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Pancreatitis Update post #30

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  • Pancreatitis Update post #30

    how soon do you normally start food after a bout of pancreatitis in dogs?
    Last edited by threedogpack; Aug. 24, 2012, 05:10 PM.

  • #2
    Unfortunately my 12 yr old JR, Shorty, is being treated for pancreatitis right now. I took her to the vet last Friday. They kept her overnight for sq fluids then fed her very small amount of Hills Science Diet i/d food the next morning. Sent her home at this time on this food which she'll eat but not with gusto. She'd love something richer I'm sure which would do her in.
    While reading up on pancreatitis I found that it is best to start food as soon as is safe to avoid "leaky gut" syndrome. I'm not sure how long the GI tract would need to rest to cause this syndrome to happen.
    I also found out that giving probiotics during pancreatitis increases risk of death. Find that one hard to process as you'd think probiotics would be THE thing especially when antibiotics are in use.
    Hope your pup is okay. This is a scary situation.
    Producing horses with gentle minds & brilliant movement!
    www.whitfieldfarm.shutterfly.com

    Comment


    • #3
      When my JRT had pancreatitis, my vet generally recommended with holding ALL oral anything for a minimum of 48 hrs. SubQ fluids (I can do these myself) only, then slowly introduce oral food and water. I generally started with just a tablespoon or so of food 4 - 6 times a day. Usually something like chicken and rice.

      He had several boutes of this over a period of several years and we never really found a trigger. What did seem to work was putting him on a raw diet.

      Comment


      • #4
        Hills Science Diet now has a special type of I/D made for dogs that have had pancreatitis. The vet clinic I work at just started carrying it. We usually keep the dog until they are eating their food well, and keeping it all down. If you're unsure of when to feed/what to feed, I'd call your vet clinic & ask for their advice. Hope your dog gets better! Pancreatitis sure can be a scary thing to deal with!
        I <3 Callie Mae

        Comment


        • #5
          Old school technique for treating pancreatitis is to withold food. Now, medicine specialists and criticalists agree that if the animal can tolerate it without extreme nausea, the goal is to feed small amounts frequently or have them on a low rate CRI. A low fat diet is easiest on the pancreas. Often the dogs dont need to stay on low fat food indefinitely, just while they get over their inflammation.

          Comment


          • #6
            I hope everyone's dogs do well recovering from pancreatitis. We just lost my Grandma's little dog to it yesterday. Have no idead what triggered it and I had just had him in the hospital this past Friday and he had bloodwork and an abdominal ultrasound and was fine. (Was a Derm/Cushings consult.) Scary stuff.

            Comment

            • Original Poster

              #7
              background.

              Sunday she spent about 7 hours in the ER. Transferred to vet that morning when the ER closed. Had 1000 NormalsolR (?sp), which finished up at about 2200 on Monday (close to 24hrs). Also on polyflex, cerenia and torbutrol. Finished up the torbutrol & cerenia on Tuesday morning, still polyflex. We were to begin offering rice & boiled skinless/boneless (3parts rice:1part rice). Tuesday night she lapped up about 3 oz for me and ate a very small piece of plain chicken w/o the rice. Today, nothing.

              Dog is recumbent, refuses or cannot stand. She urinated a lot on Monday, On Tuesday she would urinate and defecate if laid in grass outside. Again this morning she urinated and defecated outside. This evening, nothing and tonight nothing.

              Total water via needleless syringe over 4 hours, was about 4 oz.

              If she is still refusing food, I may make a gruel with the water and see if I can get her to swallow some of that.

              Any comments?

              Comment


              • #8
                Oh 3-dog, I'd have her at a large university of something where she could get top-notch treatment. She doesn't sound good at all. I'm sorry to say that. I hope for the best for her. This is a very tough disease & I wouldn't waste any more time at home. Not with her not even wanting to stand. Something's very very wrong with that whole picture.
                Praying & jingling for her.
                Producing horses with gentle minds & brilliant movement!
                www.whitfieldfarm.shutterfly.com

                Comment


                • #9
                  how was she diagnosed with pancreatitis? I am concerned about the not urinating last night. Dogs with severe pancreatitis can go into acute kidney failure. Torbutrol is not a very good pain medication. An ultrsaound may be warranted to look for pancreatic abscess or pseudocyst. Would recommend that she be seen by an internist at a facility with 24 hour care.

                  Comment


                  • #10
                    My pancreatitis dog was hospitalized for about 24 hours and they had him started back on (small, frequent meals of) a low-residue canned food before he came home. He was in pretty rough shape the first day -- took him back in the evening and got better anti-nausea meds and from there it his condition went (luckily, happily, oh so luckily) steadily uphill.

                    It's been almost a year but I believe mine was on the various meds for quite a bit longer than 2 days after coming home.

                    Don't want to scare you, but if my dog was as described, he would be on his way back to the vet pronto.

                    Hope yours improves. It's a pretty awful disease.
                    bullyandblaze.wordpress.com

                    "The present tense of regret is indecision."
                    - Welcome to Night Vale

                    Comment

                    • Original Poster

                      #11
                      she was diagnosed via Snap cPL Ko Pancreatitis test.

                      the Er also and ultrasound, CBC/Diff/Platelet count, organ profile, rads (1 view), ECG

                      I am not unhappy with the workup the ER did

                      Late this morning and afternoon, I did make up chicken/rice 1:3 into a paste that had a consistency of stiff mashed potatoes and scraped that off onto her palate behind her teeth. She swallowed that. She ate about 1 oz. over the course of 3 hours. No vomiting. Tho, she never did vomit, even prior to the ER visit.

                      I also called my regular vet office (who was out of town, will be back tomorrow), who called him. He send home another bag of fluids, hep flush and will see her at 1145 tomorrow.

                      At about 1830, she was taken out and she urinated. She did not defecate, but she has had little to eat and she did defecate a small amount this morning, which was formed, normal consistency and moist (as opposed to hard/dry/constipated).

                      What *I* am worried about is that this is not pancreatitis but something else, tho no idea what.

                      Comment

                      • Original Poster

                        #12
                        and to all, I agree, she is not good. Tho I think she is stable at the moment, I am just *really* uncomfortable with no IV fluids when she will not drink. I understand that she needs to do that eventually, but as sick as she was on Sunday-into-Monday and I think that one more bag, 72 hours after finishing that last will not hurt and may make a difference.

                        New Vet did not want to give her another bag immediately as he very much wanted her to have at least a 24 hour rest. As mentioned above it has been 72hrs now, so I don't think we will dump her into CHF via too much fluid. I do not disagree with the wait of 24 hours, but I think she needs some more supportive care now & the fluids are least likely to harm.

                        Comment


                        • #13
                          I think that the IV fluids are a good idea as well. Did they provide you with an ultrasound report? Do you know if a radiolgist did the ultrasound? There are specialist who can help you figure out what is going on and provide you with treatment options. Good luck, and I hope your dog feels better soon. So hard to see them not feeling well.

                          Comment

                          • Original Poster

                            #14
                            FAST Scan AUS, no free fluid noted near bladder, either kidney or between liver lobes. Gall bladder mostly full of sludge and GB wall hyperchoic but GB wall does not appear edematous and sludge not organized into a mucocele. Uterus not visible on ultrasound.

                            Comment

                            • Original Poster

                              #15
                              the attending emergency vet read the US

                              Comment


                              • #16
                                Whats her bilirubin?

                                Sludge in gallbladder is generally a non-issue in dogs, as it is with people, however distension of CBD can cause a backup causing increased bilis. Sometimes a very inflammed pancreas will obstruct the CBD.

                                Renal screen will tell you how the kidneys are doing (BUN and Creat), if these are normal I wouldnt worry much about the kidnetys at this point.

                                Sounds like you had an ER ultrasound fluid check...which is great, but if she isnt doing better soon I would have a radiologist or internist perform a diagnostic ultrasound. Just becuse there isnt free fluid, doesnt mean everything is normal. Hopefully it is, but its best to get a run through of all the organs in the abdomen. I would also suggest getting her to a referral hospital where she can get the best diagnostics/treatments by specialists. ER doctors are fantastic, but their job as ER is to manage a case until it can be transferred back to primary care or a specialist.

                                Sounds like you are keeping a really close eye on your dog, which is great to hear. Im sure if you are concerned you would take her back to the hospital. Its always nice to send pancreatitis dogs home to see how they do, often they are more willing to eat at home than in the hospital. However, if they are reluctant to eat at home past 24 hours or are "recumbant", further hospitalization sounds like a necessary next step.

                                cPLI's are NOT fully diagnostic for pancreatitis remember. Often other diagnostics are required to diagnose or rule out pancreatitis unfortunately.

                                Good luck!!!!!!! Jinges!!!

                                Comment

                                • Original Poster

                                  #17
                                  on sunday/monday her bun = 6 and crea =0.5, lytes ok na=138 k+ 4.7 na:K+=29 overall NSF

                                  as I said she is going back to my reg vet who is more than willing to refer if he thinks he needs to, tho we might have to think about the cost/value for an 8 year old dog.

                                  Comment


                                  • #18
                                    Originally posted by threedogpack View Post
                                    on sunday/monday her bun = 6 and crea =0.5, lytes ok na=138 k+ 4.7 na:K+=29 overall NSF

                                    as I said she is going back to my reg vet who is more than willing to refer if he thinks he needs to, tho we might have to think about the cost/value for an 8 year old dog.

                                    So it looks like they didnt run a bilirubin? Just keep an eye on her scleral color and mucous membranes. If they at all look jaundiced then she needs to be further assessed asap. Not common, but it "can" happen.

                                    What type of dog do you have? I think in most cases, if it really is just pancreatitis (but a nasty one), you have a good chance of compete recovery (IF you can afford it). Often its just a one time investment of a feeding tube, antiemetics, analgesia. Once a feeding tube is in, often these patients can be sent home. I have known some very bad cases, and they have not made it. However, I would say at lease 95% of the cases that come through hospital here do recover completely within 3 weeks and most are hospitalized for about 3-4 days.

                                    Im not going to lie, stubborn pancreatitis can cost a pretty penny,but usually there is a good prognosis long term.

                                    Might be worth a referral to an internist (and get a real utrasound done) to rule everything else out. If its not a pancreatic neoplasia, and just inflammation they can likely give you a good home care route to follow. Jingles and keep us posted!!

                                    Comment

                                    • Original Poster

                                      #19
                                      this was the vet who took her case at the ER


                                      XXX returned to Our Town in August, 2010 to join the ER veterinary staff after completing a small animal rotation internship, including emergency and critical care, at Texas A&M. A graduate of Local Private College, Dr. X completed her veterinary degree at the University of Tennessee in 2009. She gained valuable experience as a student extern at several Our Town-area veterinary hospitals, including the Our Town Emergency Center during vet school. Her areas of interest include not only emergency and critical care, but also internal medicine. She is a member of the AVMA, PVMA and VECCS.

                                      X's and Our Town supplied by me.

                                      Comment

                                      • Original Poster

                                        #20
                                        Originally posted by SquishTheBunny View Post
                                        So it looks like they didnt run a bilirubin? Just keep an eye on her scleral color and mucous membranes. If they at all look jaundiced then she needs to be further assessed asap. Not common, but it "can" happen.
                                        no, I did not see that on the discharge papers.

                                        What type of dog do you have?
                                        Pem Corgi

                                        I think in most cases, if it really is just pancreatitis (but a nasty one), you have a good chance of compete recovery (IF you can afford it).
                                        I am afraid it is something other than panceatitis, but we'll see what my vet says later this morning, I will report back in when I get home.

                                        Often its just a one time investment of a feeding tube, antiemetics, analgesia. Once a feeding tube is in, often these patients can be sent home. I have known some very bad cases, and they have not made it. However, I would say at lease 95% of the cases that come through hospital here do recover completely within 3 weeks and most are hospitalized for about 3-4 days.
                                        fingers crossed that this will do it.

                                        Might be worth a referral to an internist (and get a real utrasound done) to rule everything else out. If its not a pancreatic neoplasia, and just inflammation they can likely give you a good home care route to follow. Jingles and keep us posted!!
                                        thank you so much for the advise and the jingles. I will let you know what my vet says and if he refers us out to another.

                                        Comment

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