The game basically threw Health Ups at me and I traded them all for devil items, including Guppy's Paw
My health went off screen in Caves 1 (see above picture where I'm fighting super Pestilence) and never came back lol
I also managed to get the Skeleton Key and Guppy's Tail in one run, which is a match made in...well, Hell, because I got the Tail from Satan
Edit: Oh god lol I can't wait to see Northernlion encounter some of these new bosses, those videos should be up in about 2 days