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Dog being treated for "mild pancreatitis". Has been to

specialist and gen practice vet...
Dog being treated for "mild pancreatitis". Has been to specialist and gen practice vet and seen 3 diff vets, had bloodwork ultrasound etc. has a cyst on pancreas which we know about bc she has had chronic pancreatitis since nov of last year. Currently on pred for what was assumed to be flare up of meningitis which she has had years ago as well as pancreatitis back in feb of this year. Specialist kept her for 2 days fluids pain meds cerenia etc. has been to reg vet twice this week for still not doing much better, very picky with food now has loose stool, went back to specialist tonight bc no improvement they gave sub q fluids and cerenia again. Should a mild case of pancreatitis be causing this much trouble? I would have hoped after seeing 3 plus vets something else would've been found if there is anytbing .
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Answered in 9 minutes by:
7/14/2017
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,852
Experience: Veterinarian at Kingsland Blvd Animal Clinic
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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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I go through with my own dog every 6 months or so. She has chronic pancreatitis.

After a dog has had it once they are prone to it and each time the pancreas gets inflamed scar tissue can form and as a result it can take longer and longer for therapies to work. There are also cellular changes that can occur and sometimes cysts on pancreas's can become infected and cause recurrent issues as well and sometimes need to be drained. Callie would most likely have a high white blood cell count and fever though if this was the case.

I would see about starting her on metronidazole if she is still eating. It is an antibiotic that is good for helping diarrhea as well as calming down the gut.

If she stops eating they may need to place a feeding tube.

I get the frustrating because with my own dog I fight this battle.

Is Callie on a prescription diet?

Has the specialist discussed trying to get intestinal biopsies to see if there is some underlying Inflammatory bowel disease that is contributing to her symptoms?

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Customer reply replied 6 months ago
The specialist sent her home with metronidazole this evening. She has been on royal canon lf as well as hills low fat foods since she initially started with pancreatitis. Her cyst was first drained when it was discovered and returned within 3 weeks when she got a recheck ultrasound, were told the cyst contained fluid with very little cellularity and they were not concerned, said it was best to leave it be as it was near a major blood vessel. She is currently on 5 mg pred for what was assumed to be a flare up of meningitis although the spinal tap was completely normal. She was on 20mg pred for 2 months which seemed to be a high dose and was actually higher dose then she initially was on 4 years back when she actually did have meningitis. Have been weaning down the pred and just last week she started on pred 5 mg every other day as she was on it every day. We watch her closely and she doesn't get any food but her special diets. Concern is that she is taking longer to bounce back this time, the specialist she saw this past weekend are different specialist that she initially saw in feb when they found cyst and thought she had meningitis. These specialist do not think she had meningitis and more likely has a cervical issue as she is still somewhat guarded range of motion with her neck is done. This Saturday would be a week from her initial admittance to the specialist, more frustrating this time around since she is slower to get back to herself and our next guess was so we have our gen vet bump her back up to 10mg of pred since it is anti inflammatory or wait a few days longer and continue with cerenia and see how she does. She received fentanyl at the specialist and sent home with codeine, she refused to take the pill the day after she got home and gen vet gave buprenex, she was given .05 a few months back for pancreatitis and reacted badly(very sedated) gave .25 this time and she reacted the same way. Not sure if she is taking longer to get better since you mentioned possible scar tissues and taking longer as well as her not getting pain meds. She went in this evening because she was very lethargic, shaking, drooling seemed very nauseous and today was the first day we had not given her cerenia pills since being back home.

Poor baby. Good lord you guys have been through the ringer with her.

Can you get the cerenia down her tonight ?

I wonder if we get her a fentanyl patch for transdermal delivery ( the specialist should carry this) to cover her pain levels so that is one less medication you have to try and get down her.

Some dogs are more sensitive to buprenorphine so we should try and stay away from it period.

the increase in steroids may help but it can take time.

Have you looked into adding in some alternative medicine like acupuncture to help her recover faster? I was not a believer in this until the last round of pancreatitis with my own dog. I could not control her pain and an associate I work with does acupuncture and she did it 2x over 2 days and it was a miracle it helped so much. Now I did not stop traditional therapies or medicine but I added in the acupuncture and it was worth it.

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Just another option to consider in regards ***** ***** acupuncture

I also have my dog on canine probiotics every day which helps keep her flare ups to a minimum. I use canine fortiflora and you can get it from your vet or online at amazon.com.

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If the metronidazole does not help after 24-48 hours you can switch to Tylan capsules (tylosin powder) is a different antibiotic for diarrhea .

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Customer reply replied 6 months ago
They gave her an injection of cerenia as well as sub q fluids because she was not very dehydrated and they felt she did not need to stay the night. Our concern is since she cannot handle pain meds very well (bupenorphine, as well as tramadol in the past) is this slowing down her recovery if she is in that much pain and discomfort? Would specialist consider giving her fentanyl and sending her home due to how easily it can transfer just with skin contact? Each dr she has seen this week agrees she is uncomfortable when her abdomen and pancreas are palpated (she moans) but do not consider her a severe case. She has been going back and forth after getting home Monday eating chicken and rice and the low fat diets, whatever she will eat. How much longer should we give her to be back to normal and wanting to eat normally before we return to the specialist? In your opinion would increasing her pred to 10 hurt her pancreas? Monday she had her third ultrasound in the last 4 months and were told the cyst is no bigger and the right side of pancreas was slightly inflamed. Concern is we are making her suffer by not getting her pain meds or keeping her on iv fluids although she gets even more stressed while there. s
Customer reply replied 6 months ago
Have not tried other things such as acupuncture, honestly didn't even know it could help with this. Also didn't know probiotics could help with flare ups.

Yes just like in humans pain slows recovery exponentially because they cannot rest and if you are in pain your stress hormones are up and immune system goes down and inflammation takes longer to go away.

My specialist send home fentanyl patches for severe cases because the benefits to the patient are hugs. The patches work beautifully.

The IV fluids will speed recovery and if she is there she can get a constant rate infusion of pain medication to control her pain levels as well so there are many benefits to hospitalizing her.

I cannot speak to the prednisone increase because I cannot physically examine her so I do not want to steer you wrong. Clinical picture is 50% of it but the other 50% is being able to see the patient.

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The probiotics in my clinical experience is something I put all my chronic, recurrent pancreatitis patients on and it really helps.

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Customer reply replied 6 months ago
Thank you very much for your help, I appreciate another vets opinion. I feel as though our own vets may think we are crazy by now lol.

Since her pain levels are not good I would call them tomorrow and see About the transdermal fentanyl patch.

You can also consider that hospitalizing her will normally lead to a faster recovery. With my dog I automatically hospitalize her. I tried to do home therapy the time before last when she flared and it was a disaster. I felt like I could not get her super hydrated like she needed, forcing medications down her was horrible, I also felt like I was not controlling her pain levels adequately so I gave up after 24 hours and took her in and had her home 2 days later

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You are not crazy. I hate this disease so much. I still have no clue why my dog flares when she does. Prescription diet, no treats, probiotics, me watching her like a hawk. It is frustrating. Re running diagnostics to a make sure its the same thing and then hospitalizing her. It kills me. So you are not crazy

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Good luck hang in there.

If this was helpful and guided you on what to do 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 stars at the top) the site will not compensate me for helping 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

Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,852
Experience: Veterinarian at Kingsland Blvd Animal Clinic
Verified
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Customer reply replied 6 months ago
agreed it is a very hard disease to deal with especially when it is your own baby. Thank you very much for your help and advice and no problem

You are most welcome let me know how she does

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Dr. Meghan Denney
Dr. Meghan Denney
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Satisfied Customers: 1,852
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