Maggie's Xmas visit to ER vet--pancreas problems?

[Maggiesmom]

I had planned to drive back to Atlanta from my parents' house in Florida Sunday, about a 6 hr. drive. Maggie threw up in the morning, which I thought was an isolated incident from a Booda bone my Grandpa had given her as a gift (she doesn't normally eat those). She seemed okay, so off we went back to Atlanta. Well, she proceeded to throw up every 30 minutes or so all the way home. At one point, I considered turning around and going back, but it didn't seem sensible, and I tried to keep going, letting her out periodically. She got worse about 4 hours into the trip, vomiting large amounts of liquid, and she felt warm. I got scared. I called the ER vet I knew would be open, and arranged to get her there ASAP. We arrived, she had a temp of 104. They did complete bloodwork, a lipase test (for pancreatitis), and x-rays. Everything came back in the normal range, except lipase was a bit high at 2184 U/L. She was dehydrated, so they gave her sub-q fluids and injected antibiotics, as well as an anti-vomiting drug, and sent her home with me. I'm just so relieved she is okay.

She is on metronidazale and famotadine. She ate a bit of food yesterday and drank (as instructed), and kept it down. She seems to feel better, is just a bit lethargic.

My question is, where do I go from here with this? I intend to take her to my regular vet this week for a follow-up. Do I have her blood re-tested? Is that lipase level indicative of pancreatitis?

[Traci]

Other than the booda bone, was she given any other treats or human foods?

Lipase shouldn't be used as a sole indicator of pancreatitis, it can be tested with amylase, but neither are confirmative for pancreatitis....if your vet felt pancreatitis was a concern, he might consider a TLI test.

If your vet suspects pancreatitis or an acute episode, he most likely would have hospitalized her to monitor and repeat her bloodwork. In any event, you should followup with your vet in 48 hours after the episode and discuss re-running her bloodwork. If her fever hasn't reduced, if she has a painful abdomen, continues to vomit or is severely dehydrated and lethargic, get her back to your vet ASAP for additional diagnostics and treatment. In the immediate sense, feed her bland meals, in small amounts, and don't feed high protein diets or high-fat diets.

Hopefully, this was only a temporary GI tract upset, but if the symptoms persist or worsen, don't hesitate to get her back to your vet promptly.

[Maggiesmom]

Thanks Traci. My Dad (despite me always asking him not to do this) did give her a small piece of nonfat deli ham the night before, but it was just a small piece--could this be enough to cause this? Other than that, she just had her normal dog food the entire weekend.

The ER vet gave me the option to hospitalize her, but based on her test reuslts, he did not feel it was absolutely necessary, so since I would be home with her Sunday night and all day Monday, she came home with me.

She is better, I have been checking her temperature and she no longer has a fever. She ate a small amount of food last night, and drank some water. She seems to have more energy today.

I have faxed all results to my regular vet and am taking her in for followup this week. I just don't know if I need to ask for more tests, or assume this is an isolated incident if she gets better.

[Traci]

The small amount of deli ham probably didn't cause it, although, improperly handled or stored deli meats (fresh) can contain bacteria (i.e., e-coli, etc) which could cause very similar symptoms.

As long as she seems to be improving, and is keeping food down, and doesn't seem painful, it may not be a pancreatic attack at all, but you'll have to watch her closely, watch for diarrhea, etc and keep her well hydrated.

Additional testing may not be necessary unless the symptoms persist or worsen. If you're terribly concerned, your vet can re-run her liver and kidney levels and a CBC. Depending on her age and health history, re-running her bloodwork soon might not be a bad idea (to ensure that a liver or kidney problem hasn't been developing, etc).

Usually, a pancreatic attack or acute pancreatitis will progress in a small amount of time and the symptoms usually do not resolve without agressive hospitalization and treatment. Since she seems to be feeling better and is holding down food and water, hopefully it was just a GI tract upset or combination stress. Do however, watch her closely and ask your vet about re-running her bloodwork. Chronic pancreatitis however, can reoccur, in which treatment, change of diet, etc would be necessary, but don't assume this is the case at this point, if Maggie recovers nicely, it is unlikely pancreatitis (only time, re-occurance of an attack episode and bloodwork monitoring can determine this)

[Maggiesmom]

Thanks again. My regular vet suggested retesting her levels in a week or two, as retesting them now wouldn't be advisable, since the levels will most likely still be high regardless of cause. He said that sometimes the contractions of the pancreas with vomiting can cause the levels to be high. As you said, it may not be an indication of anything wrong with her pancreas. She is improving day by day, so hopefully this was just an isolated incident.

[davet]

how boput posting more to see how this folows up , plkease

[k9Karen]

Where were you in Florida? We've had a pretty bad virus, or somthing, going around for a couple of years. It just seemed to appear out of the blue - diarrhea w/ blood in the stool, vomiting, and fever with pancreatic inflammation. Symptoms are similar to parvo, but it isn't parvo. Angel and several of my friends' and co-workers' dogs have gotten it, and the treatment for all of them was exactly what you have described you got for Maggie. Angel's amylase and lipase were both elevated, but began to come down quickly with treatment and withholding food for 24 hours. She was seen by the emergency vet and then by my own vet within 24 hours and was also managed with a special canned food I got from my vet (but I don't remember now what it was - something for sensitive stomachs, I think). I have a feeling the emergency vet you saw suspected this virus (or whatever it is - I haven't seen anything to indicate what the cause is). Angel was a pretty sick girl for a couple of days, but improvement began quickly with the subQ fluids and meds.

[Maggiesmom]

k9Karen, I was in Ponte Vedra Beach, outside of Jacksonville, FL. Is this the same area? What virus was it?

Maggie had vomiting and fever, but strangely enough, no diarrhea.

Davet, I will post a followup once we have her levels tested again.

She continues to improve each day, thankfully.

[Maggiesmom]

Maggie had her lipase levels rechecked this weekend and they are back to normal, so hopefully this was an isolated incident. Thankyou all again for your advice.

[k9Karen]

Glad to hear all is well.

I still don't know what the cause of this thing was. Sorry I didn't see your question about what virus (or whatever) it is earlier. I tried to do a short Google search, but, really didn't come up with anything. It acts like it's infectious, but Allie didn't get it, and that would be unusual in dogs that live so closely together (plus, Allie eats anything - sticks, leaves, grass, etc., so she would be very likely to pick it up in the yard, unless, of course, it is something she had before, just not as seriously as Angel). We are between Tampa and Orlando, so about 200 miles southwest of where you were. Angel was sick about 2 years ago, so there is no telling how far it has spread since then.