Oh Beagles, I am so sorry about poor Molly. Our Billie, an 11-year old King Charles Cavalier, was diagnosed with CHF in July. Hers is also due to mitral valve disease with severe regurgitation, unfortunately a common condition in her breed. She is currently under the care of a cardiologist and is on medication to manage the symptoms.

Kudos to you for going for a cure! I hope you can work out the logistics, which it sounds like you are well on your way to completing. I will post the question to people in my dog groups to see if anyone has been overseas for surgery. Speaking with someone who has firsthand experience would be helpful.

Beagles, I wish you and Molly the best and that her treatment is successful.

Isn't she already microchipped and getting rabies vaccine periodically? I don't know anything about tapeworm treatment. Is that just precautionary?

Hang in there Molly, you too beagles.

Thanks Bonnie. I am very sorry to hear about Billie! I have joined a group for people who've taken their dogs overseas for surgery or who are in the process of doing so. Many are cavalier owners. Most have gone to Japan, as the Japanese surgeon has been doing the procedures for a longer time. I was frightened to take Molly to Japan because she would've had to go through a 7-month quarantine and I wasn't sure if she'd still be strong enough for travel and surgery by then.

Molly had a microchip put in when she was 12 weeks old. Unfortunately, it is an older 10-digit and the UK and EU now require a 15-digit ISO compliant chip. So she needs to be re-chipped. And the rabies vaccine must occur after the chipping and within 12 months of her travel time (she had a 3-year vaccine two years ago so it would no longer be sufficient to get her into the UK or any EU country) :(

Yes, the tapeworm treatment is a precaution. England is free of this particular worm so they don't want a dog coming in with it (it's not required for other EU countries).

I'm sorry to be the contrarian here, but adding this amount of stress to an elderly and ailing dog may simply be too much for her. Are you prepared for that? Are you certain you are doing what's best for her? Or what's best for you? I ask this as someone who's been through making life decisions like this for my Grandmother and my Mother and DH's old maid Aunt. I've had to grapple with that difficult question and recognize that, while we like to think that somehow with enough medical treatment we can postpone death forever, it's not true. At some point, we have to do what's most sensible and comforting for those we love rather than put them through misery just to alleviate our own suffering and reluctance to lose them.

Yes, this is what is best for her.

There is a risk she will die during the surgery, of course. She will potentially have a bit of stress on the plane, or else she will think she is on a great adventure (she enjoys travel and has gone on many car trips with us).

However, she would likely die within 12 months if she does not have this procedure whereas this gives her an 86% or greater chance to live normally for many more years with no medication and full quality of life (as in, after a few months of recovery, she can go back to chasing her ball and walking 8 miles). Dogs who have surgery are up and walking around within 4 days and are discharged to return to America after a week. After 6 weeks of restricted activity, she'll be able to gradually increase her activities. After 3 months, her heart will most likely be fully healed and will shrink back down to normal size and she can have full quality of life.

She is not really either elderly or ailing at this point in time, so perhaps I've given the wrong impression. Her CHF is currently being managed by medication and she does not appear to be ill AT ALL. She did a 3 1/2 mile walk yesterday and was pulling to go for longer. She wakes up every single morning aggressively wagging her tail and runs through the house to get her breakfast. She is at Stage C, which is the appropriate stage for this operation, and many of the dogs the surgery are between the ages of 8-12.

Further, MVD is a terrible disease. If I do nothing, eventually management with medication will no longer work. She will get progressively weaker and she will essentially drown from fluid filling up her body. It is not peasant. I would rather she have an incredibly high chance of being cured and living normally or die painlessly under anesthesia in surgery than suffer the debilitating effects of this condition until I have to put her to sleep because she longer has any quality of life.

Beagles, I am 100% in agreement that this is in Molly's best interest. It is unfortunate that this surgery is only in clinical trial stages in the US, but it is only a matter of time before dog owners in the US will not have to cross the pond to spare their dogs the pain and suffering of MVD.

Fantastic answer beagles. You're being smart and realistic about all of this. You're lucky you can financially manage this too. If it happened to one of my dogs I don't know what I'd do. :( I can afford quality local care with no problems but don't think I could swing an international affair. Kudos to you and Molly and please give her a smooch from me. She's a lucky girl.

I agree Bonnie. I cannot wait until this surgery comes to the U.S.

The University of Florida Gainsville is currently spearheading a multi-year effort to learn from Dr. Uechi and bring the procedure to the United States (It's called Mandy's Mission to Mend Hearts). I've made a donation to help support that cause.

And pb32 I agree we are extremely blessed to be able to do this for Molly. It breaks my heart when pet owners have to make a difficult choice between their finances and their pet's care. I've also recently made a donation to an organization (Red Rover) which, among other things, provides financial support to people who cannot afford care for their animals.

Whenever I spend a lot of money on medical care for my dogs, I like to also donate to help other pets who may not have the same opportunity. Some day, I intend to do much more and hopefully set up a foundation to help fund life-saving heart surgeries for animals that need it.

Beagles, I messaged you. I just was approved for membership to a MVD group. Off to read! Now I am miffed that the cardiologist did not even mention this as an option for Billie.

Oh Bonnie I am so glad you joined. Yes, that is the same group I am in. They're wonderful people and have been very helpful already. I don't think many US cardiologists are familiar with the overseas options. I just happened to luck into taking Molly to a British cardiologist in Philly who trained at RVC and who knows the team there (and of course I research the heck out of everything!). I truly hope that you can consider a surgical cure for your Billie too!

I'll be another contrarian, not about seeking the best treatment you can avail yourself of, but of cheating about this being a service dog. It's really dishonest and smacks of entitlement. To heck with people who may have true dog allergies but are forced to fly with your dog because you're cheating the system.

You say she may not survive the treatment, but then you will be without an "emotional support animal" for the return trip? I hope that doesn't happen, but if you "need" her to travel, I wonder what your contingency is?

I do not consider it cheating. I am following airline policies, I need her to fly with me, I have a medical doctor who indicated that I need her to fly with me, and I am paying additional costs. Dogs under 20 lbs are allowed to fly in cabin even w/o being ESAs so people with dog allergies have to deal with them anyway. Those are the policies put in place and I am going to confirm with the airline I will be in full compliance with the rules.

I am also going well out of my way to ensure no other passengers are being inconvenienced by getting two first class seats so she is not near anyone else (She'd be permitted to fly in economy with me and sit on the floor at my feet but I don't want another passenger to have to be in the row with us.)

Sorry if you think that's entitled. I consider it my responsibility to provide the best care for her that I can because I adopted her and pets are family.

There are also only TWO airlines out of dozens that allow ESAs (and other dogs) to fly in cabin while traveling to Heathrow. Those with pet allergies have plenty of options for a dog-free flight.

Sorry, but I just have to shake my head and say oh brother to this situation. SInce the average lifespan of a beagle is 12-15 years, a 12 year old dog with a heart condition is elderly. Stressing it further with flights and open heart surgery seems heartless. Are you sure you're doing this for the dog? Sometimes we just have to face facts. I wish you and your dog the best.

I am really not looking for a debate. She has a medical team, and I've worked in consultation with them to determine what is best for her. They believe, and I concur, that there is no reason she cannot live until 17-18 after having surgery. That means she could have up to 1/3 of her life remaining. Or, she could die a difficult death of a horrible disease. So, it is an easy choice for me and, in my opinion, a moral responsibility to give her a chance.

I am not trying to be rude at all, but I will not be changing my mind and it is a sensitive and difficult subject, so I would ask please that if you have something critical you'd like to say on this particular issue that you just please click on out of this thread without comment. Otherwise, I'll just send a request to Houzz to delete the thread.

I understand. No one likes criticism. *_*

I don’t have anything to add re flying with your dog, but want to with you success and a safe, no-stress journey. Every time I have been through customs at Heathrow, the typical question is ‘why are you here’. Just answer ‘vacation’ or ‘visiting friends’ in London and they don’t bat an eye. I was usually on ‘Government business’ and that stamp was already in the air ready to go.

There is a separate line for first class passengers so be sure to get in it. They might ask for your paperwork on your pup. The flight attendant might be able to tell you if you need to go through an additional step. Probably will would be my guess.

No one likes rude or insensitive remarks either, and I think your "oh brother" comment on a thread about potentially life saving surgery for a cherished family pet is both.

I understand that you have everything all planned, but I have a question -- could you have paid the surgeon to fly here to perform the operation? Just curious. I wish you and your dog the best of luck in this mission. Please let us know how it goes.

Thanks OutsidePlaying. The process at Heathrow is that someone from HARC will meet me at the gate, check my papers, and then give me a stamp I take through customs. Then, I have to go though the "Something to declare" line. As long as the paperwork is in order, it should be OK. I'm just nervous about making sure my paperwork is perfect.

Kitchenwitch, yes that was my first preference. As was mentioned above, several years ago, someone paid for Dr. Uechi and his entire surgical team to fly to Cornell and perform the surgery. I contacted Cornell to see if I could pay for them to come back. Unfortunately, he has not been able to get a visa to come back to the US since 2015.

It is not an option to fly over the other surgeons because they both work out of hospitals/clinics with specialized recovery centers to prevent any potential post-operative complications.

It is also not quite as simple as just flying over one doctor. You need a full team and specialized equipment including a heart/lung bypass machine.

I would probably worry too, because I am a worrier. Good to know it sounds like they have procedures in place at Heathrow and everything should go smoothly.

I've never had a pet but your story is a testament to the value they bring into human lives. Wishing all the best for both of you.

Beagles, my only comment is regarding your documentation, not your dog's. Airlines are changing their extremely generous policies about emotional support animals because of exploitation by the human element.

I'm sure that you've already done this, but your airline's requirements need to be double checked to make certain that you have the medical papers needed to document your need for a support animal.

Best of luck to you and Molly; I hope that the trip and surgery is smooth.

Thanks! Yes, there are 2 airlines that allow her to fly as an ESA, I've checked online regarding their documentation and I'm going to call them when I book my flight -- before I book -- and send in the requisite certificates and papers to make sure that we're all set!

Thanks!

This won't help you at all, but we did take our very skittish Italian Greyhound from LAX to Paris with a layover at JFK and he did beautifully. He slept on both flights on our laps and went on to enjoy his vacation with us...so I am very hopeful your baby Molly will do as well during the flights.

I support what you are doing 110%. I know it's exactly what I would do. My furkids are my only children and I can't imagine loving them anymore than I do and not taking care of them as I would a human child. And kudos to you to support others as well.

I hope Molly's results are the very best and you and your husband and Molly enjoy many, many more happy years!

Marlene, actually that's very helpful to know your dog did well!

How was your experience with Paris customs?

I'm assuming you needed a third-country vet certificate affirmed by the USDA just as we will (it looks like both London and Paris require that).

If so, how was the process with the USDA, did you have any difficulty getting your certificate? And, lastly, did your greyhound have a 15 digit microchip or a 10-digit one and where on your rabies vaccine was the chip number listed? [If you know any of those answers?)

I just want to wish you & Molly the best. I know many of us would do everything in our power & finance situation to do everything they could for our pets.

Beagles, we took Lorenzo when I was 25 or 26 and I am now 70 so that gives you an idea that my answers (if I could answer) would be obsolete. However, I know it was not nearly as complicated as it is today. I do remember we only flew into Paris to avoid the quarantine in England.

I wish I could be more helpful. I have flown within the past 4 years in cabin with two of my fur babies when I got them but that was within the US. Everyone was very helpful at the airports both times and, in fact, a couple of them went out of their way to help me get through the process.

Have you considered a private jet? There are "empty leg" flights that would cost less...

That is one lucky dog to have such good doggy parents who would (and have the means to) go to the ends of the earth for a life saving procedure. I hope everything goes well and you have many more good years together.

Wishing you and Molly the best with the journey and the procedure.

I am so sorry for your situation; how frustrating. Is she having a valve replacement vs repair?

Since she's never flown before, have you considered a short trial, local flight?

What is your plan if she goes into an acute episode of CHF while in flight? I've responded on several flights when the overhead announcement is made asking for medical personnel. Even with many, many years of emergency medicine experience, providing care in that situation is bad.

Thank you for all the positive thoughts for Molly. She is a truly wonderful dog and she loves her life. She is still very strong and happy. She even wags her tail in her dreams and she still loves going on 2 walks of 45-minutes each every day, plus longer ones periodically on special trails. I know if we can get this heart issue resolved, she will have many more happy years.

pennydesignfrom my research into this, an empty-leg flight requires flexibility. There is a 3+ month waiting list for surgery and surgeries are performed only on specific days. Molly must be there on her day, we cannot take any chances of her not being able to arrive.

mdlnthat is a great question. She will be having a valve repair, they do not do replacements on dogs because dogs do not tolerate artificial valves (replacement is standard in humans). They originally tried that in dogs many years ago, and blood clots form quickly because their bodies reject it.

Regarding the possibility of an acute episode of CHF. First, she will be having multiple ECGs in the days and weeks leading up to her flight to ensure her condition is being appropriately managed.

It is extremely rare for a dog of Molly's size to have a catastrophic event (the chances are well under 10% for her size- catastrophic events are more common for toy-size dogs).

Instead, what I have been told happens if something goes wrong is her lungs begin to fill with fluid because her heart isn't pumping properly. But it's not as though this immediately, with no warning, makes breathing impossible. If she has an ECG and chest x-ray the day before, she's not going to all of a sudden have so much fluid in her lungs that she won't be able to breathe on the plane.

I'll also have Lasix with me to give her and if there are symptoms of her lungs filling (coughing or a high resting breathing rate), I can give her a higher dose of the meds immediately (that's what they did when we took her to animal emergency. They gave her an injection of lasix and told me to give her a very high dose of the pill at home).

As I mentioned above, Molly is in Stage C. Stage C dogs have their condition well-controlled by medication. It is when dogs progress to Stage D that the CHF cannot easily be controlled and higher doses of meds are needed and not always effective. We are hoping to get her into surgery BEFORE she becomes a stage D dog.

If I were doing this, I'd seriously consider trying to use a private jet. The fee is about 65K USD one-way from NY to London. If you can share with a couple of other small groups, you can get the per person cost to be more in the range of first class on a common carrier.

According to the UK government web site, there are restrictions on which airlines can be used from different origin points. They give phone numbers for the animal checkers at different airports. Look at "Arriving in the UK." I'd build a portfolio of my documents that was as close as possible to what I would be bringing, and try to find someone at one of the animal check locations to review it prior to my journey. Here's the link: bring-your-pet-to-uk

I really don't think it would be practical to fly on a private jet. I don't think it is necessary either.

There are a surprising amount of people from the US who bring their dogs to Japan, France, or London for these surgeries. As far as I know, pretty much everyone has flown commercial and there hasn't been any issues. In fact, many people don't even go first-class -- they pay for premium economy seats and ask for bulkhead seats.

Molly travels a lot. She drives to and from Florida twice a year (16 hours in the car). She's been on numerous road trips. And she is a calm, quiet dog. I don't see why sitting on my lap or my husband's lap on a plane with her blanket and some chicken treats will be particularly stressful for her.

I am seeing US centers that do valve repair, and out of country centers that do replacements, usually porcine, is why I asked.

https://msutoday.msu.edu/news/2012/for-the-dogs-team-performs-open-heart-canine-surgeries/

https://www.navetheart.com/north-american-veterinary-heart-center-sets-the-global-standard-for-dog-and-cat-cardiac-surgery/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753627/

https://www.vetmed.vt.edu/clinical-trials/current-studies/mitral-repair.asp

ECG's tell about the electrical activity of the heart. Valve function is better evaluated by an ultrasound/echocardiogram. You are correct, if valve function decreases - blood from the lungs is not pumped to the body. The excess blood in the lungs, interferes with the ability to breathe.

The goal of furosemide/Lasix is to get the kidneys to excrete more urine (decreasing the volume of the blood), so if effective - she will have increased urine output. Given orally (vs by injection) the peak action will take 1-2 hours to work.

Stress causes an increase in heart rate and blood pressure, which puts additional stress on an already diseased valve - making it more likely to fail.

Am not saying that I would not do exactly what you are doing; good luck.

The experts I've spoken to (as well as people experienced with that surgery center) don't think much of that doctor in the first 2 links you've included mdln.

From what I have been told that North American Veterinary Heart Center is also NOT actually performing surgeries at this time, although they claim to be. What they appear to be doing, from what I understand, is charging desperate people $200 for consultations and telling them they will be performing surgeries "soon."

I did contact them because it would've been a LOT easier to take Molly to FL (given that we live in FL for part of the year) and they never even gave me the courtesy of replying to me. Unlike every single other person I contacted throughout the country.

The trials on the minimally invasive repairs going on in the county are also just trials. I think they're doing them in Maryland, Denver, and maybe a few other places.

The "proven" approach is the one pioneered by Dr. Uechi in Japan, which repairs the valves, involves using gortex. Here's a description:

Instead of a valve replacement, a valve repair is performed. This consists of replacing any ruptured or stretched chords with artificial chords made from Gore-Tex, Figure 3. A draw string type of suture is also placed around the valve annulus to draw it back down to a smaller size, Figure 4. These two steps combined improve the contact between the valve edges, meaning less leakage occurs. As it is a repair, the valve is not able to be made perfect and a small amount of leakage is still expected in most cases but at a much lower level than previously

I don't want Molly experimented on, I want her to have the technique that has saved hundreds of dogs.

An echo is what I meant. I thought ECG was short for echo. But an echo is what she's going to get. And yup, I know all about the Lasix. Molly was pottying like crazy and still is on her lower dose. And I understand the risks of stress too -- which is why we'll be trying to keep her as calm as possible.

I really appreciate your perspective on this. I'm going to talk with my vet about whether I can bring injectible latix in case of a serious emergency (but again, I don't expect that to happen when she seems well-controlled.)

Please low sodium chicken treats. :-)

Organic homemade chicken breast from Whole Foods that's been steamed :)

I think Moxie (sorry for speaking for you, Moxie?) and I are just trying to suggest ways in which Molly and you might have less anxiety. I would be a shame if she couldn't walk around and we all know that animals sense our own anxieties...It might be more relaxing for everyone, including fellow travelers...

I have had to shuttle a dog (not mine) to Iceland. It was a very long process so I feel your pain trying to coordinate all of the requirements necessary.

I wish all involved the very best outcome.

I appreciate the suggestion from Moxie, I didn't mean to come across as harsh (if I did). There's just a lot to try to manage with this already and trying to figure out how to coordinate a private plane is above my capabilities (Unless of course someone has one and wants to lend it to me, LOL).

Would you adopt me?

(Best wishes to Molly on her journey to health!)

It is not particularly difficult or complex to charter a private plane, unless you are trying to get a bargain. But I don't see what it will really get you. I don't know what carriers your are looking out, but first class on BA would have plenty of room. And most international first class carriers will; whereas domestic first class can be meaningless. Depending on the plane, you could even get the two seats in the nose. Very private.

In fact, though, the middle two seat (the ones that face backwards), in BA's business class would work as well, maybe even better. It is kind of like having a cubicle in a way. (if BA is one of your choices of carriers, and you aren't familiar, you may want to look at their seat map to see what I mean). It is hard to describe but these two seats are very private and nearly adjoin, whereas in 1st class you either have an aisle between you or a partition.

LOL nannygoat18. Not unless you're a beagle. I have my hands full at the moment!

mtnI have to fly United or Delta. I'm looking at United Polaris out of DC. Are you familiar? https://www.united.com/web/en-US/content/travel/inflight/polaris.aspx

Any advice between those two carriers?

No sorry, not to London --- always take BA.

Do look at seatguru.com as there can be pretty signif differences among planes, even from the same carrier, and business vs first and one seat vs another. Worth looking at the exact seats you can get to maximize comfort. Molly will probably become a de facto celebrity so you may want/need privacy!

Thanks! I will check out seatguru. That's very helpful. Maybe I will call BA tomorrow and explain the situation and see if they have any options for me. The veterinary hospital's travel info suggests taking United so that was why I was learning to that one.

Beagles, you are such a fantastic Furmom and it makes my heart happy to see the amount of time/effort you are putting into this.

My two dogs are my kids too (and I honestly couldn't care less if me calling them my furbabies upsets anyone!) and I salute what you're doing for Molly. She has years of good life left (potentially), whereas this untreated all but guarantees a sad and painful ending for both of you.

Life is unpredictable. You could do all of this and she could pass away unexpectedly from a stroke a month after you get home. OR, you could do this and she lives a very happy life for years.

However the beauty of what you are doing is that no matter what happens, you can rest easy knowing you did everything reasonably possible for her.

Good luck and I sure hope you'll keep us all posted on how this goes. I'm really pulling for Molly.

We took two dogs with us on international moves, one to Europe and one to Central America. They were crated and in the cargo area; both did extremely well. Best wishes to Molly!

I had a miniature schnauzer who died at the age of nine from congestive heart failure. I was given no options aside from medication which only ended up prolonging her life a few months after diagnosis. I hope new treatment options are coming soon. It's always surprising to learn we're (Canada/USA) not on the cutting edge of medical advancements.

I think it's great you have the ability to do this for your dog and as an added bonus are "paying it forward" with your contributions.

For those looking for alternatives to flying, I wanted to mention that dogs can also cruise across the Atlantic. Service dogs in cabins and on Cunard's QM2 there's even a kennel for regular pet travelers.

Thanks :)

I know there are no guarantees. While the hope of course is that Molly does well during and after surgery and lives until 17 or 18, anything can happen at any time. But, I don't want to see her get weaker and sicker from this terrible disease, so at the very least I can prevent that. Preventing that alone is worth the money and effort, no matter the outcome. She is too happy and kind of a creature to have any suffering in her life and I will do everything I can to prevent her from experiencing it.

I'm very hopeful about some of the clinical trials going on now. Not for Molly, they won't be in time for her (hence why we're going overseas) but I think/pray a breakthrough is just a few years away.

MVD is one of the leading causes of death and disability in dogs, and it affects millions of dogs. I truly hope that some of these non-invasive valve replacement solutions will mean far fewer dogs suffering from this horrible condition. {And potentially some of these solutions could one day be used to provide a less invasive option for people with mitral valve disease too).