? - 10/12 Having trouble with Charlie's P-itis recovery and numbers | Feline Diabetes Message Board - FDMB

? 10/12 Having trouble with Charlie's P-itis recovery and numbers

Charlie'sMom22

Charlie'sMom22

Member since 2025
Hi all.

Charlie and I have been in and out of the ER vet since last Friday. This started with one of his usual (suspected) p-itis episodes that was no responding well to my usual protocol of gaba, cerenia, and ondansetron. I had to take him to the ER to get bupe, which worked. We went home and were good for a few days and he started having normal cycles again. I attempted to wean off his 100 mg gaba TID and that afternoon (after 2 doses at 75mg) his numbers spiked again up into 200s and he was breathing fast. I took him to a different urgent vet and got more bupe plus a B12 shot and a bunch of tests that the ER had refused to do. Spec was fPL off the charts and he had an abnormal ProBNP.

He's been recovering since then and had a beautiful cycle yesterday. I've been watching his breathing and I have a phone consult with an IM on tuesday, so I've just been trying to get us through the weekend. Earlier today he had a normal start to the cycle but then was 114 at +4, which is very unusual for him. I had skipped his cerenia dose this AM because I was trying to give him a break, but I I gave it when I saw that number because I Thought it might be inflammation creeping back in. We went for a walk and he saw a squirrel. BG after that jumped to 158 within minutes and has not come back down. It's been 3 hours. I just tested and he's 166. I feel like if it was a spike from seeing the squirrel he should be coming back down by now.

My question is this: Does anyone know how to interpret these numbers? He doesn't seem like he's in pain, but I also wonder if the gaba could be blunting it just enough that he's only showing it through his numbers. Or does it look like the start of a loss of regulation? Given his history of insulin resistance/high doses, I am always worried about letting his numbers stay elevated

I do have some buprenorhine I can give if needed but I try to avoid that since it causes constipation. Or I can just wait until his 8PM gaba dose and hope that brings him back down. Hoping someone can provide advice on what to do ASAP.

Please lmk if 911 isn't appropriate here--he tends to deteriorate very quickly so numbers climbing like this is an emergency to me
 
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It’s so hard to know if they are in pain. I do know Max didn’t seem to be so he must have hid it well. It always took him several days to weeks to recover from a bout. He also would often go to the vet for a check up for something feeling good with great bg and come home and get a bout! He was very sensitive.

Please remove the 911 and replace it with a question mark. It’s not an immediate emergency which is when we use 911.

Cats often have higher bg when pancreatitis rears its ugly head. I would not worry at this point.
 
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tiffmaxee said:
It’s so hard to know if they are in pain. I do know Max didn’t seem to be so he must have hid it well. It always took him several days to weeks to recover from a bout. He also would often go to tge vet first a check on something feeling good with great bg and come home and get a bout! He was very sensitive.

Please remove the 911 and replace it with a question mark. It’s not an immediate emergency which is when we use 911.

Cats often have higher bg when pancreatitis rears its ugly head. I would not worry at this point.
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Thanks, I was actually thinking of tagging you specifically because I remember you saying before that Max had frequent bouts of it. I was wondering how often. The last several episodes Charlie's had he's bounced back fully within a couple days. Is this pattern similar to what Max/other cats go through while recovering? Like the inflammation/pain waxes and wanes for a few weeks along with numbers? What meds would Max take and for how long? Sorry for all the questions

He does have a couple of subtle pain signs, but he's not showing any of those right now. I guess I'll hold off on the bupe and hope that his gaba and PM insulin bring him back down
 
Max had some bouts that lasted a long time and others that went away quickly. A couple of times my vet kept him overnight. He was always inappetent and it often triggered higher bg. A couple of times he had loose stool but it disappeared before he needed any treatment. I always gave Max ondansetron at the first sign and used bupe usually just for a few days. To combat any constipation he got canned pumpkin and I upped his miralax.

Is he eating well?
 
With my GA diabetic cat and others who've had pancreatitis, I did everything I could to prevent it from occurring in the first place. So Cerenia every day, and Slippery Elm slurry, along with food that worked best for them. Cos I hated putting them through discomfort if it was preventable. To my thinking, better the meds you might not need, than any sufferring.
 
tiffmaxee said:
Max had some bouts that lasted a long time and others that went away quickly. A couple of times my vet kept him overnight. He was always inappetent and it often triggered higher bg. A couple of times he had loose stool but it disappeared before he needed any treatment. I always gave Max ondansetron at the first sign and used bupe usually just for a few days. To combat any constipation he got canned pumpkin and I upped his miralax.

Is he eating well?
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Okay, good to know. Did you increase his insulin whenever it was a longer flare with increased BG? I thought I remember reading on here that a few caregivers gave their kitties temporary dose adjustments during flares.

I wish I had had bupe when this first started last week, I would've given it straightaway. I don't think the gaba is cutting it this time.

Yes he's eating well. Very hungry today (and all days lol)
 
I disagree with you Lara. I don’t believe in giving meds all the time unless needed. When my cats return to normal I remove support one at a time and watch to see if symptoms return after a few days. I’ve always been told to treat the symptoms. None of my cats needed medication all the time for pancreatitis as it came and went. They were often fine for long periods of time. I never hesitated to restart them if needed though. There are side effects with all meds. For example ondansetron would cause constipation if needed for too long. They got it for as long as needed but I stopped it and was able to discontinue the added miralax.
 
Lara & Luciole (Lu) said:
With my GA diabetic cat and others who've had pancreatitis, I did everything I could to prevent it from occurring in the first place. So Cerenia every day, and Slippery Elm slurry, along with food that worked best for them. Cos I hated putting them through discomfort if it was preventable. To my thinking, better the meds you might not need, than any sufferring.
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I've been wondering if daily cerenia might help! Did it work for you? It seems like the last two times I've taken him off he's had some sort of rebound episode. I've stocked up on some and I'm really hoping the IM vet will okay it and tell my regular vet to give me a standing prescription for it. Are there any cautions about daily dosing? Also, what slippery elm did you use? I looked at a couple brands but they had mixed reviews and I'm unsure how to make it.

I want to do everything I can to prevent it too. I hate seeing him like that and it's really affecting our QOL with the frequency it's beein occurring.
 
Daily Cerenia is great. There's no problem with using it daily. It has a lot of benefits, such as being an analgesic.

With Slippery Elm, I have the powder and make a slurry of it with water. There's some widely-available info about how to do this, which I'll search for here, and you can do the same.

These are both great preventative steps to take, the Cerenia and the Slippery Elm, for your cat.
 
The fast breathing episode sounds scary.:bighug: And concerning along with the higher ProBNP. Are you regularly counting his RR (resting respiratory rate, # complete in and out breaths in a minute)? That'll tell you Charlie normal and when it becomes elevated to the point of concern. At rest should be under 30.

Here is the link to your last post here Charlie update

Have you seen this post? Feline Pain Scale. I find the visual cues on the pain scale quite handy.

I have an IBD/SCL kitty that is prone to p'titis flares. I keep meds on hand and start them as soon as possible. I really slowly withdraw them. If she's at all iffy, I'll do Cerenia every 2-5 days, depending on how well she's eating. No Cerenia if she's eating like a champ.

A bunch of info on SEB here,
Charlie'sMom22 said:
Did you increase his insulin whenever it was a longer flare with increased BG?
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Yes, for any obvious inflammation/infection to prevent glucose toxicity or getting used to high numbers.
 
Hey @Charlie'sMom22 , here's info about the benefits of Slippery Elm, and how to make a syrup.
It's really good for people as well, so I always have some. A bag of it lasts for a very long time.

This is the one I use. I find the taste really pleasant. Hopefully kitty does too!
1760367646787.png
 
Wendy&Neko said:
The fast breathing episode sounds scary.:bighug: And concerning along with the higher ProBNP. Are you regularly counting his RR (resting respiratory rate, # complete in and out breaths in a minute)? That'll tell you Charlie normal and when it becomes elevated to the point of concern. At rest should be under 30.

Here is the link to your last post here Charlie update

Have you seen this post? Feline Pain Scale. I find the visual cues on the pain scale quite handy.

I have an IBD/SCL kitty that is prone to p'titis flares. I keep meds on hand and start them as soon as possible. I really slowly withdraw them. If she's at all iffy, I'll do Cerenia every 2-5 days, depending on how well she's eating. No Cerenia if she's eating like a champ.

A bunch of info on SEB here,

Yes, for any obvious inflammation/infection to prevent glucose toxicity or getting used to high numbers.
Click to expand...
It was really scary and now it's yet another thing I worry about nonstop :arghh: I do count his RR throughout the day and he does get down below 30 when he's fully asleep, but he's not fully asleep often. I think all the recent stress has made him hypervigilant (just like his mom lol). I try to catch him at least a couple times a day.

I have looked at the pain scale, thank you! I've never seen the Glasgow one though, the behavioral part of that one is really helpful too. I feel like I have trouble seeing changes on Charlie's face unless the pain is really bad.

Is your IBD/SCL kitty on anything for the inflammation? Charlie is a really good eater, so I use cerenia mostly for the inflammation/visceral pain. I'm trying to see if there's anything else that might be better for that specifically, cerenia is just what I have o work with right now. One of the vets suspected it might be IBD, but I have no way of knowing without an ultrasound, and that continues to be a non-option for us. Wondering if there's any sort of empirical options for IBD/pancreatitis. This is all so hard.

Am I good to increase his dose tonight then? Or maybe give a fat .25 and see how that goes? It seems like this dose hasn't been holding him as well as it used to since this whole episode started.
 
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