Microsoft word - sarrah living legacy article.rtf
Ideopathic Liver Failure by Tiffany Newman
Cross Bay's Black Smith's Daughter May 10 2001 - August 23,2005
This article is the story of what happened to our Sarrah. Our hope is to help others
recognize the symptoms of this condition in time to possibly save their girls. Sarrah was a daughter of our foundation bitch bred back to her grandfather's brother, we used frozen semen and amazingly had a litter of 12 puppies. We kept; Sarrah and her chocolate brother "Griffin" ,and of course after waiting 9 years for a
chocolate had hopes she would carry it too. Alas the gods of color decided it was not to be and Sarrah was dominant black. At least this way I knew automatically what
her puppies would carry. I bred her last year but the breeding didn't take so I bred her this time to her half brother hoping for a tight line breeding all around that would
bring up all the qualities I liked in both dogs. This time it took and Sarrah was positively glowing, this time she would get to be a real mother!!
Like most girls Sarrah; had created her own whelping "box" in the dirt under the retaining wall to our deck. I am sure she thought it was a work of art, but she would
get terribly dirty from her digging. She seemed to go at it with a bit more gusto than any of our other girls had before and would even dig at the dirt with her mouth and
come up with large clumps in her mouth. This necessitated only letting her out with supervision so she wouldn't dig thru the wall. Sarrah had a normal whelping and
quickly showed how diligent a mother she could be. This really wasn't her first time as a "mom". Sarrah had helped raise every litter of puppies born since she was old
enough to jump in the whelping box. She delighted in cuddling and cleaning the babies. If you knew you had locked mom out of the box and heard a thud you could bet it was Sarrah jumping over the sides to be with the puppies. They never seemed
to mind, though they were disappointed she didn't have any milk. Sarrah had one puppy that was a bit slow to nurse, we would try everything to get him to latch on and though it took a while each time he did seem to be nursing well
enough, if not as hungrily as the others. Sarrah must have know something was not right with him, she would take him out of the box and jump on the bed and nestle
him between her paws and lick him. The other puppies were warm enough but this would just make him chilled and then it would take even longer to get him warmed back up again and then try to get him to nurse. We thought maybe he was just a bit
premature so I went out and bought an electric breast pump. I used that to take Sarrah's milk and bottle feed him. It would work and he would gain some strength
but as soon as you left the room Sarrah would take the puppy out of the box again. She would fret over him unless we were in the room with her. Eventually we had to
keep him on a heating pad tube feed him and give him sub q fluids, but when he showed signs of an elevated temp and sounded gurgly I brought him to the vets to
get some antibiotics. I was assured that I had done everything right I could have done but when the vet looked in his mouth she could see he had a cleft palate and so I had to make the painful decision to let him go. It was so hard because here was
a perfectly normal looking puppy I was holding in my arms and I knew that in just a few moments he would be gone. He was only four days old. I brought him home and
let Sarrah say goodbye, she licked him and looked at me and then turned her head away and I knew she knew. And then all was right in her world, she settled right in
and spent her time in the box with her puppies.
Sarrah had a normal appetite and had plenty of milk. She would continue to dig if you didn't watch her, so we would take her out in the front yard on a leash instead.
Of course there she would nibble on grass, which isn't unusual, most of my dogs enjoy grazing, sometimes you wonder if they aren't in fact horses. But then she
started with more diarrhea when the puppies were about a week and a half old. A stool sample was normal, but the vets thought putting her on a course of Flagyl
would clear up the diarrhea. I had been giving her acidophilus too. Her stools returned to normal while she was on the Flagyl but once she came off of it the
diarrhea returned. Most bitches have some diarrhea after they have puppies, between the hormones that cause them to empty out when they are in labor and then from cleaning the puppies bums it is to be expected. Her appetite was really
decreased and then she had some vomiting, so she was given compazine to stop the nausea and vomiting. It was hard for her to keep anything down, and if she did and
then manage to grab some grass it would all come up and with nursing the puppies and not keeping down enough food she was losing weight. My husband noticed that
her urine was a funny color, but compazine will turn urine an orange color so that didn't seem out of the ordinary either. Looking back it was.
It wasn't until one morning Sarrah turned onto her back for me to rub her belly and I saw her skin was yellow, I knew it wasn't from staining from the urine. I pushed up
her eyelids to check the sclera of her eyes. They should have been white, hers were yellow The jaundice is a sign of the increased bilirubin in the body from red cell
breakdown that occurs faster than the liver can break it down due to the liver being compromised.
I immediately rushed her in to the vets. They performed a battery of tests and told
me they were admitting her. She was started on IV fluids and antibiotics. When her labs came back her liver function panel was critical her Bilirubin,Creatinine and ALT/AST and white blood cells were all abnormally high, her albumin(protein) levels
were very low. Since there had been several cases of Lepto in our state - Connecticut - her titer levels were checked as this could also be a cause for the liver failure. They
were normal. She had an xray and then an Ultrasound of her heart and liver,a biopsy of her liver was done. The ultrasound showed that her liver was smaller than usual
but it also ruled out a shunt in her heart or liver as the cause of her liver failure. The results of the biopsy showed what is known as "Fatty Liver" or Hepatic Lipidosis, which is the result of the liver being over burdened and unable to keep up with the metabolism of fat. In Sarrah's case this was from her rapid weight loss. She was
started on canned I/D and also a supplement "Denosyl" also know as "Sam E" which will help the liver to heal. After a few days of IV fluids, antibiotics and the food and
Denosyl Sarrah looked remarkably better. Her lab values were still high but because she was eating some food and able to keep it down we were able to take her home.
We continued her fluids, but now these were given subcutaneously (she wasn't a big fan of her IV catheter).
Sarrah came home on a Monday, her appetite was still poor, and she wanted to be with her babies. They were already started on formula and puppy mush, but if
Sarrah had eaten and went near the puppies she would regurgitate and her meal would be lost. This did not help and then she stopped eating the canned I/D so we
tried to feed her anything at that point if she would eat it on her own. If for one meal she ate tuna then she wouldn't eat it the next. Boiled chicken and rice would be
good and then she would turn away from that as well. So we would offer her everything and hope she would eat something. If she didn't I had to resort to force
feeding her as she really didn't have the strength if she didn't eat. I would feed her a little bit every few hours and some of it would stay down, some of it would come up.
Sometimes she would keep it down for a few hours and then up it would all come back up. I asked the vet for some Reglan to help keep her GI tract moving and help
the food stay down. It did help but by the weekend even that wasn't working well anymore.
I think Thursday was Sarrah's best day. She looked more like her usual self and was
even wagging her tail again and making her "Piggy Noises" a muffled grunting sound that only she did. She would smile at us and spent most of the day by her puppies she would lick at their faces though the X-pen. We had to put it up, as sick as she
was she would still jump over the box and try to nurse her puppies Then the weekend came and Sarrah took a turn for the worse, her abdomen began to swell with fluid. At first I thought maybe she was constipated and her gut sounds
were slow, but finally she went, though it was still very soft. By Sunday she was even bigger and looking tired. I had her brother Griffin sleep with me and Sarrah at
night, I felt they should be together. He would curl around her on the bed and nuzzle her. On Monday I took her in for more blood work, the vet told me that the fluid accumulation in her abdomen was a "poor prognostic indicator", but he would tap
her belly and start her on Lasix on Wednesday. That night Sarrah started having accidents and it was obvious her body was shutting down. When I saw the bloody
diarrhea on the floor I just looked at my husband Peter and started to cry. We decided to bring her in to the vets in the morning.
Peter went to work and would meet me there when they opened. I just had to get
through the normal morning routine. Sarrah went outside with me and her mother, her brothers, sisters and nieces. I brought the camera out to get more pictures of her. I don't know why but when I asked her brother and half sister and half brother
to sit in a row they did, I got a photo of them sitting next to each other. It was the last time they would all be together. When I arrived at the vet hospital I was glad to
see it wouldn't be the vet who had been treating Sarrah. When she saw her she told us we were doing the right thing and I knew she would have told us if she thought
we should try more to save her. I had brought Griffin with us, when I went to leave the house he bolted thru the door and wouldn't go back in, I couldn't argue with him
it was his sister afterall. Sarrah slipped her earthly bonds with Peter, Griffin and I by her side. I left and took Griffin for a walk in the woods, I didn't want go to home. I knew Sarrah wouldn't be there. But part of Sarrah was, in her three absolutely
wonderful puppies. They were everything I had hoped for and more. We kept the little girl and named her Sierra. She is happy and sweet and the delight of her grandmother Jaysin and aunts Audrey and Morey. (Morey had taken over
raising the puppies at 3 weeks when Sarrah got sick.) She is growing up to be very much like her mother and when one day she made piggy noises I started to cry - and
then I smiled, her mother was still with us. All Sarrah ever wanted to be was a mother and in the end she gave her life for the very thing that defined her existence. I know Sarrah must have know she was ill, but she waited until her puppies were
weaned before she showed signs that she sick. In the end all I can do is admire her strength and treasure the time we had together.
I look back and in hind sight it was all there, the need to dig and "eat" dirt and the
extra grass should have been more of a red flag for me than it was. It's called Pica and can be a signal. The usual post whelping diarrhea that didn't clear, the dark
urine, the vomiting we thought was from eating the dirt, then the loss of appetite. My lesson from this is look closer. I will have my girls lab work checked after they
whelp so that even if they can't tell me they feel sick, the labwork will speak for them. I only wish Sarrah could have told me too.
CLIMATE CHANGE, IMPACTS AND VULNERABILITIES IN BRAZIL: PREPARING THE BRAZILIAN NORTHEAST FOR THE FUTURE THE RENEWABLE ENERGY WORLD SYSTEM INVESTMENTS AND A POSITION FOR THE NORTHEAST REGION – A SIMULATION FOR THE NEXT 20 YEARS. André Luiz Miranda Silva Zopelari INPE Aldara da Silva César UFF Earth System Sciences Doctorate Student, firstname.lastname@example.org Agribusiness Pr
Sedative-Hypnotic Use of Diphenhydramine in a Rural, Older Adult, Community-Based Cohort Effects on Cognition Ranita Basu, M.D., Hiroko Dodge, Ph.D. Gary P. Stoehr, Pharm.D., Mary Ganguli, M.D., M.P.H. Objective: The authors sought to identify patterns and associations of prescription and over-the-counter sedative-hypnotic use in an older, rural, blue-collar, community-