Sunshine - the pacemaker dog

Sunshine is a 9 1/2 year old German Shepherd dog of dubious ancestry. Her story starts with the neighbors who were busted for a drug and prostitution ring. The fellow bought Sunshine as a guard dog, and mostly left her outdoors. He took good care of her, but never interacted with her much. Cindy (my wife) used to get her "dog fix" by leaning over the fence and petting Sunshine, and sneaking her treats.

We came out one morning to find the Drug Enforcement Agency (DEA), Georgia Bureau of Investigation (GBI), Federal Bureau of Investigation (FBI), the Dekalb county SWAT team, and the local police surrounding the neighbors house, then taking most of them away. The person who actually owned Sunshine was not at the house at the time, and as we understand it, remained on the FBI's Most Wanted list as the #2 person for four months.

The neighbor got her from a pet store, for use as a guard dog (although 'Kill, Sunshine!' doesn't seem as intimidating as 'Kill, Fang!'). She's AKC registered, but is most likely a puppy-mill quality dog (of course, someone once AKC registered a cat, so that doesn't really mean much). He took good care of her, but didn't interact with her much, so she wasn't very socialized. It took Cindy 45 minutes to coax her out of the yard and on to our porch. Another 30 minutes of coaxing and food-bribes got her into the house.

I guess I should have known how unique she was when I tried to find the vet the drug-dealer used. I called the county with her rabies tag number and asked for the number of the administering vet. I started out with "I have an unusual story here: I got this dog in a drug bust...". The lady at the county said they don't normally give out the vet's number to mere citizens, but she'd make an exception.

Armed with the vet's phone number and Sunshine's rabies tag number, I called the vet. I started with "I have an unusual story here: I got this dog in a drug bust...", at which point I was interrupted by the girl with "Oh! You've got Sunshine! Is she OK?" It turns out they had heard about the bust on TV, and knew the guy who owned Sunshine. They said he took good care of her, but they knew she was bought and maintained with drug money. I asked about her health records, and they commented that she was fine. If they only knew...

Sunshine seems to be somewhat genetically deficient. When we first got her, she had problems with her paws. We had to soak her feet in the same chemical they use to kill heartworms in cattle, at about the same dosage. For several years, she was in fair health, with only a few typical minor problems.

Then, on a Thursday afternoon around Thanksgiving of 1998, she suddenly got listless and lost her appetite. Although she is the consummate chow-hound, this happens, and it was attributed it to an upset stomach. By Friday evening, she hadn't eaten at all, and we were getting pretty concerned. She went to the vet Saturday morning, who was determined that the dog might have Cushing's disease (a type of liver disorder). The vet, of course, closes early on Saturdays, and is closed Sunday, so Sunshine went to the emergency clinic to be monitored.

The emergency room did X-rays, and decided she might have an enlarged heart, but didn't have the ultra-sound equipment to properly determine this, so it was off to the UGA (University of Georgia) vet clinic on Monday. When my wife got her to UGA, the dog was fainting every 3 minutes, and had to be carried into the clinic. A few tests, and, good news! The heart wasn't enlarged. No, instead it was the two chambers of heart were not firing in the proper order. Ultimately it was determined that the conductive tissue between the atrium and ventricle chambers of the heart wasn't conducting. Normally, the atrium sucks up a load of blood, pushes it into the ventricle, and milliseconds after if pushes the blood, the pulse propagates through this tissue to cause the ventricle to contract, pushing the blood out into the arteries. Not with her! Fortunately, the ventricle builds up a little charge of it's own, and if the c charge isn't 'cleared' by the atrium firing the ventricle, the ventricle will fire on it's own, except it's out of sequence with the atrium. This caused enough blood to be circulated so her brain (as far as we can tell) wasn't starved for oxygen.

All this was determined after numerous tests, ultra-sounds, poking at the dog, etc. At some point slightly before Thanksgiving, it was determined that the dog would need a pace-maker. Naturally, Sunshine, being the dog she is, had to pick a holiday to have her medical emergency. Seems that the representative for the company that donates the pace-makers was on vacation, and wouldn't be back until the Monday after Thanksgiving. So Sunshine gets to spend her time in an oxygen pressurized crate, she's got two IV's, each one with three drugs being pumped in, and a wireless telemetry pack to monitor her heart and respiration. Monday rolls around, and the representative calls in to say he's had a death in the family, and won't be in until Thursday. Once he gets back, there's a people emergency he has to deal with, so we wait some more.

Anvil and Sunshine

In case you're wondering why she was getting six drugs in her IVs, one was to cause her heart to beat normally (isoproterenol, sadly, this drug is no longer on the market). If she was off this for more than 2 or 3 minutes, her heart would resort to misfiring. Another drug was a powerful broad spectrum antibiotic. She had an elevated white blood cell count, indicative of an infection, but the infection could never be localized. One of the drugs was an anti-nausea drug. She wasn't eating much, and it was suspected that the antibiotic was making her a little queasy. Yet another one of the drugs was to regulate her heart rate. The fifth was Ringers lactate solution, to keep her hydrated. I don't remember what the sixth was for.

At UGA, when a pet is brought in, a graduate student is assigned to the animal, and is the 'primary care giver'. The GS does the majority of interaction with both the pet and the humans, comes up with a recommended course of treatment, then consults to a board certified vet, refines the treatment plan, and then presents it to the people the pet owns. Our GS was a young lady named Marissa. Sunshine, Cindy (my wife) and I all took a liking to her, and she to Sunshine (I'm presuming she liked us, too). I asked lots of questions that (apparently) normal people don't ask, which sent her scouting for answers. In every case, she found out what we needed (or wanted!) to know.

Surgery day rolls around for Sunshine, and as the tech's are wheeling her into surgery, they're all grouped around her singing 'You are my Sunshine, my only Sunshine...'. They put her on the anaesthesia, and *boom*, the dog goes into cardiac arrest. All the students are shoved to the back of the O.R., the dog has her chest cavity split open, fur flies everywhere, and a surgeon starts performing heart massage until they get her stabilized. Meanwhile, Marissa is in the back, clenching her fists, and repeating 'Sunshine can't die, Sunshine can't die.' over and over.

The surgery is completed and declared a success. Sunshine spends a week or so in recovery, and after a while, starts making rounds with Marissa. Sunshine is the sweetheart of the UGA vet staff, and very well known. Dog gets to come home, with half her body shaved (belly and chest for surgery, legs and throat for IVs, and halfway up her sides for EKG pads). My other dog hasn't seen her in so long he barks at her and goes nuts with joy. It's all very touching. (By the way, only about 150 dogs a year get pace-makers, nationally. UGA does 2 or 3 of them a year. Often (and in our case), the pace-makers and leads are donated by the manufacturers. While pace-makers normally last 10 years, they can't be installed in humans after a year. The companies are kind enough to donate them to the vet schools.)

After a period of recuperation, Sunshine is like a new dog. She has more energy than I ever remember, and seems more lively. She also developed some new habits. My favorite is that she now howls when Anvil does (and that's every time he hears a siren, on TV or on the road). While Anvil has this beautiful baritone howl that can last a good 15 seconds without a breath, Sunshine is like a creaky old door that needs a good dose of WD-40. It's quite amusing!

For about a year, she was fine. Then she went through a small ordeal again about 1 month before Thanksgiving on 1999. She started acting oddly again, so it was off to the vet, then off to UGA. They found her white blood cell count to be up again, and she went on another regimen of antibiotics. This seemed to blow out what ever it was, but her liver enzymes are still up, and the vets can't find anything wrong. We've been wondering if this isn't a flare up of whatever may have originally caused her heart problem (which the vets think may be infection related).


On December 30th, 2001 I was taking Sunshine for a walk. Sunshine tends to lead going out, and dawdle behind me coming in. As was normal, she was behind me, when suddenly I felt the leash go taut. I figured "Oh, she's stopped to sniff something." Instead, I turn around to find her lying on her side with her front legs stuck straight out, and her back legs crossed up. Figuring that her bum back leg might have caused her to fall, I untangled them, and noticed that she was sort of glassy-eyed. Looking closer, I could see that she either was having a seizure of some kind, or had fainted. This episode lasted about 7 to 12 seconds in real time, but seemed a lot longer. She shook herself back to awareness, got up, walked a few steps, then laid down.

I got her back to the house, where she laid around panting a while, which I attributed to the stress of the fainting or seizure. After about an hour, I decided to take her temperature, which was normal. On an impulse, I checked her pulse rate (which took me 20 minutes to find a pulse, I've never done that before), and found it to be about 36 beats per minute. A normal dog her size should be around 60 to 70 resting, and with the pacemaker installed, I knew it shouldn't have dropped below 60 at the worst.

A call was placed to the UGA emergency vet (since, of course, she had picked a Sunday to have this problem), who told us that while they couldn't do anything other than provide basic care, we were welcome to bring her in, and they would check out the problem, get in touch with Medtronics, etc. We took her in around 11:30PM that night, where she was placed in ICU, some basic checks where done, etc. Normally, if a dog is having heart problems and goes into cardiac arrest, they can use the machine to jump start the dog. However, because of the pacemaker, that's no long an option, since it can cause damage to the pacemaker itself. Another issue was that they were running with a reduced staff, because of the holidays.

Monday morning X-rays were taken, and it was discovered that the ventricular lead of the pacemaker had broken. This was attributed to it not being ideally placed, because of the cardiac arrest problems mentioned above. It took about 13 days to get a new lead, get Medtronics lined up to come out, and acquire a unit for pacing the heart externally, through a transveineous lead. The intern on the case, Carrie, was fantastic, and as she said "made a pest of herself until things got done". Surgery day rolled around (which I believe was Jan 13th, I need to check this), and the surgery was declared "perfectly boring, perfectly eventless, and a complete success". The external pacing carried her flawlessly through the operation, and with the improvements in anesthesia in the last three years, she was at the least possible risk.

Sunshine came home around the 16th, and rested comfortably about the house, receiving sympathy and petting, and everything a recuperating dog needs. After about 10 days, her bandages came off, stitches were removed, and she was well on the road to recovery. Because of some confusion between the day and the date, I had thought her follow-up visit was on a Friday, when in fact it was on a Thursday. As I was making my way out to UGA, I called to make sure everything was still on. USA receptioninst: "Oh, we expected to see you yesterday, where were you?" Me: "I expected to be there today, and I'm my way out there". Receptionist: "Well, we'll have to reschedule, the person you need to see won't be here." Me: "OK..."

Back home Sunshine and I head. Later that night, she skips dinner, which was somewhat unusual. I get that feeling in my stomach that something just isn't right, so I take her pulse. It's 36 beats per minute, again. UGA gets called, we're told we can bring her in, but again, there's not much that can be done, should something go wrong. 11:30PM on a Friday night, we're back at UGA (can you begin to see a pattern here? I haven't mention the part where the other dog, Anvil, in the picture below develops GDV, and spends some quality time at the UGA Small Animal Clinic), Sunshine stays the weekend. We could have kept her at home, except where we're located requires a long walk to an area the dog can use, there are some steep hills, and overall it's just better for her to be there when they need to look at her, rather than driving for an hour.

Medtronics comes out Monday night, and determines that this is not a horribly unusual event (they expect it in humans), and what has happened is that the scar tissue forming around the replaced ventricular lead means the electrical impulse the pacemaker puts out was not strong enough to trigger the heartbeat. She adjusts the parameters, and it was said that it was like turning on a light switch. In two minutes, she went from lethargic to bouncing around the room, licking noses. So Sunshine comes home.

Cindy, Sunshine, and Anvil

You might think "My gosh, this dog has been through it all. Surely she's home, happy, and doing whatever dogs with pacemakers do (which is really anything they want, just like a "normal" dog). It's never that simple. After 10 days or so, I noticed that when I took her out for her walk, at the top of the hill she'd be a little out of breath, or tired. I started checking her pulse, and noticed it was around 60 beats per minute, which is the lower limit, and that the unit wasn't increasing her pulse when she was exerting herself like it should. Since she was due for a two week checkup, I mentioned it.

Everyone agrees this isn't normal, so Medtronics is called yet again. Nothing like being on a first name basis with your customers, even if they are dogs. An interrogation of the pacemaker reveals that it has gone into "safe-mode", which it does when the battery is close to dying. There is still some confusion as to why this should occur, since a battery check was done last time she was in, and it was reported that 18 to 24 months of battery life should be remaining. Enter Dorothea Edwards...

I hadn't heard Dorothea's name prior to all this, but when she passed away, it was her wish that her pacemaker be donated to an animal. Most people with pacemakers are buried with them, unless they are cremated, in which case they are typically disposed of. It is estimated that only about 10% of the dogs that need pacemakers get them, primarily due to cost, and secondarily due to availability. Many of the pacemakers that are buried or disposed of have enough battery life left to give a dog several years of quality living. Sadly, because of a lack of awareness of this option, many dog owners cannot afford to give their dog the care it needs. Luckily, Dorothea was aware of this option, and her wish was carried out. In this case, Sunshine is the recipient of this generous gift of Dorothea and her family, and our thanks go out to them.

On March 1st, 2002, around 11:30AM, Sunshine went into surgery. Unlike the original pacemaker installation, or the replacement of the ventricular lead, the thoracic cavity does not need to be opened, so the risks both during and after surgery are far less. Around 12:30PM, the surgery was pronounced a complete success, she was waking up in recovery, and she was pacing at a sold 70 beats per minute. It is estimated that this pacemaker should last two to three years, since it has to have the electrical impulse levels set pretty high to overcome the scar tissue surrounding the replacement ventricular lead. While it is very depressing to contemplate the demise of one's pets, the reality is the lifetime of the pacemaker is likely to be longer than her expected remaining years (German Shepherds usually live 10 to 12 years).

Sunshine on the mend

When the press department at UGA found out about Sunshine, an effort was made to generate increased awareness of donating pacemakers. To date, she has been on the front page of the Atlanta Journal Constitution, had a 20 second sound bite ("Woof!") on Atlanta's Fox 5 News, an article in the Gwinnett Daily Post, an article in the UGA Red & Black newspaper, an interview on Atlanta's WXIA 11Alive, and it's been picked up by the AP wire service.

There are a number of people who have participated in Sunshines health care. If we named everyone, the list would be huge. However, we would especially like to thank Dr. Clay Calvert and Dr. John Sessions of the UGA Small Animal Clinic, Sunshines regular veternarian, Dr. Pam Sullivan of Sugar Hill Animal Hospital (also a UGA almuni), and the people at Medtronics who have donated the original pacemaker, leads, and programming time.

This page was generated on very short notice, so that people who are interested in more detail, pacemaker awareness, and other information have an additional resource. I will be adding more information and pictures in the very near future.

If you'd like to know more about dogs and pacemakers, or are looking for recommendations for the UGA vet clinic, please feel free to e-mail me. The UGA College of Veterinary Medicine website is located here.