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What is pancreatitis?
The pancreas is a vital organ that lies on the right side of the abdomen adjacent to the stomach. The pancreas produces enzymes to assist in food digestion and hormones such as insulin, which regulates blood sugar or glucose metabolism.
When the pancreas becomes inflamed, the condition is called pancreatitis. Pancreatitis occurs commonly in the dog. There is no age, sex, or breed predisposition.
“Acute pancreatitis may either take a mild, edematous form or a more severe, hemorrhagic form.”
Acute pancreatitis may either take a mild, edematous form or a more severe, hemorrhagic form. The associated inflammation allows digestive enzymes from the pancreas to spill into the abdominal cavity resulting in secondary damage to the liver, bile ducts, gall bladder, and intestines. A few dogs that recover from an acute episode of pancreatitis may continue to have recurrent bouts of the disease, which is then called chronic or relapsing pancreatitis.
What causes pancreatitis?
“Normally, pancreatic enzymes are produced in an inactive state…”
Normally, pancreatic enzymes are produced in an inactive state and travel through the pancreatic duct to the duodenum, part of the small intestine. Once they reach the small intestine, they are activated to begin digestion. With pancreatitis, these enzymes are activated prematurely in the pancreas instead of later in the small intestine. Think of this as if a time-release capsule that suddenly bursts before it reaches its intended target; in this case, the pancreatic enzymes start to digest before they should. This results in digestion of the pancreas itself. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the amount of enzymes that were prematurely activated.
“…although it may be triggered in some cases by a fatty meal or corticosteroid administration.”
The exact cause of pancreatitis is not known, although it may be triggered in some cases by a fatty meal or corticosteroid administration. However, in many cases it appears to occur spontaneously.
What are the clinical signs of pancreatitis?
The most common clinical signs include nausea, vomiting, fever, lethargy, abdominal pain, diarrhea and decreased appetite. During an attack, dogs may take a “praying position”, with their rear end up in the air while their front legs and head are lowered onto the floor. If the attack is severe, acute shock, severe depression, and even death may occur.
How is pancreatitis diagnosed?
Laboratory tests usually reveal an elevated white blood cell count; however, an elevated white blood cell count may also be caused by many other diseases besides pancreatitis. The elevation of pancreatic enzymes in the blood is probably the most helpful criteria in detecting pancreatic disease, but some dogs with pancreatitis will have normal enzyme levels. In recent years, a new pancreatic test has become available that can accurately diagnose pancreatitis, even if pancreatic enzymes are normal. Radiographs may show changes associated with inflammation, especially in the severe hemorrhagic form. Ultrasound studies often provide a diagnosis of pancreatic inflammation or local peritonitis caused by this condition. Unfortunately, some dogs with pancreatitis, especially chronic pancreatitis, will elude detection with many of these tests.
“The diagnosis of pancreatitis may be tentative or presumptive in some cases…”
Consequently, the diagnosis of pancreatitis may be tentative or presumptive in some cases and based solely on clinical signs and medical history.
How is pancreatitis treated?
The successful management of pancreatitis will depend on early diagnosis and prompt medical therapy. With mild, edematous pancreatitis, the treatment is supportive, by “resting” the pancreas and allowing the body to heal itself. The only way to “turn off” the pancreas is to withhold all oral fluids and food, so that it is not required to secrete any digestive enzymes that may inadvertently injure itself or surrounding organs further.
“Analgesics…and intravenous fluids will be given…”
Analgesics will be given to control the intense pain and intravenous fluids will be given to maintain normal fluid and electrolyte balance. Many cases will also require anti-inflammatory drugs or medications to control vomiting or diarrhea. Antibiotics will be administered if concurrent infection is suspected. Most dogs with pancreatitis are hospitalized for two to four days while intravenous fluids and medications are administered and food is gradually re-introduced. With severe hemorrhagic pancreatitis, or if the dog is showing signs of systemic shock, intensive care using aggressive doses of intravenous fluids and medications to counteract shock.
What is the prognosis of pancreatitis?
The prognosis depends on the severity of the disease when diagnosed and the response to initial therapy. Dogs that present with shock and depression have a very guarded prognosis. Most of the mild forms of pancreatitis have a good prognosis with aggressive treatment. Dogs that are not treated may progress to the hemorrhagic form and suffer severe consequences, including sudden death.
Will there be any long-term problems?
“Most dogs recover without any long-term.”
Most dogs recover without any long-term consequences. However, with severe or repeated episodes of pancreatitis, one or more of the following problems may develop.
If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow. This is known as exocrine pancreatic insufficiency (EPI) and can be treated with daily administration of an enzyme replacement powder.
If a significant number of cells that produce insulin are destroyed, diabetes mellitus can result.
In rare cases, painful adhesions between the abdominal organs may occur as a consequence of pancreatitis.
This client information sheet is based on material written by: Ernest Ward, DVM
© Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.
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Dog – Cushing’s Syndrome
Cushing’s disease or hyperadrenocorticism, is more accurately described as a syndrome than a disease, since it produces a much wider variety of signs or symptoms than are normally associated…
Cholangitis/Cholangiohepatitis Syndrome in Cats
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Corneal Ulcers in Cats
The cornea is the clear, glistening membrane that makes up the surface of the eyeball. Think of it as a clear windowpane. To understand a corneal ulcer, you must first know how the cornea is constructed. There are three layers in the cornea, all of which are highly specialized skin cells.
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How To Treat Pancreatitis In Dogs
Sara Logan Wilson Updated: November 6, 2017 Illness 82 Comments
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Pancreatitis, or inflammation and swelling of the pancreas, is a painful and seldom-understood affliction that affects dogs worldwide. While spontaneous canine pancreatitis is not particularly well understood, veterinarians do have an idea of the causes that contribute to this condition, its related conditions and symptoms, and treatment methods to lessen symptoms. Navigate to the section of the article that interests you:
- What is Pancreatitis?
- Symptoms of Mild Pancreatitis
- Symptoms of Severe Pancreatitis
- What To Do If You Suspect Pancreatitis?
- Vet Diagnoses
- What is Fatal Pancreatitis?
What Is Pancreatitis in Dogs?
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The term pancreatitis refers to the general condition of inflammation and swelling of the pancreas. There are two degrees of pancreatitis in dogs recognized by the veterinary community: mild and severe. There are also two variations of pancreatitis that describe the length of time which your dog has suffered from the condition: acute and chronic. Acute pancreatitis is when the condition is sudden in onset, and there is no previous sign of the condition existing. Chronic pancreatitis is when pancreatitis occurs over a period of time. When the condition occurs suddenly in a dog, it takes many owners by surprise, and it can also cause a considerable amount of pain for the affected dog. The pancreas is a small organ shaped like the letter ‘V,’ sitting directly behind the stomach and the small intestine. The pancreas is responsible for producing specific enzymes that are used to promote digestion and enable the body to absorb fats in food. Without the pancreas, dogs would have no way to absorb nutrients from food.
Symptoms of Mild Pancreatitis
There are quite a few different symptoms of pancreatitis, and not all dogs show the same ones when they experience this illness. One of the most common symptoms seen in dogs is distention or pain in the abdomen. A dog with a distended abdomen will appear bloated and uncomfortable, unable to find a comfortable place to lie down. Your dog may also flinch or whine if you touch their abdomen. It is important to mention that other conditions can cause this symptom, including canine bloat, a serious condition which requires immediate medical attention. (For more information on canine bloat, and how to tell the difference between it and pancreatitis, see our Canine Bloat article)
Dogs with pancreatitis can also display the following symptoms:
- Dehydration is often caused by a lack of appetite or thirst because eating and drinking elevates discomfort and pain.
- Appearing hunched over when standing or walking is also commonly seen as well as bloat. Dogs walk this way because of the pain and pressure felt in their abdominal area.
- Diarrhea that often appears greasy and yellow in color.
Symptoms of Severe Pancreatitis
Dogs that are experiencing more severe cases of pancreatitis may display the symptoms listed above; however, it’s more likely that they’ll exhibit more serious symptoms that, if left undiagnosed and untreated, can be life-threatening. Some of these more serious symptoms include:
- Disseminated intravascular coagulation (DIC) is a condition in which multiple hemorrhages can take place resulting in possible death.
- Heart arrhythmia can occur in more severe cases of canine pancreatitis.
- Sepsis is also something that can occur if a severe case goes untreated. Sepsis is a body-wide infection that occurs when toxins are released into the blood.
- Can cause difficulty breathing.
- In the most extreme cases, the pancreas and the organs surrounding the pancreas can be digested by pancreatic enzymes that are released from the ruptured pancreas. Once organs become partially digested, the damage that has been done is irreversible.
What to Do if you Suspect Pancreatitis in Your Dog
If you suspect pancreatitis in your dog, the first thing you should do is to ensure that your dog is in a stable condition. The next thing you want to do is to get your dog to your regular veterinarian. If your dog begins to display signs of the condition when your veterinarian is not on duty, your vet clinic may have a vet on call. Otherwise, they will refer you to an emergency vet’s office. It is crucial that you act quickly if you do suspect the condition as it can worsen and, not only cause your dog significant pain but can even kill them.
How Will my Vet Diagnose?
Another commonly asked question is: How will pancreatitis be diagnosed by the veterinarian? There are a number of important factors that play into an accurate diagnosis, including your dog’s medical history, a physical examination and laboratory testing.
Your Dog’s Medical History
Your dog’s medical history is important because dogs that have experienced a bout of pancreatitis once are far more likely to experience it again during their lifetime. If your vet has already treated your dog for this condition, then it is likely that they (and you) will be able to recognize signs right away. The age of your dog can also play a part in the risk for concern, as older dogs are more susceptible to suffering. Lastly, any current medical conditions may also play a part in your dog being diagnosed. While going over your dog’s medical history with you, your vet will also ask about current symptoms you have observed that lead you to suspect pancreatitis.
A Physical Examination
A physical examination will allow your vet to determine whether your dog is exhibiting any of the physical signs of pancreatitis. If you have already mentioned swelling in the abdomen or any of the other “tell tale” signs of this condition, your vet will confirm this with a thorough physical examination. Don’t be surprised if your veterinarian notices physical signs that you did not; you are not a trained professional and cannot be expected to notice the slight physical differences that vets are trained to look for. The physical exam will consist of visually examining your dog’s stomach area in addition to palpating it gently to check for bloating and tenderness. Your vet will also check your dog’s gums, take your dog’s temperature, listen to their heart, and look into their eyes and ears to check for any other signs of illness.
Laboratory testing involves drawing blood and testing it for the presence of pancreatic enzymes. While dogs with this condition generally have increased white blood cell counts, this is not relied upon solely as a diagnostic criterion because there are many conditions that can increase white blood cells. When dogs experience pancreatitis, they usually have elevated levels of two specific pancreatic enzymes: lipase and amylase. If a blood test reveals high levels of these enzymes in the blood, then this diagnosis is usually confirmed. In addition to testing the blood for pancreatic enzymes, vets may also test for the presence of other enzymes such as those created by the liver. In cases of severe pancreas inflammation, the dog may also experience inflammation of this organ which can cause increased levels of liver enzymes in the blood as well. Veterinarians may also perform x-rays and ultrasounds to confirm a suspected diagnosis.
One of the most important steps, for all concerned, in treating a dog with pancreatitis is controlling pain. For some dogs experiencing severe manifestations of this illness, the pain can be excruciating which is why vets will administer pain relievers when necessary. The type of pain reliever given may depend upon what your vet has on hand, any allergies your dog has, and any sensitivities your dog’s breed has to a specific medication.
Treating Potential Infection
Dogs that are treated for pancreatitis by vets also often receive a round of antibiotics. Antibiotics are taken as a prophylaxis to protect the dog against any infection that could result from complications associated with this illness.
Withdrawal of Food
Pancreatitis is a tricky condition in that the best medicine is resting the pancreas and controlling any complications that have arisen as a result of inflammation. Resting the pancreas, of course, means refusing food, water and any other consumable substance for 24 hours. This allows the pancreas to rest completely by removing any stimulation received by consumption. If the dog shows improvement after a resting period, they are permitted very small amounts of bland food. The type of food preferred by most veterinarians is a bland, prescription dog food designed to be easy on the stomach due to fewer ingredients and lower levels of fats. Food intake should be increased gradually rather than introducing full meals immediately because this can strain the pancreas and cause a relapse of symptoms. Depending on the individual dog, how they responded to treatment, and how severe their case is, the dog may require bland prescription food for the rest of their life or they may be able to return to their former diet.
Treating with Fluids
As with many canine conditions, it is important that a dog suffering from pancreatitis receives adequate hydration. Hydration not only means water but also a solution of balanced electrolytes. Most commonly in dogs with this condition, these electrolyte-rich fluids are given through an IV drip or subcutaneous injection. This method of hydration ensures that the animal is hydrated without taxing the pancreas more.
Very rarely is surgery suggested in cases of pancreatitis; however, there are cases when it is necessary. Most commonly, veterinarians will turn to surgery for patients that are experiencing significant intestinal complications such as bleeding. While surgery is not a preferred method of treatment, if bleeding or other intestinal complications are not addressed as soon as possible, they can result in even bigger complications such as sepsis or even death.
Avoid Do it Yourself Treatments
While many pets benefit from holistic medicine and natural treatments, some conditions should be evaluated by a professional veterinarian. If you prefer to treat illness through a holistic route, there are plenty of certified holistic vets available that can help immediately treat your dog’s pancreatitis. It is crucial that you never attempt do-it-yourself treatments such as tips read on the internet or “cures” that work for people; dogs are not built like humans, and they do not respond in the same way to certain foods and chemical substances. While you may think that you are administering a “calming herb” to your dog, you may actually be worsening their condition or even poisoning them. This is a serious condition and should always be assessed by a trained professional.
Determining the Cause of Pancreatic Symptoms
While no one knows exactly what starts pancreatic symptoms, there are some suspect elements that your vet will be familiar with. One of the common causes is medication. In this instance, your vet will be aware that the medication that they were prescribed could cause pancreatitis and they will know how to prevent future occurrences. In other instances, you may have to go through many questions and answers before you have any idea what started the pancreatic symptoms. Regardless of how you figure out what started it all, it is important to try to narrow it down so that you can reduce the risk of another episode in your dog.
When you find yourself being able to breathe again after the panic of rushing your dog to the vet, you may feel that you have more time to narrow down what could have caused your dog’s condition. You may find that the food you have chosen to feed your dog is simply too high in fat or that it was table scraps that caused the trouble or you may find that it was a medication your dog was taking for another condition. Regardless of what you find as the cause, try not to beat yourself up over it. We cannot undo the things that have already been done, but we can certainly learn from them. For example, if table scraps caused an issue, it is up to you to ensure that no one feeds your dog table scraps again. Become a responsible dog owner and take your dog’s health into your hands.
Here is a video to learn more Dr. Karen Becker, an integrative wellness veterinarian about Pancreatitis and some ways to prevent it in your pet.
What Is Fatal Pancreatitis?
The term “fatal pancreatitis” is used to refer to when the condition causes fatal complications to develop that eventually take the life of the dog. If pancreatitis becomes extremely severe or if a dog suffers repeated occurrences they can develop a number of other conditions that can lead to death including maldigestion syndrome and diabetes mellitus. Both of these conditions are treatable; however, when left untreated they will almost certainly lead to a fatal outcome.
There are a number of things that the veterinary community believes contribute to the development of this condition.
- Overweight dogs are more likely to suffer from this illness, in addition to other serious health conditions.
- Dogs with hypothyroidism.
- Female dogs more commonly experience it than males.
- Ingestion of a single, high-fat meal can also cause the onset of acute pancreatitis.
- Dogs with diabetes mellitus.
- Certain bacterial or viral infections have also been known to predispose a dog to this condition.
- Dogs with hyperandrenocorticism also known as Cushing’s disease.
- Dogs with epilepsy.
- Dogs with gastrointestinal tract disease.
- Dogs with idiopathic hyperlipemia.
Pancreatitis is like that relative that just won’t leave: Even when they are gone, the thought of their return hovers in the back of your mind. If your dog has ever suffered from a bout of it, there is an extreme likelihood that they will experience a recurrence. Recurring episodes can be mild or severe in nature regardless of the severity of the original occurrence.
Preventing the Recurrence of Pancreatitis
As a responsible pet owner who cares about their dog, there are a number of things that you can do to help reduce the chance that your dog will experience a repeat episode of pancreatitis. Some of the tips that veterinarians offer to help reduce the chance of recurrence include:
- Reducing food intake and increasing the exercise level of an overweight dog. Make sure not to underfeed or over-exert your dog during this type of approach, though. Weight loss should be slow and steady.
- If your dog experienced a severe episode that left their pancreas damaged, provide any necessary medications to supplement pancreatic function.
- Avoid feeding any human foods to dogs. Many human foods, particularly table scraps, are high in fat content which can prompt an episode this condition.
- Feed multiple, small meals during the day rather than feeding one large meal at a time. This not only reduces the strain put on the pancreas during digestion, but it also lessens the likelihood for certain breeds to develop canine bloat.
- If your veterinarian suggests keeping your dog on a low-fat diet, ensure that you comply to maintain healthy lipid levels in your dog’s body. High lipid levels can result in aggravation of the pancreas.
Vigilance is the Key in Catching Pancreatitis
Whether your dog has already suffered from a bout of pancreatitis or whether your dog has never experienced this painful illness, vigilance is the best way to guard against this unwelcome visitor. Aside from understanding what caused any previous attacks, being vigilant in helping your dog live a healthy lifestyle is the best thing that you can do, not only to ward against illness but to also extend the life of your furry companion. Read more about other illnesses in dogs and how you can treat t=.
Have you ever treated a dog for Pancreatitis?
Sick Diarrhea Vomiting
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5 cups oat flour (could do 1/2 brown rice flour if you choose)
1/2 cup unsweetened applesauce
1 can pumpkin (100% natural with no spices-can be found in most groceries stores).
Mix all up and spoon onto cookie sheet lined with parchment paper.
I cook about 40 minutes or so on 325 degrees.
As my girls (yorkie sisters) are 13 and have lost many of their teeth, I watch the cookies closely and take out when they are fairly firm but not hard. Recipe makes a bunch and I just store in refrigerator. They do keep for quite some time. From the time I start mixing them until they are cool enough to eat, my two girls sit in kitchen waiting.
Jersey, my girl with the pancreatitis has been losing weight though even though she eats well so I still worry. Vet keeps telling me she is very healthy considering and she definitely is not in any pain so we just keep loving her.
My 9 year old dachshund has been diagnosed with EPI, pancreatitis. My vet gives me liquid b12 shots to give him every other day and digestive enzymes in a pill form to crush and put over his food. He was eating regular but then he stopped for a few days and became gaunt. My vet gave him and IV drip, which helped. He started drinking a lot more, and just the last few days he’s been eating once a day, which is very exciting, but he is so thin and turns up his nose to a lot of food.
I can get him to eat boiled chicken but then he stopped wanting it. And now he’s liking pork, but I’m wondering what else y’all have had success feeding yalls dogs with? He must gain weight, but it must be healthy spiceless food. Any suggestions? I can still see most his bones but I feel like he is gaining strength I just need some ideas on what else to feed him to nourish his weight.
Thanks you guys, anything helps 🙂
Now that I know a little about cushings I think my girls had it for years.
She’s a 12 yr old Jack Russell. She’s had a hard last 6 months and I’m really worried I’m going to lose her.
I lost my 14yr old 6 months ago and chick (my jack) has just gone downhill since.
This Monday is 2 weeks since she ruptured her cruciate ligament. … A cpl of days after that she was diagnosed with cushings (the pituitary) them meds should arrive early next week. And on Monday she was really sick. (Vomiting)
Ive taken her to the vets straight away. Pancreatitis. Not a lot of information was given by the vet (which I’m fuming about) lots of money happily taken. She stayed overnight on an iv drip. Tuesday, she’s made a massive improvement (they fed her a little bit of chicken) and they were semi happy for me to take her home. So I thought she’d be good to go home (in 12 years she’s never not eaten but back to eating, again I thought she was fine). Nope. Not fine. She was so weak when we got home I just let her sleep. She’d been pumped full of medication, spent a night away from me (which she’s not used to at all) anyway I almost took her back in but I thought she’ll be ok. She’ll eat a little bit later. Nope. (I must add, before I left the vets they gave her an anti nausea injection – and something to increase her appetite) but she wasn’t interested in food. No food. Had a few sips of water when I’d put the bowl up to her but nope.
Wed morning, we go back in. She’s back on the drip. She stayed wed night and Thursday night (I’ve visited her twice each day – morning and night) she’s looked better and then she’s looked bad. It’s really messing with her and I can tell because I’m her mother and she’s showing me.
I’m about to go in soon to see her. I spoke with one of the vet nurses this morning and today she looks great and is “comfortable” but she’s not interested in food so they were going to give her some different meds to see if she’ll eat. So pretty much – they want her to stay in again overnight if she hasn’t eaten by this afternoon.
It’s cost me 500 per night, plus ultrasounds and X-rays and every consultation fee and meds left right and centre and I’m starting to go broke. I’m so upset and pissed off with all the mucking around. I just want my girl healthy and home. This Monday will be 2 weeks since she did her knee and I’m worried sick about her recovery from surgery once she can have surgery (God knows when now because of everything else)
She’s 12kgs and a Jack Russell. I’m not a bad mother. She’s just seem to have had every symptom possible of cushings.
I’m devastated. Can anyone shed some light on me?
I’m not giving up on her. She’s my world. I am starting to become broke and I don’t have pet insurance (I tried a few hrs ago but was declined because of age)
Can someone/anyone give me any advice please
These were most of the symptoms my dog who was diagnosed yesterday had. Mainly the shaking means pain.
My dog was diagnosed with pancreatitis a couple weeks ago and, after a week of being in and out of the vet (IV Fluids, injections, x-rays, and a 3 day stay) the doctor sent us home with Famotidine, clavamox, endosorb, and Advita powder. My little guy was doing ok, after his back and forth vet visits his vomitting and constipation slightly subsided. However, now that his medication is finished, he has gone right back to being very lethargic and literally, cannot keep ANY food or water now. My dog is a 60lb Pitbull and he is now down to 50lbs since he’s been sick. I’m at my wits end and am TERRIFIED to lose him. He just turned 1 year old and is my everything since I have no children. My vet won’t give us more medication, and I can’t afford to do the week long vet visits for another vet. PLEASE HELP!
How is your dog doing? Did anything work for him that I might be able to do for my dog.
Holistic was the life changer!! My dog was allergic to chicken, chicken byproducts!! Who knew!!
We now only buy ground turkey, turkey tenderloin..basmati rice, steamer veggies…green peas, green beans, carrots, cauliflower etc. Less than expensive emergency vet bills!!! Organic Bone Broth…low fat everything!!!
It has been amazing! I use otc meds for nausea if he starts a mini cycle! Hold food for 24 hrs n reinduce food in small incremts. Usually rice n bone broth. Have brought him around and avoided many trips to the vet!! It is a learning process to know your pet n when to make an emergency run to the vet! If I see I’m not bringing him around within 4 hours..I go to reg vet. Lol usually happens on a week end!♀️
Now we are down to once a year for an uncontrolled pancreatic attack!! I keep children’s pedialite on hand n give him some by mouth with a syringe.
No fats!! Sure they get some via diet but…don’t add it! No peanut butter no added oils etc! I make my own dog treats out of baby foods, mom fat yougurt, bananas, apples, cinnamon. This disease became my personal challenge for the well being of my dog n finances!! I take a day…cook, crock pot, steamer bags etc. then divide it up into ziplock bags and always have his meals prepared!
Good luck! We have been managing his pancreatitis n what I call Irritable bowel symptoms for 6 years!! Our new Vet was amazed! We just retired to Florida n had to find a Vet I trusted…just in case!
My boy Leo who is a King Charles cavalier who will be ten next march
He has chronic pancreaitas he is under a vets
He is on gastrointestinal low fat dry food
His problem is he has constantly got runny poos
I have been back to the vets so many times the last time his poo was really loose watery he was given steroids and metrobactin within three days his poo was worse I phoned vets and was told to stop melds
I feed him three times a day so it’s not so hard for him to digest
It’s getting to the point I can’t take him out because of his runny poo it goes all down his legs
Apart from all the above he is healthy do gets excited when I give him his food
He does not have anything else
I am at my wits end now have made another appt for sat to see vets
Any advice would be appreciated
The vet also told my boyfriend that he expects it to be a very long surgery. Just curious as to how many others have had to go down the surgery road? It was my understanding that surgery, while a possibility, is actually somewhat rare for treatment. I’m reading everything I can get my hands on and waiting for a call back from the vet. Any tips will be greatly appreciated!!
I’m not sure if my last comment posted or not. How is your dog? Surgery is very rare. But if your dog had any intestinal bleeding they may have needed to do surgery to stop the bleeding . In some instances it can cause sepsis. Did they mention anything to you about that? I think that would be the only reason surgery would be necessary. My dog also has pancreatitis. It is so horrible to see them hurting. She had it really bad three months ago, and now again but levels are not as high as they were. I hope your dog is feeling better. You too!!