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Old 12-29-2013, 12:31 PM   #1 (permalink)
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An ER visit w/ pancreatitis??? maybe??? Help

We, took Kira last night to the Emergency Vet @ 11 pm. her symptoms "were";
Diarrhea, vomiting a few times all day, not her normal "Kracken" self, being "lazy" as you would imagine with an upset stomach.

I was extremely concerned with the vomiting, laziness and was afraid she had a blockage of some sort.

At the ER office, they took blood work. Found that she was dehydrated and had a "slight" urinary tract infection. White and Red blood was all good, she had no temperature either.
They were suggesting blockage too and we moved forward....

They said she needed X rays and possibility an ultrasound.

I said to go straight to the ultrasound!

The ER said, the X rays could "see" things an ultrasound couldn't.
They completed the X rays.
Told us they saw "something" but "couldn't be sure" and mentioned "Blockage again" and or slight "gas buildup."

They told me they wanted to keep her over night with IV fluids, ($$$) so the Radiologist could read the X rays better. by this time it's 2am.

I wasn't sure why they took films if they couldn't "read" them... I mean if they saw a matchbox car or a shoe I guess it would have been obvious... But still a trained professional should either be there or "on call???"

I thought that sounded "counterproductive" I mean if she HAD - HAS a BLOCKAGE she NEEDS IMMEDIATE ATTENTION not being put in a cage over night with an IV?????!!!!

I told them I wasn't leaving her to be put in a cage or waiting until the am for a radiologist to look at the X-rays again. They needed to do an ultrasound NOW...

After they came back from the ultrasound, they told us, "We don't see any foreign blockage but their could be some "gas" buildup, BUT, keeping her overnight with fluids would "probability help" clear it. $$$$$

I asked them, alright what's the next possibility to be wrong with her?
(Trying to rule out, something LIFE THREATENING vrs. an upset stomach.)

They said it could be Pancreatits. I asked them, "Alright what are those tests? What are we looking for?"

They said, "An enlarged abdomen, enlarged area around the pancreas, pain, infection in the blood....

I asked them if Kira had this???

They said, "no" but she "Could get this" (bla bla bla) we need to keep her over night to pump her with fluids...$$$$

I was getting very confused, I've "read" before about dogs getting pancreatitis a Veterinarian Dr. could diagnose this!!??...

I asked them, "Wouldn't you see something in her blood work if she HAS pancreatitis? Can you give her a test to check for this?"

The vet said, "We don't see anything in her blood work as of yet. Their is "A" TEST but it takes 4 days to confirm."

I was becoming very uncomfortable with the "shotty diagnosis"...

***It's a blockage says the X rays, "Maybe!" Lets keep her here overnight for someone better qualified to read them... $$$

*** Ok, it's maybe still a blockage, "probally" not, maybe gas... The ultrasound was inconclusive... LET'S KEEP HER OVERNIGHT... $$$

Their continual pushing of this "Gold Standard Treatment Plan" they keep telling me about and bringing me in to review the costs.... LETS KEEP HER OVER NIGHT $$$$$

I finally told them I wasn't pleased or confident with any of the diagnoses - "NOT diagnosis" they've given me. They've had her for the better part of 4 hours, haven't given her any shots or fluids while we were their.... Just a quick recap of the evening when all they say is keeping her "overnight" with the "gold standard plan" when it's almost 4 am now and I'm not sure what they think "Over-Night" is?

I asked them to do whatever they were going to if she stayed but, as an outpatient. She received a few shots and they injected her with fluid under her skin, I have some meds. and have been giving her small amounts of water which they said to do, which she is holding down...

Has anyone with pancreatitis and their Doberman been threw this?
Is - ARE there test for this which are faster then 4 days?

What are some NEW or worsening symptoms to look for???
I will be taking her to my vet on Monday... But today is Sunday and I am a nervous Doberman mom...

I would have had no problem leaving her with the ER vets but, they seamed to be more concerned with the "Gold Standard Plan" and keeping her overnight for an EXTRA GRAND then giving me a diagnosis while we were all there...

IF ANY OF YOU HAVE SOME ADVISE OF WHAT TO LOOK FOR OR BE CONCERNED WITH I WILL APPRECIATE IT... I can't lie, I would PREFER not to take her back today, but would if I see her worsening...

Right now she's sleeping and going outside for potty breaks, begging for food and just making tummy sounds...

Thank you,
bonni
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Old 12-29-2013, 03:11 PM   #2 (permalink)
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Standard protocol of care would have been hospitalization with IV fluids.

You should have listened to veterinary advice.

The subQ fluids she rec'd at your insistence, as an outpatient, will not be nearly as effective, nor does she have a catheter for ease of IV medications, as she would have, in hospital.

Four hours to work up diagnostics on an ER patient is nothing--not sure why you think they should have had a set-in-stone answer by then.

Blockages do NOT always show on either Xray or ultrasound, esp. if it is some soft foreign object, like stuffing from a toy or a couch cushion, etc.

It sounds like, from what you described, they did their utmost, and within accepted standard of care.

If they were not staffed 24/7, I could see taking my dog home just for the hours no one was there to monitor her, but this does not sound like the case here.

Her best chance would have been to be professionally, medically monitored, in hospital, and yes, IV fluids alone can often help to clear an obstruction in the gut--the extra fluids help move things along, if there is a chance of safely passing them.

I would return to the ER today, if she isn't vastly, vastly improved.
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Old 12-29-2013, 08:06 PM   #3 (permalink)
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FOLLOW UP

I finally got a hold of a different Veterinary Dr. from the same office today.
"The main MAN with ALL the paperwork on the wall Who also helped us when Kira was attacked by the Pitbull."

I spoke with him about not being pleased, or comfortable with the "midnight shift's" "confident -Not Confident" test results.

I told him a friend of mine has a family member who is a vet. She also expressed concern that a few important test were not taken, diagnosed and or showing some form of recognition along with the x rays and ultrasound. Not to mention she has ONLY seen one case in her 6 years, so "in her opinion" it's not as "common" as I was told last night. If the tests she suggested were not taken, why not, and could I bring her back in to have them done asap!

Naturally I love my "Kracken" and wanted a "better" answer, diagnosis, or a second opinion. Above all, I want to make her better!

The gentleman today on the phone was so much more knowledgeable, POSITIVE then the entire "money hungry" staff last night. He said he saw NOTHING which suggests Pancreatits upon review of her chart, blood work or films.
He then told me all of the "tell tail" tests were preformed, all were normal.
I was ecstatic to hear because last night they told me of ONLY one test which took 4 days to read.

He said, she probably ate something, which caused her to have an upset stomach, er-go the puke fest and diarrhea.

He told me to MAKE SURE she got fluids in her as that was the ONLY concern he has. If anything happens or gets worse, to call him personally.

What a wonderful, honest Dr. and man! He knew I would rush Kira back if he said so. Instead of making me believe she had some life threatening disease to get a paycheck he was so real.

Kira, "The Kracken" is looking much better today. Holding down water, white rice and one small boiled chicken bite.
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Old 12-29-2013, 08:56 PM   #4 (permalink)
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There's a SNAP test for pancreatitis that can be read in minutes. Parker had pancreatitis when he was around two (nearly five years ago) and the symptoms were so serious I was waiting at the door when the veterinary office opened. The vet took a snap test and told me within minutes what was wrong.

Parker would not eat, only threw up twice, but began to show obvious signs of abdominal pain. I've had two dogs with pancreatitis and it's very obvious something is seriously wrong.

http://www.idexx.com//view/xhtml/en_...jsf?SSOTOKEN=0

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Old 12-29-2013, 11:11 PM   #5 (permalink)
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Both times when Flirt had obstructions they showed up on xray very clearly. But once sticks looked like bones so we waited...bad idea.

I would think if she had pancreatitis they'd have had a more definitive diagnosis. Treatment is IV fluids though and some meds.

A few months ago I rushed my 10 yr old in worried. She was throwing up, wouldn't eat, wasn't sure about diarrhea and we ruled it out rather quickly. They didn't really find anything but could tell she was in pain. They gave her buprin and something for her tummy and let me take her home. Her bloodwork though was fine.
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Old 01-04-2014, 06:20 AM   #6 (permalink)
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Good information. Thanks Robin.
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Old 01-04-2014, 11:00 AM   #7 (permalink)
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I am so glad of the ER Vets I have here in Portland OR. Unfortunately, they know me... Anyway, I had Yoda in for something similar - he ended up with a mass of grass in his belly which caused a lot of gas that they kept moving all night with fluids and Barium so they could watch and see the outline. It kept moving and they kept taking xrays every hour. I picked him up in the morning and he passed the vegetation once I got him home.

I have been in for worse, but I have several ERs to choose from and I know which one I will always go to - I checked around long before I needed one - everyone needs to be ready for the inevitable - because we have dobes and this tends to happen to one of our dogs at some point. Usually I have been lucky and been able to get to the regular Vet during their longs hours for missing eyes, opened sides, seizures, etc. I agree with RFR and I am not sure about anything that went on except that I wasn't there. I agree with Adara - not all blockages show up as in the example I had - all they could see was the associated gas build up.
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Old 01-04-2014, 11:34 AM   #8 (permalink)
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I would give her a Pepcid or a gasX always keep those on hand.
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