Pancreatitis

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Postby Hollys Rangie » May 25th, 2009, 5:59 pm

Murphy, my 4 and 1/2 year old Lab/APBT mix, has been diagnosed with acute pancreatitis. He started vomiting yesterday morning at about 5:30 am. It started as a goopy and foamy mucus, but then moved to straight water and bile, so we took him to the emergency vet at 10:30 am. It took them three hours to see him. Once they did, they took two views of x-rays of his abdomen, but found that they were "unremarkable. Gas-filled but non-distended stomach. No obstructive pattern or radiopaque foreign body present." They then gave him 300ml subcutaneous fluids, a 30mg Maropitant injection, and a 25mg Famotidine injection to help with the dehydration and vomiting. Then they sent him home with instructions for us to see our regular vet today.

I called our regular vet today and got Murphy an appointment as early as they opened. He had not been vomiting, but was lethargic, his stomach area seemed painful, and he was having trouble getting comfortable. My regular vet did a blood test for pancreatitis and did barium x-rays. They put in a catheter and gave him 2 liters of fluid with 3cc/1L of Super B Complex for the dehydration (he was 3% dehydrated) as well as two injections (Baytril 22.7mg/ml=3.000cc and Butorphanol 10mg/ml=0.50cc). I don't know what is what, but one was a pain killer and the other is supposed to be an antibiotic.

The barium x-rays have not shown anything because the barium is still stuck in his stomach. The vet says he thinks that is because of all of the GI swelling. He says he sees nothing to suggest a blockage.

His temperature is down now at 100.4, but was up at 103 yesterday at the emergency vet's and 103 at our vet's this morning. Murphy is home now, but will go back to the vet tomorrow to continue on with fluid treatment. He is not supposed to ingest anything.

I know that there are a lot of people on here with a lot of dog experience, not to mention vet techs, and even a vet. I guess what I need is to know is if there is anything else I can be doing to make Murphy more comfortable, or make this shorter. Also, is there anything that I can do to prevent this from happening again? He doesn't eat any human food, and he didn't get in to anything, so we have no idea what has caused this. :confused:

Also, really, how bad off is Murphy? The vet seems to think he is going to be fine, but the paperwork said "prognosis - fair." Any suggestions are welcome.
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Postby Pit♥bull » May 25th, 2009, 7:25 pm

Sorry I cant help with answers, but lots of :goodthoughts: coming to you and Murphy.
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Postby Hollys Rangie » May 25th, 2009, 7:50 pm

Thank you! :)
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Postby Jenn » May 25th, 2009, 10:17 pm

More good thoughts for you and Murphy! I'm so sorry he's not feeling well, and ya'll are having to go through this. :(
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Postby cheekymunkee » May 25th, 2009, 10:27 pm

Poor Murphy. I hope he feels better ASAP!
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Postby CinderDee » May 26th, 2009, 1:20 am

Sending lots of good thoughts!
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Postby Malli » May 26th, 2009, 4:21 am

Hello :)
I'm not a vet or a tech, but I work at an ER Vet. hospital as a vet assistant :)

Usually pancreatitis is triggered by eating something with high fat content : butter, meat fat, cheese, bacon, etc, but I believe there can be other causes...

What kind of food does Murphy eat?

There are some pain medications that can be given for pancreatitis, so that would be good to ask your vet about - though please note some medications could make the pancreatitis worse! In leu of pain meds a nice comfy bed may also help.

Unfortunately, I don't think there is any way you can speed his healing moreso - he'll get better when he gets better :neutral:

Fair prognosis is not really a bad thing, though pancreatitis can be quite serious. It is important, as you now know :) - to avoid anything by mouth (no food or water) until the vet indicates its ok, and most likely then it will be in small amounts.

I know there can be dogs that are more prone to pancreatitis so the vet may want to have you change Murphy's diet permanently after this. Have they done any repeat bloodwork to test the pancreatic enzyme levels in the blood?
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Postby Patch O' Pits » May 26th, 2009, 7:26 am

Did the bloodwork and other tests show it was pancreantitis? ... if not I'd ask about possibly having an an ultra sound just to make sure nothing else is going on.

I hope your dog is better asap.
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Postby Hollys Rangie » May 26th, 2009, 8:14 am

Thank you everyone for your support and well wishes.

Murphy eats no human food other than unsalted, unbuttered, air popped popcorn every once in a long while, but it has been over a month since he last had that. We had asked the vet if that was okay for him, and he said it was fine. When Murphy gets it, he only gets maybe 10 to 20 pieces. We use it as a high motivation treat when training new tricks. He is not a dog that gets in to the trash or anything like that, and is always supervised when outside. When he is outside he is confined to our fenced in back yard, but like I said, either my husband or I are always with him.

Murphy is on Solid Gold Hund and Flocken (lamb and rice). I know a lot of people don't like solid gold, but it is the only food that he seems to do well on (his digestive tract is very sensitive due to the parvo that he contracted at the pound before we adopted him). He is also on the Solid Gold lamb jerky treats, but he gets those about once a week when I clean his ears or clip his nails.

The break down on the treats is Crude Protein - 12%, Crude Fat - 5%, Crude Fiber - 3.5%, and Moisture - 30%. Is that fat content too high?

The break down on the food is Protein - Minimum 22%, Fat - Minimum 10%, Fiber - Maximum 4%, Moisture - Maximum 10%. It has 367 calories per cup. Is that fat content too high?

Murphy had gotten a bit overweight (he was eating his food, and any food Wilber had left in his bowl :rolleyes2: ), but we were working on helping him slim down. I had cut down his food intake, removed Wilber's bowl if anything was left, and we were exercising a bit more. Do you think that might have something to do with this?

The blood work shows that it is pancreatitis. Murphy's pancreatic enzymes (adipase and liapse I think is what they are called?) were off the charts.

The vet put him on some antibiotics, anti inflamatories, and pain meds along with the fluids yesterday. They sent him home for the night. Murphy slept mostly through the night, but did not want to move much. This morning he was finally able to move a little stool - very muddy in consistency and color. They plan to give him more pain meds and fluids today. They are also going to redo the x-rays to see if his GI track is moving again.

Again, I want to thank everyone for their support and well wishes. My husband and I are not able to have children, so Murphy and Wilber are the closest thing we have. I know there is probably nothing that I can do, and I trust my vet completely. I just hate this helpless feeling... :neutral:
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Postby hugapitbull » May 26th, 2009, 8:38 am

Fingers and paws crossed for a speedy recovery.
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Postby Malli » May 26th, 2009, 1:38 pm

It may be worthwhile to see if they can give you something for his pain overnight, as most pain meds don't last that long...

you may have just answered your own question here : "his digestive tract is very sensitive due to the parvo that he contracted at the pound before we adopted him", maybe it was something as simple as a tiney piece of cheese off the kitchen floor??

I know I try really hard not to let my dog eat things he shouldn't (and there are a lot of things he shouldn't!) but he still gets at stuff in the house (off the ground) and outside on walks... theres really possibility??

theres no chance of him staying overnight on IV fluids is there? Continuous IV fluids might help him getting better faster and that way he could also have pain medication IV.

Watch his bowel movements - there may be more diarrhea.
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Postby blabsforbullies » May 26th, 2009, 7:52 pm

Pancreatitis can be caused just by having continued vomiting, of which we don't always know the cause. :| The pancreas lives right by the stomach, so when vomiting occurs, the pancreas becomes involved.

From what I can tell, you are doing all that you can for him. It really is a supportive care scenario while the pancreas has some time to settle. I am very aware of pain management in these cases, as I firmly believe that animals that are in pain heal MUCH slower than do those that are comfortable. :wink:

Here is a handout I often give my clients when I have a patient with pancreatitis. Hope this helps:

CANINE PANCREATITIS


What is pancreatitis?
The pancreas is a vital organ which lies on the right side of the abdomen. It has two functions:

1) To Produce Digestive Enzymes

2) To Produce Hormones Such As Insulin

When the pancreas becomes inflamed, the disorder is called pancreatitis. It is a disease process that is seen commonly in the dog. There is no age, sex, or breed predisposition.

There are two main forms of acute or sudden onset pancreatitis: 1) the mild, edematous form and 2) the more severe, hemorrhagic form. A few dogs that recover from an acute episode of pancreatitis may continue to have recurrent bouts of the acute disease, known as chronic, relapsing pancreatitis. The associated inflammation allows digestive enzymes to spill into the abdominal cavity resulting in secondary damage to the liver, bile ducts, gall bladder, and intestines. (this is rare)

What causes it?

The cause of pancreatitis is not known; however, there may be several contributory factors. It is often associated with eating a rich, fatty meal. In some cases, it may be associated with the administration of corticosteroids; however, some dogs with pancreatitis do not have exposure to either.

Under normal conditions, digestive enzymes produced by the pancreas are activated when they reach the small intestines. In pancreatitis, these enzymes are activated prematurely in the pancreas instead of in the small intestines. This results in digestion of the pancreas itself. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the quantity of enzymes that are prematurely activated.

What are the clinical signs?

The diagnosis of pancreatitis is based on three criteria: clinical signs, laboratory tests, and radiographs (x-rays) and/or ultrasound examination. The disease is typically manifested by nausea, vomiting, fever, abdominal pain, and diarrhea. If the attack is severe, acute shock, depression, and death may occur. (this is rare)

Laboratory tests usually reveal an elevated white blood cell count; however, an elevated white blood cell count may also be caused by many other things besides pancreatitis. The elevation of pancreatic enzymes in the blood is probably the most helpful criteria in detecting pancreatic disease, but some dogs with pancreatitis will have normal enzyme levels. Radiographs and ultrasound studies may show an area of inflammation in the location of the pancreas. Unfortunately, many dogs with pancreatitis will elude detection with any of these tests. Consequently, the diagnosis of pancreatitis may be tentative in some cases.

How is pancreatitis treated?

The successful management of pancreatitis will depend on early diagnosis and prompt medical therapy. The mild form of the disease is best treated by resting the pancreas from its role in digestion. The only way to "turn off" the pancreas is to withhold all oral fluids and food. This approach is accompanied by intravenous fluids to maintain normal fluid and electrolyte balance. The presence of shock necessitates the immediate and intense use of intravenous fluids and shock medications. Analgesics are often administered due to the intense pain pancreatitis often causes.

Will my dog recover?

The prognosis depends on the extent of the disease when presented and a favorable response to initial therapy. Dogs that present with shock and depression have a very guarded prognosis. Most of the mild forms of pancreatitis have a good prognosis.

Will there be any long-term problems?

There are three possible long-term complications that may follow severe or repeated pancreatitis. If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow. This is known as exocrine pancreatic insufficiency (EPI) and can be treated with daily administration of enzyme replacement. (rare) If a significant number of cells that produce insulin are destroyed, diabetes mellitus can result.(also rare) In rare cases, adhesions between the abdominal organs may occur as a consequence of pancreatitis. (extremely rare) However, most dogs recover with no long-term effects. (by far, most cases!!! :mrgreen: )
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Postby Malli » May 27th, 2009, 3:39 am

thanks Dr.Blabs!
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Postby Hollys Rangie » May 27th, 2009, 8:33 am

Thank you so much everyone!

Murphy had a really rough night last night, but is so much better this morning. His temp has been normal for 36 hours now. The barium x-rays show that his GI track is beginning to move again since some of the inflammation has gone down. He also was able to have two normal bowel movements yesterday. He even was able to eat a little bit of baby food while at the vet's yesterday. The vet told me that he thinks we are mostly out of the dangerous part of the woods now. :dance:

I know this is a slow healing process, but I am glad to see a little spark back in my boy. He even had tail wags for his favorite vet tech (Emily - she is absolutely great) this morning.

Again, I appreciate all of the support and knowledge that you guys and gals have given me over the last few days. It has helped more than you know. :)
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Postby pitbullmamaliz » May 27th, 2009, 8:48 am

I'm so glad he's starting to improve! Keep us updated!

And just so you know, it's a proven fact that if you post pictures of a sick animal, they heal faster. Hint hint. :wink:
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Postby CinderDee » May 27th, 2009, 2:48 pm

And just so you know, it's a proven fact that if you post pictures of a sick animal, they heal faster. Hint hint.


I like that!

I'm so glad to hear that Murphy's doing better! :D
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Postby hugapitbull » May 27th, 2009, 5:57 pm

pitbullmamaliz wrote:And just so you know, it's a proven fact that if you post pictures of a sick animal, they heal faster. Hint hint. :wink:


Some folks are just shameless. :shock: Correct, but shameless :wink:
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Postby Hollys Rangie » May 28th, 2009, 9:17 am

Thanks again for all of the help and support! Murphy is doing much better. They did the blood work again yesterday at the vet and his enzyme levels are still high, but are much lower than what they were, so we are moving in the right direction.

He is having regular bowel movements, is eating, not vomiting, not drooling, is interested in life again, is walking around, is sniffing things, and even cleaned Wilber's ears for him last night. (Wilber is our 16 month old APBT.) He even felt good enough to chew out his catheter at the vet's yesterday.

Murphy has lots of tail wags for everyone at this point, and seems to be in so much less pain. He even slept in bed with us last night!

Yesterday he just walked around in the back at the vet's office and "supervised" all of the activity. Oh yeah, and he even "helped" to check people in at the front desk for a while. This morning he was very excited to go back to the vet's so that he could continue his "new job."

It is so good to see my boy acting like himself again. I promise that I will post some pics when I get home from work tonight.

Again, thanks for all of your advice and support. It has meant more than you know. :)
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Postby hugapitbull » May 28th, 2009, 9:31 am

Yea! Wonderful update. I know you are glad to have the 'real' Murphy back.

And Murphy, don't be scaring you mom that way again! Not Nice!! :nono:
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Postby Jenn » May 28th, 2009, 9:38 am

Yay for good news! :)
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