Advice for Pancreatitis and Anorexia

Status
Not open for further replies.
KAYLENE529

KAYLENE529

Member Since 2020
Hi all - myself and my sugar cat, Leo, are new to diabetes and FDMB.

He is 14 years old and was diagnosed back in May. The first few months went well. He didn't get any worse and he enjoyed the Purina DM and I was hopeful we had this whole diabetes thing figured out. Until one day he started vomiting and not wanting to eat. My vet thought he was going into remission so we lowered his ProZinc doses to 1 unit every 12 hours instead of 2 units. We did some blood work and his glucose levels were almost normal so we took that as a good sign.

However, over the past ~30 days he really hasn't been wanting to eat. Before his diagnosis he was 19lbs (big boy with big bones) and now he is down to 11.6lbs. We stopped his insulin for a week to see if that helped. No improvements with his appetite and weight loss and he started drinking more but has not been vomiting. I took him to the vet last week and his blood sugar was through the roof she we started back his insulin immediately and did some blood work and other tests. It's pointing to pancreatitis and we are waiting for results for a UTI.

He got a long acting antibiotic shot, we started buprenorphine as well as cerenia and he got some subq fluids. I've tried home testing (after I insisted with my vet) but we are not very successful. He won't let me touch his ears and I can't get enough blood from his paw pad. My vet said to give him his insulin even if he doesn't eat because of how high his blood sugar is and how low of a dose of insulin we are giving him. Last night and this morning he is totally anorexic and we did get a reading of 506 this morning so I went ahead with his insulin and have been trying to get him to eat all day without any success. Over the past few weeks he is starting to be increasingly uncoordinated and weak.

We have a vet appointment tonight and I plan on discussing/administering the following:

- FreeStyle Libre monitor so I can get a better understanding of his insulin needs
- Appetite stimulants and additional food options to get him to eat (up to and including a feeding tube)
- At home subq fluids
- B12, antacids and increasing his pain meds as recommended from the vet
- Ultrasound to get a better idea of how angry his pancreas is or if there are other concerns
- Ketone test
- Exploring weather he might be insulin resistant

I'm terrified we won't be able to get this under control and I'll lose him because he seems to just be getting worse. I lost my dog last year to pancreatitis so I'm very familiar with this awful disease. But adding diabetes on top of it is a whole new level of frustrating. I'd love any advice or recommendations to those of you with an anorexic sugar cat suffering pancreatitis so I can give him the best shot possible at recovering and stabilizing his diabetes.
 
WELCOME TO FDMB Kaylene We are so glad you found us! First I would like ask Is Leo acting nauseous? Does he lick his lips and take a lick of food then turn away? If so please also ask the vets for something for the nauseousness.
That aside Your kitty has a lot going on. and I hope we can help. You may want to start here:
New? How You Can Help Us Help You!

We are dedicated to helping anyone who reaches out to us so you have landed in a safe place. While I dont have any experience with the other issues your kitty has, there are people here who do so please be patient they will find you.;)

The Libre system is an excellent one but many cats just somehow relieve themselves of it quickly. Hopefully that wont be your experience should you go that route. Most of the folks here use regular, good ol human meters. They are cheap and so are the strips you use with them. Should your vet want to sell you the alpha track system I wont lie its a good system but the strips are expensive. Either way, whatever you decide to go with, we can still help you. :)

We know its scary we've all been there so do not worry it DOES get better.
Again welcome to the best site on this planet to learn everything you need to know about feline diabetes.

WELCOME TO OUR FAMILY! :bighug:
jeanne
 
Last edited:
Hi Kaylene,

I'm so sorry to hear that Leo may have pancreatitis. It truly is an awful affliction. (((Leo)))

Your experience with managing the disease certainly shows. Your 'hitlist' above has most bases covered. The only suggestions I can think to add at the moment are:

* Check for any issues with constipation or GI obstruction (both can cause nausea/vomiting/anorexia). For obvious reasons the cat still won't eat even after anti-nausea and appy stimulant meds are administered. See the following thread for relevant information:

https://felinediabetes.com/FDMB/threads/new-member-christina-kitty-cat-9-13-20.235222/#post-2633871

* Ondansetron is another very effective anti-nausea treatment but it can take 24-48 hours before full benefit is obtained. At the start of a flare my vet would give Saoirse a Cerenia injection and that offered some help while the ondansetron was getting going. The two meds can be used together as they operate on different receptors in the body to control nausea and vomiting. Ondansetron can be more aggressively dosed for severe pancreatitis.

* Most vets prescribe mirtazapine for appetite stimulation. An alternative is cyproheptadine. It doesn't exert a stimulant effect for as long as mirtz BUT it can be administered up to 3 times a day. I found that it gave more control over appetite stimulation and also seemed to make Saoirse feel a bit better.

* Very small, very frequent meals can help at the height of a flare. Adding a teaspoon or two of water to each micro meal can help with hydration. (UK vets aren't big on home sub-q administration.) Timed feeders are a godsend in this respect.

* A lot of US members recommend offering a cat-suitable baby food when a cat is struggling to eat. Suitable products and other suggestions in the following:

Persuading Your Cat to Eat

Tips for Stimulating a Cat's Appetite

(Probably of more help once you break through the 'anorexia wall'.)

Here are another couple of resources I have found very helpful:

IDEXX Feline Pancreatitis Treatment Guidelines

Nausea and Inappetence - Symptoms and Treatments

I hope the vets will be able to put together a treatment regimen that works for Leo tonight. Sending a heartfelt prayer that he'll start eating and feeling better very soon. Be sure to keep us posted with Leo's progress.


Mogs
.
 
Last edited:
Ondansetron dosing from Plumb's Veterinary Handbook 6th Edition 2008:


upload_2020-9-5_21-7-19-png.56070



Per the above, when treating a c. 4.5kg/10lb cat for severe pancreatitis, it is possible to dose ondansetron at up to 4mg every 12 hours.


Mogs
.
 
Critter Mom said:
Ondansetron dosing from Plumb's Veterinary Handbook 6th Edition 2008:


upload_2020-9-5_21-7-19-png.56070



Per the above, when treating a c. 4.5kg/10lb cat for severe pancreatitis, it is possible to dose ondansetron at up to 4mg every 12 hours.


Mogs
.
Click to expand...
I have been dealing with severe chronic pancreatitis with my cat Buddy for years. The one thing you did not mention is force feeding, Hill's I/D or A/D are both smooth and easy to use for force feeding. Since you mentioned your cat has lost a lot of weight the A/D has more fat & calories, Buddy cannot tolerate the fat so I use I/D and add a lot of water. You mentioned a feeding tube which I have never used. Tonight, Buddy ate a new food and liked it, besides nibbling on dry food, this is the 1st time he has ate on his own in weeks. He ate some DM chunky tonight, he would not eat the pate, I am hoping he keeps on eating. Best wishes for your kitty, keep us informed and be sure to check for ketones.
 
Thank you all, here's an update!

Leo was at the vet on Friday night and again this afternoon. We gave him some subq fluids and started him on Mirtazapine , Ondansetron, Famotidine, Metronidozole and fortiflora and he got a B12 shot. I'm cutting back the urgent A/D since it's so fatty and might hurt his tummy and making the diarrhea worse. He ate really well last night but is peckish today. I'm hopeful his appetite will pick up throughout the night, I'm trying to feed him his canned Purina DM but have other yummy options on standby. He does not have a UTI and NO KETONES!!!!

We are still struggling to get an at home BG reading. His blood sugar is usually super high (500+ Friday morning and 300+ Friday night) but we are scared to give too much insulin w/o getting proper readings so we are sticking with 1 unit 2x per day. My AlphaTrack 2 keeps giving me an Error 1. I feel like I am getting a big enough sample and test comes back just fine. I want to get a human meter tomorrow that actually sucks up the blood and I'm hoping that'll help us be more successful in our blood glucose readings. Any recommendations on which one to get?

My vet is also recommending vast dosage changes of insulin. What worries should I have of not following the .25 increments I've seen talked about on this forum?

My vet is concerned that he isn't responding well to treatment that something else might be at play </3 If he doesn't make improvements in the next 24-48 hours we plan on putting in an IV and administering more meds and fluids that way. We are working on getting an ultrasound scheduled on Monday as well so we can get an idea of how bad it is or if anything else is causing this flare up.

He got Covenia over a week ago to cover our basis for an infection. He was already weak, lethargic and had a poor appetite before then. People have mentioned that the Covenia could be making him so sick. Thoughts? That seems like a leap considering he was sick before he got that injection but I'm curious if people have experience with this.

Teresa - I lost my dog last year to pancreatitis and tried force feeding and all it did was stress us both out and put a strain on relationship and made her more adverse to food and meds. I will not force feed him as I think it causes more harm than good. I don't love the idea of a feeding tube (I did this for my dog and she couldn't even keep water down that we put through the tube) but because I am seeing some improvements in his appetite so I'm hoping this won't be necessary.

Wish us luck over the next day or two! I'm really needing him to turn a corner.
 
Last edited:
I want to get a human meter tomorrow that actually sucks up the blood and I'm hoping that'll help us be more successful in our blood glucose readings. Any recommendations on which one to get

Most of us use the Relion Prime from Walmart, It's 9 dollars and sucks up their blood.
17.88 for 100 test strips
I'm praying for Leo to turn the corner
Wishing you and Leo all the best :bighug::bighug::cat:
 
The issue with Convenia is that it is an antibiotic that is best used for skin infections. In addition, if a cat has or develops an allergy to it, it is a long-acting medication. Once it's in,, you can't get it out. That's the problem.

You can also use ondansetron and Cerenia in combination. They work on different centers that control nausea and vomiting. I would suggest getting empty gel caps since both are bitter and can cause your cat of foam or drool due to the taste.

You likely already know this but you want to make sure to give the appetite stimulant at least 30 min after you give the nausea meds. The nausea needs to subside before the appetite stimulant kicks in. No one wants to try to eat when their nauseated and it can cause a food aversion.
 
Hi Kaylene,

Good to hear that Leo is eating a little bit, and that he's negative for ketones.

KAYLENE529 said:
We are still struggling to get an at home BG reading. His blood sugar is usually super high (500+ Friday morning and 300+ Friday night) but we are scared to give too much insulin w/o getting proper readings so we are sticking with 1 unit 2x per day. My AlphaTrack 2 keeps giving me an Error 1. I feel like I am getting a big enough sample and test comes back just fine. I want to get a human meter tomorrow that actually sucks up the blood and I'm hoping that'll help us be more successful in our blood glucose readings.
Click to expand...

upload_2020-9-27_14-59-53.png


Asking the following questions from a belt 'n' braces angle:

1. Have you checked that the code on the meter matches the code on your current vial of test strips?

2. Did you check the meter with the control solution supplied with the meter?

The Alphatrak strips are normally really good at sipping up the small amount of blood they need for a successful test.

3. Are you applying a very thin film of Vaseline to the ear prior to doing the poke (helps blood droplet to bead up better).

4. Are you holding the sample area on the side of the strip gently against the blood droplet until the meter beeps to confirm enough blood has been sampled? (Assuming here that you've got the beep enabled on the meter.)

(I assume you've done these things but I'm just asking to make sure I've covered all bases. :) )

Another tip might be to collect the blood sample on the back of a clean fingernail and test it from there (takes some of the time pressure off).


Mogs
.
 

Attachments

  • upload_2020-9-27_14-59-53.png
    upload_2020-9-27_14-59-53.png
    47.9 KB · Views: 396
Last edited:
KAYLENE529 said:
Thank you all, here's an update!

Leo was at the vet on Friday night and again this afternoon. We gave him some subq fluids and started him on Mirtazapine , Ondansetron, Famotidine, Metronidozole and fortiflora and he got a B12 shot. I'm cutting back the urgent A/D since it's so fatty and might hurt his tummy and making the diarrhea worse. He ate really well last night but is peckish today. I'm hopeful his appetite will pick up throughout the night, I'm trying to feed him his canned Purina DM but have other yummy options on standby. He does not have a UTI and NO KETONES!!!!

We are still struggling to get an at home BG reading. His blood sugar is usually super high (500+ Friday morning and 300+ Friday night) but we are scared to give too much insulin w/o getting proper readings so we are sticking with 1 unit 2x per day. My AlphaTrack 2 keeps giving me an Error 1. I feel like I am getting a big enough sample and test comes back just fine. I want to get a human meter tomorrow that actually sucks up the blood and I'm hoping that'll help us be more successful in our blood glucose readings. Any recommendations on which one to get?

My vet is also recommending vast dosage changes of insulin. What worries should I have of not following the .25 increments I've seen talked about on this forum?

My vet is concerned that he isn't responding well to treatment that something else might be at play </3 If he doesn't make improvements in the next 24-48 hours we plan on putting in an IV and administering more meds and fluids that way. We are working on getting an ultrasound scheduled on Monday as well so we can get an idea of how bad it is or if anything else is causing this flare up.

He got Covenia over a week ago to cover our basis for an infection. He was already weak, lethargic and had a poor appetite before then. People have mentioned that the Covenia could be making him so sick. Thoughts? That seems like a leap considering he was sick before he got that injection but I'm curious if people have experience with this.

Teresa - I lost my dog last year to pancreatitis and tried force feeding and all it did was stress us both out and put a strain on relationship and made her more adverse to food and meds. I will not force feed him as I think it causes more harm than good. I don't love the idea of a feeding tube (I did this for my dog and she couldn't even keep water down that we put through the tube) but because I am seeing some improvements in his appetite so I'm hoping this won't be necessary.

Wish us luck over the next day or two! I'm really needing him to turn a corner.
Click to expand...
I am hoping that your kitty continues to recover. Buddy, does not like to be force feed, however since he has pancreatitis and is diabetic he must eat. So my options were to force feed or let him starve, since I am very fond of him, I decided to force feed. None of my vets have ever mentioned a feeding tube, but since yours has, this might be a good option for you. Buddy, has been diabetic since 12/26/2016 and in that time I have done a lot of force feeding, I believe this last time I have been force feeding around 5 to 6 weeks. Last night & this morning Buddy ate on his own, this made me very happy, since he has not been eating for 5 to 6 weeks on his own. I would put the feeding tube in, if you do not want to force feed because your kitty has to eat to get well. Much good luck for you & your kitty.

n
 
Critter Mom said:
Ondansetron dosing from Plumb's Veterinary Handbook 6th Edition 2008:


upload_2020-9-5_21-7-19-png.56070



Per the above, when treating a c. 4.5kg/10lb cat for severe pancreatitis, it is possible to dose ondansetron at up to 4mg every 12 hours.


Mogs
.
Click to expand...
That’s the dose Minnie is on for her IBD. There’s still ocasional vomiting but it’s not frequent. I think you can actually dose every 8 hours since it doesn’t fully cover a 12 hour span
 
KAYLENE529 said:
My AlphaTrack 2 keeps giving me an Error 1. I feel like I am getting a big enough sample and test comes back just fine.
Click to expand...
When you are trying to get the sample, you are dipping the little protruding points on the edge INTO to the drop AND NOT trying to scoop the drop on Top of the black dot, correct? Those protrusions are the little straw that suck up the blood. I ask because we've had a lot of people, including myself the first few days of testing, doing it incorrectly. Doing the test correctly, the alpha needs a very small sample.
 
I’m surprised your vet hasn’t done the ultrasound right away. Have you done all the pancreatitis specific blood tests as well? Those 2 things should help rule it out. The next step would be an endoscopy to ascertain IBD or lymphoma. The feeding tube Minnie was on was traqueal and it was put in surgically. I’m not sure that’s what you’re talking about or if you mean the tube though the nostril. I have no experience with the latter.

When you test, are you warming up the ear? Are you giving him a treat immediately after testing? It doesn’t have to be food related. Maybe a favorite game or cuddling or scratching his favorite spot. Errors are often due to too little or too much blood. If the strip is getting a ton of blood it won’t be able to read just as if it’s not getting enough. I’d try getting the blood on your fingernail next time and testing from there to see if it helps.

sending you positive thoughts and prayers!!!
 
JanetNJ said:
When you are trying to get the sample, you are dipping the little protruding points on the edge INTO to the drop AND NOT trying to scoop the drop on Top of the black dot, correct? Those protrusions are the little straw that suck up the blood. I ask because we've had a lot of people, including myself the first few days of testing, doing it incorrectly. Doing the test correctly, the alpha needs a very small sample.
Click to expand...

Janet - your advice was golden!!!! I don't know how to thank you! I just used your advice and simply put the little protrusion on the edge by the black dot in the middle of the blood droplet and we got a reading (314) so now I can safely give him more insulin like he needs. THANK YOU! THANK YOU! Thank you for taking the time to respond, you've made a world of difference for me and Leo with that tip!
 
Aleluia Grugru & Minnie said:
I’m surprised your vet hasn’t done the ultrasound right away. Have you done all the pancreatitis specific blood tests as well? Those 2 things should help rule it out. The next step would be an endoscopy to ascertain IBD or lymphoma. The feeding tube Minnie was on was traqueal and it was put in surgically. I’m not sure that’s what you’re talking about or if you mean the tube though the nostril. I have no experience with the latter.

When you test, are you warming up the ear? Are you giving him a treat immediately after testing? It doesn’t have to be food related. Maybe a favorite game or cuddling or scratching his favorite spot. Errors are often due to too little or too much blood. If the strip is getting a ton of blood it won’t be able to read just as if it’s not getting enough. I’d try getting the blood on your fingernail next time and testing from there to see if it helps.

sending you positive thoughts and prayers!!!
Click to expand...

It's hard to find a good internist here in my community and all the good ones we have are fully booked! I'm hopeful we can get him in tomorrow or Tuesday for an ultrasound.

He hasn't had diarrhea for 24 hours and he is eating well for me today (Hills A/D is the only thing he will eat) and I was able to give him his mirtazapine and cerenia wrapped in a little bit of Velveta as well as get a BG reading today. We still have a long way to go but I think we have both turned a corner!
 
KAYLENE529 said:
Janet - your advice was golden!!!! I don't know how to thank you! I just used your advice and simply put the little protrusion on the edge by the black dot in the middle of the blood droplet and we got a reading (314) so now I can safely give him more insulin like he needs. THANK YOU! THANK YOU! Thank you for taking the time to respond, you've made a world of difference for me and Leo with that tip!
Click to expand...
Oh gooood. I was doing it wrong at first, too. I thought you put the drop on Top and I guess sometimes a little would go in and out would work so I thought I was doing it right but that the meter was difficult. I'm glad I was able to help.
 
KAYLENE529 said:
It's hard to find a good internist here in my community and all the good ones we have are fully booked! I'm hopeful we can get him in tomorrow or Tuesday for an ultrasound.

He hasn't had diarrhea for 24 hours and he is eating well for me today (Hills A/D is the only thing he will eat) and I was able to give him his mirtazapine and cerenia wrapped in a little bit of Velveta as well as get a BG reading today. We still have a long way to go but I think we have both turned a corner!
Click to expand...
Oh I'm so glad he's doing better!!! I had a cat with pancreatitis. He was given sub q's daily, cerenia for nausea and bupe for pain. Took a few days and his appetite was back to normal and a week he was totally himself. I hope your cat has a quick recovery like that.
 
Last edited:
KAYLENE529 said:
Can I ask about dosage for Famotidine/Pepcid?

My vet gave Leo a shot of Famotidine last night and I know he is still uncomfortable. I have both Pepcid and Prilosec on-hand and wanted to see what dosage I should give him?

Good news - he took his Metronidozole thanks to a tiny bit of Velveeta and we got a successful BG reading for the 2nd time today!
Click to expand...

For Pepcid, make sure it's the original formula; some human versions have extra coating. You want the 10mg famotidine, dose is usually 1/4.

Prilosec dosing is also usually 1/4 (5mg, 1/4 of a 20mg pill).

Both can be given once or twice a day usually.
 
Critter Mom said:
Hi Kaylene,

Good to hear that Leo is eating a little bit, and that he's negative for ketones.



View attachment 56703

Asking the following questions from a belt 'n' braces angle:

1. Have you checked that the code on the meter matches the code on your current vial of test strips?

2. Did you check the meter with the control solution supplied with the meter?

The Alphatrak strips are normally really good at sipping up the small amount of blood they need for a successful test.

3. Are you applying a very thin film of Vaseline to the ear prior to doing the poke (helps blood droplet to bead up better).

4. Are you gently holding the sample area on the side of the strip gently against the blood droplet until the meter beeps to confirm enough blood has been sampled? (Assuming here that you've got the beep enabled on the meter.)

(I assume you've done these things but I'm just asking to make sure I've covered all bases. :) )

Another tip might be to collect the blood sample on the back of a clean fingernail and test it from there (takes some of the time pressure off).


Mogs
.
Click to expand...

Thanks, Mogs! It was totally user error on how I was trying to get the blood onto the test strip. We've had 2 successful readings today and I think I have it all figured out finally!
 
THH said:
Hey, just a quick note: cat pancreatitis is unique in that diet DOES NOT affect it (unlike with dogs and people!). So if the A/D is what he's eating, that's great and won't make his pancreatitis worse. What's most important is that he's eating and feeling better :)
Click to expand...
What does it not affect, I am interested because I have a diabetic cat who has had pancreatitis since 2012. I try to get any info I can that might help my cat.
 
KAYLENE529 said:
Hi all - myself and my sugar cat, Leo, are new to diabetes and FDMB.

He is 14 years old and was diagnosed back in May. The first few months went well. He didn't get any worse and he enjoyed the Purina DM and I was hopeful we had this whole diabetes thing figured out. Until one day he started vomiting and not wanting to eat. My vet thought he was going into remission so we lowered his ProZinc doses to 1 unit every 12 hours instead of 2 units. We did some blood work and his glucose levels were almost normal so we took that as a good sign.

However, over the past ~30 days he really hasn't been wanting to eat. Before his diagnosis he was 19lbs (big boy with big bones) and now he is down to 11.6lbs. We stopped his insulin for a week to see if that helped. No improvements with his appetite and weight loss and he started drinking more but has not been vomiting. I took him to the vet last week and his blood sugar was through the roof she we started back his insulin immediately and did some blood work and other tests. It's pointing to pancreatitis and we are waiting for results for a UTI.

He got a long acting antibiotic shot, we started buprenorphine as well as cerenia and he got some subq fluids. I've tried home testing (after I insisted with my vet) but we are not very successful. He won't let me touch his ears and I can't get enough blood from his paw pad. My vet said to give him his insulin even if he doesn't eat because of how high his blood sugar is and how low of a dose of insulin we are giving him. Last night and this morning he is totally anorexic and we did get a reading of 506 this morning so I went ahead with his insulin and have been trying to get him to eat all day without any success. Over the past few weeks he is starting to be increasingly uncoordinated and weak.

We have a vet appointment tonight and I plan on discussing/administering the following:

- FreeStyle Libre monitor so I can get a better understanding of his insulin needs
- Appetite stimulants and additional food options to get him to eat (up to and including a feeding tube)
- At home subq fluids
- B12, antacids and increasing his pain meds as recommended from the vet
- Ultrasound to get a better idea of how angry his pancreas is or if there are other concerns
- Ketone test
- Exploring weather he might be insulin resistant

I'm terrified we won't be able to get this under control and I'll lose him because he seems to just be getting worse. I lost my dog last year to pancreatitis so I'm very familiar with this awful disease. But adding diabetes on top of it is a whole new level of frustrating. I'd love any advice or recommendations to those of you with an anorexic sugar cat suffering pancreatitis so I can give him the best shot possible at recovering and stabilizing his diabetes.
Click to expand...
I just wanted to tell you that I think you have a very pretty cat, for some unknown reason I like black & white cats.
 
Status
Not open for further replies.
Back
Top