Ava, a Pit Bull mix, with multiple liver shunts and reoccurring UTI and E-coli infection.
Ava is a Pit Bull mix, approximately 4 years old, and was surrendered to the Cumberland County SPCA in February 2015. On 4/21/15, she was vaccinated for rabies and tested heartworm positive. In late April 2015, Polished Pitbull Rescue pulled her from the shelter into their rescue program. She was a spunky, affectionate dog despite her previous life of neglect.
She was taken to the vet on 4/27/15 and weighed 46 lbs at that time. She was spayed at this time. She also had pyoderma (chin/inguinal area/abdomen). She was given Clavamox 250mg and Doxycycline 100mg and placed on a regimen with Doxycycline, Prednisone and Heartgard.
On 5/28/15, Ava returned to the vet because she had blood spotting from her vaginal area which was believed to be a UTI. It was also noted that the pyoderma continued. She was given a treatment plan with Cephalexin 500mg 2x/day and Zyrtec 10mg 2x/day for skin allergies. Her weight was 57 lbs.
On 7/7/15, she was brought to the vet for her first of three heartworm treatments including Immiticide injection, Prednisone and Robaxin. During this visit, there was still blood while urinating. She was again given Clavamox 250mg.
It was during this time that Ava had her first head tremor (see video). Though this one seemed an isolated incident at first, in October 2015, Ava began to have tremors regularly and consistently about an hour after she ate. She also began stargazing at this time.
On 8/19/15, Ava returned to the vet for heartworm treatments #2 and #3. Her weight was back down to 46 lbs. She was again given Prednisone, Robaxin and Immiticide injection. Staff noted she was uncomfortable and would not stand to eat; she was given Tramadol 50mg. On 8/20/15, her demeanor was happy and she urinated large amount with no visible blood and had normal bowel movement. She was given Prednisone and Robaxin, followed by Tramadol, and then Immiticide injection. She was discharged and sent home with Prednisone and Robaxin. The UTIs continued; Clavamox was not helping. UA showed rods and elevated pH; a culture and sensitivity test were done and Ava was put on Enrofloxacin 68 Mg.
On 9/12/15, Ava was brought to her vet for excessive urination and had a distended and tender abdomen. Ultrasound was ordered and performed on 9/14/15. The diagnosis was polycystic kidneys and incontinence. Also noted that she had a large left kidney.
9/30/15, foster parent noted her urine was dark and Ava’s activity level was decreased. Still eating, but drinking less. On 10/1/15, a urine sample was provided and rods were noted. She was given Zenequin 100mg.
Despite her “minor” medical UTI problem, Ava was adopted in August. But as her health issues continued to be challenging, the family decided they could not bear the heartbreak of watching Ava’s slow decline which appeared to be inevitable and decided to return her to the rescue.
10/26/15, urinary issues continue. NDSAID panel with urine. Ava was put on prescription kidney diet. Referred to Dr. Schelling for Ultrasound (reference VRC document, page 2). Diagnosis: multiple mesenteric, extrahepatic, portocaval shunts; E-coli infection involving left kidney. No treatment for UTI/E-coli, waiting for further testing/results.
11/25/15, Dr. Schelling performed a liver biopsy. Diagnosis: congenital as well as inflammatory components. Still no treatment for UTI/E-coli, waiting for further testing/results.
11/28/15, Ava was rushed to the vet, presenting with a temperature of 106, lethargy, lack of appetite. (Reference document: VRC Emergency Visit) Weight still holding steady at 46 lbs. Another U/A and culture were run. Results indicated E-coli at approximately 100,000 colonies/ml. Ava was placed on IV fluids and finally began treatment for the UTI/E-coli infection with Amikacin. Her prognosis at this time was bleak with a projected imminent death of 6-12 months, though less than that was more likely. She was sent home with a treatment protocol using Trimethoprim/sulfamethoxazole for the E-coli infection as well as Metronidazole and Lachilose. She also began a twice daily cleaning with a Chlorhexidine solution around her vulva.
Ava’s condition continued to deteriorate during this time. Her coat was dry, coarse and thin. Her skin in general was dry, scabby, and raw/bleeding in some places. Her chin erupted with blisters and a bacterial infection. On 12/16/15, Ava was brought to a Doylestown Veterinary Hospital. Additional labs were run and she was placed on an Omega 4 supplement as well as Chinese herbs to support her kidneys.
On 1/5/16, Ava completed her course of antibiotics. On 1/12/16, she had blood in her urine again and Doylstown Vet was contacted. The blood resolved within 12 hours. On 1/18/16, the blood in her urine returned. On 1/20/16, per Ludwigs Corner, she began another six week round of TMS, and she continued the Chinese herbs for kidney support.
2/8/16, Ava returned to Ludwig’s Veterinary. She had lost 10 lbs (more than 20% of her body weight) and was now at 37.5 lbs despite eating vigorously. Veterinarian believed her weight loss was due to her underlying disease process but would not rule out endocrine/parasitic/malabsorption diseases. U/A and culture were ordered; both negative, but Ava was currently on TMS. Thyroid tested at Michigan State – results were not supportive of hypothyroid but could not rule it out either.
Ava continued to lose weight and on 02/27/16, she took a dramatic turn for the worse and had an ataxic fall event while attempting to go upstairs. Her gums and eyes were pale; anemia suspected. She was given Floradix liquid iron and began a home-made diet; Ava rallied in energy but body was still deteriorating. TMS was immediately discontinued.
On 3/2/16, Ava had a recheck appointment with Doylsetown Vet. They prescribed Lactulose, Metronidazole, and Denamarin. Her foster, Kelly, began searching for dietary options to support Ava’s end of life. On 3/5/16, she attended a seminar given by Jacqueline Hill of Answers Pet Food. Everything “clicked” in Kelly’s mind and she immediately contacted Jacqueline about Ava.
On 3/11/16, Ava began her “raw milk diet” with Answers Pet Food. Her diet consisted of 20 oz Goat milk in am, 8 oz fish stock in afternoon, 13 oz kefir in evening based on 50 lbs, and she was on NO medications or supplements. This was eventually bumped up quantities to 24 oz goat, 8 fish, 16 kefir to better match her ideal weight of 55-60 lbs. Ava's body began to respond immediately although she was purging toxins through skin eruptions which continued for a while but ultimately resolved.
3/28/16 - Ultrasound guided cysto to obtained sterile urine sample. Results showed E-coli positive, resistant to all but Amikacin and TMS. Ava’s foster declined any medications and chose to continue with the raw milk diet.
By the end of May, 2016, Ava’s diet was changed to begin introducing Answers Straight Beef but was stopped within a couple of weeks due to PH issues. By July 2016, her foster began introducing small amounts of Straight Pork into her diet.
Ava has continued to grow healthier and stronger every day. She has not had a single reoccurrence of UTI since starting Answers.
October, 2016, from Ava’s foster, Kelly: Ava is thriving today and the change is remarkable. She has been completely medication free since the end of February and shows no signs of slowing down. The shine has returned to her coat and the twinkle is back in her eye. She tap dances again and finally remembers what it should feel like to be a young and exuberant dog. We don’t know where road will take Ava but I believe in my heart that the next chapter of her life will be the best yet. It is hard to imagine that a dog who spent the first few years of life nearly invisible has, through her indomitable spirit and endless capacity for love, won over so many hearts and brought together so many wonderful people who I am proud to call friends. It takes a village and oh my, what a miraculous, wonderful village have been there to carry Ava through her darkest days.
Update 8/11/17: Ava was adopted into her forever home in February 2017. From Ava’s forever mom, Jenn: "When she came to us she was a bit stressed, down in weight, chin issues and skin eruptions. Now that she is adjusted and happy, we only have some summer allergy issues and occasional chin break-outs (mostly if she chews her bones too long). Her urine is normal and clear and she has normal, healthy dog poop! She will “leak” occasionally but from what I have been able to conclude it is when she gets overheated outside and drinks too much water. Her weight is good. Her current diet consists of ALL ANSWERS products!! She gets one patty of the raw meat, with kefir poured on top and then about 48 oz of raw fermented goat milk per day."