chronic pancreatitis.

RE: chronic pancreatitis.

Bob Russell — Tue, 27 Nov 2018 14:35:41 GMT

My justification for antibiotics in acute pancreatitis is that there is often gut stasis that potentially could lead to bacterial migration.

I have even been known to give corticosteroids.

I am afraid that the pancreatitis book keeps getting torn up and rewritten on a regular basis and the hard and fast rules are neither hard nor fast. They seem to be based on strong opinions and depressingly little hard data.

RE: chronic pancreatitis.

Claire Godfrey — Mon, 26 Nov 2018 15:47:01 GMT

Just seen patient back for a recheck, doing well currently with a diet change. Turns out because she was a fussy eater the owners were feeding her all sorts, llike sausage, cheese and buttered crumpets.

So have cut out all fatty food and V+ reduced to once since last seen, eating ok, but owners do think has more energy. They are keen to persue diet changes before trying any medication due to the difficultly of administering anything to the dog.

thanks all

RE: chronic pancreatitis.

Sarah Keir — Tue, 20 Nov 2018 07:31:41 GMT

I eventually finished my first BestBET - on antibiotics in acute canine pancreatitis (http://bestbetsforvets.org/bet/438). The format does limit the search question to a very narrow field but during my literature search I read more widely than the PICO and there is no evidence to use antibiotics in canine pancreatitis. Lots of eminent people saying to use them but no evidence - so likely a psychological crutch as otherwise it feels like you can do so little.

RE: chronic pancreatitis.

Claire Godfrey — Mon, 19 Nov 2018 10:14:04 GMT

[quote user="Anthony Dennison"]

[quote user="Claire Godfrey"]Wondered whether to give a course of antibiotics (probably convenia inj in this case!) as would in an acute flare up?[/quote]

I don't tend to give antibiotics in canine pancreatitis as it's not often indicated - just pain relief, metoclop, cerenia +/- ranitidine. They usually improve with just that. What is your rationale for using antibiotics?

I may give antibiotics in feline pancreatitis with evidence of cholescytitis.

[/quote]

Quite right Anthony,

I was taught antibiotics as likely to cause necrosis of pancreas, but appears this is now out dated. Learn something new every day

RE: chronic pancreatitis.

David Mills — Fri, 16 Nov 2018 17:44:22 GMT

If it's true chronic pancreatitis, it probably needs preds.

RE: chronic pancreatitis.

Anthony Dennison — Fri, 16 Nov 2018 16:39:34 GMT

[quote user="Claire Godfrey"]Wondered whether to give a course of antibiotics (probably convenia inj in this case!) as would in an acute flare up?[/quote]

I may give antibiotics in feline pancreatitis with evidence of cholescytitis.

RE: chronic pancreatitis.

Claire Godfrey — Fri, 16 Nov 2018 16:05:13 GMT

thank you, will see about a scan

Wondered whether to give a course of antibiotics (probably convenia inj in this case!) as would in an acute flare up?

RE: chronic pancreatitis.

KMurphy — Fri, 16 Nov 2018 14:34:50 GMT

Sounds tricky! If you can get the dog to eat the Royal Canin GI low fat diet I find that helps a lot with these cases. Failing that maybe chicken and rice/potato?

Nausea and vomiting could be managed by Emeprid solution in the short term if the dog really won't take tablets, but Cerenia is tiny and only once a day so maybe that would be worth exploring? Also ranitidine can be given as a solution rather than a tablet if you find that helps.

I know pancreatic supplements aren't uniformly used in pancreatitis cases but there is some evidence to show that they can be of benefit and, unless costs are an issue, you can't really do any harm by trying them.

Finally, an ultrasound may be useful to see if there are any abscesses/necrotic lesions on the pancreas given those very high enzyme levels as these may need attended to surgically and may improve the outcome overall.

Pancreatic masses

Just a first opinion vet's offering- I'm sure somebody will be along soon with something more helpful :)

Let us know how it turns out!