pancreatitis...my baby is sick

[LoveMyGirlz]

I haven't posted in a while, but today I need advice and support. Is anyone familiar with Pancreatitis? Truffles started vomiting in the middle of the night. I didn't think too much of it because of the 3, she is the most sturdy and usually recovers quickly from any small bouts. This morning however, she was moping and when I went to clean the piddle pad I notice a rather large amount of bloody diarrhea. I got scared and rushed her into the ER. They ran tests and just called to say they want to keep her overnight....they suspect pancreatitis . It is costing my about $800 that I can't afford right now but I have to get her well. Does anyone have experience with this and how often it happens? Is it completely curable or will she always be susceptible? I don't want to leave her there! But of course I want her well..........I'm sad.

[Ellie May]

I'm sorry.
Pancreatitis is very common in Yorkies.
Any fatty food can potentially set it off and now she won't be able to have any of it. She will be put on a very low fat food.

There are two types, acute and chronic.
Both can be serious and she will always be susceptible.
It is best to leave her at the on an IV.
Anything by mouth (food or water) right now won't do her any good.
I'm not sure why it would cost $800 for one night and some tests though.
A blood panel and then Spec cPL would be about $200, then hospitalization and IV.

[LoveMyGirlz]

Thank you. Sounds like it's gonna require some work on my part if they have to eat separately now!
I am going to leave her there to get the IV. They quoted me $533-$650 when I dropped her off and that was for tests (blood work, xrays, meds, etc - I don't have the quote in front of me). After she suggested that Truffles stay, she said another $250-300 could be expected for overnight care? I just want her better and home!

[Ladymom]

Yorkies are prone to pancreatitis, unfortunately. For some Yorkies, even a tiny piece of ham or another fatty meat can trigger it.

Here is a good article for you that explains pancreatitis:

Pancreatitis (Inflammation) in Dogs

[LuvMySissy]

Unfortunately, I think there are many of us here with much too much experience with pancreatitis!!!!

When both vomiting and diarrhea are present, it is usually a pretty acute attack. At my vet clinic, a full blood panel is $120, the Spec cPL (which includes the cPL, TLI, folate and cobalamine levels) runs another $200. The only overnight care we've ever had with with their spaying though, and I've not had to have xrays or ultrasound.

The full blood panel is just as important (if not more so) than the Spec cPL, as you need to know the amalayse and lypase levels and immune system markers are also very important. Even in an acute attack, the cPL can still be normal. However, all of these tests are important in making an accurate diagnosis. It seems like from lots of the threads here that most vets automatically go with a pancreatitis diagnosis. However, if immune system markers are off and TLI is either high or low, combined with folate and cobalamine levels, many times there is truly an intestinal disorder of some kind rather than a true pancreatitis. Early detection and diagnosis when dealing with intestinal disorders can mean the difference in a long and healthy life!!!

Unfortuantely, yorkies are also prone to intestinal disorders such as Protein Losing Enteropathy, IBD, and such.

Special diets are almost always in order - low in fat, many times low in protein and also limited ingredients. There are also many great supplements out there to help your baby, such as a probiotic.

Cyndi's Izzy (IzzyPrincess) just had her 2nd hospitalization in 4 months for pancreatitis. This last one was 2 nights and cost close to $1000.

Good luck and feel free to PM me!!!!

[Ellie May]

It may have been the xray that made the bill a bit higher than "normal".

Ellie has had pancreatitis diagnosed by an ultrasound that was being done for something else. So she has had that and now has intestinal issues.

She has done well on 18% fat but this will be way too high for most dogs prone to pancreatitis. Yes, they will have to be fed separately at first and then maybe you can find a food that can be shared.

[Ladymom]

Originally Posted by Ellie May

It may have been the xray that made the bill a bit higher than "normal".

The OP lives in California. Vet bills there and in the NYC area are the highest in the country, I think.

A co-worker's little Yorkie got pancreatitis from a tiny piece of ham her dad slipped her and her bill was $1500 here in Raleigh, North Carolina about five years ago!

[mscat]

I hope that Truffles makes a full and speedy recovery. I am very sorry that she is sick.

[marcerella02]

My Layla has pancreatitis. She was diagnosed in October and I was really scared... however Layla has what we are calling, chronic a-symptomatic pancreatitis as she has had no signs and I only knew about it because we get her blood tested twice a year.

Layla is now on a nutrition formulated diet and it is very low in fat. She has been doing very very well. If you can't home cook- there are many great low fat diets that are kibble- it is ESSENTIAL that she eat only her food and that her treats are low fat as well.

Jodie is right- there are too many of us on here that have expereince with this.

Pancreaitis is not curable- it is something she will always have even when her Spec levels are "normal". It will only take one bite of fatty food to set her off again and put her back in the hospital. As long as you are diligent with what she eats, she should be fine.

[LoveMyGirlz]

Thanks everyone! Truffles is still at the hospital. I couldn't even sleep last night - and I work nights so didn't get home till 3am. I called at 2am to check on her. She was sleeping soundly but nothing much than that to report. Still had bloody diarrhea when she went out at 10pm but they say that takes some time before its better.
Her regular doctor was not in yesterday. The doc that was treating Truffles says she probably won't send her home with a changed diet?!? Because this is her first bout she says "if it happens again, then we will change her diet." I'm thinking, I don't want this to happen again! Unless she is not sure of her diagnosis??
Jodie, what should I make sure they test? I wrote down the things you mention, and I know they reported to me Truffles' lypase levels, so that was done.
I'm going to see her in a bit - if they release her I'm sure it won't be till later today.

[Ellie May]

Usually pancreatitis can be diagnosed with a Spec cPL.
If it is over 400, that is the diagnosis.
High lipase is a good indication of pancreatitis issues but it shouldn't be diagnosed by that alone.

A TLI can be done. A high level could indicate pancreatitis (although the Spec cPL is better for this). This test is sometimes done with vitamin B12 and folate level checks. Abnormalities in these could indicate intestinal disease.

In my opinion, she needs to be on a low fat food.
It is not a "wait and see if it happens again" thing.
I don't want to scare you but pancreatitis can be fatal.
It is quite dangerous and I would take every precaution that you feel is necessary.

Sometimes these dogs are sent home on Science Diet I/D and then they can be switched over to a store bought food. Some need to stay on the I/D. At teh very least I would look at the fat % in her food and then decide if you need to switch her.

[LoveMyGirlz]

I tend to agree with you, that it should not be a "change nothing till it happens again" thing! I don't want her (or ME!) to go through this again! Nor do I want to spend money if I can avoid all of this!
I am taking notes, to ask the doctor when I get there, regarding tests etc.
So, what is considered low fat food that is good for Yorkies? I feed Evangers, canned food. Says "crude fat" seems to vary from %3.00-%5.00 - Evangers doesn't add anything extra to the food, so I think this is good. BUT I also leave them ZiwiPeak dehydrated meat and this bag says crude fat = %28 !! This seems high, yes??

Originally Posted by Ellie May

Usually pancreatitis can be diagnosed with a Spec cPL.
If it is over 400, that is the diagnosis.
High lipase is a good indication of pancreatitis issues but it shouldn't be diagnosed by that alone.

A TLI can be done. A high level could indicate pancreatitis (although the Spec cPL is better for this). This test is sometimes done with vitamin B12 and folate level checks. Abnormalities in these could indicate intestinal disease.

In my opinion, she needs to be on a low fat food.
It is not a "wait and see if it happens again" thing.
I don't want to scare you but pancreatitis can be fatal.
It is quite dangerous and I would take every precaution that you feel is necessary.

Sometimes these dogs are sent home on Science Diet I/D and then they can be switched over to a store bought food. Some need to stay on the I/D. At teh very least I would look at the fat % in her food and then decide if you need to switch her.

[LuvMySissy]

Originally Posted by Ellie May

Usually pancreatitis can be diagnosed with a Spec cPL.
If it is over 400, that is the diagnosis.
High lipase is a good indication of pancreatitis issues but it shouldn't be diagnosed by that alone.

A TLI can be done. A high level could indicate pancreatitis (although the Spec cPL is better for this). This test is sometimes done with vitamin B12 and folate level checks. Abnormalities in these could indicate intestinal disease.

I have seen a normal cPL level with a very acute pancreatic dog. A good starting point is both a high amylase and a high lipase (both will probably be significantly high).

My personal experience with a high TLI was the indicator (combined with a low cobalamine, high folate, high Lymphocytes, Low Neutrophil Seg, High MCHC and borderline low Monocytes) was the diagnosis of beginning stages of Protein Losing Enteropathy for Sissy. The treatment for this was markedly different than for pancreatitis.

That being said, he first full blood panel will test the amylase and lipase along with the Lympocytes, MCHC, monocytes, Neutrophil Seg ~ all of which are immune system markers. Many vets will brush off these levels and tell you they aren't really that important, however with a dog exhibiting any signs of pancreatitis or other disease, they are important.

I would ask for a copy of all of the bloodwork so you can look at it yourself. If they haven't run the cPL panel, I would ask for that and also specifically what they test with this panel as each lab is different.

Then, armed with this information, I would consult with a nutritionist. Susan Davis is awesome and there are many of us here who have used her with phenominal results. ot tremendously expensive and quickly arranged also. Here is her contact information....
Pet Health Pet Nutritionist Holistic Pet

I would definitely start Truffles on a specific diet now. The longer you wait and the more issues you have, the more damage can be done. The diet isn't that drastic and you could put all your babies on it. Low fat is the primary key, but you also want healthy ingredients that are easily digestible. Starting her on a probiotic will also be recommended. Your other babies might also benefit from a probiotic.

I would also make sure they have tested for parasites in her stool, just in case. Hope this helps and that Truffles is home with you soon. Feel free to PM me for any other information or my phone #.

Hugs from Sissy, Angel & I

[LuvMySissy]

Ziwi Peak is a great food, but unfortunately the fat content is too high. I don't know much about Evanger's wet food. We are using The Honest Kitchen Preference (which is the veggie/fruit mixture) That I add cooked Salmon and Talapia to for one meal each day. The other meal is The Honest Kitchen Embark (turkey is the meat source). Sissy has done great on this, but her diagnosis was intestinal disease not pancreatitis.

I do know that Mango (Laurenr) is also using The Honest Kitchen Preference mixed with Salmon for one meal and Primal Venison for the other. Chicken tends to be very high in fat content in comparison to Venison, Turkey, Pheasant and Rabbit, so these are the recommended protein sources.

Home cooking is often recommended as well. If your vet doesn't feel the need for a special diet now, I would personally avoid any "prescription" diet foods sold at the vets and use that money instead to formulate a solid nutrition plan with a consultant.

[Ellie May]

Originally Posted by LoveMyGirlz

I tend to agree with you, that it should not be a "change nothing till it happens again" thing! I don't want her (or ME!) to go through this again! Nor do I want to spend money if I can avoid all of this!
I am taking notes, to ask the doctor when I get there, regarding tests etc.
So, what is considered low fat food that is good for Yorkies? I feed Evangers, canned food. Says "crude fat" seems to vary from %3.00-%5.00 - Evangers doesn't add anything extra to the food, so I think this is good. BUT I also leave them ZiwiPeak dehydrated meat and this bag says crude fat = %28 !! This seems high, yes??

The ZP looks way too high in fat.
The Evangers would need to be converted to dry matter.
I can do it for you if you can give me the moisture %.
The fat % that is recommended depends on the vet.
Usually 10% or under to start or so.

Do you have copies of the blood work that you can post?