Pancreatic Encephalopathy

[Juan61]

Hi everyone, I am new to this site having found it frantically searching for information on pancreatic encephalopathy. I took possession of a female border collie due to her having a terrible skin condition. She is my first ever dog, and a beautiful soul. She is 10 years plus, we don't really know how old, her name is Molly. To cut a very long story short, her skin is now beautiful but she contracted pancreatitis which has led to the brain injury.

She was treated rather aggressively with antibiotics, anti-inflammatory drugs and cortisone (Macrolone). At first she was on 20mg macrolone twice a day; this assisted greatly and she was doing quite well. The cortisone of course has caused other issues, excessive hunger etc, and sadly incontinence. I am managing this though, with a little trial and error I finally have a system that works!

The problem now is the vet has cut the cortisone back to one tablet a day and the effect is breaking my heart to be honest. She is very disorientated and the weakness in her legs has returned. I got so distressed at her state yesterday that I gave her another cortisone tablet last night and the effect was immediate. She is much more stable this morning.

My dilemma is of course is what to do now. I cannot keep her on such a high dose of cortisone but don't see how I can allow her to be in the state she is without it. I don't want to do the wrong thing by Molly; as I said, she is such a beautiful girl, and I can't believe how much I love her being that I have only had her for a couple of months.

Has anyone been thought a situation such as this? Does anyone know of alternatives to the cortisone? Is there anything else I can do?

I would really appreciate any advice. Thank you

[persephone]

Welcome , but I am sorry it is under such a sad circumstance.

Have specialists seen Molly ? Uni vet hospital or someone, or is this a 'GP' vet?

I don't know about her condition ....but will be thinking of you ,and hoping you can find answers.

[JRG]

I am sorry to read about your girl.

It is not good to alter the dosage of cortisone really quickly - so you could try cutting it down very slowly.

ie cut the tablets in quarters (yes I know it is a pain as they are so small) and give her one & three quarters, then drop that to one and a half and so on until you find the minimum dose that will control her condition.

I have done this with a young boy with auto-immune gastric problems and eventually got him down to a quarter every third day - it took ages (about three months) but it was worth the effort.

[persephone]

It is not good to alter the dosage of cortisone really quickly - so you could try cutting it down very slowly.<br style="color: rgb(34, 34, 34); font-family: verdana, tahoma, arial, sans-serif; line-height: 18px; background-color: rgb(238, 242, 247);">ie cut the tablets in quarters (yes I know it is a pain as they are so small) and give her one & three quarters, then drop that to one and a half and so on until you find the minimum dose that will control her condition.

YES!!!!

..and not just a few days, either . If the vet did a sudden halving of dose ..perhaps find another vet?

[Juan61]

Welcome , but I am sorry it is under such a sad circumstance.

Have specialists seen Molly ? Uni vet hospital or someone, or is this a 'GP' vet?

I don't know about her condition ....but will be thinking of you ,and hoping you can find answers.

Thank you, and no specialists. I live rural so definitely a local vet. I guess I'd have to take her to Brisbane but in all honestly, cost is a factor there. Thanks for the kind words

[Juan61]

I am sorry to read about your girl.

It is not good to alter the dosage of cortisone really quickly - so you could try cutting it down very slowly.

ie cut the tablets in quarters (yes I know it is a pain as they are so small) and give her one & three quarters, then drop that to one and a half and so on until you find the minimum dose that will control her condition.

I have done this with a young boy with auto-immune gastric problems and eventually got him down to a quarter every third day - it took ages (about three months) but it was worth the effort.

Thanks for letting me know that; you made me remember what I had to do to slowly wean my cat off cortisone some time ago. In all of my stress I just forget and when the vet said to drop the dose I did. I will start that immediately. Thanks again.

[Mad Mary]

It is not good to alter the dosage of cortisone really quickly - so you could try cutting it down very slowly.<br style="color: rgb(34, 34, 34); font-family: verdana, tahoma, arial, sans-serif; line-height: 18px; background-color: rgb(238, 242, 247);">ie cut the tablets in quarters (yes I know it is a pain as they are so small) and give her one & three quarters, then drop that to one and a half and so on until you find the minimum dose that will control her condition.

YES!!!!

..and not just a few days, either . If the vet did a sudden halving of dose ..perhaps find another vet?

So sorry that you are going through this with Molly. I am not a vet or a medical professional but I have had first hand experience using cortisone long term with my heart dog who had severe arthritis when other drugs were no longer suitable/working and my son who suffers from IBD. In many ways it can be a wonderful drug but, as you have said, it can cause other serious problems and be extremely difficult to get off.

Definitely agree with reducing the cortisone slowly. I was able to work with my vet to reduce the cortisone level gradually but maintain two doses per day which we found she did far better on over the 24 hour period until we found the minimum dose that gave her quality of life for just over a year.

Have you spoken to your vet and told him what has happened when you reduced the dose? I could be wrong, but from my quick "google" search this morning it seemed pancreatic encephalopathy was not that common. If you are in any doubt about Molly's treatment a second opinion from a specialist may be helpful.

Wishing you and Molly strength to get through this together.

Just read your posts Juan61 and see you are not in a position to see a specialist - sorry

Edited March 18, 2013 by Mad Mary

[shirra]

I'm so sorry to read of your dilemma. It must be heart-breaking. Please keep us posted on poor Molly's progress.

[Juan61]

Many thanks everyone for your help. It appears cortisone is the only treatment, I will be talking to the vet today re dosage etc.

I'm so pleased I found this site. I was never a dog person, but living rural has made me see just how wonderful they are. I know Molly is probably not long for this world, I won't regret having her, and I guess I will get another dog which is nice.

Thanks again

[Tassie]

Sorry to hear about Molly's problems - but seems like she has worked her magic on you and turned you into a dog person - welcome to the joy, craziness and sadness.

[Staff'n'Toller]

Your Vet should be quite happy to send all your girl's history and pathology tests to a specialist in the city and you should be able to do an email or skype consult without having to take her there.

Unless of course, she needs specialist imaging - but for a second opinion, or reassurance on the treatment plan - most specialists offer distance consults.

If you can't find one in your State that will, email further afield, I'm sure you'll find someone in Sydney or Melbourne but I doubt you'd need to look that far. :)

Otherwise, keep your Vet informed via phone of how she's going and what you've noticed, so that you can come to an agreement on an effective dose for her. :)

[bianca.a]

Yes I definitely agree with Staff'n'Toller, if your vet wont discuss this with a specialist, email them yourselves. I'm sure between all of us here, we can give you names.

I am so very sorry to read about your Molly and I wish you both all the best ((hugs))

[*Avanti*]

Many thanks everyone for your help. It appears cortisone is the only treatment, I will be talking to the vet today re dosage etc.

I'm so pleased I found this site. I was never a dog person, but living rural has made me see just how wonderful they are. I know Molly is probably not long for this world, I won't regret having her, and I guess I will get another dog which is nice.

Thanks again

Has the vet discussed diet with you? My dog had pancreatitis a few years ago and recovered. She is now on a very low fat diet for life and doesn't require medication but Molly's case must be different. I hope you find more answers and Molly's condition improves. It could be worth getting a second opinion.