jessies_mom
Posted : 5/5/2009 2:52:56 PM
You guys really rock; thank you for all the good vibes.Good news; there were no masses on the ultra sound. The vet also checked her liver, kidneys, spleen, and bladder; all looked fine. Besides regular veterinary training, the vets at the clinic where I go specialize in different areas. The vet who did the ultra sound has more extensive training in it than the others. The vet Jessie usually sees is very good with allergy dogs and can perform more difficult surgeries. This is very, very long (sigh);
I'm sorry I worried some of you so much; she never showed signs of the disease. Here's how we found out; Friday night April 24th, she leaked quite a bit of urine everywhere she lay, five different places. I took her to the vet Saturday to check for a UTI. They couldn't get a urine sample (DH had walked her that morning and her bladder was empty. He had gotten up before me and didn't notice all the wet spots.) Callie, the vet prescribed cephalexin for a UTI. She had ten days worth of it. Jessie hadn't had bloodwork for 7 months so she wanted to have her tested to make sure her kidneys were okay. She called Monday morning and asked me to bring Jessie in to check her blood again; her kidney values were fine but both her amylase and lipase values were over 3,000. *Some of her liver values were also elevated; I'll explain more about that later.* On Monday, Jessie's amylase was back to normal and the lipase was improving, so she didn't need IV fluids. The instructions were to continue her regular food but feed smaller meals, and be sparing on treats, so we fed her four times a day. Yesterday when her blood was rechecked the amylase was slightly over 2,000 and the lipase was too high for their machine to read. They also did a urinalysis, and if there was a UTI, the antibiotic cleared it up. Callie, my vet recommended a diet of 50/50 lowfat cottage cheese and rice. I have Monica Segal's book Optimal Nutrition and chose a diet from her chapter about pancreatitis; it has the right amount of calories for Jessie, but I won't be adding the supplements to balance it until her numbers are better. I decided not to use cottage cheese because of the huge amount of sodium, especially for a dog, but you're right about dairy; most dogs are lactose intolerant. The vet that did the ultra sound today recommended fasting her for 24 hours, so I'm doing that. I think the others didn't recommend it because she hasn't been vomiting and has a normal appetite. She acts fine; I walked her for over an hour today and she had more energy than me.
There's no obvious cause, such as raiding the trash or getting a nice piece of ham. My vet's best guess; recent food changes coupled with elevated liver enzymes from using Animax; Some of you may remember that I tried a diet balanced by Sabine last fall and after awhile Jessie started having ear infections and chewing her feet. She has many food allergies but I thought the ingredients in the diet were safe. After the third round of ear infections in 3 months, I changed her back to the RX diet SS21 because she did well on it last summer. RC had changed the formula and her stools were softer; sometimes she had trouble passing stool. I kept her on it because I wanted to use it as an elimination diet, adding different foods from the cooked diet to see what had caused her ear problems, hoping to have another diet formulated by Sabine. About 2 months ago, she stopped accepting it for treats and than started refusing to eat it unless it was mixed with warm water. It has a very strong fish taste and some dogs don't like fish kibble, and Jessie has done this with other foods. Anyway, I changed her to a lamb and rice food. Her stools were better, but she had more of them. She also had a foot infection in early April, then about a week later a nasty one in her other rear foot and infections in both ears. So, yep, I changed her diet again (sigh). And, she was getting Animax in both ears and on her feet twice a day. *It has been proven that the steroid in Animax raises liver enzymes when applied in the ears,* but Jessie's allergic to Baytril Otic and she doesn't respond as well to Mometamax, which also has a steroid. The vet and I have confirmed with a bile acid test that her lliver enzymes return to normal once Animax is stopped but it takes several weeks.
So, Jessie's adrenal glands were producing extra cortisol in response to her allergies, and more steroids were getting into her system with the Animax, causing her liver enzymes to be elevated. Plus, food allergies can cause an immune-mediated reaction of the intestines, which may affect the pancreas. Friday afternoon I gave her a beef rib. She's used to having them. I trim off most of the fat and lightly sear the meat; she chews off the meat but doesn't eat the bone. There was a small strip of fat on this rib, and my vet thinks that may have been enough to cause this when combined with everything else. Whatever caused it, she's probably staying on a low fat cooked diet permanently, which is fine with me as long as it keeps her healthy. If anyone has ideas about what caused this, I'd welcome the info. Stanton; like your dog, she's older; ten and a half. I think their digestive system is more sensitive as they age. I'm so glad we caught this before she started vomitting and having diarrhea. Thanks again for your good thoughts; I'll let you know the results of the blood test next week.
Edited to add; I forgot to mention her T4; it was .5 and normal for this test is 1.0-4.7. Her cTSH is normal. I'm going to ask my vet what relation, if any, that may have to her pancreas enzymes, but she may need a full thyroid panel done.