Prince Home last

Prince Charming

Hi Everyone! It's me, Prince, only my mom calls me Prince Charming cause she says I made her dreams come true. A long time ago, before I was born, my dog mom was rescued from a puppymill by the Angels at PMR. Not too long after she was rescued, my brothers and sister and I were born into freedom. All my family found their forever homes but I stayed with Aunt Robin and then with Aunt Renee 'cause I had some medical problems they wanted to check out. It was really nice staying with Aunt Robin and Aunt Renee, but I wished and wished for my own home with my very own forever mom and dad. Then one day, Aunt Renee held me in her lap and told me she had talked to my forever mom and I was going home. I was so excited!

I have been at my forever home for almost 8 weeks now and it is great! I have a big brother, Tucker and a big sister, Sweetie. We play all the time and I love them both very much. I have my own bed and my own toys and my very own mom and dad! Sweetie is trying to teach me how to go potty outside. (I don't know what the fuss is all about, mom cleans it up no matter where I go.) Tucker tries to teach me how to kick back and relax, but there is so much to get into and I want to explore. We have lots of toys and we get to play and go for walks and sleep and play some more. I like to walk outside in the flower garden and snooze in the gazebo and bark at the chipmunks and squirrels and birds. Me and Sweetie sleep in the big bed with mom and dad at night. I snuggle up with mom and tell her how happy I am every night before I go to sleep. Mom says I have a really cute bark but she could do without it at 3:30 every morning. I try to tell her I just can't wait to get up and see what the world has to offer every day but I don't think she cares a lot at 3:30. Go figure! Life is good, I am happy, mom says I am an official Spoiled Royal and I think that is a good thing to be.

Mom said that I have lots of cousins still in the puppy mills and we need remember them and help find a way for them to be free too. Then they can live happily ever after, just like me, 'cause every dog deserves to be a Spoiled Royal.

Prince was born into freedom on March 21, 2004. He weighs 3.8 pounds. We has a small opening in the top of his skull that did not close during his development. Prince has been under the care of Georgia Reger at Webster Groves Animal Hospital in Webster Groves, MO since his birth into freedom. He has been a happy, healthy puppy until the last month. At that time we noticed that he would draw his head towards his back when he would shake his head. It was first thought that he may have an ear infection deep in his ear that would cause this problem. After being on antibiotics for 10 days the symptoms seemed to lessen somewhat. But after being off the medications, the symptoms returned.

Click here if you would like to see a movie of Prince. In the beginning of the movie you will see his shaking of his head and his drawing of it back towards his back.

Prince went to the vet again on October 26th. They pulled blood work from him and it showed that his liver enzymes were off indicating a possible liver problem. X-rays were taken on October 29th and it showed a liver and heart of normal size and no cervical problems with his spine. He had to go back to the vet on October 30th for a bile acid test to determine if he has a possible liver shunt.

The test came back today, November 5th, 2004. Both his pre and after meal results are elevated. Pre-meal results should be less than 13. Prince's are 23. And his post meal results should be less that 25 and his are 57.5.

Prince will need to be seen by a specialist for evaluation for possible liver shunt surgery.

UPDATE: Prince has an appointment at 3:30 pm on November 16th at the Associated Veterinary Specialists in St Louis.

UPDATE

We took Prince to the specialist Tuesday, Novenber 16. Dr Allen examined Prince and all the tests results we had on him. He says that the degree of elevation of the bile acid results can be a lab error and has ordered another test to be ran. He says that the blood tests do not really make him lean towards a liver shunt but that if the results are still elevated, Prince will need to have an ultrasound. He says that Prince may have microvascular dysplasia. He also does not feel that the shaking of his head and the pulling back of it is related to a liver problem. He feels that Prince may have some degree of hydrocephalus and when he shakes his head the fluid moves and that causes the pulling back of the head. The only way to truly diagnose this is with an MRI. A lot of dogs live a long happy life with varying degrees of hydrocephalus. ultrasound. He says that Prince may have microvascular dysplasia. He also does not feel that the shaking of his head and the pulling back of it is related to a liver problem. He feels that Prince may have some degree of hydrocephalus and when he shakes his head the fluid moves and that causes the pulling back of the head. The only way to truly diagnose this is with an MRI. A lot of dogs live a long happy life with varying degrees of hydrocephalus.

Prince then went to our regular vet for a second bile acid test. We will probably get the results on Friday. If it is still elevated, we will need to schedule the ultrasound at the specialist office.

Below is information on the microvascular dyplasia.

Hepatic microvascular dysplasia is a condition in which there is mixing of venous blood and arterial blood at the microscopic levels in the liver. If you search for information on this condition, it is also called hepatoportal microvascular dysplasia so you may find information using either name. This condition has been recognized in a number of small dog breeds but seems especially prevalent in Cairn terriers and Yorkshire terriers.

It is likely that most dogs with this condition have no readily apparent clinical signs associated with the microvascular dysplasia and are diagnosed when bile acid response testing is done to rule out liver disease for some reason. Unfortunately, some dogs with this condition do have clinical signs, which can include seizures or other central nervous system disorders, gastrointestinal problems or urinary tract disease associated with ammonium biurate cystals in the urinary tract, which form due to the liver problems.

Abnormal bile acid response testing usually provides the initial suspicion that this disease is present. High bile acid levels can occur with portosystemic shunts, as well. It is necessary to rule out that possibility when considering the possibility of hepatic microvascular dysplasia. Liver biopsy adds further evidence for the presence of this condition, in part by ruling out other liver diseases.

When dogs have microvascular dysplasia without clinical signs, their prognosis is very good. In many instances there is not a need for therapy. In dogs that are diagnosed because they have clinical signs, it is often possible to manage the signs through the use of dietary therapy and medications. The dietary therapy is aimed at reducing excess protein in the diet and the medications, including lactulose and antibiotics such as neomycin or metronidazole, which are used to lower ammonia levels in the digestive tract and thus in the body. The prognosis is variable for patients who have clinical signs from hepatoportal microvascular dysplasia. Some dogs do well with therapy and live normal, or nearly normal, life spans. Others have worsening of the clinical signs over time. I do not know of a method for predicting how well an individual patient will do.

There are a number of reduced protein diets that might be helpful, including Hills k/d (tm) and l/d (tm) diets, Purina's NF diet and others. Lactulose dosage is adjusted to individual patient's needs by using it to obtain a soft but formed stool. Neomycin is usually given at a dosage of 22mg/kg of body weight twice a day and metronidazole at 7.5mg/kg twice a day. This is a lower metronidazole dosage than is
used for many other conditions. I have seen recommendations for the use of other antibiotics but these two are the most commonly mentioned ones.

Update

Prince's bile acid came back and it is a little confusing. His pre-meal results are now 49.6 and his after meal results were 51.8. I took the results by the specialists office and he has an ultrasound of his liver scheduled for December 21st. Please keep him in your prayers. He is still doing the head pull like he was previously.

Update 12/21/04

Prince had an ultrasound of his abdomen today to see if they could see any liver shunt that would require being operated on. He weighed 3.9 pounds today.

The vein to the liver looks nice and large and the liver is a normal size. There was no shunt visible that can be corrected by surgery. They feel that Prince has the multiple microscopic shunts (microvascular dysplasia) within his liver. They feel that the majority of the blood is being filtered normally by the liver. Prince will have to be put on LD Science Diet for the rest of his life.

They also found that Prince is harboring a tapeworm within his intestines. This was visible in the ultrasound. Prince's mom had a very bad case of tapeworms that they would not treat until the puppies were 2 weeks old. So we figure that he must have gotten this from mommy while he was nursing. Prince had not showed any signs of having tapeworms. So he will undergo treatment for the tape worm tomorrow.

We discussed the head pull that he is still doing. Dr Allen feels that Prince does has a degree of hydrocephalus but he does not feel that anything other than monitoring him is needed at this time. If he starts having seizures then he will need to be placed on medication. He said that the fluid pressure within the skull could increase with age so this is something that anyone interested in adopting him will have to be aware of. He did not feel that an MRI or CT scan would be beneficial at this time.

The cost for the visit today was $399.50

UPDATE

Prince has been on the LD Science Diet since his ultrasound. We had another bile acid test ran on him. We had the results faxed to the specialist and they feel that Prince's levels are exactly as they should be and did not recommend changing his treatment. So he remains on the LD Science diet. At this time this is the only special diet that he is on.

Update

Prince would like to send a special thank you to the following people who have donated to his vet fund.

Tamara Messina, Terri Woodcock, Jennifer Rosen, Marianne Landis, Deborah Fahrenholtz, Peggy Moreno, Phyllis Dohmyer, Carole Ransom, Kimberly DeLeon, JoAnn Cavanaugh, Nancy Savinski, Virginia Phillips, Christine Bentivoglio, Jill Olsson, Linda Olivet, Angela Jackson, and Eileen Franco