Maestro: Pancreatitis and Cushings - Now Regurgitation??

[joguerr]

Hi all. After being diagnosed with Cushings several months ago and put on trilostane, Maestro went downhill. Vet determined he also had pancreatitis (spec cPL test) and put him on antibiotics. I didn't realize that wasn't the best course and Maestro vomited five times in one day. Finding this website one night last week spurred me on to get a specialist for my 10-year old love, Maestro (beagle).

Internist at hospital admitted him, immediately stopped the trilostane, and attacked the pancreatitis as well as high kidney values (thought to be an infection vs. disease). After four days in the hospital, Maestro's stomach pain was gone, no vomiting, began eating and was well enough to send home. She sent him home with oral meds: ondansetron (anti-nausea), clavamox (antibiotic), Royal Canin low-fat food and decided he could start trilostane again. It was also determined that his trilostane dosage was too low (an 18 on stim test taking 20mg) which explains why he still had Cushings symptoms.

All was good last Friday when he came home. On Saturday he vomited once. Once Sunday he vomited twice....always after eating, usually after the first feeding (and taking the bulk of his meds). Took him back to the hospital yesterday. No pancreatitis but vet thought perhaps a better cocktail of meds was needed. He came home with ondansetron, omeprazole (for night-time acid) and alternagel (aluminum hydroxide) because of his phosphorus level. No antibiotics and no trilostane.

Maestro's appetite is good. His demeanor has been fair, given that he has Cushings which has made him lethargic and a bit disinterested. He vomited after eating yesterday. Did not feed him the rest of the day. Today he was brighter and hungry. Gave him ondansetron with a small bit of food and then very small meals all day. He did well until this evening, when he vomited twice (after taking ondansetron). Vet said earlier today that he isn't really vomiting - it's regurgitation - since it is undigested food and occurs after eating.

It looks like I'll be taking him back to the hospital tomorrow so they can rule out issues in his esophagus?

Has anyone had any complications like this? I'm so distraught and feel at moments that my darling is slowly slipping away!

Sorry for the long-winded email but this is the only place I've found for information and people who understand!

Jo

[doxiesrock912]

Jo,

I wonder if the frequent vomiting has affected his esophagus, making it irritated? There is often acid present with frequent vomiting and definitely can cause damage.

Did they instruct you to give him a bland diet? Since he hasn't been able to tolerate his normal diet, Maestro should be on a bland diet such as boiled chicken, hamburger, and rice. Canned pumpkin from the baking aisle is great for coating the stomach. Gradually mix in his normal food over the course of a week or two.

Try the pumpkin, just a few teaspoons full and see if that helps at all.

I would at least call the specialist first thing in the morning.

[Spiceysmum]

Hi Jo,
Have you tried raising Maestro's feeding bowl? My dog Brin (who doesn't have cushings) had serious problems with regurgitation a couple of years ago after being ill with internal bleeding. He brought up every meal as soon as he had eaten it. We raised his bowl about 12" off the ground and it stopped more or less straight away. Hope it works for Maestro as I know how hard it is to see them ill and losing weight.
Linda

[goldengirl88]

Hello and welcome to you. Sorry your baby is having so many problems. Firstly is the dosage to high making you dog vomit from the trilostane?? That is the first thing I would be concerned about. The second thing like Valerie said food coming up in the esophagus can cause lesions and they burn and become worse after time. I know this as my Tipper eats and within minutes some of it comes back up in her mouth. She did this prior to Cushings though. Has your dog done this prior to Cushings? I use Manuka honey with Tipper every day. She get like a 1/4 teaspoon. It is a wonderful healer, and the vets told me that is probably the reason she has no lesions form the acid in her esophagus. Maybe it is the Royal Canin. Did you dog eat this before? How quickly did you transition him onto this new food? Maybe this food does not agree with him. Have you tried the boiled chicken and rice? If so what happens then? I hope you can get this straightened out so your baby is feeling better. Blessings
Patti

[Renee]

I think I would have withheld all trilostane until all symptoms of his other issues were completely resolved. If he was suffering from other ailments, then your ACTH could have been affected by those issues, and not the cushings, meaning the results would be invalid. Then you increased his trilostane, which could be causing some issue too.

The idea of elevating the bowl is a really good one. I have my pugs bowls elevated too. It really helps with digestion. And, if he's been vomiting so much, I imagine his esophagus must be irritated, as was already suggested.

Finally, I think Valerie is right on the diet. Go with a bland diet and a bit of canned pumpkin (not the pie mix with the spices).

[lulusmom]

Hi and welcome to you and Maestro.

It would be a great help to us if you can set some timelines for us as well as provide reasons for you and/or your vet to suspect cushing's, such as abnormal blood chemistry, symptoms, physical appearance such as thinning coat, pot belly, etc. Can you tell us which tests were done to confirm the diagnosis and whether Maestro has pituitary dependent disease or an adrenal tumor. Can you share the results of those tests with us?

When was Maestro diagnosed and was he experiencing any sickness at that time. When did you start treatment with Trilostane and how long after initiating treatment did Maestro get sick? Were any acth stimulations test done before he was diagnosed with pancreatitis and if so, can you post the results of those test(s). I'm sorry for asking so many questions but even though Beagles are a breed that seem to gave a genetic predisposition to cushing's, it's also a disease that is frequently misdiagnosed, especially if there is an undetected nonadrenal illness present at the time of diagnosis. The more information you can provide, the better able we will be to offer meaningful feedback and appropriate references that can help guide you.

I'm sorry that your boy is going through such a difficult time as I know how difficult it is to watch your precious pup's health decline; however, I'm glad you found us so that we can all try to get Maestro's wheels on the right track to a much better quality of life.

Glynda

[Harley PoMMom]

Hi and welcome to you and Maestro from me as well! Pancreatitis can be a bugger to get under control. My boy, Harley, had chronic pancreatitis which I could never really get a handle on.

I did find that when the pancreatitis was flaring that giving him several small meals throughout the day was best. Boiled/roasted Chicken breasts that are fat-free, skinless, and boneless along with very over cooked rice seemed to agree with his tummy. Keeping them hydrated is important too so I would add water to almost everything Harley ate.

Pancreatitis is very painful and medication for pain is needed.

Hoping Maestro is feeling much better soon, please do keep us updated.

Hugs, Lori