Olive's Story

Olive's Story by Jennie Kim

December 2008. The holiday season was upon us. The time to drink soy egg nog, eat sugar-free candy canes and of course buy presents—you know, all part of a typical "L.A." Christmas. My boyfriend and I braved the "harsh Southern California winter", a chilly 65 degrees, and went to the mall to buy gifts for our families and friends.

Our mall tradition usually includes a visit to the pet store. (We didn't know a lot about about puppy mills and pet stores at the time…but we sure have learned a lot since then!) We both love dogs, but had never owned one since our childhoods. We would always begin each trip to the mall with a stop at the pet store to get our fill of puppy love, then we'd move on to the business of shopping. We never really considered buying a dog at the pet store because we always thought we would rescue a dog from a shelter. In the past, we had gone to several shelters, but could never find the right size or the right breed to fit our lifestyle. We just figured, when the time was right, the right dog would appear.

On this particular trip, we saw one puppy in particular that caught our attention. She was a 3 month old, white maltese/shitzu with grey highlights on her ears and tail, and she wouldn't stop staring at us. We spent a little time with her in a private room and before either of us knew it, instead of coming home with a car full of presents, we bought a crate, pet supplies and a little furball who we named Olive.

The next month was a crazy time, potty training her, teaching her what she could chew on and what she couldn't. She was a feisty little fluff ball. She would often playfully sneak up behind us and nip at our backs with her little razor sharp puppy teeth. We even nicknamed her "Evil-O", which is Olive spelled backwards.

At the end of the first month, we noticed something strange. Olive's belly had become swollen, like she had eaten a whole watermelon. She was still playful and seemed ok, but just to be safe, we took her to the 24 hour emergency veterinarian to have her checked out. The vet took x-rays and pulled some fluid from her abdomen. He explained that further tests would be needed to confirm the diagnosis, but that she most likely had a liver condition.

He also pointed out that the fluid accumulation (which we later learned was ascites) was an advanced sign of a serious problem and given her age of four months, things didn’t look good. He said we should seriously consider returning her to the pet store. For me and my boyfriend, that was not an option because we knew that returning her to the pet store would be a death sentence.

The next day, our vet referred us to an internal specialist who, over the next couple of weeks, ran us through a series of tests that included an ultrasound, blood test, fluid test, bile acid test, and portal scintigraphy. He also prescribed neomycin, furosemide, lactulose and Purina NF.

During this time, we spent every waking minute educating ourselves about liver shunts, researching options, taking her to other specialists for second opinions, etc. At every point, we experienced a roller coaster of emotions from hope to hopelessness. We had to have her abdomen drained of fluid about every 7 to 10 days. She also showed classic hepatic encephalopathy symptoms like "drunk walking" and walking along walls. Finally, after hearing the results that she had multiple, extrahepatic acquired shunts that are inoperable, we surrendered ourselves to the advice of our internal specialist — see how long she can maintain her quality of life with diet and medication, but when the time came, we would have to put her to sleep. The specialist speculated she had anywhere from two weeks to ten months, but with the severity of her ascites, it looked like it could be even sooner.

Not willing to let her go without a fight, I decided to join the Liver_Shunt_And_MVD_Support group on Yahoo to see if maybe there was any hope out there for Olive. I had done a ton of research and knew that Dr. Karen Tobias was the expert on liver shunts. (My boyfriend even called UT to take Olive there, but unfortunately it turned out her multiple shunts were not operable.) I was encouraged to see that Dr. Tobias was an advisor for the group.

Joining this group changed everything. I learned about supplements like milk thistle and sam-e, as well as other food options like Hills LD, Royal Canin Hepatic LS 14 and Dr. Dodd's Liver Friendly Diet. We tried all three of these foods over the next few weeks. We started her with Dr. Dodd's and she improved. Her belly stopped bloating and she seemed to have more energy. However, the downside was that she was starting to lose a dramatic amount of weight. So we slowly transitioned her diet to the Hills LD because I understood that it was better at helping dogs gain weight. Unfortunately, we had a difficult time calculating the right serving size for the amount of protein she could handle and she started to have seizures and retain fluid again. Our specialist put her on more meds, like metronidazole and spironolactone, and that helped a bit.

During this period, Olive had her good days and bad days. However, as time went on, she was slowly getting more and more lethargic and losing her will to fight. Our once vivacious puppy began to spend most of her days sleeping, not wanting to play with us or her toys. We began to prepare ourselves to let her go. At one point, she seemed to only have days left in her.

As a last ditch effort, we switched her back to Dr. Dodd's diet in order to stabilize her, but then her weight began to drop again. We were scolded by her general vet and internist because she was pretty much skin and bones. We didn't know what to do because too much food (i.e., protein) would send her into seizures, and too little food wasn't giving her the nutrition/calories that a growing puppy needs.

What seemed to turn everything around was Olive's internist suggesting that we get a consult from UC Davis' nutrition department. However, since we knew University of Tennessee, Knoxville had a lot of experience with liver shunts, we requested that he work with them on a diet plan for Olive. Within a couple weeks of trying the custom made diet, we saw a significant improvement. Olive began to gain weight, she became interested in her toys again, and we even saw the return of "Evil-O"!

Today, Olive is thriving like any other dog and lives pretty much a
normal life. (Quite frankly, she’s kind of spoiled!) No one believes
that she has anything wrong with her. In fact, many of our friends and family think that she’s “cured.” Slowly over time, and with the
approval of our vet, we've reduced the amount of meds that she's on and she's doing great. (She was on 8 meds at one point!)

Olive was first diagnosed in January 2009 and has now past her one year anniversary as a survivor!

In all honesty, for those who have just learned they have a liver shunt dog, taking care of Olive has indeed required a huge commitment and lifestyle change for both my boyfriend and I. We never anticipated having a special needs dog so early in her own life, but that said, we wouldn’t change any decision we’ve made. We were meant to take care of her and she was meant to be with us. I guess that is why she kept staring at us in the store that one day.

Thank you everyone on the Liver Shunt and MVD Support group on Yahoo who helped us get to where we are today!

Music Credit: Excerpts from Olive, You're Not Alone