A Spec cPL is being done now.
Ellie had an ultrasound for her liver and bladder and the pancreatitis was diagnosed then. I was thinking it was one acute case but now the lipase is up and she has diarrhea, so it is probably chronic.

The vet did say that this might be IBD caused by pancreatitis.
It seems that the pancreatitis could cause the high bile acids but then I had read that high bile acids can cause pancreatitis.:rolleyes: If the high bile acids are leading to pancreatits attacks, maybe Actigall would be of help?

I have been thinking about putting Ellie on fish oil for the last 10 months but haven't picked a brand yet. Now I am thinking (see the calories and knowing they are all from fat) that we will have to skip it.

Poor Ellie and poor you. I hope you and the vet can get to the bottom of the problem so she can be on her way to a full recovery.
Sending warm wishes her way,


Hugs,

yes no fatty acid supplements -- could be ibd as my boy has it from pancreatitis or it caused pancreatitis but never heard that this triggered high bile acids as the internal medicine specialist never did bile acids on him over the course of that whole year. What were the pre and post? The pancreas does affect other organs in the body and if severe enough it starts eating the other organs and that is why it is so deadly --- Since i have put dex on purina ha no more issues for 2 years and whil i do not think it is the greatest food it works. I feed him 3 times a day to help with digestion. His was never diarhea only vomitting so his was the small intestines and sounds like yours is large. He is not on any meds or supps only purina ha and it has thankfully worked because with ibd there are only a few meds they can use pred, atopica (off label) and one other i cannot think of name and prednisone can trigger pancreatitis as well so be cautious with that. I would give that food a shot and join dogpancreatitis@yahoogroups.com and ibdogs@yahoogroups.com and you will learn alot on these groups of owners all with the same conditions and get some good tips to ask the vet. I am working now with an internal medicine specialist with dex now.

make sure they do the cpli and tli - the fact that they did not do this first thing with the first blood work makes me concerned that vet is not real on top of latest information as the specialists i deal with say lipase and amylase are not accurate -- jean dodds told me it could be due to dd mvd that her lipase is slightly elevated maybe but not necessarily and the fact that amylase was not elevated too she was not concerned and dermatologist said in vet school they are not accurate anyway and like i said in other post i saw it first hand they were not accurate with dex as he had to have a plasma transfusion as almost died of pancreatitis it was so severe and you do not want them getting this over and over as it can lead to diabetes as the pancreas controls the insulin levels in the body so real important to not let this keep happening. We do no treats anymore or chew sticks they just get their kibble and an occassional piece of organic baked chicken

Ellie bile acids were:
First check: pre 4, post 47
Second check: pre 8ish, post 15ish
Third check: pre ? (it was low anyway), post 106:eek:

Liver biopsy showed mild bile stasis but no MVD (at least not widespread).
U/S was good. No diagnosis except pancreatitis. An internist did the U/S but didn't seem too concerned.

One week before the ultrasound Ellie threw up 8 times. That evidently was acute pancreatitis. So we have had one semi-serious vomiting bout.

As for food, Ellie eats homecooked. She has a nutritionist, so I'm confident that if her diet needs to be changed, she can do that. Most prescription diets will not work for Ellie anyway because they contain corn or corn derivatives and she is allergic. She may also be allergic to beef, so all animal protein needs to be named.

When the ultrasound showed pancreatitis, the internist said we could do a cPL but since we already had the diagnosis, I decided against it (we had just spent a massive amount of money with oral surgery, bile acid tests, liver biopsy...). Ellie has seemed fine for the most part since then (January). We went in for routine blood work (nothing to do with pancreatitis) and the panel showed elevated lipase. We weren't looking specifically at the pancreas. Now that it is up and with the diagnosis of pancreatitis before, the vet thought I might want to go farther and do the cPL and I agreed. Because it appeared to be one acute case maybe requiring no treatment and Ellie's diet already being low fat, I was hoping we were in the clear but obviously not.:rolleyes:

I would like to meet Dr. Dodds. She sounds awesome.:)

the purina ha is a soy hydrolized diet and dd is on it for mvd and allergies and does well on it and dex is on it for ibd and pancreatitis. So they did a liver biopsy when spay was done or did it on it's own with those post biles? Those bile acids were low and the bile acids could go up if gall bladder contracts during blood draw. Below 25 post is normal so why did they keep doing this? Sorry but i am questioning your vet at this point :( Are you seeing an internal medicine specialist or regular vet? I would stick to a fish based diet with your nutritionist as low in protein and low in fat and stick to cod as tilapia i have heard bad things about. If that much vomitting then yes as my dex kept vomitting over and over and after 6 times they said he had to go in and at the time he was 9lb so i would think sooner if a dog weighed less.

I think sometimes these vets are quick to run unnecessary tests and we need to do some research and take a step back as they wanted me to have a liver scan on dee dee at post of 76, and then second post was 54 and i said let me learn more first as she has no symptoms of a liver shunt dog - no vomitting, head pressing, not a picky eater , no seizures so when i joined liver shunt group and due to posts being below 100 it was most likely mvd and the last post i had done was 26 on soy diet. I am so glad i did not put her through that test as it was unnecessary. I think you have to treat the dog not always the blood work as certain things can affect the blood work such as stress of the blood draw.

I would have your nutritionist make up dr dodds liver cleansing diet as alot of dogs do very well on that but no fatty acids.

I hope your baby gets back on track soon as i know I have been there and it took a year and cost us 10k and i was getting so frustrated but after that happened I joined 55 dog groups and started reading about each illness and learning more so now i am very well educated and ask a ton of questions before they start doing things. I know they need to rule things out but sometimes sadly it is a business and i feel that they go the most expensive route rather than zeroing in on the most accurate tests upfront. You know the pancreas is inflamed if the cpli and tli test come back diagnosing pancreas no need to pay $400 for an ultrasound to tell you that in my opinion. Now if the cpli and tli came back normal, and everything else is normal and dog is still sick then yes do the ultrasound by all means but this really upset me when they did 3 ultrasounds costing me 1200 when now i know all that was necessary was the cpli and tli which is much less. I really felt taken advantage of when my dog was sick. This is why i speak out now to help others as my friend just went through a horrible thing with a dermatologist prescribing two drugs ketaconozole and ivermectin together which should have never been given together ever and her dog almost died. She was at a specialty hospital and they kept her sedated too long and she got pneumonia, then she went to another hospital where the derm was to cost less and they transported her with a hot water bottle when the dog had a fever and pneumonia thus could have caused the dog to have seizures again. The whole thing was all caused by a specialist and they wanted 4500 from my friend for all their errors and she almost lost the dog. I was so disappointed about it all and it made me question what my dex went through sadly as these were suppose to be specialists in their field making these life threatening errors and while i agree they are human and can make mistakes it is still very concerning for me and makes me believe you need to be even more in control of your own and your dogs health. I honestly feel they know we love our animals and will do what it takes and I do think some take advantage of that sadly. Sorry to sound so tainted but I just have to voice my opinion after all i have seen in the past 4 years with my own as well as close friends.

Dr Dodds has been awesome she is the only one who has been there for me day or night or weekends emailing me and answering questions - she is truly passionate with what she does and she does not nickel and dime you for her help which is rare since i had a vet charge me $47 phone consult after faxing blood work from jean dodds to put in my dogs file which i was furious and switched vets -- she was insecure i believe that i was working with jean as well but no one out of 4 vets and specialists could figure out my dd was hypothyroid and why she was losing her hair so i drove her down to see jean and immediately upon 6 panel thyroid test she was what i thought she was hypothyroid.

Now that i know dex has had pancreas issue when i get cbc and chemistry i automatically ask for cpli and tli add on just like with dd she gets the thyroid panel add on so you should probably do the same to eliminate the worry and expense but your vet should know that lipase and amylase are not very accurate if they are good as several specialists have told me that and it is almost as if they throw it off the testing and dismiss it.

Oh i know the cost i am 10k in on dex and about 5k in on dd with her hypothyroid, mvd and severe allergies (basically auto immune disease:( ) and now my healthy demi maltese has periodontal disease at 4 as i was so focused on the other two i did not get dentals for fear of putting her under and now i have a problem there so she is going to a board certified dentist costing me between 1200-3000 to get her teeth cleaned and teeth removed as loose and i will have to do a regimented care program for her now so i have read everything on dentals and periodontal disease now so make sure you get the dentals done and brush their teeth if you can twice a day as my two yorkies teeth are ok but i guess maltese are notorious for periodontal disease. I had no idea getting 3 dogs I would almos become a vet after it all :( I have cried alot and have come to the reason that i have them is that i can afford to get them the best care and do not have children so will do everything i can for them as they are my main focus and probably so i can help other people in the process as i am very vocal about what i learn along the way but just had no idea as growing up we had shih tzu and no health issues so going through all this has been very heart breaking.

Ellie's vet never told me to have a bile acid test done. I wanted to after some concerning symptoms. When the post came back as 47, I was given the choice to see an internist or put Ellie on Denosyl and low protein and retest in a month. We did that and the retest was post 15. Then she went in to be spayed and while the vet was already in there, she thought why not just biopsy now while she is already opened up. That came back normal but we decided to do one more bile acid test a couple months later to make sure the numbers were still down because when the post came back as 15, she came off the Denosyl. This time the post was 106 and we went to the internist. An ultrasound was done then. I know it is inconclusive for liver issues but she was also having bladder issues, so that is the way we decided to go. The internist didn't have any great answers and right now there isn't really a need to see her. Her regular vet is doing fine managing her right now.:)

The vet had said since all of Ellie's blood work had been normal, she would be very surprised if her bile acids were up but that she would test if I wanted her to. So it was my choice/idea. And with posts of 47 and 106, I'm glad we did.:)

Ellie has periodontal disease.
She was a stage 3-4 (worst is 4) and had to have nine adult teeth pulled already. Her teeth get brushed and flossed and we use OraVet.

$47 for a phone call is ridiculous.
I can talk to Ellie's vet whenever I need to for FREE.:)

oh good glad they biopsied liver during the spay makes me feel better as they should have been able to tell everything in that biopsy so the post of 106 could have been due to gall bladder contraction as well so if not having any symptoms of liver disease i would not worry about that at all anymore. Just do low protein diet - I do not even supplement dd with anything just low protein and she is on temaril p which affects her liver but after 4 years of doing atopica and her vomitting it up and everything else for allergies which could take two days to tell ya -lol i figured a short happy life is better than a long miserable one and sometimes it comes down to that and her liver is still coming back fine. We do blood work two times a year for her due to the temaril p.

I am nervous about the periodontal disease with demi -- she has 4 teeth that move with the gums and why i freaked and took her to a board certified dentist but she made me real nervous as wanted to cut gums, etc so i am getting a second opinion from another board certified dentist next week and then will decide. Her strategic teeth luckily are ok. I am real nervous as i thought i had one healthy one so more work. They said she will need chlorhexedine is that the oravet? Also i am refusing the dental vaccine as heard there are alot of side effects to it -- did you do this?

that is why her globulins are high if high on the blood work as that is tied to periodontal disease i am being told

Chlorhexedine is not OraVet. I was never offered the dental vaccine, probably because Ellie had a very severe vaccine reaction to something else, so we do as few as possible. I wouldn't recommend it anyway. Ellie's front teeth started to fall out, so we had to go ahead with oral surgery. I'm thinking an under the gums cleaning was done. Getting it taken care of is much better than letting the infection go to their organs. It was only $600 with extractions, preop blood work, isoflurane, pain meds, antibiotics, radiograghs, cleaning and OraVet. It was probably so cheap because Ellie's vet isn't board certified but she has an interest in dentistry, so I got the best of both worlds...excellent job and cheap.:)

yeah i am in california :( much more expensive -- vet is $900 and board certified quoted 600 to start but i am sure it will be like 1200 by the time he is done :( i am not doing vaccine either -- just so nervous. Did she cut gums and sew them - the flap procedure -- that is where i got woozy and nervous :(

Not sure.
Didn\'t look in Ellie\'s mouth much when it was done and didn\'t know much at the time to even think about it. Since the gums were already opened up for extractions, I\'m thinking yes.