23-032 Itty Bitty  was only 8 weeks old when she was surrendered to  AGR  in May 2023 by her breeder. This English Cream puppy was the runt of a litter and had been diagnosed with a heart condition called patent ductus arteriosus (PDA).  AGR  had her evaluated by a cardiologist with  Desert Veteri nary Medical Specialists.  We were told the condition is usually fixable (if detected early enough) either by open heart surgery (thoracotomy), or by implanting a cardiac catheter-based occlusion (i .e . a plug). The latter procedure was recommended not only due to the lower cost but also to the lower risk of complications. Our Health Care Manager got an appointment within two weeks, amazingly enough. During the puppy's exam, in addition to the PDA the doctor determined that  Itty Bitty  had sub-aortic stenosis. This narrowing of the aorta was causing increased pressure in the heart and enlarging it. One of our Intake Team members offered to foster this little girl and see her through the catheterization surgery, which was done on June 20, 2023. The surgery to correct the PDA was successful! A month later, a follow-up echo-cardiogram showed that the implant was firmly in place, there was no leakage, and the heart, which had been enlarging, was now a normal size. Also, the pressure due to the sub-aortic stenosis had dropped by half. So,  Itty Bitty , who is not so itty bitty any more at 34 lbs, is expected to have a near-normal life span. The adopter has had a challenging job with this puppy, taking care not to let her over-exercise. She decided to adopt her and renamed her  Winnie . Recently the adopter commented: 

Winnie  has been a wonderful addition to my pack, however she can be stubborn at times. When it’s  time to go rest in her pen, she will throw herself on the floor and  won’t move. I must pick her up and  put her in a walking position, pulling her along with her leash to get her moving! She’s very entertaining when interacting with the other pets in the household. She loves playing with  Charlie , especially – they play tug-of-war with the toys. He is much bigger than she is, so it's entertaining to watch her hold her own with him. She also likes playing run-and-chase with  Lacey  and will latch onto  Lacey's  tail.  Honey  doesn't get into the mix but is very tolerant of the puppy and will give her kisses if  Winnie  goes over to her. So far, there is just a stand-off between  Winnie  and the three cats. She wants to play; they usually go hide.  Life is  never dull  around our house now! 

Winnie  will need an echocardiogram at 1 year of age so the doctor can evaluate if she’ll need any meds for the aortic stenosis or can live well without them. The adopter was given a contract addendum for the follow-up and for  Winnie's  spay at 12 months.