Sick puppy.

Our Westie puppy, Minnie, is 12 weeks old today. We got her 23 days ago. From Day 1 to Day 6, she was mostly a "normal" puppy except for diarrhea. On Day 7, she had what I would describe as a hypoglycemic episode. She vomited and then fell into the vomit and was unable to walk for about 20 minutes. I immediately knew what was going on and remedied the situation. Her playfulness started to decline after that. On Day 11, she had her first vet appointment. She weighed 1.7 pounds. She was dehydrated and was diagnosed with giardia and an upper respiratory infection (she had a clicking sound while breathing). Her CBC showed extremely low red blood cell and platelet counts. The vet noticed "flea dirt" on her back and wondered if fleas caused the anemia. On Day 13, she had a blood transfusion and seemed a bit more perky after that. The diarrhea still persisted. On Day 15, her counts had improved but not yet to normal. On this day, she was also diagnosed with coccidia and most likely had some type of worms (a cough/gag thing), so we did a three-day dewormer. On Day 17, the upper respiratory infection was better and she had gained one ounce. On Day 19, I left her for approximately three hours. When I returned she hadn't moved at all and was very weak. Back at the vet that afternoon. She now weighs 2.1 pounds and all parasites are gone. Told to stop meds. Day 20, she gets up to walk towards my daughter and collapses in what appeared to be a hypoglycemic episode, but I feed her every two to three hours. I even set my alarm at night. After she collapsed, her leg was so twisted it appeared broken, but it was fine. She again was unable to walk for 20 minutes. After her first vet visit, she has only been on Prescription Diet AD. Her appetite comes and goes, but has been good for two to three days. When she won't eat, I use the syringe. Now, Day 23, the clicking is back and every once in awhile the cough/gag. She has been eating well. I mix a bit of pumpkin in with the AD and her poop is now formed and not so often. (Yay!). What's extremely concerning now is she NEVER plays. She would sleep 99 percent of the time if you let her. Five days ago the vet said that her little body needed the rest to repair itself, but now seems super concerned she's not playing. She's almost depressed. Apparently, her liver enzymes were LOW (everything I've researched only refernces high liver enzymes) on whatever the last blood test was.... RBC count had some improved or fallen. X-rays normal. Barium swallow showed no blockages. Ultrasound normal. I have contacted breeder several times and they know of no genetic issues, other pups are also small but otherwise "fine". The vet is sort of scratching her head. Can you think of anything to explore further? She can't fast for bile test. To summarize, for past two days, stool formed, click and cough/gag is back, more alert but never plays. I am so worried we're going to lose her! We are no closer to answers. :(

Thanks so much, Dr. Marie. I am going to ask about the resting bile acids test. As far as I know, that hasn't been done yet, but my husband did take her the one time, so I don't feel like I have as good of a grasp on what went on that visit.

I did forget to mention one thing. When she went to the vet this last time, one of the reasons we took her was because her belly was hard and big. She did eat some of our other Westie's hard dog food, and the vet said that may have been the cause. It resolved by the next time. But now it's like that again!! It's been like that for about a day, and she has definitely not eaten any hard food or anything she shouldn't have. She is very interested in eating our other Westie's hard dog food, so we have to make sure she doesn't get near it, but I am certain she hasn't had any.

Thanks again.

Update: She just woke up from one of her 2,000 naps, and her stomach does feel better. She has been eating what I would consider a lot, about one can of Prescription Diet per day (I think today will be a little more than that), which seems like a lot for a small dog.

The vet hasn't mentioned anything about heart conditions, but she listens to her each visit. She has mentioned the liver, kidneys, pyrovate kines (sp?).

Here is the correct spelling: pyruvate kinase.

I pray you are right that she just needs some time to get over it. I get optimistic and then get discouraged, optimistic, discouraged. Her next appointment is Saturday. I'll let you know how it goes. Thanks again for all of your help!

Hi, Dr. Marie. Still having an extremeley rough road... What can you tell me about antibiotics aggravating IMHA? Specifically metranidazole and clavamox. Also, I've read that vaccinations can trigger IMHA. How soon do the symptoms show up post vaccination if this is the case? Thanks in advance!