? 6/27 Ozzy - vet results, need advice pls

[Ozzy Pawzbourne]

http://www.felinediabetes.com/FDMB/...-on-what-to-ask-test-for.231512/#post-2589644

Waiting on a call from the vet with results from Ozzy's bloodwork

My stomach is in knots, I'm worried about my sweet boy, and have so many more questions just wish we had results already

Last night I observed his respiration rate and it never really went below 30. Checked on him this morning where he was snuggled up in his kitty tower and he was still above 30. Last night he never really seemed to relax. Usually he would curl up in a ball and go to sleep. But he stayed awake. Saw him just sitting on floor in meatloaf position and laying on floor in kitchen Also tried to take him to sleep with me above my head on my pillow and he never really went to sleep Around 1am he left the bed. I am not sure if he ate again last night or his BG stopped but woke up to a number in the 400s.

Wonder why his respiration is high. Is it from him being in pain or could soemthing be going on with his lungs?

Wonder why vet kinda dismissed IBD. Everthing I am reading says it could be a cause and no tx for pancreatis. You have to address underlying cause. He had had chronic vomiting for years. Also wonder why, if he does have IBD, how that's possible when he had eaten a 90% raw diet for almost 4 yrs. He does get.some fancy feast but its little in compared to his overall diet But will admit we were waiting on a darwins order so ate FF for almost a week. Think that could be in play here

Wondering about fatty liver disease with his weight loss...... can that be detected on blood tests

How do we bring down his temp?

Should we be giving subq fluids?

So many questions.

Ozzy only ate half his brekkie and went and hid under bed

Waiting for vet to call. Will post back when she does

 

[tiffmaxee]

I know how worried you are and I would be too. The fever is just a tad over high normal. I googled it. If in pain his respiratory rate could be elevated. Fatty liver is a real concern. If you get him to eat 75% of normal it’s less likely. How much cerenia did he get? Ask if you can increase it or try ondansetron. I forget if you got an app stimulant. I like cyproheptadine best, a human antihistamine but there’s also The transdermal for mirt is an alternative. I don’t like the pill. Tried it with one cat and had a bad reaction.

 

[Ozzy Pawzbourne]

I know how worried you are and I would be too. The fever is just a tad over high normal. I googled it. If in pain his respiratory rate could be elevated. Fatty liver is a real concern. If you get him to eat 75% of normal it’s less likely. How much cerenia did he get? Ask if you can increase it or try ondansetron. I forget if you got an app stimulant. I like cyproheptadine best, a human antihistamine but there’s also The transdermal for mirt is an alternative. I don’t like the pill. Tried it with one cat and had a bad reaction.

4 tablets of cerenia. He is to take half a day so 8 days worth I broke up last nights dose and put in his food but he didn't eat it all so no way to tell if he got the full dose. Today ai gave it orally. Just pulled him out and gave him some kitty treats and he is eating so that is good.

The weight loss has been slow over last few months. Went down from 14 lbs on Dec to 12 pounds He eats just not as much and seems to skip his 2nd and 4th feeding He is fed 4zs a day.

We.didnt get an app stimulant but will ask for one if his appetite doesnt pick back up

 

[Red & Rover (GA)]

I'm wondering if Ozzy was giving a long-acting appetite stimulant at the vet. The non-sleeping fits with mirtazapine's side effects.

 

[Ozzy Pawzbourne]

th

I'm wondering if Ozzy was giving a long-acting appetite stimulant at the vet. The non-sleeping fits with mirtazapine's side effects.

That's good to know. Thank you!

He did not get an appetite stimulant at vet She didnt mention it and not on the bill. Hoping the cerenia will help with the nausea and he will eat more. He is eating just not as much. No vomiting last night or today so far so that's good

 

[Si am cat mom]

Hepatic lipadosis ( fatty liver disease) usually happens when cats eat nothing for days. I've seen it when someone goes out of town and a feeder malfunctions or a sitter doesn't notice that the cat's dry food hasn't been touched because a cat is hiding in the home...
Liver values are usually off ( ALT / AST)

I'd say yes to subq fluids- IV fluids are best for bringing down a temp but if you are concerned about respiratory issues then fluids might complicate it.

Hopefully bloodwork gives you more answers but with Diabetes I think vets tend to lean towards pancreatitis and/ or renal insufficiency...because so often it is pancreatitis and some range of renal issues. It doesn't take much unfortunately for the pancreas to get upset...

<3 hope your furbaby is more himself soon

 

[Ozzy Pawzbourne]

Vet just called. Long post, sorry in advance. Need some advice.

Pancreatitis: Ozzy has pancreatitis. Poor kitty!!

Fructosamine: Lab work showed Fructosamine level was 263. She said that number could mean he is in remission (wrong, his glucose was 335, they tell me that every time!! And he is still diabetic!), he is being overdosed with insulin (likely), or he has good glycemic control for diabetic (also likely but you have seen his SS and he has never really been in good control with numbers all over the place. He's no Chris' China).

Eosinophils: lab value was above normal. Has been on last few lab results. She said this could be indicative of a parasitic infection. Ozzy doesn’t ever go outside. We only give flea meds a few times a year but I recognize we could bring in fleas although we have never seen fleas in our house except once in 17 years of owning indoor only felines.

Ozzy has been on a raw food diet from Darwins for over 3 years supplemented with occasional FF pate. I asked if the raw food could be at play and she said possibly. It could harbor parasites or bacteria. She is recommending a $200 fecal test. Anyone know any other reason why this lab could be elevated?

BUN: lab value above normal. Vet said this could be due to kidney or renal complications but all other labs were normal so she didn’t think so. Could also be related to GI issues which she is suspecting. Lab was only slightly elevated, she considered it mild. Other kidney values normal. His value was 47, 37 is high normal.

Rapid breathing: she said this is likely due to stress/pain. Would not be able to tell if there is lung involvement secondary to pancreatitis without further tests.

Weight loss/muscle wasting: she agreed he had muscle wasting but said it could be due to age and his DM. Liver labs did not show evidence of fatty liver disease. She could feel his spine and a little of his ribs. Keep in mind Ozzy was almost 19 lbs at his DM/life-threatening DKA Dx back in 2016 and now weighs 12lbs.

Her recommended plan of action is:

• Pepcid 2xs per day. She said we could get it OTC. What brand do you guys recommend? She said needs to have famogiden in it and he should take 5mg 2xs/day
• SubQ fluids- 100ml x1/week
• Fecal exam
• Change diet to Hills prescription WD They offer canned and dry. She said canned is 6.2% carbs. We all know how we feel about RX food. She is recommending higher fiber low fat. What are your guys’ thoughts on this? Need to consult Dr. P’s food chart.
• Also recommending an Ultrasound with an internist to rule out chronic pancreatitis as well as other issues with liver, spleen, and GI tract.
• recheck fever at home
• Wants to see him back in a week for follow up test on pancreatitis.

So here is the deal. I LOVE Ozzy. He is my baby and always was before I had a real baby and he is the sweetest cat I have ever loved. He is 12 years old and has lived 1/4 of his life as a diabetic with uncontrolled diabetes with sugar levels all over the place on a constant roller coaster and being poked and prodded with needles multiple times a day and feeling nauseated and vomiting all the time. And he likely has had painful chronic pancreatitis for who knows how long.

I am not sure I want to do the US. Negative results of other impacted organs may lead to the need for additional, maybe invasive procedures and more meds. And expensive treatments. His health care costs for diabetes over last 4 yrs has costed us close to $10k and that does not include the cost of expensive raw food diets and insulin and testing supplies.

I don’t know what kind of quality of life my kitty is really living right now. He looks uncomfortable. Has nausea and diarrhea and vomits all the time and now has painful pancreatitis. He has been hiding under the bed.

I think I want to move forward with the current meds for comfort and support (Pepcid, anti nausea, pain meds, fluids, GI meds), and look into a change of diet to higher fiber/low fat (after more research of course). But I am not sure I want to keep looking for more answers or treatments. I feel like the most awful pet owner in honestly saying this, but we can’t spend whatever it takes. This episode alone has been almost $1000 and with the fecal they want to do and additional checks and bloodwork, we are going to be up over $1400. We are in the middle of a pandemic and my husband is not working and we have a small child at home to care for and pay for now and long term.

I’m conflicted. Confused. Sad. I need some advice. Think I need someone to tell me it’s ok not to spend thousands of dollars on your beloved pet who has chronic health conditions. I still want him to be with us for a long time but I honestly admit that my sweet kitty has been the biggest burden on us. Caring and loving for a sugar kitty is a HUGE commitment. One each and every one of you can attest to.

I need kind words now and some advice from the kitty committee. No one knows or understands this journey like we do. @Marje and Gracie @Chris & China (GA) @Wendy&Neko @Taffy's mama @LizzieInTexas
Calling my long time kitty committee friends in.

 

[Ozzy Pawzbourne]

Hepatic lipadosis ( fatty liver disease) usually happens when cats eat nothing for days. I've seen it when someone goes out of town and a feeder malfunctions or a sitter doesn't notice that the cat's dry food hasn't been touched because a cat is hiding in the home...
Liver values are usually off ( ALT / AST)

I'd say yes to subq fluids- IV fluids are best for bringing down a temp but if you are concerned about respiratory issues then fluids might complicate it.

Hopefully bloodwork gives you more answers but with Diabetes I think vets tend to lean towards pancreatitis and/ or renal insufficiency...because so often it is pancreatitis and some range of renal issues. It doesn't take much unfortunately for the pancreas to get upset...

<3 hope your furbaby is more himself soon

Thank you. Results in from vet. Take a look at my recent post and let me know your thoughts. Thanks!

 

[tiffmaxee]

A lot to digest. I don’t think an uultrasound will rule in or out chronic pancreatitis. It sure never did for Max. At times it showed that he did have it but not always. It could show if there are other GI issues such as possible IBD.


I do recommend you join the groups io pancreatitis board. The moderator, Maureen, is really smart and up on all cat issues. She finds every new veterinary article out there. I’ve posted many here and Jill added some to the health site. If you do join send her the labs you have blacking out your personal info of course. That’s my two cents fwiw.

Max had chronic pancreatitis for 8 years and most of the time was a happy camper. I lost him to CHF at the age of 19. He was 12 when he first got it.

 

[Ozzy Pawzbourne]

A lot to digest. I don’t think an uultrasound will rule in or out chronic pancreatitis. It sure never did for Max. At times it showed that he did have it but not always. It could show if there are other GI issues such as possible IBD.


I do recommend you join the groups io pancreatitis board. The moderator, Maureen, is really smart and up on all cat issues. She finds every new veterinary article out there. I’ve posted many here and Jill added some to the health site. If you do join send her the labs you have blacking out your personal info of course. That’s my two cents fwiw.

Thanks. I will check out that board. Appreciate it! Also appreciate all your thoughts and comments over the past few days. I needed you more than you know.

 

[Sienne and Gabby (GA)]

Marje put together an excellent Primer on Pancreatitis. There is also a good reference on pancreatitis on Tanya's CRF guide. There was a roundtable discussion on pancreatitis that IDEXX labs had online but it seems to have disappeared. It had some good information on diet. Fundamentally, the issue of low fat high fiber is old school. Your cat needs to eat and given how painful pancreatitis is, whatever Ozzy will eat is fine.

What pain meds did the vet prescribe? I'd strongly encourage buprenorphine.

 

[tiffmaxee]

I’ve been in your shoes, minus diabetes at first. Max was pretty sick the first time and I feared he had cancer. I had just lost his sister to lymphoma and one vet thought so as well. My internist was very conservative and I had gone to a second vet. Went back to the first one and he saved Max from exploratory surgery and I learned how to keep Max feeling well. I get you can too.

 

[Marje and Gracie]

Pancreatitis: Ozzy has pancreatitis. Poor kitty!!

How was this diagnosed? Did she do a specfPL or a snapfPL? If you post his labs to his SS lab tab, I can be a little more help.

Eosinophils: lab value was above normal. Has been on last few lab results. She said this could be indicative of a parasitic infection. Ozzy doesn’t ever go outside. We only give flea meds a few times a year but I recognize we could bring in fleas although we have never seen fleas in our house except once in 17 years of owning indoor only felines.

Increased eosinophils can also be caused by allergies. While running a stool sample is not a big deal, it does add to cost and sometimes you get a negative when the wee beasties are just dormant. So...that’s really up to you and I would say it depends on how high his level is. My two often have increased eosinophils but they are also totally house cats; my vet doesn’t get too worked up over their values. I’ve fed raw for years and years and years with no issue with parasites or bacteria. The pH in a cat’s stomach is really acidic and while I won’t say they can never get bacteria from raw food, the statistics (truthaboutpetfood.com) show the instances of salmonella, etc are higher in commercial foods (dry in particular).

BUN: lab value above normal. Vet said this could be due to kidney or renal complications but all other labs were normal so she didn’t think so. Could also be related to GI issues which she is suspecting. Lab was only slightly elevated, she considered it mild. Other kidney values normal. His value was 47, 37 is high normal.

I wouldn’t want to look at this without looking at his other labs but I will tell you that raw fed cats can and often have higher BUN due to the higher protein. And he could have also been dehydrated that day.

Rapid breathing: she said this is likely due to stress/pain. Would not be able to tell if there is lung involvement secondary to pancreatitis without further tests.

Count his respirations at home when he’s at rest. Normal respirations at rest are 20-30 a minute.

Pepcid 2xs per day. She said we could get it OTC. What brand do you guys recommend? She said needs to have famogiden in it and he should take 5mg/day

Pepcid AC (not pepcid complete) is famotidine and you want to purchase the 10 mg one but, if you choose to give it, I’d give 1/4 once a day to start. I’ve used pepcid but only in my kitty that had CKD and only after the slippery elm stopped working. I’m not a big fan of anti-acids for cats or people but it does have it’s place in treatment of some conditions. I’d just suggest you read this series and decide so you can make an informed decision.

SubQ fluids- 100ml x1/week

She wants you to give it once or one time a day for a week? As long as you know his heart has no issues, this is a good recommendation for cat with pancreatitis. If you’ve never given subq fluids, this video should help.

Change diet to Hills prescription WD

’Nuff said.

Also recommending an Ultrasound with an internist to rule out chronic pancreatitis as well as other issues with liver, spleen, and GI tract.

This has to be your decision. There are pros and cons both ways. Sometimes, inflammation of an adjacent organ can cause the spec or snap fPL to indicate pancreatitis. This happened with Gracie and, upon U/S, her pancreas was totally normal which did not surprise me as she never had one clinical sign of pancreatitis. I do not think there is anything wrong in treating for pancreatitis and seeing how it goes and then deciding but if you want to know if there is some other organ involvement so you can better tailor the treatment, then it would be worthwhile.

GI meds)

Which ones?

Have you seen this post on pancreatitis? Did she give him cerenia and/or ondansetron for nausea and vomiting? Anything for pain like buprenorphine? Pancreatitis can be very painful.

Is the vomiting and diarrhea new or does he chronically have these? If he does, then the U/S might be more worthwhile. If he has indications of IBD, you can treat for it without getting a biopsy or endoscopy. There are alot of OTC treatments that can really help conditions like that without going overboard.

You might want to try giving him probiotics if you aren’t. This is a good discussion on them but I have my kitties on the Jarrow’s S. boulardi with MOS and also the NOW Probiotic Defense. While the article focuses on remedies for IBD kitties, it also discusses that non-IBD cats benefit from these. I’ve found the Jarrow’s S boulardi with MOS to be amazing for helping with diarrhea but it won’t touch it if the B12 levels are low, they kitty is hyperT, or has EPI.

Just as an offer....his SS is really a mess. I can clean it up for you if you like. Just PM me as I need editing rights to fix it all and add a 2020 tab for you.

 

[Ozzy Pawzbourne]

Marje put together an excellent Primer on Pancreatitis. There is also a good reference on pancreatitis on Tanya's CRF guide. There was a roundtable discussion on pancreatitis that IDEXX labs had online but it seems to have disappeared. It had some good information on diet. Fundamentally, the issue of low fat high fiber is old school. Your cat needs to eat and given how painful pancreatitis is, whatever Ozzy will eat is fine.

What pain meds did the vet prescribe? I'd strongly encourage buprenorphine.

I started reviewing Marje’s primer yesterday. Lots of good info. Still reviewing the info linked.
Vet did give Ozzy Bupe but not a lot. How many days should he be on this?

 

[Ozzy Pawzbourne]

I’ve been in your shoes, minus diabetes at first. Max was pretty sick the first time and I feared he had cancer. I had just lost his sister to lymphoma and one vet thought so as well. My internist was very conservative and I had gone to a second vet. Went back to the first one and he saved Max from exploratory surgery and I learned how to keep Max feeling well. I get you can too.

Thank you. That is encouraging!

 

[Ozzy Pawzbourne]

How was this diagnosed? Did she do a specfPL or a snapfPL? If you post his labs to his SS lab tab, I can be a little more help.


Increased eosinophils can also be caused by allergies. While running a stool sample is not a big deal, it does add to cost and sometimes you get a negative when the wee beasties are just dormant. So...that’s really up to you and I would say it depends on how high his level is. My two often have increased eosinophils but they are also totally house cats; my vet doesn’t get too worked up over their values. I’ve fed raw for years and years and years with no issue with parasites or bacteria. The pH in a cat’s stomach is really acidic and while I won’t say they can never get bacteria from raw food, the statistics (truthaboutpetfood.com) show the instances of salmonella, etc are higher in commercial foods (dry in particular).


I wouldn’t want to look at this without looking at his other labs but I will tell you that raw fed cats can and often have higher BUN due to the higher protein. And he could have also been dehydrated that day.


Count his respirations at home when he’s at rest. Normal respirations at rest are 20-30 a minute.


Pepcid AC (not pepcid complete) is famotidine and you want to purchase the 10 mg one but, if you choose to give it, I’d give 1/4 once a day to start. I’ve used pepcid but only in my kitty that had CKD and only after the slippery elm stopped working. I’m not a big fan of anti-acids for cats or people but it does have it’s place in treatment of some conditions. I’d just suggest you read this series and decide so you can make an informed decision.


She wants you to give it once or one time a day for a week? As long as you know his heart has no issues, this is a good recommendation for cat with pancreatitis. If you’ve never given subq fluids, this video should help.


’Nuff said.


This has to be your decision. There are pros and cons both ways. Sometimes, inflammation of an adjacent organ can cause the spec or snap fPL to indicate pancreatitis. This happened with Gracie and, upon U/S, her pancreas was totally normal which did not surprise me as she never had one clinical sign of pancreatitis. I do not think there is anything wrong in treating for pancreatitis and seeing how it goes and then deciding but if you want to know if there is some other organ involvement so you can better tailor the treatment, then it would be worthwhile.


Which ones?

Have you seen this post on pancreatitis? Did she give him cerenia and/or ondansetron for nausea and vomiting? Anything for pain like buprenorphine? Pancreatitis can be very painful.

Is the vomiting and diarrhea new or does he chronically have these? If he does, then the U/S might be more worthwhile. If he has indications of IBD, you can treat for it without getting a biopsy or endoscopy. There are alot of OTC treatments that can really help conditions like that without going overboard.

You might want to try giving him probiotics if you aren’t. This is a good discussion on them but I have my kitties on the Jarrow’s S. boulardi with MOS and also the NOW Probiotic Defense. While the article focuses on remedies for IBD kitties, it also discusses that non-IBD cats benefit from these. I’ve found the Jarrow’s S boulardi with MOS to be amazing for helping with diarrhea but it won’t touch it if the B12 levels are low, they kitty is hyperT, or has EPI.

Just as an offer....his SS is really a mess. I can clean it up for you if you like. Just PM me as I need editing rights to fix it all and add a 2020 tab for you.

I have lots of responses for you but need to get off my phone and on a computer. Thank you for coming to my rescue, as always. Can’t tell you how comforted I felt when your name popped up as a reply!!!

 

[Marje and Gracie]

I have lots of responses for you but need to get off my phone and on a computer. Thank you for coming to my rescue, as always. Can’t tell you how comforted I felt when your name popped up as a reply!!!

 

[Wendy&Neko]

Because of my own experience, I go on high alert when I read high respiration rate. Find a time when he's snoozing or just quiet, and count at home. It can be an indication of heart issues if he's above 30. For Neko, above 25 put me on alert, but that's because I knew her normal was low 20's. Adding fluids to this mix is dangerous. Ask me how I know. Did the vet check the heart or do a chest xray?

Eosinophils - my civvie also had them elevated in spite of being indoor only. My vet was not concerned, it's common in shelter cats to be higher. Not sure what Ozzy's history is. BUN also common to be a bit higher on raw fed cats.

Neko was on raw food for over 4 years when she developed what was either severe IBD or small cell lymphoma. We could not test to see which is was because the test requires anaesthesia, which her heart could not take. It's was more likely to be SCL. What causes that? Boy would I like to know - third cat in a row with that now. I would skip the WD - the whole low fat thing for p'titis is more of a dog thing. Plus w/d is more like 25% carbs on Dr. Lisa's list. Side note, Neko was diagnosed with heart, IBD or SCL, and pancreatitis at the same time. IBD/SCL kitties it's not uncommon to have pancreatitis in the mix. Raw food does not preclude IBD - you want novel proteins, no matter whether raw or canned. Neko's internal medicine vet fully supported me continuing Neko on her raw diet after her diagnoses, called it the best thing for her.

The ultrasound would show up thickened intestines if it's either IBD or SCL. It wouldn't be surprising in a cat that is a chronic vomiter as long as other things like hyperT are ruled out.

4 tablets of cerenia. He is to take half a day so 8 days worth I broke up last nights dose and put in his food but he didn't eat it all so no way to tell if he got the full dose.

Cerenia is very bitter - I think you are going to have to pill it, possibly putting it in a pill pocket or gel cap.

 

[Si am cat mom]

I don't find ultrasounds helpful for diagnosing pancreatitis exactly. We had an ultrasound in March and it was pretty much just looking at everything else- liver, kidneys, spleen, stomach- ruling out other issues and then the internists noticing " some mild coarseness " to the pancreas which isn't altogether evidence of an active episode of pancreatitis but couldn't rule out previous episodes...
I used the ultrasound to look for anything other than pancreatitis and get measurements for his kidneys to use later to compare and note changes.
I think it's easier to treat for episodes than it is to try and get labs that " prove" pancreatitis. I don't even feel like snap test in felines are that definitive in diagnosing it, but I guess that could change with advancements in the testing kit/ snaps.

I also second the cringe associated with the suggested W/d diet change. Good grief

Hugs for your little man

 

[Ozzy Pawzbourne]

How was this diagnosed? Did she do a specfPL or a snapfPL? If you post his labs to his SS lab tab, I can be a little more help

Vet performed a senior profile with Spec FPL. I will get a copy of the labs when I go in to get the SubQ fluids and post back the results.

Increased eosinophils can also be caused by allergies. While running a stool sample is not a big deal, it does add to cost and sometimes you get a negative when the wee beasties are just dormant. So...that’s really up to you and I would say it depends on how high his level is. My two often have increased eosinophils but they are also totally house cats; my vet doesn’t get too worked up over their values. I’ve fed raw for years and years and years with no issue with parasites or bacteria. The pH in a cat’s stomach is really acidic and while I won’t say they can never get bacteria from raw food, the statistics (truthaboutpetfood.com) show the instances of salmonella, etc are higher in commercial foods (dry in particular).

Thanks for this info. Think we are going to skip the $200 fecal test. We've never seen any evidence of parasites in his stool and he's never been outside so I'm highly doubtful of parasites. Agree on the raw food. Darwin's is excellent food and flash frozen and I'd think we'd see issues in our Civvie as well (we don't) since they eat from the same pack every time.

I wouldn’t want to look at this without looking at his other labs but I will tell you that raw fed cats can and often have higher BUN due to the higher protein. And he could have also been dehydrated that day.

Good to know. And he may have been dehydrated. Poor kitty vomits a lot!

Count his respirations at home when he’s at rest. Normal respirations at rest are 20-30 a minute.

I monitored his respirations several times last night (always over 30, like 33, 35), but couldn't get him while sleeping. Stayed up with him till 1am and he never slept! I even brought him in bed to sleep above my head on pillow and he didn't go to sleep! @Red & Rover (GA) said that could be side effect of metronidazole. Checked his respiration this morning when I got up and they were still over 30 (33). Will keep an eye on him. Now that he's had a few doses of the Bupe and his "high" should be at a comfortable level, will check him again and see if there is improvement.

Pepcid AC (not pepcid complete) is famotidine and you want to purchase the 10 mg one but, if you choose to give it, I’d give 1/4 once a day to start. I’ve used pepcid but only in my kitty that had CKD and only after the slippery elm stopped working. I’m not a big fan of anti-acids for cats or people but it does have it’s place in treatment of some conditions. I’d just suggest you read this series and decide so you can make an informed decision.

Will check out your link, thank you! And try the Pepcid 1x per day to start.

She wants you to give it once or one time a day for a week? As long as you know his heart has no issues, this is a good recommendation for cat with pancreatitis. If you’ve never given subq fluids, this video should help.

1x per week. 100ml. We didn't do further testing to see if there were any heart issues. I'm going to wait to see if his respirations go back to normal before administering subq fluids. I noticed his breaths were a little shallow too, so want to keep an eye on him. I mean just watching for another day or so. He just got fluids yesterday at the vet.

Which ones?

Have you seen this post on pancreatitis? Did she give him cerenia and/or ondansetron for nausea and vomiting? Anything for pain like buprenorphine? Pancreatitis can be very painful.

Is the vomiting and diarrhea new or does he chronically have these? If he does, then the U/S might be more worthwhile. If he has indications of IBD, you can treat for it without getting a biopsy or endoscopy. There are alot of OTC treatments that can really help conditions like that without going overboard.

You might want to try giving him probiotics if you aren’t. This is a good discussion on them but I have my kitties on the Jarrow’s S. boulardi with MOS and also the NOW Probiotic Defense. While the article focuses on remedies for IBD kitties, it also discusses that non-IBD cats benefit from these. I’ve found the Jarrow’s S boulardi with MOS to be amazing for helping with diarrhea but it won’t touch it if the B12 levels are low, they kitty is hyperT, or has EPI.

Just as an offer....his SS is really a mess. I can clean it up for you if you like. Just PM me as I need editing rights to fix it all and add a 2020 tab for you.

He was given metronidazole for GI issues. He is also on cerenia for nausea/vomiting at my request. Only given 4 tabs to last 8 days. Is it safe to administer more than a week? It was almost $40 for the week. Any alternatives or know of a place to get it cheaper? That's over $100 a month if we give it longer term.

Vomiting is chronic. Been going on long before the diabetes diagnosis (years). Some weeks is a few times a week, others he goes for a stretch and no vomiting, but it's always there. Diarrhea is intermittent. I would say when we give FF he gets HORRIBLE smelling diarrhea and almost none on raw. But he vomits a lot more on the raw food. Fun for my floors.

He started back on probiotics this week. He's taking nexabiotic for cats which I think has S. boulardi in it (need to double check). Also started giving him George's aloe vera juice in his food 1x per day. I still have a lifetime supply of slippery elm bark and could consider using that again instead of the Pepcid.

He got a shot of B12 at the vet.

I'd love if you could help with our SS. Thank you for the offer. I don't use a lap top at home for personal use (only table and cell) and can't really edit the way I need to in order to clean it up from a tablet/phone. You are the 100th person to tell me what a mess it is! LoL! So sorry!

Thank you for all your feedback!

I don't think we want to invest in more expensive diagnostic testing. I think we want to put our focus into treating IBD and getting the pancreatitis under control. As awful as this sounds, I don't think we can spend thousands of dollars more on further health complications. I want to try to make Ozzy as comfortable as possible and see how much more time we can have with him.

 

[Ozzy Pawzbourne]

What pain meds did the vet prescribe? I'd strongly encourage buprenorphine.

This is the one we were given.

 

[Ozzy Pawzbourne]

Because of my own experience, I go on high alert when I read high respiration rate. Find a time when he's snoozing or just quiet, and count at home. It can be an indication of heart issues if he's above 30. For Neko, above 25 put me on alert, but that's because I knew her normal was low 20's. Adding fluids to this mix is dangerous. Ask me how I know. Did the vet check the heart or do a chest xray?

What kind of heart issues? Why is adding fluids dangerous? Going to hold off on SubQ fluids to see if respirations return to normal after being on pain meds. Vet listened to heart with stethoscope, said it sounded normal. But did not do an xray.

Raw food does not preclude IBD - you want novel proteins, no matter whether raw or canned

Interesting that cats can still get IBD on raw food. I would not have suspected that. What exactly is a novel protein? Thought that was just 1 meat source at a time. He only eats Darwins's turkey and chicken. Sometimes fancy feast which results in awful smelling diarrhea. Can you recommend a novel protein food or point me to some research on it?

Thank you for your response and coming to my plea!

 

[Wendy&Neko]

A novel protein is a new protein he hasn't eaten before, such as lamb, venison, rabbit, duck, kangaroo, .... just something other than chicken or turkey. http://www.rawfeedingforibdcats.org/

What kind of heart issues?

In Neko's case, congestive heart failure. Basically fluid in the chest that made it harder for the heart to work. Adding subq fluids adds to the problem. I'm glad the vet listened to Ozzy's heart.

 

[Olive & Paula]

I think you got all the advice I could offer and then some.

My Smokey was a chronic vomitor most of his life. I took him from my parents when my mom couldn't remember to care for him. I only had him 2.5 yrs. With my parents he was fed when they remembered to get him. Noting was ever looked into as why the vomiting. Fast forward, he came to live with me. Tried all meds for the vomiting. Because he wasn't use to eating regularly, I fed small amounts hourly so not to overwhelm his sysyem. Eventually the longest he could go without eating was 2 hrs. He was diabetic but insulin was forgotten for many months. Eventually pancreatitis was confirmed after much pushing to get tested. He got cerenia and bupre. But still vomiting. I agreed to try the rx dm wet food. Surprisingly it worked, he liked it and it was 4% carbs.

Currently Ollie is chronic pancreatitis. Not a vomitor unless she goes to long without eating. She gets bupre every 8 hrs and will for life. If she starts a flare up, I have cerenia in pill and injectable. She does have heart issues so fluids are limited for her. The injectable cerenia I will give in the fluids and it helps as stings/burns awful if just giving injection.

The pill is hard to give to Ollie, she will foam, vomit and not get it down. However, the new Delectable Squeeze Up treat, I can put the pill in and she will gobble it down.

I really believe FF changed their formula again. It smells worse than it has, texture is different as well as color. All my kitties were refusing, vomiting, scratching really bad. So that might be some of the problem. Since I removed it in December, all issues have stopped.

 

[Marje and Gracie]

We didn't do further testing to see if there were any heart issues. I'm going to wait to see if his respirations go back to normal before administering subq fluids. I noticed his breaths were a little shallow too, so want to keep an eye on him. I mean just watching for another day or so. He just got fluids yesterday at the vet.

Smart.

He was given metronidazole for GI issues.

This can cause inappetence and generally feeling poorly. I’ve not had a cat yet that could take it but ECID.

Is it safe to administer more than a week? I

Absolutely. It’s a good anti-inflammatory. Gracie took 1/4 of a 16 mg tab every day for six months.

Vomiting is chronic.

Then I would expect he’s got something going on like IBD. Cats should very rarely vomit...even long-haired ones.

He's taking nexabiotic for cats

That’s a good brand but even if it has S. boulardi, you need more. The MOS really makes a difference. You can mix a little George’s with SEB and water (always be sure to give water with it) and that helps soothe the tummy and fight nausea, too. Just be sure you taste the SEB. It can go off. It should be sweet tasting.

 

[Ozzy Pawzbourne]

A novel protein is a new protein he hasn't eaten before, such as lamb, venison, rabbit, duck, kangaroo, .... just something other than chicken or turkey. http://www.rawfeedingforibdcats.org/


In Neko's case, congestive heart failure. Basically fluid in the chest that made it harder for the heart to work. Adding subq fluids adds to the problem. I'm glad the vet listened to Ozzy's heart.

Thanks for the info. I will check it out

 

[Ozzy Pawzbourne]

Ozzy seemed more interested in food this evening and came out to eat his afternoon leftovers and ate most of his dinner So that's an improvement Don't want to jinx myself before the day is completly done, but no vomiting today.

He also seems to be feeling better He hid all day under the bed but since this evening he has been out and about in the house He came and snuggled on my lap a bit ago (probably saying thank you for helping me) and I tried to catch his respirations. They were still a tad over 30. He got super relaxed and sprawled out and looked to have fallen asleep and his respirations for the first time I have been observing were 27. I am still concerned about his breathing and definitely keeping an eye out

How long does pancreatits take to settle down? When and what signs should we be looking for to know when to take him off the meds?

If he has chronic pancreatitis, will his lab value go back to normal? Vet wants to check him back in a week to see if his lab goes down. Is that necessary

 

[Ozzy Pawzbourne]

This can cause inappetence and generally feeling poorly. I’ve not had a cat yet that could take it but ECID.

Is there another GI med that's better Was just reading more about cerenia and I didnt know it was an anti inflammatory and can help with intestinal issues. Thought it was just for nausea and vomiting.. Could he just stay on this instead of the other med? Also, how/where can I get it cheaper

 

[Marje and Gracie]

Is there another GI med that's better Was just reading more about cerenia and I didnt know it was an anti inflammatory and can help with intestinal issues. Thought it was just for nausea and vomiting.. Could he just stay on this instead of the other med? Also, how/where can I get it cheaper

Metronidazole is an antibiotic and cerenia is an anti-emetic/anti inflammatory. The typical dose of cerenia is 1/4 tab per day (although it can be dosed at 1/2 tab per day but I’d start low and see if that helps) so four tabs should last you 16 days at the lower dose. $40 is really expensive. Thriving pets.com has it for $18.95 but you need a prescription from your vet. That is a reputable company...I’ve used them a lot but there might be other online veterinary pharmacies like Wedgwood that might have a good price.

To answer your question.....the two meds do two different things. Your vet is assuming he has a bacterial infection by giving metronidazole. If you want to try something different, try the Jarrow’s S boulardi with MOS and see if that helps. You can also use it with the metronidazole but he shouldn’t be on the latter long term.

 

[Olive & Paula]

There is no time line for how long p'titis will last. Flare ups for Ollie are much shorter and if caught early can get her out of it in 48 hrs. Her full blown episode lasted over 6 weeks. It's funny as it wasn't on our radar for what was wrong. She had been sick for some time but didn't have all the usual symptoms and not severe at the time. Finally her labs were sent out to IDEXX who runs the test automatically in the GI panel. That's when it came up.

Her levels are always high for it except one time it was in normal range. I do not know if test positive is always positive or not. her very 1st vet did a SNAP on her first visit with them when I got her and it was negative, and she was not well, I don't know what to think on that. I know SNAP isn't the best indicator.

I give insulin in her sides, flanks, chest area and when she reacts to the needle (normally she doesn't), I know she is having abdominal discomfort, my radar kicks in. If appy is at least half, I'll just keep watching her. The minute she walks away from food, I give cerenia in a treat or if have to I give subq fluids with the injectable cerenia. I will increase her bupre. And she will turn around within 48 hrs. She gets bupre daily. Once she is eating normally I start increasing the time between cerenia until she doesn't need it.

You don't want to stop meds to early, and only stop one at a time, and restart immediately if behavior indicates its still needed.

It has been found that cerenia has anti inflammatory properties, so its not a bad drug for GI issues to keep in hand. Of course it doesn't do a thing for arthritis but for GI inflammation it really helps.

I was told by Ollies vet she could stay on cerenia daily long term if I wanted. She certainly does better with it. But she isn't at a point where it's needed long term.

 

[Ozzy Pawzbourne]

Metronidazole is an antibiotic and cerenia is an anti-emetic/anti inflammatory. The typical dose of cerenia is 1/4 tab per day (although it can be dosed at 1/2 tab per day but I’d start low and see if that helps) so four tabs should last you 16 days at the lower dose. $40 is really expensive. Thriving pets.com has it for $18.95 but you need a prescription from your vet. That is a reputable company...I’ve used them a lot but there might be other online veterinary pharmacies like Wedgwood that might have a good price.

To answer your question.....the two meds do two different things. Your vet is assuming he has a bacterial infection by giving metronidazole. If you want to try something different, try the Jarrow’s S boulardi with MOS and see if that helps. You can also use it with the metronidazole but he shouldn’t be on the latter long term.

just purchased the Jarrow's. Won't be here for a week though. I have been giving 2 pills of the nexabiotic daily. Nothing is seeming to help with the vomiting. For past few days, Ozzy has been on cerenia, probiotics 2xs a day, and had aloe vera juice mixed in his food. I know it will take some time to soothe the gut, but I was just hoping for some relief in the vomiting due to the cerenia.

Going to head to the pet food store and get a different protein. Ozzy has been eating raw chicken and turkey. Will try a novel protein.

 

[Marje and Gracie]

just purchased the Jarrow's. Won't be here for a week though. I have been giving 2 pills of the nexabiotic daily. Nothing is seeming to help with the vomiting. For past few days, Ozzy has been on cerenia, probiotics 2xs a day, and had aloe vera juice mixed in his food. I know it will take some time to soothe the gut, but I was just hoping for some relief in the vomiting due to the cerenia.

Going to head to the pet food store and get a different protein. Ozzy has been eating raw chicken and turkey. Will try a novel protein.

You definitely need to talk to the vet about the ongoing vomiting.

 

[Ozzy Pawzbourne]

You definitely need to talk to the vet about the ongoing vomiting.

I just talked to her She said that that it could be because he is not absorbing it due to vomiting. But he threw up 3 hours after he took the pill this morning. Same yesterday it was hours after he took it Wants him to come in for cerenia injection than back on tje pills when it wears off

I'm at my wit's end So much going on right now this is just making things so much more difficult and my poor kitty

 

[Marje and Gracie]

I just talked to her She said that that it could be because he is not absorbing it due to vomiting. But he threw up 3 hours after he took the pill this morning. Same yesterday it was hours after he took it Wants him to come in for cerenia injection than back on tje pills when it wears off

I'm at my wit's end So much going on right now this is just making things so much more difficult and my poor kitty

I was just going to suggest you switch to the injections. Will she give you a prescription to get the injectable from thrivingpets?

 

[Ozzy Pawzbourne]

I was just going to suggest you switch to the injections. Will she give you a prescription to get the injectable from thrivingpets?

I asked her for the injectable and told her I felt comfortable giving it. She is looking into it. How long does it take to get it from thriving pets? My husband is furious over how much we are spending and says no more We are up over $1200 for this episode.

 

[Marje and Gracie]

I asked her for the injectable and told her I felt comfortable giving it. She is looking into it. How long does it take to get it from thriving pets? My husband is furious over how much we are spending and says no more We are up over $1200 for this episode.

I don’t know. They used to be quick but seems everyone has slowed down with the pandemic so you’d have to ask them.

However, until you figure out why he’s vomiting and address THAT, then you are just putting a bandaid on it which might pull off at any time. KWIM?

 

[Ozzy Pawzbourne]

I don’t know. They used to be quick but seems everyone has slowed down with the pandemic so you’d have to ask them.

However, until you figure out why he’s vomiting and address THAT, then you are just putting a bandaid on it which might pull off at any time. KWIM?

Yes, but we can't spend whatever it takes to run a zillion diagnostic tests. This is just a bad sitiation

 

[Marje and Gracie]

Yes, but we can't spend whatever it takes to run a zillion diagnostic tests. This is just a bad sitiation

I’m very sorry.

 

[Ozzy Pawzbourne]

could he really be throwing the cerenia up 3 hrs after taking it? wouldnt it have taken effect by then? is it ok to give and then immediately feed?

 

[Ozzy Pawzbourne]

I’m very sorry.

thanks

 

[Marje and Gracie]

could he really be throwing the cerenia up 3 hrs after taking it? wouldnt it have taken effect by then? is it ok to give and then immediately feed?

I honestly don’t know. I wish I had answers for you. One would think that the cerenia has had plenty of time to work. Usually it’s 30 mins.

I’m truly sorry I can’t offer you more insight. I’m not a vet and with a cat as sick as Ozzy is, you have to rely on your vets Who also have the benefit of seeing him.