| Maggie Mae Liver Shunt Yorkie (MVD) |
| The story of Maggie Mae will be written below as it unfolds, with pictures and updates often. |
| A heart felt thank you to the folks who have helped us to be able to help this special little girl is written below. These are the names of some wonderful and generous people who will alway have a big chunk of my heart and my gratitude forever. Bobbie |
I got a call from a man who said that he had a Yorkshire Terrier that he wanted to
surrender to our rescue. He said she was only about 3 years old and they had
found her last year lying beside the road. He said they thought she'd been hit by a
car and they took her home to try to nurse her back to health. He told me that they
had taken her the vet, told me the name of the vet and that they just were not able
to help her, that she was not improving and thought that we might do better. He
said he told the vet he thought she'd been hit by a car and that is why she is as
she is. I said of course I'd come.
When I got there I found a little 5 pound Yorkie who could no longer walk or even
sit up. The good Samaritan said that she had indeed been walking on her own and
even going outside to potty but had begun to loose weight and could no longer
walk or even stand. So I took the little girl and thanked the man for all that he had
tried to do for her and was about to leave... He said, "Wait! I have her food." and
he handed me canned puppy food for her. I thanked him again and left with little
Maggie Mae. I could tell she was a very sick girl.
surrender to our rescue. He said she was only about 3 years old and they had
found her last year lying beside the road. He said they thought she'd been hit by a
car and they took her home to try to nurse her back to health. He told me that they
had taken her the vet, told me the name of the vet and that they just were not able
to help her, that she was not improving and thought that we might do better. He
said he told the vet he thought she'd been hit by a car and that is why she is as
she is. I said of course I'd come.
When I got there I found a little 5 pound Yorkie who could no longer walk or even
sit up. The good Samaritan said that she had indeed been walking on her own and
even going outside to potty but had begun to loose weight and could no longer
walk or even stand. So I took the little girl and thanked the man for all that he had
tried to do for her and was about to leave... He said, "Wait! I have her food." and
he handed me canned puppy food for her. I thanked him again and left with little
Maggie Mae. I could tell she was a very sick girl.
| At the Vet... |
| Maggie and I meet... |
I called the vet he mentioned and we talked. She told me that this dog would have
to be fed with a syringe and would be this way all her life. I asked if what I was
seeing was seizures. She said no, that it was brain damage from being hit by a
car. I pondered this for a bit. I looked at Maggie and I could tell that if this tiny
creature had been hit by a car then she would be dead. If she were hit by a
bicycle she'd be dead. I sought a second opinion.... and tests.
I went to a different vet and asked for a complete blood work up and bile acid tests
to see if anything could be found. He came out and said it looks like Liver Shunt. I
got copies of the tests and went home with Maggie, some meds and special dog
food. He said it would help and to let him know if we needed a referral to the
University of Tennessee where they do excellent work with liver shunt dogs.
The tests from these two vets seemed to be at odds with one another so off I went
to a third vet. This vet took blood work and did a complete panel and sent it the
University of Kentucky lab for analysis. This work also confirmed liver disease. It
was at this point I asked for the referral to the Veterinary Internist.
I also joined a wonderful group called Liver shunt and MVD Support. This is where
my education really began. This is a group of individuals who all live with liver
shunt dogs and the University of Tn also posts to this group as well. There is
much information and all kinds of files with explanations about Liver Shunt, MVD
and the neurological problems brought on by them.
to be fed with a syringe and would be this way all her life. I asked if what I was
seeing was seizures. She said no, that it was brain damage from being hit by a
car. I pondered this for a bit. I looked at Maggie and I could tell that if this tiny
creature had been hit by a car then she would be dead. If she were hit by a
bicycle she'd be dead. I sought a second opinion.... and tests.
I went to a different vet and asked for a complete blood work up and bile acid tests
to see if anything could be found. He came out and said it looks like Liver Shunt. I
got copies of the tests and went home with Maggie, some meds and special dog
food. He said it would help and to let him know if we needed a referral to the
University of Tennessee where they do excellent work with liver shunt dogs.
The tests from these two vets seemed to be at odds with one another so off I went
to a third vet. This vet took blood work and did a complete panel and sent it the
University of Kentucky lab for analysis. This work also confirmed liver disease. It
was at this point I asked for the referral to the Veterinary Internist.
I also joined a wonderful group called Liver shunt and MVD Support. This is where
my education really began. This is a group of individuals who all live with liver
shunt dogs and the University of Tn also posts to this group as well. There is
much information and all kinds of files with explanations about Liver Shunt, MVD
and the neurological problems brought on by them.
| One of the words I learned was Hepatic encephalopathy. Click the words to read about this condition. |
What follows is the summary from our visit with Dr. Radhakrishnan, Veterinary
Internal Medicine today. I will copy directly from his report.
Maggie
Diagnosis: Suspect Primary Liver disease including microvascular dysplasia
(extrahepatic shunt unlikely): also suspicious of permanent brain
disease/problems.
Medications: Continue lactulose and neomycin as prescribed, reduce
metronidazole (250mg) 1/4 pill 3 times a day to 1/4 once daily
Next appointment: as needed and call back in 1 to 2 weeks
Ultrasound was performed and the liver is near normal size with increased
echogenicity. They was a lot of gas making visualization of the blood vessels
difficult however I do not expect that there is an extrahepatic shunt since the liver
is near normal size and no shunt was seen. MVD or primary liver disease is still of
concern. A liver biopsy is technically necessary. I do not think it is a good idea to
pursue this because there may very likely be permanent rain disease because of
the seizures and the head trauma she suffered prior to your adopting her.
I recommend reducing the metronidazole in case metronidazole toxicity is
contributing the neurologic problems. If after aggressive medical therapy we are
unable to see neurologic improvement, then I think it is unlikely she can ever be
any better and euthanasia may need to be considered as a better option. The
goal of any of our tests and treatment will be to improve quality of life.
Please call us with an update to let us know how she responds the lower dose of
metronidazole and if you wish to pursue more aggressive therapy in hospital.
Thank you for bringing Maggie in. We appreciate the opportunity to participate in
her care. Please call us if you have any questions.
Sincerely,
Antu Radhakrishnan, DVM
Diplomate, American College of Veterinary Internal Medicine
That is copied from his letter to me as a summary of today's tests and
observations and exams.
Here are the blood work results:
Bun 7 mg/dl should be 10.00 - 28.00
Albumin 2.50 mg/dl should be 3.10 - 4.30
Glucose 61.00 mg/dl should be 65.00 -130.00
Creatinine 0.3 mg/dl should be 040 - 0.70
Anyway, this is what the Internist had to say and what he did and the results we
got. Maggie is MVD and brain damaged. We will try as soon as we have the
money to have her stay the two nights. It will be over $1000. I'm am praying.
If it is found she cannot be improved I know she can not continue this way. These
swings and seizures are very hard on us both. She gives me so much hope
though when she is "here" with me. When she is quiet and wants to be held. I
have soft sides around her but she still manages to bang her head. I just don't
know yet what to do.
Internal Medicine today. I will copy directly from his report.
Maggie
Diagnosis: Suspect Primary Liver disease including microvascular dysplasia
(extrahepatic shunt unlikely): also suspicious of permanent brain
disease/problems.
Medications: Continue lactulose and neomycin as prescribed, reduce
metronidazole (250mg) 1/4 pill 3 times a day to 1/4 once daily
Next appointment: as needed and call back in 1 to 2 weeks
Ultrasound was performed and the liver is near normal size with increased
echogenicity. They was a lot of gas making visualization of the blood vessels
difficult however I do not expect that there is an extrahepatic shunt since the liver
is near normal size and no shunt was seen. MVD or primary liver disease is still of
concern. A liver biopsy is technically necessary. I do not think it is a good idea to
pursue this because there may very likely be permanent rain disease because of
the seizures and the head trauma she suffered prior to your adopting her.
I recommend reducing the metronidazole in case metronidazole toxicity is
contributing the neurologic problems. If after aggressive medical therapy we are
unable to see neurologic improvement, then I think it is unlikely she can ever be
any better and euthanasia may need to be considered as a better option. The
goal of any of our tests and treatment will be to improve quality of life.
Please call us with an update to let us know how she responds the lower dose of
metronidazole and if you wish to pursue more aggressive therapy in hospital.
Thank you for bringing Maggie in. We appreciate the opportunity to participate in
her care. Please call us if you have any questions.
Sincerely,
Antu Radhakrishnan, DVM
Diplomate, American College of Veterinary Internal Medicine
That is copied from his letter to me as a summary of today's tests and
observations and exams.
Here are the blood work results:
Bun 7 mg/dl should be 10.00 - 28.00
Albumin 2.50 mg/dl should be 3.10 - 4.30
Glucose 61.00 mg/dl should be 65.00 -130.00
Creatinine 0.3 mg/dl should be 040 - 0.70
Anyway, this is what the Internist had to say and what he did and the results we
got. Maggie is MVD and brain damaged. We will try as soon as we have the
money to have her stay the two nights. It will be over $1000. I'm am praying.
If it is found she cannot be improved I know she can not continue this way. These
swings and seizures are very hard on us both. She gives me so much hope
though when she is "here" with me. When she is quiet and wants to be held. I
have soft sides around her but she still manages to bang her head. I just don't
know yet what to do.
| At the Internist visit.... |
| Donations are gratefully accepted and appreciated more than I can say. Please click the donation button below to help this tiny girl get the medical help she so badly needs. |
| Maggie's Angels |
| The following people have contributed to the care of Maggie. I am forever thankful for Maggie's Angels. |
| Sybil Gates Karen Prince Olga F. Sam Press Grant Mobray, Higgins and Lauren Rebecca Morriss Sandra Klyn Margy Feigelson Sheree Moore Myrna Childress Odean Cusack Lisa Wallace Kathryn Alexander Cheryl Castaner |
| Maggie's next visit at the Veterinary Internist is scheduled for May 5, 2008, I will update more at that time. |
Maggie was admitted to the Bluegrass Veterinary Specialists Clinic in Lexington on
May 5, 2008. She had a neurological work up and CT.
As promised I just talked with Dr. Antu Radhakrishnan and he had some results
back from blood work and the CT. Here goes...
Maggie has Hydrocephalus. But they said it is minor so it is not contributing but
maybe 10% to her problem. She also has a very deep ear infection and between
the two it is only contributing a total of 20% to her problem. She has liver disease
though as well and he wants to do the liver biopsy on Thursday if they have an
appointment time on that day. This means she will stay until then and come home
afterwards. If they don't have time to schedule her on Thursday then she will come
home and hopefully we can take her back for the surgery. He told me that if the
biopsy doesn't show the MVD he suspects then we won't be able to help her at all.
He does think she has the MVD and that it treatable as are the other conditions.
We are both encouraged because she has improved so much since he saw her
two weeks ago.
He is also checking to see if she has bladder stones because of the discoloration
of her urine etc. But he says she is doing well.
So between now and Friday I guess it is in air still. No wonder the poor little girl was
nearly dead when she came. Please pray we can help her have a good quality of
life and that we can help her.
May 5, 2008. She had a neurological work up and CT.
As promised I just talked with Dr. Antu Radhakrishnan and he had some results
back from blood work and the CT. Here goes...
Maggie has Hydrocephalus. But they said it is minor so it is not contributing but
maybe 10% to her problem. She also has a very deep ear infection and between
the two it is only contributing a total of 20% to her problem. She has liver disease
though as well and he wants to do the liver biopsy on Thursday if they have an
appointment time on that day. This means she will stay until then and come home
afterwards. If they don't have time to schedule her on Thursday then she will come
home and hopefully we can take her back for the surgery. He told me that if the
biopsy doesn't show the MVD he suspects then we won't be able to help her at all.
He does think she has the MVD and that it treatable as are the other conditions.
We are both encouraged because she has improved so much since he saw her
two weeks ago.
He is also checking to see if she has bladder stones because of the discoloration
of her urine etc. But he says she is doing well.
So between now and Friday I guess it is in air still. No wonder the poor little girl was
nearly dead when she came. Please pray we can help her have a good quality of
life and that we can help her.
| May 6 update |
| Pictured here is Maggie Mae exhibiting the tremors. She only does this when she is trying to do something. If asleep or just lying down she doesn't have them. |
Maggie the morning of May 7, 2008
I just talked with the hospital and Maggie is having her biopsy at 10 am and then I
will get a call from Dr. Radahkrishnan. He will then give me a report of his findings.
The actual results of the biopsy won't be back for 5 to 7 days.
Karen, with whom I spoke this morning, said he will be looking at all things in her
abdomen which will include the bladder to check for stones. He is going to call me
after the procedure is done and we will talk at that time.
So I am carrying the phone in my pocket as I do my work today. I will immediately let
you know what he says.
I am discouraged as she is losing weight. She simply can not continue to lose weight
as her body can't take it. But I have to remember that they are feeding only 3 times
a day and I feed 6 times a day as per discussion on the list about this particular
thing. It is going to be a long ride for this girl getting back to the best health she can
achieve and mantain. Prayers are still very much needed for her.
Thank you again for all your help and support.
Bobbie still without Maggie
Nancy KY
I just talked with the hospital and Maggie is having her biopsy at 10 am and then I
will get a call from Dr. Radahkrishnan. He will then give me a report of his findings.
The actual results of the biopsy won't be back for 5 to 7 days.
Karen, with whom I spoke this morning, said he will be looking at all things in her
abdomen which will include the bladder to check for stones. He is going to call me
after the procedure is done and we will talk at that time.
So I am carrying the phone in my pocket as I do my work today. I will immediately let
you know what he says.
I am discouraged as she is losing weight. She simply can not continue to lose weight
as her body can't take it. But I have to remember that they are feeding only 3 times
a day and I feed 6 times a day as per discussion on the list about this particular
thing. It is going to be a long ride for this girl getting back to the best health she can
achieve and mantain. Prayers are still very much needed for her.
Thank you again for all your help and support.
Bobbie still without Maggie
Nancy KY
Maggie's test results came back and it is very sad news for this tiny angel. She has
liver disease, brain damage, infections that we just can't get ahead of because she
is too weak to fight any more. She is now blind and she only sleeps or thrashes
about. I hold her and feed her and try to comfort her. She can't see me any more
but she does try to find my voice. She is now sleeping in a large tub because she
flails about and her legs get caught in the bars of the crate that she can not see.
The bruises tell me it happens now even when she sleeps. I padded the crate but
when she flails she can work her way over the top and still catches her legs. She
also hits her head when she does all this.
Too much for such a tiny body to fight... She has fought. She continues to lose
weight no matter how much she eats. She can only potty now with enemas and she
has absolutely no more quality of life at all. It is time to let her go to the bridge.
Maggie has touched many lives. The prayers and support for her has been
wonderful. As she traveled this path she has not been alone. She has been and is
still loved. She knows this. Thank you everyone who has helped with Maggie.
Maggie has taught me so much about fighting even when it is hopeless. I am
spending tonight and tomorrow letting her have anything she wants. I will try to let
her have treats and I will talk to her. I will let her feel the sunshine on her face, give
her a much needed bath and let her hear her song one time more. Then I will take
her to get the relief she needs. I will post more later.
Bobbie and Maggie on her last day....
liver disease, brain damage, infections that we just can't get ahead of because she
is too weak to fight any more. She is now blind and she only sleeps or thrashes
about. I hold her and feed her and try to comfort her. She can't see me any more
but she does try to find my voice. She is now sleeping in a large tub because she
flails about and her legs get caught in the bars of the crate that she can not see.
The bruises tell me it happens now even when she sleeps. I padded the crate but
when she flails she can work her way over the top and still catches her legs. She
also hits her head when she does all this.
Too much for such a tiny body to fight... She has fought. She continues to lose
weight no matter how much she eats. She can only potty now with enemas and she
has absolutely no more quality of life at all. It is time to let her go to the bridge.
Maggie has touched many lives. The prayers and support for her has been
wonderful. As she traveled this path she has not been alone. She has been and is
still loved. She knows this. Thank you everyone who has helped with Maggie.
Maggie has taught me so much about fighting even when it is hopeless. I am
spending tonight and tomorrow letting her have anything she wants. I will try to let
her have treats and I will talk to her. I will let her feel the sunshine on her face, give
her a much needed bath and let her hear her song one time more. Then I will take
her to get the relief she needs. I will post more later.
Bobbie and Maggie on her last day....
| Maggie May 15 2008 |
I got up this morning and tried to finish Maggie's burial memorial but I just can't yet. I
checked email and I have over 600 emails. I am so sorry I can not answer each one
individually. Please know I will read them all. Thank you everyone who went through
this with me for all your help and support.
For those who do not know it all I will take you on her last journey.
Maggie came to our rescue and my home almost 2 months ago. She was a sick little
girl and I had been told she had been hit by a car and the people who surrendered
her had tried to nurse her back to health. It seems they could not and when taken to
the vet by me the first thing they said was "Liver shunt". Well there was a bit more to
it than just that.
I fed her hourly at first, she did improve and I went then to every two hours. She'd
give little kisses and finally sat up on her own... she even walked a few steps. I
thought she'd come back. So she went for tests. The blood work was a mess and
did not make a whole lot of sense. She did have liver disease but it turned out to be
MVD. She was referred to an Internist and off we went for that. He wanted more
tests but she needed to be built up physically first so I took care of her as best I
could and yes, she improved. She even tried to play with a little toy and gave such
tiny little kisses. She was curious about her surroundings and I had hope for her.
The Internist said he could hardly recognize her as the same dog when I brought
her back to him for "aggressive treatment of her symptoms and tests". She stayed
there for nearly a week.
She had a CT and it showed Hydrocephalus and a deep inner ear infection. She
had a laparoscopic test on her liver and bladder. More blood work was done. I came
to pick her up and wait for results.... but I did not pick up the same improving doggie
I took there. She had an ulcerated eye now and was blind on that side. She was not
having seizures but was flailing about and just miserable. Still waited yet another
week for test results. It was not good.
Meanwhile I was taking care of her as before but she was still losing weight and kept
injuring herself no matter the padding around her. By now she had to be turned and
syringe fed, and needed enemas to poop. I continued sleeping in the recliner by her
side as she'd wake up for feeding and she'd hurt herself during the night. By now
she was blind in both eyes. She'd hear my voice and turn towards the sound and
when she would find me she'd still give little kisses. But the oddest thing happened
on Wed night. All my dogs gathered around and laid down and watched her quietly.
They were not the happy playing pack I'm used to watching and interacting with
daily. They were so quiet that I actually felt it. They stayed that way all night with me
and Maggie the center of their gentle attention.
As I said, the tests were back on Thursday. Maggie had lesions in her brain, MVD
and fibrosis in her liver, she was blind, diabetic and the list just goes on. No matter
what we did she would never be normal even with treatment if she survived the
treatment. She was also now in pain as well. My board and I talked about it and it
was decided it was time to stop. She was so weak and exhausted and didn't wake up
any more for feeding or anything but to shiver in pain. Our vet here gave her valium
to help with the flailing about and continued injury to herself. And I spent the last day
with her.
On Friday, I gave her anything she could have ever wanted to eat. She had ice
cream, puppy food (several flavors) She munched away, some food falling back out
of her mouth and I gave her all she wanted. I held her and talked to her about all the
people, especially me who loved her. I told her how many lives she had touched and
how much she meant to me. I sang to her and held her until I knew she understood. I
watched her closely and she listened to me and pressed a bit closer and I knew it
was time.
AT 4:45 pm on Friday May 16, 2008 an little angel named Maggie Mae make her
journey to the bridge with the help of Dr. Patti Prather at Midway. I held her and
breathed her last breath with her. I talked softly to her and told her again how much
she was loved and told her I'd see her there when it was my time. She is now
romping the way a 3 year old should in the grass she could not play in while here.
She is pain free and her spirit can do anything her frail little body would not let her
do here. I brought her home and laid her to rest in a small arbor in front of a Oakleaf
Hydranea where she will be shaded and protected. I am looking for a plaque for her
too. She is surrounded with flowers and shaded from the sun. She is finally at rest
and where I can visit whenever I like. She will never be alone or abandoned again.
Thank you Maria for your words and giving me the strength to write of Maggie Mae's
final days. Maggie taught me so much. I got an education about Liver disease and I
think I may have really needed it to help some future other little one who can be
saved. She taught me to let go when the battle is lost. She taught me how to actually
lose the battle and know I did all that could be done... for she taught me that not all
battles can be won. She taught me patience. The only thing she gave was love... no
matter what was done to her. She is sorely missed.
checked email and I have over 600 emails. I am so sorry I can not answer each one
individually. Please know I will read them all. Thank you everyone who went through
this with me for all your help and support.
For those who do not know it all I will take you on her last journey.
Maggie came to our rescue and my home almost 2 months ago. She was a sick little
girl and I had been told she had been hit by a car and the people who surrendered
her had tried to nurse her back to health. It seems they could not and when taken to
the vet by me the first thing they said was "Liver shunt". Well there was a bit more to
it than just that.
I fed her hourly at first, she did improve and I went then to every two hours. She'd
give little kisses and finally sat up on her own... she even walked a few steps. I
thought she'd come back. So she went for tests. The blood work was a mess and
did not make a whole lot of sense. She did have liver disease but it turned out to be
MVD. She was referred to an Internist and off we went for that. He wanted more
tests but she needed to be built up physically first so I took care of her as best I
could and yes, she improved. She even tried to play with a little toy and gave such
tiny little kisses. She was curious about her surroundings and I had hope for her.
The Internist said he could hardly recognize her as the same dog when I brought
her back to him for "aggressive treatment of her symptoms and tests". She stayed
there for nearly a week.
She had a CT and it showed Hydrocephalus and a deep inner ear infection. She
had a laparoscopic test on her liver and bladder. More blood work was done. I came
to pick her up and wait for results.... but I did not pick up the same improving doggie
I took there. She had an ulcerated eye now and was blind on that side. She was not
having seizures but was flailing about and just miserable. Still waited yet another
week for test results. It was not good.
Meanwhile I was taking care of her as before but she was still losing weight and kept
injuring herself no matter the padding around her. By now she had to be turned and
syringe fed, and needed enemas to poop. I continued sleeping in the recliner by her
side as she'd wake up for feeding and she'd hurt herself during the night. By now
she was blind in both eyes. She'd hear my voice and turn towards the sound and
when she would find me she'd still give little kisses. But the oddest thing happened
on Wed night. All my dogs gathered around and laid down and watched her quietly.
They were not the happy playing pack I'm used to watching and interacting with
daily. They were so quiet that I actually felt it. They stayed that way all night with me
and Maggie the center of their gentle attention.
As I said, the tests were back on Thursday. Maggie had lesions in her brain, MVD
and fibrosis in her liver, she was blind, diabetic and the list just goes on. No matter
what we did she would never be normal even with treatment if she survived the
treatment. She was also now in pain as well. My board and I talked about it and it
was decided it was time to stop. She was so weak and exhausted and didn't wake up
any more for feeding or anything but to shiver in pain. Our vet here gave her valium
to help with the flailing about and continued injury to herself. And I spent the last day
with her.
On Friday, I gave her anything she could have ever wanted to eat. She had ice
cream, puppy food (several flavors) She munched away, some food falling back out
of her mouth and I gave her all she wanted. I held her and talked to her about all the
people, especially me who loved her. I told her how many lives she had touched and
how much she meant to me. I sang to her and held her until I knew she understood. I
watched her closely and she listened to me and pressed a bit closer and I knew it
was time.
AT 4:45 pm on Friday May 16, 2008 an little angel named Maggie Mae make her
journey to the bridge with the help of Dr. Patti Prather at Midway. I held her and
breathed her last breath with her. I talked softly to her and told her again how much
she was loved and told her I'd see her there when it was my time. She is now
romping the way a 3 year old should in the grass she could not play in while here.
She is pain free and her spirit can do anything her frail little body would not let her
do here. I brought her home and laid her to rest in a small arbor in front of a Oakleaf
Hydranea where she will be shaded and protected. I am looking for a plaque for her
too. She is surrounded with flowers and shaded from the sun. She is finally at rest
and where I can visit whenever I like. She will never be alone or abandoned again.
Thank you Maria for your words and giving me the strength to write of Maggie Mae's
final days. Maggie taught me so much. I got an education about Liver disease and I
think I may have really needed it to help some future other little one who can be
saved. She taught me to let go when the battle is lost. She taught me how to actually
lose the battle and know I did all that could be done... for she taught me that not all
battles can be won. She taught me patience. The only thing she gave was love... no
matter what was done to her. She is sorely missed.
| I am making a memorial garden for Maggie where she lies at rest. Here is the beginning.. I will add pictures as I build it. |
