Re: 6/26 Jinx PMPS 410 (sigh), CP question
Hi Joe,
A couple people have emailed me about Jinx. I am not a diabetes expert but am very vocal in educating people on the importance of assist feeding.
Quick background - my cat Maverick almost died due to negligent vet advice. He was as close to death as you could get and ended up needing a feeding tube for ten weeks. My friend found a yahoo group dedicated to assist feeding cats the night of his tube placement. Maverick would have died without their knowledge and support. Since that day in July 2008 I have been very active on the Yahoo Feline Assisted Feeding Group and pay it forward. Cats can't go very long without eating or a week or two with too low calories. When cats bodies resort to body fat to make up a calorie deficit their livers clog with the fat and actually fails.
Jinx is diabetic which makes calories even more critical. Infection, lack of calories and not enough insulin can lead to diabetic keto acidosis which is deadly fast and most cats need expensive hospitalization to recover. You will get amazing diabetes advice here. We went through five vets before finding the perfect one. One that was not old school (I have the white coat its my way or the highway), that listened and looked into things if they didn't have the answer. They do exist. You are Jinx's parent and its your job to advocate for him. The poeple on these groups read endlessly about these specific issues and know more than vets. Vets are generalists and not up to speed on the latest treatments. These groups save lives so please listen to them.
There is a yahoo group dedicated to assist feeding cats: http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/ More on this below.
Vets are quick to dispense appetite stimulants without addressing nausea. It is like giving you an appetite stimulant with the flu. You know how horrible feeling nauseated feels like. Add a chemical on top of that that makes you eat and its a recipe for long term food aversion. You probably would never eat chicken soup again. Appetite stimulants should not be given to an anorexic cat. If your cat is eating but just not enough it can be a great tool but must be given with an a true antinausea medication. A pancreatic cat needs an antinausea medication regardless. Ondansetron is very affordable but pricing varies. Many members say Costco is good and you don't have to be a member. Thrivingpets sellls it for 80 cents per four mg pill (four doses). Up here in Canada I paid 9$ a pill and it was worth its weight in gold. If Jinx is vomiting also - Cerenia is the best for this but not nausea. Here is a technical article for you written by a vet for vets on controlling nausea and vomiting in cats.
http://tinyurl.com/24wrt8v. A lot of vets prescribe reglan/metoclopromide which doesn't work on cats for nausea. It does in dogs.
Pancreatitis is horribly painful and nauseating. The standard course of treatment is fluids, pain control (buprenorphine) and antinausea medications. Metacam kills cats even with one dose - causing acute renal failure. It has a black box warning and you should have this on your file to not give to your cat.
There is a great yahoo group dedicated to pancreatitis: http://pets.groups.yahoo.com/group/Feline_Pancreatitis_Support/
Assist feeding - your cat needs calories to survive pancreatitis and avoid DKA. A high fat diet can be hard on a pancreatic cat so others who have dealt with this can recommend something for you to feed. Maybe pure meat baby food. Assist feeding involves syringe feeding, finger feeding, feeding on a baby spoon, plopping on the floor - what ever works. Never assist feed a food you need him to eat on its own. This helps avoid aversion to that food. If you go to the FAF website I linked to there is a video on our home page of a cat being syringe fed. Also if you join you will get sent five auto files. One of them is how to syringe feed safely and effectively. It gives you lots of tips on things to try for your cat. Assist feeding is invaluable and everyone should try this for their cats before there is a crisis. Its a tool to get you through the flare up. If your cat is prone to pancreatitis you may have to intermittently jump in and assist feed in the future. It is a new skill that takes a bit of practice. It can be overwhelming reading everything but you aren't in this alone. You have the people here who know more than diabetes that will help you through this. The goal is to maintain weight and even more if there are ketones. A pet/baby/shipping scale that weighs to the ounce is the best way of knowing if you are feeding enough. The baby scale actually caught Maverick's diabetes before any other symptoms arose and he was diet managed for a year.
You have to be strong and get what you need from your vet, and if you can't - find a new one. I had a horrible first vet that was an actual bully. To this day I have anxiety issues when I need to go to the vets. For a couple of years I needed a pep talk and support to get the courage to do this for Maverick. To help give me courage to speak up and not freeze. I eventually got the courage to fire him and go through others and found the perfect one. So lean on people here to help you prepare. I also got advice to practice out loud what I was going to say and to talk it through with "Dr. Maverick". It may sound silly but it helped a lot. Its overwhelming at first - but you'll survive it and so will Jinx
Edit - I see there is also elevated liver values. You will also need to add a liver supplement to the mix. This is proven to improve survivability. Denosyl, Marin or Denamarin are the most common.
