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Giardia and pancreatitis



 
 
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  #1  
Old May 30th 07, 07:12 PM posted to rec.pets.dogs.health
Judy
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Posts: 1,411
Default Giardia and pancreatitis

Anybody who has any information - please let me know.

Sassy (miniature schnauzer, 5 & 1/2 years old) is at the vet's. Yesterday
afternoon, after our agility class - where she was fine - she threw up on
the way home. Got home and she ate supper. Seemed fine all evening.

3AM asked to go outside to poop. Very unusual for her. Came back in and
settled back in bed. By 4:30A, she was throwing up - looked like remnants
of supper. Kept throwing up every half hour or so. Eventually, it was all
whitish, frothy phlegm. 8:30A she went outside, had a loose but not watery
bowel (which I scooped up for the vet) and didn't throw up anymore until we
were in the car on the way to the vet. The earliest appointment they could
give me was 11:30A. If she had kept throwing up, I would have just gone and
sat on their doorstep but when it stopped, I waited.

At the vet, her fecal exam showed giardia - a fair amount of it. We had
just treated both dogs three weeks ago when Spenser's stool showed some
signs of it and Sassy's was clear. (And she was fine then.) The stool
sample also showed some other parasites that they couldn't clearly
identify - so they have sent it away for further testing.

Bloodwork was done - showed a slight dehydration and amylase levels at three
times normal. Heart sounded good and her gums were normal color. No fever.

Vet is administering IV fluids, antibiotics and drugs to control pain. They
will also be sending off samples to A&M for eventual confirmation of
pancreatitis. (But that's going to take too long to be helpful in her
treatment.)

They have told me to expect that she will need to be there at least 24
hours. I'm a little concerned about this because there is no one on the
premises after 7PM. I do have the option of driving her to Cornell - about
90 minutes away - where they are staffed overnight. Then I can either
continue her treatment there or bring her back to my vet during the day.

We have reviewed everything that she has eaten. There just is nothing about
her food that could have set this off - which the vet agrees with. Her best
guess, as I understand it, is that the giardia had weakened her system and
the pancreatic reaction is a result of that.

I don't even know what questions to ask the vet. And should I be concerned
about her staying there overnight with no staff on hand? Is it likely that
she really would require attention during the night?

Judy


  #2  
Old May 30th 07, 08:41 PM posted to rec.pets.dogs.health
Lynne
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Posts: 2,609
Default Giardia and pancreatitis

on Wed, 30 May 2007 18:12:59 GMT, "Judy" wrote:

I don't even know what questions to ask the vet. And should I be
concerned about her staying there overnight with no staff on hand? Is
it likely that she really would require attention during the night?


I'm not clear on this, but does she definitely have pancreatitis? I've had
two dogs with pancreatitis. Based on my experiences, I wouldn't leave her
overnight without care and attention.

Can you take her home and then back in the morning? It may be less
stressful (on both of you) than than transporting her to Cornell, but only
if you are comfortable with administering her medications at home, which
will include keeping an eye on her IV to make sure it's flowing properly.
If your vet objects to sending her home on an IV, ask about giving
subcutaneous fluids and injections of her meds at home. Once the vet shows
you how, it's not too difficult, and I believe it's easier to recover at
home than in a hospital.

--
Lynne
  #3  
Old May 30th 07, 09:23 PM posted to rec.pets.dogs.health
Judy
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Posts: 1,411
Default Giardia and pancreatitis

"Lynne" wrote in message
. 97.142...
I'm not clear on this, but does she definitely have pancreatitis? I've
had

two dogs with pancreatitis. Based on my experiences, I wouldn't leave her
overnight without care and attention.


Her amylase level was three times normal. It's not an absolute test but at
that level it does generate concern. Slightly high could be a sort of false
positive. This high probably is not. From what the vet said, the only
place that can do the definitive test for pancreatitis is A&M. We have sent
a blood sample there but it takes a very long time to hear back. We can't
wait for it to treat.

A lot about her having pancreatitis doesn't make sense. Yes she's a female
miniature schnauzer. But not at all overweight. There was no high fat food
involved. No drugs or underlying disease. But pancreatitis doesn't always
make sense. There is the possibility that she has an intestinal blockage.
Normally, that might raise the amylase levels but not to this point. Unless
the blockage was also blocking the pancreas. If she is not (dare I say
continuing to) responding to the treatment, then we will do an x-ray
tomorrow to check for blockages.

I can call the vet back during her supper break - an hour before they close
for the night. I'm not clear on how sedated Sassy is. And I'm not totally
sure what that would mean in my decision anyway.

Can you take her home and then back in the morning? It may be less
stressful (on both of you) than than transporting her to Cornell, but only
if you are comfortable with administering her medications at home, which
will include keeping an eye on her IV to make sure it's flowing properly.
If your vet objects to sending her home on an IV, ask about giving
subcutaneous fluids and injections of her meds at home. Once the vet
shows
you how, it's not too difficult, and I believe it's easier to recover at
home than in a hospital.


I suspect the vet is concerned that if we bring her home that we won't show
up back there in the morning. We will. I think when we talk with her again
that we will discuss this further. I can transport Sassy to and from there
for as many days as is necessary. And in between, I can promise to keep her
constantly crated. There is nothing on my schedule that would make any part
of this a problem.

The breeder has said that she would be happier if she were being given
subcutaneous fluids but that at this point the volume necessary probably
make that impossible. But even with an IV, if the concern is that it might
not work correctly all night, then that's all the more reason to have
someone watching.

Argh! This really, really sucks.

Judy


  #4  
Old May 30th 07, 09:38 PM posted to rec.pets.dogs.health
Sue and Atty
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Posts: 293
Default Giardia and pancreatitis


snip

The breeder has said that she would be happier if she were being given
subcutaneous fluids but that at this point the volume necessary probably
make that impossible. But even with an IV, if the concern is that it
might not work correctly all night, then that's all the more reason to
have someone watching.

Argh! This really, really sucks.

Judy

I understand your concern - I'm always leary about leaving my dog in a
clinic with no staff overnight. It doesn't mean it's a bad vet, but I want
to know someone there if she goes into distress. I know they come in and
check, but I have lots of worries. For example - what if she pulls the IV
out, what if the IV kinks and doesn't work, what if she gets sick or has an
accident in her kennel - I know Atty gets very stressed out if she's left in
a kennel with either vomit, pee, or feces. A dog on IV fluids should have
to piddle lots, right? Can she hold it all night? Probably in good health,
but she's not there because she's in her best form of health, so I would
expect her to not be able to hold it. Too many "what if's" for my comfort
level.

When Atty was thought to have pancreatitis, I didn't buy the diagnosis. She
had none of the classic signs that I read about - pain, for one. She'd
throw up and want to play, repeat cycle over and over.

I'd push to bring her home, IV and all. Changing a bag isn't hard. They
wanted to keep Atty, but my husband insisted they call me at work - he said
if he came home without her, he didn't want to come home! He said, "You
tell her." They sent her home with sub-q fluids after I explained that I
was quite fluent in doing them, based on having experience with a kidney
failure dog before Atty.
Maybe talking to them will result in some sort of compromise.

Best of luck,
Sue and Atty


  #5  
Old May 30th 07, 10:43 PM posted to rec.pets.dogs.health
Lynne
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Posts: 2,609
Default Giardia and pancreatitis

on Wed, 30 May 2007 20:23:16 GMT, "Judy" wrote:

Her amylase level was three times normal. It's not an absolute test
but at that level it does generate concern. Slightly high could be a
sort of false positive. This high probably is not. From what the vet
said, the only place that can do the definitive test for pancreatitis
is A&M. We have sent a blood sample there but it takes a very long
time to hear back. We can't wait for it to treat.

A lot about her having pancreatitis doesn't make sense. Yes she's a
female miniature schnauzer. But not at all overweight. There was no
high fat food involved. No drugs or underlying disease. But
pancreatitis doesn't always make sense. There is the possibility that
she has an intestinal blockage. Normally, that might raise the amylase
levels but not to this point. Unless the blockage was also blocking
the pancreas. If she is not (dare I say continuing to) responding to
the treatment, then we will do an x-ray tomorrow to check for
blockages.

I can call the vet back during her supper break - an hour before they
close for the night. I'm not clear on how sedated Sassy is. And I'm
not totally sure what that would mean in my decision anyway.


Ah, okay. I thought maybe she had pre-existing pancreatitis and was
having a flare up, but it wasn't clear. The treatment for pancreatitis
should help her no matter what the real underlying problem might be. I
hope the tests are conclusive when you get the results back, so you know
for sure what you are dealing with.

I suspect the vet is concerned that if we bring her home that we won't
show up back there in the morning. We will. I think when we talk
with her again that we will discuss this further. I can transport
Sassy to and from there for as many days as is necessary. And in
between, I can promise to keep her constantly crated. There is
nothing on my schedule that would make any part of this a problem.


It's really not the vet's decision, it is yours. Just make sure she
shows you everything you need to be able to do (twice if neccessary) and
leaves you a number to call if you have questions.

The breeder has said that she would be happier if she were being given
subcutaneous fluids but that at this point the volume necessary
probably make that impossible. But even with an IV, if the concern is
that it might not work correctly all night, then that's all the more
reason to have someone watching.


I'm with Sue. Take her home (or to Cornell). There are far too many
reasons not to leave her there overnight.

Argh! This really, really sucks.


Yes it does. I'm sorry you have to deal with this. Please keep us
informed on how things are going. I'll keep you guys in my thoughts.

--
Lynne
  #6  
Old May 30th 07, 11:01 PM posted to rec.pets.dogs.health
Judy
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Posts: 1,411
Default Giardia and pancreatitis

"Lynne" wrote in message
. 97.142...
I'm with Sue. Take her home (or to Cornell). There are far too many
reasons not to leave her there overnight.


We're on our way to Ithaca. Turns out to NOT be Cornell itself but rather
another place nearby. I've called friends in the Ithaca area and they speak
very highly of the place.

The vet thought that bringing her home with sub-q treatment would lose too
much ground. She finally said that if we wanted to be sure that we had done
everything possible then we should go to Ithaca.

I guess I can't argue with that.

Thanks for the help,

Judy


  #7  
Old May 31st 07, 12:41 AM posted to rec.pets.dogs.health
Lynne
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Posts: 2,609
Default Giardia and pancreatitis

on Wed, 30 May 2007 22:01:11 GMT, "Judy" wrote:

We're on our way to Ithaca. Turns out to NOT be Cornell itself but
rather another place nearby. I've called friends in the Ithaca area
and they speak very highly of the place.

The vet thought that bringing her home with sub-q treatment would lose
too much ground. She finally said that if we wanted to be sure that
we had done everything possible then we should go to Ithaca.

I guess I can't argue with that.

Thanks for the help,


I'm sure you are already on your way, but I just want to say that I think
this is a good plan. Ideally, Sassy should be under the close watch of a
vet, and now she will be. Second best would be at home, under your
supervision. Alone in a hospital all night shouldn't have even been an
option for your vet to consider or suggest if being home with you wasn't
okay! You are definitely are taking the best possible course of action for
her.

I hope she is feeling better very soon and that you get to the bottom of
this. If it is pancreatitis, it could just be the luck of the genetic
draw. She may have been predisposed to it and the trauma of the giardia
could have triggered it, just as the vet suggested. Your excellent
attention to her diet all these years probably kept it at bay.

My 6 year old Sheltie has been stable after a very terrible bout of
pancreatitis ~3 years ago that nearly killer her. Her pancreatic and liver
enzyme levels were literally off the charts (out of range of the
measurements). This happened after she snarfed a can of cat food...
Through very careful attention to diet, she has done very well since
recovering, though she was left with the habit (need?) of constantly
panting, which is a bit unsettling sometimes.

Let us know how Sassy comes along.

--
Lynne
  #8  
Old May 31st 07, 12:10 PM posted to rec.pets.dogs.health
Sue and Atty
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Posts: 293
Default Giardia and pancreatitis


"Judy" wrote in message
...
snip

We're on our way to Ithaca. Turns out to NOT be Cornell itself but rather
another place nearby. I've called friends in the Ithaca area and they
speak very highly of the place.

The vet thought that bringing her home with sub-q treatment would lose too
much ground. She finally said that if we wanted to be sure that we had
done everything possible then we should go to Ithaca.

I guess I can't argue with that.

Thanks for the help,

Judy

I'm glad the vet finally acknowledged that a 24/7 facility was the best
situation - knowing full well that you can't guarantee nothing will happen.
Chances are she would have been fine. Chances are - but what if? I'm sure
you slept better last night. Are you leaving here there for the remainder
of the treatment, or bringing her back to your home vet?

Sue and Atty


  #9  
Old May 31st 07, 04:13 PM posted to rec.pets.dogs.health
Judy
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Posts: 1,411
Default Giardia and pancreatitis

"Sue and Atty" wrote in message
. net...
I'm sure
you slept better last night. Are you leaving here there for the remainder
of the treatment, or bringing her back to your home vet?


I did sleep better. It also helped that while we transporting Sassy to the
other vet she was NOT dramatically sick. Definitely sick, yes, but she was
picking up her head to notice things. I sure didn't want to let her go once
we got there though.

She will stay there for her treatment. There was the option of taking her
back and forth but that would have been silly. Might have saved a little
money - because the new place sure isn't cheap - but we would have only
spent it on gas.

I also think she's getting better treatment there. Well, maybe not better
but more attentive. They put her on meds to settle her stomach but were
able to hold off on giving her drugs to keep her from vomiting. She hasn't
vomitted since before she got to the vet yesterday and because they would
have someone there all night to react if she started up again, they could
avoid that drug and also determine more quickly that she *wasn't* going to
vomit.

They will decide in a couple of hours if they will be doing an ultrasound to
check for pancreatitis or an intestnal blockage or if we'll just go ahead
with an attempt to get her back on oral treatments. If a blockage is found,
they have a board certified surgeon who can do it fairly quickly.

The new vet felt that there was a definite possibility that it was a case of
"indiscriminate diet" - as in who knows what she might have grabbed and
swallowed before we could stop her. She does have that habit and while
we're aware and watchful she is really, really fast. She said that she
didn't get the response she would have expected in the physical exam for
pancreatitis. It didn't rule it out - Sassy could be incredibly stoic,
which she is - but it was a hopeful thought. She also could not feel an
intestinal blockage - but again, that certainly doesn't rule it out.

She did believe that the giardia was not the cause of the vomiting. Sassy
didn't have the classic watery diarrhea of giardia. Her primary symptom was
vomiting.

Now I'm torn as to whether to make the drive up today to see her. It's
three hours of driving - which I would do without a second thought if I
believed that it would help her. I'm not sure but that seeing us would make
her more anxious. I'm going to wait and see what the vet has to say about
what our next steps are.

Thanks for the support.

Judy


  #10  
Old May 31st 07, 05:55 PM posted to rec.pets.dogs.health
Lynne
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Posts: 2,609
Default Giardia and pancreatitis

on Thu, 31 May 2007 15:13:51 GMT, "Judy" wrote:

Now I'm torn as to whether to make the drive up today to see her.
It's three hours of driving - which I would do without a second
thought if I believed that it would help her. I'm not sure but that
seeing us would make her more anxious. I'm going to wait and see what
the vet has to say about what our next steps are.


When my dog was hospitalized, I found (the staff reported) that my visits
agitated her. Not while I was there, but after I left her. I think she
didn't understand why I wasn't taking her with me. That may not be the
case for Sassy, but it's something to consider.

--
Lynne
 




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