Jag's StoryHow it all began... In May 2011 there it was a message from my stepmom on Facebook about a little male yorkie who needed a home, all the way down in Alabama. Now, our life had somewhat normalized since 2009 and the sudden losses of two furbabies and the maybe-too-quick additions the same year. Our home was filled with life and love from Belle, a 10.5 yr old female Shih Tzu mix with special needs; Coco, a 2.5 yr old female Yorkie diagnosed with MVD; and Pickles, a 2 yr old female Yorkie with a habit of finding things to eat that she shouldn't ingest. Last thing we needed was another baby, hubby had already indicate "absolutely not" on a few occasions.  

My best friend was going to take Jag but her daughter was 4 years old at the time and she had recently given birth to a baby boy. Jag was said to be timid around young kids, so we were approaching them taking him tentatively. May 31, 2011......I packed up and flew to Alabama with Pickles, my husband had already told me to just bring him home because of the possible issue with kids. The moment I saw Jag, I knew he couldn't stay with my friend....he had to come home with me. He just wasn't a healthy little boy. He was severely malnourished.  I loaded him into the rental car with Pickles and me and headed back to my friend's house where we were staying. We weren't 5 minutes down the road and he was vomiting. It was his nerves, right? Being in the carrier, with Pickles?  

For 45+ mins that first night I sat on the front porch cutting mats off of him since the groomer was closed the day I got him. Some boiled chicken and rice for a few days and all seemed well.

Fast forward to our departure day...packed up the car, ready to head to the airport, put Jag & Pickles in the carrier and he vomits on the way to the door. I called my vet back in NJ, spoke to a local vet in Alabama, took him in....got fluids, an injectable and off to the airport. We made it back to NJ without another issue but over the course of the next 8-9 months we would struggle to stabilize and diagnose Jag. Some weeks would be constant, daily vomiting....then 2-6 weeks of no issues.....then the cycle would start again.

We did routine bloodwork, and foolish me didn't then realize the blood panel would be normal and he could still have abnormal BATs.  I had to fight to get Coco's MVD diagnosis because her routine bloodwork and urinalysis were normal, my regular vet finally biopsied her liver while spaying her to get her diagnosis started. So back to Jag, he started Pepcid daily and we became regulars at the vet's office. My vet shared her after-hours contact info for me to reach her if I was concerned and considering heading to the emergency vet, made sure I could give sub-q fluids at home, and set me up a small pharmacy for emergency situations. I would text her an issue, she names off various meds, I confirm which I have on hand, we treat over night and I see her the next morning. Insane, no?

Fast forward to the end of January 2012, I'm cleaning vomit up and I call my husband "what did he eat last night, what kind of protein?" It was a can of Merrick that contained buffalo. I remembered he had had venison the week before when he was so sick. For the love of humanity, could he possibly have liver disease after all? Beating myself up horribly at this point, HOW DID THIS ESCAPE ME! I called my vet and she went to her office that night to check his file and she couldn't believe we never did a BAT. We got him better again and took him in three days later for a BAT. Sure enough, his BATs came back with a pre-prandial of 96 and a post-prandial of 89.3. She felt he had MVD, I felt he had a shunt because a majority of the time all of my furkids were following Coco's diet for MVD. I asked for a liver biopsy, to add denamarin, lactulose, began a treatment of metronidazole and strictly liver friendly diet. With those BAT results I called the University of Tennessee and scheduled an appointment when Dr. Tobias.  We needed to secure funds for the evaluation and possible surgery. We proceeded with the biopsy and my vet recommended biopsies of the stomach and intestines as well to cover all bases, I agreed.  

The results diagnosed Jag with helicobacter infection in his stomach and suggested a liver shunt. The appt at UT was a definite. Paperwork was completed, faxed and a copy picked up to have on hand. The helicobacter infection was treated and the vomiting began to subside. April 16th, I packed up, gathered Jag & Pickles and began my 11+ hour drive to UT,  Jag's appointment was Tuesday morning, April 17th @ 9:30am. We arrived at UT and met with our student, Whitney...she took a very thorough history. She was awesome! She left the room and returned with Dr. Tobias and Dr. Raj (her actual last name is longer) and we discussed Jag some more. The initial thought for Drs. Tobias & Raj was that Jag had MVD, clinically it didn't appear to be a shunt and of course a shunt and MVD show up quite similar on biopsy.. They would run the diagnostic tests and we would take it from there. During our discussions, both Dr. Tobias & Dr. Raj complimented how diligent my local vet had been and were especially pleased she had biopsied the stomach and intestines as well as the liver and treated the helciobacter infection prior to our arrival. A few hours later Dr. Tobias called and surprisingly Jag did have a shunt, they would do his surgery the next day.   

I went back to see him and complete paperwork and all was set.  I was an emotional mess! How much more could he or I tolerate?  One of my favorite things at UT was Whitney would take Jag from the room before I left so it didn't appear I was leaving him. They also never rushed me out.  Both of these gestures were so appreciated. With nothing more I could do there, and not being able to see him until the day after his surgery, I headed to my hometown in Alabama to see my great grandmother. Early Thursday morning I was on my way back to Knoxville, a 4.5 hour drive. I had stopped for fuel and received a call, it was Dr. Headrick. Whitney thought she had noticed a very faint crackle in Jag's lungs during morning rotations, he checked and didn't initially hear it and then the ICU nurse later called him to check Jag, mentioning she had been monitoring & heard something as well...Jag had also developed a low grade fever. An X-ray indicated that my sweet little guy had developed aspiration pneumonia, THANKFULLY due to the diligence of Whitney and the ICU nurses this issue was caught early and treated aggressively. Although he wasn't eating very well, they released him to me Friday evening...the thought was he may eat better for me. That wasn't the case.  Although I had been warned that he would likely have some regurgitation, I wasn't expecting it to actually occur but that night, he regurgitated once. Jag then regurgitated several times throughout Saturday, by that night it seemed to be getting much worse.  

I had called UT so much that week, especially the last 25 hours....luckily Dr. Raj was on rotation covering clinic that weekend. I took Jag over around 9:30...he wasn't eating as we'll as he had initially when I brought him to the room and I was worried he would dehydrate.  Dr. Raj gave me the option to bring him back to my room or re-admit him, to quote her "neither option was unreasonable". As I sobbed in the exam room, I decided to leave him there. Their aftercare is one of the most valuable resources they offer and I would never forgive myself if I took him back to the room and he continued to decline. They gave him fluids and treated the esophagitis he was experiencing from ventilation during. I  picked him up Sunday evening, with a pill to crush and coat his esophagus and stomach. There was also a medication that I was to continue for nausea, in addition to the other meds he had initially been discharged with.  

He ate that night and again Monday morning. I was still a bit too nervous to leave so I decided to stay another day so he was on the rebound a full 24 hours plus before embarking on our road trip back to NJ. We got home, uneventfully, Tuesday evening around 8:30pm. All went well until Saturday, May 5th....17 days post op and we had an episode of vomiting. My vet took X-rays, called the on-call vet at UT, sent them the X-rays, treated for vomiting and sent us home. All still looked good. I contacted Dr. Tobias the following Monday for her opinion, she agreed all looked normal. Jag's first set of bloodwork came back all within normal limits except for his post-BAT.  

I should mention his BATs in UT were significantly higher than our first ones in January-pre was 162, post 347 I believe. His newest numbers are pre at 3, post at 32. He is due soon for another check. I consulted the nutritionist at UT and have a white fish diet formulated for my furkids. They get veggies, fruits, and very select manufactured treats. We use a vegetarian dry kibble. They all receive supplements, especially Denamarin chewables. What a blessing to have been able to take Jag to UT. He has gone from a malnourished 2 pounds 6 ounces in June 2011, to 3 lbs 13 oz in November 2011, to 4 lbs 3 oz in February 2012, to 4 lbs 10 oz in April 2012, to an impressive 5 lbs 7 oz in September 2012. Also, as Dr. Tobias suggested it would, his coat has turned to a typical steel blue color instead of the "rare silverback" coloring he was.  I did not realize the abnormal coat coloring was another indication of liver disease. My only regret is that I wasn't a part of the Liver Shunt and MVD Support Group on Yahoo prior to me taking Jag to UT! Thank you for allowing me to share our experience, hopeful this will help others.

God Bless, Christie, Jag, Coco, Pickles, & Belle in NJ