Finally, it happened...

September 2025
Back in Tokyo.
This time in Osaka, too,
there was no vomiting, and no need for emergency hospital visits, so

we decided it might be bad if we didn't stop the antibiotics... so we made the tough decision to stop them, thinking that even if she gets sick again, we'll deal with it then!

Then, as expected, her condition worsened,
and the cholangitis recurred. Pancreatitis and cholangitis were hitting her one after another without a break.
In the end, we had to restart the antibiotics.

I'm also worried about her anemia.

Even after a while,
her appetite didn't really return...

She's trembling, and I'm worried about her breathing too...

When we consulted the hospital and had them listen to her heart,

The doctor said, 'Oh, her heart...'

She finally developed mitral valve insufficiency.
It seems she was on the verge of pulmonary edema.

For the past 17 years,
Lil had a strong heart, even for a Chihuahua.

I felt like, 'So it finally happened,' but
at the same time, I felt a strong sense of
gratitude that her heart had stayed strong for this long.

'We will protect the heart, even if it means sacrificing the kidneys,'
the doctor explained, so we decided to have her undergo outpatient treatment for a few days while balancing things with diuretics.

Her kidneys were also in the end stages, so I was anxious about using diuretics, but that somehow helped me understand the current state of Lil's body.

She had been taking steroids as a form of palliative care, but we stopped them because they put a strain on her heart.

With pancreatitis and cholangitis, plus heart disease,
the kidneys were a huge blow.

We reduced the amount of subcutaneous fluids I usually gave her twice a day at home, and to avoid straining her heart,
we had no choice but to find a balance.

The heart medication was liquid, and she has a high rate of disliking liquid medicine,
often going wild and panicking, so the doctor was worried, but
this medicine must have been tasteless, as she took it easily, which was a relief.

From here on, I decided to manage her respiratory rate even more carefully than usual.
(I managed her respiratory rate using a mobile app, not a notebook.)

Thanks to the treatment, the mitral valve insufficiency
went from stage C to stage B2.
The kidney values had exploded, but since her arm veins were still usable,
we had them add one day of intravenous fluids while monitoring the balance to bring the numbers down a bit.

They said food and medicine are the keys, so I hope she can start eating little by little again.
But I know this really means
the limit is approaching,
so in the latter half of September 2025, I decided that if it's too much, it's too much, and I will make sure to accept that.