HELP! How Can We Help Dogs With Acute Pancreatitis?

[Nikki]

I have been reading about pancreatitis on the boards and the interweb and am left quite confused. Haidut posted a study which blames serotonin for acute pancreatitis. Another study I found, supports this. However, serotonin is needed (it seems) for insulin production.

My understanding is that normally digestive enzymes are produced by the pancreas are not active until they reach the small intestine. In pancreatitis, they are ativating in the pancreas causing damage to the tissue which (stupidly?) isn't designd to withstand the enzyme(s). Does anyone know if this is accurate? What is causing it to activate? How can we stop the premature activation of protease (without causing insulin resistance or diabetes)? Does anyone have personal experience or a very good grasp of all aspects of this disease?

Because I am not wanting to activate the production of protease (until this passes), I am feeding low protein diet (small amount chicken breast with a lot of white rice). I would normally not give them carbs because it isn't part of their natural diet. If I am feeing carbs, adequate insulin production must be allowed so I'm nervous to block serotonin production.

??? what to do???

The one patient is young and adorable, and very sweet and he wants to survive this! He may have "microvascular hepatic displasia" as well as pancreatitis and chronic liver disease can be a contributing factor of pancreatitis (though the mechanism has never been explained to me). He has been having seizures that some say are related to the liver condition and some say are unrelated.

It's all overwhelming for my little brain.

 

[ecstatichamster]

I find progesterone, sugar, pregnenolone, thyroid, taurine, vitamin D and K2 very helpful for my dog. She has serious liver issues but these help her and she's quite normal in behavior and apppetite. I'd suggest a course like this for your sick dog. Even just sugar, Progesterone and T3 can do wonders.

 

[Stilgar]

I asked Ray about microvascular dysplasia and seizures in dogs, because my Mum's dog has it and suffered a lot. Her ammonia levels were very high and her calcium has been intermittently elevated. My mum doesn't listen much to me unfortunately, but if I had a dog with it - or connected conditions, I'd follow Rays advice for sure. The diet recommendations from most vets for this liver problem is low protein, except dairy, so I asked if he thought this would help and if there was anything else he could suggest. So cheese and cottage cheese is ok and as are most fruits. It's a pretty cute Peat style diet for dogs, actually. He said the following -

The recommended diet sounds good, and tetracyclines, erythromycin, or penicillin in small amounts could by supported by naturally antiseptic foods, maybe cooked mushrooms for example. The fat in ice cream helps to suppress bacteria. Did they check her thyroid function? A thyroid supplement to make the liver more active might help.

Unfortunately, my mum has resorted to mostly commercial low protein dog food and sort of semi starvation to keep her protein intake low. It stops seizures but I'm sure there will be complications later on. She trusts her vets too much!

Hope that helps.

 

[Nikki]

I want to tell everyone that this dog looks like a very healthy dog. He is frisky, well-muscled, and looks good (funny looking, but healthy looking). He goes wild when he is allowed off leash in a park or when I take him down the street to the beach. He has beautiful fur, perfect skin, bright eyes, healthy ears, healthy joints and he smells very good for a dog who doesn't get a bath very often. He occasionally has a flea but has no allergic response to the bite so in some ways he is healther than my other dogs. He also can (could?) eat many more things without any allergy or tummy upset. In person he appears the picture of health. On paper he appears to be a special needs case due to a mild (questionable, IMO) arrythmia, "seizures" (he remains conscious and is just weak and wobbly), and the recent suggestion that his liver may be a bit small (supposedly MVD), and now the acute pancreatitis, which is my priority to fix at the moment. Please, please, please help me fix this.

The rest of my post it is patchy and I apologize. I have been running back to type a little between other activities. The flow was certainly compromised. Hopefully it isn't too annoying.

Last night, we ended a 20 hour fast with no food. I allowed H2O while he was fasted. Can anyone tell me withholding water is advised when resting the pancreas? To his shaved ventrodorsal abdomen, I applied DMSO 50% diluted with Colloidal silver. I used this combo because I already had it made up from when I was treating another case, but perhaps it's wise to have the silver applied in such a way that it will permeate the pancreas. Silver ions are known to de-diferentiate cells and can help with regeneration, though I am not sure in this situation such actions could be expected. Pup received 2 applications DMSO 2 hrs apart just before fasting; 7 hours overnight he received no treatments; 3 applications of DMSO approx 2 hours apart in the AM while fasting). At the end of the DMSO treatment, he was showing interest in food. I continued fasting him about another 8 hours. I then fed him beef bone broth (not gelatinous, so hopefully low protein for the temporary relief this should provide the pancreas) with white rice and colloidal silver for 8PM dinner and midnight snack. He ate eagerly. I applied 1 drop progest E after he ate dinner last night at breakfast time this morning and again tonight after what would have been dinner time. Tonight, Pup was very happy on his walk and practically wanted to sprint home at the mention of "dinner". Once home, he wanted to wrestle and play tug. I wish he would have wanted to eat, as that would have relieved my worry. Last night and earlier today, (breakfast and lunch) he begged for a second serving after each meal. I resumed topical DMSO (with CS) tonight as I am feeling now that was what healed him, not the progest E, notthe broth.

I had a pretty remarkable case of "curing" triaditits in an 18 year old cat using topical DMSO and colloidal silver. That cat had a lot of DMSO applied to her daily and she was fine (but stinky!).

I need help figuring out if DMSO is appropriate therapy for a dog with pancreatitis, "seizures" and possible reduced liver function. I was concerned about precipitating a seizure and would not have resorted to DMSO if I didn't feel the benefit would outweigh the risk. I was banking on the seizures (not tonic) being related to reduced liver function, in which case, DMSO had a good chance of being beneficial (IMO). There are some sources which say to refrain from use DMSO in those with reduced liver function, but for me it is one of the first things I consider when considering liver support along with milk thistle extract or Denamarin.

Does anyone understand the link between serotonin and acute pancreatitis? Is serotonin causing the enzyme inhibitor to fail?

Can you all help me to pick apart the information available linking DMSO to seizures? What about the relationship between glycine and seizures?

I've read that SSRIs can be helpful in reducing seizures, but that may be because the receptors are being blocked and serotonin, if not in competition with SSRI, may have caused seizure. ?? Am I on the right track? Since I have no advanced degree or recent courses on chemistry, physiology, pharmocokinetics, etc, I struggle to visualize the processes I am reading about. It would be nice to have some help understanding the concepts.

An important thing for us to keep in mind is that. The seizures are not typical grand mal or tonic nature so when we read "Seizure" or read about epilepsy, it may be a completely different process they are writing about. These "Seizures" also may or may not be related to the perceived liver issue. He has not had an MRI of his brain yet to rule out lesions/meningioma nor can we be sure they aren't related to his arrythmia. He had three seizures 7 weeks apart, so they are not frequent. Prior to those three episodes. There seemed to be 14 month lapse however he was not under 24 hour watch and may have had others.

When I read things such as this, I don't know what to make of it. "Inhibition of glycinergic neurotransmission is an alternative strategy for controlling seizures..." that I understand but it seems to imply that reducing glycine would be beneficial. and what do you make of this: Glycine Transporter 1 is a Target for the Treatment of Epilepsy which states "Although glycine was not quantified directly in the present study, previous findings from us and others support an inverse relationship between GlyT1 expression levels and extracellular glycine (Supplisson and Bergman, 1997; Yee et al., 2006). We therefore hypothesize that the increased expression of GlyT1 in the epileptogenic hippocampus leads to reduced extracellular glycine during the interictal phase. Under those conditions preferential activation of pro-convulsive presynaptic glycine receptors would contribute to seizure generation in chronic epilepsy" (Huh? What does supplementing glycine do? Increase the extracellular glycine levels?)

"MDA and NO levels... decreased in the drug-administered [DMSO] group versus the control clamped group" The effects of dimethyl sulfoxide on liver damage caused by ischemia-reperfusion. - PubMed - NCBI

"DMSO pre-treatment did not affect survival but resulted in a significant reduction in liver enzyme (aspartate aminotransferase, alanine aminotransferase) release on the first postoperative day following total ischaemic times of 90 min or greater (p < 0.05). After 120 min of total ischaemia, DMSOpre-treatment resulted in higher preservation of adenosine 5'-triphosphate liver content (p < 0.05" Effects of the free radical scavenger dimethyl sulphoxide on experimental normothermic ischaemia of the liver. - PubMed - NCBI

Not directly related, but supportive of DMSO in cases of toxin-induced liver damage "Dimethyl sulfoxide (DMSO) can protect the liver from injury produced by a variety of hepatotoxicants" Late dimethyl sulfoxide administration provides a protective action against chemically induced injury in both the liver and the kidney. - PubMed - NCBI

Dmso Is Similar To Reserpine, Lowers Serotonin, Increases MAO-A ). Then, I fed the controversial (not gelatinous) 3-hour beef bone (knee cap) broth added to white rice. He loved it and has had three meals of it since last night. I also applied a drop of Progest E to his shaved belly last night and will repeat twice daily. I don't want to discontinue DMSO yet, but am nervous to continue it. His willingness to eat at every meal time in a row is a good indication that his panreas had time to rest and recover but I don't know how much of that was due to the DMSO.

"Now important evidence has been accumulated supporting a pivotal role of intracellular levels of calcium in the early pathogenesis of the disease. A sustained increase of cytosolic calcium concentrations, as observed in various models of acute pancreatitis, was identified as sabotaging crucial cellular defense mechanisms and initiating premature trypsinogen activation." http://www.sciencedirect.com/science/article/pii/S0039606012002218
Just before this condition came up, I had run out of lean meat which I used to mix in with the ground chicken necks I fed the pets. Chicken necks are generally too boney to be a staple diet. It is sensible to cut them 2:1 or 1:1 with meat. Did the overage of calcium or possibly glycine from the neck bones cause this?

There is a lot of controversy over whether or not to fast dogs with this condition. Anyone want to weigh in on that? They used to fast them for 5 days which is too long in some cases (causes atrophy of intestinal cells, supposedly). That was the standard. Now most vets say do not fast because of it's effect on the intestine. I am pretty sure in human medicine they still fast acute pancreatitis patients.

@ecstatichamster Thank You for your help. What dose/frequency/route do you use for those supplements? How do you give your dog sugar? I tried to give my dog gelatine with sugar in it, he doesn't want it at all. He will eat sweet yogurt, but yeast is a concern with these dogs. When I was feeding about 50% cottage cheese and 50% meat, the dogs would lick their paws resulting in red discoloration, a sign of yeast. I can't explain why it happened, but am sure it was the cottage cheese. I was excited to have found something convenient to feed them and was so sad that it didn't work out. There were no other issues, but excessive licking and red discoloration, doesn't seem healthy to me.

A few months ago, I was giving each pet pregnenolone (I had no way to measure it, I just put a tiny sprinkle from a 100mg capsuled into the bowl so it was about 5-10mg (what RP suggested for my 6lb cat) and progest E in their meals for a while. When I developed spider veins in reaction to Progest E (applied on gums) I was concerned what it might do to the pets. Someone on the boards suggested gut bacteria may be converting it to estrogen. I would apply topically to avoid the gut bacteria concern, however when I had the first spider vein reaction to progesterone, it was from strictly topical application. I have to go back and read the thread because I may be forgetting important details. I was also giving D complex by Designs for health which has ADE&K. Can anyone weigh in on whether or not this is a good product for pets? Trying to dose out liquid, oily vitamins for small pets (smallest is 4lbs) when they are created for 100lb plus people, is not easy (can't compound it in oil to because of low fat diet requirement).

@Stilgar That's sad that your mum wouldn't heed your advice. I think my dog would love the ice cream advice. He should probably stay on a low fat diet until I know what I am doing without doubts. Do you know why cottage cheese would be OK but not lean chicken/eggs? I'm surprised RP would think fruits are good for a dog. I thought he was anti-fiber? I am not sure what he meant when he wrtoe about the antibiotics and mushrooms. Do you know what he was getting at? I would happily give the pets colloidal silver every day since they are getting it very often anyway.

Exhausted.
Thankful for your help.
Good night.

 

[Stilgar]

Using cottage cheese as a primary protein source was suggested as a well digested protein source that produces less ammonia than meats etc. Chicken and other meats also contain large amounts of tryptophan, which can block thyroid function. I imagine gelatin would be good too. My mum's dog was having seizures because her ammonia levels were too high, and she was producing ammonia because of gut bacteria and being unable to detoxify it enough due to poor liver function. Poor liver function is often a combination of low thyroid function, endotoxin overload and poor protein intake. This produces a poor metabolic stare via the actions of serotonin, histamine and estrogen. I imagine the same is true from pancreatitis. My mum's dog is permanently on lactulose, a diarrhoea inducer that lowers ammonia. She was also on long term antibiotics but was recently taken off them. Again, the antibiotics function to lower bacterial load in the gut, thus reducing the ammonia burden, lowering serotonin and estrogen.

Mushrooms, raw carrots and cooked bamboo shoots would all function for that purpose - Ray suggests indigestible cellulose travels through the GI tract undigested and sweeps the intestine. They are gentle, natural antibiotic fibrous foods, that don't provide food for potentially harmful bacteria.

Fruits are highly recommended on a Peat diet. Dr Peat doesn't like an excess of fibrous vegetables, especially raw, or starches, which feed endotoxin and stress the gut. The sugars in fruit, however, are highly protective and stimulate cellular metabolism, repair and regeneration. These sugars are balanced with protective minerals, and the fibres are mostly cellulose, which are not food for most bacteria. Some fruits can be irritating if they are very seedy, or they are rich in pectin and obviously some are toxic to dogs- like grapes/raisins. Tropical fruits like papaya, lychees, cherimoya and sapote are good, also oranges and watermelon. My mums dog begs for watermelon and is crazy about it! If your dog eats currently few sugar sources, it needs sugar! Ray once made a comment saying most dogs he had met loved sugar. That desire has a physiological function.

 

[Nikki]

@Stilgar- Thank you! I thank you so much for your patience and wanting to help.

I understand the fruit, sugar, antibiotic angle now.

I am feeding mostly non fat cottage cheese now. They don't love it, but they will eat it if I add in some chicken breast or very lean beef.

Do the raw carrots have to be eaten on an empty stomach to work? Is psyllium a bad idea? I was feeding canned pumkin to help firm up the stool. Now I'm not sure if that is good or bad. Most dogs love pumpkin and the ones who don't, usually will tolerate it if it's mixed into something they like. Won't this do a fine job of sweeping the colon? Do I even need to worry about this if they get colloidal silver orally 2-4 times a day? Wouldn't adding colloidal silver to meals more or less eliminate gut bacteria and prevent endotoxin issues?

I love colloidal silver (Meso brand). I take a tablespoon twice daily and the dogs get an even larger dose (per lb). I offer it not just to reduce gut bacteria, but to help keep dental issues at bay. Four of the dogs have a broken tooth. I have avoided extraction surgery or root canals because I don't want to stress their livers/hearts with anesthetics. The vet dentist said the only reason they "need" root canals or extractions is to prevent infection in the pulp cavity. If I keep them on CS daily, I imagine that keeps infection from setting in, for the most part. It has kept me from picking up viruses and as long as I take it daily, I am flu-free and tonsilitis free and my complexion is better.

Does anyone know how much pregnenolone and progesterone one can offer a dog? Does it matter if they are spayed/neutered/intact/menopausal/etc?

Would offering pregnenolone reduce the need for progesterone?

Does anyone know a lab for doing more elaborate testing of thyroid hormones in dogs? I think the lab my vets use only tests T4. I can't really afford to boost their caloric requirements right now while their living of mainly non-fat cottage cheese and eating 4 times a day to keep weight on. I'm not sure how to navigate treatment with natural thryoid supplements especially if it isn't easy to find a consistent dose. I had a bad reaction to Armour, so I hesitate to use it in pets who can't voice their experience. How has this gone for other pet owners?

Since dogs affected by pancreatitis don't seem to be able to tolerate oils/fat, Progest E is not a good option for oral supplementation. Topically it's sticky and messy. I may be able to find a less oily topical (suggestions?) or a low fat oral version (suggestions?) to play ith but how can we test levels in a pet to ensure we are not causing harm?

So many questions. I'd love to explore the answers with the fine folks here.

=)