Dog with pancreatitis
 

I took my 11 yr old min pin to the vet Tues Aug 17 as she had vomited the day before and twice on the 17th. After running numerous blood tests, xrays, ekg, blood pressures, the diagnosis came back as pancreatitis. Her Amylase was unreadable, (meaning off the chart) and her lipase was 5504. She has been on IV fluid therapy and fentanyl patches for pain control. A recheck on her blood today showed her lipase at 4498, her creatinine at 2.2, and her bun at 46. The vet also ran a Spec CPL and it showed a level over 1,000. He wants to run the test again tomorrow, which is fine but I have 2 questions. He mentioned that her lipase could be elevated due to the pancreatitis and the use of the fentanyl pain patch, but also could indicate a pancreatic tumor. By running the Spec CPL again tomorrow, if the levels drop significantly is this an indication she is improving? My family is trying to decide (with tears from everyone) if we can base a decision on ongoing treatment for her if the numbers on this test are less or should we face the fact that if the numbers are still increased we should end her agony and let her peace at peace? I need some sound advice from anyone who might have dealt with this type of situation or might know anything about the tests and numbers that i have mentioned. Thank you to anyone who can assist me in anyway during this crisis.

I'm PM'd Dr Lee with a link to your thread, addienana08. He's a vet who volunteers his time on the board. Not sure when he'll be logging on again, but I'm hoping he can give you a little more info to go on :fingerscr

Best wishes for your min pin. :goodvibes: Please keep us posted on her progress!

[QUOTE=addienana08;945858] By running the Spec CPL again tomorrow, if the levels drop significantly is this an indication she is improving? My family is trying to decide (with tears from everyone) if we can base a decision on ongoing treatment for her if the numbers on this test are less or should we face the fact that if the numbers are still increased we should end her agony and let her peace at peace? [/QUOTE]

It is important that we treat not only the numbers but the pet. Some pets can do very well with astronomically high numbers and visa versa. So while numbers are important, they should not be the only factor. With that said, when we have pancreatic numbers this high, we have to worry about DIC (disseminated intravascular coagulation) which can be a life threatening sequella of severe pancreatitis.

The only way to evaluate for pancreatic cancer is really an abdominal ultrasound. I would recommend this for several reasons. It will be important to look for pancreatic or any other type of mass. This may help very much with your decision process. Furthermore it is important to rule out pancreatic abscess, cysts and free abdominal fluid.

It is a very difficult time and situation for you and I do wish you the best. Pancreatitis can be a horrible disease. Many pets can get over severe episodes of pancreatitis but it can also be fatal. It is important to have your veterinarian give you assessments which should include: patient physical assessment (alertness, comfort, etc), blood pressure/oxygenation/etc., and diagnostics (blood value recheck and ultrasound). By looking at all of these, they can give you realistic expectations of prognosis, cost ranges, etc.

I hope that that helps. :pawprint:

We went through this with our (then) nine year old Australian Terrier about four years ago. Our regular vet didn't have the resources to deal with it and Boomer spent two weeks at the local vet school.

He was extremely sick and the vets thought he probably would not make it. He did however pull through. He lived another two years when sadly lung cancer got him.

Everyday when I got off work I drove over to the vet school and spent time with him, the docs and the breeder who had given him to me felt that that had helped him to pull through. The first week or so was a roller coaster ride where he would do a little better one day then crash the next. I don't remember much about the "numbers" but do remember being told that some stuff was astronomically high.

You have some very tough and emotional decisions and times ahead of you, I wish you and your little friend the best. Good luck.

Update on Franny
 

Here's an update on our min pin Franny. We brought her home on Friday eveing (Aug 20), she peed, drank, and also ate. she's on Flagyl twice daily, and Cerenia until tonight for vomiting. She has not vomitted since we brought her home (none in the hospital), is doing lots of resting/sleeping (which she pretty much always has done), and has only had 1 accident in the house. (my daughter didn't think Franny or any of the other dogs really needed to go outside even though it had been 3 hrs). I'm logging all of her med, food, elimination, and liquid times so we can basically keep track of what she does last. I've spoken to the vet twice since she's come home and they agree that sometimes you have to treat the dog and let her (or him) set the tone. We all are agreeing that Franny has probably has this for awhile and her body has just sort of adjusted, and last week it just hit her full force and it ended up being a bad attack. I do understand about the ultrasound, but in doing this procedure, if we find "bad news" so to speak, what do I do next? We all agreed in the family, and the vet understood as well, that bringing Franny home and monitoring her would be the best and safest road to pursue at this time. Her heart murmur (grade 4) is also a concern, as well as her kidney disease. Am I being heartless in the way I am approaching things with her, or am I doing what most people would do in the same situation? I do have Tramadol on board if she appears to be in pain, but am also trying to approach things in a relatistic way knowing that she may not fully recover and my family and I need to realize this as well. She does have her perky moments when she runs up the stairs or wags her stump because she wants to jump on the bed (which she is no longer allowed to do). Taking it one step at a time seems to be all we can do at the moment, sans the ultrasound, is there anything else we can do?

[QUOTE=addienana08;946698]Am I being heartless in the way I am approaching things with her, or am I doing what most people would do in the same situation? I do have Tramadol on board if she appears to be in pain, but am also trying to approach things in a relatistic way knowing that she may not fully recover and my family and I need to realize this as well. She does have her perky moments when she runs up the stairs or wags her stump because she wants to jump on the bed (which she is no longer allowed to do). Taking it one step at a time seems to be all we can do at the moment, sans the ultrasound, is there anything else we can do?[/QUOTE]

It sounds to me that you're doing all you can for her. Monitoring at home seems to be a wonderful solution for all of you :grouphug:

So take it one step at a time, do your best, and make all your decisions in Franny's best interest and, regardless of the outcome, you will have made the [I]right[/I] decision!

How is she doing today? Any better? :fingerscr

[QUOTE=hazelrunpack;946972]It sounds to me that you're doing all you can for her. Monitoring at home seems to be a wonderful solution for all of you :grouphug:[/QUOTE]

I agree with HRP. By monitoring Franny at home you will know how she's dealing with her condition and you will be the first to know when she's no longer coping. She will be comfortable in familiar surroundings with people she knows and loves. My opinion has always been to treat until the condition becomes so severe that there is no more quality of life, only an existance. As long as Franny seems to be enjoying her life to a reasonable (you judge) degee, keep doing what you're doing because it seems to be working.