May 7, 2020

White Dog left with Steve early this morning for her scheduled dental. I kissed and held her as I whispered love, hurry homes, and don't forget my note for Dr. Julia. Then they were gone.

Dr. Julia called midmorning. There was no dental. In the pre-surgery check and in answer to my letter of questions and concerns, she discovered Siku has what she thinks is a pancreatic abscess the size of a soft ball resting between her stomach and small intestine. THIS is why she is not eating; there is no room for food. Our brilliant vet is consulting and researching the most up-to-the-minute treatment.

After Dr. Julia’s call with preliminary findings about Siku’s failure to eat. I looked up Pancreatic Abscess and my heart sank at the treatment and survival rates. Dr. Julia and I exchanged information several times across the day as we gained knowledge in our differing avenues of research; our information agreed agreed but my amazing wonderful vet had done some out of the box thinking and went back to Siku.

She did several more fine needle aspirations at different locations and ran each individually, then looked at the samples under the microscope. She found some anomalies that did not perfectly fit the literature on pancreatic abscessesShe wondered if there was perhaps ANOTHER possibility that fit closely but included some of the things that did not match (like it was not pus withdrawn with the needle but brown fluid). 

A pseudocyst, not an abscess, seemed like an even closer fit of the symptoms. Both are VERY similar and rare; both demand to be taken seriously.  Treatment and recovery options are MUCH more favorable for this. (BIG momma sigh of relief).

Pancreatic pseudocysts are non-epithelial lined cavity lesions filled with fluid containing pancreatic cells and/or pancreatic enzymes. They are a common complication of acute or chronic pancreatitis in humans, and are seen less frequently in dogs and cats.

Clinical signs are usually nonspecific and mimic those of pancreatitis. On abdominal ultrasonography, a cystic structure in close proximity to the pancreas can be identified. Aspiration of the pseudocyst is relatively safe and should be attempted for diagnostic and therapeutic purposes. Fluid from a pancreatic pseudocyst should have few cells and should not contain any evidence of inflammation. Pancreatic pseudocysts can be treated medically or surgically. Medical management involves ultrasonographic-guided percutaneous aspiration and close monitoring of the size of the pseudocyst.

Siku is home now and has begun a course of antibiotics as well as a strict liquid diet. She is pretty wiped out from her experience and not excited by the bone broth offered for her dinner. But she made me smile by managing to choke down two tiny bites of cheesecake, one of her favorite desserts.

On Monday she will return to Dr. Julia who will use ultrasound to guide the drainage of the bubble and receive antibiotics via iv. It should be day surgery and then she can come home. But the thought is that the beginning of the week gives us the week to bring her into vet and track progress without interruption of weekend.

Since this condition can return and is a result of pancreatitis, Siku will likely need regular checks of her pancreas enzyme levels to avoid further issues.  Paws and fingers crossed and asking all of the Rainbow Bridge Army to look over their leader, THIS will be the solution and we will not need to fear abscess.

Please send your amazing powerful positive thoughts. Unlike early, tonight we have hope.