Bells not drinking and back to trying to eat grass

[KatysMom]

Originally Posted by BellymonsterMom

...her dx is...she said Pancreatitis...Ultrasound- no masses...She was on fluid, is getting the plasma, taking anti nausea, anti inflam and a pain killer as well...

Thank you for the update and bless you for getting this care for your pup .

[ladyjane]

I would ask them if this is standard to give plasma.....I have only seen it done in severe cases. Maybe it is a standard they use..I don't know.

I am glad you got clarification. You need to know what is being done with your pup. No idea why the worry about her platelets....that would not be a concern with any of this...and, yes, if they did basic labs that is in it.

Please let your husband know that her diet is going to HAVE to be monitored carefully from here on out. She cannot have people food!!

Thanks for updating...please keep us posted.

[dottiesyrky]

I agree with all LadyJane has said, especially following the dietary in structions and informing your hubby of the importance of this. As I have a dog prone to P, I have proven that the regimen works. I feel mean only giving him the same old ID low fat kibble for all meals, but as it works I feed him only that! Thank goodness he seems to like it and not get tired of it!
Hope your stress is reducing now and that your baby gets well after the vet stay and keeps well. Also I pray that the health of all your family improves. You have been through a lot!

[BellymonsterMom]

Thanks Dottie and all who've replied and helped. I'm getting ready to head over to the hospital to visit her. I will spend the night in the hospital waiting room or my car in the parking lot. I want to be there for her something bad happens. She's always there for me.

[KatysMom]

Originally Posted by BellymonsterMom

...I will spend the night...I want to be there for her something bad happens. She's always there for me.

Bless you. These little ones do give so much.

[ladyjane]

Originally Posted by BellymonsterMom

Thanks Dottie and all who've replied and helped. I'm getting ready to head over to the hospital to visit her. I will spend the night in the hospital waiting room or my car in the parking lot. I want to be there for her something bad happens. She's always there for me.

Did they say she is in dire shape?? Or are you just worried? I once did that at Texas A&M .. had a dog that had cervical disc surgery and he had complications after...I slept outside in the parking lot all night. In the end, he was fine!

[BellymonsterMom]

I'm here now... they keep saying she's good but she seems confused, head down whimpering disoriented . I know she is on meds... so I hope that was it. She was wagging her tail when she saw the kids .

[ladyjane]

Originally Posted by BellymonsterMom

I'm here now... they keep saying she's good but she seems confused, head down whimpering disoriented . I know she is on meds... so I hope that was it. She was wagging her tail when she saw the kids .

Poor baby...I do hope she is ok.

[dottiesyrky]

How sweet of you to keep watch all night. You are such a caring dog mom.
I am sure she will be ok and her behavior is probably due to the treatment and her illness. Great news that she perked up on seeing the kids. She is probably not too pleased about being in the hospital and not with you at home. But she is in the right place at this time and being treated well, so try not to worry unduly.
Prayers for you and your baby continue.

[Wylie's Mom]

Originally Posted by BellymonsterMom

I called as my husband said it would annoy them if I dropped in since it is an ER.

I asked what her dx is...she said Pancreatitis.

She did have the Ultrasound- no masses.

She is getting plasma because the pancreatititis seems to respond to that well. There was no fluid in her stomach/ her albumin was not low. All her blood work was fine but for the Pancreatic number. They sent PLI to idex to get an exact numbers for her Pancreatitis- how severe it is.

She was on fluid, is getting the plasma, taking anti nausea, anti inflam and a pain killer as well.

I will be going in to visit her later after the shift change and ask the one question I forgot - about doing the scope. My sister asked me to ask them about platelet count...but if her blood work was fine- wouldn't that be included? I asked if the blood work was fine 3 times.

I'm so very sorry for all you're going through with your poor baby .

I just fostered a severely emaciated German Shepherd (body condition of ZERO! Weight 37 lbs) and 1 of his diagnoses was pancreatitis along w/ low protein/low albumin. One general Vet mentioned plasma as a potential treatment -- our rescue group then consulted with THREE different *extremely* highly-respected Internists and one ER Vet in Arizona -- all of whom said that this is considered a very 'old-fashioned' treatment belief and that there is absolutely no scientific literature to support the use of plasma to treat pancreatitis alone. You'd use it during pancreatitis *only if* there is also prolonged clotting time, as confirmed via blood tests (see PT/PTT numbers on blood testing results). Tell them you want a print out of her blood results for your own records - that is not abnormal to request at all.

See link: https://vetgirlontherun.com/treating...log-scheduled/

[ladyjane]

Originally Posted by Wylie's Mom

I'm so very sorry for all you're going through with your poor baby .

I just fostered a severely emaciated German Shepherd (body condition of ZERO! Weight 37 lbs) and 1 of his diagnoses was pancreatitis along w/ low protein/low albumin. One general Vet mentioned plasma as a potential treatment -- our rescue group then consulted with THREE different *extremely* highly-respected Internists and one ER Vet in Arizona -- all of whom said that this is considered a very 'old-fashioned' treatment belief and that there is absolutely no scientific literature to support the use of plasma to treat pancreatitis alone. You'd use it during pancreatitis *only if* there is also prolonged clotting time, as confirmed via blood tests (see PT/PTT numbers on blood testing results). Tell them you want a print out of her blood results for your own records - that is not abnormal to request at all.

See link: https://vetgirlontherun.com/treating...log-scheduled/

Not for pancreatitis alone, but it IS considered for pups with fluid in the abdomen and low protein. The internist I use gave it to only one of my pancreatitis pups...George....but he was really in bad shape and only given a 50/50 chance of making it. He had fluid in his abdoment. He lived and I have always felt the plasma was the reason. ETA" I should add that actually it is hetastarch, not plasma that is used.

And, yes, if DIC is a possibility....I thought of that later when I said why look at the platelet count.

[Wylie's Mom]

Originally Posted by ladyjane

Not for pancreatitis alone, but it IS considered for pups with fluid in the abdomen and low protein. The internist I use gave it to only one of my pancreatitis pups...George....but he was really in bad shape and only given a 50/50 chance of making it. He had fluid in his abdoment. He lived and I have always felt the plasma was the reason. ETA" I should add that actually it is hetastarch, not plasma that is used.

And, yes, if DIC is a possibility....I thought of that later when I said why look at the platelet count.

We were advised by all of the Internists against using plasma bc of lack of evidence (scientific or anecdotal) and they said we'd see no appreciable nor *sustainable* change in the low albumin or low protein (or ascites). This was from 2 different Internist practices that had multiple Internists on staff (as well as several ER Vets, Cardios, ENTs, Opths, Orthos, Neuros - that type of Vet practice). We kept asking and asking about it (the Hetastarch) bc I was reading about it in the old literature as a treatment back then -- and we were SO desperate for Tucker at that point -- we'd have tried anything. They said we'd literally be throwing our money away.

From that link:

"As for the use of FFP to increase albumin in these hypoalbuinemic patients: the VETgirl team believes the use of plasma therapy for administration of albumin is an often ineffective therapy. Remembering you need to give approximately 20-40ml/kg of plasma to raise the albumin level by 0.5-1 g/dL (as compared with the dose of 6-20 ml/kg of plasma to treat a coagulopathy). The use of FFP is a very expensive therapy when used to increase albumin levels, when colloids can be used alternatively [Of course, this opens up the whole can of worms of whether or not colloids cause acute kidney injury (AKI) or not. Check out our podcasts on that here.] In pancreatitis cases with multi-organ dysfunction syndrome (MODS) and AKI or azotemia, we wouldn't recommend the use of colloids, however, until further evidence assessing the safely of colloids in veterinary patients can be reviewed."

[ladyjane]

Originally Posted by Wylie's Mom

We were advised by all of the Internists against using plasma bc of lack of evidence (scientific or anecdotal) and they said we'd see no appreciable nor *sustainable* change in the low albumin or low protein (or ascites). This was from 2 different Internist practices that had multiple Internists on staff (as well as several ER Vets, Cardios, ENTs, Opths, Orthos, Neuros - that type of Vet practice). We kept asking and asking about it (the Hetastarch) bc I was reading about it in the old literature as a treatment back then -- and we were SO desperate for Tucker at that point -- we'd have tried anything. They said we'd literally be throwing our money away.

From that link:

"As for the use of FFP to increase albumin in these hypoalbuinemic patients: the VETgirl team believes the use of plasma therapy for administration of albumin is an often ineffective therapy. Remembering you need to give approximately 20-40ml/kg of plasma to raise the albumin level by 0.5-1 g/dL (as compared with the dose of 6-20 ml/kg of plasma to treat a coagulopathy). The use of FFP is a very expensive therapy when used to increase albumin levels, when colloids can be used alternatively [Of course, this opens up the whole can of worms of whether or not colloids cause acute kidney injury (AKI) or not. Check out our podcasts on that here.] In pancreatitis cases with multi-organ dysfunction syndrome (MODS) and AKI or azotemia, we wouldn't recommend the use of colloids, however, until further evidence assessing the safely of colloids in veterinary patients can be reviewed."

As you know, I use a very well known hospital in Houston with all of the above mentioned specialties. This was used on George and a couple of days later when I was speaking with the boarded criticalist, she said that it had been a wise choice by the internist on duty.

The above is speaking about multi organ dysfunction which is not exactly the same. It IS true that you really cannot use enough plasma, but I believe hetastarch is a wiser option because of that fact. I would have to look that up again.

I do know there is plenty of literature and I believe some studies that do support using it in some cases. I had looked it up at the time George had it. I had not heard of it before then, so I came home to drive myself nuts with google.

[ladyjane]

And, while it may not have been appropriate for Tucker, I am not sure it is not appropriate in all cases. Each case is different. I am sure I have some links that I may have bookmarked. If I have time later, I will look.

[ladyjane]

Originally Posted by Wylie's Mom

We were advised by all of the Internists against using plasma bc of lack of evidence (scientific or anecdotal) and they said we'd see no appreciable nor *sustainable* change in the low albumin or low protein (or ascites). This was from 2 different Internist practices that had multiple Internists on staff (as well as several ER Vets, Cardios, ENTs, Opths, Orthos, Neuros - that type of Vet practice). We kept asking and asking about it (the Hetastarch) bc I was reading about it in the old literature as a treatment back then -- and we were SO desperate for Tucker at that point -- we'd have tried anything. They said we'd literally be throwing our money away.

From that link:

"As for the use of FFP to increase albumin in these hypoalbuinemic patients: the VETgirl team believes the use of plasma therapy for administration of albumin is an often ineffective therapy. Remembering you need to give approximately 20-40ml/kg of plasma to raise the albumin level by 0.5-1 g/dL (as compared with the dose of 6-20 ml/kg of plasma to treat a coagulopathy). The use of FFP is a very expensive therapy when used to increase albumin levels, when colloids can be used alternatively [Of course, this opens up the whole can of worms of whether or not colloids cause acute kidney injury (AKI) or not. Check out our podcasts on that here.] In pancreatitis cases with multi-organ dysfunction syndrome (MODS) and AKI or azotemia, we wouldn't recommend the use of colloids, however, until further evidence assessing the safely of colloids in veterinary patients can be reviewed."

And, also from that link:

VETgirl's take? If your patient is coagulopathic (e.g., prolonged PT/PTT), then the use of FFP is warranted. However, keep in mind that plasma transfusions are not benign, and while rare, complications such as transfusion related circulatory overload (TACO) and transfusion-related acute lung injury (TRALI) can be seen.

So, should we be reaching for FFP in every pancreatitis case? Likely, not. In severe cases (e.g., necrotizing pancreatitis) that are coagulopathic or have clinical signs of SIRS, sepsis, or MODS, yes. Otherwise for colloidal support, the VETgirl team recommends albumin therapy or synthetic colloid therapy, saving the plasma therapy for another patient in need.

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Oh, and let me add this: Keep in mind that plasma and hetastarch are often used interchangeably.