Louie, an 8-year-old Cavalier King Charles spaniel, is a loyal, happy, and lucky dog. 

A routine exam at the Virginia-Maryland College of Veterinary Medicine's Veterinary Teaching Hospital (VTH) discovered a serious and unexpected heart disease, atrioventricular (AV) block. 

His owners, Bobby and Bonnie Cooper, are no strangers to the breed – or the heartbreak. Cavalier King Charles spaniels are genetically predisposed to mitral valve disease, a condition in which the heart's mitral valve degenerates. When the disease progresses, it can cause heart failure.

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Mitral valve study 

The Coopers' previous three Cavaliers developed mitral valve disease, so when they had the chance to enroll Louie in a clinical study on mitral valve disease at the Virginia-Maryland College of Veterinary Medicine, the choice was obvious.

"We were happy to help – anything to help figure out what's causing this and see if they can take care of it so it doesn't continue," said Bonnie Cooper. 

For years, Louie has come into the Veterinary Teaching Hospital every six months for a physical and echocardiogram as part of the study conducted by the cardiology team, which includes Giulio Menciotti, assistant professor and Alessandra Franchini, cardiology resident. 

The study follows Cavalier King Charles spaniels with and without mitral valve disease in an attempt to predict the age of onset for the disease with the help of 3D imaging. 

"He just lays there when we're taking images, and he's always wagging his tail," said Franchini.

Something else was wrong

In May, Louie was diagnosed with an early stage of mitral valve disease, but during his next checkup, Franchini immediately noticed that something else was wrong. A dog's normal heart rate is between 60 and 160 beats per minute, but Louie's heart rate was dipping as low as 30 beats per minute.

The appointment immediately shifted from a "healthy dog" exam to determining the cause of Louie's startlingly low heart rate. Louie was diagnosed with a second-degree AV block.

"Most of the impulses that originate in the heart that create each heartbeat were blocked halfway through, so they were not causing the heart to pump," explained Menciotti.

"The vast majority of these AV blocks are progressive, so the heart rate would become slower and slower until it becomes too slow to maintain a normal lifestyle, which is when many dogs are presented [at the clinic]. We were lucky enough with Louie that, just because of the scheduled recheck for the exam, we were able to catch this before he developed clinical signs."

As longtime owners of Cavalier King Charles spaniels, the Coopers were well prepared to deal with mitral valve disease – however, they did not expect Louie to be diagnosed with a completely unrelated life-threatening heart condition.

(From left) Alessandra Franchini, Louie Cooper, and Giulio Menciotti during his checkup at the Veterinary Teaching Hospital.
(From left) Alessandra Franchini, Louie Cooper, and Giulio Menciotti. Photo by Margie Christianson for Virginia Tech.
(From left) Bonnie Cooper and Louie Cooper going for a walk.
(From left) Bonnie Cooper and Louie Cooper. Photo by Margie Christianson for Virginia Tech.

Pacemaker 

Even though Louie wasn't showing any obvious clinical signs, the AV block could still cause sudden death. The best way to treat Louie's AV block was to implant a pacemaker that would regulate his heartbeat, giving his heart the electricity it needs to pump regularly.

The Coopers had walked into the VTH expecting a routine exam and walked out knowing their dog needed major surgery. Though the surgery was less costly than it would be at many private practices, the price tag was hefty.

"Deep down inside, we both knew we would do [the pacemaker], but we wanted to calm down and think about it quietly," said Bobby Cooper. "We both worried about it, and when we went to bed that night, I was still awake and thinking about it – and all of a sudden it dawned on me, we had Trupanion pet insurance on Louie." 

The Coopers called Trupanion the next morning, and by the end of the day, they had 90 percent of the procedure's cost covered by insurance.

Back to his favorite pastimes

Louie's AV block was discovered on a Friday; on the following Wednesday, he received his pacemaker implant.

After the surgery, Louie had to spend eight weeks with limited activity – that meant no more jumping on the couch to watch golf on TV with Bobby Cooper. After those eight weeks were up, Louie returned to the VTH for a checkup and was given the green light to return to normal activity.

Thanks to his pacemaker, Louie can return to his favorite pastimes: spending time with his people, going for walks, and embodying the happy-go-lucky spirit Cavalier King Charles spaniels are known for.

"They're just little fluffs of love,” Bonnie Cooper said. “They're companion dogs for sure,"

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