patent and whether the myocardium is still a good candidate for closure. With the minimally invasive ACDO technique now available, more dogs than ever before can benefit from definitive treatment.
If you have a patient with a suspected or confirmed PDA and would like to discuss suitability for ACDO closure, please contact the team at Southpaws Malvern. We are always happy to speak with referring veterinarians about individual cases, review echocardiograms, or provide guidance on the best timing for referral.
Bobo’s story is a wonderful example of what can be achieved when a late-presenting PDA is identified and treated with modern interventional techniques. We look forward to partnering with you to give more dogs like Bobo the chance of a long, healthy life with a “fixed” heart.
A short video of the pre procedure ultrasound and procedure can be seen here.
