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Again, spoilers for 8x03 and speculations beyond! Beware!
Okay, there aren't really any spoilers, just speculation. And I wouldn't even call it that. It's more like... Brain-farting.
So, here is what's happening - Amelia is not real. When Sam hit the dog and brought it to the vet clinic, it actually died and Sam snapped, making out this fantasy of living with the dog (by the way, Riot is an amazing name in my opinion) and the nice animal doctor lady, because he couldn't deal with being so alone anymore. That's why all his flashback have this dreamy quality to them - they are just that, dreams. That's why Sam doesn't call her, why she doesn't call him...
This is basically all I got from this episode. This, and that Papa Ackles is awesome.