Emmitt is part of a litter of 11 that was born just days after momma Priscilla was pulled from the high kill shelter in West Texas. Puppies would be good with other dogs, kids, and cats with proper introductions and training.  All dogs and puppies require supervision and training. 

Emmitt is a very special little guy who has been through a lot already in his 9 weeks of life and will be going through even more in the not so distant future.  Approximately 2 weeks ago he was lethargic and his gums were extremely grey (anemic).  His foster at the time brought him to Southview Animal Hospital where it was determined that he would need a blood transfusion.  Unfortunately, they could not do that procedure and referred us to Animal Emergency and Referral Center.  Oh boy... that is where it got dicey.  Here is the just, he had his blood transfusion and saw a cardiologist who said his prognosis is guarded.  I will paste the medical terms below, but just know he has been fighting...and seeing him you wouldnt know he had severe heart anomalies going on. 

Cardiology Diagnosis:
1. Moderate to severe pulmonic stenosis - Partial "type B" morphology, R2A anomaly not suspected
2. Moderate dynamic left ventricular outflow tract obstruction secondary to systolic anterior motion of the anterior mitral
valve leaflet ("SAM")
3. Left ventricular hypertrophy - Suspect secondary to SAM +/- left heart volume underload, less likely primary
hypertrophic cardiomyoapthy
4. Rule out mild to moderate cor triatriatum dexter, other venous return abnormality, or vascular shunt to the right atrium
- Caudal caval dilation, though no evidence of congestive right heart failure today.
5. Severe anemia - Being investigated by the AERC emergency/critical care department
Emmitt has moderate to severe pulmonic stenosis, an inherited heart defect that causes thickened pulmonic valve leaflets that do not open as well as they should. This makes it hard for the heart to pump blood to the lungs. Animals with mild pulmonic stenosis typically never become symptomatic for the disease and live a normal life span. However, in dogs with severe disease, the increased workload on the heart causes heart muscle thickening and damage over time. Clinical signs can include fainting, exercise, intolerance, fluid in the
belly (congestive right heart failure), weakness, collapse, and unfortunately even sudden death from fast arrhythmias (ventricular tachycardia and/or fibrillation). When severe, the treatment of choice for this disease is balloon valvuloplasty, a minimally-invasive procedure in which a balloon is inflated across the fused valve leaflets to open them more, with goal of reducing the severity of the obstruction. If successful, this will hopefully reduce the risk of complications and improve both quality and quantity of life. Emmitt has a moderate to severe obstruction with mild to moderate secondary heart changes, and it is questionable whether or not he needs balloon
valvuloplasty intervention at this time. His pulmonic valve also has a component of thickening ("type B" morphology), which sometimes don't respond as well to ballooning compared to strictly thin tethered "type A" morphology valves, but his valve does have components
of both. Once Emmitt is stabilized with his other non-heart abnormalities, starting a beta blocker (e.g. atenolol) may be considered to help reduce workload and oxygen demands on the heart. Depending on recheck echocardiogram findings, we can discuss whether a beta blocker and/or balloon valvuloplasty procedure would be recommended. The echocardiogram today also showed Emmitt's mitral valve is moving abnormally (systolic anterior motion, "SAM"), causing the valve
to leak (mitral regurgitation) and partially obstruction blood flow out to the body. This has led to left ventricular hypertrophy (thickening). There is a chance that the SAM is from being volume underloaded/dehydrated, and the thickening is "psuedohypertrophy," too. Treating with a beta blocker (as above) would hopefully also help reduce or even eliminate the obstruction. I have seen some puppies with this that after they have grown, the obstruction goes away and they do not need the beta blocker anymore.

Finally, the veins returning blood flow from the abdomen appears to be partially obstructed. This may be due to a membrane covering the caudal vena cava, called cor triatriatum dexter (though a definitive membrane was not seen, it did appear narrowed). However, it is also possible he has different congenital vascular abnormalities/shunts. A CT-Angiogram would be the recommended next step to investigate his circulatory system. Cor triatriatum dexter can sometimes be treated with a balloon dilation +/- stent placement, though other vascular anomalies may not be able to be treated. Regardless of underlying cause, this has led to the backup/congestion of blood
in his liver veins, and he is at risk of developing congestive right heart failure (ascites, fluid in the abdomen). However, if it is not a cortriatriatum dexter and it is an anomalous venous return, then there may not be interventions to control his liver venous congestion, which could lead to congestive right heart failure in the future. If heart failure (fluid build-up) were to ever develop, diuretics such as furosemide (Lasix) would be needed to help resolve/control fluid build-up, though this would potentially be more concerning as a life-limiting condition, even with a successful pulmonic stenosis balloon valvuloplasty. While we can perform a balloon valvuloplasty of the pulmonic valve here, we are not currently equipped to balloon and stent a cor triatriatum, so if one is present and you would potentially be interested in interventions, we can help facilitate referral to the U of MN

Priority will go to applicant who can bring to vet visits in the Twin Cities Metro, MN and keep him on the NO forced exercise and follow rescue protocols on treatment. Please put in your application on our website mattysheartandsoulanimalrescue.rescuegroups.org. OR we would always welcome any donations on his behalf to help cover the mounting vetting that will be consistent in his young life.