Triglyceride problem stumps the vet
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Annie's Mom
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- Joined: Fri Jul 18, 2003 7:03 pm
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Re: Triglyceride problem stumps the vet
There is one other office. The one I'm going to now is supposed to be the "good" one, with the certified vets etc, but I am going to consult with the other one ASAP. Only other alternative is driving both cats an hour and a half each way down and up wind-y mountain roads, both carsick and screaming.
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Annie's Mom
- Posts: 5
- Joined: Fri Jul 18, 2003 7:03 pm
- Contact:
Re: Triglyceride problem stumps the vet
Update: Today the vet confirmed that Annie did have every test you mentioned, with the exception of the TLI specific for pancreatitis (and it was instructed that this test would require fasting). From my reading today, I understand that if Annie does have pancreatitis, the treatment would be to (1) try to find the cause and prevent it, and (2) a diet like SD W/D. The only typical cause (from my reading) that might relate to Annie is exposure to organosphosphates in pesticides, but I did not match any of those pesticides to the list provided by our exterminator, and he does not treat indoors. Still, a possibility, and I will query the exterminating company next. But even if Annie does have pancreatitis, the treatment would be the same diet she was already on when her triglycerides were so high. And Annie does not have lethargy or lack of appetitite that would indicate this illness. Round and round.Traci wrote:Still would like you to talk to him about pancreatitis, diabetes and hypothyroidism...
Annie hasn't had IBS since she was a kitten, before she was put on Science Diet (which is why I was hesitant to take her off it). Still, IBS and vomiting (which she has only occasionally) are linked to pancreatitis ... but the treatment is the same diet she's already on (round and round again). I'm still back to trying to find the cause. Also will try to get a phone consultation, at least, with the other vet (if I can locate her -- I went to the address today to scope the place out, but they must have moved, sigh.) Thanks for all the leads. Lynne
Re: Triglyceride problem stumps the vet
I'm starting to feel as stumped as your vet. I think I would start by running the triglycerides through a human lab. If still high or out of normal range, then start with new diet (I wouldn't recommend the Nutro) but rather maybe Purina Veterinary or IVD vet diets. As you found on the dietary page, your options are there, most vets can special order if they don't carry one particular veterinary brand.
You are correct about treating as if pancreatitis, however, there is another type called necrotizing pancreatitis (abcess or adhesion on the pancreas), that may not be detected unless through an ultrasound--an ultrasound might also show fribrosis, undetectable on bloodwork). In necrotic syndrome, the treatment might consist of removing an abcess or fibrous tissue. However, again, chemical analysis probably would have shown some inconsistencies to alert your vet if necrotic syndrome was a concern. The problem with pancreatitis testing, is that not all of the specific pancreatic enzymes will show there is a problem, some pancreatitc patients can be in acute illness, yet their labs won't show typical significance, such as amylase, lipase, and even a TLI does not always confirm. This is why I would start with running baseline triglycerides through a human lab. Then, if still high, try a new diet, and perhaps nothing else is needed at that point.
Some chemical analysis your vet may want to pay particular attention to when considering pancreatits or necrotic syndrome: High elevations of ALT, ALP, bilirubin, glucose, cholesterol, amylase, lipase. A CBC might show neutrophils or non-regenerative anemia. Remember, normal pancreatic enzyme levels do NOT always mean there is no pancreatic activity. Also, x-rays, if done, might have shown edema or abdominal effusion, if none were detected, could probably rule out an acute pancreatitc episode (plus, her lack of symptoms)
So, going back to step one...if you do have the opportunity to speak to another vet, ask about running at least the triglycerides through a human lab, ask about ruling out necrotic syndrome (state the lack of symptoms, and reveal x-ray findings if necessary), and concentrate on new diet. It would be great if you could contribute this soley to the previous diet. The other vet may even state he doesn't think the triglycerides are a significant test at this point. As with all chemical analysis, some pets of course do not automatically fall into the normal range.
You are correct about treating as if pancreatitis, however, there is another type called necrotizing pancreatitis (abcess or adhesion on the pancreas), that may not be detected unless through an ultrasound--an ultrasound might also show fribrosis, undetectable on bloodwork). In necrotic syndrome, the treatment might consist of removing an abcess or fibrous tissue. However, again, chemical analysis probably would have shown some inconsistencies to alert your vet if necrotic syndrome was a concern. The problem with pancreatitis testing, is that not all of the specific pancreatic enzymes will show there is a problem, some pancreatitc patients can be in acute illness, yet their labs won't show typical significance, such as amylase, lipase, and even a TLI does not always confirm. This is why I would start with running baseline triglycerides through a human lab. Then, if still high, try a new diet, and perhaps nothing else is needed at that point.
Some chemical analysis your vet may want to pay particular attention to when considering pancreatits or necrotic syndrome: High elevations of ALT, ALP, bilirubin, glucose, cholesterol, amylase, lipase. A CBC might show neutrophils or non-regenerative anemia. Remember, normal pancreatic enzyme levels do NOT always mean there is no pancreatic activity. Also, x-rays, if done, might have shown edema or abdominal effusion, if none were detected, could probably rule out an acute pancreatitc episode (plus, her lack of symptoms)
So, going back to step one...if you do have the opportunity to speak to another vet, ask about running at least the triglycerides through a human lab, ask about ruling out necrotic syndrome (state the lack of symptoms, and reveal x-ray findings if necessary), and concentrate on new diet. It would be great if you could contribute this soley to the previous diet. The other vet may even state he doesn't think the triglycerides are a significant test at this point. As with all chemical analysis, some pets of course do not automatically fall into the normal range.
..........Traci