[Ann F]

Sorry I can’t be of much help. I don’t know what signs your dog showed of pancreatitis in the past, and whether your vet ordered a blood test to confirm it. For us it was pain and refusal to eat or drink any water. There was no vomiting or diarrhea. We did amylase and lipase which were both highly elevated. Then we’d do the Spec-cPL which came back around 1000 when he had pancreatitis. For the most part we were able to treat him at home with pain and nausea meds. If blood tests were not elevated it was something other then pancreatitis. It would take some fasting, subQ fluids, and the meds I mentioned to slowly get him out of it. At times it would take a week or so to get over it. They’d repeat the Spec-cPL and it would be back in the normal range.

I’d go on vacation, but make sure you have a plan with your vet about what your parents should do. You’d sign a release to give them permission to seek medical care in your absence. I remember missing so many family events. How long would it take for you to get home, and do your parents mind taking care of an animal that needs TLC?

[Ann F]

I believe the RC LF-20 is the most fat restricted diet on the market. Maybe the ultra low-fat works really well for her. Since Pork and Chicken was a trigger for us, the only other option for an ultra low-fat diet was the formulated one with Fish. If this is working your vet is wise.

http://web.archive.org/web/20100727135638/http://www.royalcanin.us/adx/aspx/adxGetMedia.aspx?DocID=134,293,12,1,Documents&MediaID=5953&Filename=Canine+Gastrointestinal+Low+Fat+LF.pdf

We had a diagnosis of Helicobacter, and gastritis when we did the scoping. His stomach was noticeably raw with lesions. Back then we did the amoxicillin and metronidazole, and it went away. Because the gastritis was part of the auto-immune, eosinophilic problem finding the right novel protein diet was important for us.
Later he had tested for a tick disease, and needed to be on Doxycycline. This was before he was stabilized on the diet. To get him through the harsh antibiotic we used Sulcrafate, and an acid-reducer. I had to time things very closely, and feed a slurry of some broth and boiled potato every hour to keep his stomach full. I think it was Pepcid, then 1/2 hour later Sulcrafate. He got a cup of the potato slurry, then the Doxycycline an hour after the Sulcrafate. Something like that I repeated three times a day. It is possible if you can get your vet to make up a schedule, and you have lots of timers to set:-)
It looks like the RC low-fat has corn grits as a carb. Maybe you can use small amounts of grits to keep his stomach full between regular feedings. That’s a question for your treating vet to answer about adding stuff. Do you have somebody at home to help? It is great if you can get out.

[Ann F]

Charisma, I wondered if you have consulted with a board-certified nutritionist? You mentioned looking into a BalanceIt recipe, but I wasn’t sure if it was formulated using medical records from your vet. Years ago my Internist worked with a vet nutritionist to finally get a diet that worked for longer then a few months. If there are side effects from the medications she is on, the professional would be able to sort through that. There is a list of resources on the American Society of Veterinary Nutritionist site. I have no experience with any of them, but just looking at the PetDiets.com site you can get a consult for $350.00 and provide the contact for them to get records from your veterinarian. No experience with Rebecca Remillard either. I think the more experience a vet has in nutritional management of complex medical conditions, the better they may be in finding answers for dogs like ours.
My dog passed away a few years ago, but not from the IBD/pancreatitis. One of the vets we worked with had chronic pancreatitis herself. She said that she felt bad if she ate a large meal. She ate small meals frequently throughout the day, and that worked the best.

[Ann F]

Poor baby! Is he still just eating the RC low-fat food? How is his weight? Our vet had us repeat the Spec-cPL tests a few weeks after recovery. If it had not gone into the normal range, we would have to revisit his diet. When did you test for pancreatitis last?

The vet you’re seeing now should be able to get the exploratory surgery records from the specialist you didn’t like. Maybe that vet was just having a really bad day. This is awful stuff, and you feel no matter what you do they still get sick.
Some dogs with IBD, and pancreatitis also have gastritis. You could ask your vet if this might be adding to the problem.

[Ann F]

Charisma, I don’t know if your dog has been diagnosed with chronic pancreatitis. With the diagnosis of IBD was there blood and mucous? I never could tell if the IBD, or pancreatitis was flaring up at times. Some dogs with pancreatitis show atypical signs. Mine refused to eat or even drink water so we would do a Spec-cPL test to measure pancreatic specific lipase. If that was normal we figured it was the IBD. Several times a year we would end up in the ER because the pancreatitis is so dangerous. Couldn’t tell what set it off, probably stress at times. It was very expensive, but the Specialist I finally found worked in collaboration with the UC-Davis Vet School, GI Department. I think they are doing the most research. My understanding is that they no longer believe prednisone causes pancreatitis. There are no studies about auto-immune pancreatitis in dogs, but it is present in humans. You don’t have intestinal biopsies to tell if your dog has eosinophilic enteritis. If there is an auto-immune component to the IBD there should be a response to the prednisone. They also use a drug called Budesonide in some cases.

We didn’t start the prednisone until we had also started the formulated diet. I was petrified because so many other foods had not worked. Run everything by your vet when you are dealing with a medical condition like this one.

[Ann F]

Charisma, sorry I have not been on this site for some time. I don’t know if you can PM in this group, but I wouldn’t mind helping out. You said that Turkey was the only protein suggested with the BalanceIt. I’d check again! For a formulated BalanceIt diet, they gave us a choice of Duck or Fish. Some of their diets use more exotic proteins, low-fat cottage cheese, or tofu.
We used fish which I steamed or microwaved. For an 80 lb dog I needed about a lb of fish a day (before cooking). I’m hoping you have a smaller dog:-). I was in contact with the vet who formulated the diet at least weekly. We tweeked what was not working, and kept track of the stool changes. I gave NOTHING besides his daily food. If I’d started adding slippery elm, probiotics and miscellaneous supplements my Internist would never be able to evaluation the value of the diet. Too much stuff! After this worked we did add a very tiny amount of prednisone because the IBD was eosinophilic also. This had inflamed his small intestine, and even though he did not test for SIBO, he needed a bump in the amount of BalanceIt to compensate for some absorption issues.

We used pork enzymes for a trial after some pancreatitis. Ended up he was very reactive to Pork after a month. We couldn’t give him even hydrolyzed chicken in a vet diet. He recognized it for what it was eventually. There are still preservatives in the highest quality manufactured pet food. I think we finally did well when I made a fresh diet up. I’d been scared to do this for years, wish I hadn’t waited so long to cook my own formulated. Quality of life would have been so much better for him. It was hard to cut out treats, but there are a few you can give.

[Ann F]

We had the first endoscopy done when my dog was about 15 months old. He’d been still having some IBD symptoms on his Duck and Potato kibble. Poor thing! His intestines, and stomach had deep crater-like sores from the smoldering inflammation. Biopsies of the large and small intestines showed he had Eosinophilic Gastroenteritis, along with another type of IBD. Steroids were the only treatment for the Eosinophilic cells since it was mainly an auto-immune problem. Budesonide did nothing, but we had major improvement with just a very small amount of prednisone, and of course the novel protein diet. This type of IBD can damage the small intestine so much that it is not able to absorb the nutritional components well in the foods the dog eats! With the BalanceIt vitamin, mineral and amino acid supplement the nutritionist could compensate and bump up what he couldn’t absorb from his damaged intestines. Honestly, I’m not selling anything. This just worked so well in our case after years of searching.

[Ann F]

BalanceIt was a life saver for my dog with IBD, and concurring pancreatitis! Everything in the supplement is hyperallergenic, which you can’t count on when you do the supplements yourself. LID, and Veterinary diets didn’t work for more than a few months without another flare. There was some type of preservatives in the other foods that my Internist though was setting off some of the IBD, It’s a single protein, single carb diet mix, but you can add veggies and fruits later. Easy to make, and fairly cheap even when we used fish. The Academy of Board Certified Vet Nutritionists has a list of nutritionists you can contact, and many use this supplement in their formulated diets.

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