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I have an old dog who previously had pancreatitis. She

I have an old...

I have an old dog who previously had pancreatitis. She vomited a couple of nights ago and was poorly - my vet said her temp was high and diagnosed it as another bout of pancreatitis. She's over 24 hours into treatment with antibiotics, painkillers and electrolytes. But now she is leaking urine so I'm wondering if the vet got the diagnosis wrong.

Veterinarian's Assistant: I'll do all I can to help. Hopefully it didn't make a mess. Did the dog eat anything unusual?

Thanks - no the vet said she can only have a small amount of chicken. She is quite thirsty but the vet said only 10ml of water per hour.

Veterinarian's Assistant: What is the dog's name?

Pippa

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Pippa?

She is elderly - will be 14 in a few months and she is going blind with progressive retinal atrophy. The urinary incontinence just came on quite suddenly and I'm not sure if it's a symptom of pancreatitis or something else my vet misdiagnosed.

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Answered in 2 hours by:
3/3/2018
Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,226
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but can you tell me:

What medications is she on specifically?

Was she put on fluids?

Does the urine look dilute/watery or darker/odorous then usual?

What tests did they do to diagnose this for her?

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Customer reply replied 4 months ago
Hi Dr B. The vet didn't do any tests - she just did a physical exam including rectal temperature measurement which was over 40 degrees Celsius.The vet gave her 3 shots - painkiller, antibiotic and an anti-nausea med. She gave me an electrolyte mix for fluids and told me to start antibiotic tabs (Amoxyclav) and Metacam for pain relief 24 hours later. So far Pippa's had 1 tablet this morning and is due for another before bed. She seems a little brighter today than yesterday and is obviously hungry - there hasn't been any vomiting since before I took her to the vet.Pippa's urine seems normal as far as I can tell - not smelly. She still goes out to pee as usual but today suddenly started leaking urine when lying down inside.I forgot to mention that Pippa has a star-shaped growth in her spleen - it didn't change size for about a year after they found it (after initially looking at the pancreas when the original bout of pancreatitis was diagnosed maybe 3 years ago). I haven't had it scanned for ages as she's too old for spleen removal etc, it seemed to be benign anyway and her fur didn't grow back properly after shaving her whole belly. I told the vet I was concerned the tumour may have grown and the spleen might be bleeding but she thought it unlikely and decided the problem is pancreatitis.

Hello again,

I have just gotten your reply but do you know what the painkiller was (it will be on your receipt)?

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Customer reply replied 4 months ago
Metacam for pain relief
Customer reply replied 4 months ago
I don't have the receipt for the painkiller shot but the one the vet prescribed for me to give her is called Metacam.

Thank you, ***** ***** fine.

I just need to finish typing my thoughts.

Dr. B.

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Now the reason why I ask about drugs specifically is because pancreatitis doesn't usually cause bladder issues unless drugs that promote urination or fluids are given. As well with regards ***** ***** while it would be ideal to be checking a blood sample (canine pancreatic lipase and general panel) or ultrasounding the pancreas to ensure it is our culprit, we'd not expect common bladder issues to cause vomiting as you saw. So, from what you described a pancreatitis or a gastritis (causing gut infection) would be our top suspects. And the treatment she was given will help with both concerns. So, from what you have said, their approach was not unreasonable but if we had any doubt the above tests should be considered.

Now with regards ***** ***** leakage, this could be from one of a few reasons. First, if she is still uncomfortable with her abdomen (pancreatitis is reported to be excruciating in humans) then she may be trying to urine hold to delay going out to toilet. And that is one of the most common reasons we can see this suddenly. Otherwise, it can be in response to pushing fluids (so if you are giving an electrolyte mix/increased fluids), or sometimes a rare side effect of Metacam (something in dogs with reduced kidney function, so that too may be a reason to check bloods). And I would just note while bladder infection can also cause leaks, the antibiotic and metacam will help with that too if present.

Overall, even though no specific was testing was done, Pippa's signs do sound suspect for pancreatitis or gastritis. So, her vets approach here wasn't unreasonable and the treatment will help with all 3 of those health concerns I noted. Of course, if we want to be definitive bloods and ultrasound should be considered. And I suspect the leak if from one of those above concerns, so we can monitor and see if it settles as she is treated and the treatment course finishes. Or since she is older we can think about bloods to check her kidneys while also confirming the pancreatitis suspicion at the same time.

Kind regards, Dr. B ************

I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you! : )

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Customer reply replied 4 months ago
Thanks Dr. B. I will look into getting Pippa blood tested. Previously she had diarrheoa when she got pancreatitis but this time round her stomach isn't upset.With the leaking, it happened just after I saw her pee outside which seemed a bit odd so maybe it's related to the Metacam.I forgot to say that Pippa is panting regularly - can't tell if it's pain and/or fever though yesterday she definitely felt hot. I've been putting a fan on her which seems to help her relax.Does Metacam help with reducing fever or would you expect that to take a while to come down til the antibiotics start working?Also is it best to restrict her from eating and drinking? She's obviously hungry and thirsty and but I'm trying to just give her small amounts of food and electrolyte mix regularly so her pancreas doesn't get overloaded. She wants more than I'm giving her though!Thanks again.

You are very welcome, my dear.

It can tricky to tell the difference with panting since they just cannot tell us which is causing them bother. So, usually the hope is that if we treat both pain and fever (which Metacam does), she will settle. And as the antibiotics reach therapeutic levels the fever should clear completely. But the fan is fine to keep her comfortable and prevent overheating. As well, small/ often is the best approach to meals to prevent her from causing herself to vomit. And if you are not already, a light diet that is low fat is preferable for pancreatitis. Examples of that are cooked white rice with boiled chicken, boiled white fish, cottage cheese, scrambled eggs, or meat baby food (as long as its garlic/onion free). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. For the water, we only need to restrict if she is gorging herself on it (as that can make them vomit). But it sounds like you are doing the right thing there and we just would keep to small meals often and then gradually increase for her. Otherwise, I'd just keep an eye on the leaks and see what those bloods tell us.

All the best,

Dr. B

************

I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you! : )

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Customer reply replied 4 months ago
Ok great - thanks for explaining everything. It's good to hear another opinion and get peace of mind.All the best from Cassie & Pippa! :)

You are very welcome,

I am glad I could be of help and wish you both the best. :)
Have a lovely day,
Dr. B.

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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,226
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
Verified
Dr. B. and 87 other Dog Veterinary Specialists are ready to help you
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Hi Cassie,
I'm just following up on our conversation about your pet. How is everything going?
Dr. B.
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