? 4.25.22 Update: pancreatitis + possible UTI?

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AggyBear

AggyBear

Member Since 2021
My sweet girl Agatha has been in remission for about 3½ months now. But she continues to have a distended belly and occasionally I smell she has gas. She's eating + drinking well but also sometimes vomits her food up. She hasn't been doing it as much the last week or so but for quite a while it seemed there was a pile to clean up every day. It's her Friskies pate with water mixed in.

I know she doesn't feel great because of this- she sleeps behind the chair in my bedroom various points of the day but still does come into the main room and walk around and get attention + enjoy the breeze and sunshine on the balcony.

I've continued to check her BG and It's always in good range. I can post some BG numbers when I get home tonight if that helps.

Any thoughts on what could help her feel better I would greatly appreciate! Love from Sammy and AggyBear!
 
AggyBear said:
My sweet girl Agatha has been in remission for about 3½ months now. But she continues to have a distended belly and occasionally I smell she has gas. She's eating + drinking well but also sometimes vomits her food up. She hasn't been doing it as much the last week or so but for quite a while it seemed there was a pile to clean up every day. It's her Friskies pate with water mixed in.

I know she doesn't feel great because of this- she sleeps behind the chair in my bedroom various points of the day but still does come into the main room and walk around and get attention + enjoy the breeze and sunshine on the balcony.

I've continued to check her BG and It's always in good range. I can post some BG numbers when I get home tonight if that helps.

Any thoughts on what could help her feel better I would greatly appreciate! Love from Sammy and AggyBear!
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Hi I don't know much about what you & your girl are going through but if you put a question mark in your title you might get some help quicker. I'm going to tag a few people & see if they can help you @FrostD @Wendy&Neko @Bandit's Mom @Diane Tyler's Mom @carfurby @Bron and Sheba (GA)
 
Wendy&Neko said:
This might be time for a visit to the vet. An ultrasound may be needed to see what is happening inside her GI system. Any chance she might have food allergies? Or maybe a flair of pancreatitis?
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I think it's pancreatitis-related but the vet suggested putting her on the high fiber food which is higher in carbs than acceptable for our sugar babies.
 
Hello friends, here's an update on sweet Agatha:

The pet store doesn't carry FortiFlora anymore. I found another called FloraCat which she doesn't like- that or nausea had already set in several days ago.

I made the following notes on my spreadsheet:

12am (Friday 15): BG 76, gave Cerenia + buprenorphine, at 2:30am gave 100ml fluids. About an hour after the buprenorphine she did a crazy apartment cat run around the house which ended up at her being at the food station, where she ate a little bit. That's when I took her in to give fluids. I think it must have given her some kind of poison relief energy?

The past 4 or 5 days Agatha isn't wanting the various flavors of pate. I noticed she's eating 3 or so bites of the Friskies pate when I open a new can, she'll return but doesn't eat much more- the food ends up drying up and going to waste. My civilian Freya is eating but also doesn't seem thrilled with the varieties. Tonight Aggy drank tuna juice and a couple bites of tuna + drinking water. Urine smells sweet + seems to be a bit of an increase in box, she's rubbing on corners and stretching which is a good sign, came to lay on bathroom rug. Belly is round, feels tight + has gas. Gas started + she started hiding behind bedroom chair at various points of the day but not always about 2 months ago, other than that appetite has been strong until last several days, not wanting the various flavors of Friskies pate.

So thankful to have the meds on hand, ondansetron, buprenorphine, Mirataz, fluids. I also have a supply of Prednisone from last year *in case* it was needed which it wasn't. I think Dr prescribed for the pancreatitis inflammatory condition?

I will email this info to my doctor tonight to see what he recommends.

I will continue to give the meds etc for now. Thank you for all your suggestions and love.

-Samantha + Agatha
 
Hello Sam and AggyBear.
I am sorry to hear Aggy is not feeling 100%.
Do you have a current spreadsheet? I can’t find one. I can see you have written information for 14 April but it is in the middle of the 2021 information. Would you like sine help setting up a current SS. I can ask @Bandit's Mom to help you if you like?
 
Bron and Sheba (GA) said:
Hello Sam and AggyBear.
I am sorry to hear Aggy is not feeling 100%.
Do you have a current spreadsheet? I can’t find one. I can see you have written information for 14 April but it is in the middle of the 2021 information. Would you like sine help setting up a current SS. I can ask @Bandit's Mom to help you if you like?
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Yes please, that would be so helpful! Thank you Bron!
 
Here's Drs reply:

"Hi there,
If her glucose is in the range of 76 consistently without insulin, then I would consider her to be in remission too and treat her for the possible pancreatitis using the cerenia every 24 hours, the buprenorphine 2 to 3 times a day, mirataz every 24 hours (all of these until normal- 3 to 5 days) and 5mg pred today then 2.5 mg a day through the weekend.
There is an newer appetite stimulant in the form of an oral liquid (Elura) that can be used as well if the mirataz doesn't seem to be helping as much. I think we have some at the clinic.
Take care"
 
Mochi & Me said:
I actually just posted about this as my vet prescribed it for Mochi and it says right on the box that it can raise serum glucose levels and may not be appropriate for cat with diabetes. :(
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Thank you so much for this information- definitely won't be using that.

I did have some of this dry food (link at bottom) my sister gave me which she was eating happily earlier. After she ate some I tested BG + was 99. I know it's important that she gets a strong appetite back. The Friskies pate + a bit of flaked tuna left out for her too but the kind is what she wanted. I had to leave them for the evening, I hope this will be ok.

Also gave the Prednisone 5mg, Cerenia + bupe around noon today.

Whenever @Bandit's Mom has time to help with a 2022 SS I'll get to updating. Thank you all so much.

Canidae PURE Limited Ingredient Dry Cat Food, Grain Free, Premium Clean Proteins https://www.amazon.com/dp/B01HBH896Q/ref=cm_sw_r_apan_i_6SF2KA4X9J15Z8KXQTP1?_encoding=UTF8&psc=1

Minimum Crude Protein: 36%
Minimum Crude Fat: 12%
Maximum Fiber: 5%
Ingredients:
Tuna, salmon meal, menhaden fish meal, lentils, chickpeas, sweet potatoes, suncured alfalfa, canola oil, natural flavor, minerals(zinc proteinate, manganese proteinate, copper proteinate, zinc sulfate, manganese sulfare, copper sulfate, potassium iodide, manganous oxide, sodium selenite), vitamins(vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, biotin, calcium pantothenate, menadione sodium bisulfite complex, riboflavin, pyridoxine hydrocholoride(vitamin B6), vitamin B2 supplement, vitamin D3 supplement, folic acid), choline chloride, DL-methionine, taurine, mixed tocopherols(a preservative), dried enterococcus faecium fermentaion product, dried lactobacillus acidophilus fermentaion product, dried lactobacillus casei fermentation product, dried lactobacillus plantarum fermentation product, dried trichoderma longibrachiatum fermentaion extract”
 
AggyBear said:
So what food is good for kitties with pancreatitis? She's gotten mostly only Friskies pate options, and occasionally raw chicken hearts + freeze dried liver.
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That sounds fine to me. I used to give Sheba Weruva cats in the kitchen cans plus some home made food which included hearts and liver.
Just. Make sure it is low carb.
 
Her BG yesterday at 12:39pm was 99. Just now at 2:05pm it was 265. She's drank a lot of water. She's eating some. Looks like she feels weak.

Will Agatha need insulin now again or is this temporary with the steroid prednisone?

This is frightening territory for me again. I just want to help her get better. We thank you for all help.
 
There's no way to tell about the prednisolone. Not all cats need pred for the treatment of pancreatitis. It might help if the vet ran a Spec fPL (or Snap fPL) to confirm a diagnosis.

I'd also be thinking about what you're feeding your kitty. I'm betting it's high in carbs. You can check by Googling "cat food carbohydrate calculator" and plugging the numbers in. It will give you a ballpark for the amount of carbs.
 
Sienne and Gabby (GA) said:
There's no way to tell about the prednisolone. Not all cats need pred for the treatment of pancreatitis. It might help if the vet ran a Spec fPL (or Snap fPL) to confirm a diagnosis.

I'd also be thinking about what you're feeding your kitty. I'm betting it's high in carbs. You can check by Googling "cat food carbohydrate calculator" and plugging the numbers in. It will give you a ballpark for the amount of carbs.
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He has told me he doesn't have the ability to run that at his office, I asked several times. I just took away the high carb food so that she couldn't eat it.

I know I just started yesterday supportive care with the meds, so it's early. I've seen her pick at the food today some.

Wondering when I should start syringe feeding? I have 2 or 3 cans of a/d.
 
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Are you testing for ketones? If she is feeling weak and not eating well and she is not getting insulin (which I am assuming she is not) I would definitely test for ketones daily at the moment. Ketostix is what you need from Walmart or a pharmacy.

If she is not eating I would try syringe feeding.
 
Bron and Sheba (GA) said:
Are you testing for ketones? If she is feeling weak and not eating well and she is not getting insulin (which I am assuming she is not) I would definitely test for ketones daily at the moment. Ketostix is what you need from Walmart or a pharmacy.

If she is not eating I would try syringe feeding.
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I have the test strips at home, I can't remember exactly how to trap the urine- I think a ziplock? I will syringe feed tonight. This all feels like the first time again. Thank you Bron.
 
Quick update - I re-read the pancreatitis primer and the low fat/high carb diet is no longer necessary with current treatment options. Some studies suggest a low residue diet may help, and possibly supplementing cobalamin and folate if those levels are low may help recovery
 
FrostD said:
Quick update - I re-read the pancreatitis primer and the low fat/high carb diet is no longer necessary with current treatment options. Some studies suggest a low residue diet may help, and possibly supplementing cobalamin and folate if those levels are low may help recovery
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I also have methylcobalamin I will give, thank you for your reminder.
 
Samantha --

Most vets send samples out to labs to have tests run -- or at least the tests that take more complicated equipment. My vet routinely sends blood samples to IDEXX for analysis. Most vets can't afford a lab quality serum chemistry analyzer in their office. (It's the same in your doctor's office. They can look at some samples but otherwise, have to use a lab.) In addition, the Snap fPL is meant to be an "in office" test. It's like a pregnancy test -- you put the sample on what amounts to a strip and it gives a "+" or "-" result. The Spec fPL needs to be sent to IDEXX. Your vet doesn't know what s/he is talking about.
 
Sienne and Gabby (GA) said:
Samantha --

Most vets send samples out to labs to have tests run -- or at least the tests that take more complicated equipment. My vet routinely sends blood samples to IDEXX for analysis. Most vets can't afford a lab quality serum chemistry analyzer in their office. (It's the same in your doctor's office. They can look at some samples but otherwise, have to use a lab.) In addition, the Snap fPL is meant to be an "in office" test. It's like a pregnancy test -- you put the sample on what amounts to a strip and it gives a "+" or "-" result. The Spec fPL needs to be sent to IDEXX. Your vet doesn't know what s/he is talking about.
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Thank you for this information. What exactly is IDEXX? If I understand correctly what you are saying, they would be able to do a "Snap fPL" in office? Do you know how much that generally costs? I have updates that I will post below.
 
Here's our update (I will update our SS asap but below is what will be in it). Thank you to everyone helping.

Agatha has continued to get around 3-5pm Cerenia or ondansetron, Mirataz + prednisolone 2½mg once daily- the prednisolone being an exception as the vet suggested weaning her off by skipping Thursday + Saturday and giving Friday + Sunday.

Appetite is strong but increased drinking + urinating. Tested negative for ketones. I noticed yesterday + today Agatha looked quite poorly. Today she urinated outside the box and the last time she did that was back at the end of October when she was having what I think was a pancreatitis flare + her BG was so high I think caused a UTI. As soon as we started her on the Veraflox she stopped.

I will wait to see if she does it again during the night. Her ears are not warm to touch but the pred knocked her blood glucose up to 200 one of the times I caught it. Today without that dose of prednisolone was in a lower range. I'm wondering if is caused her to get a UTI or something.

Here's what I emailed Dr:

"Good morning, I have continued the Mirataz, Cerenia or ondansetron + buprenorphine, as well as the prednisolone, skipping Thursday as you suggested.

If I can bring her in today, Friday, other than examining her what options are there to help her? Does it sound like another possible UTI? If the Veraflox sounds like the right option, may we pick that up? I'm just going off our experience the last time in October. I appreciate your help. I don't want her conditions to worsen over the weekend. -Samantha + Agatha"

Back to post: I, Samantha, have been struggling with acute mental + emotional distress due to health issues and am doing my best to take care of my baby girl. Right now she's laying in my lap but I must get up to go to sleep and await your responses. It's hard to think clearly on matters, having y'all to suggest + support is my lifeline. If I'm overlooking anything please let me know.

Below is a picture of her laying on the bathroom rug 3 hours ago: :https://photos.app.goo.gl/Zu7YrfbYuUXVtoeM6
 
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IDEXX is a commercial lab that many vets send samples to for analysis. They have more sophisticated equipment than most vets have in their office and they can run labs that are not frequently done and which a vet would not have the equipment or reagents to do. I have no idea about cost. You can Google IDEXX to get more information.
 
I didn't get in to see the vet but the jist is: continue with supportive meds over weekend. I am deciding to quit the prednisolone. I asked if the Veraflox was a good idea- I didn't get to speak to the vet but he read my email, I spoke with the receptionist. They said I could pick it up if I want to but I'm just not sure. I feel like I'm trying to do this on my own.

At 1:30pm today I gave her ondansetron, methylcobalamin pill, buprenorphine + 100ml fluids with plenty of food + water, BG 81 at 2:30am, this afternoon at 12:30pm BG 107.

Still deciding on whether to pick that Veraflox antibiotic up. I'll be back in town where my vet is Tuesday so that's an option too.

I know that getting over a flare takes time, I think maybe I'm being impatient? It just hurts to see her bc feeling so poorly. I don't know if the prednisolone was helpful or hurtful- her BG goes up when taking it + increased thirst + urination. Which is why I decided to stop it today. Need to study the pancreatitis primer again and again.
 
I should've gotten the the antibiotics yesterday. When I got home last night she'd peed outside the box again. I waited up till the vet opened to buy the Veraflox and a family member picked it up (my vet is an hour from me). Now I'm on my way to pick it up. Hers ears are warm to the touch + just feels so poorly. She's eating a lot + BG is 200. I'm going to start her on the antibiotics as soon as I get back home. I will need a refill of the buprenorphine too.

She was in remission for over 4 months. Since this flare and starting the prednisolone it's been in the higher 100s + up to 200.

With her BG being elevated right now, do I need to start her on insulin again? The pancreatitis primer says "In diabetic cats, BG levels often increase possibly in response to pain but also inflammation."
 
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AggyBear said:
She was in remission for over 4 months. Since this flare and starting the prednisolone it's been in the higher 100s + up to 200.

With her BG being elevated right now, do I need to start her on insulin again? The pancreatitis primer says "In diabetic cats, BG levels often increase possibly in response to pain but also inflammation."
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I can’t see any BGs in the SS. Can you update it for us to see please and keep adding the BGs.
I would be testing for ketones in the urine if the BGs are above normal, and she has a possible infection.
How is she eating?
 
I just updated all the BG I tested in 2022 + then as many notes I could remember off hand + will look to see what I've posted in this thread + add those notes.

I tested ketones several days ago + was negative, I can test again when I get home tonight.

Update: all notes that I can recall are in SS. Thank you for encouraging me get them in. @Bron and Sheba (GA). SS doesn't say when but she did always get a second dose of bupe.
 
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Her belly is big + hard and I'm afraid there could be a blockage? There is poop in the box but it's shared with my civilian so I can't be sure. I need to get her to the vet- I'm scared of what the bill will be. I made a tentative appt to drop her off in the morning.

The woman on the phone said the Dr may do x-rays or blood test.

She's had a very strong appetite up until what I've observed today but not much food is gone from this morning- she lapped up some tuna juice. 4:27pm BG 97.

FrostD said:
but also how is her breathing?
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I can hear her kind of making labored breathing noises, almost like a burp/exhale kitty noise. I've heard her do it a couple times yesterday and today.

Does buprenorphine cause constipation or the labored breathing? I'm just trying to think of anything.

I'm packing our bags to stay with family overnight so I can get her to the vet at 8am tomorrow morning. Going to give ondansetron for the car ride and make it as gentle a ride as possible.
 
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