+2/2 Fred +11 313 Pred?

Purrberry

Purrberry

Member Since 2020
https://www.felinediabetes.com/FDMB/threads/2-1-fred-10-402-ultrasound-day.258710/

Thanks again to everyone who followed Fred's journey over the past 10 days or so.

Now that we've gotten over the immediate scare, we have to deal with what's there...pancreatitis..be it chronic or a flare. I'm still awaiting his bloodwork/fPLI from yesterday.

Though I know it would wreak havoc on his BG, is prednisolone out of the question for this? Even just a short anti-inflammatory course? It would seem kind of logical to me, but I don't know. I have no problem adjusting Fred's insulin if the pred would help him.
 
Max had chronic pancreatitis for a few years before becoming diabetic. I shared his story with you. It is not easy to treat and frustrating at times but if it remains uncomplicated far better than the other possibilities.

We have a Pancreatitis Handbook that explains it all. No prednisolone! Treat the symptoms. For max he was nauseous and whenever his appetite waned I knew to start ondansetron for nausea. He also sometimes needed an appetite stimulant and I used cyproheptadine, a human RX. Max only need a sliver of a 4mg pill. Vets like mirtazapine but it has more possible side effects. Pancreatitis can be painful so he got buprenex if a bad flare. Prednisolone is NOT standard treatment. I will link the handbook.
 
Honey was on budnesonide for chronic pancreatitis. The internist at Cornell said in the event it effected her blood glucose, they would simply adjust the insulin. He was also a proponent of Tiki Cat cat food for pancreatic issues.
 
Prednisolone would be a last resort in my opinion. Max had chronic pancreatitis for over 7 years. Never was on it. It’s not recommended. Read the articles in the handbook.
 
@tiffmaxee You have shared your story, thank you! I've been at Dr. Google again and had read the primer as well as the linked articles. My take on it is that while there are no specific studies on cats, in dogs and humans, it has shown some promise. It is not standard, though, no.

I'm pulling this from the primer:
Steroids: Steroid treatment using such drugs as prednisone, prednisolone, or dexamethasone can be useful for treating chronic feline pancreatitis. Insulin needs “might” increase with the use of steroids if the veterinarian believes steroid therapy is required.

And this from the IDEXX Treatment Plan:
Cats with chronic pancreatitis alone may actually benefit from the anti-inflammatory effects of corticosteroids

I wouldn't be thrilled about placing Fred on a long term dose. But I do wonder about a short course to perhaps help to get him over the hump. (that's if I can get him to take the pill...ha!) If I really search back in my memory, I'd say that Fred started to get picky with his food during the summer of 2020. He was diagnosed with diabetes in December of 2020, but I think he had been borderline for some time. So it might be a chicken and the egg situation. Did he perhaps have subtle pancreatitis that I didn't pick up on (or at that point, even know about) and that caused his diabetes, or vice versa?

@NyCatMom Hello! How did you feel Honey did on the pred? Did it affect her numbers much? ECID, I know. And how I wish Himself would deign to eat commercial food! Once he's (hopefully) passed this, maybe something different will tempt him, as I'm afraid he's gotten adverse to his usual diet.
 
Honey improved dramatically on the pred and chemo therapy drug but it was short lived due to other medical conditions. The guy we saw was Dr Forman at Cornell vets. We went there because we were told he had a lot of experience with feline pancreatitis. I pulled up Honeys discharge notes with food recommendations for pancreatitis. The Tiki cat recommendation was for less than 2.5% fat as listed on the can. Here is an excellent paper on the subject. Pain relief was key to get through attacks. Sometimes I think it helped her more than anything else.
https://onlinelibrary.wiley.com/doi/10.1111/jvim.16053
 
If it were me I would start by treating the symptoms like Elise suggested. Steroids for me are last on the list, just because of all the other effects (budesonide on the liver, pred and BG, etc). Flares can last a week or two, so I would try that first and if he's really really having trouble give the pred a shot.

Cerenia is one medication used to treat the symptoms and does have some mild antiinflammatory capabilities

Also, I'm sorry about the p'titis. It sucks. I hate it the most
 
Purrberry said:
https://www.felinediabetes.com/FDMB/threads/2-1-fred-10-402-ultrasound-day.258710/

Thanks again to everyone who followed Fred's journey over the past 10 days or so.

Now that we've gotten over the immediate scare, we have to deal with what's there...pancreatitis..be it chronic or a flare. I'm still awaiting his bloodwork/fPLI from yesterday.

Though I know it would wreak havoc on his BG, is prednisolone out of the question for this? Even just a short anti-inflammatory course? It would seem kind of logical to me, but I don't know. I have no problem adjusting Fred's insulin if the pred would help him.
Click to expand...
Shouldn’t you be giving fluids for pancreatitis? Or is that a “no go” with Fred?
 
And yes, as Melissa mentioned, Cerenia is frequently given to cats with chronic pancreatitis - daily - not for nausea but the anti inflammatory effect in pancreas as I understand it. But this would mean a daily wrestling match with Fred, I am afraid. And Cerenia is very bitter and must be put into a gelcap or do injections which I believe you have already tried and they sting. So Just continue with the Zofran and potentially pain meds??
 
Sabrina has a very enlarged pancreas due to either chronic pancreatitis or pancreatic cancer. Both her IM and primary vet don't want to put her on pred. We were specifically told by her primary vet that pred would make Sabrina feel better but she would also decline fast.

We use SubQ fluids, Cerenia, and bupe to keep her hydrated and keep nausea and pain at bay. We also have CBD on hand but haven't started yet. Primary vet also recommended Onsior for short term use to manage inflammation.
 
From my own experience, I spent a lot of time and money making sure that Ruby really needed pred before putting her on it, mostly because she was nearly in remission and I had a strong feeling that she would be knocked out of it if I did. When her SCL diagnosis come through loud and clear, I knew I had to privilege the cancer. Steroids have a lot of side effects--immune system suppression, weight gain, and aggression are among the ones I have noticed with Ruby, not to mention insulin resistance that takes 3 units of insulin to combat. If only there were a single pill you could pop to make pancreatitis go away, but it seems from what I know that it's about managing it with anti-emetics, subQ, and pain meds.

The other thing I would suggest, though I don't know if you or Fred will like this, is to switch to a raw or homecooked diet. He would benefit from more nutritious food, and avoid the additives that are in commercial food that might aggravate his pancreas. His kidneys would benefit as well. You could do something as simple as poaching some chicken or pork and putting it in his bowl to see if he goes for it.
 
NyCatMom said:
The Tiki cat recommendation was for less than 2.5% fat as listed on the can
Click to expand...

This is amazing. I was always told that cats with pancreatitis don't need a special diet and they tolerate fat just fine. But that is really not Sabrina's case. Food with high fat content definitely triggers her flare.

Thank you for sharing this.
 
Jia&Sabrina said:
Sabrina has a very enlarged pancreas due to either chronic pancreatitis or pancreatic cancer. Both her IM and primary vet don't want to put her on pred. We were specifically told by her primary vet that pred would make Sabrina feel better but she would also decline fast.

We use SubQ fluids, Cerenia, and bupe to keep her hydrated and keep nausea and pain at bay. We also have CBD on hand but haven't started yet. Primary vet also recommended Onsior for short term use to manage inflammation.
Click to expand...

yes. Lower fat is easier on the pancreas for sure.

my cats liked Tiki cat foods, but all the ones I found were too high in phosphorus and thus too hard on the kidneys.
 
NyCatMom said:
Honey improved dramatically on the pred and chemo therapy drug but it was short lived due to other medical conditions. The guy we saw was Dr Forman at Cornell vets. We went there because we were told he had a lot of experience with feline pancreatitis. I pulled up Honeys discharge notes with food recommendations for pancreatitis. The Tiki cat recommendation was for less than 2.5% fat as listed on the can. Here is an excellent paper on the subject. Pain relief was key to get through attacks. Sometimes I think it helped her more than anything else.
https://onlinelibrary.wiley.com/doi/10.1111/jvim.16053
Click to expand...
What cancer did Honey have that she was on pred and chemo?? SCL?
 
Suzanne & Darcy said:
@THH & Snowcrash (GA) you have a lot of experience with pancreatitis — and you use Cerenia in your panc kitties, don’t you?
Click to expand...

Yes, and we used cerenia at the rescue I was with too, either daily or as-needed. There were a lot of diabetic cats that would have bouts of pancreatitis; most weren't longterm, but they'd have flares off and on.

For my cats at home, both Emily and Cinnamon are on daily cerenia... but both also take prednisolone 5mg daily; both have inflammation in multiple systems, so it's necessary.
 
Suzanne & Darcy said:
Shouldn’t you be giving fluids for pancreatitis? Or is that a “no go” with Fred?
Click to expand...
I know fluids are so important, but I'm afraid that's one skill have not perfected. I'm not sure he'd hang out long enough for me to get them in.

Thanks, everyone for your input. I finally got a call from the vet last night to go over his labs, from blood taken on Tuesday, the day of the ultrasound. All his kidney numbers were good, and his potassium had corrected itself. All good.

But, his fPLI was 13. :-( (range being 0-3.5) I know others have had levels even higher than that, but she said "cats with a level that high are usually hospitalized". The highest he's ever gone previously is 5.7. His last level on 12/2/21 was 3.4. So this was definitely a bad one for him, poor guy. Additionally, they found very very few bacteria in his urine, so they want to put him on Veraflox for suspected UTI. Finally, she suggested gabapentin for a few days for pain, even though he didn't present as painful on physical exam.

I was able to get him to eat his brekkie with the gabapentin in it, but I'm worried about the Veraflox. Normally, he'd eat it fine in his food, but he's JUST starting to get into his wet food again. I hate to taint it further.

At the end of the conversation, I asked the vet about pred, and she said no, she wouldn't do that. So I guess that's my answer for now!
 
Some good news in there! If he gets really bad again you may want to consider hospitalizing him for a few days. I know.... you don't want Fred to be away from you! But if you can't give fluids or the other meds that he needs then you should consider it. Sorry... that sounds so mean!! I don't mean it to be like that. I'm just worried about Fred! What the vet said about most cats with the fPLI so high are hospitalized is just kind of scary. Poor Fred. He must be a tough guy!
 
Good to see Fred's blood work is improving. Neko's had fPLI at 14.7 and I didn't get the suggestion she should be hospitalized.

Will Fred eat meds in Churo's or other treats? Maybe all meat baby food? Something different so he doesn't associated meds with his food.
 
You must log in or register to reply here.
Back
Top