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Author Topic: Another Lola - pancreatitis - Immune Mediated?  (Read 4356 times)

Anita

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Another Lola - pancreatitis - Immune Mediated?
« on: October 02, 2012, 09:46:19 AM »

Hi all, you may remember me from the old board, where I got some wonderful advice and encouragement when Lola our English Springer Spaniel was ill.

Lola's story is quite long for a nearly 4 year old dog, but the very short version is that she was treated for, what the Uni Vet called "immune mediated 'itis", she was ill on and off from around her first birthday and finally tapered off the Pred, February 2011.

She exhibited signs of IMPA and SRMA but the joint and spinal taps were done twice and were negative and/or inconclusive.   In the end she crashed very badly after being spayed and the AI treatment and likely diagnosis was what we were left with.   She was on Pred from the end of August 2010 to early Feb 2012 and we tapered very slowly using the MJ Day protocol. 

She developed some other odd symptoms at various time, such as fluid around her pericardium and a odd cough which went away with a steroid injection.   The Uni vet always described her as "complex"!

The uni vet was always a bit concerned that we had never entirely got to the bottom of things and had planned that if she relapsed again to put her through the CT scanner to see if there was potentially a real infection lurking.

Anyway, fast forward to Monday of last week where Lola was vomiting and appeared in significant amounts of pain.  Our local vets had a communication issue and it took till Friday for them to tell us that the test for pancreatitis was positive, she seemed to be recovering on Saturday but started vomiting again on Saturday night and was admitted early Sunday morning and has been at the vets on a drip since then (Tuesday today).

I know that dogs that have had Pred are more prone to pancreatitis but I wonder whether there is a possibility that this might be the start of another AI episode?   I see from Googling that there is a form of Immune mediated pancreatitis.

I'm waiting for the vet to call this morning as she's been called out on an emergency, they haven't done an ultrasound as yet which I'm going to ask them to do (they are saying that there is little point as they know her pancreas is inflamed but I'd quite like them to have a look and check that all looks normal).   I also would like to get her referred to the Uni vet who treated her previously

I can't work out whether I'm over reacting and that this is just a stand alone condition or whether I am right to be concerned that her previous history may be relevant?
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gschellinger

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #1 on: October 02, 2012, 10:34:57 PM »

Sorry to hear your Lola is sick. Having the ultrasound can tell them if she has a cyst or something else going on so it isn't a wasted procedure. My Lola got pancreatitis when she was on pred. which is not uncommon. Some dogs just get it because they can't handle the amount of fat in their diet. Some breeds are more prone to it also.

It is surely a very serious disease and from what my vet told me, it is as serious as an autoimmune disease. I don't know about the link with autoimmune disease and pancreatitis, but after all we have been through with our Lola, it wouldn't surprise me. Of course you would be working against the best treatment for panreatitis if you had to give steroids for AI.

Hope your Lola gets well quick.
gail.
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gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

Penel CIMDA moderator

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #2 on: October 02, 2012, 11:01:00 PM »

Hiya - so sorry to hear Lola has pancreatitis.  I too would want her referred ASAP to the vet college where she was treated previously.  Do you know if the same specialists are still there - I always find it helps if the same specialists are on the case.
It's a difficult condition to treat and there are differing opinions on whether to feed the dogs or not - it used to be nil by mouth for a few days, but now "they" say that the sooner they start to eat the better - as long as it's very low fat, bland food.
I take it she's on opiate based pain relief / drip / antibiotics?
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Penel
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Anita

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #3 on: October 03, 2012, 07:59:37 AM »

Thanks both.

Our vet has spoken to the Vet hospital and unfortunately the specialist who treated Lola before has moved on which is a real shame.   However, they are going through her records and will then give a view on whether the think she should be seen.   Our vet is happy to do the referral so I think we'll progress that.   

Lola came home yesterday, she had been on an opiate based pain relief, anti immflamatories and a drip so she's fairly well hydrated and hopefully the medication will have settled her pancreas.  She now has Omeprazol to help settle things down - she took that as her gastroprotectant previously.   They had been trying to get her to eat but she was refusing, they thought that she might do better at home and she did start eating within an hour or so of being home, so we're continuing to feed little and often at the moment and at the moment she's doing OK.   However, she did OK for 36 hours last week before relapsing again so we have our fingers firmly crossed.   

She looks around 75% fit, her ear's are still down and she's clearly not feeling 100% so we'll continue to monitor her.   

I remain concerned that this is another bout of "Lola'itis" which, whilst it is completely different is in some way linked to her previous problems.   Maybe we just get over anxious when we've had dogs with odd illnesses...

Here's Lola feeling thoroughly sorry for herself - sporting a very fetching pink camo bandage

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gschellinger

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #4 on: October 03, 2012, 02:39:13 PM »

She is very cute. I hope she continues to improve.

So many Lola's we have on cimda. My friend's mom, who is 96 and has always been quick to cause grief, is named Lola. My friend tell's me the name means 'woman of woe' but I don't know if it is true. For my Lola it fits pretty well.
gail.
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gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

Penel CIMDA moderator

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #5 on: October 03, 2012, 08:31:11 PM »

Aww what a gorgeous Lola she is.  Her eyes look very anxious, bless her, I think she knows she's poorly again  :(
I really hope she's been ok today.
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Penel
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Anita

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #6 on: October 03, 2012, 08:50:32 PM »

I don't normally take her photo when she's poorly as I hate the look in her eyes, she knows entirely that she's not well and looks at us for help  :(

The photo was just after she came home yesterday lunchtime and she has improved since then and looks much less anxious, she's still pretty clingy but that's quite usual for her after she's been admitted.   

We're watching her very carefully at the moment as we're a bit concerned that she is showing the early signs of another flare up.  Nothing for sure as yet so we haven't rung the vet as yet, I don't want to take her there unnecessarily as it makes her more anxious. 

If she goes down again then we will get the Uni hospital referral ASAP and hopefully get her up there tomorrow. 
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Anita

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #7 on: October 04, 2012, 04:14:20 PM »

Hmm probably not good news.

She stayed fairly stable overnight but was clearly unwell.  We took her to our vets this morning, they wanted to do ultrasound/xray (I've been asking for ultrasound since SUNDAY) but we had already decided that we wanted to take her to the Uni hospital.   

We got her up there at 11am, she threw up on their floor three times bless her.    She was examined and the vet thought that she could feel something in her abdomen - OH had felt something on Saturday but our vet thought it was just that she was tense.   

They have carried out an ultrasound and believe that it is something within the wall of the intestine rather than something that she has eaten.   They think it may be a haematoma, an absence or some kind of mass.   

She is having surgery this afternoon - they had an emergency to clear first so we don't know when.   

We could do with lots of good vibes for our Lola that she comes through the surgery and that they don't find anything too sinister and that it doesn't kick off any AI issues. 
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Penel CIMDA moderator

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #8 on: October 04, 2012, 07:13:55 PM »

Oh golly, poor you.  Keeping everything firmly crossed here.
My Lola just got through major abdominal surgery so I hope your Lola can too xxx
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gschellinger

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #9 on: October 04, 2012, 08:33:17 PM »

Oh, my goodness...keeping all things crossed for you and Lola. Keep us updated when you have the time.
Hugs,
gail.
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gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

Penel CIMDA moderator

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #10 on: October 05, 2012, 09:26:08 AM »

Just checking in to see any news of Lola - might hop over to ST see if there's news there.
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Anita

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #11 on: October 05, 2012, 10:33:42 AM »

Thanks Penel, your help is as always invaluable x

 Update time.

The vet hospital called and it's "so far so good", she had a good night and appears comfortable, she is able to get up and about and has been able to go outside to stretch her legs.

Whilst that is great news, she's nowhere near out of the woods, the risk is still from the bowel leaking and peritonitis, her odds remain the same for the next 4 or 5 days so keep those fingers crossed x

Penel, Glad to hear that your Lola is doing a bit better, it's nice to hear a positive similar story. They are assuming that the damage was caused by the sharp bone they found lower down but they are waiting confirmation of the analysis of the tissue that the damage to the intestinal wall wasn't caused by any kind of growth.

I've rung our vets this morning and asked them to get a partner to review Lola's case. It seems unthinkable to me that a dog who had been under their care for 10 days, including 2.5 days as an inpatient could remain undiagnosed in this way. We can't change that but I do need them to review what has happened.

It's an awful time, the house is so quiet, she is in the right place though and she has always been fairly happy at Langford.
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Jo CIMDA

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #12 on: October 05, 2012, 02:54:30 PM »

Hi anita

I do hope Lola continues to improve.  Penel knows so much about this now and I'm sure you will too by the time your Lola is back home

Fingers crossed.
Jo
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shawkyelisabeth

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Re: Another Lola - pancreatitis - Immune Mediated?
« Reply #13 on: October 05, 2012, 07:32:17 PM »

best wishes for a speedy recovery
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