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Jetty's story begins when he was born on February 18, 2010. My fiancé Ryan and I live in Massachusetts and purchased our puppy on May 2, 2010 from a pet store in Danvers, MA. When we saw the black lab puppy sleeping soundly in his cage, something tugged at my heartstrings. We asked to take the puppy out to play and after spending fifteen minutes with him we were in love. We left the store but returned ten minutes later, signed on the line, stocked up on every toy imaginable, and were handed the most adorable ball of fur swaddled tightly in a blanket to take home with us. This is how our family begun.

Looking back on it now, I truly believe that something led Ryan and I into that store that day. I think we were meant to find Jetty, to become his caretakers, because as we were soon to find out, he was certainly unable to care for himself.

We brought Jetty home with an excitement like no other and couldn't wait to show him off to our family and friends. We made many visits that day and everyone fell in love with Jetty. He was the sweetest, cutest, most well-behaved puppy that anyone had ever seen. He loved to give kisses and had no objection to just cuddling up in your arms. Once we got him back to his permanent home that night, we almost couldn't believe our luck. By a stroke of luck, we had ended up with a puppy that didn't bark, wasn't crazy and wild, didn't chew everything to bits, was content to sleep for hours on end, and just loved being loved. Perfect, right? But, just like in the pet store earlier, something tugged at my heartstrings.

The days went on, and we started noticing some of Jetty's `quirks'. He still hadn't barked, and was the quietest puppy we'd ever known of. He discovered his favorite sleeping spot on a body pillow in the corner of his room and would curl up there for hours on end. When he did get quick spurts of energy, he's always end up back on that pillow moments later. He had little interest in all his appealing toys and seemed so tired. He appeared shy, reserved, and would sit and blankly stare at walls. He seemed unsteady when he sat and would often sway from side to side. We chalked it up to him being so young and still not used to his surroundings. "Once he gets comfortable here he'll open up and become the puppy we know he is", we'd say. After all, he'd had two initial vet visits already and passed with flying colors… there couldn't possibly be anything wrong. Again, that tug at my heartstrings.

The days wore on and we brought Jetty to a bunch of family cookouts. Jetty would greet everyone but then revert to his shy self and spend most of the time sleeping or sitting quietly in a corner. "Something's wrong with that puppy" we'd hear from our closest family members, "He seems sick, He looks so sad". We'd balk at their assumptions, try to ignore their comments. He'd been to the vet three times now with not a thing out of place! He was the love of our lives; there couldn't possibly be anything wrong. What were we missing that everyone else could see? Tug, tug, tug.

That very night, around 2 AM, Jetty had to be rushed to the 24/7 Animal Hospital. He was clinging to the side of his crate, unable to yelp, unable to walk, and foaming furiously from the mouth. He was pressing his head to the floor with his rear end up in the air. He was on the verge of a seizure, and as we would come to find out, the brink of death. Something was very, very wrong with our beloved "Jetty Bear". The emergency veterinarians rushed him to the back of the hospital immediately while we were hit with a $1300 bill at the front desk for all the testing to find out what was causing Jetty's illness. They needed to keep him overnight, they said, and would call us with any updates. It could be a myriad of different problems ranging from poisoning to a severe neurological problem and everything in between. Extensive testing was the only way to find out, along with several consults from veterinarians specializing in neurology and internal medicine.

Hesitant to leave, we were reassured that there was nothing else we could do, and it was all in their hands now. We were terrified. As they carted Jetty off, his blue bone-shaped nametag showing perfectly over the nurse's shoulder, he looked at us with those sad eyes as the door closed behind them. My heart broke in a thousand pieces.

When we returned home, Ryan and I were met with the worst night of our lives. I grabbed Jetty's favorite toy, a big stuffed green dog, curled up with it in the bed and hysterically cried myself to sleep. Ryan had an entirely sleepless night, kept awake by sadness, terrifying thoughts, and the fear that Jetty would not make it through.

Morning came and the depression set in. How could this puppy, which had already brought so much joy to our lives in the two weeks we had owned him, have something seriously wrong with him? How could the dream we had of beginning our family with a lab puppy be about to shatter to the ground? Would he be okay, could he make it through? He's so small, so fragile, would he have the strength to fight whatever it was that was ailing him? We couldn't eat, couldn't talk, couldn't work, and couldn't sleep. We spent all morning waiting by the phone, waiting on a call for an inkling of hope.

The phone finally rang and we were informed that Jetty was doing okay, he was able to stand up on his own and his tail was wagging. They were still performing a ton of tests, and waiting on the neurological consult. However, the results of his blood levels were back, and Jetty's ammonia levels (usually between 80-100 for dogs) was 480. His blood was severely toxic to his system. He was also scheduled to have an ultrasound later in the afternoon, and our next phone call would be after the results of that, which meant more anxious waiting for us. We kept telling each other that if Jetty was making it through this, so could we. So, we waited.

The phone rang around 1:30 PM with the news that was sure to change our lives. The results of the ultrasound were in, and Jetty has been diagnosed with a large intra-hepatic liver shunt. We were informed what a liver shunt is (an incorrectly formed blood vessel that "shunts" blood away from the liver instead of through it). Because the blood doesn't get the opportunity to be cleansed by the liver, toxins build up in the bloodstream and cause a multitude of problems and complications as Jetty had exhibited, along with not being able to absorb nutrients to grow. There are also two different kinds of liver shunts: extra-hepatic and intra-hepatic. Extra-hepatic shunts are located outside the liver, often seen in small-breed dogs, and are a quick and relatively easy fix. Intra-hepatic shunts are the worst kind, are difficult to operate on, and yield a low success and survival rate. Jetty's shunt was large, and right in the center of his liver. These types of shunts are rare, even rarer in a lab. How rare? 1 in 1000.

We were told our options: medical management or surgery. For now, Jetty was started on a medication called Lactulose and was steadily improving. The medication has a laxative effect, so the toxins do not have the chance to build up and enter the bloodstream. He was then started on Neomycin, Flagyl, Prilosec, Carafate… However, medical management was similar to a band-aid. It doesn't cure the problem, just masks it. It would give Jetty no more than six months to live. Surgical intervention was an advanced procedure with innumerable risk and a low survival rate. It was also very expensive, and may have to be performed more than once to ensure success. However, if it did work and Jetty did make it through, the prognosis was good and he could live a couple of years longer than he would have, or he could live a full long life. It was his only chance. The good news? We could come to visit Jetty in a couple hours.

Tear-stained and puffy-faced from crying all night, we headed to the hospital to see our little guy. We walked through the automatic doors and said why we were there, and were met with the most inspiring stories about Jetty. True to his nature, he had cast his spell on all the nurses and staff, and everyone was so in love with him. It was hard not to be. They brought Jetty out to us and it was a moment that I'll never forget when they handed him back into my arms. I knew at that moment that I would give anything I had to and do anything I had to in order to save this puppy. He owned such a big part of my heart and the day that we brought him home we promised to take care of him no matter what. He was a helpless, innocent soul who relied on us to make him better. How could we not be his voice? How could we not give him his only shot?

We got to take Jetty outside and spend some time with him. They had shaved his belly for the ultrasound along with his arm so they could get the IVs in, and that arm was wrapped in a cast-type material so that he wouldn't bite his needles out. He was so happy to see us, and all he wanted to do was play! Those moments with him, although some of the hardest, were also some of my favorite moments, because they solidified my love for this puppy. My life, our family, is not complete without him. We walked him back in the doors and were told that they needed to keep Jetty for one more night to observe him, but he could come home tomorrow. Knowing he would be back where he belonged the next day is all that got us through the night.

Taking Jetty home, although a relief , was not all sunshine and roses. Jetty had to be administered Lactulose three times a day, along with an anti-diarrhea pill twice a day. He was also put on a prescription diet of Hill's L/D, and there could be no protein in his diet. Treats would now have to consist of baby carrots and rice cakes. He could only exercise when he felt up to it, and would have to come back on a bi-weekly basis to have his ammonia levels checked. We would constantly have to monitor him for any signs like he exhibited before. Surgery would have to wait until he got a little bigger and a little stronger so he had a fighting chance to handle it.

On his medication, Jetty is a completely different puppy. He is acting like a puppy should! He is full of energy and pep, gets into everything, chews everything, barks all day and night, and most importantly brings us great joy every second of the day. He loves to play, but still has that sweet sense about him and will calm down enough to let you cuddle him. He is doing well, but we are still constantly on edge. We have to schedule his medication in conjunction with his feedings, we have to try to find a balance to control his diarrhea, we have to make sure he doesn't overexert himself, we have to watch for any signs and symptoms of his toxin levels rising, we have to control his vomiting, we have to make sure he's not out in the sun too long, and we have to remember that he is still a very sick puppy and right now it is just barely being kept under control. We are thrilled to have him home, but it comes with a lot more stress and responsibility than a regular puppy would. Every day, we tell ourselves that this day that he gets to live is more than he would have gotten from anyone else. Every day that he gets to live is a gift.

Two weeks passed and Jetty just had his ammonia level check-up this past weekend. He marched right into that hospital with his head held high and that "I'm ready" look in his eyes. I will never forget the image of the nurse walking him down the empty hallway, tail wagging, ready to face whatever came his way through those sliding doors. The bravest dog in the world. His courage is what gives us our courage to keep fighting for him.

When he was rushed to the hospital, his level was 480, it is now 205, still elevated. They upped his dose of Lactulose, which in turn is making his diarrhea worse. We have yet to find the delicate balance and we have to bring Jetty back in another two weeks to check his levels again. Until they reach a normal level, we will continue to check him every two weeks. Once they are normal (if they become normal), we can push his next check-up to a month and so on and so on until he is medically stable enough to handle the surgery.
Thank God Jetty ended up with us, because almost anyone else would have returned him without a care in the world, or worse, ended his precious life.

We don't know how much time we will have with Jetty, or for how long he will bless our lives for. So now, I hug him a little tighter, and I hold on a little longer, and I take more pictures, give him more belly rubs, and shower him with more kisses, and I do everything humanly possible to make sure that the time he has here is full of happiness, because who knows when that time will run out. For now, we are taking our cues from him, gaining our strength from his, ready and willing to face whatever comes just as he is, with hopeful eyes and wagging tails. We are cherishing every moment and loving every second. We are hoping that he will be our miracle.

No matter what the outcome with Jetty, we are bound and determined to give him the best that we can, and are hoping against hope that he will give us a miracle in return. If any special puppy can handle this, he can. He is just over three months old and has already survived so much. He faces each day with a bravery I could only dream of. If any dog could pull off a miracle, it would be him. And if not, we can go on knowing that we gave him the best possible shot that he had. Like I said, there was something that led us into that store that day, something that made us take him home. Something that pulled at our heartstrings. That special something that makes Jetty, Jetty. The stuff that miracles are made of.

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On August 9, 2010, at six months old, we brought Jetty to the Animal Medical Center in New York City to undergo surgery with Dr. Allyson Berent, a renowned specialist in the field. Jetty was diagnosed with a left divisional intrahepatic shunt (IHPSS) via catscan. With his history of collapse and mental inappropriateness, which responded immediately to Lactulose, Neomycin, Metronidazole, Prilosec, Carafate, and Hills L/D food, his blood work was also compliant with the diagnosis.

When we met with Dr. Berent, she talked with us in great detail and diagrams of Jetty's condition and all our options. While we opted to move forward with the coil embolization procedure for Jetty (PTCE), there were frightening risks, especially for GI ulceration. This risk was almost 5x higher for labs. We decided to have Dr. Berent perform an upper GI endoscopy on Jetty the day before his surgery to see exactly what we were dealing with ulcers-wise. His entire intestine looked great, and no ulcers were seen! What a relief. The biopsies also showed a normal GI tract, which was another blessing and greatly lowered his risk for post-op complications or death. Another great sign: he had great portal perfusion to his liver, which Dr. Berent said was something they very rarely see, and was thoroughly impressed.

On August 10, Jetty underwent the PTCE procedure. However, Jetty being Jetty, he did not make it easy! His heart was racing out of control, so the procedure needed to be slowed down multiple times. A procedure that should take around 50 minutes ended up taking 3 hours, and Jetty received 14 (!!!!!) coils in his shunt along with a stent in his vena cava. I think out of about 125 cases that Dr. Berent has performed, he holds the record! His shunt was extremely large, BUT even after 14 coils, the pressures in his portal system didn't change, which is another risk that Jetty avoided! Jetty recovered and after 36 hours, we could take him home to MA and now, even as I write this a week later, Jetty is almost back to his normal self and thriving! As Dr. Berent said to us when we were visiting Jetty after his procedure, he really is a 'rock star'.

On a side note, if any of you are searching for a specialist and can get to NYC, go to Dr. Allyson Berent. She is a phenomenal veterinarian and surgeon, and gives her all to these dogs. We were so impressed with her from the start. We had been emailing back and forth getting advice from her just after posting on the yahoo group, before she had even met or talked to us or Jetty! She answered our barrage of questions happily and most importantly, POSITIVELY. It was always a "don't worry", "he's in great hands", "he is going to be fine and do great". Our regular vet and specialty vet here in MA were not so optimistic, they gave us a 50/50 shot, Allyson gave us 95%. Her upbeat attitude and positivity kept us going through those hardest times, and we would recommend her endlessly to anyone who needs this procedure done. She is the perfect match of knowledge, talent, and down-to-earth and we really could not have asked for anyone better. We credit her with saving Jetty's life, and she truly cares about each dog or person she comes in contact with, and their story.

The plan is to re-check his bloodwork in a month, and if Dr. Berent says all looks good, he will be weaned off all of his medication. If that all goes well, his prognosis is EXCELLENT!

To anyone seeking advice, comfort, or guidance for your liver shunt pets, the one thing we can tell you is not to give up. From the start, we were determined to do whatever we had to do to save Jetty, including using all what would have been our honeymoon money to pay for his $7000 surgery. You've got to make that decision and hold to it. Take advantage of the information on this website and the yahoo group, do your research, and find the absolute best place and surgeon to operate on your baby. The single most important decision we made was to go to Dr. Berent in New York. We knew we were going to the best of the best, and if anything ever happened to Jetty, we could live with ourselves knowing that we gave him the best shot that we possibly could and didn't settle for a closer or less expensive surgeon who gave Jetty a poor prognosis and negative outlook before he even stepped foot in the door. Do what you have to do, because you are your pet's only hope and their only chance. There are going to be heartbreaking moments, moments of anger, instances of guilt and regret, but we made it through by looking in Jetty's eyes and knowing we had no other options. Be determined, be strong, don't waver, and believe in the miracles like Jetty.

Suzanne Bozak & Ryan Tildsley