3rd Episode of Pancreatitis - Feeling Defeated

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Draper

Draper

Member Since 2020
Hello,

Semi-lurker here and I am feel very lost on next steps for Draper. I'm hoping that someone out here in this lovely forum may have had a similar situation. He just got home from a short but severe bout of pancreatitis and I'd like to follow up with our vet this week to discuss what to do next. I know pancreatitis can be very unpredictable and unexplainable but I am a bit frustrated with hearing that with no other options/suggestions. He's only 10 y/o and has been seemingly fine since moving to 1u of Lantus almost a year ago.

1st pancreatitis episode - April 2020
2nd pancreatitis episode - August 2020
Diagnosed with FD - August 2020
FD regulated at 1u Lantus - Spring 2021
3rd pancreatitis episode - Feb 2021

Currently feeding him wet DM with a few kibbles on the top to entice him to eat. I also try to put a bit of water in the bowl to add extra hydration. The ER vet recommended switching to EN or ID but at this point, I wonder if we should find a low carb, lower fat non-prescription wet? I will review the amazing spreadsheet of dietary options here soon but would love any recommendations.

I'd also like to re-try taking daily BG at home. We didn't have much luck with the Alpha Trak but open to any suggestions as well. He is a quite large and fiesty maine coon that has to be semi-sedated for every vet visit. I'm willing to try it again with another method, if possible. I do suspect that maybe another curve is needed as well?

Also, I'd like to ask the vet if we should continue with the Pred. He was originally put on it many years ago due to allergy issues. I've heard conflicting options on if this is helpful or hurtful for cats with FD and pancreatitis. Dosage is currently at a half 5mg tablet every 12 hrs (given before his insulin shot).

Apologies for the long post but I just feel a bit hopeless at this point and I just want to do the best I can to keep him pain-free.

Thank you in advance!
-Draper's Mom
 
Hello and welcome. First of all the "GA" prefix is used to signify cats that have "gone ahead" or are now "guardian angels", hopefully not the situation here with Draper.

Unfortunately pancreatitis and diabetes do seem to be common companions. Tagging @tiffmaxee who's kitty had chronic pancreatitis.

And here is a link to our A Primer On Pancreatitis

Testing at home and low carb wet or raw food are two of the things we believe in strongly here. You don't need to use the AlphaTrak - it's test strips are very expensive. We are used to using human meters and our dosing methods use the human meter numbers. Some people get a Freestyle Libre put on until they are more comfortable with home testing.

Prednisolone can also raise the blood sugars. If it's necessary we can deal with it but I'd only put him on it if needed.
 
So sorry you had to find us but I think we can help you. Max was diagnosed with chronic pancreatitis when he was 10 and probably had it for about 6 months before diagnosed. I think it’s what caused hi, to be come diabetic when he was about 14. In your case the prednisolone might have led to diabetes. My vet never put Max on a steroid. What allergies does he have? I have a 5 year old with skin allergies and switching to a protein she never had before has helped a lot. My fear is one day she too will need medication so I am super strict in what I feed her.

I digressed. I treated Max’s pancreatitis by treating the symptoms. He got ondansetron for nausea and sometimes cyproheptadine as as appetite stimulant. He always became inappetent when he had a flare so I started at the first sign his appetite was off. Some of the time he needed buprenorphine for pain. I fed him fancy feast pates as diet didn’t cause flares. He was very sensitive and stress was his trigger. No need to feed RX food. Some cats can be triggered by a super high fat diet but fat doesn’t have the same effect on pancreatitis in cats as it does for humans and dogs.

Does your cat still have allergies? Skin or stomach? Symptoms? Did you give a treat after you tested his bg? 100% protein treats are great for that especially if that’s the only time the treats are given.
 
My cat Sheba also used to have chronic pancreatitis. She seemed to get one or two flares a year.
She always went off her food so I knew what it was. She rarely vomited or had diarrhoea and she appeared in pain. She responded well to the subQ fluids, antinausea injection and pain injection.
I started to keep the antinausea meds and pain meds at home and could also give sub Q fluids at home so at the first sign I started them.
I fed her a home made diet of chicken and kangaroo meat with supplements. Sometimes it took a few days for her to get back to eating it. She seemed to like some canned foods for a few days as she improved before returning to her normal home made diet.

I have a cat who has skin allergies and gets a runny eye with it. I find a 1/2 Zyrtec 10 mg tablet once a day controls it well.

I think it would be a great idea if you set up the spreadsheet and started testing. If you live in the US you can get a ReliOn human meter for $9 and 100 test strips for 17.88. Troy wil also need some lancets size 26 or 28 gauge and some cotton rounds to put behind the ear when you test.
Here is a link to the spreadsheet, signature and hypo box and other information. HELP US HELP YOU

and a link to TESTING HINTS AND LINKS
 
tiffmaxee said:
So sorry you had to find us but I think we can help you. Max was diagnosed with chronic pancreatitis when he was 10 and probably had it for about 6 months before diagnosed. I think it’s what caused hi, to be come diabetic when he was about 14. In your case the prednisolone might have led to diabetes. My vet never put Max on a steroid. What allergies does he have? I have a 5 year old with skin allergies and switching to a protein she never had before has helped a lot. My fear is one day she too will need medication so I am super strict in what I feed her.

I digressed. I treated Max’s pancreatitis by treating the symptoms. He got ondansetron for nausea and sometimes cyproheptadine as as appetite stimulant. He always became inappetent when he had a flare so I started at the first sign his appetite was off. Some of the time he needed buprenorphine for pain. I fed him fancy feast pates as diet didn’t cause flares. He was very sensitive and stress was his trigger. No need to feed RX food. Some cats can be triggered by a super high fat diet but fat doesn’t have the same effect on pancreatitis in cats as it does for humans and dogs.

Does your cat still have allergies? Skin or stomach? Symptoms? Did you give a treat after you tested his bg? 100% protein treats are great for that especially if that’s the only time the treats are given.
Click to expand...

Thanks, @tiffmaxee. Your post gave me a little bit of hope today.
I have records somewhere saved in our house but for the first 2-5 years we went through multiple allergy tests. We bounced around foods until we came to Royal Canin Hydrolyzed Protein - this is also when the Pred was introduced. He seemed okay on it but continued to have a pink belly and a patches of spotty fur from over grooming. Since being diagnosed with diabetes, it seems like the allergies have all but gone away. He is almost long haired and this is the most fur he's ever had!

100% protein treats are on their way. Once I get testing up and running (ReliOn meter and lancets should be here in a few days), I hope we can figure out next steps for food. Thank you for the reccos, @Bron and Sheba (GA).

In regards to anti-nausea and pain meds to have on hand in case of symptoms again, can I ask my vet for those? If I do have them on hand, I would worry that I should go to the vet asap, maybe that's just my gut feeling. Do you have any guidance or references on what to do in those situations?

Thanks again and I'll (hopefully) get a spreadsheet up and running this week!
 
You won’t need to go to the vet if you have the medication we suggest and start it at the first signs of her being off. Vets only treat the symptoms too. Max rarely vomited unless he had a hairball. He was long haired. He would stop eating or only want dry food. That was before diabetes. I had already switched to all canned before diagnosis but it was high carb canned. Ondansetron is a human RX that really helps. When you get a chance look at the pancreatitis handbook. There are articles with information from prominent veterinarians.
 
Thanks @tiffmaxee. Life got a bit crazy and I didn't have a chance to respond.

I'm picking up medication from the vet this weekend so it'll be great to have that on hand in the event of an other episode (I hope not!).

Should I inquire about taking him off the Pred? The vet seems to think that it may help with the pancreatitis episodes but clearly this is still happening.

Also, have you had any luck with trying enzymes or probiotics to fend off further pancreatitis episodes? I saw some on Chewy's site and wasn't sure if that was worth trying. I guess at this point anything is worth trying :)
 
I would see if going off prednisolone resolves the fd or at least gets him controlled. I never used it for Max and for me it would be a last attempt to make my cat feel better if nothing else was working. Max had chronic pancreatitis for a few years before fd. Since you say it’s not helping I would go off. It has to be weened off slowly. Will you have your vet’s support?
 
I dint think probiotics are going to help and enzymes I would not give unless needed. Giving supportive meds or supplements when not needed can do more harm than good if not needed in my opinion. Read some of the articles in the pancreatitis handbook.
 
Please join the groupsio pancreatitis group. There was a conversation today on enzymes and prednisolone the ones you were looking at were likely plant based and if no use. The real ones are no longer suggested to prevent pancreatitis.
 
Oh cool, I just signed up. Thanks for the recco!

And my vet is very supportive and open-minded. She has referred me to a local internal medicine vet for advance testing but I have been hesitant to put Draper through the stress of going to the vet for even more testing.
 
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