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Left Atrial Decompression in a Dog
Ah B, 12 years old, was a challenging case, battling refractory or stage D myxomatous mitral valve disease (MMVD), atrial fibrillation, heartworm disease, and pulmonary hypertension. Despite maximal medical management, he required 4 emergency admissions over the past six months. We knew that his life is nearing its end. In an effort to slow […]
Heartworm Removal in a Poodle
On 28 December 2025, heartworm removal was performed in a poodle weighing 4.35 kg, via minimally invasive surgery. Although only a single worm was extracted, removing one heartworm can be much harder than removing a whole bunch. Imagine fishing in a pool, catching one fish is often harder than catching many fish. The heartworm […]
Patent Ductus Arteriosus Occlusion in Dodo: A love of 6 months, a lifetime of devotion
Dodo is estimated to be 5 years old. She was adopted just six months ago, with very little medical history available. During a routine visit to a local veterinarian, a heart murmur was detected. Recognising that this required further investigation, the attending veterinarian promptly referred her to us for advanced cardiac evaluation. Timely referral […]
Atrial Tachycardia – the last case before CNY
Just as we were about to celebrate Chinese New Year, the last case presented with an arrhythmia, which is uncommonly seen in our practice. She is a 14-year-old Labrador, referred for further evaluation due to exercise intolerance and detection of an abnormal heart rhythm. Summary of Findings Blood Tests Blood test results were […]
Atropine Response Test
What Is an Atropine Response Test in Dogs? Sometimes a dog’s heart rate is slower than normal. When this happens, we need to find out why. One simple test we may perform is called an Atropine Response Test. The test helps us decide whether a slow heart rate is functional (nerve-related) or structural (heart-related), guiding […]
Systemic Hypertension in Pets
What Is Systemic Hypertension? Systemic hypertension means your pet’s blood pressure is consistently higher than normal. Just like in humans, high blood pressure can silently damage important organs including the eyes, kidneys, heart, and brain. Some cats may succumb to heart failure. • Normal: <150 mmHg • Pre-hypertensive: 150–159 mmHg • Hypertensive: 160–179 mmHg […]
Pushing the Limits – Our Third and Fourth TEER Journey
Recently, our team performed transcatheter edge-to-edge repair (TEER) procedures using the V-Clamp device in two dogs — one with stage C and another with stage D myxomatous mitral valve disease (MMVD). These cases mark the third and fourth TEER procedures performed in Malaysia. What is TEER and V-clamp? TEER stands for transcatheter edge-to-edge repair. […]
Hypertrophic Cardiomyopathy and Mavacamten in Cats
Hypertrophic Cardiomyopathy (HCM) It is the most common heart disease in cats, affecting up to 30% of cats aged 9 years and above. Obstructive HCM (HOCM) Some cats also have HOCM, where the thickened muscle blocks blood flow out of the heart. This is the “obstructive” type. Heart Failure in HCM or HOCM As disease […]
Coughing and Nebulization
Coughing is a protective reflex that helps clear the airways of mucus, irritants, or infection. Respiratory versus Heart Disease In most cases, coughing originates from respiratory (airway or lung) disease, not the heart itself. Common respiratory causes include bronchitis, tracheal collapse, infections, asthma, or pneumonia. Most cough receptors are located in the upper respiratory tract, such […]
Sleeping Respiratory Rate in Pets
Did you know that counting your pet’s breaths while they sleep can give important clues about their heart and lung health? The best part? It’s a simple, free tool that anyone can do at home to help keep pets healthier, longer. For my clients, you should not be unfamiliar with the term SRR, as I […]
Malaysia-Indonesia-Singapore collaboration
Mid-August was a busy and fulfilling period for me. On 13–14 August 2025, I had the privilege of being invited to Jakarta, Indonesia, to lecture at two veterinary hospitals — MediVet and Pet+Vet. I’ve always placed greater value on practical application rather than textbook-perfect theory. From this clinical perspective, I shared on pathophysiology and pharmacology, systemic hypertension, MMVD, DCM, feline cardiomyopathies, congestive heart […]
Successful PDA Occlusion with Amplatzer Vascular Plug IV in a Small Dog in Malaysia
On 15th June 2025, our team performed a heart procedure that was nothing short of a roller coaster ride and we’re thrilled to share that it ended with success! Our patient was a 2kg, small Pomeranian dog, born with patent ductus arteriosus (PDA) – a congenital heart disease. (What is PDA? Click to read more) […]
My pet has heart disease – Isn’t anesthesia too risky?
“My pet has heart disease. Isn’t anesthesia too risky?” That’s a very common and completely valid concern from pet parents. Pets are family, and it’s natural to worry about putting them under anesthesia, especially if they have a heart condition. But does heart disease mean your furry friend can’t have anesthesia? Not necessarily. It depends on the […]
Minimally Invasive Surgery to Treat Patent Ductus Arteriosus in Dogs
Patent ductus arteriosus (PDA) is a congenital heart defect in which a fetal blood vessel, the ductus arteriosus, fails to close after birth. This results in abnormal blood flow between the aorta and pulmonary artery, increasing the heart’s workload and potentially leading to heart failure. If left untreated, dogs with hemodynamically severe PDA usually do not […]
Ventricular Septal Defect in Cats
Some kittens are born with a hole in their heart, known as a ventricular septal defect (VSD). This causes the lungs to receive excess blood from the left side of the heart, which would normally be distributed throughout the body. If the hole is large, it causes severe left heart dilation and heart failure. […]
The Use of Adipose-Derived Mesenchymal Stem Cells in Two Poodle Dogs with Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
Our team recently published an article titled “The Use of Adipose-Derived Mesenchymal Stem Cells (AD-MSCs) in Two Poodle Dogs with Pulmonary Hypertension (PH) Secondary to Myxomatous Mitral Valve Disease (MMVD)” in Jurnal Veterinar Malaysia. This is the first reported case in veterinary literature that explores the therapeutic potential of stem cells for treating PH due […]
Malaysia’s First Successful V-Clamp Surgery In a Dog
On 8th December 2024, our team performed Malaysia’s first successful V-clamp surgery on a Cavalier King Charles Spaniel. The dog, named Oscar, had been diagnosed with advanced-stage B2 myxomatous mitral valve disease (MMVD) in June 2024. Since his diagnosis, he had been taking pimobendan, benazepril, and spironolactone to manage the disease. Understanding the severity of […]
Trans-Esophageal Echocardiography (TEE)
Transesophageal echocardiography (TEE) is a type of heart ultrasound that gives veterinarians or cardiologists a very detailed view of a pet’s heart. Unlike regular heart ultrasounds, where the probe is placed on the chest, TEE involves inserting a small probe into the pet’s esophagus (the tube connecting the throat and stomach). This enables the examiners […]
Thank You
31st August 2024 marks five years since I returned to Malaysia in 2019 after completing my PhD studies, and one year since establishing my main practice in Kota Damansara. As I reflect on this journey, my heart is filled with deep gratitude for the incredible people who have stood by me, offering their unwavering support […]
DCM and Elvis
Elvis is a 5-year-old Doberman. When he was first presented, he had been treated with pimobendan for presumed dilated cardiomyopathy (DCM) by a preceding veterinarian. What is DCM? Dilated cardiomyopathy (DCM) is a type of heart muscle disease common in large breed dogs. In DCM, the heart muscle weakens and becomes dilated, resulting in reduced […]
Successful heartworm removal surgery
Recently, our team performed surgery to remove heartworms from a local dog. When is heartworm removal by surgery indicated? When heartworms have migrated downstream into the right atrium and right ventricle, causing obstruction, surgery to remove the worms is recommended. If heartworms are present in the pulmonary artery, their removal is technically challenging and […]
About Heartworm Disease in Dogs
My dog is old, so I stopped giving heartworm prevention. Dr Anthony: Not often, but occasionally, I smirk helplessly when my clients say that they have stopped giving heartworm prevention to their old dogs. As we all know, heartworm disease is transmitted by mosquitoes. Being old does not mean that these blood-sucking insects will spare […]
The Story of Vin Vin
Vin Vin is a miniature schnauzer. He was missing for a few months. When he was found by his owner, he was given heartworm preventive medication. Later, he showed difficulty breathing and coughing. His primary veterinarian referred him to me for further investigation. Chest X-rays, echocardiography, blood tests, and a heartworm test were performed. The […]
The story of Ang Pao
Ang Pao was merely 13 weeks old during the first examination, and she weighed only 1.3 kilograms. She was experiencing difficulty breathing due to pulmonary edema. After the examination, it was discovered that she had patent ductus arteriosus (PDA), one of the congenital heart diseases. Patent ductus arteriosus (PDA) is a relatively common congenital heart […]
Facts about Diuretics
Diuretics are also known as “water pills” and are used to treat pulmonary edema (lung congestion) caused by heart failure. In Malaysia, the common diuretic is “furosemide.” In recent years, “torasemide” has also begun to attract the attention of veterinarians. Furosemide has a duration of action of about 6 hours in the body and needs […]
Holter versus ECG
Holter’s monitoring and electrocardiogram (ECG) both record the heart’s electrical activity. However, unlike a standard ECG, the Holter’s monitor can continuously record the pet’s heart’s electrical activity for an extended period (24-48 hours). In contrast, a standard ECG is generally used to record the heart’s electrical activity for a few minutes. Both are used to […]
Understanding MMVD and treatments in layman’s terms
MMVD stands for Myxomatous Mitral Valve Disease, also known as degenerative mitral valve disease. The exact cause of MMVD is still unknown, but we do know that it commonly affects small to medium breed dogs. Certain breeds, such as Cavalier King Charles spaniels, Dachshunds, and Chihuahuas, can develop MMVD at a younger age, suggesting a […]
V-clamp surgery training for MMVD
Great news for all dog owners in Malaysia! Our team underwent intensive training on mitral valve clamp surgery in China. This procedure involves minimally invasive surgery that doesn’t require a bypass machine or stopping the heart, aiming to reduce the severity of mitral regurgitation. After the surgery, the dogs may not require any cardiac medications. […]
Prevalence of heart failure among different common dog breeds
The graph below depicts the prevalence of heart failure due to MMVD among different dog breeds at Shinzō Clinic. Prevalence refers to the number of dogs within each breed examined by us that were found to succumb to heart failure. Breeds such as the miniature pinscher, chihuahua, and cavalier King Charles spaniel are the top […]
Dog breeds by percentage at Shinzō
This pie chart illustrates the distribution of dog breeds by percentage, which were presented for cardiac evaluation at our clinic. A total of 1003 dogs were seen by us. The most common breed is the Poodle, followed by the Shih Tzu, Pomeranian, and Miniature Schnauzer. Please note that not all dogs had heart disease. This […]
Survival of dogs diagnosed with stage C MMVD
After a dog is diagnosed with stage C MMVD (heart failure stage), how long can it survive? In the literature, a median survival of 9-15 months is reported in other countries. In Malaysia’s context, in a preliminary study by Shinzō, 30 dogs diagnosed and treated by us survived for approximately 366.6 days, or about 1 […]
Common dog breeds diagnosed with heart failure due to MMVD by Shinzō
If you’re wondering, in our clinic, what the common dog breeds are that succumbed to heart failure due to myxomatous mitral valve disease, this graph explains it all. In a total of 61 dogs, Poodle is the most represented (33%), followed by Miniature Schnauzer (16%), Shih Tzu (11%), and Pomeranian (8%). (Please note that this […]
