by Barry B. Burtis D.V.M.
While his family was on vacation, Aston was staying with friends. A handsome, always obedient, 4 year old neutered male Schnauzer, he was no trouble at all and his caregivers were happy to have him visit them again for a few days. However, they became very concerned when, two days after arriving, he vomited four times during the day and seemed in considerable discomfort. When consulted, his veterinarian agreed that Aston needed to be examined. Aston had been seen at the veterinary hospital ten days earlier for occasional early morning vomiting in the previous two weeks. Blood tests had revealed no abnormalities and anti-nausea medication had been prescribed for a few days of treatment.
This time when Aston was given a general physical examination, besides being a bit more quiet than his usual cheerful self, the most significant finding was that he seemed to be painful when the forward part of his abdomen was gently palpated. An x-ray that was taken did not reveal any foreign material that might have been swallowed. Aston was admitted to the hospital for further care. Blood tests were repeated and an abdominal ultrasound was performed. Changes now in the blood values that had been normal earlier and the ultrasound examination were consistent with pancreatitis being the cause of Aston's illness.
Pancreatitis is inflammation of the pancreas. Problems in this vital organ occur when digestive enzymes it produces begin to damage surrounding cells in the pancreas itself. This process initiates a cascade of consequences in the pancreas and other organ systems that can result in very serious, possibly life threatening illness.
When Aston's initial response to therapy was poor, he was referred to a teaching hospital for evaluation and further care. For the next 6 days, Aston was maintained on intravenous fluids, intravenous pain medications and drugs to control his nausea and vomiting. He was then released to his owners with pain management medicines and strict diet recommendations. He was to eat only a very low fat diet, prescription food.
Two days after his release he was rechecked by his regular veterinarian. At this time, although there had been no vomiting and Aston was alert and bright, he was not eating and on examination his mucus membranes were jaundiced. Immediate intensive care, including intravenous fluids, to stabilize his condition were begun. The specialist who had been caring for Aston at the teaching hospital was contacted and Aston was re-admitted to that facility. Tests showed Aston's pancreatitis was resolving. However, based on another abdominal ultrasound and repeated blood tests, it was determined a bile duct obstruction was causing Aston's failure to improve. An exploratory abdominal surgery was performed and a tube placed in his bile duct to allow aspiration of bile directly from his gallbladder. A liver biopsy was taken and a culture was taken from a pancreatic abscess that was identified. An esophagostomy tube was placed following his surgery and a chest x-ray was taken to confirm its proper placement. After three days post-operatively in the Intensive Care Unit, Aston was released to his owners for continuing nursing care at home. If Aston was not eating a sufficient amount of food, he could be fed through his esophageal tube. Low fat treats such as apples, carrots and frozen green peas were allowed in moderation. Antibiotics, medicines to combat nausea, pain relievers and drugs to protect and help the liver problem were to be given.
Over the next three weeks, thanks to the wonderful care he received from his loving owners, his committed professional health care providers and his indefatigable spirit and will to survive, Aston made a steady and continual recovery from his life-threatening illness. His esophagostomy and cholecystotomy tubes were removed. His medications have all been able to be discontinued. He will need to continue to watch what he eats, avoiding high fat foods or fatty treats that would increase a risk of a recurrence of pancreas issues. However, now nine months after Aston's health crisis, he is the picture of a happy, healthy, little Schnauzer. He is home again now, after enjoying some winter Florida sunshine with his adoring owners to aid in his recovery. Barry Burtis is a local companion animal veterinarian. Past Pet Tales can be found at www.baycitiesanimalhospital.ca