vomiting immediately after eating? - update page 6

Sammy vomited again tonight.  We have an appt on Friday with a new vet (earliest they could get us in).  I do plan on trying to find a TCVM vet as well.

I feel helpless, and overwhelmed.  Good thoughts that we can get some answers or at least a specific plan of action?

NicoleS

I have to use some canned, but I got the z/d, which, surprisingly (not!) has very little protein, or fat.  It's 2.3% fat whereas the canned I was using before was 4%, so at least that's about half. 

 

  If you compare the canned z/d to kibble on a dry matter basis, it's about 14% fat.

http://www.hillspet.com/hillspet/products/productDetails.hjsp?PRODUCT<>prd_id=845524441780767

  I agree with Cathy about staying on the z/d for now; most RX diets for pancreatitis are 10% fat except for Royal Canin which is 6% fat. Dogs with pancreatits need a low fat, low fiber diet and a moderate amount of protein. You want to rest the pancreas and fat, followed by protein, stimulate it to produce the most enzymes. Try to feed several small meals a day if possible. Here's some links;

http://www.peteducation.com/article.cfm?c=2+1580&aid=335

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2008&PID=23846&O=Generic

http://www.vetinfo.com/dpancrea.html

  I feed Jessie a diet formulated by Monica Segal;

http://www.monicasegal.com/

My vet said the diet is excellent. Jessie has many food allergies so having a diet formulated for her was the best option.

 The antibiotics your vet prescribed won't hurt and may actually be helpful because pancreatitis can be secondary to another infection.  Jessie has had a soft cough since early spring, before she had pancreatitis. About a month ago it was discovered that she had a bacterial infection in her lungs and she's on doxycycline. Her cough is getting better. My vet said the bacteria in her lungs may have also caused the pancreatitis so I'm hopeful that when her lungs are clear the chronic pancreatitis may subside. She is doing better on this diet than she's ever done with any kibble and I'm going to stick with it even if the pancreatitis is related to her lung infection and resolves.

  Poor Sammy; I hope the new vet will be more helpful; {{{{{{hugs}}}}}}

 

 

  

  Poor Sammy! I hope things go well with the new vet. I wish I had words of wisdom for you, but I don't, just commiseration.

Oh, poor Sammy!!  I thought there was a prescription diet for pancreas problems, maybe the i/d??  I thought maybe the w/d could be used too. 

NicoleS

I feel helpless, and overwhelmed.  Good thoughts that we can get some answers or at least a specific plan of action?

 

You are such a good dog mom.  You've sure had more than your share of problems with Sammy and I will be sending good thoughts.  Hugs for you and scritches for Sammy. 

thanks, guys. I really appreciate the support and good thoughts, keep 'em coming.

Lori, I think those diets you mention are more often used.... but the vet had us on the z/d for allergies and wasn't all that interested in even doing blood work. I requested it. At this point, i don't want to change too much too fast, so I'm going to wait until our appt on Fri with a new vet before doing anything.

The vet called about the biopsy -- it was just granulation tissue so no real worries -- but didn't even ask how Sammy was doing overall. Another reason I don't want to go back there. And, he had said his other blood work was essentially normal, and I get copies of past blood work today and the one from Sat shows quite a few numbers "out of range" -- including way high amylase (consistent with the pancreatitis), lowish T4, high hemoglobin, low monocytes and low platelets. As well as bilirubin in the urine. I would think, with a dog who has some obvious clinical symptoms, that some of these values would be cause for concern!

He's been doing OK so far, he wasn't having as frequent bowel movements and then finally did today and it was kind of greasy -- again the pancreatitis -- so of course I'm worried about it all, and want to fix him ASAP. But, I know I can't keep making changes, and he has another vet appt on Friday with hopefully a better doctor. Hopefully we can get him on a better path before it becomes more serious. I just worry that each day that goes buy, is doing him more harm.

he vomited again last night as well.... so it's hard to give him pills when he keeps vomiting them up and I'm not sure how digested they are. But, just need to make it a few more days, just keep taking it one day at a time...

NicoleS

Sat shows quite a few numbers "out of range" -- including way high amylase (consistent with the pancreatitis), lowish T4, high hemoglobin, low monocytes and low platelets. As well as bilirubin in the urine.

 

  Jessie's T4 was .5 when she was diagnosed with pancreatitis. It's normal for the T4 to be low when they're sick; her T4 is now 2.83. Here's a link that explains what the different items on blood test results mean; 

http://www.rajah2004.com/aboutbloodwork.htm

 Jessie's values on the Spec cPL  got much higher than Sammy's ( in the 600's ) but she never vomited; makes me wonder if something else is causing the elevated pancreatic enzymes. Please give Sammy some lovin' for me; I'll keep him in my thoughts.

jessies_mom

 Jessie's values on the Spec cPL  got much higher than Sammy's ( in the 600's ) but she never vomited; makes me wonder if something else is causing the elevated pancreatic enzymes

Me, too. But that's why we're going to the new vet -- the 'old' one was like, OK that's it let's go with it. BUT, Sammy could still theoretically something like an obstruction that's CAUSING the rest of this. And reading online makes it sound like the cpl levels being high isn't the whole story unless it accompanies other symptoms (one of which is vomiting but there are others). But, SOMETHING caused it, right? I don't ever like just treating symptoms without knowing what's going on.

Thanks for the link, I'll check it out today. I know some of them just from being in science, but I'm fuzzy on some of the relationships between values. Good think I work with a bunch of doctors and medical students; usually the relationship in humans is similar in dogs.

What symptoms did Jessie have that made you realize something was wrong and suspect pancreatitis?

(and Sammy has been getting TONS of lovin' since we both like to cuddle and I spoil him when he's not feeling well)

Hi, just chiming in to let you know I, too, am wishing Sammy the best and sending lots of "feel better" thoughts.  You are such a good mama and Sammy is so very special.  I'd be changing vets too....to someone who will listen to you and show compassion to your baby.

You keep at it, girl.

NicoleS

What symptoms did Jessie have that made you realize something was wrong and suspect pancreatitis?

 

   I thought she had a UTI.  She was restless one night and wet everywhere she laid; her bed, the sofa, about five places altogether, and she really soaked each place. The vet put her on Cephalexin for a UTI and did blood work to make sure her kidneys were okay since it had been seven months since her last full blood panel. Her kidneys were fine but she had very high amylase and lipase, along with elevated alkaline phosphatase and cholesterol.  A Spec cPL was done to confirm pancreatitis; it was in the 600's.  My vet thinks that the pain from her pancreas caused her to wet. It's the only symptom she's shown. The only thing we could think of that may have caused it was a beef rib with a small amount of fat I had given her that afternoon although she's had them before with no problems. When her levels remained elevated a week later, my vet did an ultrasound to look for abscesses or masses on the pancreas but it appeared normal. After Jessie had been on a low fat diet for a month, my vet did another Spec cPL and she still had pancreatitis although she tested lower; about 380. He consulted with an internist to see if anything else could be done but was told to continue to monitor her and keep her on a low fat diet. In mid August a tracheal wash was done to determine the cause of a soft cough she'd had since spring after 10 days of Clavamox didn't clear it up. It was learned that she had mycoplasma bacteria in her lungs so Doxycycline was prescribed for six weeks; she has one more week to go. Her cough has been getting better. Mycoplasma bacteria can be hard to get rid of, which is why she needed a long term dose of antibiotic. The reason I'm telling you this is because my vet thinks the bacteria may be the cause of her pancreatitis. I'll be looking for an update on Sammy after his visit with the new vet; good luck.

 How low does the fat need to be?

 

I ask, because Ena eats Precise Light. It's 18% min protein. It has 7% min fat and 9% max fat. I've been very happy with the results, and it struck me this afternoon that it might be appropriate for a dog with fat sensitivities.

 http://www.precisepet.com/light-1.html

Janice, Thanks for the info and sharing yours and Jessie's story. It's crazy to think about the damage bacteria can do, if that's what it is.

Mycoplasma is interesting since we have been battling it in cultures at work for several months now. It's a really hard thing to see in cell cultures unless you test for it; it's a common bacteria, but I obviously know I've been around it for a really long time. We can't get rid of it well at work either! Good luck on the doxycycline and it clearing her infection.

Good thing they caught it for Jessie -- the normal blood panel they've been doing for Sammy doesn't test for amylase or lipase so only my request to run the spec cpl, it showed that they were high. He also has had some weird eosinophil numbers for a while now; apparently in humans, there is a form of eosinophilic pancreatitis. I work with a lot of medical students/residents/doctors so I'm always asking them questions about this sort of thing. But in humans, pancreatitis is most often caused by alcohol and gall stones, so obviously it's different for dogs.

I'm trying to think of what could have caused it, but honestly couldn't think of anything in the immediate past around the time he started vomiting. It's feasible it could have been going on for a while, I don't really give him bones or many table scraps. None of the other blood tests for the past 3 years looked at any of those values. I seriously wonder if something was up with that bag of kibble -- we started a new one, and about a week later the vomiting started. We switched kibbles and he was fine for maybe 5-6 days and then vomited a few more times. Since starting the z/d he's vomited twice, but that's only since Saturday.

I'm glad Sam's been keeping down the antibiotics. He hasn't vomited since Tuesday. I can't wait for our appt tomorrow, hopefully get some decent advice.

Jennie, I wasn't sure about fat content, but above I think Janice mentioned that it should be around 10% or lower; the food you mention probably would be good! I'll go check it out and keep it in mind, since obviously the z/d is kind of high in fat (14% I believe).

Thanks, guys, for all the help and input -- I totally appreciate everything, and the support, and I'll update tomorrow evening once we are back from our appt. It's not until 7, so I still have to make it through the entire day... sigh.

ETA -- California Natural, Wellness and Innova both have a reduced fat similar to the Precise you posted, Jennie, so at least there are multiple options in the 7-9% fat range. The wellness was a little higher on protein, but the other two were close to the 18%. I'm glad that it looks like there are a number of options other than RX foods, depending on what we decide to do. Also depends on the allergies! The derm vet by us comes pretty highly recommended by a few people (good, since there's only ONE) so if that's in our future then so be it.

Nicole, I just wanted to drop in & tell you to hang in there.  You are doing a great job making sure that Sammy is being taken care of, & you will get answers.  Just keep plugging away.

We're all pulling for you here.

Sorry-- the last couple of days have been nuts and I haven't been able to check back in.

Your musings about that one bag of food -- it could have been "it".  Especially since Sammy seems to be responding now that he's beginning to keep down the antibiotics. 

Pancreatitis is one of those opportunistic diseases -- it's like there are times (and high allergy times or times after there's been significant illness for a long while) when the body is just kinda wide open to certain problems -- and bacterial junk going deep to attack an organ (like the pancreas or the liver) can HAPPEN.

You're not likely to find a "cause".  It's more like certain things just plain lined up -- all increasing Sammy's vulnerability to a problem and then all it takes is the wrong bacteria at the wrong time (i.e., at another time his body might have thrown it off -- but not *now* for some reason).

One of the good things about looking for a holistic vet (not to be your "sole" vet -- but literally a vet to add some complimentary therapy to this) is that often they diagnose things *very* differently.  Rather than simply saying they have to have a particular "test" to diagnose a particular disease -- they will put together certain chains of events and say something like "added to what I can see on my exam ... this plus this can often bring *this*"

Years ago when my Prissy had pancreatitis, I know she got into a discarded box of KFC chicken on a walk (my friend's dog AND Prissy both found it while we were waiting at a stoplight), but during the night she woke me by staring into my face and I got up to find a whole apartment full of bloody diarreha and bloody vomit.  No other previous symptoms -- but that was long ago and MUCH less experience.

Billy developed the  pancreatitis/hepatitis (both were bacterial) at the end of his treatment for the IMHA -- He's been on anti-inflammatories for 18 months, and his body had been SO abused.  But all *I* Knew was that suddenly he just wasn't feeling "good" and SOMETHING was a bit wrong. 

After dealing with IMHA I was watching for the first crossed eyelash -- but we literally found this BEFORE he was symptomatic in a big way.  But it was almost just a "feeling" I had.

It was **ME** who had the meltdown at the vet, to be honest (like after having him be SO sick for 18 months, and ME ... who had gone thru the "sickest of sick sick SICK" dogs with Prissy  so many years ago, just the mere mention of "pancreatitis" literally put ME into a tailspin.  And it wasn't nearly as bad to treat as I feared.

You asked above if sweet potato and potato were far eough apart?  YEP -- sweet potato is really more almost like squash (altho it's a tuber).

I wouldn't try pork SIMPLY because of the fat issue.  Fish -- can be an easy one to do (because different types of fish are so different -- but look around and see what is reasonable where you live -- frozen being better than canned because of the salt issue).

NicoleS

He also has had some weird eosinophil numbers for a while now

just to let you know that Bugsy's eosinophil numbers are ridiculously high - Dr Dodds told me after his last bloodwork that in his case it is likely due to his thyroid issues being the autoimmune type and the fact that he has severe allergies to so much. Not sure that helps but wanted to let you know that she really sounded like that number is not something they tend to panic about - she was like no biggie - may be because she attributed it to his thyroid.

hope you get some answers soon