Case Study – Janus the Greyhound and TVD

By: Sara Beth Bordelon, DVM, MS, Diplomate, ACVIM (Cardiology)

Say hello to Janus! This handsome 4-year-old greyhound came to CVCA inside Austin Veterinary Emergency and Specialty Hospital in August 2018 when he was only 2 years old. At that young age, Janus already had a swollen belly from heart failure.  Janus’ vet sent him to CVCA for a complete heart exam because of the swelling and presence of a loud heart murmur. A heart murmur is due to abnormal blood flow in the heart. Some murmurs are not a problem but Janus’ vet was worried because the murmur was so loud.  It was graded a 5 on a scale that only goes up to 6. 

Dr. Bordelon met Janus at that first visit and agreed the murmur was a concern. She did an ultrasound of the heart (echocardiogram) and found that the murmur was due to leakage of blood across one of the valves inside the heart – the tricuspid valve. This valve separates the two chambers on the right side of the heart and for Janus, the valve was not made correctly before he was born. This is a problem called tricuspid valve dysplasia (TVD).

Parts of Janus’ tricuspid valve were too long, others were too short. Because of these problems, the valve did not close normally and there was a big leak in the middle. The leak is called tricuspid regurgitation. Over time, the leak causes the right side of the heart to enlarge and then weaken. When the muscle gets weaker, fluid backs up behind the heart and can leak out around the lungs or in the belly. This is called right-sided congestive heart failure.  This is what Janus had, when we first met him at 2 years of age. 

People with this condition will have surgery to repair or replace the abnormal valve.  In dogs, this is possible but not done very often. CVCA cardiologists use medicine to improve the heart function and help the fluid resolve.  In Janus’ case, we have been keeping the right-sided heart failure under control and he has been doing great for the last few years. His heart is even a little smaller than when we first saw him. We cannot cure Janus, but we can keep him happy and healthy so he can enjoy his great life!

Top: Ultrasound image of Janus’ heart before starting treatment for heart failure. The image shows the abnormal tricuspid valve (TV). You can also see that the valves do not close completely. Bottom: Janus, 2 years after starting treatment. The right heart is much smaller. The abnormal leaflets can still be seen and they continue not to close, but they are much closer together than before treatment. RA (right atrium); RV (right ventricle); TV (tricuspid valve)