Portosystemic Shunt

Cosmo is a two-year-old Westie who found himself in an unfortunate situation on June 16, 2017. Cosmo has an unfortunate disease called portosystemic shunt (PSS) that he has likely had since birth. A portosystemic shunt is a disease where the blood that is normally taken through the liver to be filtered is redirected around the liver via a vessel that is not there in a normal dog. When this happens the toxins that would normally be filtered out of the blood by the liver remain in the blood and can cause symptoms that can complicate the lives of the dogs with the disease. While some dogs do not develop signs and can live a semi-normal life, Cosmo was not so lucky. Cosmo is normal on the outside and loves to play, explore, and bird watch out the window; however, he has had difficulties with the side effects of the PSS.

Cosmo experienced urinary tract signs and symptoms of PSS including the development of bladder stones and urinary tract infections that were hard to control along with bouts of diarrhea. Cosmo’s previous owner paid for surgery to have the stones removed and even started medical management in an effort to control the signs and symptoms of the PSS.

Unfortunately, Cosmo still struggled and began urinating in the house multiple times a day. As much as Cosmo’s former owner loved him, it became too difficult to take care of Cosmo’s extra needs and clean up the messes. Cosmo was brought in to be humanely euthanized when his veterinarian asked if she could try and find a home for the adorable, life-loving pup.

A day later, I, a fourth-year veterinary student at Louisiana State University, went home to visit the clinic where I have worked since I was fourteen years old. My wife of one year and I were visiting with the veterinarian when Cosmo came running around the corner exploring his temporary home. My wife saw Cosmo and immediately fell in love wanting to foster him. We have a few other dogs and I immediately indicated that this was not a great idea and he would find a home. For about a week my wife would ask me if I thought we had made the right decision and if I really thought Cosmo would find a forever home. I would answer, “I’m sure he’ll be fine.” After a week of my wife trying to find homes for Cosmo, I told her that if she wanted to go pick him up and he got along with our current dogs we could foster him until the clinic could find him a home.

Cosmo came home with us six days after our initial meeting and he fit right in. On the second night of his stay with us, Cosmo slept right next to my head and I fell for him as hard as, if not harder than my wife had. He is so personable and loves to play so much that he truly adds to the joy in our lives. After discussing it, I told my wife if we could raise the money to get Cosmo’s condition fixed we would keep him. I took Cosmo to school with me the next week and began talking to clinicians in the hospital and we commenced testing to find out exactly what was wrong with Cosmo. That day Cosmo was officially diagnosed with PSS after an ultrasound revealed a large vein bypassing the liver. Options were discussed and surgery is the absolute best treatment for this particular condition. We started Cosmo on two weeks of medication to prepare his body for the surgery and scheduled the operation.

As a single income family, with myself in school, it was not going to be easy to pay for this surgery, but Cosmo had stolen our hearts. We began looking for ways to raise money for his surgery. That is when I found WestieMed and reached out to them for any help that they could offer. Their staff has been great to work with and help us along this process and they have been so generous to make this surgery more affordable for my wife and I. We are looking forward to Cosmo’s surgery and recovery allowing him to live a more normal life! Thank you WestieMed!

Kevin, Joy, & Cosmo

Update July 24, 2017

Cosmo - WestieMed Grant Recipient July 2017

We wanted to update you on Cosmo’s status. He underwent surgery on Tuesday (7/18). While they were doing the surgery, they took a biopsy of his liver. Unfortunately, there were significant changes in the liver that indicate a lack of oxygen and cellular death, which means he will likely have liver issues for the rest of his life. However, the surgery itself was successful.

He stayed in ICU for 4 days and received medication for pain, seizure preventive, and antibiotics. He was finally able to come home on Friday with the understanding we’d watch him for seizures, which is a possible complication of the surgery. He is now on a special diet and will remain on the prescribed medication for eight to sixteen weeks. He goes back in two weeks to have his incision checked and will go back in six weeks after that to have bloodwork done. That will tell us if the surgery has started closing off the shunt. He will then go back again in another eight weeks and hopefully by the shunt will be completely closed. At that time we can start weaning him off of medication.

We wanted to keep you guys updated. Thank you again for WestieMed’s generosity. Your financial assistance made it possible for Cosmo to have this necessary surgery and have a full life. Even though his liver is not normal, he will have the best life possible with us and his siblings at home!

Sincerely,
Kevin, Joy and Cosmo Shrewsberry
Class of 2018
Louisiana State University
School of Veterinary Medicine
SCAVMA, AABP, AAEP, AASV, HSVMA, ASV

Update January 24, 2018

First, let me express our thankfulness for WestieMed’s financial assistance in Cosmo’s veterinary care. It was a long process to get Cosmo’s liver working better, but he is definitely a healthy dog now!

From the first day I met him, Cosmo was a happy, outgoing little man. However, now, he is even more exuberant (if that is possible) displaying the Westie characteristics! He is definitely a special part of our family’s life. He loves to play with his brothers and sisters; even when everyone else is sleeping, he will go to each sibling and annoy them until someone plays with him. He is convinced he is the largest dog on the block and takes his job as guard dog very seriously until he realizes he could get a scratch from a human or meet a new dog friend then his toughness melts away to wags and licks. Finally, he is a master at expressing his feelings 100% of the time. If we kennel him and he doesn’t like it, he will sit there and make noises like he is having a conversation with us about his situation (it’s especially hilarious when guests are over because they don’t know if they should respond or what). We rescued Cosmo because he was in need of help – regardless of his breed. But it has been a bonus to get to enjoy his Westie personality. Dynamite definitely comes in small packages!

Health-wise, Cosmo is doing well. I can tell he has become stronger. Before his surgery, he would need to stop and have me hold him on our walks. Now, he leads us the entire way! Before the surgery, he would have two to three accidents a day (at least) in the house. This was a primary reason his first owner surrendered him to a veterinary clinic. Now, he rarely has accidents! Cosmo is still on a special diet due to the damage already done to his liver. If it were not for that fact, you would not know he had overcome the disease of a portosystemic shunt (PSS).

Thank you again for helping us give Cosmo the best life he can have! Cosmo always seems to have this little grin when I look at him for more than 5 seconds as if he is saying, “Yeah, I’m pretty awesome”. We are forever grateful for your generosity toward our Cosmo!

Sincerely,
Joy, Kevin and Cosmo Shrewsberry

Little Louie was a “surprise” gift, along with another Westie puppy, for a girl from her boyfriend. Louie was four months old, and Lloyd was five months. She did not have time to devote to their care, and she surrendered them to the Atlanta Westie Rescue Committee in September of 2012.

When Louie arrived for foster care, we noticed that he was very small, even for four months, and he also had a very sensitive stomach. We finally put him on a diet of boiled chicken and white rice. Our rescue vet, Montrose Animal Hospital in Marietta, Georgia, recommended that we add a kiddie vitamin and fresh spinach and sweet potato to his diet to ensure he was getting the proper nutrition. He still had stomach issues though, and at one point had to go to the emergency clinic for a day. He was a tiny little puff ball at 5-1/2 pounds and did not appear to be growing. We were concerned that perhaps he was suffering from “failure to thrive.”

Louie’s big boy neuter surgery was scheduled in November, and that is when his little life changed. Dr. Davis at Montrose said that his pre-surgery blood work showed numbers “all over the place,” with high liver enzymes and high WBC count of most concern. Given Louie’s other symptoms, Dr. Davis suspected Portosystemic Shunt (PSS, or liver shunt), which means that the blood was bypassing the liver and therefore not being cleansed of all the toxins. Dr. Davis felt that an ultrasound might be beneficial, and it did show a very small liver. The neuter surgery was canceled and Louie was sent home with antibiotics and a special hepatic diet.

There was a huge difference in Louie in just a couple of days as his body fought off infection and he received the proper nutrition. Another medication was added to help Louie pass the toxins out of his body, and again there was a marked improvement in his demeanor. These medications were given in anticipation of Louie having corrective surgery for the PSS.

Louie was referred to Dr. Berryessa at Georgia Veterinary Specialists (GVS) for a consult. Louie’s “entourage” consisted of his foster mom, the chair of the rescue, and the VP of the Westie Club of the South, all there for moral support. After the initial examination, Dr. Berryessa suggested another ultrasound to try to confirm that Louie had a PSS. We met the most amazing staff, all very caring, and they even let us go back with Louie for the ultrasound so we could see what they were looking at. The procedure was thoroughly explained to us, and it was confirmed that Louie was very sick with a PSS.

Due to the fact that we had changed Louie’s diet and had him on medications, he was looking healthier and gaining a little weight, which made us happy. We also discovered this amazingly active pup with newfound energy who played until he couldn’t anymore! What a difference that made, and we were hopeful that the surgery would help even more.

Surgery day arrived and we dropped Louie off bright and early at GVS. They took him back and Dr. Winkler, the surgeon, came and talked to us before we left and assured us that he would call as soon as the surgery was over, which he did. However, the news was not what we had hoped for. They were unable to repair the liver shunt because (1) the veins were in the wrong location and (2) Louie’s liver was very tiny. The surgeon was able to neuter Louie while he was under. He had an overnight stay, and we were able to pick him up the next afternoon.

As an aside, my teenage daughter had a liver transplant eighteen months ago; as difficult as it was for me, I could deal with that okay. However, I was not prepared for the pitiful little baby I picked up from GVS, and it just tore my heart to pieces. We brought Louie home and put him in a nest that we had created to keep him quiet and away from the pack to try and help his little body heal. The first couple of days he was pitiful, but as his incision healed he started acting more like himself. After about a week, it was difficult to keep him quiet because he wanted to play and be with the pack.

Since then, my daughter and Louie have been on the same schedule for medications (so Mom can keep it all straight). Now almost three months later, Louie is thriving and growing and is a happy pup at thirteen pounds – almost tripling his weight since diagnosis. Although he may have a shortened life span, he is living life to the fullest and is a sweet, mischievous little man who makes us laugh all the time. He is a delight to have in the house, and all of our children’s friends have “adopted” him as their foster brother, too!

All we can say to WestieMed is “thank you for being there when we needed help.” There is no way we could ever thank you enough for your assistance with Louie’s surgery.

Rhona Terrell, Grateful Foster Mom
Westie Club of the South, Inc.

Update October 1, 2013

Louise - WestieMed Grant Recipient March 2013 — Louise – WestieMed Grant Recipient

Many of you will recall the story about Louie, the littlest four-month-old Westie I had ever seen. He was surrendered in 2012 along with Lloyd by a woman who was “surprised” by her boyfriend with two puppies, and she had no desire to raise any puppies. Apparently a backyard breeder was getting out of the business (i.e., someone had turned her in) and she would not take the puppies back.

Louie came in relatively small, but he didn’t thrive no matter what Rhona fed him. After about a month, Rhona and his two aunties (Cindy and Harriett) took him for a consult with Georgia Veterinary Specialists, and Louie was diagnosed with a liver shunt, which was unable to be surgically repaired. Louie has been on medications ever since to keep him as healthy as possible.

His foster mom, Rhona Terrell, was up with him all night last night. A trip to the vet showed that Louie is going into the next stage of his liver disease. His protein and albumin levels are very low, and there is fluid in his belly. After discussing his condition with the vet, I have opted to keep him comfortable on diuretics and anti-nausea medicines.

Louie is still a very happy (although somewhat tired) one-year-old. Rhona, James, Matthew, and Kathleen (and all of their friends) are taking wonderful care of him. Rhona said it best this morning: “Louie has loved a lifetime in his short life” and I don’t know anyone who has met him that did not fall in love at first sight.

I just wanted to update everyone on his condition and express my appreciation of everyone coming together and rallying around this little pup. Now Louie and his foster family need our prayers and all good thoughts.

Cindy Levine

Update February 24, 2014

Louie is doing well most days and continues to delight us with his antics.

He has slowed down a little, which is all part of his condition.

He still loves to play with the pack but prefers to sleep by himself most nights as he gets restless and, due to being on diuretics, has frequent bathroom breaks (so does Mom).

Whether he is running and playing or just chilling in the sun, the outdoors is his favorite, although at the end of the day he is very content to be snuggled up in someone’s lap with a blanket.

We go on walks to the park with him and the other dogs, he can’t go the same distance but he is very happy to be in his stroller (see attached picture) after he is done walking.

He will turn two in May and we know every day with this loving little guy is a blessing.

Please enjoy his pictures.

Thank you again WestieMed for being there in his time of need; we are all truly grateful.

Rhona Terrell, Foster Mom
Westie Club of the South, Inc