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English setter beats odds, survives cardiac arrest during surgery at UF

Bess, a setter that survived cardiac arrest during surgery at UF’s Small Animal Hospital, is reunited with her owner, Richard Thomas, at discharge on July 21.

By Sarah Carey

A 2-year-old English setter named Bess is now recuperating with her owner in Georgia after being revived from cardiac arrest during surgery to remove an area of infected tissue in her chest at the University of Florida’s Small Animal Hospital.

“She’s doing well, in the house, on the sofa or wherever she chooses to be,” said her owner, Richard Thomas, of Albany, Georgia.

Thomas drove his beloved family pet to the hospital’s emergency room on July 14. She showed signs of increasingly labored breathing, and had been diagnosed by the owner’s daughter, Dr. Paige Thomas, a veterinarian, with pleural effusion — an unusual amount of fluid around the lungs. She and Dr. Steve Whatley, another veterinarian from Albany, recommended UF for Bess because of the benefits they saw in procuring treatment for her in a university setting.

“Our emergency team performed a thoracocentesis and pleural fluid cytology, which revealed pyogranlomous inflammation with bacteria present,” said Dr. Kaitlyn McNamara, a UF small animal surgery resident who worked on Bess’ case.

The presence of bacteria is consistent with a condition known as a pyothorax, meaning there is evidence of purulent, or pus-filled, material present in the chest. Causes can range from an infection within the chest, presence of foreign material, a lung lobe abscess or neoplasia, an abnormal growth of tissue.

Bess was transferred to surgery, where a CT scan further revealed that the mediastinum, or tissue separating both sides of the chest, was diseased. The UF team observed expansive disease affecting several surrounding structures, including the sac of tissue that surrounds the heart, known as the pericardium, several lung lobes and a major heart vessel known as the caudal vena cava.

“In order to remove the diseased mediastinum, we had to also remove most of the pericardium and about 30% of Bess’ total lung volume,” McNamara said. “There were large, firm, abscess-like structures within the mediastinum that were removed.”

After nearly two hours of surgery, Bess went into cardiac arrest, and open-chest CPR was initiated by members of the anesthesia and surgery teams. Anesthesia team members included Dr. Luisito Pablo, Dr. Keaton Schmidt and Margaret Gonzales. Surgery team members, who assisted with internal defibrillation, included Dr. Alex Fox-Alvarez, McNamara and Dr. Joel White. After about 15 minutes of CPR, which included internal defibrillation of the heart, the veterinarians were able to revive Bess.

“Bess made a miraculous recovery, and ended up waking up and breathing on her own very quickly after surgery was completed,” McNamara said. “She did stay in an oxygen cage, but did not require any ventilator support.”

Only about 5% of dogs that go into cardiopulmonary arrest actually come back and survive to discharge, she added.

The cause of Bess’ infection was thought to be a small grass seed that was found within one of the abscesses removed from her chest during surgery, a probable diagnosis arrived at due to Bess’ history as a working field dog.

“This case took a lot of teamwork to have a successful outcome,” said Dr. Gareth Buckley, a clinical associate professor of emergency medicine and critical care and chief medical officer for the UF Veterinary Hospitals. “Our emergency, anesthesia, radiology, surgery and ICU teams were all involved. Given her cardiac arrest, she had a low chance of survival, so she really has beaten the odds.”

Bess was discharged July 21. Thomas happily greeted members of her care team and presented them with bags of pecans from his family farm in appreciation of their efforts to save his beloved bird dog, whose lineage goes back four generations of dogs, all living at his Albany property.

“She gets her fighting spirit to live from a number of her ancestors, all buried here on the farm,” Thomas said. “I am deeply grateful for that incredibly dedicated team of professionals and their staff for rescuing our little Bess from the jaws of death,” Thomas said.