Addisons + pancreatitis - help!

Re: Addisons + pancreatitis - help!

Vikki Halliday LLB — Wed, 03 Feb 2010 09:11:47 GMT

[quote user="Hanna Bennett"] has anyone seen pancreatic cancer in a dog?[/quote]

Not ever seen a primary but have seen spread from e.g. splenic masses. Not impossible to have a primary somewhere else in the abdo. Plain thoracic and abdo radiographs maybe rule this out?

Has the dog had any abdominal surgery? also once saw a treatment resistant vomiting/pancreatitis type in a young dog due to an inadvertently retained abdominal swab. (VDS got rather excited bout that one, thank god we hadn't done the original surgery! "There by the Grace of God and good nurses go I.")

Re: Addisons + pancreatitis - help!

Hanna Bennett — Wed, 03 Feb 2010 09:05:45 GMT

Have scanned him, and certainly an area of mixed echogenicity in the region of his pancreas, but unsurprisingly i don't scan many pancreatic tumours, so not sure if the scan would be representative of that or just severe inflammation! has anyone seen pancreatic cancer in a dog? I've seen a few in cats despite its' supposed 'rarity' but never in a dog. I know that doesn't rule it out, but really see the only definitive way of excluding it being an ex lap and biopsies, which seems a little excessive at this stage.

Was planning on checking PLI again end of this week as felt three days wasn't long enough to assess any changes properly. Currently he is on 0.25mg/kg pred sid as any higher and he gets pupd and incontinent, any lower and he becomes lethargic. Nice to know no one thinks i'm missing anything. Just a bad combination fo diseases to have i guess!

Re: Addisons + pancreatitis - help!

warwickshire vet — Tue, 02 Feb 2010 21:43:31 GMT

I echo above posts about scanning abdomen, as often high lipase = pancreatic tumour. I guess treat each problem as best and face diabetes if it rears its ugly head. I would stick to steroids, analgesia, adequate fluids and electrolytes and see where you end up.

Re: Addisons + pancreatitis - help!

Vikki Halliday LLB — Tue, 02 Feb 2010 21:35:58 GMT

Oh and also have you done Canine specific Pancreatic Lipase again? Might give you a better indication of how persistent the pancreatitis is.

Re: Addisons + pancreatitis - help!

Vikki Halliday LLB — Tue, 02 Feb 2010 21:34:14 GMT

Have you scanned his abdo? Both could conceivably be tumour spread related? In which case, perhaps you might have to admit defeat.

On the other hand, a good long (3-4 week) course of broad spectrum antibiotics, and continue with the preds, possibly at a moderate dose, (you don't say what dose level he is currently on). I certainly wouldn't risk stopping the preds, I'd probably try at about 0.5mg/kg as a short term measure.

I've probably upset all the internal medicine specialists with this suggestion, but short of referral that's what I'd try.

Re: Addisons + pancreatitis - help!

Hanna Bennett — Tue, 02 Feb 2010 14:47:37 GMT

referral is not that simple as the owners are both nurses, one currenlty on day shift the other on nights, and care for a disabled sister so cannot have time off in the next week or two. Any other thoughts?

Re: Addisons + pancreatitis - help!

sophia guymer — Tue, 02 Feb 2010 13:56:14 GMT

I agree with Wynne, refer ASAP.

But on the issue of steroids and pancreatitis, surely that is not an issue with the steroids given for Addisons as you are only giving what the dog would otherwise produce himself.

I have a 'skin dog' (already seen by David Scarff, on steroids and ucerax and hypoallergic diet) who we diagnosed with pancreatitis a few months ago. So now on chappie and trying to control the skin with the med's but he was in yesterday and I think we are failing miserably to manage the skin problem. Daren't put up the steroids though in view of the pancreatitis issue.

Thats life I suppose, in human med's they quite happily just tell you to cope with a problem as they can't solve it, end off! .

Re: Addisons + pancreatitis - help!

Hannah Wynne Richards — Mon, 01 Feb 2010 16:50:20 GMT

Since he's so complicated and also insured, I would refer ASAP

Wynne