Vet advice please
Discussion
Following on from my comments on this thread http://www.pistonheads.com/gassing/topic.asp?h=0&a... I could do with some advice perhaps from Bex or TheVet.
Our Springer Spaniel Lola was very poorly over Monday night, took her to the vet Tuesday morning, vet agreed to take blood to check for pancreatitis and also for liver function (liver function as Lola spent 6 months on high dose Prednisolone for an auto immune condition) and "other tests".
The Practice rang on Tuesday afternoon as promised with the result of the pancreas test and they advised that it was normal.
Lola has been poorly for the rest of the week so I made an appointment to take her in this morning as when I made the appointment first thing this morning she really wasn't any better.
Saw a different vet this morning who seemed to assume that I knew that they were of the view that her problem was with her pancreas.
They still don't have the liver results back but have others that are leading them to believe that it's pancreatitis and her symptoms fit.
We're feeding her a low fat diet and taking her back next week and she still seems to be improving.
I could do with some advice about why we got a duff first Pancreatic result - is this just "one of those things" or is there a problem somewhere?
They hadn't called me to tell me what they thought was wrong and I only booked today's appointment today so they didn't know I was coming in. I'm bothered that we were effectively just left with something that could have been hugely problematic. We have also not been helping her because we have been trying to persuade her to eat with high fat foods because we had been told that the pancreas result was clear.
Sorry, it's long
Our Springer Spaniel Lola was very poorly over Monday night, took her to the vet Tuesday morning, vet agreed to take blood to check for pancreatitis and also for liver function (liver function as Lola spent 6 months on high dose Prednisolone for an auto immune condition) and "other tests".
The Practice rang on Tuesday afternoon as promised with the result of the pancreas test and they advised that it was normal.
Lola has been poorly for the rest of the week so I made an appointment to take her in this morning as when I made the appointment first thing this morning she really wasn't any better.
Saw a different vet this morning who seemed to assume that I knew that they were of the view that her problem was with her pancreas.
They still don't have the liver results back but have others that are leading them to believe that it's pancreatitis and her symptoms fit.
We're feeding her a low fat diet and taking her back next week and she still seems to be improving.
I could do with some advice about why we got a duff first Pancreatic result - is this just "one of those things" or is there a problem somewhere?
They hadn't called me to tell me what they thought was wrong and I only booked today's appointment today so they didn't know I was coming in. I'm bothered that we were effectively just left with something that could have been hugely problematic. We have also not been helping her because we have been trying to persuade her to eat with high fat foods because we had been told that the pancreas result was clear.
Sorry, it's long
Thanks Bex, that's the kind of info I wanted, thank you.
I know some tests aren't conclusive (Lola didn't ever produce positive joint or spinal taps even at the height of her AI type issues) but we got a very positive "negative pancreatitis" call which is why I kept her home all week despite the fact that she wasn't improving.
I'm booked in again for Wednesday but I think I will ring on Monday morning to see if I can get in earlier in the week and I'll suggest an ultrasound as well.
One of my initial concerns is that the Uni vet never satisfactorily (in her own view) ruled out some kind of lurking infection in Lola
In your view what is the best way to deal with my concerns? Should I ask to see a Partner or the Practice manager? I don't want to make a huge fuss but I do want to understand what went on.
I know some tests aren't conclusive (Lola didn't ever produce positive joint or spinal taps even at the height of her AI type issues) but we got a very positive "negative pancreatitis" call which is why I kept her home all week despite the fact that she wasn't improving.
I'm booked in again for Wednesday but I think I will ring on Monday morning to see if I can get in earlier in the week and I'll suggest an ultrasound as well.
One of my initial concerns is that the Uni vet never satisfactorily (in her own view) ruled out some kind of lurking infection in Lola
In your view what is the best way to deal with my concerns? Should I ask to see a Partner or the Practice manager? I don't want to make a huge fuss but I do want to understand what went on.
Thanks again, I think I'll have a chat with the second vet at the next appointment either Wednesday or earlier and raise my concerns and see how they are dealt with. My usual concern with this practice is a lack of communication, it's always a different vet and nobody ever seems to actually take ownership of a patient. They are a fairly large practice and see to have a very high staff turnover at assistant level - I suspect vets use it as a good training experience in their early years and then move on.
Lola is looking pretty good at the moment, she's clearly not 100% but she's eating and she's got some energy - we've been for a very short walk with her and she trotted around at probably 60% of her usual speed. She is back to being her normally alert self and is not showing any signs of pain. I'm just not sure whether this is a definite road to recovery or whether we might expect another pancreatic flare up.
Lola is looking pretty good at the moment, she's clearly not 100% but she's eating and she's got some energy - we've been for a very short walk with her and she trotted around at probably 60% of her usual speed. She is back to being her normally alert self and is not showing any signs of pain. I'm just not sure whether this is a definite road to recovery or whether we might expect another pancreatic flare up.
Update time: Lola is worse again and we've just had to admit her to the vets for IV fluids, pain relief etc.
She was OK up until last evening when she started to refuse food, then started vomiting again.
We took her in at 9.30pm for another anti sickness injection and agreed to see how she went overnight rather than admitting her then but she got worse overnight so she went back in at 6am, she's clearly in a lot of pain again.
Got some more detail last night on what may have happened with the testing, the inhouse test was negative, the external test then came back indicating pancreatitis BUT in the meantime they had rung us to say "all clear" and they hadn't told us that there was a second, external test being done. They then failed to act on the external results. I suspect ideally as GD says they should also have started to treat for pancreatitis anyway as with hindsight (wonderful thing I know) her symptoms were textbook.
The on call vet tonight and this morning says she heard Friday's vet raising the issue on Friday and said that there had been a bit of a "hoo ha" about it so it sounds like they recognise that there was a problem. I'll follow this up again during the week to ensure that the practice is aware of this.
Very empty house this morning
She was OK up until last evening when she started to refuse food, then started vomiting again.
We took her in at 9.30pm for another anti sickness injection and agreed to see how she went overnight rather than admitting her then but she got worse overnight so she went back in at 6am, she's clearly in a lot of pain again.
Got some more detail last night on what may have happened with the testing, the inhouse test was negative, the external test then came back indicating pancreatitis BUT in the meantime they had rung us to say "all clear" and they hadn't told us that there was a second, external test being done. They then failed to act on the external results. I suspect ideally as GD says they should also have started to treat for pancreatitis anyway as with hindsight (wonderful thing I know) her symptoms were textbook.
The on call vet tonight and this morning says she heard Friday's vet raising the issue on Friday and said that there had been a bit of a "hoo ha" about it so it sounds like they recognise that there was a problem. I'll follow this up again during the week to ensure that the practice is aware of this.
Very empty house this morning
Just thought I'd update this. We've not had a good week or so.
Our vets kept her in from early Sunday morning until Tuesday lunchtime, on fluids, pain relief etc. to try to help her pancreas.
When we picked her up she didn't look good, her ears were very low and she didn't look bright. We took her home and watched her carefully and by Wednesday night she was off food and struggling again.
She wasn't vomiting though so, in consultation with the vet we kept her home overnight on Wednesday and then took her in first thing Thursday morning.
As background on the previous Saturday night when we took her in for an anti-emetic injection, OH told the vet that he thought he could feel a lump in her abdomen, we asked for an ultra sound and a referral to the Uni Vet Hospital where she was treated before. These things hadn't been done all the time that she was with them - the vet said that there was no point doing an ultra sound as it would only show them that her pancreas was inflamed.
They hadn't progressed the referral so by the Thursday morning we were no further forward - they were suggesting that they would scan and xray on Thursday but we took her to the Uni Hospital as we were very concerned about her.
The Uni vet saw her immediately and could also feel a lump in her abdomen, they admitted her straight away, scanned her and found a mass in her intestinal wall. They operated and found that she had a very sharp bone in her lower intestine which appeared to have perforated the bowel wall, causing damage to the wall - they have removed a 10cm section of her lower intestine BUT she had peritonitis.
She came through surgery (on Thursday) well but there is a huge risk that the infection will reoccur, we were given a 50% chance of her surviving depending on what happened over the next 4 to 5 days. We are now at day 4 and *fingers crossed she seems to be progressing well.
It's a bit of a horror story and we still don't know if she's out of the woods.I still don't understand how a dog that is being seen by a vet and had been an inpatient for 2.5 days can end up with an undiagnosed blockage leading to peritonitis. I've asked the practice manager to ask one of the Partners to review and report back to me.
The moral of the story is to follow your instinct. I wish we could go back 5 or 6 days and I'd got her to the Uni Hospital earlier
Our vets kept her in from early Sunday morning until Tuesday lunchtime, on fluids, pain relief etc. to try to help her pancreas.
When we picked her up she didn't look good, her ears were very low and she didn't look bright. We took her home and watched her carefully and by Wednesday night she was off food and struggling again.
She wasn't vomiting though so, in consultation with the vet we kept her home overnight on Wednesday and then took her in first thing Thursday morning.
As background on the previous Saturday night when we took her in for an anti-emetic injection, OH told the vet that he thought he could feel a lump in her abdomen, we asked for an ultra sound and a referral to the Uni Vet Hospital where she was treated before. These things hadn't been done all the time that she was with them - the vet said that there was no point doing an ultra sound as it would only show them that her pancreas was inflamed.
They hadn't progressed the referral so by the Thursday morning we were no further forward - they were suggesting that they would scan and xray on Thursday but we took her to the Uni Hospital as we were very concerned about her.
The Uni vet saw her immediately and could also feel a lump in her abdomen, they admitted her straight away, scanned her and found a mass in her intestinal wall. They operated and found that she had a very sharp bone in her lower intestine which appeared to have perforated the bowel wall, causing damage to the wall - they have removed a 10cm section of her lower intestine BUT she had peritonitis.
She came through surgery (on Thursday) well but there is a huge risk that the infection will reoccur, we were given a 50% chance of her surviving depending on what happened over the next 4 to 5 days. We are now at day 4 and *fingers crossed she seems to be progressing well.
It's a bit of a horror story and we still don't know if she's out of the woods.I still don't understand how a dog that is being seen by a vet and had been an inpatient for 2.5 days can end up with an undiagnosed blockage leading to peritonitis. I've asked the practice manager to ask one of the Partners to review and report back to me.
The moral of the story is to follow your instinct. I wish we could go back 5 or 6 days and I'd got her to the Uni Hospital earlier
Thanks Bex and Jill, fingers are still crossed.
Bex, not sure about the bone, we feed her raw chicken wings and have done for years but the bone described was longer and very sharp and they did not think it was raw chicken as those bones are shorter and softer. We are always careful about cooked bones and she's not really a scavenger so I'm not sure where she would have got it.
She had peritonitis when they operated and they have washed out her abdomen, she'd first become unwell over 10 days before this so I guess things were getting very nasty. They have been monitoring ever since to see if there are further signs. They felt that if it recurred, in their experience, dogs who are as poorly as Lola struggle to fight it off, hence the odds.
I can't dare to breath yet, she's a tough little thing, but we really did think we'd lost her, can't bear to get my hopes up though.
Bex, not sure about the bone, we feed her raw chicken wings and have done for years but the bone described was longer and very sharp and they did not think it was raw chicken as those bones are shorter and softer. We are always careful about cooked bones and she's not really a scavenger so I'm not sure where she would have got it.
She had peritonitis when they operated and they have washed out her abdomen, she'd first become unwell over 10 days before this so I guess things were getting very nasty. They have been monitoring ever since to see if there are further signs. They felt that if it recurred, in their experience, dogs who are as poorly as Lola struggle to fight it off, hence the odds.
I can't dare to breath yet, she's a tough little thing, but we really did think we'd lost her, can't bear to get my hopes up though.
So long as she doesn't have any further problems, the vet hospital hope that they will be able to release her late tomorrow. We'll still need to watch her closely for problems but they are hopeful that having got this far the outcome should be positive.
Can't quite believe it and won't until she's back here x
Can't quite believe it and won't until she's back here x
Thanks for thinking of us. She is home, we picked her up late yesterday 
It's a pretty rubbish photo but her belly looks like this on both sides, so she's got no fur below shoulder level on either side and also a couple of chunks missing from her neck, legs etc.
This was her snuggling up with OH last night.
She's eating a bit but not really poo'ing very much at the moment, which we've got to watch. She has to be rested for a month but so long as the staples and the tissue in her intestine stays intact then she has a good chance of making a decent recovery.
We are very relieved to have her home, she'll be four in a week and with her auto immune issues and this episode she's certainly living up to her "complex" tag.
It's a pretty rubbish photo but her belly looks like this on both sides, so she's got no fur below shoulder level on either side and also a couple of chunks missing from her neck, legs etc.
This was her snuggling up with OH last night.
She's eating a bit but not really poo'ing very much at the moment, which we've got to watch. She has to be rested for a month but so long as the staples and the tissue in her intestine stays intact then she has a good chance of making a decent recovery.
We are very relieved to have her home, she'll be four in a week and with her auto immune issues and this episode she's certainly living up to her "complex" tag.
Gassing Station | All Creatures Great & Small | Top of Page | What's New | My Stuff