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Old 05-15-2018, 02:15 PM   #1
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Default Update on Bells- released today and papers

It's too late re the Plasma and now I'm worried. I will put together a list of questions for the doctor as we only saw the nurse at discharge- he was in surgery and I didn't want to keep her there any longer.

It looks worse than I thought...and now with other concerns...liver biopsy? Huh? No one mentioned that at discharge...3 days of no eating and she goes into an oxygen chamber? Ut oh. She's sleeping now, but with tons of meds to give and a tornado/thunderstorm in our area- she'll be all up and miserable soon.

If anyone has any info about the plasma that looks on the bright side for an already bad situation, the liver scary stuff or any of it. HOW do I feed a dog meds with food when she doesn't eat on a good day? Just give them and rip up h er stomach- don't give them and she dies of pancreatitis?

Thanks in advance.
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Old 05-15-2018, 02:38 PM   #2
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So I take this as...we are not out of the woods, she's just not hospitalized. It may have worked, it may not have and she will be back in the ER in 3 days if she's not eating. And the liver? Yikes. She's due two pills that need to be few with food and she's no where near wanting food.

Last edited by BellymonsterMom; 05-15-2018 at 02:39 PM.
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Old 05-15-2018, 02:58 PM   #3
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Hi BellymonsterMom,

Thank you for taking the time to update. I'm so happy for you (and Bella) that your pup came home. Yeah!

Perhaps I missed a notation in the discharge papers, but do you know if Bella ate while she was in the ER? If she did, what food and how much?

They recommended "Hill's low fat I/D or baked chicken with mash potato." Don't know if you have the Hills, but I say nom-nom to the latter. They have prescribed the appetite stimulant (Mirtazapine), as needed. I see the notation "12 noon tomorrow." So, maybe you serve up the chicken and mashed before then to see if she eats.***

You wondered how to administered the meds if Bella is not eating. Two thoughts--not eating is different than not drinking water. She may accept the meds and then drink a little water afterwards. In the alternative, you can inquire to learn which of the meds can be ordered as a compounded/suspension form. Most or all of my late little one's meds were prescribed that way and administered via an oral syringe. Katy didn't take pills well (er ... maybe because I was a nervous wreck in the act), but never had an issue with the liquid.

Even with compounded/suspension, some meds are to be administered with foods. If she's not eating, and you have meds (pill form or other) that direct you to administer with food, I would administer the meds once, but little-old-novice-me would call the vet's office for their okay before administering them the second time.

You had other concerns--oxygen chamber; liver biopsy.... For the next 24 hours, I hope you can take some comfort knowing she is there with you!! What's the saying, all in due time ...

Again, so happy she's home.

***I'll leave it to those more expert to weigh in on this, but have always thought pups were like humans when it came to food and water--need fluids regularly but can go longer without eating food.
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Old 05-15-2018, 03:08 PM   #4
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Thanks for your reply! They said she did eat the IC Hills Chicken Stew-,they didn't give amount- they said the stimulant helped. She has had that at home. Bella really doesn't eat a lot or consistently.

It says in the discharge-- she should start eating at 3 days..but give her meds with food today? Crazy inducing!!! I will definately look into compounding into liquid!

Last edited by BellymonsterMom; 05-15-2018 at 03:10 PM.
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Old 05-15-2018, 03:18 PM   #5
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...she did eat the IC Hills Chicken Stew... said the stimulant helped...
Well, if you have the chicken stew, I'd set out a serving. The can should tell you how much to feed daily; you'd want to give her half that amount twice a day. The discharge papers indicate that she can have 1/4-1/2 c. chicken and mashed twice a day.

Discharge papers say she will "start eating within the next 3 days." I read that to mean that she may eat in a few hours, 24-hours, etc. The "Follow up" section indicates you should contact them if she exhibits "a lack of appetite."

Those with more expertise can weigh in, but I read the whole to mean you should be concerned if she has not eaten by the third day.

Again, I'm so happy that she is home with you.
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Old 05-15-2018, 03:18 PM   #6
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Originally Posted by BellymonsterMom View Post
It's too late re the Plasma and now I'm worried. I will put together a list of questions for the doctor as we only saw the nurse at discharge- he was in surgery and I didn't want to keep her there any longer.

It looks worse than I thought...and now with other concerns...liver biopsy? Huh? No one mentioned that at discharge...3 days of no eating and she goes into an oxygen chamber? Ut oh. She's sleeping now, but with tons of meds to give and a tornado/thunderstorm in our area- she'll be all up and miserable soon.

If anyone has any info about the plasma that looks on the bright side for an already bad situation, the liver scary stuff or any of it. HOW do I feed a dog meds with food when she doesn't eat on a good day? Just give them and rip up h er stomach- don't give them and she dies of pancreatitis?

Thanks in advance.
Giving her plasma was harmless. The ondansetron is to reduce nausea and the gabapentin is to reduce pain. They are both relatively nontoxic/harmless medications, and should have minimal side effects (other than possible drowsiness from the gabapentin). You can try wrapping the pills up in SMALL pieces of cheese to see if she'll eat them that way, and follow up with boiled chicken and mashed potatoes (no added salt or butter) as directed by the vet. The most critical thing is to feed her a low fat diet. The additional testing/hospitalization is for only if she doesn't improve. Let's hope she improves, and cross that bridge only if she comes to it.
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Old 05-15-2018, 04:25 PM   #7
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Thanks for your reply! They said she did eat the IC Hills Chicken Stew-,they didn't give amount- they said the stimulant helped. She has had that at home. Bella really doesn't eat a lot or consistently.

It says in the discharge-- she should start eating at 3 days..but give her meds with food today? Crazy inducing!!! I will definately look into compounding into liquid!
It says she should be eating normally in 3 days...not that she shouldn't eat for 3 days!

As to the Mirtazapine....that is a miracle drug in my opinion and I would continue it for at least a couple of days until she is feeling better. It is a tiny thing and you should be able to get it down her.

I really wish they had supplied you with compounded meds. SO much easier. I use a pharmacy in Houston that ships my meds the same day if ordered early enough and I have them the next day via Fed Ex Express. They are a great pharmacy....the other ones that are well known take far too long to get things to you and they are awful to work with. BCP has these awesome little chews that my pups love...they are about the size of an M&M and you can choose the flavor. My pups don't bother to chew...they gulp them down! They also do make liquids but for most I use the chews. Here is a link if you want to try them: BCP Veterinary Pharmacy | Specializing in the Pharmacology of Animals

Some of that report has me baffled....I got the impression they "think" it could be heliobacteria since that can cause stomach wall inflammation.. And, the liver thing...gosh I don't know how quickly I would be scheduling a biopsy. I have had similar reports and they have given the meds...antibiotics and denamarin and repeated the ultrasound. I might have to think long and hard on that one.
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Old 05-15-2018, 04:26 PM   #8
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Giving her plasma was harmless. The ondansetron is to reduce nausea and the gabapentin is to reduce pain. They are both relatively nontoxic/harmless medications, and should have minimal side effects (other than possible drowsiness from the gabapentin). You can try wrapping the pills up in SMALL pieces of cheese to see if she'll eat them that way, and follow up with boiled chicken and mashed potatoes (no added salt or butter) as directed by the vet. The most critical thing is to feed her a low fat diet. The additional testing/hospitalization is for only if she doesn't improve. Let's hope she improves, and cross that bridge only if she comes to it.


I agree with all of the above! I am hopeful she will be fine and not need anything else.
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Old 05-15-2018, 04:27 PM   #9
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Well, if you have the chicken stew, I'd set out a serving. The can should tell you how much to feed daily; you'd want to give her half that amount twice a day. The discharge papers indicate that she can have 1/4-1/2 c. chicken and mashed twice a day.

Discharge papers say she will "start eating within the next 3 days." I read that to mean that she may eat in a few hours, 24-hours, etc. The "Follow up" section indicates you should contact them if she exhibits "a lack of appetite."

Those with more expertise can weigh in, but I read the whole to mean you should be concerned if she has not eaten by the third day.

Again, I'm so happy that she is home with you.
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Old 05-15-2018, 05:37 PM   #10
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Thank you so much for the update. Although the discharge report seems scary, in fact it does give hope that your baby will improve, if not completely cured in the near term, with home care. They did say that she responded fairly well while in the hospital and if you try and feed small quantities of the suggested food, she should be able to take in the necessary meds. It is likely that her appetite will not be good but hopefully she will be able to absorb small quantities at frequent intervals. She obviously had a bad case of pancreatitis from the test numbers and does not feel good. This is a very debilitating disease, but she has survived so far and has been discharged from the vet care.
I sure understand that you are very concerned for her and upset that she is still sick, but hopefully the intensive vet treatment will show good results soon, after your loving home care. Just take it as it comes and do what you can with the discharge instructions, you might not be able to follow them 100%, but do what you can. If you are really worried you can call the vet to ease your mind.
How I feel for you and your baby. It must be hard to keep going, but you will get the strength to succeed. Prayers, hugs and healing wishes.
By the way, my dog would take the Hills ID low fat canned food when he was treated at home for P. I just gave him a teaspoon by hand as often as he would eat it, together with meds. This food is also high in water, so she would get liquids as well. Good Luck and hang in there.
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Old 05-15-2018, 05:40 PM   #11
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So sorry about the storms, I understand it will be hard on your baby. But perhaps some of the meds will calm her. My dog goes crazy in storms so I do know how badly it can affect some pets.
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Old 05-16-2018, 04:47 AM   #12
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This report makes sense to me - and I think it's very thorough too.

-- They're saying they expect/hope she is increasingly eating within the next 3 days, if not - consult with them

-- I would *absolutely* be giving the Mirtazapine until you see appetite normalize

They are mentioning Helicobacter -- this may sound kind of familiar in a way bc 'h.pylori' is a Helicobacter SO common in humans and much talked about. In dogs, there are other strains of Helicobacter -- and when infectious, they can really be dangerous.

Symptoms (and link to Helicobacter page):

Vomiting
Dehydration
Poor appetite
Bowel sounds
Abdominal pain
Weight loss
Diarrhea
Weakness
Sudden death

However, I'm not exactly sure I'd rush, quite yet anyway, to diagnosing Helicobacter. The reason is bc of the stomach's proximity to the pancreas, which is severely inflamed. An inflamed pancreas can sometimes also cause a somewhat inflamed stomach lining, bc of proximity. For me, it would depend on the health of my dog and whether or not I could wait to 'heal' the pancreatitis first, and then see about Helicobacter.

The fact she has pancreatitis is really concerning - and this could take a long time to recover from. Be extremely careful with feedings - NO extra fat whatsoever. She could be very fatigued for a good while during recovery.
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Old 05-16-2018, 05:38 AM   #13
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This report makes sense to me - and I think it's very thorough too.

-- They're saying they expect/hope she is increasingly eating within the next 3 days, if not - consult with them

-- I would *absolutely* be giving the Mirtazapine until you see appetite normalize

They are mentioning Helicobacter -- this may sound kind of familiar in a way bc 'h.pylori' is a Helicobacter SO common in humans and much talked about. In dogs, there are other strains of Helicobacter -- and when infectious, they can really be dangerous.

Symptoms (and link to Helicobacter page):

Vomiting
Dehydration
Poor appetite
Bowel sounds
Abdominal pain
Weight loss
Diarrhea
Weakness
Sudden death

However, I'm not exactly sure I'd rush, quite yet anyway, to diagnosing Helicobacter. The reason is bc of the stomach's proximity to the pancreas, which is severely inflamed. An inflamed pancreas can sometimes also cause a somewhat inflamed stomach lining, bc of proximity. For me, it would depend on the health of my dog and whether or not I could wait to 'heal' the pancreatitis first, and then see about Helicobacter.

The fact she has pancreatitis is really concerning - and this could take a long time to recover from. Be extremely careful with feedings - NO extra fat whatsoever. She could be very fatigued for a good while during recovery.


I also wonder about the bacteria....I think it was just a guess kind of thing..no scope or culture was done. You would probably start an antibiotic anyway based on everything going on and I bet the white count is elevated.

I too would never stray from a very low fat diet for her...she has had pancreatitis before and is probably chronic

And YES to the mirtazapine...I would not stop it even if she is eating. Not until she is back to eating normally.
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Old 05-16-2018, 08:58 AM   #14
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I also wonder about the bacteria....I think it was just a guess kind of thing..no scope or culture was done. You would probably start an antibiotic anyway based on everything going on and I bet the white count is elevated.

I too would never stray from a very low fat diet for her...she has had pancreatitis before and is probably chronic

And YES to the mirtazapine...I would not stop it even if she is eating. Not until she is back to eating normally.

H. pylori can be diagnosed using a fecal, blood, breath, or urine sample, at least in humans, so it's possible that Bells was diagnosed in that manner without doing an endoscopy. See https://www.ncbi.nlm.nih.gov/pubmed/17382278. Hopefully, Bells will improve on her current medication and the liver biopsy won't be necessary, but you have to do what you have to do.
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Old 05-16-2018, 12:51 PM   #15
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H. pylori can be diagnosed using a fecal, blood, breath, or urine sample, at least in humans, so it's possible that Bells was diagnosed in that manner without doing an endoscopy. See https://www.ncbi.nlm.nih.gov/pubmed/17382278. Hopefully, Bells will improve on her current medication and the liver biopsy won't be necessary, but you have to do what you have to do.
Even at that, was a culture done?? It isn't mentioned. It says there is diffuse thickening in the stomach wall and that "often" this can be due to helicobacteria. My impression was they are guessing this.....
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