Tuesday, February 11, 2014

Savannah's Pancreatitis

by  Krista Magnifico, DVM

In order to accurately portray the magnitude of the severity of this story I need to first introduce you to my dog Savannah. She was adopted by us in the fall of 1996. We had just adopted Ambrose, who my sister had rescued off of the streets of NYC 2 months ago with a compound fracture to his right femur. He was about 6 months old.  He needed a friend and we were looking to adopt another dog. As we were walking into my favorite coffee shop I saw a picture of a small beagle mix puppy that needed a home. We called the number on the flyer right away and after a coffee and a quick conversation we headed the three blocks away to a small apartment on the outskirts of campus. Savannah was tied to a small post in their tiny back yard.


She must have weighed about 4 pounds and she was irresistible. 

The other thing that really struck me about my first meeting with her is that she was almost expressionless, like she had been tied out for so long that she had given up being excited about the chance to meet a new person. The college student who had adopted her wasn’t allowed to have a dog and was quickly busted by her landlord for having her. I took her home immediately.

She, (the college student) swears she saw the mom and dad, is a black lab and husky mix. I don’t know who that girl saw at that house but Savannah is a beagle. She looks like a beagle. She walks like a beagle, quacks like a beagle, sniffs like a beagle, well, you know the rest. She also has the belly and nose of a beagle. She lives for food and affection, and in that order. I compare her demeanor to my pet pigs’; I know that she is ready to leave this earth when she no longer begs for food.

She is my constant companion. 

She follows me with unfailing loyalty and is a very obedient, a little bit snobby, aloof girl. She always listens to my commands and she is never a trouble or a worry. She is a thousand times easier than those rambunctious puppies I always write about.


But her obsession with food, man, you have to keep an eye on her about that.

She will take any opportunity she can to steal food. She is so short and old that the only score she ever gets a chance at is the cats food. She is a sleuth at sneaking cat food.  I have to watch her like a hawk and really I should investigate gifting her an ankle bracelet for warnings of entrance into our cat room.

Savannah’s obsession came to full fruition when we had our annual 4th of July party. 

Ambrose (our other dog) had just come home from surgery to remove his spleen and take a kidney biopsy because in the preparation for chemotherapy we had found three “areas of concern” in his belly. Four days later we had about 60 of our friends over to our house to eat a full bar-b-que and pretzel bar.

By the end of the 6 hour soiree Savannah had made the rounds at least twice to every guest. 

Her patient, charismatic determined charm had gotten her about 3 pounds of Italian sausages as hand-outs. Worse yet, I truly had no idea that she had done so much begging and I had no idea my guests, (who all know full well that I am a veterinarian) had given in to her pleadings so readily.

I realized the gravity of my short sightedness the next day when she walked away from her food bowl. 

Two days later she wasn’t getting out of her bed. Now I am a very fastidious observant doting mom and I did see all of her clinical signs and I was alarmed by them. But, I was also watching my 16 year old diabetic die of chronic disease that I should have been able to cure. I was beating myself to an emotional raw pulp and still my cat was dying, and I was coordinating radiation for Ambrose.


As day three was starting, the clinic was calling me to tell me that my kitty was looking “really really bad and needed to be put down.” With tears streaming down my face I drove to the clinic. When I arrived I much too emotionally sat next to my cat and racked my brain as to any answer that might be the miracle to save his life.

I also asked my technicians to run some blood on Savannah.  

Forty-five minutes later I huddled in full blow out hysterics over my kitty as my technician meekly called my name. I knew the minute I saw her face that my bad day was getting much worse.

Savannah’s blood work was disastrous. Simply, disastrous. 

It was one of those moments where the world drives you to your knees you throw your head back, expose your jugular and wait willingly for the ax to fall.

That day I put my beloved orange tabby, who had struggled with diabetes for over 6 years, down. I sat in the treatment area and pushed that pink syringe into my cats arm and just sobbed. To this day, I feel so guilty about him that I still have not completely forgiven myself. When he laid his head down for the last time I had to turn my focus on Savannah. It took every ounce of my failing strength to see her clearly and be able to stay upright in my own hospital.

Savannah’s blood work was so terrible that I didn’t believe it. 

I had every other vet in the clinic look at it. As each of them did, they all looked at the paper, looked at me, and just shook their head. I sent it to my friends at the vet school, I had the lab re-check it, and had it reviewed by a pathologist. It was the equivalent of losing a card game and asking for “best two out of three.” In Savannah’s case her verdict was unanimous.

She had 100% agreement that her numbers were “not compatible with life.”

In typical Italian fashion I jumped in and immediately decided that I was not giving into her terrible odds. It took 3 months to get her blood back to normal. She was on i.v. fluids for three weeks. She also received two plasma transfusions.

Savannah had pancreatitis. 

The severity was undeniably severe, and it was impacting her liver so significantly that there was a very strong possibility that her liver might not survive.

We set up a portable i.v. hospital in our bedroom, and we went from the hospital during the day to the bedroom at night. For three weeks I did not sleep. I willed that dog of mine to live and I know that if she was anyone else’s it would have been very hard to honestly try to persuade them to keep treating. Her cost of care would have been well in the thousands of dollars. It was a bleak picture for a long time.

I have learned that the old adage of “where there is a will there is a way” holds in veterinary medicine.

When your profession has such a limited ability to provide optimal diagnostics and treatment options for so many conditions it helps to be stubborn and determined, as long as your own will isn’t costing your pet the ability to stop suffering.

Savannah is in the last chapter of her life. She is officially a geriatric patient. Without intending to hurt her feelings, I would classify her as “in hospice care.” I hope she is here for a long time still. She is an old stubborn determined girl, just like her mom.

***

Krista Magnifico, DVM owns a small animal hospital in northern Maryland, where she practices everyday. She wants to make quality veterinary care available to everyone, everywhere at any time; trying to save the world 1 wet nose @ a time.  Her blog is a diary of he day-to-day life & the animals and people she meets. 

Dr. Krista is also the founder of pawbly.com, free pet advice and assistance.

To contact her, you may leave a comment on her blog, email her or catch her on Twitter or Facebook.

Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke 
Parvo: Cora's Story 
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma
The Ear Ache That Wasn't Going Away: Tottsie's Story
Cody's Eyelid Tumor
Ruger's Mysterious Illness
The Day The Heart Stood Still: Timber's Story 
Different Definition Of Comfort Food: Levi's Story
The First Seizure: Honey's Story  
Savannah's Cognitive Dysfunction Diary 

Related articles:
The Project That Is Cookie: Pancreatitis Up Close And Personal 
The Perplexities of Pancreatitis 
The House Is On Fire! Bridget's Pancreatitis
Holistic Look At Pancreatitis
Dog With Pancreatitis In Critical Condition

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