9/25 Tableau Update

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ehsuan

Member Since 2011
Previous Condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=52803

Hello all you wonderful, kitty-caring people in Lantus Land (and FDMB). I know you know how incredible you all are for the support and knowledge and hand-holding you provide, and for caring for your wonderful kitties.

Writing with an update for Tableau. I'd like to say that things are improved, but unfortunately, they are not.

Tableau spent THursday and Friday in the hospital on IV fluids and electrolytes and perked up amazingly. So much so that this 16 year old cat was batting around cotton balls and swatting flies. He at like a little piggy, and when I got him home Friday night, he ate and ate and ate.

He was diagnosed with Pacreatitis . His fPL results were >50!!! WHich as some of you may know, is extraordinarily high. Additionally, his ALT was 647 (also extremely high). Kidney function is fine.

The vet sent us home with the following meds:

Metronidazole (50 mg 2x a day)
Ursodial (.3 mls 1 time a day)
Buprenex for pain 2-3 times a day
Cyproheptadine for appetite (1/2 tab once a day).

Additionally he is on 1 unit Lantus 2x day
1 ml amlodipine (high blood pressure)
cisipride for constipation
SUBQ FLUIDS

Wondering if anyone sees or suggests a different treatment plan or addition?

Unfortunately, since Saturday morning, he is back to not eating. He wants to eat but won't. Today he has been meowing so forlornly (and he's usually a quiet cat). We could put him back in the hospital, but even the vet thinks that it's a bandaid, and may not be worth putting him through anymore.

Basically he has so many uncontrolled health issues, that it seems insurmountable. He keeps getting worse and worse. His recent history (since April) is as follows:

Nasal carcinoma diagnosis (20 days of radiation)

Bortadella infection and ecoli in the nose. Those finally cleared up after three courses of antibiotic. But even with that cleared up, his nose is so compromised that he has chronic, significant, snuffy nose, so he can't smell and he has a lot of uncomfortable mucas in his throat.

He's had chronic constipation (although that's cleared up).

Uncontrolled diabetes since beginning of August.

Pancreatitis.

In the hospital they were able to control the diabetes with quick acting insulin and I wonder if that's why he was feeling so much better (in addition to the electrolytes).

He pretty much the last two days laying by the food bowls and staring at the wall. As I mentioned, he's also been meowing in what I assume is pain. He does get up and walk around, so he's able, but he doesn't really do anything (but that could be because of the pain medicine).

The last ditch effort she is suggesting is a course of prednisone. Again - last ditch effort. She says she's not recommending this lightly and that it may be the thing to get the inflamation under control so that we can then hopefully get the diabetes under control.

She doesn't, and I agree, want to do anything invasive (like a feeding tube) at this time. She feels he's too unstable. I forgot to mention he also has a heart murmur and asthma (controlled).

Anyway, I'm really looking for any advice or thoughts about all this. I know some of you have a lot of experience with so many feline issues. I also don't want him to needlessly suffer and it does seem like he is, for the first time, suffering.

THank you.
 
Oh Emily, I'm so sorry to hear that Tableau isn't doing well. I'm sending healing thoughts and prayers for Tableau and thoughts for peace and rest for you. ((((Hugs))))
 
oh, Emily...my heart goes out to you on Tableau's suffering.
BUT:

since i have joined this forum, i have watched time and again folks & their furbabies working through multiple overwhelming health issues..and have been
amazed and humbled to see what can be endured with good quality of life.

So don't despair yet...there is a wealth of knowledge and support here...so I think you will begin to see a lot of responses from folks who have experience with the conditions you are dealing with.

If you havent already done so...i would suggest that you cross post this on the main health forum so more people see it and can chime in.

Holding you and Tableau in our hearts...
celi & binks
 
The only thing I would add is to really push for an antinausea medication. This is one of the cornerstones to pancreatitis treatment. Vets often prescribe metoclopromide which is ineffective for nausea not caused by low stomach motility in cats. Push for ondansetron or dolasetron. Ondansetron is the generic of Zofran and can be found cost effectively at pharmacies - call around as prices vary. Dosing for an average sized cat is 1mg (1/4 of a 4mg pill). And with elevated liver enzymes I wonder about a liver supplement such as denosyl, marin or denamarin.

I wish I had an answer for you. You can only treat the symptoms. Can you syringe feed Tableau safely? In order to prevent Feline Hepatic Lipidosis you need to make sure Tableau maintains his weight. Not smelling his food is probably a big factor in not eating.

How are you holding up? Sending lots of hugs your way.
 
From manhattancats:
For years, veterinarians have grappled with diagnostic tests for pancreatitis. The disorder cannot be diagnosed based on historical or clinical signs alone, because the clinical signs (lethargy, inappetance, weight loss, vomiting, diarrhea) mimic many other diseases in cats and are not specific for pancreatitis. Further complicating matters, pancreatitis in cats often develops concurrently with other diseases, such as hepatic lipidosis (fatty liver disease), cholangtiohepatitis (inflammation of the liver and bile ducts), and inflammatory bowel disease. (In fact, the concurrent occurrence of these three disorders in a cat has been termed “feline triad disease” or “triaditis”).
 
(((((Emily & Tableau)))))
We are thinking good thoughts and sending prayers for strength for you and your boy that things will improve and that he will feel better tomorrow. It is indeed distressing to stand by and watch your kitty try to deal with multiple issues and pain. Listen to Tableau. He loves you. He may indeed surprise you and rally tonight. We are sending the best and most potent healing vines. Get well, Tableau!

Many hugs,

Ella & Rusty
 
Many of the cats here who have dealt with pancreatitis, including Gabby, were also prescribed Pepsid. Karrie's suggestion re. an anti-nausea medication is a good, if not better, alternative.
 
Emily, I hope these suggestions can help Tableau. Sending you and him lots of healing energy. We are thinking about you and hoping for the best.
Liz
 
emily, i'm glad to see a condo from you but sorry to hear tableau's not feeling better. poor little buddy. violet & garland seemed to get a good response with the combination of anti-nausea and getting food into garland. i hope you can get some of the anti-nausea drugs that karrie suggested.

scritches to our little buddy. sending healing thoughts and prayers your way. :YMHUG:
 
Oh Emily... :YMHUG:

I am soo sorry to hear about what Tableau is going through. Though I do not have any advice to give, I want you to know that you and Tableau are in my thoughts and prayers.

Pettings for Tableau cat_pet_icon cat_pet_icon and hugs for you :YMHUG: :YMHUG:
 
I gave him some pepcid this afternoon and maybe it helped a little...I will call the vet tomorrow and get the other anti-nausea med that Karrie mentioned. I do have some denamarin from when Daisy had HL. I will give him some of that as well.

Thank you all.
 
Karrie-

I just looked at the bill from the hospital and they did give him Dolasetronwhile he was there so I bet that's why he ate so well when he got home. I'm definitely pushing for this tomorrow with the vet (or the other one you mentioned).

Thanks again
 
Hope Tableau is feeling better soon. Pancreatitis is miserable for the kitties. I find that pain meds, liquid pepcid, and fluids make the biggest difference for Willow. After a few days of those, I add the appetite stimulant to the mix and after awhile, things start looking up for awhile.
 
The meowing you mention may be a side effect of the cyproheptadine, which can cause restlessness and vocalization. Maybe you could try a smaller dose. I agree totally with the anti nausea meds.

Steroids will likely cause BG's to go up, but they can also be life saving for cats with GI inflammation that cannot be controlled. It may be worth considering.

I hope that the anti nausea meds help.
 
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