Sweet June, Bug for Short

I am sorry for the time in between posts, but I have been dealing the loss of one of my pets.  This loss is something I have helped many, many clients get through, but have never really had to experience myself.  I have lost several of my childhood pets but never one that was my responsibility as an adult.  I have been so lucky that all my other pets have been super healthy.  My boyfriend and I recently had to euthanize our Labrador June.  This was a hard decision for us, and I find myself even more thankful and appreciative of my veterinary staff.  They cried with me, offered words of solace and advice.  They helped to make this as easy as it could be.  I have wanted to talk about June's disease for a long time but could never seem to find the time to write about it.  I guess now is the time...

June was only 2 years old when she died; she was born with a liver condition.  The fancy name for her condition was a Congenital Portosystemic Shunt.  What happens is; the blood from the puppy's intestines bypasses the liver.  During pregnancy it is normal for the puppies’ blood to bypass the liver (i.e., the mother's liver filters out the toxins for the fetus).  Normally this shunt (the vessel bypass) closes within 3 days after birth.  In animals like June, the shunt doesn't close and the blood continues to bypass the liver.  Because the liver filters toxins, the toxins build up in the body.  This results in the puppy having slow or nonexistent growth.  June was only 50 pounds; she should have been more like 70-80 pounds.  If this is left untreated, puppies are not likely to survive.



June at diagnosis-12 weeks old
So sad...



Signs we saw:

June was diagnosed very early; she was only 12 weeks old.  She was having symptoms like not growing well, not eating well, sleeping alot and drinking and peeing alot.  We diagnosed her when she had more severe symptoms after eating a large meal, she become temporarily blind and had a seizure.  June had alot of symptoms and they occurred rapidly.  This is not a disease that occurs very often in Labradors, it is really more common in little Yorkie Terriers. 

Tests:

We took June for some testing at a specialty veterinary clinic.  They were able to take pictures using an ultrasound and used nuclear medicine to diagnosis and stage her disease.  This step is very important because it can determine if the dog is a candidate for surgery.  This is a disease that is usually very fixable in Yorkies, with appropriate surgery and care.  The problem with June was, she wasn't a Yorkie...  Her shunt was much more involved and deemed a very poor surgical risk.  We contacted numerous specialty clinics and university's to see if anyone had any surgical cures for June.  The answer was the same every time, they all felt that she would either die during surgery or do very poorly following surgery.

Decision Time:
By the time we had went though the tests and talks with specialists, June was doing great on her medical management.  We had a very active and loving puppy.  She was in no shape or form 'normal' but she played and terrorized all the other pets, much to their displeasure....  We decided we would treat her medically as long as she was active and healthy.  I cautioned my boyfriend that she may only make it a couple of months before she began feeling sick again.  But June surprised us all and just kept on doing great!  She went through all her puppy shots, got spayed, and became a beautiful adult dog. 

Medical Treatment:
June's medical treatment consists of by mouth medications to help prevent protein absorption in the intestines.  These proteins are what become toxic to the liver.  Some dogs do great with just one drug.  June was on 4 drugs!  We added drugs as her symptoms progressed.  These dogs are also on special diets.  These diets are very low in protein.  June's was on a prescription food from Science Diet.
Medical management is more a matter of avoiding certain things.  If June ate anything other than her food it would prompt a bout of not feeling good and usually a trip to the clinic for fluids and intensive care. 

Being a Labrador, June was always trying to, and sometimes succeeding in eating things she shouldn't....  She woke us up once at 5am, during a snow storm, wearing the kitchen trash can lid around her waist(she was in the bed)!!!  She had got up very early in the morning and quietly eaten and spread garbage all over the kitchen floor!!!  We so badly wanted to be mad at her but it was just too funny....  Needless to say, eating garbage doesn't make a normal dog feel good, June ended up in the clinic once again on fluids...

Prognosis:
The dogs that are able to have surgical repair of their shunt have a very good long-term prognosis.   Most of those dogs go on to have normal life expectancies.
Those dogs like June, whose shunts aren't surgically repairable live an average 10 months.  There are new studies out there that are saying that with new understanding and medical treatments they maybe able to extend that average to 3 years.  June was right in the middle. 
This is considered to be an inheritable problem.  This means that a dog with a shunt should never be bred because it can pass it on to its puppies.  I would also never breed the parents of the dog affected with the shunt.  There is a very good chance another puppy will be affected.
After my experience with June, I would whole-heartedly encourage people to medically treat those dogs who aren't candidates for surgery.  We had a wonderful 2 years with June!  She was a dog like no other! She had everyone who ever met her falling in love with her!  We will miss her and think of her often...