? Ivy, Pancreatitis - Not Eating Well

Staci & Ivy

Very Active Member
Ivy has pancreatitis it seems. We had labwork yesterday which confirmed it.

It's been about 6 days of what's been going on. She began last Thursday with very loose stools and barely any appetite.
If followed her routine lab visit to check her T4 values last Tuesday as we are still working on her proper dosing to get T4 under control (hyperthyroid since last March 2024) (she gets sedatives of gabapentin and trazodone night before vet and labs as she is fractious at the vet), and again the morning of appointment and I was fasting her and giving a 1/2 dose night prior and skipping insulin morning of appointment (so if she dove lower, and I didn't have food in her system it's a bad result, been there done that).

I won't fast her and give insulin, doesn't work for her.

Friday I took her back to the vet after I had begun treating her with Ondansetron 4 mg and mirtazipine (1/2 dose, which has worked in the past), S Boulardi 1/4 capsule 4x daily, Animal Essentials Colon Rescue (worked in past when she's had loose stools).
She still wasn't eating and stools were very loose. Vet ran the remainder of bloodwork from Tuesday's blood draw and all looked fine.

I added Cerenia 12 mg on Friday night, she puked within 10 minutes. She also puked 2 other times Friday night.

By Saturday, she was so lethargic I took her to the ER at 3 pm as she hadn't peed or pooped all day, I was very worried. They gave her fluids and told us to continue with same meds (included with Cerenia). She peed on the table at the ER!

Sunday same situation. She's just been lying in a dark room with her head in a corner. Wants to be left alone. I eliminated the Ondansetron since she was lethargic and I felt it was making her too sedated.

By yesterday, still not eating and I have mostly been syringe feeding since last week to get food in her and giving a full dose of insulin (3.5 Fat dose Lantus)
She has some form of IBD, we feed a homemade diet of lamb and sweet potato with supplements, formulated by a nutritionist.

Her stools have become better since last week, still soft, but somewhat formed. At least the mushy poop is gone.
She is peeing, just not as much as her normal (3 times a day instead of 4-5).

Last night was a long night of lower numbers on Ivy’s Libre so there was some MC carb feeding going on. Syringe fed when necessary.

I gave a very slight reduction this morning from a fat dose of 3.5 F down to 3.5 units. I’d like to reduce a little bit of the diving until she eats better. :blackeye:

Last night I syringe fed her dinner again, which takes a long time. Yesterday was somewhat lower BG cycle on her Libre.
We did go to the vet yesterday and got fluids and did more lab work to see what’s going on why her appetite is still diminished:(

This morning she ate a little bit of her regular lamb diet and then stopped, so I offered a combo of 14% +2% (8%) Fancy Feast just to get her to eat something and she ate about the can’s worth. I gave the same thing an hour later a little bit just as a snack. Will offer more of that over the next couple hours as insulin onsets.
I hate feeding her canned food, but I need her to eat, so that’s more important.

I did get some Hills A/D from the vet. I will try feeding that tonight to see if that's a better choice.

I did give a full dose of the mirtazapine last night and so far it hasn’t made her ravenous. Just hoping for some real interest in eating.
Still giving Cerenia 12 mg 1x daily and Jarrow’s S Boulardi 4x a day (1/4 capsule).
(We haven’t had any vomiting since Friday night, knock wood).

BM is a little softer than a day or so ago, still a bit formed. Not normal yet.
With pancreatitis, how long until they feel better and eat better?

She’s still pretty much just wanting to sleep and be left alone in the corner. Not her normal behavior she did jump up on the one or two times overnight on the sofa and lay down next to me on the pillow so that was good, but not as much as she normally does.

I did pick up some fluids to try to give to her (have never done it with her before, so that will be tricky).
I've done them about 17 years ago with my former cat who was very, very chill, the opposite of Ivy!)
I am out of practice.

So, anything I should be doing or asking of the vet to get her turned around and eating better?

Also, any pet thermometers and ketone meters recommended for monitoring??
(she's never had DKA but just want to be cautious and monitor if needed).

Any suggestions are appreciated!!

@Bron and Sheba (GA)
 
Ivy has pancreatitis it seems. We had labwork yesterday which confirmed it.

It's been about 6 days of what's been going on. She began last Thursday with very loose stools and barely any appetite.
If followed her routine lab visit to check her T4 values last Tuesday as we are still working on her proper dosing to get T4 under control (hyperthyroid since last March 2024) (she gets sedatives of gabapentin and trazodone night before vet and labs as she is fractious at the vet), and again the morning of appointment and I was fasting her and giving a 1/2 dose night prior and skipping insulin morning of appointment (so if she dove lower, and I didn't have food in her system it's a bad result, been there done that).

I won't fast her and give insulin, doesn't work for her.

Friday I took her back to the vet after I had begun treating her with Ondansetron 4 mg and mirtazipine (1/2 dose, which has worked in the past), S Boulardi 1/4 capsule 4x daily, Animal Essentials Colon Rescue (worked in past when she's had loose stools).
She still wasn't eating and stools were very loose. Vet ran the remainder of bloodwork from Tuesday's blood draw and all looked fine.

I added Cerenia 12 mg on Friday night, she puked within 10 minutes. She also puked 2 other times Friday night.

By Saturday, she was so lethargic I took her to the ER at 3 pm as she hadn't peed or pooped all day, I was very worried. They gave her fluids and told us to continue with same meds (included with Cerenia). She peed on the table at the ER!

Sunday same situation. She's just been lying in a dark room with her head in a corner. Wants to be left alone. I eliminated the Ondansetron since she was lethargic and I felt it was making her too sedated.

By yesterday, still not eating and I have mostly been syringe feeding since last week to get food in her and giving a full dose of insulin (3.5 Fat dose Lantus)
She has some form of IBD, we feed a homemade diet of lamb and sweet potato with supplements, formulated by a nutritionist.

Her stools have become better since last week, still soft, but somewhat formed. At least the mushy poop is gone.
She is peeing, just not as much as her normal (3 times a day instead of 4-5).

Last night was a long night of lower numbers on Ivy’s Libre so there was some MC carb feeding going on. Syringe fed when necessary.

I gave a very slight reduction this morning from a fat dose of 3.5 F down to 3.5 units. I’d like to reduce a little bit of the diving until she eats better. :blackeye:

Last night I syringe fed her dinner again, which takes a long time. Yesterday was somewhat lower BG cycle on her Libre.
We did go to the vet yesterday and got fluids and did more lab work to see what’s going on why her appetite is still diminished:(

This morning she ate a little bit of her regular lamb diet and then stopped, so I offered a combo of 14% +2% (8%) Fancy Feast just to get her to eat something and she ate about the can’s worth. I gave the same thing an hour later a little bit just as a snack. Will offer more of that over the next couple hours as insulin onsets.
I hate feeding her canned food, but I need her to eat, so that’s more important.

I did get some Hills A/D from the vet. I will try feeding that tonight to see if that's a better choice.

I did give a full dose of the mirtazapine last night and so far it hasn’t made her ravenous. Just hoping for some real interest in eating.
Still giving Cerenia 12 mg 1x daily and Jarrow’s S Boulardi 4x a day (1/4 capsule).
(We haven’t had any vomiting since Friday night, knock wood).

BM is a little softer than a day or so ago, still a bit formed. Not normal yet.
With pancreatitis, how long until they feel better and eat better?

She’s still pretty much just wanting to sleep and be left alone in the corner. Not her normal behavior she did jump up on the one or two times overnight on the sofa and lay down next to me on the pillow so that was good, but not as much as she normally does.

I did pick up some fluids to try to give to her (have never done it with her before, so that will be tricky).
I've done them about 17 years ago with my former cat who was very, very chill, the opposite of Ivy!)
I am out of practice.

So, anything I should be doing or asking of the vet to get her turned around and eating better?

Also, any pet thermometers and ketone meters recommended for monitoring??
(she's never had DKA but just want to be cautious and monitor if needed).

Any suggestions are appreciated!!

@Bron and Sheba (GA)
I did not read anything about medicine for pain. Sounds like you are doing about everything you can, except pancreatitis is very painful.
Maybe there is something on here for pain, but I did not see anything. When I had a cat that had chronic pancreatitis I always kept buprenorphine for pain on supply at home. Some vets use Tramadol, but I think Buprenorphine helped my cat the most. Don't let any vet tell you they do not need pain meds, pancreatitis is very painful. I changed vets several times till I found vets that agreed that cats with pancreatitis needs pain meds and it was worth it.
 
I did not read anything about medicine for pain. Sounds like you are doing about everything you can, except pancreatitis is very painful.
Maybe there is something on here for pain, but I did not see anything. When I had a cat that had chronic pancreatitis I always kept buprenorphine for pain on supply at home. Some vets use Tramadol, but I think Buprenorphine helped my cat the most. Don't let any vet tell you they do not need pain meds, pancreatitis is very painful. I changed vets several times till I found vets that agreed that cats with pancreatitis needs pain meds and it was worth it.
Thank you, Teresa, I’m waiting for a call from the vet so I can pick up the buprenorphine. It’s been all day. I’ve been waiting. I’m getting quite frustrated. I’d like to get the dose into her body already. It’s been almost a week. We’ve been dealing with this.
 
Also, does anyone know if glucose will go down as a result of the pancreatitis? I’m noticing her numbers have been lower the past several days. Is that because she’s eating less or some other effect from the pancreatitis or from administering two rounds of fluids? I’m not sure what I’m seeing.
 
Also, does anyone know if glucose will go down as a result of the pancreatitis? I’m noticing her numbers have been lower the past several days. Is that because she’s eating less or some other effect from the pancreatitis or from administering two rounds of fluids? I’m not sure what I’m seeing.
Aww Staci, I hope Ivy feels better soon. I'm glad you persisted and finally got some answers. Petey had pancreatitis when he was diagnosed and I was told it will raise BG. We suspect chronic pancreatitis may be the cause of his diabetes... Interesting you're seeing lower numbers, I am sure not eating is playing a factor and the fluid can certainly help with some of the inflammation. :bighug::bighug:
 
Aww Staci, I hope Ivy feels better soon. I'm glad you persisted and finally got some answers. Petey had pancreatitis when he was diagnosed and I was told it will raise BG. We suspect chronic pancreatitis may be the cause of his diabetes... Interesting you're seeing lower numbers, I am sure not eating is playing a factor and the fluid can certainly help with some of the inflammation. :bighug::bighug:
Thanks, Laurie, interesting feedback. I am seeing lower numbers! And oddly her T4 went down from what was tested last week!
It was 2.9 yesterday, 4.7 last week and 5.2 a month ago (we raised her methimazole dose)!

I hope Petey doesn't have any more issues with it! Nasty stuff!!:bighug::bighug::bighug:
 
Staci, we have the KetoBM ketone meter that works for us. The strips are expensive (like $1 each) but I think a lot of them are like that.
 
Fwiw I think the lower T4 is possibly euthyroid sick syndrome. When there’s a significant illness, serious inflammation with cytokine release, or inadequate nutrition/starvation, the body starts to throttle back the thyroid to prevent the body from destroying itself. This can look like hypothyroidism in a normal patient and like a normal thyroid in a hyperthyroid patient.

my guess the lower BG is due to inadequate calorie intake in the face of the usual insulin dose, although the lowered T4 may be playing a role I’m not sure. Some of it can be dilutional from the fluids.

I hope Ivy gets better soon, fingers and paws crossed here for a speedy recovery
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and we’re all praying for you and Ivy
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I’m glad Teresa mentioned pain meds. Pancreatitis is very painful. You will definitely need those.
Some cats respond quickly with supportive treatments and others take a lot longer.
I think the a/d is a good idea if it is tolerated with the IBD.
I would definitely be checking for ketones either with a urine test or a blood ketone meter.
You may need to get some sub Q fluids as cats with pancreatitis get dehydrated easily.
How much is she eating for you now.? Do you think she is still nauseated?
If Ivy continues to not eat, you may need to talk to the vet about a feeding tube.
 
:bighug::bighug:

Try the liver shake: https://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

Or maybe this: https://oxbowanimalhealth.com/product/critical-care-carnivore/ I have no idea how palatable this is for cats but it's a powder so easy to mix with water or broth. I've only used the product for small animals mixed into with fruit baby food.

I have a baby thermometer. It's easy enough to take a cat rectal temperature with it. Just hold it firmly to prevent it from going into the cat (happened long ago on FDMB).

I think the IBDKitties web site has info on a harness thing that could be helpful for giving fluids to a squirmy cat.

Are her teeth ok?

Not to worry you more but my previous diabetic had pancreatitis was admitted to the ER for a couple of days. He had a n-tube put in because he wasn't eating at all. The ER staff did what our regular vet recommended for treatment which was everything in the book. The regular vet even put his resident on the case for experience. Unfortunately my cat didn't make it :( The whole story as posted on FDMB has been lost to time. FDMB changed servers not long afterwards and everything on the board was lost. No Wayback Machine archive of the old board exists.
 
:bighug::bighug:

Try the liver shake: https://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

Or maybe this: https://oxbowanimalhealth.com/product/critical-care-carnivore/ I have no idea how palatable this is for cats but it's a powder so easy to mix with water or broth. I've only used the product for small animals mixed into with fruit baby food.

I have a baby thermometer. It's easy enough to take a cat rectal temperature with it. Just hold it firmly to prevent it from going into the cat (happened long ago on FDMB).

I think the IBDKitties web site has info on a harness thing that could be helpful for giving fluids to a squirmy cat.

Are her teeth ok?

Not to worry you more but my previous diabetic had pancreatitis was admitted to the ER for a couple of days. He had a n-tube put in because he wasn't eating at all. The ER staff did what our regular vet recommended for treatment which was everything in the book. The regular vet even put his resident on the case for experience. Unfortunately my cat didn't make it :( The whole story as posted on FDMB has been lost to time. FDMB changed servers not long afterwards and everything on the board was lost. No Wayback Machine archive of the old board exists.
I have used the liver shake lots of times and I have had cats that would not eat like this. I think it looks sickening. Sometimes, I have had to start out using a syringe, but then they would come around and start licking it up. It is worth a try.
 
Fwiw I think the lower T4 is possibly euthyroid sick syndrome. When there’s a significant illness, serious inflammation with cytokine release, or inadequate nutrition/starvation, the body starts to throttle back the thyroid to prevent the body from destroying itself. This can look like hypothyroidism in a normal patient and like a normal thyroid in a hyperthyroid patient.

my guess the lower BG is due to inadequate calorie intake in the face of the usual insulin dose, although the lowered T4 may be playing a role I’m not sure. Some of it can be dilutional from the fluids.

I hope Ivy gets better soon, fingers and paws crossed here for a speedy recovery
View attachment 72949


and we’re all praying for you and Ivy
View attachment 72948
The top cat looks like a small KitKat. The bottom cat, looks like KitKat's face, especially the eyes. He does not have that much white on his chest or paws.
 
I have used the liver shake lots of times and I have had cats that would not eat like this. I think it looks sickening. Sometimes, I have had to start out using a syringe, but then they would come around and start licking it up. It is worth a try.
Sounds disgusting, but I’ll have to see if I can get her to try it. Good to know about it though! :bighug::bighug:
 
:bighug::bighug:

Try the liver shake: https://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

Or maybe this: https://oxbowanimalhealth.com/product/critical-care-carnivore/ I have no idea how palatable this is for cats but it's a powder so easy to mix with water or broth. I've only used the product for small animals mixed into with fruit baby food.

I have a baby thermometer. It's easy enough to take a cat rectal temperature with it. Just hold it firmly to prevent it from going into the cat (happened long ago on FDMB).

I think the IBDKitties web site has info on a harness thing that could be helpful for giving fluids to a squirmy cat.

Are her teeth ok?

Not to worry you more but my previous diabetic had pancreatitis was admitted to the ER for a couple of days. He had a n-tube put in because he wasn't eating at all. The ER staff did what our regular vet recommended for treatment which was everything in the book. The regular vet even put his resident on the case for experience. Unfortunately my cat didn't make it :( The whole story as posted on FDMB has been lost to time. FDMB changed servers not long afterwards and everything on the board was lost. No Wayback Machine archive of the old board exists.
Thank you so much for the great ideas. I’ll have to check them out. Powdered critical care product would work for a cat.

And the liver shake sounds absolutely gross but hey, if it works, it’s worth it. I’m gonna have to really read through that recipe to see if it’s something that I can throw together.

I’m so sorry about your kitty. That must’ve been just awful. What a sad story sending you lots of hugs and memory of your sweet kitty. Thank you for reaching out to us. I really appreciate it. :bighug::cat::bighug::cat:
 
I’m glad Teresa mentioned pain meds. Pancreatitis is very painful. You will definitely need those.
Some cats respond quickly with supportive treatments and others take a lot longer.
I think the a/d is a good idea if it is tolerated with the IBD.
I would definitely be checking for ketones either with a urine test or a blood ketone meter.
You may need to get some sub Q fluids as cats with pancreatitis get dehydrated easily.
How much is she eating for you now.? Do you think she is still nauseated?
If Ivy continues to not eat, you may need to talk to the vet about a feeding tube.
Hi Bron, I don’t think she’s still nauseous, but not positive. I’m not really sure how to tell.

She seemed to really love the AD last night when I fed it to her, although possibly the Miritaz was really kicking in and or the buprenorphine was given about an hour before dinner, so maybe that helped her appetite as well.

At the moment, I don’t have a ketone meter, but apparently I need to get one. I do have urine test strips and use them often and I’ve been using them even more often during this bout and they’ve been negative.

She hasn’t vomited since last Friday night, so I’m happy about that, and she does seem a lot more alert and interactive since yesterday
She’s definitely not back to herself yet but even tonight overnight she’s climbed on me a few times and is purring and wants to cuddle so that’s a good sign.
I just need her to get eating consistently & independently.

And I’m concerned about feeding the AD for too long that may upset her stomach because her body’s not used to it.

I’d like to transition her back to her regular healthier food as soon as possible.
Not sure how to safely do that though or do I just feed the AD for a couple days?
The vet felt the AD was fine to feed her as long as she’s eating.

But, it may be making her stools a little bit softer. I’m sure there must be a transition in her body because she’s not used to this food.
As for the fluids, yes, I did pick some up so that I can try to administer them if needed. How do you know when to use them and if so, how often are they needed?
Thank you for your recommendations:bighug::bighug:
@Bron and Sheba (GA)
 
Fwiw I think the lower T4 is possibly euthyroid sick syndrome. When there’s a significant illness, serious inflammation with cytokine release, or inadequate nutrition/starvation, the body starts to throttle back the thyroid to prevent the body from destroying itself. This can look like hypothyroidism in a normal patient and like a normal thyroid in a hyperthyroid patient.

my guess the lower BG is due to inadequate calorie intake in the face of the usual insulin dose, although the lowered T4 may be playing a role I’m not sure. Some of it can be dilutional from the fluids.

I hope Ivy gets better soon, fingers and paws crossed here for a speedy recovery
View attachment 72949


and we’re all praying for you and Ivy
View attachment 72948
Thank you, Colleen, we appreciate And support and thanks so much for the great medical explanations. Hugs to you and your sweet boys:bighug::cat::bighug::cat:
 
Staci, we have the KetoBM ketone meter that works for us. The strips are expensive (like $1 each) but I think a lot of them are like that.
Thanks for letting me know what you use Tim, I appreciate it. I’m gonna have to do some research. Seems like a dollar apiece seems to be The going rate
:banghead:
:bighug::cat::bighug:
 
If you are testing the urine for ketones and managing that ok you don’t have to buy a blood ketone meter

I think it would be fine to use the a/d for a few days. Cats that are tube fed use a/d for a lot longer than that. It is a healthy meal and if your kitty is eating it and it’s not upsetting the tummy I’d stay with it sit a few more days.

Sounds like the pain meds are helping.
I’m very glad to hear things are improving.

Did you ask the vet about using the sub q fluids? You always need to get their ok first before using.
Cats with pancreatitis can get dehydrated. Sheba always did when she had a flare. I think you could safely give 50ml once a day while she is unwell. But you might like to run that past the vet.
 
If you are testing the urine for ketones and managing that ok you don’t have to buy a blood ketone meter

I think it would be fine to use the a/d for a few days. Cats that are tube fed use a/d for a lot longer than that. It is a healthy meal and if your kitty is eating it and it’s not upsetting the tummy I’d stay with it sit a few more days.

Sounds like the pain meds are helping.
I’m very glad to hear things are improving.

Did you ask the vet about using the sub q fluids? You always need to get their ok first before using.
Cats with pancreatitis can get dehydrated. Sheba always did when she had a flare. I think you could safely give 50ml once a day while she is unwell. But you might like to run that past the vet.
Hi Bron,
OK, that’s good to know. I will watch the urine strips daily just to keep an eye On the ketones.

I lowered her dose yet again to 2.75 units Lantus (yesterday morning I was at 3.5 units and not seeing any rise in glucose after lowering it to 3 units last night.

The vet did say that I could do fluids if I wanted to I could certainly give it a try with her. She’s very feisty, but at least I have the supplies in the house now and I could give it a go.

My main concern at the moment is her BG has been much lower for her the past few days yesterday and today I’ve lowered her insulin and she’s still as low as she’s been. (See my SS)
On the Libre she’s in the 50s (and even lower) which is usually around 140 or 150 on a handheld meter for me. Yesterday I tested her and she was 120 on a handheld meter at one point.

It’s one thing when she’s not eating for her blood glucose to be lower, I’m concerned now that she is eating her blood glucose is still low. That makes me worry that with her pancreatitis she’s not producing the enzymes she needs to breakdown and absorb the food that she’s eating so it would just move through her without her really getting anything out of it, which can set her up for a euglycemic DKA.

I’ve also noticed overnight her stools are becoming looser again, so I’m concerned about the possibly its from eating the AD and yesterday eating fancy feast.

This morning I was able to feed her her regular lamb/sweet potato diet and she ate it up completely and happily, so that was good.
Do you think there’s a downside for me to be giving her her regular diet if she will eat it?

Do you think giving her kaolin would be a good idea for the looser stools?

Thanks again, Bron. I’m very concerned. This is our first time dealing with this :bighug::bighug:
 
Wasn't there a Ensure-like product for cats some years ago? It was a liquid nutritional supplement, not kitten milk replacer. Is there something similar that might be helpful?
 
Wasn't there an Ensure-like product for cats some years ago? It was a liquid nutritional supplement, not kitten milk replacer. Is there something similar that might be helpful?
I have no idea. Would she need something like that on top of eating her regular food if she Is eating that?
 
Do you think there’s a downside for me to be giving her her regular diet if she will eat it?
I think if she will eat her regular food that is fine.
I’ve also noticed overnight her stools are becoming looser again, so I’m concerned about the possibly its from eating the AD and yesterday eating fancy feast.
As she has IBD the new foods are probably causing the loose stools. Maybe cut back on the A/d. If she is eating her regular food that is great.
Do you think giving her kaolin would be a good idea for the looser stools?
i have never used kaolin so can’t really comment in that. Did you try pumpkin or SBoulardii?
 
think if she will eat her regular food that is fine.
Ok great. She just ate her dinner and it was her regular food and she finished it so that was good.
As it turned out, she only had AD last night for her one meal and their snacks.
i have never used kaolin so can’t really comment in that. Did you try pumpkin or SBoulardii?
I used S Boulardi this week and hope it’s helped her.
She has sweet potato in her food that I make her, I believe it’s
Similar to pumpkin, isn’t it?

I was curious about the Kaolin. I haven’t used it myself, but I know others have and report it’s really good.

Thanks again for your help. I appreciate your time. I hope you have a great night.:bighug::bighug:
 
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