# Advice please. Continual vomiting



## Bella's Daddy (Apr 19, 2005)

Bella joined our household 3 weeks ago at 7 weeks old.

For the first 3 days she was happy, playful and full of life. Then the vomiting started.

We were feeding her 4 small meals a day, using IAM's puppy food. She started with vomiting about a half an hour after being fed and just once. She progressed to vomiting after each meal continually until all she could bring up was a clear, foamy vomit.

We took her to our vet and he told us she *may* be suffering from Mega-esophagus, or in lay terms an abnormal pouch in her esophagus. He told us to feed her a gruel mixture of water and finely ground dry food and then hold her erect for 20 minutes. This offered no relief.

4 days ago she became extremely distended and was whimpering in pain until she began passing gas (not a pleasant experience). Once she did this she was much better and became playful once more, but with her next meal she started the vomiting again.

We are now feeding her just a small mouthful of wet food, but this comes up immediately. She is becoming dehydrated (for which we are giving her twice daily injections of 0.9% NACL) and has today displayed a slight staggering. I know this is a sign of hypoglycemia and we are trying to treat her for that with honey-water, but she brings this up immediately.

Not meaning to offend anyone but she is starting to look like a death camp survivor. Each meal is now followed with loud screams of pain and followed with vomiting. She has not had a bowel movement for 2 days and is continually trying to express her anal glands (dragging her bottom along the carpet, wood floor and cement patio).

She is scheduled for a barium swallow x-ray tomorrow, so we should get some answers then. But in the mean time, has anyone experienced this same condition? If so what did you do to help your baby?

My wife and I both have backgrounds in medicine (she is a RN and I am a retired Special Operations Paramedic) but we are at our wits end. We've have become very attached to Bella in the last 3 weeks (something that really surprised me about me). I find myself up all night just holding her and praying to my God.

Please, someone advise us.

Bella's Daddy


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## ilovesadie (Jun 1, 2004)

Bella's dad, megaesophagus is fairly uncommon in small breed dogs, but hopefully the contrast radiographs will tell the vets what might be going on (foreign body would be high on my list). Any diarrhea, or hematochezia, any other symptoms? Something I might also consider is an serious case of internal parasites, parvovirus (did they run tests?). One last thing that also is extremely rare in small breeds, but gastric dilatative volvulus (GDV) can result from eating/playing simulatenously (especially when rolling around on the ground), where the stomach torques around and the torsion creates a blockage for food, hence, continual vomitting ensues. Another possibility is intestinal herniation which may explain the on/off kind of syndrome your pup experiences. 

One last thing I'd definately ask the vet to consider is inceception of the intestines (when a section of the intestine folds over another, creating a tapered closure), which is something we often DO see in young, small breed dogs as a result of chronic GI upset. The lack of bowel movements makes me especially suspicious of this (or foreign body). Can they palpate any evidence of inteceception in abdomen, or does it appear abnormal on ultrasound? 

If your current vets can't figure it out after the contrast, start seeking second opinions or advice from a veterinary internist. Situations like these can't wait and normally turn worse very quickly without a positive diagnosis. It's also tough to make a good diagnosis without a lot of diagnostics, and a contrast series will help out. Was there any bloodwork done or radiographs, or ultrasound?

Hopefully, it all cracks down to simple gastroenteritis or pancreatitis. That would be a best-case scenario, and I'm crossing my fingers for you and your pup. I know exactly how you feel, and it's so hard to feel helpless when you can see your baby suffering. Hang in there and know we're all rooting for you.

Good luck with the contrast shots, keep your pup hydrated, blood glucose up, and hospitlizaed if necessary, you cannot be too careful as you know =)

Let us know if there is anything else we can do! It looks like you're in Southern California (although not quite in Los Angeles) but if you need a referral to a great internist and would consider the drive, I have some numbers that of people who may be able to help.

-Nate


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## ilovesadie (Jun 1, 2004)

Instead of force feeding honey water, smear Karo syrup directly onto her gums, it will be absorbed through the mucus membranes and won't be vomitted up immediately. The effects will be quicker!

Has your vet prescribed carafate or anything for esophagitis? Often during chronic vomitting their esophaguses are extremely enflamed and irritated, and sometimes the inflammation also invokes gagging when they are fed, and is also very painful. As you know stomach acid burns!

Good luck, and keep us updated.


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## Bella's Daddy (Apr 19, 2005)

Nate, Thank you for your advice and concern.

We have taken notes from your post and will present them to our vet tomorrow.

I understand what you said about the GDV as I, myself, suffer from Gastric Reflux Disease. But I had thought that carafate had been discontinued (at least in humans it has been).

No, there has been no diarrhea or hematochezia. In fact there has been no bowel movement for 2 days now.

I can only pray that it is not inteceception of the intestine. The military does not pay much in the way of medical retirement pay and as we all know nurses do not make what they truly deserve. That with one child in college (and of course she picked the most expensive - Azusa-Pacific) and another just entering the "age of clothing enlightenment", things get pretty tight around the house hold.

Again, thank you for your advice. We are now much better prepared for speaking with out vet.

Kurt Gerber, MHA
HM1(FMF) USN (Disabled)


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## xx-nathalie-xx (Jan 10, 2005)

oooh i hope everything will be ok with your baby!! it sounds like you are doing the best you can ......  

kisses nat


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## MsStephanie (Apr 3, 2005)

I hope everything will be okay!! I'm so sorry for what your baby is going through!! And I thought Dixie had the most severe problem... Warm regards to you, your wife, and to Bella! Keep us all updated...

MissStephanie & Dixie


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## KB (Apr 13, 2004)

Good vibes and prayers to your baby, please let us know


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## luv4mygirls (Feb 20, 2005)

i'm sending prayers and good thoughts your way! keep us posted please!


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## Rachael Polachek (Feb 19, 2005)

You'll find that the people in this forum care greatly about all chi's so please know that we are genuinely interested in your Bella. Try to keep us updated, as time permits. I will keep you and Bella in my thoughts and prayers, as I know how easy it is to get attached to these sweet creatures.


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## latenight423 (Aug 2, 2004)

*Bella...*

Nate has offered great advice for you and Bella. I hope it is nothing as severe as some of the things he described. 

Good luck and good medicine! Keep us informed, OK?


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## ilovesadie (Jun 1, 2004)

Hi, not sure about carafate (sucralfate) use in humans, but we use it widespread in chronic vomitors for esophagitis. It's very safe, can be used in diabetics despite it's sucrose ingredients, and is very effective in protecting ulcerations along the upper GI tract. 

Please update us, and take all suggestions on the web with a grain of salt, only your vet knows what's best as he/she has done the PE, and will be able to best direct you towards the right course of action and diagnosis.


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## chimom (Apr 1, 2005)

I feel so sorry for poor Bella. It's so hard to see your little one suffer. My thoughts and prayers are with you, Bella and your family. Please keep us updated. God bless.


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## my3angels (Apr 15, 2004)

Nate gave you great advise. We are all praying for your little one! Please let us know of any updates!

PS - I am Catholic so I believe in all the saints. St. Francis is the saint for nature and animals. There is one prayer I say for anyone who's animal is sick and I thought I might share it in case there are a few who would like to know it. Religion is a very tricky topic so I hope I really dont offend anyone here. Please let me know if I do. 

*St. Francis of Assisi Lover of all Creation Prayer for Sick Animals:* 
Heavenly Father, 
you created all things for your glory 
and made us stewards of this creature 
If it is your will, restore it to health andstrength. 
Blessed are you, Lord God, 
and holy is your name for ever and ever. 
Amen


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## Bella's Daddy (Apr 19, 2005)

I just got back from the vets office. It was not a good visit. As we thought Bella does have megaesophagus with little to no food passing to her stomach.

He consulted with an Internal Medicine and Surgical vet. Both agree that surgical intervention would be the solution of choice, but do not feel she is a candidate as she is now less than 1 lb. Neither feels she would survive the surgical procedure.

That leaves us with only one solution. We are going to keep her one more night and have her put down tomorrow.

My heart is truly broken. I have lost important people in my life and more then enough Marines in combat, but with Bella I feel like just rolling into the fetal position and staying there.

I beg all of you not to look at us as not caring. It is because we do care for her that this decision is being made. She is in such dire pain right now and she is just too beautiful of a soul to have to suffer any more.

Kurt


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## chimom (Apr 1, 2005)

Words cannot express how sorry I am to hear this. I don't think anyone on this forum would think of you as uncaring, rather as someone who truly cares and doesn't wish to see this poor baby suffer. I am so, so sorry :sad10: My heart goes out to little Bella and to you and your family, and you will all be in my prayers.


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## Gadget's Mom (Jan 14, 2005)

Kurt, Bella and Family, 

I am so sorry for your Baby to have to go through this but you and your vet know best. The best thing for Bella is to make the pain and suffering stop. 

The best thing foryou and your family is to hug her and love her this one last night and pray that she will be better off going to the rainbow bridge. 

I hope you get through this and my prayers and thoughts are with you.


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## nabi (Nov 25, 2004)

I am so sorry to hear of poor little Bella's condition....thank goodness she has loving care givers like you and your wife who understand that sometimes " being put gently to sleep " is the most loving thing you can do. We will keep you all in our prayers tonight and tomorrow.


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## dastowers (Mar 24, 2005)

Kurt,
I am so full of tears I can't write what I want. I am so sorry..

Davena


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## KB (Apr 13, 2004)

I too am filling up. I was too afraid that might be the outcome, I just had a gut feeling. We do not think bad of you...its the selfish person that would not do that....Believe me *we are all here for you *and crying with you.....

In time perhaps when you heal you can find another chi never to replace but perhaps fill that void just a little bit. 

God Bless


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## Rachael Polachek (Feb 19, 2005)

Kurt, believe me, no one here will think of you as uncaring. It's obvious that you're letting this little girl go because you love her enough not to prolong her agony. I know your heart is breaking and I don't have the words that can lessen your pain. I believe in the Rainbow Bridge and I believe that's where you'll see your Bella again, but without pain and without sadness. I'm so terribly sorry this is happening to Bella, to you and to your family.


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## nikki (Jan 28, 2005)

Why not try the surgery? What if she does survive? Am I totally wrong for suggesting this??  Its just that, if you are going to put her down, and they don't think she will survive, isn't it worth trying? I'm not a vet so I don't know, but isn't there at least a little possibility she could make it? I'm sooooo sorry you are in this situation. I'm just the type of person who tries to see hope in everything. I'm sorry if it is wrong to suggest this.  I hope you feel better and ill pray for you and your puppy.


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## Auggies Mom (Jun 9, 2004)

I am so sorry for your family and Bella. Seeing anything so small suffer is unbearable. I hope in time you get another baby to love because you sound like a person who really loves their dog. I lost a chi puppy at 12 weeks and getting another a few months later was the best thing that I could have done.


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## luv4mygirls (Feb 20, 2005)

my heart goes out to you and yours... that is all i can say at the moment.


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## ilovesadie (Jun 1, 2004)

Kurt, I am truly sorry to hear the news. It is difficult to make such a decision, but in your case I do believe you are taking the right course of action for your dog. Even if your dog does survive the surgery, she may not survive the recovery period because of her condition going into the surgery. To relieve her suffering is the best thing to do in situations like these. 

However, if you do reconsider, I can give you a little bit of hope: I performed almost 20 dental extractions on a 13year old 2lb chi yesterday under veterinary supervision and close anesthetic monitoring. She was given a poor prognosis if the surgery wasn't performed, and a 50/50 chance of survivng the surgery. With all extra precautions she pulled through the surgery with a few scares, but she is recovering beautifully. If you do chose the surgical route, Tiny and I will be here to give you hope. 

We are all here in your support whatever you decide, and am praying for you, your family, and Bella.

-Nate


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## my3angels (Apr 15, 2004)

I was also afraid of that outcome for Bella. I am so sorry about this. Words cannot express how sorry I am. I wish there was something I could say to take away the pain. You are doing the right thing by putting her out of her pain. 



> Why not try the surgery?


I would not suggest the surgery for a couple reasons...one the chances of recovery are very slim in cases like this. I have head about this condition at work and even with surgery the life expectancy is low. Second like he said the weight is a HUGE issue. I really cannot see poor Bella surviving such a procedure. Third, its a very painful recovery and for such a small dog she might not survive the recovery. This is a very serious condition in such a tiny dog and honistly the kindest thing to do would be to end Bella's suffering. The negatives outweigh the positives for the surgery.
Again i am so sorry it came to this. Just know you are doing the right thing and that we will always be here if you need to talk.
Take care. My prayers are with you in this difficult time.
-Jessica

*THE LAST BATTLE OR IF IT SHOULD BE
If it should be that I grow frail and weak,
And pain should keep me from my sleep,
Then will you do what must be done,
For this -- the last battle -- can't be won. 

You will be sad I understand,
But don't let grief then stay your hand,
For on this day, more than the rest,
Your love and friendship must stand the test. 

We have had so many happy years,
You wouldn't want me to suffer so.
When the time comes, please, let me go.
Take me to where my needs they'll tend, 

Only, stay with me till the end,
And hold me firm and speak to me,
Until my eyes no longer see.
I know in time you will agree,
It is a kindness you do to me. 

Although my tail its last has waved,
From pain and suffering I have been saved.
Don't grieve that it must be you,
Who has to decide this thing to do; 

We've been so close -- we two -- these years,
Don't let your heart hold any tears. *
[/u]


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## Bella's Daddy (Apr 19, 2005)

After much research on megaesophagus (good thing I'm self-employed) my wife (Virginia) and I decided to speak with another surgical vet. We actually spoke with a surgical vet and an internal medicine vet. We were hoping that the placement of a feeding tube would relieve the esophageal irritation and thus reduce the inflammation.

Well, both vets felt that Bella was a perfect surgical candidate, with a 90% chance at total recovery. To make a long story short, Bella is undergoing an endoscopy in the AM. If that shows “Vascular Ring Anomaly" as the vets are sure it will, she will undergo surgery immediately following the endoscopic procedure. (I'm sure my oldest will understand why she can't finish college - *when I get the nerve to tell her* - just kidding) This is going to set us back a bit ($ 6,450.00 - to start with), but as I told Virginia "Bella is an expression of God. She deserves the chance to live."

My family and I wish to express our gratitude to everyone for their prayers and good wishes. I will inform you as to her status tomorrow evening.

Kurt


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## Seiah Bobo (Mar 31, 2005)

I truely am sorry that this is what it has come to. My prayers are with Bella and the family.    I wish only good news comes tomorrow.


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## xx-nathalie-xx (Jan 10, 2005)

6.450 usd :shock: :shock: pfff that is extreme........

but i'm glad you have chosen not to put her to sleep , i lost a puppy too when i had him three weeks and i was totally lost after that. i would have given all i had to save him....  

it's good you went for a second opinion......many cases here on the forum, when a second opinion was suggested and the outcome was way different than the initial.
i hope everything will be worth it and bella can have a wonderful life with loving people as you ........she and you deserve it !!

i'll be keeping my fingers crossed!!

kisses nat


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## luv4mygirls (Feb 20, 2005)

prayers still being sent your way


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## Rachael Polachek (Feb 19, 2005)

ilovesadie said:


> I performed almost 20 dental extractions on a 13year old 2lb chi yesterday under veterinary supervision and close anesthetic monitoring. She was given a poor prognosis if the surgery wasn't performed, and a 50/50 chance of survivng the surgery. -Nate


Nate, it's a good thing you didn't mention that 50/50 thing prior to the surgery because I, for one, would have been a basket case waiting for the outcome! I mean, I know that anesthesia is always a risk, increasing when the dog is older and malnourished to begin with... but a 50/50 chance of survivial would have floored me. Thank you for withholding that bit of information.  

Having said that, I'm even happier than I was that Tiny is doing so well! :lol:


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## Rachael Polachek (Feb 19, 2005)

Kurt, I'm delighted that baby Bella is getting a 2nd chance. You and your wife, well, you are incredibly kindhearted and generous people. I will keep Bella in my prayers and hope she survives this ordeal.

If you have time, maybe you could post a photo of Bella here? I think we'd all love to see the tiny girl who has captured your heart.


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## KB (Apr 13, 2004)

Rachael Polachek said:


> If you have time, maybe you could post a photo of Bella here? I think we'd all love to see the tiny girl who has captured your heart.


My thoughts exactly  

I find you think just like me.....very strange huh? :lol:


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## ilovesadie (Jun 1, 2004)

Kurt, I wish you and Bella the best as she undergoes endoscopy today. The beauty of being young is that recovery is easy. She'll be easy to place a esophageal feeding tube since she's so small, and I'm glad you got a second opinion. Keep us updated, and know we're all pulling for you.

-Nate, Krisitn, Sadie, Ritz and Tiny


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## nikki (Jan 28, 2005)

Wow, I am so glad(and relieved) that you decided to try to save her. :thumbleft: I pray that she will be ok. Good luck with everything and please continue to keep us updated.


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## jlcase (Feb 8, 2005)

Ok this is the first time I came across this thread and there are tears in my eyes, so sad to hear about a little baby so sick.

Yes, please let us know how the procedure goes. It's too bad that it's going to cost so much that is really high!! :shock:


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## Owned (Sep 22, 2004)

Bella's Daddy said:


> This is going to set us back a bit ($ 6,450.00 - to start with), but as I told Virginia "Bella is an expression of God. She deserves the chance to live."
> 
> Kurt


And I can assure you, that if she pulls through this okay, in a very short time you're going to feel like that was the BEST $6,450.00 + that you've ever spent. :wave: 

I will keep Bella and her family in my thoughts.
Good luck with everything!


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## Rachael Polachek (Feb 19, 2005)

Kemo's mamma said:


> Rachael Polachek said:
> 
> 
> > If you have time, maybe you could post a photo of Bella here? I think we'd all love to see the tiny girl who has captured your heart.
> ...


Scary... for you.


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## Bella's Daddy (Apr 19, 2005)

Here is one picture. They may be rather large (still getting used to posting pics).










I will post a few more latter.

Kurt


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## nikki (Jan 28, 2005)

Awww she is beautiful! :love10:


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## sullysmum (Mar 6, 2004)

I expect its going to sound really stupid after the vets have seen her and ive never had a chihuahua so young though i have had a long experience of having chihuahuas but could something as simple as worms have anything to do with her stomach problems?


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## ilovesadie (Jun 1, 2004)

The name Bella suits her perfectly! She's beautiful!


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## oliversmom (Apr 12, 2005)

Your family and Bella are truly in my prayers. I hope you can let us know how things turn out. Honestly to me animals are like children in that they are defenseless and precious and you never want to see one hurt or ill. Good luck from Oliver and me.

I had to come in and edit this - cause I just saw the picture of Bella. She could be Oliver's sister - they look SOOO much alike. I have not seen a chihuahua in this group that isn't beautiful though - I think I'm hopelessly hooked on them!


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## Bella's Daddy (Apr 19, 2005)

Well, she had her endoscopy. The results were not as promising as we had expected. She has "Congenital Megaesophagus" and there is no surgical intervention for it.

We have chosen to have a PEG feeding tube placed for now and will move to a "button" version later. We will also need to teach her to eat in a standing position and keep her quiet for 15-20 minutes after each meal. This will be a life long commitment, but then, she would be a life long commitment either way.

Kurt


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## KB (Apr 13, 2004)

wow well it does not sound too bad! That is good.....when is the tube being insterted or is it already? 
Who knows maybe down the road there will be something they can do. Technology is ever moving in leaps and bounds!!
Hugs to you all!! {{{HUGS}}} :wave:


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## Gadget's Mom (Jan 14, 2005)

God Bless Bella, you and your family.


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## nikki (Jan 28, 2005)

I think it will all be worth it, to know that you saved her life. Good luck and I hope your puppy stays happy and healthy from now on. I'll keep you in my prayers. :wave:


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## Rachael Polachek (Feb 19, 2005)

Thanks for the picture. She is so beautiful, it's no wonder you're hopelessly in love with her. :love4: 

Although today's procedure wasn't as promising as you'd hoped, it sounds like there are some other good options you're willing to try. As you said, either way she's a lifelong commitment. I'm looking forward to further updates and more pics.

We're here when you need us. Please tell your wife as well.


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## sjc (Jan 14, 2005)

Wow! My thuoghts and prayers are with you. She is a beautiful little Chi-baby! It is amazing how quickly we become attached to them. I do hope she makes a speedy recovery and she is blessed to havae such a wonderful caring family! Please do keep us updated on her progress!

sandra


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## blossom (Mar 8, 2005)

^ Ditto! :wave:


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## nabi (Nov 25, 2004)

My Bella sends your Bella a big hug !


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## chimom (Apr 1, 2005)

While it may not be the good news you hoped for, it sounds as though there is at least treatment, and with the right care she could live a relatively normal life. You and your family are to be commended for being willing to go the extra mile with this sweet baby. As you said, she is a lifetime commitment regardless. Saw her pic and she is a real sweetie. it doesn't take long for them to wrap themselves around your heart! My thoughts are with all of you and please keep us updated on her progress.


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## SC (Oct 15, 2004)

I haven't been here in a few days and am just now seeing this. So sorry that your little Bella is so sick. What an ordeal all of you have been through.  After reading the entrie thread, I'm happy that there is an option for little Bella afterall. I'll keep you all in my prayers. Please keep us updated as to her progress!


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## Seiah Bobo (Mar 31, 2005)

Bella is soooooo beautiful!!!


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## luv4mygirls (Feb 20, 2005)

she is truly a precious little baby.


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## Bella's Daddy (Apr 19, 2005)

Its been a busy day, both at work and at the hospital. Here are a few other photos as I promised this morning.




























Hope you all enjoy them.

Kurt


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## ilovesadie (Jun 1, 2004)

Great pictures Kurt =) Bella looks like she is happy to be home, and it's wonderful you decided to give her a second chance. It is owners like you that make the veterinary business satisfying and you are a great role model for many new dog owners out there. If you are ever in the West LA area I would be glad to do a free portraits for you and your puppy!

-Nate


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## xx-nathalie-xx (Jan 10, 2005)

aaaw what a sweet little cutie !! i hope she will pull trough !!

kisses nat


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## KB (Apr 13, 2004)

she's precious!!!!!!!


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## Rachael Polachek (Feb 19, 2005)

ilovesadie said:


> If you are ever in the West LA area I would be glad to do a free portraits for you and your puppy!
> 
> -Nate


Kurt, trust us... you definitely want to take him up on this offer. Nate and Kristin take the most incredible photos of their dogs. You will not believe your eyes!

Bella is lovely, so sweet and girlie looking. I love her pink belly. :lol:


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## Frasier's Mommy (Jan 30, 2005)

She just looks so sweet and cute. You and your wife are wonderful people to work so diligently to save her.

I'm only down the road from you (Murrieta), though I'm in the midst of moving to Dallas. I'm sending prayers and good thoughts for all three of you up your way.


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## nikki (Jan 28, 2005)

Awwww, she is sooo cute!


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## oliversmom (Apr 12, 2005)

Bella is so lucky to have found such good parents. I hope she will get strong and healthy very soon. I know as you say her condition is life-long but how worth it she is. I can't get over how much she looks like my Oliver. He said hi to Bella too.


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## nabi (Nov 25, 2004)

Your Bella is just beautiful.......hope all is going well with her feeds. I remember the first time I did a tube feed LOL....thank goodness the patient thought I was an old pro !


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## sonny's mama (Apr 14, 2005)

OMG! Bella ( i think thats the dog in the most recent pictures) looks JUST LIKE Sonny...Identical! As soon as I figure out how to, i will post a picture of Sonny...
Sorry to hear about all the issues with Bella...my prayers and thoughts are with us as well!


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## Gadget's Mom (Jan 14, 2005)

Kurt I am so glad bella is doing better


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