? 5/5 Panic is very sick - pancreatitis CONFIRMED

Panic

Panic

Member Since 2019
This is cross-posted in the Health Forum, just looking to get some experienced eyes on here.

Previous board.

Summary: Panic stopped eating this past Sunday and has been nauseous. That PM I gave her 2mg of zofran which did not help. Monday (yesterday) I took her to the vet who said she ate for them (only 1/4 can of FF it turns out), gave her a shot of cerenia and said all her blood work was good. I received the blood work last night and it's not great?? Lab results are attached, Low WBC, NEU, EOS, High HBG, MCH, MCHC, FRU. I need help understanding the results, I already know about the FRU test and am not sure why they ran it. They did not do a comprehensive panel either. The vet did not tell me if they thought anything was wrong.

I gave her another 2mg of zofran last night and another one this morning. She is hanging by the water bowl but not eating. I have tried regular food, chicken, beef, liver shake, and baby food. She doesn't want any of it but will lick up what I wipe on her face for the most part. She is laying on her side a lot and drinks whenever I give her food.

She was not tested for it but I'm wondering if she may have pancreatitis?
 

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I can’t download the test results you have posted.
I would take her back to the vet and ask for a SnapfPL which they can do in the vet office. That will tell you yes or no if it is pancreatitis.
She may need some pain medication, IV fluids and another cerenia injection if it is pancreatitis.
It is important you get to the bottom of what is wrong so she will start to eat again.

Did you test for ketones?

Sending many vines.
 
Sorry about that, here is a screenshot instead.

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I will call them again when they open. Abouts how much does it cost do you know/remember?
She is drinking a lot at least.
 

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I haven't checked for ketones, she hasn't been going to the bathroom really (inside anyway, she was outside just a little yesterday after coming home). The vet did not check.
 
I don’t live in the US and I haven’t had to get a Snap fPL for about 4 years but it used to be about $40.
It is an in-house test and will tell you yes or no whereas the Spec fPL will give you a number as to how bad it is. It is sent away and you won’t get that test for a day. I’d go with the In-house test and get an answer at least.
 
Panic said:
I haven't checked for ketones, she hasn't been going to the bathroom really (inside anyway, she was outside just a little yesterday after coming home). The vet did not check.
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I would try and get a Ketostix test in and check for ketones ASAP. That needs to be ruled out.
 
Thank you. A ballpark is better than going in blind haha.
I have about ten more minutes until they open, I was going to give her about 2u since her +11 was 373. Does that sound ideal? Normal dose was 2.5 and I've been giving half that.

Can the vet check for ketones any way other than the standard ketostix test? Wondering if they may have an easier time than me.
 
I agree-- get a snap fPL, you need to know what you are dealing with. If it's pancreatitis, that gives you a few additional tools like pain meds and antinausea meds to try to get her feeling better.

Definitely check for ketones (they can do that at the vet too if you can get her in quickly, but pick up some ketostix as well so you can check at home).
 
Panic said:
Oh good, I really never catch her peeing at home.
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If they do find ketones at the vet, another option for checking at home is a blood ketone meter. Extremely pricey strips (but you don't use as many as the BG strips), helpful when you have a shy kitty!
 
That's a good idea Nan, I will have to look into a meter just to us as a spot checker since the stix are hard to use.
Minus this morning though she's been running in the 200s - I was under the impression 350+ is when ketones could be suspected?

Yes I've heard that too Bron!
 
Ketones can develop if there is not enough insulin, not enough food and an infection or inflammation. It’s not only about the BG level. If she is not eating enough, the body starts to use fat and protein for energy and that in turn produces ketones and if she has some sort of infection or inflammation present, that could increase the chances of ketones in the picture.
 
Makes sense.

The vet says she wants to run an x-ray because she doesn't have SNAP fpl??
 
They also said they didnt do a URI because they couldnt get a sample. I am calling another vet to see if they can do it.
 
Panic said:
3 vets in town and no one is carrying a SNAP fpl test. :arghh:
What should I do?
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Whoa. That is disturbing. I wonder if there are supply chain issues????

Anyway, I guess go to your vet??? An x-ray is better than nothing, perhaps it will turn up some clues about what is going on. While you are there, see if you can get them to prescribe pain meds and more anti-nausea (in addition to the cerenia shot, I don't know how long those last) anyway (assuming there are no contraindications on any of the differential diagnoses).
 
Also, if no one has the Snap fPL and you are there anyway, you can ask for the Spec fPL and get a pancreatitis answer that way (just a bit later).
 
Im not sure if I'd want to spend another quoted $240 for xrays when they're probably pointless ... could I just treat it as if it it was and get pain meds/more cerenia?

I've called four vets and no one has it, one said the tests expired all the time so they stopped carrying it. They recommended the Petsmart vet so I'll try them I guess.
 
Was she ever vomiting, or is it just that she isn't eating? The other thing an x-ray would reveal is if she has some kind of blockage, so that's a good reason to do that, but I understand the cost concern.
 
No vomit, just feeling bad and no appetite. Im on hold and the Petsmart vet DOES carry the test.
 
My cat had almost died from ketones . DKA . He’s sugar was in the 200s mostly low 200s . Please start insulin soon . If it’s what he or she needs . Don’t wait ! I saw my cat Almost die of it . I was treating him first on diet Alone while I was trying to get help to start him on insulin . Three months he almost died . It’s dangerous read all
About it here . This is the international diabetic cats . It’s apart of this group too . Diabetic Ketoacidosis (DKA)

When you see your cat act like mine did he was lethargic and almost dead ! Its very scarey ! It starts off with the same symptoms your cat is having . They are getting dehydrated too ! My cat was starting to suck and like a baby . My baby was dying . Its very serious !

ishttp://diabeticcathelp.com/related-conduitions/
 
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Think you posted on the wrong board, Tina!

Okay I have her an appointment at Banfield in a couple hours since they have the test.
 
Of course. What should my next step be if it ISNT pancreatitis? I told the Banfield vet I only wanted the test done.
 
OK, good luck! It sounds funny to be "hoping" for pancreatitis, but at least that is something known and with some tools to combat it. If the Snap fPL turns up negative, I hope they're able to figure out what it is, not knowing what you can do to help your cat feel better is the worst.

Panic said:
Of course. What should my next step be if it ISNT pancreatitis? I told the Banfield vet I only wanted the test done.
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That's a really good question. I suspect the next step would be an x-ray, but hopefully the vet there will have some other diagnostic ideas. Definitely bring all the bloodwork results and any other recent info to help them narrow things down.

This is probably not comforting right now, but I have a civvie who displays similar symptoms (except with a little vomiting and diarrhea in the beginning) roughly once a year. Every time, I bring him in for tests, x-rays, ultrasounds-- we've even discussed emergency surgery, because for one episode he was sooooo sick the vet was convinced he had a life-threatening blockage, even though nothing showed up on the scans. We have never figured out what it is, but every time, no matter how sick he is on Days 1-3, he's completely back to normal on Day 4 or 5 (my bank account, less so!). So, not exactly comforting, but just as an example of cats being really resilient as well as mysterious creatures.

Much better to find out what it is, though!
 
I know, right? I don't really know what I want it to be, I just want her feeling better, she's so quiet and not moving and I feel awful. I just want to cry.

That does help actually, knowing they can randomly pull through it. What's she's doing now just makes me think she's acting exactly like she was before she got diagnosed/right before FD symptoms started. Maybe she had a bout of pancreatitis then? She started eating three days later. But I'm just speculating trying to make sense of everything.

I guess I can ask for x-rays to see a blockage if it isn't pancreatitis?
 
I am at my regular vet now, they were able to get a urine sample from her so they're checking for ketones now. I stopped by to get a rabies vaccine because I can't find my records (I got it from a mobile vet so they don't have those records) because the Banfield vet wants to charge $26 whereas my vet will do it for $10.

Very hectic morning ahh!
 
Thank you both. The vet says she has +1 ketones, I'm not sure what that means off the top of my head, is that above trace??
 
Elizabeth,

Panic does have 1+ ketones in the urine. There is also a high level of glucose in the urine and some blood. Like we had talked about yesterday, she is not regulated currently so this can be some of the cause of her illness. If she also does have pancreatitis, then she will need IV fluids/antibiotics/antinausea/Protectants. Let me know if you have any questions

^ email I received
 

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I am waiting at the Banfield vet now for them to do the SNAP test. They said it'd take maybe 45 minutes
 
Hmmm, in the screenshot of the bloodwork there is a category "KET" which I assume is for ketones (???) there's no scale or reference range for the number (15), but it would match the ketodiastix reference for the "small" category, 15mg/dL. So if that's what it's referring to (would make sense to call that +1), a bit above trace.
 
Also, it sounds like your vet is totally on top of pancreatitis treatments, which is great. Sounds like they know their stuff!
 
That's what I was wondering as well? I just can't find anything for +1. So not DKA yet but getting there? I gave her 2u this morning.

Well I feel like she didn't know her stuff yesterday! :banghead:
So still waiting on results but sounds like she needs to go back to her regular vet afterwards either way. At least for appetite stimulants?
 
I would ask for sub-Q fluids as well if you go back to the regular vet. She mentioned doing IV fluids for pancreatitis, but sub-Q should be fine, and will help with the ketones.

I have to say, the "small" ketones are not surprising given that she hasn't been eating and clearly has something going on, but it's concerning. I would be worried about trying to handle it at home without getting a clear diagnosis of the underlying issue and a plan of attack to address it and get her eating again.

The other thing to get at the vet for home care would be a few feeding syringes and some A/D if they have a few cans. With ketones on board, you can't wait for her to start eating on her own.
 
The vibe I'm getting is she thinks the ketones are the reason she's sick, and then ketones are from her not being regulated. But clearly she's got some other infection/etc going on.

Thank you, I will bring all that up when I get there. Are giving subQ fluids the same as you would insulin?
 
Panic said:
Are giving subQ fluids the same as you would insulin?
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No, you use a larger needle and a big bag of fluids plus a bunch of tubing. I haven't done it in ages, but basically you harpoon in the scruff area, leave the needle in, and basically use gravity to slowly move the fluid from the bag into the cat, adding 100ml or so in a session. Others here can give expert tips.
 
Tagging @tiffmaxee , she has had extensive experience with pancreatitis and (I think) sub-Q fluids, she may have thought of some other things to ask for/about with your vet. Let's see if we can do this in just one more visit!
 
Thank you! My regular vet said I have to wait till after 1:30 (it's 11:48 here) because of surgeries she's doing so if I can compile a list of stuff I need to get and address before then that'd be great.
 
Ugh, right? Today isn't our day. :(

I was reading that last night too, so subQ fluids, cerenia, an appetite stimulant...
 
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