OneAndOneIs2

The puppy is home again, and you'd think from the way she's bouncing around that nothing was wrong with her.

Sadly, there is.

We finally got a diagnosis. Nothing to do with bumping her head, she had the weird behaviour and sudden seizures as a result of hepatic encephalopathy - a buildup of toxins that should have been removed by the liver instead stuck around and caused problems.

The good news is, her liver is fine. The bad news is, it's being bypassed: All foetuses bypass their own livers before they're born - their blood is kept clear by their mother - by having a big blood vessel in place. That vessel is supposed to close sometime near birth, forcing the blood to go through the liver properly. Sometimes it doesn't, it stays in place - it's known as a porto-systemic shunt.

This basically means that our little puppy's blood doesn't get cleaned by her liver very well, because a lot of it just doesn't go THROUGH her liver.

The main cause of toxins comes from bacteria in the gut, which we solve by having her eat a VERY sticky syrup of lactulose, which she's actually rather fond of; and protein breakdown. Here things get more awkward - puppies need protein to grow, but she can't have too much or it'll build up as toxins in her blood that'll kill her.

So we need to keep her on a (relatively) low-protein diet and keep her gut bacteria down, and that should eliminate most of the toxin buildup and keep her fairly healthy. And indeed, she's full of energy and very much her old self so far.

But it's not a good long-term solution - what she really needs is to undergo surgery to close the rogue blood vessel. Only two problems there - it's fairly major surgery, which means it's inherently risky; and it's very expensive - several thousand more than her insurance will cover.

And several thousand more than we currently have available ourselves.

So at the moment, her diet is keeping her pretty healthy, but she's not better and won't be until/unless she undergoes surgery that we can't pay for and she might not survive. Even if we find the money, it'll be at least a month before her toxin level is low enough that she can be safely put under anaesthetic.

So.. not really good news, I'm afraid. She thinks she's better and is being most unfairly given a really crappy new type of dog food. But she's a long way from being all better and may never be..