Annabelle Has Pancreatitis--again
 

Our four-year-old yorkie Annabelle was hospitalized last night with a diagnosis of pancreatitis. She spent the night at the emergency vet overnight, approximately a year ago--give or take a few months--for a mild case, which the ER vet said yorkies were prone too and could have been caused from any number of things, "even stress."

Lately they've been on meds for allergies, recently got off a short bout of Prednisone for bad allergies, which seem to be worse this time of year, plus Annabelle's on amoxicillin to counteract any possible reaction to her vaccine boosters she had about a week ago. To get the pills down them three times a day, I've been using hot dogs. So now I'm thinking they may have been the culprit. Our other yorkie, Turner is six, her full brother from another litter, and he's never had this problem. But Anna may be more sensitive.

This ER vet said of the two markers they look for in the general blood workup they did, the second one was so high it was off the chart. When I told her about the hot dogs and asked about how to get pills down Anna, she just said no people food and if she won't eat the dog pill pockets to try peanut butter or, if I had to, cheese. But these are high in fat so I wondered about that.

I looked online for diets and recommendations, they were all over the place, from raw foods to Hills prescription food.

So I'm at a loss and really want to do the right thing. Any suggestions?

Poor Annabelle! I have not experienced pancreatitis with my dogs, but I would avoid the peanut butter and cheese, along with the hot dogs.

Does she do okay with chicken? I use steamed chicken to give Teddy pills. Sometimes I have to use a pill cutter and serve the pill in smaller pieces.

Since Annabelle is at risk for pancreatitis, I would talk to a vet nutritionist about diet plan. Many members here have had great success with:
https://www.petdiets.com/

Sending well wishes for your little girl.

My Zoey has had pancreatatis several times. Now she is on Royal Canine Gastrointestinal Low Fat canned and kibble. She will eat this the rest of her life. I tried home cooking but she got tired of the chicken and rice. For treats she gets Cherrios. Your vet will probably put her on a rx diet. It is very important that she gets no people food.

Thank you for responding and thanks for the link. I really appreciate it. I will look for a vet nutritionist. Good idea.

Thank you for responding. I can always count on the YorkieTalk's community for help and comfort. I just found out that she will have to spend another night, though her numbers have improved some. She's refusing to eat, but both my dogs refuse food when they are left anywhere; we're retired and are with them almost constantly so they aren't used to being left much. I hope she can come home tomorrow. We all miss her.

Pancreatitis
 

Hi.
So sorry your baby has this nasty disease. Sounds like she has other issues too that mean she has to take more meds, poor baby.
It does seem that some Yorkies are predispodsed for the horrible P disease. My dog had a mild attack about a year ago and ever since I have fed him Hills ID Low Fat Prescription kibble and perhaps sometimes the canned ID if he is not feeling so good. The vet told me to feed no people food now and I think my issue with him before was I used to give him meds in cheese, so he gets no cheese now. Since on the Hills he has been fine and the PCL numbers are down to 63.
As he is so well, I now put a small amount (Like a thumb nail) of boiled low fat chicken breast as a topper for the kibble to give him some 'real food'. I also give him some cooked veggies as a treat if we have them.
My dog also has acid reflux disease and I have a theory that acid has some bearing on P in his case, but no proof! Since his last attack when he was prescribed Pepcid antacid, I give him Pepcid at night with his last small meal, he is very well. Now he has no throwing up bile in the mornings.
Hope your girl feels better soon and is back with you and keeps well on the special diet.

Thanks for replying. Yes, I was leery of the suggestion the vet gave to use peanut butter or cheese to give meds, especially since I believe my giving her meds three times a day within hot dogs probably at the very least contributed to this attack.

I should have known, having had another dog who had two pancreatitis attacks and was put on a low fat diet, but he was old and had kidney disease right on the end of the pancreatitis and I guess I attributed it all to age.

Also, a cautionary tale: Anna's first attack was so mild. She didn't really seem ill at all and her regular blood work didn't show a rise in the markers. But she had thrown up a few times that day, so my regular vet did the specific test that is only for pancreatitis and it showed a slight elevation. Just to be safe that time, we took her to the ER. They kept her a night for IV fluids but she felt great the next morning and that vet sort of blew it off as, "Well, it's common in these dogs and could be caused by anything, even stress."

I wish he'd have warned me to go low-fat with her at the time. I guess I wanted to be relieved and think it was just a fluke. So I was and I did. Now I know it wasn't and I think maybe I could have prevented this worse attack.

I hope anybody who's reading this takes a "mild elevation" seriously and can maybe prevent their baby from having one that isn't so mild. It's really scary and that guilty feeling is heavy.

The good news is that they finally got Annabelle to eat some chicken baby food twice, so at present she seems to be getting better.

Thanks to all who responded with helpful advice and kind wishes. :love:

P
 

I agree with you about taking even a mild attack of P seriously.
My dog usually has very normal stool and doesn't get sick as a rule. He did have the occasional bile issue early in the morning, but I knew what that was.
However when one morning he threw up his breakfast and had loose stool, I knew something was up. When I took him to the vet that morning the snap CPL test showed up a value of 299, which is not that high. The vet did all the tests and the high P value was proven true. So my dog was treated with the usual meds etc and fed small amounts of the Hills ID canned at frequent intervals. No hospitalization or IV fluids. In a day or two he was fine and eating the canned food well. No more throwing up or soft poops. So we got through that bout fairly quickly and I don't think my dog was ever in pain. So the vet then told me to keep on the Hills food and no more fat or people food. So if your dog shows unusual GI signs, get him or her to the vet pronto , just in case it is the start of P. We don't want it to progress to the severe form of the disease.
A few weeks ago my dog threw up once and I was scared and thought it was the P again, so I immediately took him to the vet and had the CPL plus other tests done. The CPL snap test was only 63 and that was a relief, but he had a mild UTI. That was soon fixed with antibiotics and he was fine in a day or so.
Better to act quickly than suffer later.
It is encouraging that feeding the Hills and keeping to the strict diet does work....or at least it has so far.

Thanks. That's good advice. Anna was fine the night before this last bout. Woke me up to go out, loose stool and vomited small amount. A few hours later I took her to the emergency vet, as it was a Saturday. It came on very quickly this time.

P
 

It is good that she is eating a little baby food. I am sure that you will have her home tomorrow if she is getting better and stable. She will be more comfortable at home. Perhaps they will give her a shot of Cerenia, or oral meds, if she is nauseous and that may improve her appetite. If the Vet says it is ok I would start her on the canned ID prescription food, small amounts every few hours for a few days to rest her P and GI system. Then you could feed her the Hills kibble, perhaps mixed with some canned at first.
I think as you caught her early she will get better very soon. Hope she will eat the Hills food as it is not as tasty as her past diet:). Usually my dog loves the canned Hills, and now also eats the Hills kibble ok.
Hope she gets better soon and that the horrible P never returns.
Don't worry, she will be fine :)

Pancreatitis is nothing to take lightly. Uni has had it twice. Her trigger the first time was lamb. We only know bc she had a recent change in diet. The second time wasn't as bad and I don't remember what happened. But the first time she had diarrhea and vomiting for two weeks and was very lethargic. Her lipase and amilase was off the charts.

I think the hot dogs most def set Annabelle off. As for cheese, you can give low fat string cheese. That is no where near as fatty as hot dog, not to mention hot dogs has way too much salt, spices (such as garlic and onion which is poisonous to dogs) and nitrates. Peanut butter is a common and popular treat for dogs, and in small amounts I wouldn't see why would be too bad.

I myself am recovering from a bad case of pancreatitis. Trust me, you do not want to put your dog through it again. Yes I do believe it can be triggered from many different things aside from fatty foods. Mine was triggered by too much alcohol. Not only did I get pancreatitis, but also liver failure, respiratory failure, fluid in my lungs and I needed a blood transfusion. I was hospitalized for over a month. Yes people and dogs can die from it. Please be careful, and you must give your dogs her meds but don't give it in fatty foods. I usually give mine with Greek yogurt.

So sorry you have a sick baby. Pancreatitis is definitely nothing to mess with. I am glad that she is being kept on IVs. I have had different pups over the years hospitalized with pancreatitis and never really knew the cause since they don't have varied diets and definitely no scraps from the table. I am quite sure the hot dogs probably caused this because they really are a trigger for pancreatitis.

As for giving meds, I either use some of the canned food to hide the pill in (like a tiny meatball) or a small piece of a sweet potato. They are pretty sharp...if it is a pup who hates to take pills, I put it in their bowl of food so they don't realize there is something different. I always have sweet potato chunks on hand for treats. I learned that from a vet nutritionist when I consulted with her for a diet for one of my pups with lymphangectasia. If you don't mind home cooking it is a great way to go...but definitely only under the direction of a board certified vet nutritionist. You can go to petdiets.com or balanceit.com Balance it has free diets for healthy pups, but will require your vet's clearance if the pup has an illness. As for commercial foods, Royal Canin, Hill's and Purina all have RX foods that are low fat. One of my pups is on Purina EN .. they put him on it after a bout of pancreatitis that landed him in ICU.

I hope Annabelle is better soon and back home with you! :)

Annabelle's Home
 

Thanks for much for your kind comments and helpful information. There'll be no more hot dogs for my babies.

Our regular vet was closed when we picked Annabelle up this evening, so I made her some watery, overcooked rice and mixed it 2 parts to 1 part of shredded, boiled boneless, skinless chicken breast. Also gave her a little bit of low fat cottage cheese. I offer her small amounts at a time.

Anna was so glad to see us; she whimpered and climbed all over us. The receptionist said she was "talking" a lot while she was there. Talking? She said like what she's doing now while she stayed there. Breaks my heart. So glad she's home.

I'll call my regular vet tomorrow for some prescription food. I've researched it and know she will have to stay on low-fat food from now on.

Thanks again for sharing your stories and information with me. It has helped me to get through the wait and given me some valuable information to go on for the future.

Home:)
 

So happy to hear your baby is home again. I bet she is over the moon with happiness after her spell at the vet's. The food mix you are giving sounds very bland and should not tax her system. I hope she is eating it. Good idea to feed a little and often until she is well again. When you talk with the vet I am sure he will give the right food and advice on her diet from now on. Also did he give her any Cerenia for nausea? If she is enjoying her food she probably does not feel sick though. Hoping you all have a good night and that your baby feels much better now.

That's wonderful Annabelle is home...poor baby girl. I hate seeing them have to be hospitalized...I always wonder what they are thinking. :(

I still haven't looked at the list of things they gave her. Too busy trying to give her the right diet and our other dog his right diet and keep them from getting into each other's food. I also spent time rubbing Anna's tummy while she went to sleep in my arms.

She only threw up once--I guess it counts as once since she ate it back up before I could stop her the first time--before I took her to the hospital. It was a tiny bit, but she wasn't interested in anything and I could tell she felt really bad.

At first when I got her back home she was a little tentative about eating, but by her last portion I offered her, she was really into it. I didn't give her more tonight. I thought it best to wait until morning and not tax her system.

That same thought kept going through my mind the whole time.

Update 2
 

Anna had loose stool with blood and mucous this morning, which was one of the things we were told to look out for.

We took her to her regular vet who checked her stool sample for certain parasites, which he didn't find, but to help with other possibles, she's on Flagyl temporarily.

I post this for anyone who has a dog with pancreatitis and may not know that this is something you look for when they are "better."

She's playing and her tummy isn't tender. She's also whining a lot more, not in pain but more like "I want attention." She's probably feeling a bit insecure. Can't blame her.

Pancreatitis
 

So sorry that poor Anna has the loose and bloody stool. Did your vet think it was still the lingering Pancreatitis or something else? Did they get a cPL number for her to see what the level of the disease is now? You say she is on Flagyl but did the vet also suggest Cerenia? I say this as when my dog had the P this helped him a lot with nausea. I also think that getting her on the canned ID Low Fat food is important. Could be even the bland diet you were giving her was too much for a weak tummy.
Sorry for all the comments, but they are based on what happened to my dog.
Hope she feels better soon. I know how concerned you are with your poor baby.

Poor baby....do hope she clears up soon. :) Sounds like she is on the mend....I am sure your vet advised you to let them know if things don't improve.

Honestly, cPL is not as great as one might think. It is used as a diagnostic tool, but there are so many other factors to consider. I have had so many different pups with pancreatitis and spent a lot of time talking with the specialists about it. It really is a scary thing as you have mentioned....I almost lost a pup to it and that happened very quickly. He had to be given plasma and was given a 50/50 chance of survival. His symptoms had only started that day.
I have never had a repeat cPL suggested and/or done with any of my pups. Just an FYI because it does cost a few bucks and it takes a couple of days to get results. There is a snap test, but again, it is not a total 100% great diagnostic tool. Symptoms, physical exam, ultrasound and other blood work is all put into the mix to come to a diagnosis.

A link regarding the accuracy of cPL and Snap in diagnosing pancreatitis:

Diagnostic accuracy of the SNAP and Spec canine pancreatic lipase tests for pancreatitis in dogs presenting with clinical signs of acute abdominal disease - Haworth - 2014 - Journal of Veterinary Emergency and Critical Care - Wiley Online Library

P tests
 

Thank you for your comments and for the link.
I agree that the snap and full cPL tests are not 100% conclusive, and other exams and tests have to be used to have a definitive diagnosis.
All I know is my own limited experience with my dog. When he got sick the vet did all the usual exams and tests and a snap cPL. This latter test showed that pancreatitis was likely and the full test showed a value of 399. The other indicators also supported a P diagnosis. After a couple of weeks of meds and prescription food, my dog seemed well again. The cPL test then came back at 93. So for my dog the cPL test seemed to be a good indication of pancreatitis, and I suppose I now have faith in it. I also feel that the snap test can be done quickly in the vet's office and can indicate the possibility of P without waiting for the full tests the next day or later. That is all I am saying, it can be a quick test and it worked for me. I did not feel the cost was that excessive as a first shot.
As for Annabel, I understood she had been diagnosed with P at first, but I do not know what tests resulted in that diagnosis. I again was only suggesting the test as it could it helpful, but of course the vet decides what tests to carry out to check on the progress of the disease.
I know that any info we give here can only be based on our own experience and is not to be taken as gospel. Most people go to vets but still ask here for the views that others here may have.
Hoping little Annabel feels better soon.

Test numbers can fluctuate greatly and while the snap test is relatively inexpensive, the cPL is not. I believe it is around $150 but could be more, but my guess is that it would probably be meaningless to repeat it at this point. I am surprised your vet did that repeat test...I have not ever been advised to do that. I have had blood work repeated by them, but not cPL or snap cPL. But, each vet has his/her own thoughts on things. Mine usually like to treat the dog, not the numbers. That was emphasized greatly by one of the specialists I see and it really is what I have experienced with most vets. There is one vet at my vet's office that tends to rely way too much on lab studies...kind of avoid that one as much as I can. I always agree to have all necessary labs done, but this vet seems to be out fishing if that makes sense. I really was only sharing what I have been told based upon more experience with pancreatitis than I ever wanted to have. As you know, it can be downright frightening...and can kill. I hate that our beloved breed is so prone to it.

My post # 8
 

Correction.
On reading my past posts on this thread I said the cPL test number was 299, but it was 399!! I also gave numbers after my dog was better from P and mistakenly gave cPL numbers as snap instead of the complete test. Sorry, but it was some time ago and I got it wrong. :(

I don't think it really matters. I wouldn't worry about that at all. I didn't even catch it....snap does not have numbers.

Vets
 

My vet suggested the cPL test the first time but it was I who requested the repeat to see if my dog was feeling better. Unlike you, I did have faith in that test and therefore the numbers were important to me. I do trust my vet and I do not think he suggests tests just for the income.
I am so terrified of my dog getting P.again that if he has the slightest GI issues I take him in for tests. I requested the full CPL test and the vet did it for me. But he also did a full blood and urine panel. Lucky he did as my dog did not have P but a UTI!!! If you remember he also included the new SDMA kidney function test! Probably as my previous girl died of kidney failure and he knew that concerned me!
We all have our views on vets and other matters and I respect that.

I corrected the numbers as I did not wish to be inconsistent! I also understand that the snap is only qualitative and that is why I corrected that too.

I wish he had given her Cerenia because last night she began vomiting. At the time we saw the vet she wasn't vomiting, and even though the stool sample showed none of the parasites that could be seen through their microscope, he wanted to put her on Flagyl in case she had P *and* something else.

The vet didn't do more bloodwork, but palpated her, took her temperature, looked at her gums, did a pretty thorough exam plus the analysis of the stool sample. She seemed to feel okay other than the blood in the stool.

But when I got her home and gave her boiled rice with a tiny bit of low-fat cottage cheese and a miniscule amount of boiled chicken breast, she ate with gusto and may have eaten too fast or too much, though it was a small amount. Plus she's hard to give pills to but is suffering from terrible itching from allergies, so I wrapped half a Benadryl (approved by the vet) in a bit of the chicken and she threw that up whole. So now we're struggling to give her meds without food.

She was playing and acting more like her old self a little while ago, though not as vigorously as usual. I didn't let it go on too long because I assume she needs to take it easy.

She drank water and kept it down. So I peeled and cut up a potato and boiled it until it was falling apart and gave her a smear--about 1/8 of an eraser tip. She ate it (she was refusing rice or the cottage cheese--and she's kept that bit of potato down as well as the water, Benadryl and Flagyl. So I've got my fingers crossed and am waiting for the vet to call back about the vomiting.

She got up in the middle of the night and left a loose bowel movement on the floor--not something she would normally do. i slept through it but my husband cleaned it up, looked for signs of blood and saw none.

Guess this is going to be a longer road to recovery than I thought. I did copy a recipe for a homemade diet from a book at the vets office. I didn't like that it said to put a salt substitute and iodized salt in it, but I guess that's for the minerals. Also said to supplement with a children's vitamin and mineral pill. I think I'd prefer to make her a homemade diet, and maybe supplement with prepared dog food.

I had another beloved yorkie who passed from kidney disease in cancer in 2006 two keeps shy of his 15th birthday. He had also had pancreatitis. He hated the Hills Rx food, and even back then it was more than a dollar a can. Anna's 9.6 lbs. Not fat but a little bigger than the average yorkie. (Her brother is 13 libs.) Oh, and that's another thing: my dogs were on self-feed with their Blue Buffalo grain-free kibble plus, regrettably, table scraps, so I don't even know how much to feed her when she's well, though I'm sure that information is available in lots of places.

Thanks for taking the time to respond. Every bit of information helps. And it's comforting to not feel so alone in this.

I would hold back on the cottage cheese. Dairy products can cause GI issues.

The only thing I feed my pups after a bout with pancreatitis is either Hill's ID or Purina EN .. per the vet specialists I use.

The original vet was the emergency vet. They took her back to examine her while we were left sitting and waiting in the waiting room. When we got to talk to the vet, she said they did a general blood work up and maybe--I just can't remember because I was so stressed--a more specific test. She said something about the first number (of the two markers), which I also can't remember, but what I do remember was that the first number was so high they couldn't read it. She also said that Anna seemed to be very tender in the area of the pancreas and they thought she should stay and it likely would not be just one night. She said they could run the specific test for P but that would only tell them to look elsewhere. As I type this, this doesn't make much sense but I was scared and was looking to the expert for help. if she'd told me it would be helpful if I stood in the middle of the highway and tried to juggle, I probably would have done it.

I'm not as knowledgeable about the differences in blood tests, so I can't really address that.

The vet called and since she's kept the water, pills and potato down and the stool looks better and she's been playful, we're going to wait and see how she does, and tomorrow if she's still vomiting we'll take her to see him. He said we could give her Pepcid, and if it gets really bad, a "shot" for the vomiting. He said it could be that she ate too much for her and her stomach was distended which brought on the vomiting.