Bells not drinking and back to trying to eat grass
 

I'm sorry for all the messages, I just don't have anyone to brainstorm with me about this as my family doesn't voice opinions or suggestions and I'm getting frantic.

Bells didn't drink at all yesterday. I tried with the water syringe didn't get much in each time. Last night in despair I put some lactose free milk in about a quarter of a cup of water just to tinge it with the smell/color and she drank it out of my husband's cup ( she loves milk it's the only thing that intices her). She played a bit last night- I was so encouraged with this and that she ate in the morning and she had some pieces of boiled beef last night ( but nowhere near a meal).

This morning she awoke a little frantic. I took her out and she ran to the grass to start eating, again. I stopped her, brought her in to offer food & water - wanted neither. She wanted out again for grass. She's been laying on the couch blah. Just found a pile of POOP laying on top of yellow mucus in the living room she must have passed while I was making breakfast.
- but no blood.

She's been on the Metronidazole and the Cerenia on schedule since Saturday. She's obviously not getting better and I fear it's something worse. As an aside, I've noticed her biting her backside a bit the last few days. Didn't think much about it but as it's the only thing she's doing other than laying around I thought it might be important.

Any ideas- does this sound like something other than Pancreatitis? That fact she's not better already due to meds point to something really bad? I have a call into the vet. So scared.

First of all, try to focus away from the water drinking thing. Many times they don't drink water and it means nothing....she might be getting it from her food. What is she eating? Just make sure she is not dehydrated by checking to see if her gums are wet to the touch.

I would not give any form of milk...lactose free or not! Aside from not having lactase to digest milk, they can be allergic to milk. And why boiled beef? Has your vet not suggested a prescription food for her? What you are feeding her can counter the meds you are giving her.

I don't recall your other posts...going to read them now and will post again.

OK....first thing I see is the following post from another thread:
https://www.yorkietalk.com/forums/4760556-post22.html

Your husband needs to stop feeding her people food! Perhaps providing things for him to give her might help....maybe some carrots or green beans? He needs to realize she could die from pancreatitis. It is not something to play with! I saw that you commented about giving her Royal Canin Gastrointestinal diet until she is better....she could very well have chronic pancreatitis which would mean she should remain on that food forever! I would try to avoid enticing her with chicken and beef....she will learn to hold out. Of course you don't want her not eating for extended periods, but missing a meal or two won't be harmful.....she needs to believe that is all she is getting. That there is no room for bargaining!

She could be eating grass because of all these different things she is eating! She also could have IBD which I saw someone mention.....no way to really know that but with IBD they react to proteins and you are giving a bunch of different ones! Best to stick with ONE food and see if you can stabilize her with the meds and that food.

Unless she is dehydrated, I would not go to the vet and see if just sticking with the above helps.

You might also want to have bile acid testing done at some point. It is probably not likely she has a liver shunt but if the GI issues don't clear up, it would be worth looking into.

Thanks for the reply
 

I wish I had seen this message before we left this morning for the Vet ER. The regular vet told us to take her there.


They admitted her and will give her an ultrasound later today. I'm not certain what is going on but we're very scared.

Well, there very well may be something going on....so probably a good thing. I cannot imagine they would do ultrasound if they were not concerned. Was she hydrated?

Let us know how it goes.

Oh, and the ultrasound is actually a good idea....they will be able to see if the pancreas is inflamed. The blood tests are never 100% accurate for a diagnosis of pancreatitis...they are good, but the best way honestly is with ultrasound especially with a really symptomatic dog that isn't improving.

Linda (LadyJane) is the absolute voice of wisdom. Listen to everything she says very carefully. I'll just re-emphasize a couple of things she said:

(1) Absolutely no people food--it could be causing her the problems she's having, and it could end up killing her. Please tell your husband this, and if he doesn't believe it, show him our posts.

(2) Continuity of treatment is important. Be sure to follow all of the recommendations of all of the vets, and make sure that all of the vets know what the other vets are doing and thinking.

(3) The two most likely issues your dog is experiencing at this point are IBD and/or pancreatitis. It sounds like the vets are doing the proper diagnostics and treatment. Please stick with it.

(4) Your vets should be able to handle the situation, but if you feel that they can't, don't be afraid to ask for a referral to an internal medicine specialist.

(5) Get a print out of all of the diagnostics and medicines for your own records, and so you can share information with us. Don't try to rely on your memory only. It's easy to forget things when you're upset.

Dr Called
 

I just spoke to the doctor and didn't ask some questions I should have ( like did she have the ultrasound already what was the platelet count) . Someone will be calling me back.

He said that Bella's stomach & pancreas are inflamed with some slight liver inflammation. He said she has H. Pylori in the stomach. He said she will get plasma, antibiotic, fluids, Pepcid AC and milk thistle & have to stay in the hospital.

I asked what caused this and to be honest I can't remember I was so stressed. I have to think about it and then will share. I remember a mention of perhaps Auto-immune and he said he didn't see signs of Cushings. He talked about High Fat food so maybe he mentioned pancreatitis.

He did say it's not cancer, kept telling me staying at the hospital is better for Bella and we will take this one day at a time fixing her up. He kept telling me to calm down and they will reassess if they maybe will send her home for us to care for her tomorrow.

Does this sound familiar to anyone?

Belly
 

Thank you for all the latest info on your baby. It sounds like she has a few GI issues to deal with and that the vet is addressing these. So please try and believe that she is being treated and will get well soon.
If your baby is prone to Pancreatitis it is likely that is part of the trouble now. When the vet has finally diagnosed and treated the issues in house, you may have to keep a regimen at home to prevent these things happening again. In my case, my dog had one mild case of P and since then I have only fed prescription low fat food, with no treats or people food. This has kept him well.
I well understand you are stressed and concerned for your baby and hope that the time at the vet will get her better and ease your mind. Thank you so much for giving updates. I am sure you appreciate the suggestions given by YTers here who give helpful advice and the benefit of their expertise with dogs.
Praying peace will reign soon. Healing wishes.

Thank you
 

Yes, I really appreciate all the help, suggestions & information. I have health related anxiety- panic attacks after being diagnosed with cancer myself- and then after me my husband had a heart attack and cancer- I just don't cope well. I get frantic and can't think straight. I never know if what I'm doing is based on good info and sound decision making or my frantic anxiety is not allowing me to see facts for what they are. I can't even read other information about people/dogs being ill as it sends me into a panic.


I really appreciate all the info as it's all that is helping me to process at this time.

Why is she getting plasma? Does she have fluid in her abdomen...and is her albumin low or something?

You need to call them back with a list of questions so that you fully understand. Take a deep breath and try not to panic.....I know it is hard but if you have an idea of what is going on it will be much easier for you. Call him, make him take his time and WRITE EVERYTHING DOWN so you can share with us and we can try to help you sort it all out.

1. ask him what are the different diagnosis he is ruling out - tell him to talk slowly and write what he says down! I am sure he has a list of things he is attempting to rule out.

2. ask him why the plasma - write the answer down

3. ask him how this bacteria you are talking about was identified ... did they do a scope?

You are so sweet, Phil.

YES on that number 5....get that in addition to what I suggested. Copies of everything and share with us .. maybe we can help you sort it out and relax a bit. Have a sick pup is very stressful.....I know as I have been there more times than I can count. It is easier for me when it is someone else. LOL

You are all so sweet.

I will head over to the hospital now to get copies and to talk to them.

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.

Forgot to say that they found the lining of the stomach slightly thickened but said that's a normal finding with this?

:thumbup:

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

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.

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!

Thanks
 

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.

Bless you. These little ones do give so much.

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!

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.

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.

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

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.

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.

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.

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.