Iris update II

Iris is doing great! After I got home from the vet with her on Thursday I did some research into low-protein diets specifically for management of liver disease/liver shunts. I cooked up a small batch of a very low-protein diet for her; I'll only use it a week, then I'll switch her to a slightly higher protein diet made with tofu, cottage cheese, and rice. She ate a little of the new food on Thursday, but turned her nose up at it yesterday so I added a teaspoon of cottage cheese to jazz it up a little and she ate it all up at both meals. She turned up her nose again this morning, she wanted to be in with her sisters and eating what they were having.

The puppies are in a setup in my living room that consists of an extra-large wire crate with an exercise pen hooked onto the sides to make a "play yard". Iris clearly wanted to eat with her sisters this morning, so I put them and their dish into the crate and shut the door, and put Iris and her dish down in the play yard right outside the crate door. That did the trick, she ate all her breakfast and was looking for more, so I gave it to her.

Iris is getting metronidazole (generic Flagyl) twice a day to control bacterial buildup in her intestines. If she needs long-term antibiotic therapy, I'm going to ask Doc about switching her to Amoxi, it doesn't have the same toxicity risk that metronidazole has. She's also getting 2-4 doses of Lactulose, a mild laxative, a day. When protein is digested in the gut, one of the waste products is ammonia. A normal liver neutralizes the ammonia, but Iris' liver can't do that so ammonia builds up in her intestines. It's the ammonia that causes the neurological effects I was seeing. Lactulose increases the acidity of the contents of the intestines, reducing the absorption of ammonia. It also decreases the transition time of matter through the intestine, which also decreases the absorption of ammonia. The goal is to get stools that are soft but not loose, so I'll have to tweak the dosage of lactulose until I get the desired result. The good thing is that lactulose is sweet and Iris likes it, so getting her to take it is a piece of cake.

It's been about 48 hours since Iris got her first doses of metronidazole and lactulose, and about 40 hours since her first meal of the new diet. All her neurological symptoms are gone! She's clearly feeling better, she's back to normal puppy activity and hijinks again. I am much more optomistic about her future than I was the other day. Please keep our little girl in your prayers.

Iris Update

We're back from the vet, and the news is not good. The presumptive diagnosis is that Iris has a liver shunt. The cost to definitively diagnose the problem and fix it - if, in fact, it is the type of shunt that can be fixed - would be $1,000 or more. While I know there are rescues who'd be willing to spend that kind of money on one dog, I just can't see that it's a responsible thing to do. That sum would provide routine vetting for 8 dogs, or routine vetting plus dentals for 5 puppymill dogs.

We will be doing what we can to manage this condition with diet, antibiotics, and lactulose, but the prognosis is not good. We'll keep her here with us, make sure she has the best possible quality of life and all the love she can handle. When that's no longer enough, we will let her go.

Iris

Iris, one of Lilac's Bouquet puppies, isn't growing like her sisters. She did for a while, but the last couple of weeks it's clear she's falling behind.

I wormed the pups with Strongid three times. When I noticed that Iris looked - and her breath smelled - like she still had worms, I gave her a 3-day course of Panacur just to be sure. The other pups continued to grow and thrive, but not Iris.

Note: You know that "puppy breath" that everyone loves? Not the metallic odor of blood from teething, but puppy breath? Sorry to disillusion you, but it's caused by worms. Puppies that don't have intestinal parasites don't have puppy breath.

Hyacinth, Scilla, and Larkspur are sturdy, muscular, active puppies; Iris is much smaller, has much less meat on her bones, has slightly bowed rear legs, a thin coat, is frequently "roach-backed" - with her back rounded rather than straight - less energy than her siblings, and a smaller appetite. She also seems to have difficulty regulating her body temperature, she shivers at times when it's fairly warm in here (72-73 degrees). She eats, but she doesn't eat much at a time. She's a feisty little stinker, loves to play, but only in short bursts. Her sisters could run all day and not get tired.

I've been doing some research tonight, and I don't like the answer I keep coming up with. It's possible she's got rickets, which is easily treatable. What seems more likely is that it's Juvenile Renal Dysplasia (which is not curable), or a portosystemic shunt (which may be fixable, but would be prohibitively expensive to do). All her symptoms fit, including the smell of her breath. It's not typical puppy breath, it's different. The best way to describe it is having a slightly musty, scorched odor.

(I sniffed her breath tonight and she bit my nose, drawing blood. Little carnivore!)

I'll call the vet tomorrow and get an appointment to get her in.

Lost Dog

I lost a dog this morning. Not 'lost' as a euphemism for dead - I misplaced him. Well, he misplaced himself.

I let the little dog pack out in the yard - Max, Chooch, Sparky, Lilac, Bunny, Ruby, Bibi, Baby, Marco, Woodrow, Petra, Elvis the Shih Tzu, and Lina the tiny Chihuahua (who decided no more ex-pen for her, she wanted to go out in the big yard with the "big" dogs). I let Cider and Barclay out with them, too. It's a nice sunny morning and it's already about 30 degrees so not too cold to stay out for a few minutes and get some exercise. In the meantime, I filled their bowls with breakfast then sat down to check e-mail.

When I open the door to let them in, they come through the door in one big wave. All I see is a swirl of fur and tails and ears as they fly down the hallway to the kitchen gate. When I open the gate, the wave surges through there, too, and everyone runs to their crates and waits for me to get there with their dishes.

The way crates are set up at the moment, Cider's first, then Bibi, then Marco and Woodrow. Then Bunny, Ruby, and Lilac on the other side of the room. Last comes Barclay and then anyone who's not yet worked into the "regular" routine - in this case, Elvis and Lina - and finally Petra as I go back through the kitchen to let "family room group" out. (Max, Chooch, Sparky, and Baby aren't crated to eat, so they don't get fed until everyone else has been out, come back in, and gone into their crates to be fed.) Because Lina's so small I was afraid she'd get trampled in the chaos, so I scooped her up first, put her in her crate, and shut the door. Then I started the routine.

Cider's already in her crate, put the bowl in, close the door. Bibi - into her crate, put the bowl in, close the door. Usually Marco's next, but when I turned around Woodrow was going into his crate without being asked. Good - put the bowl in, close the door. Where's Marco? Hey - where's Marco?! Marco is always one of the first in his crate, he doesn't want to miss a single bite and he knows I'll put his food in with him as soon as he's in his crate. No Marco. I did a headcount on the little dogs still uncrated - no Marco.

I quickly got the others into their crates and fed them, then went looking for Marco. He's nowhere to be found. I looked in Cider's crate - nope, he's not in there with her. I looked in Woodrow's crate - nope, he's not in there with him. Crap. I went to see if he got left out in the hallway when I closed the gate to the kitchen. Nope, no Marco. Not in the family room, either. Not on the patio, so I walked the whole yard and he's not outside. Well hell's bells, he can't just have vanished into thin air, he's got to be here somewhere. Check Cider's crate again - nope. Check Woodrow's crate again - nope. Checked all the other crates, both occupied and empty - nope. By this time I'm on the verge of panic.

Then I happened to glance at Lina's crate. She was sitting in front of the doorway, but I saw a flash of white further back in the crate. I stuck my head down there and sure enough, there was Marco, in the back of Lina's crate. I never thought to look in there, he's never gone in there before and besides, I could clearly see Lina sitting in front of the door and I didn't think she was big enough to block my view of anything that might be behind her.

Marco was liberated from Lina's crate, he hopped up into his own crate, I put the bowl in and shut the door. And heaved a huge sigh of relief.

Somebody please adopt this adorable little guy. He needs to be in his forever home. They don't come any sweeter or smarter and I absolutely adore him, but he gives me a heart attack at least a couple times a week.