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Very worried for Daisy.

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I really feel for you, my heart just sunk when I read this. You & Daisy are in my thoughts and prayers.
 
So very sorry to read about Daisy, as if she did`nt have enough problems, thinking of you and Daisy and sending you both hugs.:hug:
 
She had a very restless night.My husband went to collect her new meds and noone seemed to know about my conversation with the vet.
So a different vet reviewd her notes and suggested we do a cPLI test for pancreatitis.So that's been done and results should be back after the holidays.
The food she got was Royal canin gastro intestinal low fat diet as opposed to the royal canin liver support diet.
So I have no idea what's right or wrong...one vet says stop the new NSAID,another says it's ok.
Anyway,she ate the food and kept it down..so that's a positive.
Sins
 
Sins I am so sorry to read the updates, I was hoping that things were on the up. Poor little lass, her problems are not helped by a lack of continuity at the vets. I hope things continue in a positive way until after the holidays when you can get some results. Reading back through the thread there are a couple of pointers that you noticed yourself, (the tenderness in the abdomen area). I couldn't find the name of the new NSAID, just out of curiousity I was wondering what it was and when she started it?
Gentle hugs for Daisy, bless her...
 
So sorry to read about Daisy and it must be very worrisome particularly at this time of year. Hopefully the food will make a difference to her and combined with her meds that she will be picking up soon. Trapper had v mild pancreatitis a couple of weeks ago - nothing as bad symptomwise as Daisy- but he recovered very quickly on a combination of special gastro food and antibiotics. We will be keeping our fingers crossed
 
I'm sorry to hear that Daisy is so poorly. It's good that she is keeping her food down and hopefully the test results will help give a clearer picture of what meds she needs and she can start on the road to recovery. Sending gentle hugs and positive thoughts to you.
 
Sins,

I'm so sorry to ready about Daisy! I hope you get things sorted. I just kinda skimmed through the thread because I have to leave soon but it did bring something to mind.

My Holly had an episode where she had extreme vomiting. She spent a week at the vet on IV fluids. Aside from being severely dehydrated my vet couldn't find anything wrong. She was extremely tender in the abdomen. She had no interests in foods. After a week my vet assumed pancreatitis and sent her home. Even though the tests said no. Well after only being home for 1 1/2 days she was keeping food down again and things seemed to be looking up. Then out of no where she vomited, staggered, stumbled, wobbled around and dropped to the ground. She had rapid & strange eye movement. One eye stayed in place and the other eye sort of bulged out and off to the side. She was limp and unresponsive. Her gums went white. By the time we got the the ER vet (about 30 minutes later) she was fine. (She slowly recovered over the 30 minutes. It was not an instant improvement). Her stomach continued to be very sensitive. You could actually see her having stomach cramps (stretching out) and she would yelp if you pushed on it. All of her tests came back normal. We went to a specialist the next day where they did an ultrasound of her heart & belly. They also did some other heart tests. Turned out she had a 2nd degree heart block. (Her heart was beating too slow and very irregular. She also had a 1-2 murmur and high blood pressure) All of this was basically causing fainting spells. Her excessive vomiting was caused by being nauseous and dizzy. So after starting medication everything went away and she is fine now. I know it's not exactly the same but maybe something to consider? I don't know if this would cause liver issues but could be a combined problem?
 
Sins,

I’m a bit reluctant to post, but here goes. Pet owners have different views on dealing with illnesses – some want to understand everything that is going on and get copies of test results, do independent research, and be a part of the treatment planning and decision making “team.” Others are more comfortable following the direction of their vet and have no need to understand the specifics. There is no right or wrong way, it’s just individual preference. Also, depending on where we live, we have different access to specialists and specialty treatment. I think we know where I fall on that continuum!

Some thoughts and questions:

Time has been lost, through no fault of yours – I re-read the entire thread and see references to vomiting, abdominal pain, eating ham, shot of Metacam, sedation, etc. When a dog, esp a young dog, has an episode as you describe at the beginning of this thread, generally the vet’s first thought is to run blood chemistry to rule out metabolic/major organ causes, and most vets will get results the same day or the following day. When this kind of episode happens to a dog with SM, it is natural to think that everything is SM related so the urgency to do blood chemistry is lost. (This is a good reminder to all of us to not assume that everything is SM related.)

Was blood chem done on the 16th, but it took seven days to get the results? Do you have a copy of the report? When was her last blood chem done which gave normal values? Do you have a copy of that report so that you can compare the differences? How fast can you generally get blood chem results? Here is a link with info about interpreting blood chem and other tests:

http://dogaware.com/health/tests.html

Was the shot of metacam given before or after the blood was drawn for analysis? What NSAIDs does she take? There is a potential of NSAID hepatotoxicity – have you discussed this with the vet? Is she taking NSAIDs now? You mentioned a “new NSAID” – I would be VERY reluctant to continue on any new NSAID until you understand what you are dealing with. I would make a chart with a history of what NSAIDs she has taken with start dates, any unusual symptoms, and results of any monitoring blood chem done along the way since you started drug treatment for her SM. You can also keep a diary and make notes about vomiting, abdominal pain, anorexia, etc. which will be helpful. You are in a difficult spot because of her SM – normally one would stop all NSAIDs in the presence of potential hepatotoxicity until you can figure out what is going on and get her stable.
You mention that she was under sedation – what was that for and what agents/drugs were used?

Potential problems are reported to be liver and pancreatitis – you need to see the specific liver values on the blood chem to understand the degree of the problem. What are the differential diagnoses – which means what different potential liver diseases do they suspect and what are the potential causes? Did vet use the term hepatic encephalopathy to describe the initial event?

Was pancreatitis diagnosed based on amylase and lipase values on blood chem? A cPLI is a MUCH more definitive test – so that vet was correct. Pancreatic enzymes on a general blood panel can be affected by other major organ disease, including kidney and liver disease.

What are the new meds she is taking and at what dosage?

Have you talked with vet about additional tests such as bile acids test and ultrasound of the liver? Do you have access to an internal medicine vet specialist?

I’ve actually compiled five pages of information and links about liver disease and pancreatitis, diet, supplements, etc. There is also information on home cooked diet options, which would be my preference during a crisis rather than the vet script commercial foods. I can also copy information from my vet textbooks, but it would be better if I had a more clear idea of the possible diagnoses so that I can only include information that is relevant so that you don’t have to wade through a lot of info that won’t be helpful. I’ll save this and can email it to you if you’d like as it is way too much to post on a message board. I’ll pm my email address to you.

If this is far more than you want to hear or digest, I completely understand! I am way “over the edge” when it comes to veterinary information, and I understand that most people really don’t want to get into this kind of detail.

Pat
 
Hi Pat,
Thanks for posting.I'm aware of the gravity of the situation and aware of the time lost.Our local vet has limited facilities for diagnosis of illnesses outside of the routine.She was seen last friday and abdominal tenderness noted.She was given the metacam and an IV antibiotic(can't recall which one and referred).She was seen on Wednesday and was not on any medication at the time the bloods were drawn apart from the metacam shot and antibiotic.
sedation was listed as ACP/Morphine and a VLSI standard profile was done.She had x rays which found marked HD and Onsior prescribed.She has 10 mg on Thursday and Friday.I expect the bloods would have been drawn while she was under sedation and definitely before the onsior.
Blood results came back yesterday and reported marked elevations in liver enzymes,bile acids,and bilirubin consistent with significant hepatocelllular damage,dysfunction and cholestasis.Pancreatitis could also cause this pattern and assessment of canine PLI may be helpful.
so the PLI test was ordered this morning.Probably no results until Wednesday.The earliest the ultrasound can be done is on Wednesday as the hospital is closed...
She's not had any NSAIDs today and I'm not giving her anything.
She vomited her prescription food but had a few tablespoons of rice about three hours ago and is sleeping restfully now.
Not sure what else I can do except keep her comfortable and get through the holidays.
forgot to say...they are aware of hepatotoxicity,but as she had the seizure before the new meds were given and had been vomiting,I get the feeling they're looking at pancreatitis as no 1 possibility or a tumour unfortunately.
Sins
 
Sins,

I read your email, and the details you gave tell me that you are very knowledgeable about what is going on and you are on the absolute right course at this moment.

I will reply via email, and I'll send those links and info that I gathered that might be helpful for you to read. At this moment, I must jump into the shower to get ready for a Christmas Eve party at my neighbors' that begins in one hour. You'll have an email to read when you wake up tomorrow.

You and Daisy will have a special place in my Christmas thoughts and prayers. She is lucky to belong to you!

I hope that both of you have a restful night,

Pat
 
Hi Pat,
Again thank you taking the time to reply,considering the holiday schedule.
I started life as a vet labtech in Ireland and in Devon so can manage to get my head around what's happening.(just about).
We just got back from church and she walked out to greet us from her crate,tail wagging so she's a lot brighter and seems much more comfortable.
It's unfortunate with the holiday timing that we have to wait for the ultrasound and the PLI test to make all the pieces fit.
Enjoy your Christmas day and best wishes from Cork.
Sins
 
Think I would have stopped the new NSAIDS too, Sins, so pleased to read the little lass seems alot brighter, they are wonderfully stoical these little ones aren't they?
 
The ultrasound is booked for 5 th January.
She's definitely improving,no vomiting,looking a lot less jaundiced and eating well.
Her energy levels are coming back up so we're happy enough with her at the moment.
So no quick answers..
Sins
 
Thanks for the update Sins, have been thinking about her a lot. Sounds like things are looking up a bit, even if you don't have the answers as to what is wrong yet. Let's hope she continues to improve.
 
The ultrasound is booked for 5 th January.
She's definitely improving,no vomiting,looking a lot less jaundiced and eating well.
Her energy levels are coming back up so we're happy enough with her at the moment.
So no quick answers..
Sins

I've been looking for an update. I'm so glad she is doing better. <3
 
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