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.

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