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