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 Post subject: Arlo's World
PostPosted: Wed Jul 11, 2012 2:25 pm 
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UPDATE: Jan 5, 2014

If you are just now viewing this thread.
You can skip over the Arlo medical issues posts. (unless you want to know outcomes of on-going medical issues)

Currently
- Arlo is 2.2 years old and he (knock wood) has finally settled down.

He had ear surgery - when a young puppy.
Had his blind eye surgical correction (cataracts) at 10 months old.
Was sick on and off (stomach) and went through numerous diet changes.
And, went through a shocking amount of tests.
His medical bills to keep him alive his first year alone was over $12,000.

All that said - Guess what?
Little Arlo pulled through it all with an ADORABLE (while still as nutty as his mom's) personality.
He only grows more and more adorable.

So - if you want to gloss over the big long medical posts - Please do :)
And, just catch the posts that continue to give sweet little updates on "Arlo's World".

We'd be honored.

Love
Arlo :Parti and his mom - Leigh


___________________________________________________________________________________________________


This will be a new thread for Arlo as the initial one began dealing with his ear problems.

Most of you have since learned that Arlo has been deemed an official "Lemon" by California Lemon Law guidelines.
This means he has many medical issues - most of them hereditary or congenital.

Arlo is currently 9 months old (born 10.8.11)

Moving forward we'll talk about Arlo's new issues - "Arlo's World" as he is living it.
A constant comment we hear from all the vets is how sweet he is. And, he's such a good dog :)

Here is a link to the initial thread.
http://zimfamilycockers.com/Forums/view ... =35&t=7378
(page 2 gets into the issue of Arlo's middle ear infection - the required myringotomy and treatment plan).

My next post will pick up with today's update on Arlo.

Meet Arlo: Video link to Arlo as a younger puppy. And, below a photo at 4 months.
http://www.youtube.com/user/PacPalVetCe ... sults_main


Attachments:
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Arlo18WeeksWeb.jpg [ 144.69 KiB | Viewed 10505 times ]

_________________
Arlo (Male B/W Parti) 10.08.11
http://www.youtube.com/watch?v=_ycQNqVT5Lg


Last edited by leigh4ta on Sun Jan 05, 2014 5:16 pm, edited 2 times in total.
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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 4:46 pm 
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Today's Arlo Update. July 11, 2012

Recently Arlo was determined to have a cataract. He is now blind in his left eye and his right eye has a beginning cataract.
We have determined (today's appointment) that he does qualify for corrective surgery.

This would have been good news.. but for.

A few days ago - We awoke to find Arlo's face covered in drool and he was shaking badly.
Off to the Vet. They did blood tests and gave him anti-nausea meds along with fluids.
The next day - we did a liver enzyme test & bile acid. The results - Indication of Liver Shunts.

For those of you not aware of this problem:
A link to a web site:
http://www.natural-dog-health-remedies. ... -dogs.html

An excellent youtube video.
http://www.youtube.com/watch?v=fAh8rWFD ... e=youtu.be

Much of Arlo's trouble's throughout his young life begin to make us wonder.
The seizure after anesthesia.
The failure to gain weight for past 2 months.
The low appetite.
Why DOES he keep trying to eat paper.
The unwillingness to take walks.
The excessive sleeping.
And, now - the drooling and shaking ...

Next step - the tests to rule in or out this terrible problem.
We are going to the "best in the state" Dr Michael Broome
And, getting a Liver Scintigraphy supposedly the "gold standard" in diagnosing this issue.
Cost $495
From there - the reputed top doctor doing the cutting edge - non invasive surgery is Dr Chick Weiss.
(this is if the Shunt is internal vs external). Dr Weiss is far away - PA. But, rumor has it he visits LA to do surgery.
We don't know if this is true - but we will find out. If not. We might be taking an east coast vacation.

What has been so difficult in this journey has been the constant "cliff hanger" vet appointments.
They end with the news that Arlo might have something we HOPE he does not have.
But, we must go to further (usually expensive) tests to determine these things and the course of action.
Today's cha ching - $1,000 - We keep saying .. there goes the Juvederm Plus Injections... :)

Back to a serious note:
So far - these issue have not been life threatening - until now.

IF he does have a Liver Shunt - We will be learning all we can and doing all we can.
We live in hope that this is just one more cliff hanger with a good outcome.

Sad as we are - Arlo's World is much more challenging. And, yet he remains our dear sweet boy.

###

_________________
Arlo (Male B/W Parti) 10.08.11
http://www.youtube.com/watch?v=_ycQNqVT5Lg


Last edited by leigh4ta on Tue Oct 30, 2012 9:04 pm, edited 1 time in total.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 5:00 pm 
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This news brings me to tears for arlo and you. I can't imagine how upsetting these constant not so good reports must be. What I do know is arlo is a lucky little boy to have such a wonderful family and to loved so much

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 5:07 pm 
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I am so sorry for all these health issues that keep coming. My heart to you and Arlo. What a handsome boy. He is too young for all those issues. Prayers coming your way for health and good outcomes.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 5:13 pm 
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Oh dear, I am so very sad for all you and Arlo have been through. It's heartbreaking for everyone. I hope your appointment offers some hope and a good, solid fix of this latest problem. We'll be keeping you in our prayers. Arlo is such a beautiful dog and it just doesn't seem fair that he has all of these problems.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 5:24 pm 
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Iam so Sorry that you are having to go through this. When you fall in love with them you will do whatever it takes and no matter what price. I pray that all goes well for you and Arlo. When I saw your Arlo ,I was looking at my Izzy. I can't imaging going through the things that you are. :cry Keeping you in our prayers.


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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 5:54 pm 
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Hi Leigh,

This just breaks my heart for you and Arlo. :cry On the other hand, you know how much I :luv your little Arlo and am hoping for the best results possible. As you stated, you are doing all that you can (and even much more) and always hoping for a good outcome to whatever the problem he has at the time.

I know that you are getting the very best Doctors possible and doing all that is humanly possible for Arlo. :hp So, we can all take heart in that. I know that this is so heart wrenching for you and your Husband. You have been on that "cliff" for all too long now. But, all you can do is move forward and do everything to help your little boy. He is way too young for all these "issues".

When I think that I have more that I can handle, I just take a very deep breath and just go and put out the biggest "fire" first. Then move on to the next and the next. :love

I will be keeping you and Arlo in my thoughts, visualizations and my prayers. Keep on "truckin". You will get through this... :sun

Dawn :paw :hp

For once, I am finding myself at a total loss for words.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 6:03 pm 
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Sorry to hear all you - and Arlo - are going through. I don't know ehere in PA that doctor is or of there are places in NYC that he may come to. Check that out. If you need it you can stay with us (we're less than an hour from NYC and about 2 hours from Philly, PA). We have a fenced yard for pups and Lord knows we're pet friendly. At least you won't have to worry about finding a room (and staying in only one) and paying for that.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 6:32 pm 
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Poor little guy has had way too many challenges in such a short time. I applaud your efforts to continue doing the very best for Arlo. You are wonderful cocker parents. I will be praying for you and Arlo and all of this has a good outcome. Arlo is so adorable. It is clear to see why you want to do all that you can for him.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 7:00 pm 
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Leigh,
Reading your post really hit me hard!
I know you will do everything you can to give Arlo the best possible care and get this little guy as healthy as he can be!

Sending prayers and positive thoughts, along with a gentle hugs for all.

Thanks for the links, they were very informative.

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Waiting at the Bridge: Little Sister, Savana, Tivy, Slider, Arrow and all the others, I will always love you.


Last edited by Marianne E on Wed Jul 11, 2012 8:41 pm, edited 2 times in total.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 8:19 pm 
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Oh, No!!! Poor Arlo! Poor you! Honestly, this is all just so- sad.
That having been said, after reading the link you posted, it sounds like you may be getting close to the root cause of all of the little guy's medical difficulties. Wow.
Sending prayers and holding good thoughts.

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 Post subject: Re: Arlo's World
PostPosted: Wed Jul 11, 2012 9:54 pm 
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Hope is in our hearts...

Thanks so much everyone for your posts.

We have been having a sad family night here - and treating our Arlo with extra loving care.
(As if we could love him any more :)

I've spent the entire night searching the web for SOME shred of hope.
It is important that IF Arlo does have Liver Shunts that it be extrahepatic vs intrahepatic.

Here is what the Article said:

"Cocker Spaniels are among the breeds likely to have congenital PSVA, although the condition also can be acquired later in life due to another illness, such as hepatitis or cirrhosis. Cockers typically develop extrahepatic shunts in which the abnormal vessel is located outside the liver. This type generally involves one or two large veins and is usually easy to correct surgically. In contrast, large breeds tend to develop intrahepatic shunts, or those located inside the liver. These are more difficult to treat and may involve small, multiple veins."

Entire article below: Talks about ways to identify Liver illness sooner and type Cockers prone to get.
http://www.akcchf.org/news-events/libra ... te0707.pdf

Tonight we live in hope. :)

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 3:28 am 
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Poor baby :cry He's so young and has been through so much already. I can't imagine having to go through so many scary incidents with my pup. I will keep you, and Arlo, in my thoughts.

I love his name and his sweet little face! :hp

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 4:03 am 
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Sending prayers and hugs to you all!
:hp
Becky

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 10:28 am 
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leigh4ta wrote:
Hope is in our hearts...

Thanks so much everyone for your posts.

We have been having a sad family night here - and treating our Arlo with extra loving care.
(As if we could love him any more :)

I've spent the entire night searching the web for SOME shred of hope.
It is important that IF Arlo does have Liver Shunts that it be extrahepatic vs intrahepatic.

Here is what the Article said:

"Cocker Spaniels are among the breeds likely to have congenital PSVA, although the condition also can be acquired later in life due to another illness, such as hepatitis or cirrhosis. Cockers typically develop extrahepatic shunts in which the abnormal vessel is located outside the liver. This type generally involves one or two large veins and is usually easy to correct surgically. In contrast, large breeds tend to develop intrahepatic shunts, or those located inside the liver. These are more difficult to treat and may involve small, multiple veins."

Entire article below: Talks about ways to identify Liver illness sooner and type Cockers prone to get.
http://www.akcchf.org/news-events/libra ... te0707.pdf

Tonight we live in hope. :)


Well Leigh,

We are all standing here right behind you and sending our best wishes and prayers for Arlo.

Where there is hope, there is PROMISE! :luv :sun

Dawn :paw :hp

I am off to read that link to your info about Cocker's and Shunts. :th-up

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 10:35 am 
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Your poor precious Arlo. I would see if there are others with your experience who can give you their opinions and advice. I know that Beth F had a puppy in a fostered litter who had liver shunts and he lived successfully. I know that diet was an important factor.

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 11:33 am 
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Leigh...

I can only imagine the emotional toll that Arlo's medical issues have taken on your family. Not everyone would be able to cope with such a burden. The financial impact is immense as well. That so much has happened to this sweet little guy in his young life is heartrending!

I remember you saying that he's had behavioral issues since he was a baby....makes you wonder how long this has been brewing, and how much of an impact it was having (unbeknownst to you) on his personality.

I pray for Arlo's health as you enter this chapter of Arlo's World.

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 2:16 pm 
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Arlo is set for his tests on Monday.
We will know on Tuesday or Wednesday if he qualifies for the surgery.

If he is an excellent candidate he'll have an 85% chance of doing very well - provided he lives beyond the immediate recovery period after surgery.

If he is not a candidate - then it is medical management (which he is currently on now).

So the mantra is:
Only one shunt - extrahepatic - low fracture.

I'll address medical management once we know his test results.

Notes to a few posters:
Deborah - Not sure if Beth F is the member name Mark F? I emailed that member just in case.
Lisa R - YES! Many - if not all - of his issues now point back to this problem.

The vet reminded me today that we don't now for SURE that he has this. He just has like - 100% of the symptoms. Other liver issues could be untreatable - but he does not seem to have those kinds of symptoms.

Today he began by waking up- going potty (pooping is now critical to carry out the toxins). He then stares and sleeps - non responsive- NO desire for food or water. Then about 1 to 2 hours later. Wakes up - poops - wants to eat - then becomes maniacal. Most recently - howling and not able to stop himself. It is almost like he is on a Hallucinogenic. These are all behaviors from toxins being left in his brain.

Many people end up putting the dog down because while the dog can "live" with the medical management, he really has not much of a life. For now .. we only visit the good possibilities. We'll face the bad ones once we have those tests.

Daily- cliffhangers. Really could do without them - life is interesting enough. :)


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Arlo (Male B/W Parti) 10.08.11
http://www.youtube.com/watch?v=_ycQNqVT5Lg


Last edited by leigh4ta on Thu Jul 12, 2012 4:58 pm, edited 2 times in total.

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 2:36 pm 
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Arlo has my prayers for the very best outcome. I don't know how you handle it. I would be out of my mind. I guess it's as they say. You do as you have to do.

Is it safe to say that Arlo has always been sick, but now to the point where it is evident?

I'm sending you a PM

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 Post subject: Re: Arlo's World
PostPosted: Thu Jul 12, 2012 3:13 pm 
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Okay - no more reading your posts while at work!
Wow, I can't see thru the tears.

Bless Arlo's little heart!
More prayers coming your way, with added good thoughts and hope for some good news with the test results.
Thank you for taking the time to keep us posted.

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Louie 02/15/2002
Cooper 12/07/07
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Echo 08/10/12

Waiting at the Bridge: Little Sister, Savana, Tivy, Slider, Arrow and all the others, I will always love you.


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 Post subject: Re: Arlo's World
PostPosted: Fri Jul 13, 2012 12:27 pm 
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Arlo Update:

Some good news about the medical management for Liver Shunt treatment.

The purpose of the medical management is to keep the toxins in the colon low so that they are not absorbed into the blood stream and making the kidneys work too hard as well as the brain having the extra toxins.

Hindsight is so amazing - We look back and see how strange he always was at certain times of day. And, good at others.
We now know it was when he had a good poop - all those toxins left.

He is mentally strange when those toxins get high. And, when they were really high - he was very very sick.

Today - he is responding to the new regimen. He is not perfect - but we can see the Arlo we know and love.

Medical management is:
http://www.vet.utk.edu/clinical/sacs/shunt/faq.php
Low protein diet. Several small meals.
Royal Canin Hepatic LS 14
http://promotions.petsmart.com/landing/ ... epatic.pdf
At time of meal administer Lactulose
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000654
Lactulose helps keep the ammonia in the colon so it will leave the body and not go into blood stream.
Antibiotic - Kills the bacteria that creates ammonia.

All these things together are designed to lower the toxins that the liver would have removed from the blood.

Side note:
Dr's and and information for Liver Shunt treatment.
Dr Karen Tobias is an expert in Liver Shunt surgery and treatment - and her facility performs these surgeries frequently.
The follow up directly after surgery has many possible complications.
So, it is not just the surgeon. It is the team that takes over.
From all that I have learned - this is critical to a successful surgery.

She practices at the University of Tennessee College of Veterinary Medicine
http://www.yorkierescue.com/livershunt/ ... Tobias.pdf
http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

If we lived near this location it would be our first choice.
IF the Liver Shunt is Extrahepatic (meaning external shunt)
However if we had a dog with intrahepatic Liver Shunt who was a surgery candidate.
Then we'd seek out Dr Chick Weisse and his techniques before making making any decisions.
http://www.amcny.org/node/292
Good link about IHPSS and new technique by Dr Chick Weisse
Intrahepatic Portosystemic Shunts (IHPSS) or Liver Shunts
http://www.thorncreekbmds.org/www.thorn ... mat-08.pdf


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http://www.youtube.com/watch?v=_ycQNqVT5Lg


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 Post subject: Re: Arlo's World
PostPosted: Fri Jul 13, 2012 2:03 pm 
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Hi Leigh,

I have to give you a LOT of credit for researching Arlo's condition so thoroughly! :th-up :hp I surely can relate to all of your research to better understand what can be done for Arlo and WHO should do it. I was forced to get a "crash course" on IMHA when Moonbeam contracted that nasty disease.

Anyway, I can really tell that you HAVE done your homework and are thinking far ahead. :th-up I am hopeful that Arlo's tests Monday will come up negative for liver shunts. But if his diagnosis is positive for a shunt, I will be hoping for an external shut, a fabulous, successful surgery and recovery for your little guy! :hp

Although I did not read the entire thread you posted, I did carefully scan the info provided. The following paragraph caught my attention and made me realize why you have picked Dr. Tobias if Arlo has an internal shunt. I did pick up on the surgery using an ameroid constrictor. As I read it, this type of surgery is more successful???? Am I correct?

Quote: "What is the prognosis for dogs after ameroid constrictor placement around a shunt?
Survival rate from the surgery is over 95% for dogs with shunts treated by ameroid constrictor placement, and our long-term prognosis is better with this technique than with most other methods. Many dogs are clinically normal within 4-8 weeks after the surgery. Long term, about 85% of dogs with liver shunts closed with ameroid constrictors do well clinically. About 15% continue to have problems, probably because the tiny blood vessels inside the liver were also abnormal. Usually these dogs develop multiple acquired shunts and must be managed with a protein restricted diet and lactulose for life."

Again, preferably Arlo will not need surgery! :love But, if he does, I think that you have done all your research, totally understand his prognosis and will proceed in a manner that will be the BEST for Arlo and you. :luv

Dawn :paw

I will be watching for you further updates and your results from Monday's test.

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 Post subject: Re: Arlo's World
PostPosted: Fri Jul 13, 2012 4:54 pm 
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Reply to Dawn:

<< I did pick up on the surgery using an ameroid constrictor. As I read it, this type of surgery is more successful???? Am I correct?
Quote: "What is the prognosis for dogs after ameroid constrictor placement around a shunt?
Survival rate from the surgery is over 95% for dogs with shunts treated by ameroid constrictor placement, and our long-term prognosis is better with this technique than with most other methods. Many dogs are clinically normal within 4-8 weeks after the surgery. Long term, about 85% of dogs with liver shunts closed with ameroid constrictors do well clinically. About 15% continue to have problems, probably because the tiny blood vessels inside the liver were also abnormal. Usually these dogs develop multiple acquired shunts and must be managed with a protein restricted diet and lactulose for life.">>

The best outcome is for the Liver Shunt to be external and be able to do the surgery.
These are the dogs that have 85% recovery and can live out a long life.
The 15% that don't do well are then treated with "medical management" for their remaining life.
The constrictor you mention is the best one now - because is slowly shuts off the shunt allowing the liver to begin functioning again. The old way - full shut off resulted in death because the liver could not function.

In a way- it has just been sitting there - no working. so, it now has to wake up and go to work - and regenerate.

However, the statistics for a dog that is medical management is only 33% survival and 50% are usually euthanized within 10 months.
This is due to quality of life - or seizures. At a certain point the problem becomes Hepatic encephalopathy.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001347

For dogs with internal shunts - the surgery is much more difficult with lower survival rate.
Dr Chick Weisse does a procedure that is reported to drastically improve the survival rate.
He operates out of NYC.

If a dog has either external or internal shunts and does not qualify for the surgery - then it will be on the "medical management" for their life. Again - with not the best statistics.

For the 33% that respond well to the regimen - I have not yet learned the "typical" survival age or when and what complications one deals with along the way.

I know urethra issues and bladder stones are one.
And, seizures - along with being very sick.

If Arlo were to remain as sick as he was early this week and be considered the best that medical management could do. We feel we would not put him though that. It is no life to live.

But, as I have written earlier - So far - Arlo is responding in a GOOD way.

Today is his best yet .. he is nearly the Arlo we know.

:)
Leigh

PS- Sorry for some of the long and detailed writing. I am trying to do so in case someone who finds themselves in this boat lands here - Hopefully, they'll have some helpful information and a direction to go in.




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Arlo (Male B/W Parti) 10.08.11
http://www.youtube.com/watch?v=_ycQNqVT5Lg


Last edited by leigh4ta on Sun Jul 15, 2012 9:47 pm, edited 1 time in total.

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 Post subject: Re: Arlo's World
PostPosted: Fri Jul 13, 2012 5:22 pm 
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Location: Los Angeles, Ca
Video of Arlo today doing well on "medical management".

Encouraging moments :)

http://www.youtube.com/watch?v=nV3Nb4EjD9Q&feature=plcp

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Arlo (Male B/W Parti) 10.08.11
http://www.youtube.com/watch?v=_ycQNqVT5Lg


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 Post subject: Re: Arlo's World
PostPosted: Fri Jul 13, 2012 5:34 pm 
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That is just awesome!!!!! :th-up . Hope that each day just gets better and better.
Keeping you and Arlo in our prayers.

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Izzy- born Dec,11,2009
Gotcha day Feb 15 2010
Abby - rainbow bridge Feb 16,2010 forever loved


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