# Kody's 2nd opinion - long!



## Nana52 (Apr 28, 2012)

We went to my former vet (oh, how I've missed her) for a review of all Kody's lab results. She spent a lot of time with us, patiently listening as I relayed the whole long story about all that had transpired since March, asking questions, taking notes. Then she said “the pancreas is an awful little organ, I just hate it, but it's not something to take lightly.”

Her opinion in a nutshell is this. While it's true the lipase level on a routine chemistry panel is not specific to the pancreas, and it may be skewed somewhat based on what/when he ate, given his history, she feels pretty strongly that this is likely pancreas related. When a dog has one episode of pancreatitis, they are very high risk for repeat episodes - not all, of course, but the majority - and that it can often no matter what you do. Said she'd had a couple of really bad cases in recent months and had done a lot of extra reading up on it herself. It's near impossible to pinpoint the exact cause ... pancreas issues affect the liver, liver issues affect the pancreas, what comes first and why is a subject of much debate. One big thing she said she learned was that the combination of phenobarbital and potassium bromide is a huge risk factor, so she was very glad I elected not to give him the potassium bromide prescribed that other vet. She did say, in the other vet's defense, this didn't seem to be a well known (maybe someone has just made the connection??) and she herself had not been aware of it until recently.

Since he doesn't have “active” disease at the present time, she didn't think much would be gained by doing the pancreas specific testing right now and said her recommendations would remain the same regardless.

Her recommendation was that I continue what I'm doing, especially as regards slowly, slowly lowering his phenobarbital, the goal being to control his seizures (she was amazed that he's gone as long as he has without one) on the lowest dose possible, that I continue to monitor/control his fat intake, using the leanest cuts of meat I could manage with skin and visible fat removed, didn't feel that supplements; i.e. probiotic/digestive enzymes would be of any real benefit. And …. WAIT FOR IT …. she said she had no problem whatsoever with me feeding raw! She said it makes sense to her that raw meat would be easier to digest; however, her one request was that I do just a quick sear on the outside, since he is compromised better to err on the side of caution, but raw and bloody inside, she has no problem with. I showed her the feeding-dogs-with-pancreas-issues in Lew Olsen's (?) book, and she got very excited when she saw one “recipe” that included beef heart. She said beef heart with the chunks of fat removed would be very lean and very nutritious, but she didn't know if I could get it here. I told her I absolutely knew where to get it, and she said awesome! I know I'll need to do introduce that slowly, but what a relief that she's on board with me. 

I didn't go there for the purpose of other vet bashing, but I did say something like - I'm sure Dr. Whosit is a good vet, she's doing what she was trained to do, but it's exhausting debating with her about vaccinations and flea prevention and what to feed, yada, yada. She said said something like - we're here to help, and we all have an opinion, but if you don't agree, just nod your head, say thanks for the advice, I'll take it under advisement, but then you decide what you think is best for your dog.” Did I mention I've missed her so?

So bottom line: Lower seizure medication as much as possible (aiming for totally off, but may not be possible), lightly seared/otherwise rare/low fat diet, recheck in 90 days, hope for the best, but be aware that he is at risk for recurrence and we'll deal if/when that happens.

At the end of our appointment, she hugged me, said she understood why I was going to other vet due to transportation issues, but to call her any time and she'll help in any way she can.

Whew! Thanks to all who made it to the end of this diatribe.


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## xellil (Apr 4, 2011)

I know why you miss her. I had a vet like that in Indiana and I'm still looking for one half as good.

And the fact that she supports raw feeding should put your mind at ease quite a bit


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## Nana52 (Apr 28, 2012)

xellil said:


> I know why you miss her. I had a vet like that in Indiana and I'm still looking for one half as good.
> 
> And the fact that she supports raw feeding should put your mind at ease quite a bit


I surely does. I was so dreading broaching the subject with "other vet." She more or less blamed me for him getting sick to begin with. Like I need that.

While the visit didn't really result in what one would call "great" news, at least my questions were answered, and I have a better idea what I'm dealing with. Besides which, Kody and I had a long talk, and I made him promise to not get sick. Dogs .... whatcha gonna do?


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## MollyWoppy (Mar 19, 2010)

Yeuup, I sure wish I had a vet like this one. Seriously, I'd consult her about everything, she thinks outside the box. Ask her if she wants to relocate to FL, I'd be very happy to have her down here!


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## xellil (Apr 4, 2011)

Even though she supports it, unless she feeds true raw to sick dogs I doubt she realizes the real miracles it can work. 

Snorkels is a shining example of that. She would either be dead or in constant misery without it and I don't think I'm exaggerating. I have faith that the pancreatitis will not recur.


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## Nana52 (Apr 28, 2012)

MollyWoppy said:


> Yeuup, I sure wish I had a vet like this one. Seriously, I'd consult her about everything, she thinks outside the box. Ask her if she wants to relocate to FL, I'd be very happy to have her down here!


I have hard enough time getting to her way the other side of town, no way she's going to FL. She pretty young, only been in practice about 5 years, and in her own words "country as a dirt clod." 

I know the searing is not entirely in the spirit of raw, but I'm okay with her "erring on the side of caution," still more supportive than I dared hope for. If he continues to do well and his numbers look better on next check, maybe will go 100% then. In the meantime, I'm comfortable with her advice.


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## creek817 (Feb 18, 2012)

Sounds like good news to me =) Did she have a reason for wanting you to sear the meat? Like, a medical reason? It doesn't seem to me that searing does much other than make things difficult for you. JMO. But very good that you got to see her, and she's so supportive.


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## Nana52 (Apr 28, 2012)

creek817 said:


> Sounds like good news to me =) Did she have a reason for wanting you to sear the meat? Like, a medical reason? It doesn't seem to me that searing does much other than make things difficult for you. JMO. But very good that you got to see her, and she's so supportive.


She wants to kill surface bacteria, just to be on the safe side, due to his liver/pancreas not being completely normal. For this same reason, she advised again ground meat, which I wasn't planning on using anyway.


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## creek817 (Feb 18, 2012)

Gotcha. I guess that's an okay reason. As far as I know, you could also spray the meat with ACV to kill bacteria. If you were interested in an alternative =) If not, I still think you're doing the best possible for Kody, and he is a very lucky pup =)


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## Nana52 (Apr 28, 2012)

creek817 said:


> Gotcha. I guess that's an okay reason. As far as I know, you could also spray the meat with ACV to kill bacteria. If you were interested in an alternative =) If not, I still think you're doing the best possible for Kody, and he is a very lucky pup =)


I think I've heard that about ACV also. I'll probably do that for his small bone-in meals, since heating and bone are a no-no, but the searing takes literally 2 minutes from turning on the heat under the pan to taking meat out of pan. That I can handle. 

It seems that neither dog is going to require much bone, poops looking good with mostly boneless, not that either is producing much poop. That's a good thing, right?


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## magicre (Apr 7, 2010)

for newly transitioning dogs, i think that searing the meat is fine, especially if it makes you feel better about your dog's condition and the ability to whack those germs out of existence.

once he does transition, there won't be a need to sear....mainly because bacteria is simply not just on the surface.....we cook it out. dogs have an immune system that is so preventative....it really is.

but, considering all that you've been through and glad i am that you went back to this vet, searing certainly won't hurt what you're about to do....

i'm glad you went, i really am. i hope this gives you some comfort about feeding raw....

and, whilst i would not feed pork hocks, necessarily due to the high fat content, working your way up will be better for him in the long run.....i don't feed all of the fat to my dogs, even now...but i did learn the hard way that they need fat....so i cut some off, not all....and make cubes for when they are eating things like rabbit or very very lean meat.

fat makes dogs function.....and it is burned first so the protein can do its thang.


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## Nana52 (Apr 28, 2012)

Thanks to one and all. I do feel bit more calm now. As you can see, Kody is pretty bummed out about the whole thing


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## Nana52 (Apr 28, 2012)

magicre said:


> and, whilst i would not feed pork hocks, necessarily due to the high fat content, working your way up will be better for him in the long run.....i don't feed all of the fat to my dogs, even now...but i did learn the hard way that they need fat....so i cut some off, not all....and make cubes for when they are eating things like rabbit or very very lean meat.
> 
> fat makes dogs function.....and it is burned first so the protein can do its thang.


I get what you're saying about how dogs need/use fat. But before they can use it, it's gotta be processed/broken down, right? And he's not doing that right now. I'm hanging on to the hope that if I can keep him healthy and that his numbers will be improved next time (wouldn't normal lab work be awesome ... gal's gotta dream) that I can start to slowly slowly slowly add some fat back in. Just trying to take it a day at a time.


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## magicre (Apr 7, 2010)

Nana52 said:


> I get what you're saying about how dogs need/use fat. But before they can use it, it's gotta be processed/broken down, right? And he's not doing that right now. I'm hanging on to the hope that if I can keep him healthy and that his numbers will be improved next time (wouldn't normal lab work be awesome ... gal's gotta dream) that I can start to slowly slowly slowly add some fat back in. Just trying to take it a day at a time.


you may never get normal lab work. few people or dogs do.

but if the fat isn't somehow being processed or broken down, dog catabolises protein, then dog dies.

your dog looks nice and healthy. fur looks good...i imagine IF there is skin under all that fur, it looks good. that would be a sign of unhealth. 

if the fur were dry and brittle, i might agree, but it isn't.


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## magicre (Apr 7, 2010)

i read for humans, at least, that fish oils can actually cause blood liver enzymes to rise.....which means nothing, actually. but it can skew the numbers.

i dread going in for my blood work with all of the supps i take....LOL


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