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My 9 year old maltese-pom cross is hospitalized again this

week, the 3rd time in...
My 9 year old maltese-pom cross is hospitalized again this week, the 3rd time in 6 weeks for pancreatitis. The vets here cannot find a cause. They've done ultrasounds and blood work and even consulted with specialist in internal medicine who concluded that it might be food allergy. He's been on the same vet medicated gastro food for 7 years due to esrly bouts with colitis. He does not get people food, other than few carrots or plain chicken every now and again. We need to find cause but we aren't getting answers from our vet. If we can't stop these bouts of pancreatitis, he could die.
JA: I'm sorry to hear that. What is the Maltese's name?
Customer: Milo
JA: Is there anything else the Veterinarian should be aware of about Milo?
Customer: He's 9 years old, had bouts of colitis in his early years, is on Royal Canin Gastro Formula kibble, he weighs 12 pounds, he has a disc slipped in his back, he is currently on his 4th flare up of pancreatitis.
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Answered in 2 hours by:
6/28/2017
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,852
Experience: Veterinarian at Kingsland Blvd Animal Clinic
Verified

Hi I am Dr. Denney. I am currently reviewing your post now. Please give me a few minutes to type my response. Thank you for trusting us with your question.

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Pancreatitis is really tough to prevent because we do not always know what the cause is. My own personal dog suffers from this. She gets pancreatitis about every 4-6 months despite being on a strict prescription diet (same one as your actually) and no treats and I make sure she never gets anything else and she still flares. So I completely get your frustration.

I make sure I have her abdomen ultrasounded once a year to make sure there are no tumors (which can predispose them to recurrent bouts of pancreatitis and I check her blood work every 6 months).

I also have some patients that are the same boat as my dog and Milo where each flare up is harder to treat and eventually I worry I will not be able to save them. For these cases I make sure they are on a canine probiotic to help digestion and take the pressure off the Pancreas during digestion. I use Fortiflora Canine mixed into food once a day. I also have some patients that I pulse a course of cerenia medication once a month for 4-5 days. Cerenia is an anti nausea, but also has anti inflammatory effects to the pancreas. That has seemed to really help these patients (including my own dog).

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I am really sorry you are going through this with Milo. Know that you are not alone. Pancreatitis is extremely frustrating for both veterinarian and owner because some patients get it recurrently and there are times when I never find a cause.

In my recurrent cases I always recommend the ultrasound of the abdomen to make sure there is not a structural issue with the organs, a tumor somewhere in the pancreas or near it that can be causing inflammation to occur again and again in the pancreas , and the ultrasound will look for scar tissue in the pancreas which can also explain the recurrences.

So if he has not had an ultrasound that would be the best recommendation I can make, because if there is a tumor or abnormality near or in the pancreas that could explain why this keeps happening and we may be able to work towards prevention.

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Customer reply replied 6 months ago
Thank you Dr. Denney. We are very frustrated and have spent a small fortune treating him. We just wish we knew the cause.
He has had one full abdominal ultrasound and three additional focal ultrasounds of the pancreas and liver but the vets here are not seeing anything. Is that the best test for locating tumors?

Yes generally the ultrasound is a good modality, but a CT can be a little more sensitive for internal pancreas tumors or scar tissue.

I feel your frustration as I go through this myself. Even with being my own dogs veterinarian its still 500-600 $ a day to treat her when it is a bad flare.

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Try the probiotics and pulse courses of cerenia with Milo. That has really helped my dog and my recurrent pancreatitis patients.

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The CT scan will need to be done with a specialist and can be quite expensive ($1200-1500( generally, but it is slightly more sensitive than an ultrasound in some cases. You may also benefit from a consult with an internal medicine specialist which you have to have to get the CT done.

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Good luck with Milo I hope this gave you some other ideas and things to try.

If this was helpful I would be most appreciative if you could take the time to rate my assistance so the site will credit me with helping you. Without a rating the site does not compensate me for assisting you.

I am also here for additional questions you may have just reach out to me here and I will be more than happy to assist you.

Kind regards,

Dr. Meghan Denney

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Customer reply replied 6 months ago
My husband has been reading up and a few potential causes came up such as duodenum to pancreatic duct reflux. Is this something you've seen or diagnosed or dealt with?
Actually we paid to have a consult with an internal medicine specialist. There is no one locally so all his medical info was sent out and we were very disappointed with response. He said he suspected a food allergy, even thou Milo has been on tjis same food for 6 years with no issue. Our vet didn't fully agree with conclusion. We feel consult was complete waste of $300.

Yes it is possible to have a duct issue, but that it really rare. I have not seen a case of that.

Food allergy can cause pancreatitis, but the risk of trying a new diet called hydrolyzed protein diet is that it is not as low fat as what you are on. It may be worth a try, but that is a tough call.

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The duct issue is more commonly seen in humans as well I believe.

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Customer reply replied 6 months ago
The specialist did suggest new food, maybe what you mentioned. Might be why our vet was not on board, higher fat content.
How would duct issue be detected?

A CT would probably be your best bet to see the duct because it will outline it and they will be able to inject dye to get a better image.

Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,852
Experience: Veterinarian at Kingsland Blvd Animal Clinic
Verified
Dr. Meghan Denney and 87 other Dog Veterinary Specialists are ready to help you
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Customer reply replied 6 months ago
Thank you so much! I appreciate your response.

You are most welcome good luck!

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Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Meghan Denney
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Dr. Meghan Denney
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
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