Page updated Saturday, April 13, 2002
Pedigree || Weight Chart || Marley || Chip
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January 1 (whelping day) January 3 (2 days old) January 6 (5 days old) January 12 (11 days old) January 17 (16 days old) January 19 (18 days old) January 25 (24 days old) |
January 28 (27 days old) February 6 (36 days old) February 10 (40 days old) February 14 (44 days old) February 17 (47 days old) February 21 (51 days old) February 23 (53 days old) |
March 2 (60 days old) March 4-8 (Ebi) March 9-10 (Ebi) March 13 (Ebi) April 13 (14 weeks old) |
At 8:00, Marley became very restless and went throughout the house as if searching for something. At 8:30 her water broke, she got back in the welping box, and strong contractions began. The first puppy, a beautifully-ridged female weighing 15 1/4 ounces, was born at 8:47 am (Uni). This puppy has white toes on all four feet and rear dew claws, single on one one foot and double on the other.
The second puppy, another ridged female weighing 11 1/4 ounces, was born at 9:50 (Ebi), followed by a ridgeless female weighing 13 3/4 ounces at 10:02 (Unagi). The ridged female has white toes on all four feet, a large white chest patch, and no rear dew claws. The ridgeless female has no white feet, a small white chest patch, and rear dew claws, single on one foot and double on the other.
At 10:17 the fourth puppy was born, a ridged male weighing in at a whopping 17 3/4 ounces (Maguro). This boy has a nice ridge, very little or no white, and no rear dew claws. At 10:50, Marley delivered a perfectly-formed, 13-ounce, stillborn female. This puppy had rear dew claws on both feet and a perfect ridge. She was still pink at birth, but would not breath, even when given mouth-to-mouth CPR. At 11:52, the sixth puppy, a 16-ounce ridged male, was born (Himachi). This puppy has minimal white and no rear dew claws.
A seventh puppy came at 2:00 pm. This puppy, a 13-ounce ridged female, was stillborn.
On Tuesday morning, February 12, Ebi vomited her breakfast and was clearly in distress. For the first time, she was lethargic and seemed to be having trouble breathing easily. We took her to the vet, who did x-rays and an ultrasound examination. The diagnosis was that she had a diaphragmic herina and that some of her digestive organs, which should be in the abdominal cavity, were instead in the chest cavity. They also found that she had aspiration pnenomia.
Early Wednesday morning, we dropped Ebi off at Bishop Ranch Veterinary Clinic. At about 1 pm, Dr. Pogrel performed surgery to repair the problem. The surgery was successful. When he opened her up, Dr. Pogrel found that she had a large hiatal hernia. For those who don't know, there is an opening in the diaphragm through which the esophagus passes to get to the stomach. Sometimes this opening is enlarged and not fully attached to the esophagus. This is not uncommon in humans--I have a hiatal hernia myself. This is the main cause for the condition called "GERD", which stands for gastric reflux disease, and is the reason we have Zantac and Prilosec and other drugs like that.
Anyway, in Ebi the opening was about four times as big as it is supposed to be and obviously not fully attached to the esophagus. At some point, her entire stomach, spleen and some of her intestines had slipped through the hernia above the diaphragm. This is why she had her periodic bouts of vomiting since she started eating from a bowl. She worsened on Monday-Tuesday apparently because she contracted aspiration pneumonia.
To repair the problem, Dr. Pogrel pulled the organs from the chest cavity through the hernia back down into the abdominal cavity, stitched the hernia closed and tacked the diaphragm to the esophagus. He also tacked the stomach to the inside of her abdominal cavity (this is the same procedure that is used to repair damage done when a dog has bloat).
When we talked to the clinic last night she was resting comfortably and had even eaten a little of their high-potency diet food. They have her on an IV so that they can administer antibiotics and keep her sedated. She stayed there overnight and will be there until at least the end of today. We may bring her home tonight or she may stay one more night--we will know this afternoon.
After she comes home, we have to keep her separated from the other puppies for two weeks so that the incisions and repaired tissues can fully heal. This means early crate training and she will obviously get to sleep in our room at night and not out in the kennel. During the day, we plan for her to have her own kennel run, adjoining the one the other puppies are in. That way she will have company but not be subject to rough and tumble puppy play.
For the time being, she gets 1/4 pepcid two times a day, banana-flavored liquid clavamox two times a day, and cherry-flavored stuff to coat her esophogas and reduce inflammation three times a day. She absolutely adores the cherry stuff and detests the banana stuff.
We have to give her lots of small meals until she gets control of the regurtitation. We also elevate her food and water bowls and hold her upright for 15 minutes after each meal. We are feeding her five times a day, each time with 1/4 cup goats milk formula mixed with two tbs of ground kibble. She manages to keep this down. During the first day we tried a stiffer brew that had more kibble and also some rice cereal, but she regurtitated this in two of her five meals. Today, with the leaner, 'more runny' mixture, she has only regurgitated a very little in one of her four meals.
A week ago today, Ebi weighed 8 pounds, the same as her sister Uni. On Wednesday morning before I took her to the hospital for her surgery, she weighed 7 1/2 pounds. Yesterday she weighed 8 1/4 and today she weighs 8 1/2. So she is gaining weight again, and at a good rate. However, she has lost a week on the litter. Little Uni, who was the same weight as Ebi only seven days ago, now outweighs her by two pounds! You can clearly see the difference when we put Ebi with the other pups. It is turning out that her name is appropriate, since Ebi is the sushi name for 'little shrimp'.
Her illness and major surgery has not interfered with her zest for life. We put her with the other puppies for short periods each day so that she can get the benefit of the social interaction. It is clear that she has missed something being away from them for the last week--whereas they have taught each other some 'limits,' little Ebi is a fearless little viper in puppy play. She pounces on the males, who out-weigh her by four pounds, with reckless abandon. What she lacks in size, she makes up in braveness.
They had lots of visitors today. David and Greg came in the morning and made them run up and down for the video camera. Then Chris and Michele came at 1 and made them do it all over again. Then Pamela, Shauna, Pamela's mom Diana, and Jeanne Hayes came at 3 and the pups had another romp in the yard and then in the family room.
However, she was still a very happy puppy, growing legs and ears like she should be at 9 weeks, but she could not keep enough food down. As a result, she only weighed 12 pounds on Saturday, whereas Maguro weighed 20. On the basis of reading about megaesophagus on various websites, I asked our vet on Saturday to give us a medication called Propulsid, which stimulates the contractile muscles of the esophagus and aids in swallowing. It is used for humans who lose the ability to swallow effectively. These are little chewable tablets that we cut into thirds and give just before each meal. Dr. Delano suggested that we try feeding her by rolling canned puppy growth food into little balls and have her stand with her paws on our legs while popping them, one at a time, into her mouth. We then cradle her in an upright position for at least 15 minutes after feeding. We tried this but found the canned food to be too brittle, so the little meatballs didn't stay together. As a result, she would dive for the floor to retrieve the crumbs, often initiating an episode of regurgitation.
So we invented 'puppy esophagus cookies'. We mix the contents of the can of food with two eggs, then make little 'cookies' which we bake at 350 degrees for about 20 minutes. This dries it out somewhat and leaves a crust on the outside but still moist inside. We feed her standing up and she eats the cookies heartily. (This was an interesting way to initiate our brand new Dacor convection oven).
This seemed to work from the point of view of keeping the food down, but she still was not gaining weight--on Monday she only weighed 11 3/4 pounds. At this point we were keeping her with her brother Maguro, and we discovered that she was having fits of vomiting and/or regurgitation between meals. Since he would help her eat up the barf, and since he is lots bigger, she was not actually getting very much of what we were so painfully managing to get into her with the esophagus cookies. We also noticed that she would often eat, then go drink a lot of water and then regurgitate several times. On these occasions, the barf was so diluted that she could not even eat much of it back up (and it made a heck of a mess to clean up!)
So we changed our routine in several ways. First, we keep her separated from Maguro except for sessions of supervised play time. Second, we do not give her water until an hour after eating and then we are very conservative about how much we put in her pan. Third, we have upped the number of eggs in the esophagus cookie recipe (now we use five eggs for two cans of puppy food). Finally, we hold her upright after eating for longer than 15 minutes if possible (last night I cradled her for an hour and a half while I watched a TV show).
This seems to be working. She has retained most of what she has been fed for the last 48 hours and is gaining weight again. This morning (Friday) she was back up to 12 3/4 pounds. She is looking less and less like a Biafra dog and more like a normal puppy. She still regurgitates, but has not had any of the violent episodes that we witnessed before we got this routine down. It remains to be seen how this will all come out. Clearly, this maintenance is not something to which anyone would look forward for the entire lifetime of a dog. Our hope is that, by nursing her through the next few weeks, her esophagus will heal and become stronger and that she will 'grow into it'. Dr. Pogrel thinks there is a good chance that, as she gets bigger, the stretched esophagus will become more normal-sized, relative to her, and that her muscle tone will be restored.
I have been told by several friends that we should have had her put down when the hernia was first diagnosed at six weeks of age. However, at the time, we thought her problem was just the hernia and that this could be corrected by a relatively straightforward (albeit expensive) surgical procedure. We had the surgery done because we get very emotionally attached to these little critters, especially the ones that have problems. Now we are persevering because when we are cradling her after her meals and she looks up with those adorable big brown eyes, there is no other choice.
She is actually looking very good--not quite normal, but her coat is sleek and shiny and she us up to 13 1/2 pounds (for comparison, Maguro weighs 24 pounds). She plays actively with Maguro when we let them be together and also with the adults. She is particularly fond of Nana, our old RR x Chessie rescue dog.
The feeding routine worked really well all day Friday and Saturday. At the 2 am meal last night, she was unable to keep anything down and urped all over my sweatshirt and the kitchen floor. I don't know exactly why, but it may just have been that she ate a whole lot in her three Saturday feedings and her stomach was just not ready for more food yet. However, she had a pretty normal Sunday morning meal and went right to sleep for her nap. We are going to skip the night meal from now own and just feed her three times a day for the next week.
All in all, I would say things are looking up. In several of her meals over the last two days, it seemed that the food was all being swallowed pretty much normally. Maybe our hope that she will 'grow into' her esophagus will come to pass.
It had become clear that this was a losing battle--Ebi was never going to be able to have the life of a normal puppy--so we took her to our vet this evening had her put to sleep. It was a really hard thing to do--she was such a sweet puppy and we had tried so hard to save her. But it was the right thing to do.
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