Diagnosed with Pancreatitis - any advice much appreciated!

[Monica & Josie]

Our Josie age 13 just been diagnosed with pancreatitis
Vet told us to change diet completely to go 'low - fat' and suggests Hills Digestive Care ID food but everyone says to stay away all prescription food for diabetes so not too keen going down that road for pancreatitis either if there's another option..
She said high carbs were ok for her to eat and that made me cringe! Surely not?
Just did a little research and read on various pet websites that the food doesn't have to be low fat just whatever is easy to digest and the cat is happy to eat..?
We're in the UK and she's been eating happily Sheba Fine Flakes and Butchers Really Meaty both low carb.
I am gutted everything we've been working so hard on from spending ages finding the right food to regulating her BG levels might just be going out of the window and we would have to start all over again..
It's even more sad that this all happens just as we started getting low PS numbers which gave me a tiny little glimpse of hope that maybe finally we were heading in the right direction..
I don't even know if it's manageable on long term?
She was prescribed Metoclopramide for the vomiting and Meloxidyl for pain. Are they any good?
If any of you with experience in dealing with Pancreatitis could give me some advice and support that would be really appreciated guys! Thanks so much

 

[Wesley and Spicoli]

With pancreatitis it really is about getting them to eat whatever they will eat. A cat that doesn't eat for 24-48 hrs is at high risk of developing fatty liver. If she's eating on her own then that's a good sign. Don't worry about her numbers so much as they are going to be inflated from her not feeling well.

We've been on the same nausea meds and they've helped us alot. No experience with that pain med.

Right now getting food and fluids in her is the most important thing. It can take some time for kitty to start feeling better. It took us about 5-6 days before we were back to normal. So don't be alarmed if shes not back to normal in a day or 2.

 

[Tuxedo Mom]

She was prescribed Metoclopramide for the vomiting and Meloxidyl for pain.

I used Cerenia for the nausea, although others have used different meds with good success. The Meloxidyl is the generic name for Metacam which is a NSAID for pain relief. In the UK the dosing of Meloxidyl is lower than in North America, but there is still some controversy as to the safety of Meloxidyl in kitties. Personally I used buprenorphine for pain relief and found it worked very well, although it does have a sedating effect with some kitties. It is important to make sure Josie does not go too long without eating as this can lead to liver issues. If she is not eating well on her own with the meds then you may need to syringe feed her until she is feeling well enough to eat on her own.

 

[tiffmaxee]

Sorry about the diagnosis. There's a primer for pancreatitis on this forum. Basically low fat is needed for dogs and not cats. Max had chronic pancreatitis that likely led to him becoming diabetic for about six years. It's quite commercial n and not diagnosed as often as it occurs. The treatment is to treat the symptoms. For Max it was always inappetence. They don't need to vomit to be nauseous. I fave him m ondansetron or cerenia at the first sign he was feeling off. Some have pain and for that buprenex works well. You just drip a few drops on the gums. Meloxidyl has a black box warning for cats in the U.S. because it can cause kidney damage so I wouldn't use it as a first choice.

Here's a good article.

http://www.idexx.de/pdf/de_de/small...ine_pancreatitis_roundtable_discussion_us.pdf

 

[tiffmaxee]

Here's the primer:

http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

 

[Monica & Josie]

With pancreatitis it really is about getting them to eat whatever they will eat. A cat that doesn't eat for 24-48 hrs is at high risk of developing fatty liver. If she's eating on her own then that's a good sign. Don't worry about her numbers so much as they are going to be inflated from her not feeling well.

We've been on the same nausea meds and they've helped us alot. No experience with that pain med.

Right now getting food and fluids in her is the most important thing. It can take some time for kitty to start feeling better. It took us about 5-6 days before we were back to normal. So don't be alarmed if shes not back to normal in a day or 2.

That's great thank you!

See the thing is she is actually fine at the moment. She's been having these episodes when she vomits and refuses to eat for a couple of days. Then she starts eating again and back to normal again for some time. Then sick again, then fine again. That's why it took us a while to figure out what to look for..
She had a very rough episode a couple of nights ago, that's when I insisted on having more blood tests done specifically for pancreatitis which now came back positive. She recovered again and doing well at the moment. She's been drinking lots of water and keeps asking for food and eats it as well. Is this an on and off thing then? How's it for your kitty?

 

[Monica & Josie]

I used Cerenia for the nausea, although others have used different meds with good success. The Meloxidyl is the generic name for Metacam which is a NSAID for pain relief. In the UK the dosing of Meloxidyl is lower than in North America, but there is still some controversy as to the safety of Meloxidyl in kitties. Personally I used buprenorphine for pain relief and found it worked very well, although it does have a sedating effect with some kitties. It is important to make sure Josie does not go too long without eating as this can lead to liver issues. If she is not eating well on her own with the meds then you may need to syringe feed her until she is feeling well enough to eat on her own.

Thank you. I'll make a note of the Buprenorphine. I really wouldn't mind the sedating effect as she's driving me mad always wanting to go outside to the front garden to sit and watch the world passing by for hours rain or shine! Sometimes she gets soaking wet and still I have to drag her in..
She's eating well and drinking well and seems all normal, that's why it's so confusing...!

 

[Monica & Josie]

Sorry about the diagnosis. There's a primer for pancreatitis on this forum. Basically low fat is needed for dogs and not cats. Max had chronic pancreatitis that likely led to him becoming diabetic for about six years. It's quite commercial n and not diagnosed as often as it occurs. The treatment is to treat the symptoms. For Max it was always inappetence. They don't need to vomit to be nauseous. I fave him m ondansetron or cerenia at the first sign he was feeling off. Some have pain and for that buprenex works well. You just drip a few drops on the gums. Meloxidyl has a black box warning for cats in the U.S. because it can cause kidney damage so I wouldn't use it as a first choice.

Here's a good article.

http://www.idexx.de/pdf/de_de/small...ine_pancreatitis_roundtable_discussion_us.pdf

Thanks very much that's really good to know, will probably ask for other pain relief med!

 

[tiffmaxee]

It's definitely an on and off thing. Which test was done? With diabetes already present the tests aren't foolproof. Often cats with pancreatitis have IBD and that could be responsible for the vomiting. Did you get a copy of all her labs that you could post or are the latest already on your ss? Has she ever had an Ultrasound?

 

[Wesley and Spicoli]

It can be an on again off again thing. Many kitties have chronic pancreatitis and it can be days, weeks, or months in between flare ups. We have had only had one bad bout with it (that was tested for) but my vet believes hes a "pancreatic kitty" and his occasional appetite problems/random high bg have been related to that.

She's been drinking lots of water and keeps asking for food and eats it as well

You are EXTREMELY lucky. I had to resort to force feeding. Not fun and very messy (at least for us).

You mentioned a garden. Do you use pesticides she could have come into contact with?

 

[Tuxedo Mom]

My boy had chronic pancreatits and only had about 5 episodes in 2 1/2 years that required intervention. He was a food hog and if he did not eat every last morsel of food I KNEW there was a problem. That was my signal to really watch closely for signs of pancreatitis...not eating normally, lip smacking, going to food dish and turning away..etc. He only threw up a couple of times, but the signs of nausea were definitely there. With chronic pancreatitis if you catch it early and give the right supportive meds it can usually be dealt with fairly well at home. There were a number of times I had to syringe feed for a day or so, then "tempt" him with added tuna or juice on the food. If Josie is still eating and drinking, even if somewhat reduced portions to her normal, then you will be well able to deal with this at home.

 

[Monica & Josie]

It can be an on again off again thing. Many kitties have chronic pancreatitis and it can be days, weeks, or months in between flare ups. We have had only had one bad bout with it (that was tested for) but my vet believes hes a "pancreatic kitty" and his occasional appetite problems/random high bg have been related to that.


You are EXTREMELY lucky. I had to resort to force feeding. Not fun and very messy (at least for us).

You mentioned a garden. Do you use pesticides she could have come into contact with?

Thank you, I could really do with some 'lucky' these days..
I'm sorry you had it the hard way.. I don't think I could do force feeding so it is lucky..

No pesticides and only sits in small front garden at the front or under bush

Your comment got me thinking though, her preshot numbers are significantly lower since rushed visit to vet and given Cerenia shot two days ago.. Could these two be related by any chance?

She started the vomiting/ off food episodes long before diagnosed with diabetes in April..

 

[Monica & Josie]

It's definitely an on and off thing. Which test was done? With diabetes already present the tests aren't foolproof. Often cats with pancreatitis have IBD and that could be responsible for the vomiting. Did you get a copy of all her labs that you could post or are the latest already on your ss? Has she ever had an Ultrasound?

Yes I believe she had an ultrasound a couple of weeks ago with X-Ray and general blood work done ( which I tried to enter accurately on SS.. ) but nothing showed up. Asked vet to email me a copy of her second blood test lab results as well she said she would so waiting at the mo, will share once received.

 

[Monica & Josie]

My boy had chronic pancreatits and only had about 5 episodes in 2 1/2 years that required intervention. He was a food hog and if he did not eat every last morsel of food I KNEW there was a problem. That was my signal to really watch closely for signs of pancreatitis...not eating normally, lip smacking, going to food dish and turning away..etc. He only threw up a couple of times, but the signs of nausea were definitely there. With chronic pancreatitis if you catch it early and give the right supportive meds it can usually be dealt with fairly well at home. There were a number of times I had to syringe feed for a day or so, then "tempt" him with added tuna or juice on the food. If Josie is still eating and drinking, even if somewhat reduced portions to her normal, then you will be well able to deal with this at home.

Haha yes my Josie is a foodie too, she probably takes after me! lol

Yes these been the same signs for Josie as well what you mentioned, shame I didn't pick up on this sooner!

 

[Tuxedo Mom]

Haha yes my Josie is a foodie too, she probably takes after me! lol

Yes these been the same signs for Josie as well what you mentioned, shame I didn't pick up on this sooner!

It is easy to logically explain it away as a touch of "kitty flu". With our FD we kitties need to be very proactive when the usual "norms" suddenly change...not eating, signs of nausea, more lethargic....I totally missed the first episode since I put it down to vet stress, with Tuxie having had the one AND only glucose curve at the vet that day. He came home from the curve..threw up..had loose stinky poops and didn't want to eat. He was SO SO stressed at the (first) vets that I though that was the problem. After him refusing food the next day I knew there was more to it than stress. Trust your knowledge of how Josie normally is.

 

[Wesley and Spicoli]

Could these two be related by any chance?

They *could* be. I'm not saying they are but in my little experience with FD, if my sugar cat is feeling under the weather his BG nearly always spikes. So feeling better again *could* equal a more normal/expected response to insulin.

And as for the force feeding...We do what we have to to keep our fur babies going.

She started the vomiting/ off food episodes long before diagnosed with diabetes in April..

If that's the case she could have had pancreatitis then...and might be a chronic P kitty. Or she may have an underlying disease like IBD like tiff said. We have suspected IBD (surgery is the only real way to tell and we haven't elected to do that yet) and mine will vomit occasionally. The main difference I've noticed is IBD vomits are food, digested and undigested, fur balls. Pancreatic vomits for us have mainly been bile. But every cat is different.

 

[Monica & Josie]

They *could* be. I'm not saying they are but in my little experience with FD, if my sugar cat is feeling under the weather his BG nearly always spikes. So feeling better again *could* equal a more normal/expected response to insulin.

And as for the force feeding...We do what we have to to keep our fur babies going.


If that's the case she could have had pancreatitis then...and might be a chronic P kitty. Or she may have an underlying disease like IBD like tiff said. We have suspected IBD (surgery is the only real way to tell and we haven't elected to do that yet) and mine will vomit occasionally. The main difference I've noticed is IBD vomits are food, digested and undigested, fur balls. Pancreatic vomits for us have mainly been bile. But every cat is different.

I see, yes just as well. But back then we had an idiot for a vet. Ex vet... Josie vomits up green/yellow foamy bile most of the time..

 

[Tuxedo Mom]

Josie vomits up green/yellow foamy bile most of the time..

Another thing that could be happening is over acidity of the stomach. My chronic pancreatits kitty would sometimes get the foamy throw ups if he hadn't eaten often enough. I would give him 1/4 tab of Pepcid AC (famitodine) or a small dose of slippery elm bark to help with the excess stomach acids. Quite often this would help and he would not have another pancreatic episode ( at least at that time) Something else to consider.

 

[Monica & Josie]

Another thing that could be happening is over acidity of the stomach. My chronic pancreatits kitty would sometimes get the foamy throw ups if he hadn't eaten often enough. I would give him 1/4 tab of Pepcid AC (famitodine) or a small dose of slippery elm bark to help with the excess stomach acids. Quite often this would help and he would not have another pancreatic episode ( at least at that time) Something else to consider.

Yes hopefully now that we started her on the 1/4 anti acid tablet twice a day as a prevention it will make a difference. I feed Josie quite often, even get up in the middle of the night to check on her and giver a little food if she's interested. Which is always..

 

[Tuxedo Mom]

Smaller meals more often will sometimes work better for some kitties. Many vets say to only feed twice a day, but in my experiences with 2 FD kitties this does not work well at all. I usually feed about 4 smaller meals and snacks in between. The only time I withhold food is within 2 hours before preshot testing time.

 

[Yong & Maury GA]

Hope Josie starts feeling better soon. I just had my first bout of pancreatitis with my boy last month. Caught it early but with conservative treatment it did take over 3 weeks for him to noticeably feel better. Important things are what the others have stated already, getting her to eat (even if you have to go a little higher carb than usual) and dose around the effects, pain management, and anti inflammatory. I also used Cerenia for nausea, Mirtazapine (as needed) for appetite stimulant, and Buprenex (liquid form of Buprenorphine). Mid way I did start using slippery elm bark (SEB) and I think that helped things a bit more. He mainly needed Cerenia and a little Bupe longer than Mirtazapine. Only attempted to give Famotadine (pepcid) once and it did not go well but he didn't seem to really need it.

 

[Wesley and Spicoli]

Just a side note - if you have trouble pilling your girl, pepcid can be compounded in liquid form. We use along with metoclopramide when we start having tummy troubles.

 

[Megan and Boots (GA)]

I can echo some of these experiences. Boots has chronic pancreatitis that thankfully hasn't brought us in for emergency treatment, we've always been abll to manage at home. Making sure they keep eating and drinking during a flare is critical. When Boots starts turning his nose up at food or licking it once then walking away, I know we're likely at the start of a flare, and we begin daily Cerenia (4mg dose). We do that for several days until he's eating better, then taper it off (though our vet told us we could start giving it daily, long-term if we wanted as a maintenance med). He has occasional vomiting too, but that might be more a factor of his IBD, it's hard to know. We're probably going to try Slippery Elm Bark soon, as it seems to be very helpful for a number of digestive issues. Good luck, and ask loads of questions here, because lots of people have answers and suggestions for illnesses other than just FD!

 

[Yong & Maury GA]

How is Josie, Monica? How are you?

 

[Diana&Tom]

How is Josie, Monica? How are you?

Yong, Monica's on holiday atm and is not looking in here, I don't think.

 

[Elizabeth and Bertie]

There have been a couple of food-savvy UK'ers with p'titis kitties. Both kitties went into remission, and their caregivers don't post at the moment, but I will look up/into their food suggestions when I have a mo....
.

 

[Monica & Josie]

There have been a couple of food-savvy UK'ers with p'titis kitties. Both kitties went into remission, and their caregivers don't post at the moment, but I will look up/into their food suggestions when I have a mo....
.

Thanks so much Eliz! And apologies everyone I was away on hols with a dodgy wifi..

Just started a new thread with update re. Josie, pancreatitis and battling with vet..

Thank you all