From:
Melissa Litwicki
Date: 2002-10-07 17:45:20 UTC
Subject: Puff, insulinoma, splenectomy, recovery
To: "'ferrethealth@smartgroups.com'" <ferrethealth@smartgroups.com>
Message-ID: <Pine.BSO.4.44.0210071326540.23041-100000@naughty.monkey.org>
A few days ago I posted about Puff, a 6yo who has recently undergone a
spleen removal, lump removal, and insulinoma surgery. She was experiencing
post-surgical pain, displayed by tooth-grinding, trembling, glassy-eyed
staring, and what I term 'pain escape' running - darting around a room
trying to find a bedding spot that 'doesn't hurt'.
Puff is being weaned off prednisone, has dropped a considerable amount of
weight, and has sticky, dark stool. She has an appetite, but after a
small amount of eating, starts grinding her teeth. I started giving her
Pepto Bismol (.5 2x/day) last night, and that seemed to improve her
interest in food almost immediately, and lessen the pain that seemed to
accompany eating.
Today we went to the vet, who speculated that pancreas irritation caused
by the insulinoma removal could be responsible for a lot of the digestive
upset, while admitting that an ulcer was a strong likelihood as well. She
gave me sucralfate in suspension (.1ml 2x/day), amoxicillin (.5ml 2x/day)
even though she doesn't typically like to dispense antibiotics, and a
narcotic (sorry, can't remember the name, starts with a t and the bottle's
at home) to have around to dispense up to 2x/day, but mostly 'as
necessary' to deal with pain. She noted that a narcotic would, of course,
make her drowsy and might affect her eating, so to try to keep her pain
managed while also keeping her appetite up would be important.
The vet also commented that high fat levels irritate the pancreas, and to
try to stay away from excessive amounts of fat until she is further along
in the healing process. As stated above, after .5ml Pepto last night and
this morning, Puff had an improved appetite and mood. Her color (nose,
gums, tongue, foot pads) is good, she isn't dehydrated, and abdomen
doesn't seem to be causing her as much discomfort - which is good, meaning
the surgical area should be healing.
We'll see how the sucralfate helps and I'll post when we have the
pathology report on the lump they removed. The vets are also going to
consult about doxorubricin as an insulinoma therapy (Puff had a suspected
insulinoma that couldn't be removed due to proximity to the pancreatic
duct) and discuss starting a diazoxide therapy sooner rather than later.
Thanks,
Melissa