Meile is a darling, happy (aren't they all?) yellow lab who is REALLY hurting today-and all because of that yummy, very fatty marrow-filled beef bone she ate way back at the beginning of the week. You would think if she was going to be sick after eating something, it would have been right away, but Meile doesn't have gastritis (an upset stomach) or enteritis (inflamed intestines). She has a disease that can happen a few days after over doing a very rich or fatty meal. Meile has pancreatitis.
The pancreas is an endocrine (glandular) system organ that sits under the stomach. Its main function is to secrete enzymes that help digest food, especially fatty ones. The pancreas is also responsible for producing insulin and glucagon, which is important for blood sugar metabolism as we discussed with our "sweet", diabetic cat, Cooper.
In pancreatitis, the usually pale pink organ becomes inflamed and the digestive enzymes it normally stores are released prematurely. This can cause living tissue surrounding the organ (usually the stomach, liver and intestines) to become damaged, literally being "digested" by itself. Toxins are released from this process and as tissue is destroyed the entire body has an inflammatory response.
Many things can cause pancreatitis, and sometimes we never find the cause. Some breeds of dogs such as Schnauzers are actually more likely to get this disease. While Meile is not a Schnauzer, she showed the classic signs of pancreatitis, vomiting, diarrhea, and abdominal pain. When I palpated her abdomen in the exam room, she kind of grinned at us, licked her lips as if she was nauseated, and sure enough, vomited again about a minute later. The poor girl. We started her therapy before we definitively knew her diagnosis; we gave her an injection of an anti-emetic (anti-vomiting medication) right there in the room. Meile was actually vomiting a lot of foam tinged with blood. Vomiting is no fun for anyone and I wanted that symptom stopped ASAP.
Meile was a very good girl for her nurses as we went about the job of collecting blood samples and taking abdominal x-rays. (Her owner couldn't be sure she didn't swallow some type of bone or rock or even a tennis ball, so radiographs helped us rule that out.) The blood tests were not definitive (exact) in their diagnosis, but that is often the case. Putting all the information together, the history, (what the owner tells us) the exam findings, the radiograph and blood work results....it all added up to pain in the cranial abdomen-just where the pancreas sits.
As it sounds, pancreatitis can be very serious, even life-threatening in some animals. It is also very painful. We know that untreated pain can affect the immune system, so pain management is a very important part of the treatment plan. Meile really improved right away with her first dose of a narcotic pain medication.
It is also important NOT to stimulate the pancreas at all for the first few days of treatment; giving anything orally, even water, can easily cause this to happen. Taking Meile off all food and water today and giving her intravenous fluids has helped prevent dehydration and gave her much needed electrolyte support. She was also placed on antibiotics because even though pancreatitis is rarely a bacterial disease, bacterial invasion from the adjacent diseased intestines is a common occurrence.
We will continue to withhold food and water from Meile overnight and start her back on oral fluids and bland food very gradually only if she continues to do well-no vomiting or diarrhea overnight. There is always a potential for a chronic inflammation of the pancreas, so a long term use of a low fat diet may be necessary. Meile, like a lot of Labs, has some weight to lose after we get her over this illness, so the low fat diet will be perfect for both conditions. Meile is lucky because she has wonderful owners who got her in right away when they saw she was vomiting. I know they will watch her carefully and follow instructions to the letter, calling me if anything changes for her.
Meile isn't likely going to turn down a nice fatty marrow bone in the future-what Lab would? But it really isn't going to be a great idea. Her humans will have to be tough, enforcing her new diet and not giving into those sad, begging eyes. I doubt she'll starve anytime soon.
Peace,
DrReneigh
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