4/12 Rusty PMPS 201, +4.5 64. Dx: Pancreatitis

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Ella & Rusty & Stu(GA)

Ella & Rusty & Stu(GA)

Member Since 2010
yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=68474

Good Morning, Everyone,

Rusty's 229 this morning might reflect that he ate most of his nighttime food 1/2 hour before we got up this morning. But even so, it is worrisome and I'm glad I made the appointment with the vet (at noon).
Edward thought he smelled Lev. after I gave the shot this morning, but I didn't smell it. ( It would be typical for me to give a fur shot just now!!) Otherwise, all seems OK. Rusty ate about half of his Wellness Turkey breakfast (he does tend to free feed, and since he ate his nighttime food very close to AMPS, I'm not particularly concerned.)

It's not raining!!

Full report this afternoon. Wish us luck!

Ella & Rusty
 
Re: 4/12 Rusty AMPS 229(!), vet visit today

Ella, sending good Vetty vines to Rusty today. KTSS and kitties crew will visit Rusty later with soups and presents. Maggie also free feeds and snubs the auto feeder. Take care.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit today

Good luck at the vets Rusty!!!!! Henry is going to the vets today too for a checkup.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit today

Extra strong good vetty visit and healing vines, Ella. Please keep us posted.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit today

Good luck at the vetty Rusty and enjoy that manicure/pedicure. We'll check in later.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

All fingers and paws crossed for a good vet visit today, Ella.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

Hi again, everyone, and thanks for all the well wishes,

Rusty got carsick on the way to the vet's and vomited up a good sized hairball! Yay!!! Also had a poop in the travel litterbox. I'm wondering if maybe the hairball is the source of his higher numbers lately. He has been trying to hack one up!

Rusty's vet thinks he looks good: good eyes, ears, mouth, heart rate, breathing, no fleas, no lumps or anything. He weighed 17 lbs. on her scale (which is not a digital scale), but he weighed 16 lbs. 14 oz. on our digital scale this morning. Anyway, she is not displeased with his weight! She didn't seem worried about his scratching his eyebrow and will give us some cortisone cream to put on it if it gets worse (it looked pretty good this morning). She thought his lower energy level and his lower than normal appetite could be seasonal, but agreed that full blood work and urinalysis were especially important for a feline diabetic to have periodically. Then Rusty went into "the back" to have his blood drawn and his urine drawn by cystocentesis. The only problem was that his bladder was empty. So we left him there and they are going to give him fluids and try to get the urine. We'll pick him up in the late afternoon.

He will have a full blood panel and urinalysis. Also a T4. Also the spec fpL. The vet says that IDEXX has just recently made the analysis equipment necessary for the spec fpL available to vets and she has purchased it, so we'll be able to get that result this afternoon, along with the other results (she uses the IDEXX equipment for all the lab work). I asked if it was true that Rusty would have to fast before the spec fpL and she said no.

We discussed the vaccines and she thinks that, in addition to the NY State required yearly rabies, the FVRCP every three years is important, but that the Feline Leukemia vaccine is only important if Rusty spends a lot of unsupervised time outdoors. She will only use the non-adjuvanted vaccines. She says that some of her patients request that she do a titre instead of giving a vaccine. If it turns out that the cat's current level of protection is fine, she will not give the vaccine. She asked if we would want to do this, and I said yes. So she will do that today, too.

I took the opportunity to give her a copy of the Roop/Rand article in the professional journal as well as a copy of our TR protocol. She was impressed that so many of the FDMB kitties were diet-controlled and is looking forward to her "reading". I also gave her a copy of Rusty's SS. So all in all, I think I covered everything that Linda suggested. I forgot to ask about arthritis, however, so I will do that this afternoon, when we pick The Laird up.

bbl,

Ella
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

Good news on the interim report, Ella. It sounds like the vet must be using this test that I am hearing more about lately - the SNAP fPl test. I believe that the result will come back as either "normal" or an "abnormal", rather than a number. I will be interested to hear about it.

I am glad that Rusty was able to get rid of his fur ball in the car. I hope he doesn't get too upset by having to wait in the back for his other procedure. Poor guy. He will be happy to be home tonight, I am sure.
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

HOORAY FOR A GOOD INTERIM REPORT!!!!!

Binks can't wait to pitch in on The Laird's spa treatment-
but fear not, Rusty...I checked his pockets and parcels before he left,
and confiscated all the hair dyes, gels, and makeup :-D
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

That sounds great, Ella. Good report and great that the vet will read up on FD. Way to go!

Melanie & Racci
 
Re: 4/12 Rusty AMPS 229(!), +4 299(!!) vet visit interim rep

Great news!!! We are hoping the hairball was the issue and will be paws crossed that all tests are 100% normal!

Rusty...dude!! Tobes here!! I'm on my way with the others for KTSS and to get that vetty smell off you! Hang on bro!!!
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Hi again,

Well, I guess it's more than a hairball! His spec fPL came back positive for Pancreatitis. The vet was surprised. She didn't see it indicated in the other values (urinalysis had to be sent out and will not be back until Saturday). She complimented me on "knowing thy cat" and for requesting the spec fPL. She would not have done it as a routine matter with a cat who looked so good, and she said she really learned something today.

So where are we? The vet thinks Rusty's Pancreatitis is very mild, but she wants us to keep close tabs on it. I think the first thing I will do is to change his everyday food from Wellness Turkey to Merrick's BG Turkey. It is much higher in protein and much lower in fat than Wellness. He doesn't like it as well, but he eats it. It's going to be harder to get the required number of calories into him, since BG turkey is only 151 kcal per 5.5 oz. can, whereas Wellness turkey is 218. But the % of calories from protein in Wellness is 31%, whereas in BG it is 65% (% of calories from fat in Wellness is 65%, whereas in BG it is 34%)--almost exact opposites! Carbs are 4% in Wellness and 1% in BG. I wonder what the percentages are in the "new" FF T&G? I have a question in to By Nature, but haven't received a reply yet (will call them tomorrow).

I need to know whether the pancreatitis inhibits the pancreas from producing insulin. If Rusty's pancreas was producing even just a little insulin, the pancreatitis may be disrupting this and this may account for why his bgs are higher. Should I raise his insulin dose??

I forgot to ask about pain medication. I'll bring this up when I go back to get the rest of the test results. Should I ask for buprenorphine? Is it difficult to administer? Help!

That's it for now. Tomorrow I'll put the new values on the Labs chart in Rusty's SS. Right now I just want to watch TV!

Thanks for your good thoughts. Please continue them!

Ella & Rusty

p.s. OMG, I just saw that BigMac has passed. Oh, I am so very sorry. And here I was just blithely writing about our own problem.
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Why did the vet tell you to switch his food? For some reasons, vets are under the old understanding that the intake of fats affects cats like it does dogs but that is not true. I'm glad she didn't tell you to fast him because many vets
are still thinking along those lines as well but it's old school. Did she say anything about fluids? Yes, I would probably give pain meds and the buprenorphine is probably the best choice. It has the least side effects. It's easy to give....it's just put on the gums or in the cheek pouch....it's a liquid but it's not given as a traditional liquid medicine. It needs to be absorbed by the soft tissues.

I'm not sure about his dose......if his BGs stay high, you might want to add a drop to try and give those beta cells a rest and let the pancreas work off the exogenous insulin.

Sending Rusty many healing vines. What great beans he has to get right on top of this.
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

I was in the hospital with pancreatitis for a few days last fall. Tell Rusty I feel his pain! I'll be keeping a good thought for him.
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Oh, Ella...so sorry to hear this!

But he couldn't be in better hands- you are a wonderful care-giver to The Laird.

sending hugs...

animals-baby-black-and-white-cat-hug-Favim.com-275834.jpg
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

ELLA!!! RUSTY!!! I am shocked that he has pancreatitis, but SO GLAD YOU KNOW THY CAT!!!!!!!!!
Thank Heavens you knew how he was acting, & his numbers, and brought him swiftly to the vet!!
I was really shocked to see this, but Thankful it was a quick DX!
Bupe is delivered via mouth squirted into the cheek with like a small food syringe, it is really quite easy, and I think injection...Praying for quick & easy recovery for our sweet love Rusty!!
So with the skin problem & the pancreat. No wonder his numbers were so high!!!

Speedy Recovery to our Boy Rusty!!
Rusty Boy The KTTS is on it's way over wif chicken soup(NO Fatto makes you all better--I am driving so I will be dere soon--Loves you Rusty Boy--We is all gonna make you better--Hugs from Moonie & aLL LL!!
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

sorry to hear that diagnosis - but how great that you got him right in and figured it out. you do know him, and he's so lucky to have you in his court!

cheering Rusty on - punkin says he'd like to join the chicken soup brigade and come visit rusty!
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Ella,

(((Rusty)))

I am sorry to hear of this diagnosis, but it just goes to show that you know your cat, and that you should always respect your instincts.

I agree with what Marjorie said about high fat diets and pancreatitis. At one time there was felt to be a correlation, but more recent thinking is that dietary fat is not implicated in CP. Some owners do find that their cats do better on a lower fat diet. You should be able to figure out which foods he seems to do better on. I feel that the number one priority is always to keep the cat eating, especially in an illness which has potential to impact appetite.

Pancreatitis can be painful. Burprenorphine is the best medication for pain. It can be given as a sub Q injection (if supplied in sterile packaging), but most vets dispense it for trans mucosal (through the lining of the cheek) administration. From what I have seen, most cats are initially prescribed way too high a dose. I would ask your vet to start very low and work up to effect, as Bupe can be extremely sedating, and it sometimes causes more problems than it resolves.

I can't answer your question about the pancreas and insulin production, but I do believe that pain itself can raise BG's. Treating the pain may bring them down.

Sub Q fluids can be given if there is any indication of dehydration.

If needed, medications for nausea (Ondansetron) or vomiting (Cerenia) can be given. Cerenia is also good, as there is new evidence that it helps with visceral pain.

Vitamin B12 (cyanocobalamin) sub Q injections are felt to be helpful with pancreatitis.

Pepcid AC can be given to help with stomach acid.

Not all of this has to be thrown at Rusty. It is best to go slowly, so that you can tell what is having an effect and what is not.

My two biggest pieces of advice are (1) keep him eating and (2) give pain relief but start very low and go very slow.

http://www.idexx.com/pubwebresource...pec-fpl-treatment-for-feline-pancreatitis.pdf
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

I would definitely get bupe. It can be given orally, like Marje said, or as a sub-q injection (just like Lantus).

You may want to take a look at this clinical roundtable on pancreatitis. On p. 11 it mentions food. The issue of low fat is not applicable to cats.


This link is to a post from Jojo on pancreatitis. You may want to discuss giving Rusty Pepsid with your vet.
 

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Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Ella & Rusty & Stu(GA) said:
Hi again,

Well, I guess it's more than a hairball! His spec fPL came back positive for Pancreatitis. The vet was surprised. She didn't see it indicated in the other values (urinalysis had to be sent out and will not be back until Saturday). She complimented me on "knowing thy cat" and for requesting the spec fPL. She would not have done it as a routine matter with a cat who looked so good, and she said she really learned something today.

So where are we? The vet thinks Rusty's Pancreatitis is very mild, but she wants us to keep close tabs on it. I think the first thing I will do is to change his everyday food from Wellness Turkey to Merrick's BG Turkey. It is much higher in protein and much lower in fat than Wellness. He doesn't like it as well, but he eats it. It's going to be harder to get the required number of calories into him, since BG turkey is only 151 kcal per 5.5 oz. can, whereas Wellness turkey is 218. But the % of calories from protein in Wellness is 31%, whereas in BG it is 65% (% of calories from fat in Wellness is 65%, whereas in BG it is 34%)--almost exact opposites! Carbs are 4% in Wellness and 1% in BG. I wonder what the percentages are in the "new" FF T&G? I have a question in to By Nature, but haven't received a reply yet (will call them tomorrow).

I need to know whether the pancreatitis inhibits the pancreas from producing insulin. If Rusty's pancreas was producing even just a little insulin, the pancreatitis may be disrupting this and this may account for why his bgs are higher. Should I raise his insulin dose??

I forgot to ask about pain medication. I'll bring this up when I go back to get the rest of the test results. Should I ask for buprenorphine? Is it difficult to administer? Help!

That's it for now. Tomorrow I'll put the new values on the Labs chart in Rusty's SS. Right now I just want to watch TV!

Thanks for your good thoughts. Please continue them!

Ella & Rusty

p.s. OMG, I just saw that BigMac has passed. Oh, I am so very sorry. And here I was just blithely writing about our own problem.
Click to expand...

Pancreatitis is VERY PAINFUL. If you did not get pain meds from your vet, I am shocked. Please get some buprenex if you don't have some at home.
The other two items to keep on hand would be pepcid and especially fluids.
Did you vet give you fluids to give at home? If not, get a fluids kit when you you get the buprenex.

Ask the vet what was the result number for pancreatitis.... mild does not cut it.
0 to 3.5 is negative, I think 3.6 to 4.0 is a grey area and above that is for sure positive.

My Oliver was always just under the 4.0, so I gave him small amounts of fluids.
My Shadoe was always in the teens and had fairly regular attacks. I gave her pepcid BID and most definitely fluids and bupe for the few days following her attacks.
Because her issues were frequent, my vet had me start giving her B12 shots weekly for the pancreas inflammation. After starting the shots, she had only one attack in months.

Quite often, you may see higher BG, lip licking, hiding, and meatloafing when having an attack/flair. By giving pepcid when you see lip licking, you can help the upset stomach and if still acting 'off', a bit of fluids and a small amount of bupe will help.

Pepcid, pain meds, and fluids, are all needed to treat pancreatitis.
If you do not have all 3 on hand, you need to get them.

ETA: snap test only positive or negative? I think I prefer the number to know how bad it is?
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

I'm sorry Rusty is sick and so glad you caught it early. I hope he feels better quickly.

Melanie & Racci
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Ella,

Maybe this plush pancreas toy will help Rusty feel better.
 

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Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

oh my gosh Linda, what is that?? lol

(((Ella))) I am sorry about this dx for Rusty!
I don't have any experience with it, but looks like you received a lot of good info.
(((((hugs for Rusty, you and DH)))) feel better soon Rusty!
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

Hi Ella - oh wow, I sure didn't expect this DX. I hope it is just a mild case. I can't offer opinion, and will leave that up to those that have already responded. They know best. Be well Rusty! I will be thinking about you tonight Rusty. Mannie is on his way, he wants to help.

Take care guys.
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

hi Ella and Rusty

hope you are able to get some painmeds....buprenex in place is a must for the CP.....and they can get dehydrated very quickly so keep an eye on that....

sorry you guys are dealing with this.....hope Rusty feels better soon....

hugs from us to you!
 
Re: 4/12 Rusty AMPS 229 +4 299, PMPS 210. Dx: Pancreatitis

So sorry to hear that our Handsome Rusty has to deal w/pancreatits but so glad the report said it was mild...still I would definitely keep an eye on it and give pain meds when needed. We are sending Rusty as many bouquets of heal-quick vines as he needs.

Tawny & Tinkerbell & Mommie too & everybody else.
 
Oh Ella , i am so sorry to hear this. You knwo rusty so well, I'm sure that is why you caught it so early.

Get better sonnn Laird Rusty. KTSS will be there to serve YOU chicken soup this time.
 
Thanks everyone,

Marje, the vet didn't say to feed him lower fat food. She said to feed what he liked and to make sure he had enough food. I found the reference (anecdotal) to the possibility that some cats do better on lower fat food in the Round Table that Sienne posted (I had read it yesterday). Linda and Gayle, thanks for the clue that the IDEXX snap fpL might not be the same as the spec fpL. The snap T4 gives values, so maybe the snap fpL does too. When we went to get Rusty this afternoon the vet office was very busy and the vet had forgotten to give me one of the sheets with the results, so she just wrote "positive" on one of the other sheets. I'll be sure to find out when I go back, either tomorrow or Sat. I will ask then about the pain meds and the fluids, too. Rusty almost never drinks water (he has 2 large bowls and a fountain), but I always mix a lot of water into his wet food.

Rusty was exhausted tonight after his ordeal at the vet, but perked up just now (after some Fancy Feast T&G). Wow, his bg really dropped! Probably from not enough food. Anyway, he started playing with one of Alice's old rubber broccoli bands (something he has never played with; it was in Stu's "theater of mice", which is still here, but was empty except for the broccoli band). I think Alice and Stu are watching over him. I put out a big dish of FF T&G and Wellness Turkey for him to eat over night.

Ni ni, and thank you all again,

Ella & Rusty

Keeping Carolyn in our prayers and thoughts tonight. BigMac is on his journey, flying free, watching over his mamabean.
 
So sorry for the pancreatitis diagnosis. Healing vines to Rusty's tummy. I would definitely get the bupe. Our kitties are so good at hiding pain, but it helped Tarragon immensely when he had pancreatitis. Hugs to you Ella!
 
So glad you took Rusty to the vet to figure things out:) It's important to get on top of pancreatitis or it can cause lot's of pain. Ella had acute pancreatitis and it was heartbreaking to watch. I'm so happy to caught it in time:)

Hugs to you and Rusty :YMHUG:
 
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