? 3/16 Mr Kitty Emergency Vet

FrostD

FrostD

Very Active Member
Yesterday

Had to syringe feed last night, though he did eat some of his own volition. Today more force feeding, just staring at his bowl like he wants to eat but can't. Pretty mad at me.

Can't get into regular vet so taking him to emergency vet I've never seen. Makes me nervous.

What all should I be asking for? Oral exam? Nausea meds? Which ones? Bloodwork for pancreatitis?
 
:bighug::bighug::bighug::bighug::bighug:
Sounds like he is nauseous. Poor guy. That is a classic symptom of pancreatitis. I would be asking for the pancreatitis Spec fPLI test for sure. Yes it's bloodwork. You may want to get the senior panel, cbc. Sorry this is just off the top of my head. Hopefully others will be able to weigh in.

There is also the Snap fPLI, which is quicker but not as accurate as it is just a "yes/no" rather than a measurement on a scale.

For pancreatitis, which butters has, here is what I'd ask for (meds wise):
cerenia and ondansetron (for nausea, they work different pathways so can be used together and it's good to have options). Ondansetron sometimes requires a prescription as it is a human med not all vets keep it on hand.
cyproheptadine for an appetite stimulant (but must be used in combo with meds for nausea)
something for pain. If it is pancreatitis, that is extremely painful. Most kitties do very well with buprenorphine. Some use gabapentin. With Butters, I keep both on hand. She seems to do better with gabapentin but I prefer buprenorphine for her.

I'd ask for a full examination of him, if he were my kitty. From nose to tail, including mouth and abdominal exam. They should be able to tell you from that if they suspect pancreatitis, and if so, I would immediately request all of the meds.

Sending many healing vines to Mr. Kitty. Keep us updated.
 
Yes. If you are going that route, please request that it be done by a boarded radiologist. They are the experts and it tends to make a difference in accuracy of results. Butters had one done by a boarded internal medicine vet and it was okay...although the vet's written report was poorly done.
 
Just from memory - something is sticking in my head about some of these being pill vs liquid form? Some bitter, some not?
 
From what I know of:

cyproheptadine is a pill. Not sure it comes in liquid.
ondansetron is a pill.
Cerenia definitely comes in pills and I think you can get a liquid.
Buprenorphine comes in liquid.
Gabapentin definitely comes in capsules & pills...I think there is a liquid option. You can ask.

FWIW, I would coat the pills and capsules in a little butter and butters will swallow them. Alternately, you can get empty capsules and add the pills into a single capsule and then pill Mr. Kitty that way..with just a single capsule rather than multiple pills. Just a thought.
 
Ondansetron and Cerenia also come in injectibles. Cerenia stings like heck, so if you can get a pill down, that is best. Gel caps, size number 3, 4, or 5 are best for kitty. Larger size, smaller cap. They were great when I had to give Neko multiple meds.

Thinking of you, keep us posted, :bighug::bighug:
 
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At vet now, he started panting in the car which I don't like. Temp normal, sugar high, but breathing fast and heavy. Waiting on Dr for game plan, preliminarily looks like need to hospitalize but not sure
 
Snap fPL came back abnormal and amylase high, so moving forward as if it's pancreatitis. Will start sub Q fluids, anti nausea injection, and antibiotic injection (I guess some cases of pancreatitis can resolve with antibiotics?), and mirtaz. Vet still wants x ray but I told her we'll hold off and see how he does with all this. Also sending us home with cerenia, figure it'll be nice to have on hand even if he starts feeling better. I'll bother our regular vet about ondansetron.

If he's not better by tomorrow I'll come back for stuff to do subQ at home and probably do x-rays.

Reminds me I forgot to ask about pain meds, will do that when she comes back in.
 
Hoping for the best for your kitty, Melissa. Have you done the SubQ's before? I had to do it with my Simon who had stage 4 kd but it wasn't as bad as it sounds and it certainly made him feel better and want to eat. My prayers are for your Mr. Kitty and for you.
 
Get them to show you how to do the sub-q fluids at home. It will really help. It is quite different than giving a quickie insulin injection. Hope Mr. Kitty feels better soon.
 
Buprenorphine for panc pain. Hope they will give it to you. I think somebody already mentioned putting the cerenia in a gel cap? It is bitter so it helps. Follow all pills with canned food or water syringed in if they won't eat. Never dry pill a cat. You probably already know all this stuff!
 
FrostD said:
Snap fPL came back abnormal and amylase high, so moving forward as if it's pancreatitis. Will start sub Q fluids, anti nausea injection, and antibiotic injection (I guess some cases of pancreatitis can resolve with antibiotics?), and mirtaz. Vet still wants x ray but I told her we'll hold off and see how he does with all this. Also sending us home with cerenia, figure it'll be nice to have on hand even if he starts feeling better. I'll bother our regular vet about ondansetron.

If he's not better by tomorrow I'll come back for stuff to do subQ at home and probably do x-rays.

Reminds me I forgot to ask about pain meds, will do that when she comes back in.
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Make sure that he is not nauseated before you start the Mirataz. If it's "Mirataz" in a tube, then you put it on the inside of the ear. I would NOT give the full dose. Once you are sure he shows no signs of nausea and you are giving the Cerenia daily (and ondansetron if you end up getting that from a pharmacy) then start with about 1/2 of the length of the strip on the box that the tube comes in. A lot of cats have strong reactions to Mirataz. I used to give 1/2 the strip on my kitty Tabitha's ear only every other day usually and it helped her appetite. I started out giving the vet recommended 1.5 inches on the ear every day and it made her very aggressive toward the other cats. A lot of people have cats that won't settle down and meow incessantly, too (from the Mirataz, I mean.)
 
Suzanne & Darcy said:
Buprenorphine for panc pain. Hope they will give it to you. I think somebody already mentioned putting the cerenia in a gel cap? It is bitter so it helps. Follow all pills with canned food or water syringed in if they won't eat. Never dry pill a cat. You probably already know all this stuff!
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Did not know this, thanks! Never had to pill a cat.

Vet did not want to give pain meds tonight, because of how he was acting she was concerned I wouldn't be able to tell feeling "meds dumpy" vs "emergency dumpy" and tbh I think she was right. So we'll get pain meds tomorrow. She was a bit worried about treating initial pancreatitis flare as outpatient but didn't give me flak, which I appreciate.
 
Suzanne & Darcy said:
Make sure that he is not nauseated before you start the Mirataz. If it's "Mirataz" in a tube, then you put it on the inside of the ear. I would NOT give the full dose. Once you are sure he shows no signs of nausea and you are giving the Cerenia daily (and ondansetron if you end up getting that from a pharmacy) then start with about 1/2 of the length of the strip on the box that the tube comes in. A lot of cats have strong reactions to Mirataz. I used to give 1/2 the strip on my kitty Tabitha's ear only every other day usually and it helped her appetite. I started out giving the vet recommended 1.5 inches on the ear every day and it made her very aggressive toward the other cats. A lot of people have cats that won't settle down and meow incessantly, too (from the Mirataz, I mean.)
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Thanks for this too! I gave about half dose... although she told me give the Cerenia about an hour to kick in, then give Mirataz. Oops. Next dose I'll be sure to wait for signs of nausea to go away.
 
Aside from calling BG of 385 "not too high, not too low", I'm pretty happy I lucked out with a decent emergency vet. While not super well versed in FD, she was great about everything else. Didn't give me any flak about wanting to treat at home vs hospitalize for 1-2 days, declining x-rays for now, and the meds I asked for.

Now that it's had some time to sink in, I have a slew of questions. I'll post them sometime tonight/tomorrow as soon as I get kids in bed, cat bathed and taken care of.
 
I guess the Cerenia injection has some sort of pain relief for GI? I didn't have time to fact check, but the tech said that should at least help him a bit
 
FrostD said:
Thanks for this too! I gave about half dose... although she told me give the Cerenia about an hour to kick in, then give Mirataz. Oops. Next dose I'll be sure to wait for signs of nausea to go away.
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It’s just really that you don’t want to make a nauseated cat hungry. Then they’ll be hungry and yet nauseated all at the same time. Got to take care pf the nausea first then get them hungry.
 
FrostD said:
I guess the Cerenia injection has some sort of pain relief for GI? I didn't have time to fact check, but the tech said that should at least help him a bit
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Cerenia should help a little for the inflammation and nausea and especially if there’s any vomiting. It’s not really a pain reliever. But you explained the vets logic on pain meds for tonight. By tomorrow you really should get something for pain though. I hope sweet Mr. Kitty will feel better soon. Fluids will help a lot!
 
Ok questions:

Is this likely a chronic thing? We had a similar episode 10/16/20, but he was fine by morning so he didn't get checked out.

If it is chronic -
is there anything I can do to help prevent it or lower likelihood of recurrence?

Do I just keep all the meds and supplies on hand to treat? Vs being reactive and getting from vet when it happens. Not sure about shelf life/expiry dates, but fear is night time/weekend issues.

How do you treat at home? For example, this week his appetite actually started slowing down Saturday, then ate/drank nothing Sunday til today. So would I have started Sunday with the anti nausea meds, then if that didn't work add in the app stim, then sub q as last resort?

A few people mentioned ultrasound, what will that show/look for?

Anything else I'm maybe not thinking of? I've got two kids in the middle of sleep regressions plus the cat and brain is foggy :confused:
 
I always treated Sheba’s pancreatitis at home after the initial visit to the vet.
Pain meds made a difference....pancreatitis is painful so I’d push for some pain meds.
Treatment is supportive until it all settles down again. May take a day, may take a week or two.
Antinausea meds may or may not need to be continued for a while, Same with the pain meds and the sub Q fluids....depending on how severe the pancreatitis is.
Sometimes Sheba only needed the first day of treatment, other times she needed several days.
I never got an ultrasound done, the vet always went on symptoms. I got a fPL test the first few times but got to recognise the symptoms.
Sheba used to get a flare up of pancreatitis about twice a year.....I found stress played a part.
Yes, keep a supply of meds on hand in case of a flare up......it always happens after vet hours.:rolleyes:
 
FrostD said:
A few people mentioned ultrasound, what will that show/look for?
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They look at the liver, kidneys, adrenal glands, and the small intestine for any abnormalities. The ultrasound would rule out IBD or small cell lymphoma, as those will also cause GI distress and inappetance. It's good that your vets were able to zero in on the pancreatitis, as there are meds to manage the symptoms/flare ups in a more immediate way.
 
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