Dose Advice Needed for Kitty with Acute Pancreatitis. TYIA

[Jia&Sabrina]

Hi everyone,

It has been a whole week since last time my Sabrina ate on her own. She was diagnosed with acute pancreatitis and hospitalized for three days and two nights. She was discharged with meds for nausea, bupe, fluids, and appetite stimulant. Unfortunately she still shows little, if not zero, interest in food. We talked to internist yesterday and if things don't get better we will have to install a feeding tube. We were told that she has severe pancreas changes and they can't rule out cancer considering that Sabrina is 16 year old.

Today she seems a little bit better. I offered her Fancy Feast marinated chicken, which used to be her favorite, and she actually did a couple of lickings. So my questions is, if Sabrina gets better and is willing to eat some high carb food, what should I do in terms of monitoring her blood glucose and adjusting insulin. Internist told me not to give any insulin if BG is below 160, while give 0.5u if BG bw 160-250, 1u if BG above 250. Sabrina has been on Lantus which is a long acting insulin, so I am not sure if adjusting dose for every cycle is a good option.

Please advice! And please keep Sabrina in your happy thoughts if you see this post. Very much appreciated!

 

[Diane Tyler's Mom GA]

Hi everyone,

It has been a whole week since last time my Sabrina ate on her own. She was diagnosed with acute pancreatitis and hospitalized for three days and two nights. She was discharged with meds for nausea, bupe, fluids, and appetite stimulant. Unfortunately she still shows little, if not zero, interest in food. We talked to internist yesterday and if things don't get better we will have to install a feeding tube. We were told that she has severe pancreas changes and they can't rule out cancer considering that Sabrina is 16 year old.

Today she seems a little bit better. I offered her Fancy Feast marinated chicken, which used to be her favorite, and she actually did a couple of lickings. So my questions is, if Sabrina gets better and is willing to eat some high carb food, what should I do in terms of monitoring her blood glucose and adjusting insulin. Internist told me not to give any insulin if BG is below 160, while give 0.5u if BG bw 160-250, 1u if BG above 250. Sabrina has been on Lantus which is a long acting insulin, so I am not sure if adjusting dose for every cycle is a good option.

Please advice! And please keep Sabrina in your happy thoughts if you see this post. Very much appreciated!

I'll tag a few members for you, what date was she hospitalized and released?

@Wendy&Neko

@Sienne and Gabby (GA)

@Chris & China (GA)

Thank you ladies

 

[Jia&Sabrina]

what date was she hospitalized and released?

Thank you Diane. Sabrina was admitted on Sunday (5/2) and released on Wednesday (5/5). She was very stressful and barely moved in the hospital so the internist thinks it would be better for us to take her home first to see if she would eat at home.

 

[Jia&Sabrina]

We syringe feed her at 6am(10ml), 830am(20ml), 1230pm(20ml), 430pm(20ml), 830pm(20ml). But she needs more calories to maintain weight. We are still debating to proceed to feeding tube. One minute I'm determined to give it a try, the next I don't want to put her through all the trauma and general anesthesia.

She is alert but sleeps most of time. She sleeps in an awkward position and that shows me that she is still in pain...

 

[JaxBenji]

So sorry you are going through all this @tiffmaxee and @Butters & Lyla also have experience with Pancreatitis. I'm not sure how familiar you are with it (I'm not at all ), but there is also a plethora of info here - A Primer on Pancreatitis

My kitty did have a feeding tube (he was battling a stomach ulcer and nasty infection) - I will find the notes I've shared with others here but in summary it was so nice to get food into him and then once he was eating on his own I was able to push his medicine cabinet of meds down it too. I want to say he only had it in 3ish weeks. There's some info here if you want to read more on them - https://catinfo.org/feeding-tubes-for-cats/

 

[JaxBenji]

My kitty did have a feeding tube

Jax had an esophagostomy tube in 2018; in Jax's case we were battling a severe stomach ulcer and suspected sepsis. His tube was in for about 3 weeks but I only used it for feeding for about a week (I think we fed watered-down Hills A/D). After Jax started eating food on his own, I still pushed extra mls of water as well as his meds. The feeding tube definitely allowed me to get food (& meds!) in him and gave him energy to heal.

One other thing about the feeding tube decision is you don't want to wait too long as there needs to be anesthesia so the kitty needs to be stable enough for that.

Here's Jax eating with his Kitty Kollar which helped hold his e-tube in place (clearly, prediabetes with mounds of dry food lol ).

Happy to answer any questions (if I can remember ). Whatever decision you make is the right one Hugs to you all

 

[tiffmaxee]

Ask for ondansetron for the nausea. For many cats it works better than cerenia . Some cars need both as they work differently. Which one more you given? Try feeding a different flavor food in case a food aversion developed towards the old favorites. I also found Gerbers baby food worked when everything else was turned down, the 100% protein. Ham was a big hit with mine.

 

[tiffmaxee]

As for the sliding dosing, not a good idea. Lantus likes consistency. Since you are syringe feeding I would try .75 unless the BG is under 150 as you aren’t seeing low numbers. It’s dosed based on how low it takes your cat. It can take time for pancreatitis to resolve. You might also want to try a different appetite stimulant. I like the human RX cyproheptadine.

 

[Jia&Sabrina]

Hi Susanne, thank you so much for sharing Jax's experience with feeding tube. He's so chill in the pic with cute blue collar. He reminds me of the first kitty I had.

I'm new to pancreatitis. But Sabrina might have it for a while. When I look back right now, there were signs. We noticed her meat loaf position a few months ago. We were worried about it but when we touched and rubbed her belly, she didn't seem bothered and changed into a relaxing position. So we thought maybe it was because of her shaved belly (did ultrasound last July, hair never grow back...). When she was diagnosed with diabetes we switched her to low carb food which she doesn't like. So when her appetite fluctuates, we thought it was because of the food... I never thought she could be in pain and discomfort. I feel so bad for not being able to catch those signs...

Now my biggest fear is that even with the placement of feeding tube for weeks, she wouldn't eat on her own. They did ultrasound twice and we were told that she has severe pancreas changes. I'm scared to put her through everything but still not good enough to help her.

Right now she is fairly stable. The internist is out of the office and will return on Monday. If she doesn't eat on her own over this weekend, we will probably go get feeding tube. If her situation gets worse, we will get the tube through ER per the internist recommended.

Thanks again! <3

 

[Jia&Sabrina]

Ask for ondansetron for the nausea. For many cats it works better than cerenia . Some cars need both as they work differently. Which one more you given?

Thank you Tiff. I have both ondansetron and cerenia. I asked a local vet to prescribe me ondansetron. I do believe it works better than cerenia.

I also found Gerbers baby food worked when everything else was turned down, the 100% protein. Ham was a big hit with mine.

ER gave Sabrina Garber. I kept giving it to her for last two days then I switched to Tiki After Dark Venison. She stopped eating once in April, the Garber Chicken I gave to her caused diarrhea. I am not sure if it is the cause though but Sabrina does gag at the smell of food with high fat content like Wellness Tiny Taster and Weruva Jeopardy. Before she was diagnosed with diabetes, Sabrina was on Fancy Feast Elegant Medleys, gravy lovers, etc. Those are pretty low in fat. I understand that there is no evidence to prove that pancreatitis in cat is related to high fat diet. But I am not sure if it is the case for Sabrina. I bought chicken thighs and livers and am going to cook for her tonight...

 

[Jia&Sabrina]

As for the sliding dosing, not a good idea. Lantus likes consistency. Since you are syringe feeding I would try .75 unless the BG is under 150 as you aren’t seeing low numbers. It’s dosed based on how low it takes your cat. It can take time for pancreatitis to resolve. You might also want to try a different appetite stimulant. I like the human RX cyproheptadine.

Thank you! .75 is the dose that we are giving today.

I never heard of RX cyproheptadine but I will look it up. Thanks a lot for recommendation!

 

[JaxBenji]

I feel so bad for not being able to catch those signs...

Gosh, I feel like we've all been there with our pets for one reason or another. I know you can't help but feel a twinge of guilt but the only advice I have is to recognize the information you have now and then make the best decision you can for your family

chill

lol. I'm laughing because Jax was feisty as all get out sweet, lovable kitty to me but if you had a white coat you were from another planet lol. He NEVER met a vet he liked.

BTW, if you want another option for high protein / low fat food (and low-carb), I feed my civvie (non-diabetic) Tiki Cat chicken-only formulas - Puka Puka Luau and Koolina Luau. I buy the 6oz cans from Chewy though I think my Petco carries the 10oz can (if I still had more than one cat, I'd go for the larger can).

 

[tiffmaxee]

Thank you! .75 is the dose that we are giving today.

I never heard of RX cyproheptadine but I will look it up. Thanks a lot for recommendation!

Cyproheptadine is a human drug. Sorry I wasn’t clear. You will need an RX from your vet and then get it from a pharmacy. I like it because it can be given twice a day. Just a sliver got Max eating. Cyproheptadine was used a lot before mirtazapine. Less side effects too.

 

[Butters & Lyla]

Oh goodness. I'm so sorry to hear what you're going through with Sabrina. Butters was hospitalized for five nights because of a pancreatitis flare in October 2020. Like you, I realized after that pancreatitis was something she likely had for a long time...long before diabetes came into the picture.

I also use ondansetron and cerenia together for nausea and cyproheptadine as an appetite stimulant if the anti-nausea drugs aren't enough to get her eating. The cyproheptadine really worked wonders to get Butters eating again. She wasn't eating when she was hospitalized and an e-tube was discussed for her as well, but in the end she ate just enough to manage to avoid that.

I don't have anything else to add, really. It has been well covered by Elise and Susanne. Sending many eating vines to Sabrina.

 

[Jia&Sabrina]

@Diane Tyler's Mom
@JaxBenji
@tiffmaxee
@Butters & Lyla

Thank you everyone for your extremely helpful advices.

After not wanting anything to do with food for ten days, Sabrina finally started to show interest in eating again yesterday. She had half can of Fancy Feast Elegant Medleys, some freeze dried chicken. And she grazed on some YA kibbles last night.

We still need to keep syringe feeding for a while I suppose as we are not sure how much she would be willing to eat, but definitely some progress there. Her blood glucose is a bit all over the places. We gave 1u this AM since it was over 250 last night. We will keep the dose for three days and see how things would go.

Thanks again ladies for being so caring and supportive! <3

 

[Diane Tyler's Mom GA]

@Diane Tyler's Mom
@JaxBenji
@tiffmaxee
@Butters & Lyla

Thank you everyone for your extremely helpful advices.

After not wanting anything to do with food for ten days, Sabrina finally started to show interest in eating again yesterday. She had half can of Fancy Feast Elegant Medleys, some freeze dried chicken. And she grazed on some YA kibbles last night.

We still need to keep syringe feeding for a while I suppose as we are not sure how much she would be willing to eat, but definitely some progress there. Her blood glucose is a bit all over the places. We gave 1u this AM since it was over 250 last night. We will keep the dose for three days and see how things would go.

Thanks again ladies for being so caring and supportive! <3

Jia, I'm so happy to hear that Sabrina ate on her own , it definitely is progress.
Looking at her pic, she's so adorable Jia.
Sending prayers she continues to want to eat ♥

 

[tiffmaxee]

I’m do glad to read this.

 

[Butters & Lyla]

So happy to hear she is interested in food again. I hope she continues to improve. Sending lots of eating vines her way.

 

[JaxBenji]

Hi Jia What wonderful news - thanks for posting an update

I'm not sure if you are looking for any help with dosing (if not, ignore and carry on ) - there are lots of experienced people here (like Elise!) who can help if you want it (would just need your SS updated if it's not already)

Hope Sabrina continues to improve