hemorrhagic pancreatitis- pain med question

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SpecklesandMe

SpecklesandMe

Member Since 2015
Hi all,
We're freaking out because we haven't been able to get my cat's diarrhea under control. I'm new to the forum- so I don't have an excel sheet yet, but his last BG was 304 and he had trace ketones in urine. Diarrhea has been ongoing for a week and a half. I have tried pumpkin (no effect), 1/4 tsp psyllium husk for 3 days (poo went from liquid to pudding-ish), Imodium (terrible side effects and little impact on the diarrhea), Fortflora, Pet Ultimates Probiotics for Cats, and kaolin/pectin solution. The last 3 things in my list were started yesterday morning, but he had diarrhea again at midnight and 4am.
We had bloodwork done on Fri and his sodium, potassium, and chloride all looked fine. The diarrhea smells bit acidic though.
Not sure what else to try? If the kaolin/pectin is going to work, will I see the results today? I am desperate to get this under control because he hurt his leg on Fri and is limping, which I think is keeping him from drinking as much water while he has the diarrhea- worried about dehydration.
Thanks much!
AJ
 
Thank you! I'll get the Pedialyte. I was doing 1.5 tablespoons pumpkin 2x per day with no effect. If he had pancreatitis, would he still be eating and hungry a lot?

Also, in the past when he's had diarrhea, the only thing that's helped has been Hill's W/D canned food. But now he's on a high protein, low carb diet. Would it be safe to give him a can of W/D and then get BGs before and after, and give him like .25u extra Lantus to handle it if there' s a big increase in BG?
 
Hi AJ,

Keep an extra close eye on his BG if you're adding fibre to the diet - it can have a lowering effect on BG levels and you may need a dose adjustment.

Based on what I've learned in the past year, pancreatitis flares are usually accompanied by reluctance to eat but every cat is different (and my knowledge is limited). If it is something you're concerned about then I'd recommend discussing it with your vet.


Mogs
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The vet can give you Flagyl or Panacur. Probiotics can help -- my vet suggested plain yogurt but I never tried it. I've just bought Jarrow Formulas 15 Billion CFU probiotic pills but they will take a couple of days to kick in (dose is half a capsule).

Sounds like that amount of pumpkin would have helped if it was going to work. Are you still giving psyllium? Seems like that helped a little, so maybe he just needs some more days of it.

Not to alarm you, but pancreatitis or lymphoma can cause diarrhea. I don't know a lot about them but if it were me, I'd call the vet and ask if he/she thinks either of those might be the cause.

Also, I'd go ahead and give the W/D. It's not ideal in terms of carbs, but if there's something else going on (IBD, pancreatitis, etc), it's more important to get those under control. As you said, the dose of insulin can be adjusted if need be.

Good luck and let us know how it goes.
 
Thank you all so much! I will try the suggestions and post an update. You're all so helpful!
I was at the vet on Fri, and based on his labs, the vet didn't think it was likely to be pancreatitis, but I've read a lot about it now and I'm not sure how he drew that conclusion. He didn't run an fPLI or anything. I am kicking myself for not pushing them to run more tests. It's really hard to get my kitty to the vet because it stresses him to the max and he hardly lets anyone touch/examine him. Even with Feliway, herbal sprays, Rescue Remedy, etc. he still freaks out. That's why we tried Xanax a couple weeks ago. He had bad neurological side effects to it, and the day gave him the first pill is the day the diarrhea started. I wondered if it was the Xanax for a while, but it seems like it would have gone away by now if that was it.
 
SpecklesandMe said:
... we tried Xanax a couple weeks ago. He had bad neurological side effects to it, and the day gave him the first pill is the day the diarrhea started. I wondered if it was the Xanax for a while, but it seems like it would have gone away by now if that was it.
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I don't know whether or not this might be helpful to you but a few months back Saoirse had a minor pancreatitis flare triggered when a specialist put her on a buprenorphine pain relief trial to see whether it would help reduce the inflammation in her pancreas. Saoirse is very med-sensitive. Prior to the start of the trial Saoirse had been fairly perky and in pretty good form. On the first day of the trial, I gave her two of the higher doses of buprenorphine prescribed. I woke the following morning to find I had a very, very poorly cat. Needless to say I stopped administering the bupe. It did take her a while to recover.

I wonder whether other meds might irritate the pancreas? I'd suggest discussing whether the Xanax might have been a trigger of some sort with your vet.

Mogs
.
 
That's a very good question. I will ask but I have a feeling the answer is going to be that they don't know if Xanax could have done that. I can't believe how few answers I have for how many tests we have run!
 
SpecklesandMe said:
Hi all,
We're freaking out because we haven't been able to get my cat's diarrhea under control. I'm new to the forum- so I don't have an excel sheet yet, but his last BG was 304 and he had trace ketones in urine. Diarrhea has been ongoing for a week and a half. I have tried pumpkin (no effect), 1/4 tsp psyllium husk for 3 days (poo went from liquid to pudding-ish), Imodium (terrible side effects and little impact on the diarrhea), Fortflora, Pet Ultimates Probiotics for Cats, and kaolin/pectin solution. The last 3 things in my list were started yesterday morning, but he had diarrhea again at midnight and 4am.
We had bloodwork done on Fri and his sodium, potassium, and chloride all looked fine. The diarrhea smells bit acidic though.
Not sure what else to try? If the kaolin/pectin is going to work, will I see the results today? I am desperate to get this under control because he hurt his leg on Fri and is limping, which I think is keeping him from drinking as much water while he has the diarrhea- worried about dehydration.
Thanks much!
AJ
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We've just been through this with Morrigan, SpecklesandMe. She also had blood and mucus. We had her to an ER vet clinic and paid a fortune to find out that was colitis and the food as a cause.

Call your vet and get a script for Metronidazole (Flagyl). Guaranteed to clear it up within 24 hrs. No side effects for Morrigan or my dog...who also had to go onto it.

Did you change foods?
Canned food too high in fats?
Too quick a change of foods?
Went from kibble to canned food?

Make note of the batch number of the foods that you've fed and call the manufacturer.

You're going to need to figure out what caused it and if it's not pancreatitis (I doubt it too) then, it's food related...maybe even a sensitivity to something like chicken???

But, Flagyl (Metrodinazole sp?) works! Pumpkin and psyllium didn't do a thing to help nor, did probiotics like FortiFlora.
 
One thing to be aware of: Flagyl can have a side effect of causing vomiting and loss of appetite in some cats (that happened to my cat Marshmallow after two doses). But it definitely works. It usually takes about 5 days/doses for the cat to be regular again after starting Flagyl.
 
Thanks, Louellen and Granadilla! I only changed the food after the diarrhea started. I just caved in and gave him W/D canned and we are planning to adjust his insulin dose accordingly. He's had two reasonable poos since we gave him W/D last night and this morning. I am trying to figure out how to rehydrate him but can only find Pedialyte that has dextrose (aka glucose). Any ideas?
Thanks again!
AJ
 
The W/D took care of his diarrhea thankfully (4 pretty normal poos and counting!). Phew! We are watching his blood glucose. But I just got a call from the vet. He was on Orbax 2.5 weeks ago for a suspected UTI. There were rods in his urine, but it was not clean capture (I collected it at home). I was hesitant to put him on it to begin with because of the non-sterile collection method, but the vet convinced us to do it.
On this past Fri, I gave them a new urine sample (again collected from home- this time with brand new no-sorb litter and in a new litterbox). There were leukocytes in it; so they sent out a culture and sensitivity. It came back as E. Coli and the vet wants him on a new antibiotic starting today. So, I am hesitating again b/c: 1) we've barely gotten his diarrhea under control and I don't know if the W/D will keep helping if he's on an antibiotic; 2) are we really sure he has an infection when the pee was collected at home? I know I used a new litterbox, but it could still be contamination, esp since he won't let me clean his bum and had been having diarrhea. Do I want to reload him on antibiotics if we're not sure? I don't know the cost-benefit ratio here.
We were hoping to transition him back to his high protein food slowly starting Fri, but if we put him on the antibiotic, I won't feel safe taking him off the W/D til he finishes all the antibiotic.
Not sure what to do... Advice or any other thoughts?
Thanks so much for all your support!
AJ
 
SpecklesandMe said:
The W/D took care of his diarrhea thankfully (4 pretty normal poos and counting!). Phew! We are watching his blood glucose. But I just got a call from the vet. He was on Orbax 2.5 weeks ago for a suspected UTI. There were rods in his urine, but it was not clean capture (I collected it at home). I was hesitant to put him on it to begin with because of the non-sterile collection method, but the vet convinced us to do it.
On this past Fri, I gave them a new urine sample (again collected from home- this time with brand new no-sorb litter and in a new litterbox). There were leukocytes in it; so they sent out a culture and sensitivity. It came back as E. Coli and the vet wants him on a new antibiotic starting today. So, I am hesitating again b/c: 1) we've barely gotten his diarrhea under control and I don't know if the W/D will keep helping if he's on an antibiotic; 2) are we really sure he has an infection when the pee was collected at home? I know I used a new litterbox, but it could still be contamination, esp since he won't let me clean his bum and had been having diarrhea. Do I want to reload him on antibiotics if we're not sure? I don't know the cost-benefit ratio here.
We were hoping to transition him back to his high protein food slowly starting Fri, but if we put him on the antibiotic, I won't feel safe taking him off the W/D til he finishes all the antibiotic.
Not sure what to do... Advice or any other thoughts?
Thanks so much for all your support!
AJ
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I can only answer what I would do in this situation....and that may or may not be right or possible for your situation but, here's what I might be inclined to do with this.

1) Since you are unsure about the diagnosis and sterile conditions...I might be inclined to take kitty to the vet and have them do the urine sample (needle into the bladder and not painful for kitty really). I believe it's called Cystocentesis (a needle in the bladder to remove urine). It's about as sterile as it goes.

2) I'd likely ask your vet about the GI upset and whether he/she thinks this particular antibiotic will cause it or not. Some don't.

3) I'd keep kitty on the w/d as that is what is clearing up the digestive upset for now and UNTIL you can get word from your vet as to what to do with the antibiotic. Some vets will say to worry less about that than getting the infection cleared up...which will also bring down the numbers once more cleared. A cat who has an infection will see numbers rising *IF* that is indeed the case but, only a sterile sample will yield a proper answer.

Then, once you know for sure what to do, you can proceed with that course. Please don't be afraid to voice your concern to your vet. If they are a good vet (most are), they will answer your questions and give reasons why they are thinking as they are. I drive my poor vet NUTS with questions, apologize and get the "hey...that's what we're here for...ask away...I'd rather have patients who want to know what's going on than those who just ask me 'how much is this gonna cost?'" So, I ASK and ask and ask. LOL

Hope this is something to think on and form your own opinion on?
 
I'm on board with Louellen. I'd take him back to the vet for the urine capture so you can make sure it's a clean capture. Then if it still comes back that he needs antibiotics, discuss the GI situation with your vet. My vet wasn't worried about that when Marshmallow had diarrhea on antibiotics, he was more concerned with getting the infection fixed. And yes, I'd keep him on W/D until his GI situation is settled down. Having an upset stomach will only make him feel worse and further raise his BG, poor kitty.

Let us know what happens. Crossing paws for a quick recovery!
 
Thanks to both granadilla and Louellen for their responses! I was thinking about calling and talking to the vet about it again- so I will do that for sure. I really want to get a cystocentesis but I need to find a vet that does house calls, b/c going to the vet often stresses him out so much that he gets diarrhea all over again.
I have thought a lot about what would have happened if we'd had him since he was a kitten (we got him around age 1) and had just driven him around in the car at a young age to get him used to it. I wonder if that would have worked to reduce travel anxiety later. I have tried Xylkene, Feliway, Xanax, Rescue Remedy, and other calming treats/sprays. He still panics on the way there even though it's literally a 5min drive!
 
You and I are both in the same boat again now SpecklesandMe. Morrigan WAS cleared up from colitis on the Flagyl but, 4 days off of it and it's back again. Just started again tonight. Uggghhh. I am thinking that it may be corn or chicken sensitivity in her from the m/d kibble now. Waiting to talk to the vet about this tomorrow when he's back in again. :(
 
Systematic desensitization and counter-conditioning may help reduce the stress of vet visits. This is where you take tiny, tiny steps for a week or so at a time and reward him for accomplishing the step with low carb treat, and/or play, and/or toy, and/or praise - things which are mutually exclusive with stress. It is a process, not an event, so you'll have to work at it consistently, every day, to succeed.

IMPORTANT: each step is at least a week, more until you can do it without him getting horribly stressed.

First, leave the carrier out all the time, with a comfy blanket or towel in it, a spritz of Feliway/Comfort Zone or a pinch of catnip, and a favorite toy. Move it around day to day and freshen it every once in a while. When you see him in it, give him a low carb treat and praise him.
After a week or so of this, you're ready to close the door for a moment, then open it again.
Add in picking up and putting down the crate.
Add in taking a few steps between picking up and putting down the crate.
Add more steps until you can get to the car and back.
Add in going into the car and returning inside.
Add in turning on the car, then off, then going back inside.
Add in driving a short distance and returning.
Gradually extend the driving until the time is about the same as the vet trip.
See if your vet will do a practice visit or two, with treats and petting.
Etc.
 
BJM said:
Systematic desensitization and counter-conditioning
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BJM, the process you've outlined above is awesome! Thank you! I just hope we can get him to do it. If I could do it all over again, I would definitely do the above process with him when he was young, before he got set in his ways, but I know there's hope because we've been able to do some clicker training with him somewhat recently.
 
Cat Ma, can you recommend a particular brand? I've tried some that didn't help but could be that they didn't have the same things in them as the ones you use.
 
One of our vets thinks my kitty does have pancreatitis but the other doesn't. I gave him a tsp of the liquid from his normal Tiki Cat food on Sat night with the W/D and it gave him mild diarrhea again (resolved when I stopped adding anything other than plain water to the W/D). I am considering giving him 1 Marin and 1 Denosyl per wk. Has anyone used these? Is this a bad idea for some reason? Any side effects?
THANK YOU! Thank you! Thank you!
 
Saoirse had some liver abnormalities show up on a scan in the spring, and our vet recommended a SAMe and sylibin supplement. Initially I gave her Samylin (1 tablet a day, Saoirse weighs c. 10lb/4.5kg) but the tablets were very big and I was worried about them going down the wrong way. I switched her to Hepatosyl 50 instead. She gets 1 capsule BID. It's a powder so it's easier to give. I mix it with water flavoured with some spring water from a can of human tuna (palatability can be a problem), but she will eat it at a push mixed with a little of her normal food. SAMe supplements need to be given on an empty stomach. I feed Saoirse mini meals because of her pancreatitis. When her Hepatosyl dose is due, I allow two hours after the previous meal before giving it to her and then I wait an hour before giving her next meal.

Some of Saoirse's liver lab results have improved since starting the supplement in March of this year. The others are stable. Her fasting blood glucose levels showed some improvement, too. (Saoirse has impaired fasting BG.)

SAMe is used as a supplement by some people who have problems with depression. I have noticed that Saoirse purrs a bit after the Hepatosyl sometimes and her mood seems good.


Mogs
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Would it be bad to use SAMe or sylibin supplements if he doesn't have liver abnormalities on his labs? I was reading in the IDEXX pancreatitis treatment guide that they give these supplements as supportive therapy, but is that only when liver issues are present?
I looked up side effects and didn't see anything too serious. What you said about Saoirse purring post-Hepatosyl sounds cute! :)
 
He is almost 11.
With regard to his poo, if I add any of his old food to the W/D canned, his poo gets to be pudding-y again! Even if it's only a tsp. So, he's just on the W/D for now (which really firms up his poo and stops his diarrhea) and I will try adding a tsp of high protein food to his W/D again at the end of the week to see what happens.
 
With an 11-year-old I'd suggest asking your vet about whether there are any risk factors involved in giving Speckles the Denamarin. (I must confess I'm a bit of a 'when in doubt, leave it out' kinda gal, but that doesn't mean it's a good idea to leave something out sometimes.)

Re the poop, if I were in a similar situation with Saoirse, I would go onto the websites for the different foods I'd tried (including w/d) and collate the nutrition profiles into a single document. With the ingredients of all the problem foods side by side it may be easier to spot suspect ingredients. If you use the w/d ingredients as a reference point, maybe identify ingredients that aren't in the w/d recipe and also see if there are any suspect ingredients in common across all the foods you've tried. It is very hard trying to spot culprits. :( Eventually I had our vet run some allergy tests from a blood sample for Saoirse. They can identify sensitivities, but there is - apparently - no guarantee of a correlation between a positive test result and the severity of reaction to a particular foodstuff if, indeed, there is any reaction at all.

SpecklesandMe said:
If he had pancreatitis, would he still be eating and hungry a lot?
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Prior to commencement of insulin treatment Saoirse had undiagnosed pancreatitis. (I suspect she may have had it for quite some time. :( ) When she was polyphagic due to the diabetes, the pancreatitis didn't stop her eating anything that wasn't nailed down. In Saoirse's case, it's only when she is nauseated that she becomes reluctant to eat. She's still hungry, though.

As I was typing the first part of this post, it just struck me that pancreatitis may possibly be a factor. Hills w/d is relatively low in fat. A lot of pancreatitis kitties are very, very sensitive to fat. Maybe compare fat content across foods as a starting point, AJ?


Mogs
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Thank you for the detailed response, Mogs! Brilliant idea! I'll compare the food ingredients and fat contents today. I will say that some of the Tiki Cat Gourmet Carnivore foods do seen greasy- maybe that's part of the issue.
"When she was polyphagic due to the diabetes, the pancreatitis didn't stop her eating anything that wasn't nailed down." - This sounds a lot like what I suspected was happening with my kitty...
I will also call the vet about the Denamarin. With our recent history of having new things we try backfire on us, we're better safe than sorry! lol
 
Glad I could give you some ideas, AJ. Food woes are a mare to get to the bottom of. (*sigh*). It may be worth getting a Spec fPL test done to determine

On the liver supplements, the liver deals with fats in the body. I wonder whether Maybe hold the Denamarin in reserve for now, but don't completely rule it out.

Be sure to update us with developments.


Mogs
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@SpecklesandMe Just an update on Morrigan to add to this discussion as I've been busy but, watching this thread still. :)

Morrigan is on her "taper off dosing" for the Flagyl and solely on the m/d kibble. She's on 1 dose every other day then, she'll begin every 3rd day for 1 dose and see where she goes but, her numbers are WAY up again on solely this m/d kibble. Yet, I was told to NOT up the dose or change foods until we see where she's going with this colitis stuff as even a dose change can "stress" her body and GI system. And NO food changes whatsoever. However, I'm going to have to ask him about w/d now and dose up to it.

@Critter Mom ....I also agree with you that holding off on adding anything more might be wise for both of us. :) I really like the idea of comparing ingredients. Though my vet swears that a true allergy to ingredients is 1 in 1 million....I'm far from convinced of that through personal experience with myself. I won't get into the phonecall I had with Hills yesterday as I'll go off on a total rant about their lack of ability to answer questions about the food other than a "canned response" from a computer screen. (rolls eyes here) And, don't get me started on their "nutritional counselling" line!!!!!!!!!!! Trust me....I asked....there are NO vet nutrition trained persons manning those phones! They are simply customer service people who have been schooled on Hills jargon. If you ask anything out of their "scripted responses" from a computer screen...they will tell you that they can't answer it. And, when I finally asked if they are "vet nutritionists"....they told me that they weren't. They were simply schooled on Hills and took seminars. I was told "you ARE asking all of the right questions....we just can't answer them". I got to supervisor's supervisors and even they couldn't answer the questions. When I finally asked where all of the so-called "thousands of vets and vet nutritionists are that Hills brags about having on staff"....they answered...."there aren't any...you'll have to seek one out on your own." HA! So much for Hills! There's more to it but, I'd take a day and a half to rant about it. Better I don't go there for your sakes or mine. LOL Besides, I like my computer. ;)

I'm SO with you SpecklesandMe on this with wanting to get Morrigan onto canned foods but, this darned digestive thing is a HUGE issue! I hear your frustration as I've pounded some pretty innocent pillows to shreds over the past several weeks now. I need a new set now. ;)

How are the numbers going on the w/d? Is it the wet or dry version (Morrigan won't look at any prescription wet foods). And, by the way, I really DO believe that "fat content" IS an issue....as it is for me, personally as well.

:bighug:
 
@Louellen - Class 'A' rant! Fair dues to you for getting so far up the chain of command. :D

When Saoirse went to the specialist hospital earlier this year I mentioned that I was considering the possibility of moving Saoirse to a home-prepared diet if I could not find a commercial low carb food she would be able to tolerate. The specialist told me they had a wonderful centre in America that they consulted on feline nutrition issues and that said centre would be able to provide me with recipes should I wish them to place a referral on Saoirse's behalf. She then informed me the wondrous American centre of excellence was Hill's ... ...

I respectfully declined the referral. ;)


Mogs
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@Louellen, keep us posted on Morrigan's progress as you wean her off the Flagyl. I'm surprised your vet didn't want to increase insulin if her numbers are up. If she stays on the dry M/D and her numbers are up, I would think that would increase her GI upset more than an insulin increase. When Marshmallow was diagnosed with IBD I was told that we needed to find a food she could tolerate well and then adjust insulin accordingly. But every bit of vet advice can be as different as every cat. :rolleyes: Fingers crossed for solid poops as you wean off the Flagyl!!
 
Critter Mom said:
@Louellen - Class 'A' rant! Fair dues to you for getting so far up the chain of command. :D

When Saoirse went to the specialist hospital earlier this year I mentioned that I was considering the possibility of moving Saoirse to a home-prepared diet if I could not find a commercial low carb food she would be able to tolerate. The specialist told me they had a wonderful centre in America that they consulted on feline nutrition issues and that said centre would be able to provide me with recipes should I wish them to place a referral on Saoirse's behalf. She then informed me the wondrous American centre of excellence was Hill's ... ...

I respectfully declined the referral. ;)


Mogs
.
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Mogs back to you too! :) :bighug:

LOL...recipes for home cooked food by Hills, huh?
How many bushels of CORN do you think you would have to shuck for that recipe?! :eek: :rolleyes: :smuggrin:
(You know it's an excellent source of protein, so easily digestible, don't you? :confused: And, you can charge an arm and a leg for adding it to your recipe! ;) :D)

Home cooked...HA...I would gladly stand over the stove for Morrigan. Heck, I'd put on a winter coat, hat, boots, mitts, scarves, long underwear, shovel a pathway to stand in 6' of snow....and BBQ her meals for her in the middle of a blizzard....IF SHE'D EAT IT!! o_O :banghead:

I'd have respectfully told them where to shove that referral now. ;) :p
 
granadilla said:
@Louellen, keep us posted on Morrigan's progress as you wean her off the Flagyl. I'm surprised your vet didn't want to increase insulin if her numbers are up. If she stays on the dry M/D and her numbers are up, I would think that would increase her GI upset more than an insulin increase. When Marshmallow was diagnosed with IBD I was told that we needed to find a food she could tolerate well and then adjust insulin accordingly. But every bit of vet advice can be as different as every cat. :rolleyes: Fingers crossed for solid poops as you wean off the Flagyl!!
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granadilla...yeah, I'm sure that once we've settled on a diet for sure (there *may* be changes to be made yet still), our vet WILL up the dosage. If he doesn't...I will! ;)

I'm thinking (translation: HOPING) that he's got some real thinking on this going on right now and that he is doing things very methodically so as not to confuse the situation. At least, that's what he's told me that he's doing. :nailbiting: :rolleyes:

See, I've been asking him all kinds of questions. I even had him paged while he was on his 4th or 5th vacation for this year :eek: :woot::woot: (I've lost count) and had him call me FROM his vacation because I was fed up with him being ON YET ANOTHER VACATION! :mad: (Yes, I seem to send him on quite a few of them!)

We had a nice chat while he grilled salmon on a BBQ. o_O

What he was explaining to me is that we have to get her GI tract settled down with NO other changes right now so that we can narrow it down to what is causing it.
She's solely on m/d kibble as that is what she will really eat. That's ALL that she's getting...besides water. Even the dosage of insulin is staying the same so as not to "stress her system". He's saying that for right now and another few days as we're tapering off...he wants ZERO changes to anything.
*IF* her system is still reacting poorly...there's going to have to be a discussion about diet changes and what *may* be the cause there...*IF* needed.
THEN, once we've decided on a "regular diet"...stay there and we'll do a curve again as well as another fructosamine level and then, change the dosage to suit the diet.

If I can do it...he would like me to try to get back onto ANOTHER canned food as that is where I was getting the lowest numbers...WITHOUT setting her GI tract off again.
If not...and she's ok...we'll stick to whatever she can and will eat that doesn't upset her GI tract and DOSE to that food.

So, he seems to have method to his thinking and treatment plan. I'm just not as patient as he is but, he's the doc and I'm not schooled enough nor, is anyone here really, to make other decisions. Heck...it's my constant switching things to try to better those numbers that *may* have been culprit to the GI upset! He's scolded me for that one too.

Right now, I'm taking it day by day, testing only as necessary (no stressing her out and no need to do more at this moment) and seeing where this goes. This time...*IF* (knock on wood NOT) there were more upset...either it's the m/d itself causing it...or.....(knock on wood NOT) there's something else going on that needs looking into.
At this point in time, he believes that it's been because of changes in food that has upset her GI tract that hasn't ever settled down fully before I attempted to get her back onto the Purina Pro Plan Kitten wet food. This time, he's making sure that I don't screw up what he's trying so, I'm being a good girl! :rolleyes: :confused:

Sometimes, I just have to let someone else figure it out for me as I sure as heck have screwed this up! I've listened to far too many sources and tried far too many things.
I have to give him a chance to figure this out.

Will keep everyone updated though. One hour at a time, I guess right now, one day at a time. But, I sure HATE these numbers while we're going through this!!!! :(

:bighug: :bighug:
 
Hi Louellen,
Thank you for posting about Morrigan. I wasn't sure I was going to have the energy to write about all this today, but when I saw your post, I knew I should. Sorry, everyone, this is going to be a long one...
On Thurs, I called both our vets to say that it was disturbing to me that after 2 weeks of diarrhea, followed by a week of mushy but formed poo on w/d, the poo still smelled acidic and he still seems to be having GI distress. While he's been on the w/d, we've been testing only as needed to minimize stress, but have up-ed his Lantus dose by .25u per injection, and then again another .25u per injection. So, when he started on the w/d, he was on 1.5u Lantus 2x per day and by the end of the week we were doing 2u two times per day. Each time we up-ed by .25u, we gave it a few days to give him a chance to adjust to the incrementally higher dose and re-test.
On Thurs, about 5 hours after insulin shot/breakfast, we used our Freestyle Lite and got 3 readings from the same blood sample- the first was 52 (we were like no way that's real), the second was 164, and the third was 255. The three tests were done within seconds of each other. We decided to up his dose again starting Fri night so that we would be home to watch him. Thurs night he was acting fine. Trying to jump despite his limp, hanging out with me, etc.
Fri morning at 5am, I woke up because I heard him go to the litter box. When I checked on him, he was trying to pee but then suddenly laid down flat in the box (very weird for him). A little later, I did a urine strip when he peed a tiny amount. It was on the highest level of glucose. At 6:15am when we gave him w/d and 2u Lantus and a B12 shot, but he was already very lethargic and acting exhausted ever since he woke me at 5am.
He was lethargic and weak all day. When I checked his skin, he seemed dehydrated. I kept trying to give him fluids (water mixed with Fortiflora and unflavored Pedialyte), and all week we'd been adding water to his canned w/d to the point where it was like a stew at every meal. I think he was drinking less on his own, but attributed it to the added water and the fact that he's limping (we put out lots of new bowls but he only likes drinking in one room for some reason). And I thought the water added to the canned w/d could compensate for some of that given that his poo looking okay.
Yesterday 3pm, I fed him to try to get more water into him. Then I ran another urine strip (his pees were tiny) and it was again very high for glucose. At that point, I could not keep him awake more than 5min at a time and I couldn't get blood from his ear no matter how much I tried, so we rushed to the vet. His vet's out of town and we saw a new person. I told them to run anything they can on the blood (pancreatitis tests, B12 levels, full liver/kidney panels). His BG on their monitor was like 540! And he was definitely dehydrated. They gave him 100cc of subQ fluids. He seemed to perk up pretty soon after that. I asked if I should up the Lantus and the vet said no. We got home and fed him again (w/d soupy). He was doing okay and then seemed to get sleepy again. So, I started reading about diabetic hyperosmolar syndrome and freaked out. So, we gave him another 50cc of subQ before bedtime. It stressed him TO THE MAX to get the subQ. We were so worried about the stress-benefit ratio but didn't know what else to do.
So, now, he's on 2u Lantis 2x per day still (no increase since vet visit), 2.5u desmopressin 1x per day (for diabetes insipidus), 1 Zenequin per day, 2 Zobaline per day, and probiotics.
I think with his BG peaking so high on top of the dehydration, I am worried about him developing hyperosmolar syndrome if we don't deal with this correctly. And I'm worried he might be anemic. I started adding in a high protein low carb low fat canned food this morning into the w/d. I want to get him off the w/d b/c of the BG#s but I also think his poo will get wetter again if I do. It's a Catch 22. I am so scared. He's our heart and soul. It would kill me if we did the wrong thing. Please let me know what you think. And thank you all so much for your support!
 
We haven't started metronidiazole yet b/c of the Zenequin. I can ask about it once we're done with the Zenequin, but we still have 10 pills to go...
 
Wow, SpecklesandMe....we're both in a bit of a pickle here, aren't we...in differing ways.

I don't have anything that I can add about the meds or other things that you've mentioned as I don't know what they are but, I'm sure that there's others in here who do! :) (If I start searching and reading up on things....poor Morrigan and poor me....I'll be imagining everything possibly wrong! I even have to meter my time on these boards a bit for when I'm not quite so vulnerable to what "could go wrong" scenarios or I stop sleeping, eating and even leaving the house! LOL)

I do know that when we need to do something for them, the only thing that we can do is to do it...stressing for them or not. We can only try to do what we can, the best way that we can and beyond that...we need to do what we need to do for them.

The Metronidazole does work. :) That's the good news. The trick, I've learned, is not to take them off of it too quickly. I'm still with held breath on Morrigan's GI tract, trying to wean her off of the Metronidazole and don't know what will happen....and the vet doesn't want to up her dosage just yet either. He prefers to wait to get this GI situation under full control because...he mentioned something about the idea that we don't know how much is food induced with the m/d kibble raising it...or...whether it's the GI tract still somewhat upset or both and where that line lays. So, that may also be YOUR fill-in vet's thinking right now as well????

Right now though, I do know that any food changes that you make...have to be done VERY slowly. At least you're already on canned food so, that's a good thing (something that is a hard trick with Morrigan). I think the most important thing right now is to watch the fat content. Too high a fat content can be bad for the bowels....so, try to do the maths to see which canned foods are lower in fats and higher in fibre??? All of them are going to be higher than the w/d in fat because they have to replace the grain somehow so, the up the fat or fibre content instead. Better a fibre than a fat.

But, right now, I'm thinking....given my situation and vet's opinion...that the way to go is with either Flagyl (Metronidazole) or Tylan/Tylosin...also used for the SAME purpose . It was a toss-up for which one to use on Morrigan. And, if his BMs are not "runny" right now, formed but just mushy, he's likely not getting too dehydrated from losing fluids through the bowels. (The corn is allegedly a good both DIGESTIBLE protein source as well as a fibre source which bulks up the stools). Please excuse me if you've already mentioned but, have you had a stool sample analyzed for parasites/bacteria? Even so...even if it's negative....they still give something like Metronidazole or Tylan/Tylosin....which work. It may be longer termed but, works. I'm wondering if the Tylosin/Tylan is contraindicated with the Zenequin???

Honestly, I think you might be better to keep him going on a single diet that you know is not going to upset his GI tract and dose UP to that food's numbers. If he's even mildly dehydrated...that can also do a number on numbers. Being unwell can raise those numbers...or so, I've read and 4 vets have said.

And, by the way...I know our vets are more than entitled to their days off and holidays and lovely vacations as they work hard BUT...isn't it a pain in the rear when you're really in trouble and have to see a vet who doesn't know us or our pets? About the only thing that I'll say about that is that SOMETIMES...a fresh set of ears and eyes on an issue, *can* render a different perspective and a different angle to come at it with. They'll *sometimes* do more research as well because they want to learn more so, don't stop asking questions...even if you have to call 30 times in a day! ;)
 
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Louellen, thank you so much for your kind and thoughtful response. I am a little less panicked now. We were able to do about 100cc subQ fluids this morning and he seems more alert. I really want to try the metronidazole but I guess we're waiting for Mon for his normal vets to be back and some of the lab results to be in (we know he's parasite free). I don't know if it or Tylan are contraindicated with Zenequin, but hopefully not. Originally I was worried about having him on 2 antibiotics at the same time, but perhaps it's worth it given all the issues. I guess we just need to focus on keeping him hydrated and stable til Mon. He is mad at us (hates the subQ) and has been hiding under the bed, but overall he's a forgiving kitty. ;)
Fingers and paws crossed for Morrigan too! Thanks again for your calming and wise words!
 
Dehydration can cause an elevation of blood glucose which probably explains why your vets do not want to increase the insulin until the GI issues that are causing dehydration are dealt with. One problem tends to feed off another so as hard as it is to stick with a plan without seeing a quick response, I think if you find food that alleviates the bowel issues, I'd stick with it with no additions other than water or pedialyte for hydration until you are sure the worst is past. Another marathon to be sure but slow and steady wins the race!
 
Hi AJ. I'm so sorry you're going through this. I know hard it is on both the kitty and the caregiver when our cats aren't doing well. I'm sure Speckles hates the fluids but as you've seen, they help so much. I agree with @Louellen about sticking to the W/D. You've found a food that works for now, so I would stick with it until you talk to your regular vet on Monday. When a kitty has diabetes plus another issue, the school of thought seems to be: treat the other issue and adjust the insulin as needed. Once the other stuff is under control, maybe then he'll be able to tolerate a food switch.

Please try to take a moment for yourself and breathe. Marshmallow was sick earlier this week and I also wasn't feeling well. I ignored the wise advice I received here and didn't take care of myself, which made me worse. I can't help Marshmallow if I'm not doing well myself. So I'll paraphrase the wise words of @Critter Mom and say: please try to take care of yourself as well. Best of luck and keep us posted.

Shane
 
Thank you all so much for being the voices of reason. We were going nuts but we managed to do subQ twice yesterday and this morning he seemed less dehydrated (skin test). He was also walking around a little more. So, hopefully (really, really hoping), we're over the worst until we get the lab results tomorrow. THANK YOU all again!
 
SpecklesandMe said:
Thank you all so much for being the voices of reason. We were going nuts but we managed to do subQ twice yesterday and this morning he seemed less dehydrated (skin test). He was also walking around a little more. So, hopefully (really, really hoping), we're over the worst until we get the lab results tomorrow. THANK YOU all again!
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We're all hanging in there with you for good results and the ability to speak to the vet as to what your next step is now. Sending good energies! :) :bighug:
 
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