Thursday, July 30, 2009

Why is it always the sweet ones?

Today the last chapter of Madison's story was written. She is no longer working hard for every breath, wondering why she does not feel so good. She has joined her siblings across the Rainbow Bridge.

But perhaps her story has an epilogue. Maddie's condition, which has been well documented, caught the attention of the excellent veterinarians at the NCSU College of Veterinary Medicine. With her records, those of her sister Tuscon, and those of Patience's pups and another litter in Pittsboro, they are going to publish a paper. Maybe this will help advance the topic of virally induced congestive heart failure in pups.

I smile to think of how happy Madison was this last month. After the last Updates that I posted about her, she did very well. She had one bout with shortness of breath, and the vets kept her overnight to get her stabilized and run tests. We changed her dosages and added one med (5 medications and 4 nutriceuticals) and she came home to her friends. Aida and I wrestled with the choice - do we keep her completely calm to help her heart and lungs, or do we let her be a happy puppy for the time she has left? Well, mostly both. We kept her times of high activity to a minimum, but let her be all the puppy she could be.

And she was.

She hung off of Roscoe's jowels, and he played along. She did her best to convince the grumpy old Husky Kiko that play is a good thing (can't blame Kiko, though, as she is recovering from cruciate ligament repair). Gabriel was happy to roll on his back or play bow if she insisted that it was his turn. She even claimed a coveted spot on The Bed.

Maddie knew her name, and would come running if you called, body wagging. She loved her people. Especially Maia, who seemed to be the world's best chew toy.

She was one happy pup. Until last night. She started having problems breathing, and you could just see in her eyes today that she was not feeling well. We had an appointment with the vet to check on her status today, so that timing was good.

The news on the check up was not. The arythmia was much, much worse, and it was clear that the errant beats were being triggered from multiple locations. Her heart was even bigger, and now there was fluid leaking from her heart too. Maybe some time with lasix by IV would ease things for a day or two, but the story was clear. Madison's heart was not able to do the job her body needed it to do, and never would. She was not comfortable, and never would be again.

The vets and staff at the vet school are wonderful, and it was with the greatest of tenderness that they helped Maddie to breathe easily the last few times. She gave us a few kisses before she closed her eyes.

Play well, sweet sweet Maddie. We will miss you forever.

Wednesday, July 8, 2009


I have two updates.

First, we took Madison to the Vet School yesterday for a full cardio workup. The bad news is pretty much what we already knew - she has bad arythmia, and her contractile ratio (how elastic the heart is, so basically how well it pumps) is badly decreased. Her heart is full of scar tissue, which is not elastic and does not conduct the "pump now" signal. The vet there is wonderful, and everyone there just loves Maddie.

The good news is that they are guardedly optimistic about her prognosis. We will continue on her current meds, bumping the dosage up, and we will start with some new holistic meds to help balance the system out, especially the ion pumps associated with the heart muscle. She continues to play and love, looking for all the world like a normal pup, so we will give her all of the love she can handle. We will bring her back in 7-10 days to evaluate her heart again, perhaps with a Holter monitor. Cross your fingers.

Second, I told you back in May, in the blog Give the Boy a Break, about our precious Einstein. The poor guy just had one ding after another, and I asked God to give him a break. Well, Einstein had his break from pain - a couple of weeks ago several of his systems just gave out, and he crashed. The labs and evaluation made it clear that he was just not assembled according to the instructions. He was in pain, and was never going to recover. Einstein is now playing with the other pups over the Rainbow Bridge. He will will always have a room reserved in our hearts. Play well, little man.

Tuesday, July 7, 2009

The joys of Dog Laundry... and Toys!

One of the great joys of fostering dogs is that you get to hone your skills with the laundry. There is a load about every other day, sometimes more often, of towels, bedding, and toys to be washed. It is amazing how many of those squeaker and noise-making inserts in the toys survive a washing. They can't survive 2 minutes with a Husky pup...

Why in the world am I talking about laundry? Well, our newest foster, Koi, provided the incentive. Koi came to us, along with a couple of others, from a hoarder bust in South Carolina. As usual with dogs from cases like this, her coat was nasty, she stank to high heaven, and half of the fur has been bitten off of her ears by flies. After several days, we are still trying to settle her tummy down, but the diarrhea has not yet stopped.

What did Koi do? Well, Huskies are VERY curious dogs, and she just HAD to know what mom was up to in that little room. Ooooh - I see TOYS!! Clearly, investigation is in order.

Yep, thar's toys here! Ya'll come see!

No Huskies were harmed in the making of this blog. And yes, Koi is happily chewing away at a squeaky toy right now, fresh from the dryer. I like my warm towel fresh from the dryer when I come out of the shower. Koi will take her toys fresh from the dryer, thank you very much!

Monday, July 6, 2009

The Circle is Complete

Back in the post called Circle of Life I told you about the wonderful event of the birth of Margo's pups. Ten live, one born dead. Cute little things, all brown and wrinkly.

What I have not done is tell you about the pups since then. It is a painful story, a learning experience, and it is not over yet.

Right after giving birth to her pups, Margo had bad diarrhea. That is not uncommon, especially in strays, since they ingest a lot when cleaning up the newly born pups. The problem was that hers did not stop for nearly four weeks. I mean it was EVERYwhere. Poor Aida, she cleaned it up almost every time, with several relief turns by Deanne, who came by to check the pups every day. Well, we gave her everything you can give a nursing mom, but it was clear she was "immuno-naive" - she had never seen a booster shot, or been dewormed.

The puppies grew, and ate, and peed and pooped, and eventually opened their eyes. We charted their weight, and swapped them around on the nipples to make sure everyone got their share. It all looked good.

Until right about four weeks. One of the pups suddenly showed signs of problems breathing, and was dead within an hour. Then another. And another. Within a few days, there were only five left, and we were talking with the two vets we regularly use. We had an expedited necropsy performed on one of the first ones to pass. We were horrified to learn that it was the same virus that killed all of Patience's pups! Could it be our environment?

Truth is, no one knows for sure. CPV-1 is very little understood. It is the other variety of the Canine Parvo Virus (type 2) that is too well known by every shelter and rescue, and by many owners of new pups. It is really rare. The biggest problem is that it is really only seen, as far as we know, in immuno-naive dogs, those who have never been immunized. It does not affect the adults, but it causes massive developmental problems in newborns, ultimately leading to congestive heart failure (CHF) and pulmonary problems. The pups have problems breathing, the heart quits. In the ones we looked at, the hearts were very poorly formed - the pups would have never thrived even had they not died of CHF.

With the CPV-1 information in hand, we went back to our primary vet, who contacted several other vets who specialize in cardiology, internal medicine, and viruses. It was all new territory, but they decided on a plan of action, essentially treating it as CHF. We got the meds and rushed home to start the treatment. Before the sun set that night we were down to two, Tuscon and Madison.

Tuscon and Maddie responded to the meds. They stayed active and playful - all of them were active and playful until minutes before they dropped dead. But this seemed to do the job. They were five weeks old.

At seven weeks, we had an echocardiogram and EKG performed, along with CBC and Chems blood work. Nothing alarming in the blood, but the echo and EKG told an unhappy story. Maddie's heart was badly damaged, and had lost almost a third of its contractile ability. Tuscon's was much better, but they both had arythmias. In addition, Maddie had a mitral valve defomity. Our hope was that with the meds, and prayers, their hearts would "remodel" as they developed, and the ectopic foci that caused the arythmias (probably from scarring) would go away.

We followed them as they played, checking breathing and heart rate. They ate well, and played. We checked with the Vet, he consulted with the other vets, and the consensus was to let them grow and monitor them. Don't change the med doses, just let them grow out of it. If they show signs of problem, up the dose again.

They played and chewed and peed and pooped and played and played for two more weeks. They're getting big - 17 pounds! Probably some Mastiff in there somewhere. On Saturday, July 4th, nine weeks and a day old, Tuscon slowed down, a lot. She was having problems breathing, her heart rate was up. We increased her dose by half, to catch up to her current weight. We debated taking her in, but decide to watch and see if the increased meds helped.

Sunday morning it was obvious that she was not better. Her heart was beating too fast. We took her to the Vet School Emergency Room, and they immediately set about stabilizing her. She was in superventricular tachycardia, and in danger. Vagal stimulation did not help. The Cardiologist arrived, and they set about getting her stabilized with calcium channel blockers and beta blockers. They started the echo, and learned right away that the left side of her heart was not working at all. Her heart stopped. They got it started again, but it stopped again. She was clearly in pain, and was not going to win this fight. They helped her out of her pain, and her heart stopped forever.

Yesterday I lost a friend. Maddison lost a sister and playmate.

Maddison is not in the clear yet. I am taking her in tomorrow to have her heart evaluated again. She is playful and active today, and eating well. Today. It may well be that her heart is already too damaged to carry her through a full life. It could be that he heart will remodel.

Maddie goes in tomorrow for an evaluation. I hope I have good news.

Because the Circle is complete for all of her sisters and brothers. Play well on the other side of that Rainbow Bridge, little ones.