PANCREATITIS

[Jane, Guinness and Murphy]

After just going through a case of acute Pancreatitis with Guinness I thought it would be helpful to post the things that I've learned about this disease. 

• If your dog vomits more than once (sometimes with accompanying diarrhea, but not always), isn't interested in eating, and is listless or not wanting to move or get up....get him to a Vet.  This is what Pancreatitis looks like in its early stages.  The Vet will often be able to determine if it actually is Pancreatitis through a quick blood test which shows elevated pancreatic enzymes.  Catching this early is critical, and repeated vomiting can quickly lead to dehydration.   We got Guinness into the Vet within the first 12 hours and he was already dehydrated.  While you're waiting to get your dog into the Vet be very careful of any food you give him....low fat only, if anything.
• Pancreatitis is an inflammation of the pancreas...the organ that secretes enzymes that are used in digestion.  When something causes these enzymes to be activated prematurely, they can actually begin to digest the pancreas itself which causes pain and the inflammation.  There are two forms of pancreatitis....acute and chronic and either one can be mild to very severe.  Guinness had acute pancreatitis which occurs very suddenly and is often severe.  Chronic pancreatitis is an ongoing inflammation and often there are no symptoms.
• Acute pancreatitis is extremely painful, so pain management is usually part of the treatment.  I could tell that Guinness was in pain because he kept himself in a "ball" and would not move.  It can be fatal, especially if it spreads to other organs.  The symptoms are loss of appetite, vomiting, weakness, depression, and abdominal pain....sometimes diarrhea but not always.  Because of the nausea, they will often drool or smack their lips....actually the lip smacking was something I noticed right away because Karen's JD had the same symptom with his IBD.
• For mild cases all that may be needed is withholding food and water for 24 to 48 hrs and managing the pain.  IV fluids are usually administered during this period to prevent dehydration.  The thinking used to be that food and liquids should be withheld until the symptoms subsided in order to rest the digestive track, but that thinking has changed.  Now there is growing evidence that recovery time is reduced and survival rates increased when dogs are fed early in the recovery process.  Withholding of oral food and water for more than 48 hrs can lead to "leaky gut" and atrophy of the digestive cells in the small intestine and sepsis.  I learned this from both my regular Vet and the Specialty Vet in the Hospital.  Basically without oral nutrition the intestines starve even if nutrition is provided to the rest of the body through IVs.  This is because the intestines receive their nutrition only from what passes through them.  This was very surprising to me...I had believed that as long as Guinness was getting IVs he was okay.  This is also why there was so much concern about him not eating.  I really think they wanted to keep him in the Hospital for one more day, but getting him to eat was more important, and they felt like he needed to be home for that to happen.  As a last resort, they would have gone to a feeding tube...thank heavens we were able to avoid that.
• Guinness was on lots of meds:  antiemetics to control the vomiting, antibiotics for secondary infection, anti-diarrhea meds, pain management meds, antacids, and a probiotic.  There is apparently a lack of agreement on the probiotics but both of his doctors prescribed them.  A plasma transfusion was considered when he was in the Hospital, but it did not come to that.
• Chronic pancreatitis is a continuing low grade inflamation.  Symptoms are occasional vomiting and loss of appetite.  The symptoms can be pretty non-specific and may go unnoticed.  Chronic pancreatitis can occasionally flare up resulting in acute pancreatitis.  It's uncertain at this point whether or not Guinness has this, but for now we are going to act as if he does.  Often the symptoms of chronic pancreatitis are blamed on other diseases like IBS/IBD.  A low fat diet is key with chronic pancreatitis....I will be home cooking for Guinness for the foreseeable future.
• So what causes pancreatitis?  This is where things get confusing for me.  Clearly a high fat diet is usually blamed for this disease....but I have not been able to find any scientific evidence to fully support this theory. When dogs who ingest something high in fat after being on a low to moderate fat diet they are susceptible.  We assumed that Guinness was triggered by the treats he had at training the prior day.  I have since heard from the trainer and the treats she gave him were only 7% fat and mine were 6%.  It may have been the volume...he did have more than he would normally get since for regular training I don't use treats.  So maybe that's the cause or maybe he has chronic pancreatitis that flared up.  We don't really know.  Low protein diets and certain medications have also been identified as potential causes...these did not apply to Guinness.  There are also some underlying conditions that can predispose a dog to pancreatitis....e.g. diabetes, hypothyroidism, Cushings disease.
• Pancreatitis hits young and old dogs of all breeds, although it is most common is middle to old age overweight and inactive dogs.  I found it interesting that data suggests that Cocker Spaniels and miniature Poodles have an increased risk of chronic and acute pancreatitis. Guinness is an ALD...so he has both breeds in his genetics.
• Diagnosis...Guinness was diagnosed through a blood test which showed significantly elevated pancreatic enzymes.  However, we were lucky.  In some cases, the enzyme levels test normal even though the dog has pancreatitis...actually this happens almost half of the time.  That makes diagnosis a little more difficult and the Vet may decide to just treat the clinical signs.
• Managing your dog through treatment can be a challenge.  Guinness was hospitalized during the day on IV meds and fluids, and he came home at night to sleep.  We did this for four days and when his symptoms were not improving he was admitted to a Specialty Hospital for round the clock care.  At that point his condition was very serious and he needed the care of an Internal Medicine Specialist as well as 24 hr management.  After two days he was able to come home. 

I hope this information is helpful...but that you never need it. 

[Donna K & Quincy]

That Guinness is well is totally the most important thing. It's just good to have all the info that you can.

[F, Calla & Luca]

Absolutely on both counts.

[Nancy, Ned, Clancy, and Charlie]

Thanks!

[charlene]

This information is good.  My labradoodle, Geno, in the fall had pancreatitis.  It was very scary and we almost lost him.  After 3 days of IVs, he finally started eating again.  He did great until earlier this week when he had a mild case of pancreatitis.  He's eating and finally stopped vomiting.  Looking much better.  Vet said he may get this from time to time.  We have him on a very strict diet which helps a lot.  I think we got a little lax on his diet (too many treats, etc.) which is why it happened again. 

 

It seems to be a 'way of life" for us now.  The warning signs you talked about were true with Geno too.  The licking of the lips and his breath got really bad the last time, so if I smell that again I know he's starting to have problems and watch him very closely.  My vet said I can treat early stages at home but if he stops eating to get him in there asap.

[Frances Pendrous (Horan)]

Hi Jane, what a wonderful informative lesson on pancreatitis that was. Sadly, we both had to go through all of that in the past as it truly is a rotten, insidious disease that I am sure has triggers. Johnny has had mild forms of it ever since he was hospitalized for a week the first it was diagnosed. You are right, there are tell-tale signs that it is coming on and both Johnny and I are familiar with it now. For Johnny, he starts to refuse any treats and starts vomiting and hacking up clear bile. I then know it is the beginning of the dreaded "P" and straight away put him back on his "pancreatic diet" that the vet prescribed for him when he came home from the hospital. It is prescription canned food. No dry food allowed. He stays on is for about four to five days and then, thank the Lord, he gets over it. I really don't know the trigger still, but I am sure it is when we overdo the rich treats. I guess this is something we are going to live with for the rest of his life, but thankfully, being educated on the subject and also knowing how to treat the early warning signs has helped. Once again, thank you for the very informative information on the subject as, like you and I were in the beginning, who knew that dogs got pancreatitis....!!!! Hope all is well xxxx

[Joanne ~ Spud*]

Thank you for this  reference. Years later,  I knew this was here and used it at 3am.  Spud was diagnosed today with Gastroenteritis not Pancreatitis, thank goodness.

Reading this last night, I knew this was not the symptoms we were dealing with the past few days.

Just saying thanks

[Hazel & Chester Wayte]

Hope Spud is doing OK..

[Joanne ~ Spud*]

Aww thank you Hazel.  I hope so too. I put this here because I was so very thankful members  of DK  can find information in the middle of the night.  This is a great community and I am so happy to be able to locate posts like these.

Here is an update I posted on my status today. 

Update on Spud
After another long night going out every 20 minutes or running to the basement to potty, throwing up just tbsp of yogurt and pumpkin, he was rushed into the vet this morning.
Again, I've closely followed the DogCV virus in our area and did not see the blood, breathing problems- but 4 days with each day worse, last night was very worrisome.
He has Gastroenteritis. He smells horrible but the vet was not too concerned at this time. Or maybe he was. He just didnt tell me anything.  Spud did get a shot and some oral medication to calm down his gut.
He isn't playing or eating yet, but hopefully we will see improvement soon.
He does not counter surf - rarely. He doesn't chew toys, he eats only treats we make, and is on good food. We have no idea why at this time. Stool was negative for parasites.
Thank you for the emails, messages

Read more here: http://www.doodlekisses.com/profiles/status/show?id=2065244%3AStatu...

[Carol and Banjo]

Same here Joanne,  like Jane.....I had no idea Spud had been ill.   I hope things are improving daily for him.    Doodle hugs to all of you.

[Jane, Guinness and Murphy]

I'm just now seeing this, Joanne.  I'm so sorry about everything that Spud (and you) have been through.  Hoping the worst is over, and I'm glad if this helped.

[Lauria Orr]

Jane, This is 4 years after you posted this, and I am so grateful for the information. My little Melody was just diagnosed with Pancreatitis last night. I had taken her to our vet yesterday, after she was unable to have a bowel movement, other than initial diarrhea. She began to have urgency with trying to evacuate her colon, but would only pass this brownish mucousy blood tinged liquid. We had the liquid tested and it was clear of any pathogens whatsoever. She skipped a meal altogether, and vomited only once.  Based on her exam and symptoms, the Vet suggested it could be colitis, and ordered Flagyl, and also an anti-nausea medication. He gave us some probiotics as well. He drew a blood panel, and 6 hours later results came in the Melody's pancreatic enzymes were quite elevated and she had an elevated white blood cell count. We have been trying to get her to take fluids, which she will not. She has a declined energy level, and even still perks up when we mention "Let's go for a walk."  We went back to the Vet today for fluids, and I will give them myself SQ tomorrow, which is Sunday. I have her labs should she need hospital admission.  Her new diagnosis is pancreatitis, and we have yet to see how intense this may become.  She has never had a high fat diet, and eats "Taste of The Wild Fowl" for her kibble. She rarely has a treat, as she is not treat oriented at all. It is a puzzle as to how this has occurred. We are trying to feed her small amounts frequently of a little bit of chicken. She declined the white rice. The Vet gave us some pills for pain for her and she has had only one.  She doesn't demonstrate that she is in bad pain, but I think she must have some.  I am hoping we get through the weekend without a hospital stay, as she is an anxious dog already, and being away from us and sick would be very hard.  We will support her with the fluids, anti-nausea meds, Flagyl, pro-biotics,  pain meds as needed, and small low fat meal of chicken, for now.  Any other suggestions?  We will probably get an ultrasound on Monday. I hope she does not have anything else we need to be worried about.   Maybe we can do hospital during the day and bring her home like you did Guinness.  It makes me so sad Guinness was so sick, and yet, I am very grateful you were able to get him the exceptional help he needed, and you pulled him through.  Bless your hearts! 

[Jane, Guinness and Murphy]

Oh Laura I am so sorry to read this.  Yesterday was a busy day so I didn't get to DK.  I can say that Guinness has been fine since this episode of Pancreatitis.  I do watch the fat content of everything that he eats.  It takes a few days to treat this so please don't get discouraged.  I knew Guinness had pain because he didn't want to move.  The pain meds did seem to make him more comfortable.  The key seems to be trying to keep them comfortable and hydrated.  If you're getting her to eat a little white meat chicken, that is good too....I wouldn't worry about the rice right now.  Please keep me posted and I'm sending prayers and hugs that Melody turns the corner quickly.