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-   -   Jackson's not feeling well. :( (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/231418-jacksons-not-feeling-well.html)

BonBon 08-02-2011 01:46 PM

Quote:

Originally Posted by Ellie May (Post 3619648)
"Protein
Free amino acids (i.e. phenylalanine, tryptophan, and valine) in the duodenum are a strong stimulus for pancreatic secretion, in fact, more so than fat. 49 Therefore, excess dietary protein should be avoided, while providing adequate protein for recovery and tissue repair. Protein levels (DMB) of 15 to 30% for dogs and 30 to 45% for cats are appropriate."

49 Go VLW. Hofmann AF, Summerskill WFJ. Pancreozymin assay in man based on pancreatic enzyme secretion. Potency of specific amino acids and other digestive products. Journal of Clinical Investigation 1970; 49: 1558-1564.

"Feeding a high-fat (>20% DMB) food, treat or table food has often been associated with the onset of acute pancreatitis. Experimentally, feeding high-fat, low-protein foods was associated with the development of pancreatitis and hepatic lipidosis changes in dogs. 43, 44"

43 Lindsay S, Entenman C, Chaikoff IL. Pancreatitis accompanying hepatic disease in dogs fed a high fat, low protein diet. Archives of Pathology 1948; 45: 635-638.

44 Goodhead B. Importance of nutrition in the pathogenesis of experimental pancreatitis in the dog. Archives of Surgery 1971; 103: 724-728.

And a note from the chapter about digestibility:
"Carbohydrates make up the largest nonwater fraction of foods formulated for managing GI diseases. Carbohydrate digestibility of pet foods is influenced by source and processing. Dogs digest most properly cooked starches very well, including starch components in corn, rice, barley, and wheat. Other starches, including potato and tapioca, are less digestible, particularly when inadequately cooked."

All taken from:
Small Animal Clinical Nutrition 4th Edition
Hand, Thatcher, Remillard, Roudebush

Hope this helps some.
The second excerpt is just showing where the WDJ got some info from about low protein diets triggering pancreatitis. Those diets appear to have also been high in fat...

The last one is just something about digestibility. I have NO IDEA what ingredients Jackson will do best on. He may do fine on everything that is low fat. That'd be great. But it's just an example of what your vet might be talking about when expressing concern over ingredient found in tons of the newer holistic food. I also have no idea if he will need a highly digestible food. Maybe not. But your vet may feel the major brands are more digestible because most include grain. Sooo, all that to say that may be what your vet meant by ingredient differences.

I somehow missed seeing this post until now. Thank you, Crystal! I wouldn't have brought it up again if I had seen this first. :)

Brit, I'm still thinking of you and Jackson. Sending lots of prayers you get answers soon. I'm happy to hear you liked today's vet a bit better!

Ellie May 08-02-2011 01:54 PM

You should bring it up all you want. :) Curiosity is good.

Brit, I don't know. If they were just monitoring lipase/amylase, then maybe they didn't feel a cPL was needed. But then after it came back high last time, yes, they should have done it then in theory.

This test is what we use to monitor E's pancreas. If she is having issues, this is right where I go. Not wrong to go to lipase and amylase (seeing the CBC and such is important in pancreatitis patients), but for us this is how we know there is a problem. He lipase has been high while having a normal cPL (but she also has intestinal problems).

It's not wrong of them to keep doing blood. I wonder if they ahve a lack of direction though. I'd be interesting in seeing what the plan is if the cPL is abnormal. They might have an idea yet.

Why drawing out of the leg? Why not jugular?

Maximo 08-02-2011 05:18 PM

Sending prayers for Jackson and you that tomorrow's test brings much better news and more answers.

yorkieusa 08-02-2011 05:40 PM

Quote:

Originally Posted by Britster (Post 3620293)
I take him tomorrow at 3pm for the bloodwork to be sent out to the lab. I'll give him his last meal tonight around 8pm or so...

I'll be keeping him in my thoughts and prayers.

ArmaniMan 08-02-2011 05:43 PM

No advice- just wanted to let you know I think about Jackson everyday- I hope you get better news tomorrow, I will keep him in my thoughts.

107barney 08-02-2011 05:49 PM

Bully sticks, a vet nutritionist's opinion
 
Since the topic of bully sticks came up recently and especially here, some here expressed concern about bully sticks being fed. I took it upon myself to inquire with a board certified vet nutritionist for my own curiosity and I just got a reply. Here is my question, followed by her answers:

Q: In general, what is your opinion of bully sticks as chews for dogs?
A: High protein and sometimes high in fat ....

Q: And specificially, if a dog has a history of acute pancreatitis, can he have bully sticks such as the ones made by the Merrick company? They are low in fat at 1.5% but protein is high.
A: That 1.5% is a minimum not the actual content. Both high fat, and sometimes more so, high protein tips off a pancreatitis. I would not feed it to dog with a history of pancreatitis that required hospitalization.

Nancy1999 08-02-2011 06:39 PM

Quote:

Originally Posted by 107barney (Post 3620632)
Since the topic of bully sticks came up recently and especially here, some here expressed concern about bully sticks being fed. I took it upon myself to inquire with a board certified vet nutritionist for my own curiosity and I just got a reply. Here is my question, followed by her answers:

Q: In general, what is your opinion of bully sticks as chews for dogs?
A: High protein and sometimes high in fat ....

Q: And specificially, if a dog has a history of acute pancreatitis, can he have bully sticks such as the ones made by the Merrick company? They are low in fat at 1.5% but protein is high.
A: That 1.5% is a minimum not the actual content. Both high fat, and sometimes more so, high protein tips off a pancreatitis. I would not feed it to dog with a history of pancreatitis that required hospitalization.

Oh great, what a crazy way of labeling why would someone want to know the minimum level of fat? I want to know the maximum level. Thanks for taking the time to do this.

Ellie May 08-02-2011 06:44 PM

Quote:

Originally Posted by Nancy1999 (Post 3620670)
Oh great, what a crazy way of labeling why would someone want to know the minimum level of fat? I want to know the maximum level. Thanks for taking the time to do this.

This is how most dog foods are labeled. So a food that reads 18% minimum fat, it can be much higher (like 22%).

Nancy1999 08-02-2011 07:22 PM

Quote:

Originally Posted by Ellie May (Post 3620674)
This is how most dog foods are labeled. So a food that reads 18% minimum fat, it can be much higher (like 22%).

Is there a range or is the sky the limit? I thought with with human hamburger it was just the opposite, for example, a product that says 20% fat can have much less, it will never have more than 20.

Ellie May 08-02-2011 07:32 PM

Not sure. Could try to find it in AAFCO literature. It can vary quite a bit though.

Companies that can be consistent with ingredients become pretty important here. They will usually be able to tell you what the % runs around.

The food I feed..I'm not worried about the companies doing anything too crazy with maximum levels, so I don't bother checking into it. With most companies, I would be asking.

Ellie May 08-02-2011 08:46 PM

While we're on the bully topic, I found this interesting:
http://www.royalcanin.us/adx/aspx/ad...roceedings.pdf

Might have to cut and paste to Google.

Clostridium has been found (which is old news), but now MRSA has been found. Very interesting.

gidget529 08-03-2011 03:44 AM

Quote:

Originally Posted by Ellie May (Post 3620778)
While we're on the bully topic, I found this interesting:
http://www.royalcanin.us/adx/aspx/ad...roceedings.pdf

Might have to cut and paste to Google.

Clostridium has been found (which is old news), but now MRSA has been found. Very interesting.

Unbelievable. I cannot believe MRSA is in canines. Of course, I'm so old I remember when it was considered mainly nosocomial. Is MRSA mainly being seen in HA in vet med or CA cases?

I would definitely stay away from bully sticks if these contaminants are being found in them.

gidget529 08-03-2011 03:45 AM

Forgot to add, Great post Crystal!! :)

Ellie May 08-03-2011 04:54 AM

No idea. Not something I've really looked into..yet.

I think it's a matter of each owner has to decide how much risk they are willing to take. If it was found in a few kibbles, I'd still feed kibble, but that's more of a necessity. If it was found in treat or chews, they would be skipped here.

It seems everything is contaminated now. The animal by-product treats appear to be at the top of the list though. There was a case of clostridium from a bully on YT awhile back. Turned me off pretty quickly. I don't want hospital bills over a dog chew!

Britster 08-03-2011 07:03 AM

Quote:

Originally Posted by Ellie May (Post 3620362)

Brit, I don't know. If they were just monitoring lipase/amylase, then maybe they didn't feel a cPL was needed. But then after it came back high last time, yes, they should have done it then in theory.

This test is what we use to monitor E's pancreas. If she is having issues, this is right where I go. Not wrong to go to lipase and amylase (seeing the CBC and such is important in pancreatitis patients), but for us this is how we know there is a problem. He lipase has been high while having a normal cPL (but she also has intestinal problems).

It's not wrong of them to keep doing blood. I wonder if they ahve a lack of direction though. I'd be interesting in seeing what the plan is if the cPL is abnormal. They might have an idea yet.

Why drawing out of the leg? Why not jugular?

Interesting. Well, I'm very curious to see how the results of the cPL turn out for sure.

Is it possible for a dog to always have a slightly high lipase? Like, is that ever "normal" or not really? I am just wondering because Jackson never had bloodwork before, not even before his neuter. So I really have nothing else to compare to with him and I was wondering if possible having a slightly lipase is "his" normal?

What are some other reasons, if any, for a lipase to be slightly elevated?

I am not sure why they are drawing out of leg and not jugular. Should I ask? I know it's always his leg because he always comes back with an ace bandage around it, lol.

Britster 08-03-2011 07:12 AM

Quote:

Originally Posted by 107barney (Post 3620632)
Since the topic of bully sticks came up recently and especially here, some here expressed concern about bully sticks being fed. I took it upon myself to inquire with a board certified vet nutritionist for my own curiosity and I just got a reply. Here is my question, followed by her answers:

Q: In general, what is your opinion of bully sticks as chews for dogs?
A: High protein and sometimes high in fat ....

Q: And specificially, if a dog has a history of acute pancreatitis, can he have bully sticks such as the ones made by the Merrick company? They are low in fat at 1.5% but protein is high.
A: That 1.5% is a minimum not the actual content. Both high fat, and sometimes more so, high protein tips off a pancreatitis. I would not feed it to dog with a history of pancreatitis that required hospitalization.

Thanks for the info!

Quote:

Originally Posted by Ellie May (Post 3620778)
While we're on the bully topic, I found this interesting:
http://www.royalcanin.us/adx/aspx/ad...roceedings.pdf

Might have to cut and paste to Google.

Clostridium has been found (which is old news), but now MRSA has been found. Very interesting.

I just briefly read through it but will read more in full later.

I had never heard of MRSA before (where have I been?) but just googled it. Pretty scary stuff!

But like you said, it seems like everything these days is contaminated, or causes cancer, or something else. I mean, it's just hard to say how big the risk truly is.

I have a question. My vets office sells the CET Chews which I always hear about on here. But, I mean... aren't they rawhide? I feel like I'd rather feed a bully stick than rawhide, but maybe that's just me.

Would something like a CET chew, though, be okay for a dog like Jackson? I've got to find SOMETHING safe for him to chew on. If he doesn't have something, the risk of him swallowing plastic (from kids toys) and whatever else he finds on the ground, I think, is a much higher risk....

BonBon 08-03-2011 07:22 AM

Quote:

Originally Posted by Britster (Post 3621018)
Interesting. Well, I'm very curious to see how the results of the cPL turn out for sure.

Is it possible for a dog to always have a slightly high lipase? Like, is that ever "normal" or not really? I am just wondering because Jackson never had bloodwork before, not even before his neuter. So I really have nothing else to compare to with him and I was wondering if possible having a slightly lipase is "his" normal?

What are some other reasons, if any, for a lipase to be slightly elevated?

I am not sure why they are drawing out of leg and not jugular. Should I ask? I know it's always his leg because he always comes back with an ace bandage around it, lol.

To expand on Brit's question a bit, is it possible for a dog who has always had normal bloodwork to suddenly develop pancreatitis? Or does annual bloodwork usually show indicator signs of some sort?

For example, my pups have always had good results on their yearly bloodwork, which gives me comfort and assurance that they're healthy. But it's still possible for them to one day have an attack like Jackson's?

Ellie May 08-03-2011 07:30 AM

I guess if they are getting enough out of his leg, that is fine. There are some challenges with taking it that way in small dogs because their veins collapse. So most go for the larger vein (jugular). Nearly all blood draws on all sized pups are taken from the neck here, so was just kinda curious..

There is a link somewhere here about what makes lipase go up. It's not just the pancreas, but after acute pancreatitis, that is highly likely. You can Google "dog lipase" to see what you get. I think Cornell has some info on it.

If it doesn't go down over time or if it does go down but the cPL stays up, I'd assume that's how a chronic issue is diagnosed. You don't always have continuous symptoms with a chronic problem.

It has only been 10 days though, so his pancreas is probably just still angry. And I'd trust the outside lab's reading much more.

Yup, baseline bloods on all pups so you can compare later. So you'll know for the next pup you get.. Ellie hadn't had bloods til like age 5! Oops.

All animal by-product chews are going to be the same story. No reason to risk it with that much protein and fat content is variable. You don't want him to be getting a bacterial infection that sets off the intestines and makes things angry in there. So they are all best avoided in his case.

You will be able to find something he can have. I'd talk to the vet about it. Lots of people like the CET Chews. They tend to be good for teeth. But they do seem like a choking hazard. Not something I give Rylee. Nylabone Flexibles and Gumabones are what we're going to start using for him to see how it works. I like that they are soft enough for his teeth, but large pieces won't come off (unless your pup proves to be a very powerful chew). I wouldn't give him anything except he has taken to licking and trying to chews up carpet fibers - and he tries to chew my hair...sooooooo, he wins this one.

Britster 08-03-2011 07:34 AM

Quote:

Originally Posted by BonBon (Post 3621030)
To expand on Brit's question a bit, is it possible for a dog who has always had normal bloodwork to suddenly develop pancreatitis? Or does annual bloodwork usually show indicator signs of some sort?

For example, my pups have always had good results on their yearly bloodwork, which gives me comfort and assurance that they're healthy. But it's still possible for them to one day have an attack like Jackson's?

I'm going to make an assumption that, yes, a dog could definitely have normal bloodwork all of it's life and then develop pancreatitis. There are a lot of healthy dogs who get pancreatitis after Christmas and Thanksgiving, etc, after consuming one too many fatty foods. So I think if you were to go give your pups a big fatty ham to chow on, throwing them high salted deli meat, etc, it could certainly make their levels go up and for their bloodwork to appear different than before, when they were healthy. Bloodwork always changes. That's why after Jackson stayed in the hospital on IV's, his numbers went down by 1000.

roseslevi 08-03-2011 07:37 AM

Just checking in Brit on you and Jackson. This has turned into a very informative thread, many things I have read here I was unaware of. Thank you everyone for all of the great information. Still praying for Jackson that his blood levels will become normal and he continues to improve. ((hugs))

Ellie May 08-03-2011 07:40 AM

Yes, a dog can get an angry pancreas even if they have had normal bloodwork all along. You can't really tell which dogs are at risk for the most part, so if there is a predisposition in the breed, it's all the more reason to be careful.

But with that said, I don't think there is a reason to live in panic thinking that it will happen. Even if it's a common Yorkie issue, still most Yorkies are not affected.

IMO:
Feed a good food and involve a vet or veterinary nutritionist in the decision.
Be careful with fat and maybe even protein intake.
Give treats in moderation and nothing high fat.
Avoid overly rich human foods. If they never get it, then they don't know what they are missing (and I suspect they are just as happy with a tiny piece of lean chicken or the like anyway).
Don't give over 10% of daily food intake as treats or chews as a general rule. Overtime, you run the risk of unbalancing the diet.
And if they get pancreatitis after doing that, then there is not a darn thing you could have done to stop it.
Bottom line is to think about everything that goes in their mouths (within reason). Enjoy your pups. The ydon't want you worrying about their pancreases too much. :)

Maximo 08-03-2011 07:41 AM

^^The Cornell website indicates something like 28% of dogs with pancreatitis have normal lipase.

Pancreatitis can be triggered by fatty foods, certain drugs, or other illnesses like hypothyroidism or diabetes.

Maximo 08-03-2011 07:43 AM

Quote:

Originally Posted by Ellie May (Post 3621048)
Bottom line is to think about everything that goes in their mouths (within reason). Enjoy your pups. The ydon't want you worrying about their pancreases too much. :)

:thumbup::thumbup: :)

Britster 08-03-2011 07:48 AM

Quote:

Originally Posted by Ellie May (Post 3621048)
Yes, a dog can get an angry pancreas even if they have had normal bloodwork all along. You can't really tell which dogs are at risk for the most part, so if there is a predisposition in the breed, it's all the more reason to be careful.

But with that said, I don't think there is a reason to live in panic thinking that it will happen. Even if it's a common Yorkie issue, still most Yorkies are not affected.

IMO:
Feed a good food and involve a vet or veterinary nutritionist in the decision.
Be careful with fat and maybe even protein intake.
Give treats in moderation and nothing high fat.
Avoid overly rich human foods. If they never get it, then they don't know what they are missing (and I suspect they are just as happy with a tiny piece of lean chicken or the like anyway).
Don't give over 10% of daily food intake as treats or chews as a general rule. Overtime, you run the risk of unbalancing the diet.
And if they get pancreatitis after doing that, then there is not a darn thing you could have done to stop it.
Bottom line is to think about everything that goes in their mouths (within reason). Enjoy your pups. The ydon't want you worrying about their pancreases too much. :)

Really good post. I agree, I wouldn't sit there and wait for it to be happen. I'd just be careful.

I am certainly wondering if this is chronic and maybe something Jackson has had for a while but I just didn't know it... and with us just constantly feeding him everything under the sun, one day his little body just couldn't take it anymore.

I mean, looking back, he got a lot of people food. I really think had he just had a bit of cheese every now and then, or a piece here and there, it wouldn't have been a big deal or bothered him (well, it didn't seem to, for 2 1/2 years) but it was the fact that he probably consuming at least SOME people food once a day. It wasn't always massive amounts or anything. But I think the Friday BBQ just totally set him off, who KNOWS what else he got into besides what I saw...

BonBon 08-03-2011 07:53 AM

Quote:

Originally Posted by Ellie May (Post 3621048)
Yes, a dog can get an angry pancreas even if they have had normal bloodwork all along. You can't really tell which dogs are at risk for the most part, so if there is a predisposition in the breed, it's all the more reason to be careful.

But with that said, I don't think there is a reason to live in panic thinking that it will happen. Even if it's a common Yorkie issue, still most Yorkies are not affected.

IMO:
Feed a good food and involve a vet or veterinary nutritionist in the decision.
Be careful with fat and maybe even protein intake.
Give treats in moderation and nothing high fat.
Avoid overly rich human foods. If they never get it, then they don't know what they are missing (and I suspect they are just as happy with a tiny piece of lean chicken or the like anyway).
Don't give over 10% of daily food intake as treats or chews as a general rule. Overtime, you run the risk of unbalancing the diet.
And if they get pancreatitis after doing that, then there is not a darn thing you could have done to stop it.
Bottom line is to think about everything that goes in their mouths (within reason). Enjoy your pups. The ydon't want you worrying about their pancreases too much. :)

Quote:

Originally Posted by Britster (Post 3621057)
Really good post. I agree, I wouldn't sit there and wait for it to be happen. I'd just be careful.

I am certainly wondering if this is chronic and maybe something Jackson has had for a while but I just didn't know it... and with us just constantly feeding him everything under the sun, one day his little body just couldn't take it anymore.

I mean, looking back, he got a lot of people food. I really think had he just had a bit of cheese every now and then, or a piece here and there, it wouldn't have been a big deal or bothered him (well, it didn't seem to, for 2 1/2 years) but it was the fact that he probably consuming at least SOME people food once a day. It wasn't always massive amounts or anything. But I think the Friday BBQ just totally set him off, who KNOWS what else he got into besides what I saw...

Thank you both! This does make me at least feel a lot better. I do like the food I've chosen for them and the fat/protein content of it. And my gang never gets human food except for veggies as a treat. So I'm going to quit worrying about what may never happen and just enjoy them. Thanks! :)

107barney 08-03-2011 07:57 AM

Quote:

Originally Posted by Britster (Post 3621024)
Thanks for the info!



I just briefly read through it but will read more in full later.

I had never heard of MRSA before (where have I been?) but just googled it. Pretty scary stuff!

But like you said, it seems like everything these days is contaminated, or causes cancer, or something else. I mean, it's just hard to say how big the risk truly is.

I have a question. My vets office sells the CET Chews which I always hear about on here. But, I mean... aren't they rawhide? I feel like I'd rather feed a bully stick than rawhide, but maybe that's just me.

Would something like a CET chew, though, be okay for a dog like Jackson? I've got to find SOMETHING safe for him to chew on. If he doesn't have something, the risk of him swallowing plastic (from kids toys) and whatever else he finds on the ground, I think, is a much higher risk....

I wouldn't feed it to a dog with a history of pancreatitis. I like flexible nylabones.

107barney 08-03-2011 07:59 AM

Quote:

Originally Posted by Maximo (Post 3621049)
^^The Cornell website indicates something like 28% of dogs with pancreatitis have normal lipase.

Pancreatitis can be triggered by fatty foods, certain drugs, or other illnesses like hypothyroidism or diabetes.


It can also be triggered by a whole bunch of other things. It is not known all the things that trigger pancreatitis.

107barney 08-03-2011 08:05 AM

Quote:

Originally Posted by Ellie May (Post 3621048)
Yes, a dog can get an angry pancreas even if they have had normal bloodwork all along. You can't really tell which dogs are at risk for the most part, so if there is a predisposition in the breed, it's all the more reason to be careful.

But with that said, I don't think there is a reason to live in panic thinking that it will happen. Even if it's a common Yorkie issue, still most Yorkies are not affected.

IMO:
Feed a good food and involve a vet or veterinary nutritionist in the decision.
Be careful with fat and maybe even protein intake.
Give treats in moderation and nothing high fat.
Avoid overly rich human foods. If they never get it, then they don't know what they are missing (and I suspect they are just as happy with a tiny piece of lean chicken or the like anyway).
Don't give over 10% of daily food intake as treats or chews as a general rule. Overtime, you run the risk of unbalancing the diet.
And if they get pancreatitis after doing that, then there is not a darn thing you could have done to stop it.
Bottom line is to think about everything that goes in their mouths (within reason). Enjoy your pups. The ydon't want you worrying about their pancreases too much. :)


:thumbup: Barney has had a lot of blood work in his life. His lipase has always been completely normal, right in the middle of normal ranges, except during a pancreatitis event. However, his blood will show lipemic (triglycerides up) from food changes. I just won't risk it, he eats his home cooked food and his RC kibble and that is just it. He has vegetables for snacks. He is a beautiful 11 year old dog with no medical issues with a long shiny coat and supple skin who has been eating 25% protein and 15% fat his entire life, going to 23% protein and 3% fat 17 months ago. It isn't worth it to my dog to risk it.

With all that being said, I am not paranoid about this! I just make the best decisions I can. If a piece of pepperoni falls on the floor, I make a judgment about whether I'm giving a Pepcid AC or inducing vomiting. But, I dont sit there and peel off the pepperoni for him. If he wants to chew something, he gets a flexible nylabone or a Cuz ball. If he wants a snack, he gets vegetables or tiny slivers of chicken breast or white fish that I make in my home. That's it. And, the others get the same.

My dogs are not garbage disposals and no one else's should be. If you're not doing that, then there are no guarantees in life, but chances are your pups will remain healthy and happy for many years to come.

Maximo 08-03-2011 08:11 AM

Quote:

Originally Posted by 107barney (Post 3621065)
It can also be triggered by a whole bunch of other things. It is not known all the things that trigger pancreatitis.

I know, you have taught me that.

I agree with you and Crystal that we control what we can, but we can't worry ourselves about the things we can't control.

QuickSilver 08-03-2011 08:47 AM

Aw, poor chew-less Jackson!

I'm not extremely educated about pancreatitis, but wanted to offer up some other options for chewing:

- Freeze a kong or something similar with lean chicken or low fat cream cheese in it.
- Give him raw chicken breast bones, or the raw bones of another animal (you can can freeze them for a few months to kill any bacteria, then let them thaw out).
- I would recommend pig feet, ears, and tails - I would imagine they are all cartilege - but I seem to remember you saying that Jackson considers these too high value to eat, and buries them instead.


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