This page details our personal experience and is intended as a resource for breeders who have encountered a rare condition known as Persistant Right Aortic Arch (PRAA)

We would like to thank Dr. Chris Girling and Dr. Penny Tisdall for their help and consent in producing this page.

On 27th of December 2006, Euzkadi welcomed 7 Pyrenean puppies into the world - 4 boys and 3 girls.

All puppies gained weight and developed normally.

At around 4-5 weeks of age, the litter was transitioned from a soft gruel meal to a dry kibble meal and it became apparent that ‘Daisy’ was not digesting her food properly. She would devour food quickly then regurgitate it back up again. She would repeat this cycle until finally able to digest her meal.

Initially we thought she may have been eating too quickly and this was the cause of her chronic regurgitation. So we experimented with feeding her in isolation (to deter her from scoffing food alongside her 6 littermates from the puppy feed trough). However food regurgitation persisted even when fed on her own.

Her chest soon developed a ‘rattling’ sound that was noticeable after exercise or meals. We initially thought that this may have been some mild virus that she had come into contact with.

However with the concurrent problem of food regurgitation, we decided to consult our vet. Daisy was taken out to see Dr. Chris Girling at Noah’s Crossing Veterinary Clinic, who quickly diagnosed her as having a Persistant Right Aortic Arch (PRAA), a type of vascular ring anomaly. This was diagnosed using a barium xray, where Daisy was given a meal containing a barium solution and simultaneously xrayed to assess the state of her gastrointestinal tract.

Dr. Chris Girling explained that PRAA was a rare congenital condition where the oesophagus was trapped between the right aortic arch and the heart. This inhibited the growth and function of the oesophagus, and restricted the passage of food into the stomach. This meant that food would pool in a portion of the oesophagus preceding the constricted area leading to regurgitation.

The ‘rattling’ in her chest was diagnosed as aspiration pneumonia – a common secondary condition caused by food and fluid being inhaled into the lungs with repeated regurgitation and vomiting.

The cause of PRAA is not entirely understood. In some breeds there is thought to be some genetic influence, yet in other breeds PRAA occurs so infrequently that it’s cause may be entirely idiopathic (arising spontaneously). To our knowledge, we can only assume that Daisy falls into the latter category given that the occurrence of PRAA in Pyrenean Mountain Dogs (or Great Pyrenees) is near negligible.

So our options were to treat the condition via surgery that was both invasive and expensive, or to have her put to sleep. We took her home, and deliberated over our next course of action, while treating her pneumonia with antibiotics.

As a breeder, every so often you have a puppy come along that instantly warms your heart – And ‘Daisy’ was one of those puppies. Even before her condition became apparent, she had one of the most enchanting souls. We would often watch her interacting with visitors and say “If show dogs were judged on personality, she would be our future BEST IN SHOW winner!”
It was a soft spot for this young puppy, combined with our ability to undertake the surgery that led us to take the path that we did.

Dr. Chris Girling referred us onto the Adelaide Veterinary Specialist and Referral Centre, where we met Dr. Penny Tisdall, a  small Animal surgeon. She told us that 95% of these cases are in fact PRAA, but another 5% of vascular ring anomalies are more complicated and sometimes inoperable. She also told us that 80% of dogs that undergo corrective surgery recover well and regurgitation discontinues. However she also advised that despite surgery, some dogs required a life-long commitment with raised feeding and a vigilant diet. Some dogs also have persistent problems that lead to aspiration pneumonia, emaciation and ultimately euthanasia.  With all of this in mind, we decided to proceed with the surgery.

On the 22nd of March 2007, ‘Daisy’ was admitted to the Specialist Centre for corrective surgery. During her 1-hour thoracotomy, Dr. Penny Tisdall was able to isolate the ligamentum arteriosum and transect it to relieve the constriction on the oesophagus. Following 1 ½ days of hospitalization ‘Daisy’ was discharged and was able to return home.

Daisy is still on the road to recovery and her diet consists of many small meals of mushy kibble. Her long-term prognosis is that she may still have some residual damage to her dilated oesophagus (the extent of which is not known until she fully matures), but her oesophagus can now pass food into her stomach.

Daisy will never be bred from – as with all congenital conditions, it is best to remove those affected from the gene pool as a precautionary measure.

For anyone who is faced with a similar decision after having a dog diagnosed with PRAA, we believe that the surgery is well worth the investment if you can afford it (Approx. $3000- 3500 AUS). It may be a life-long commitment to caring for your pooch – but for us the satisfaction of giving Daisy a new lease on life was worth every penny!

Please stay tuned for Daisy's progress post-surgery.

Please feel free to contact us if you have any questions.