9/8 Frosty - likely chronic pancreatitis

Ana & Frosty (GA)

Ana & Frosty (GA)

Member Since 2018
Frosty definitely hasn’t been his perky lively self over the last 24 hours. He tolerated 3 small feedings last night but then threw up a moderate amount of food & water 8 hours later. I just got him in the car and he’s not even caterwauling like he usually does - just some soft whining. Hopefully will get some answers today.

My biggest fear is that I’ll put him through all the tests and spend all this money and we still won’t know what’s wrong. But at least we are addressing it and this didn’t happen last week while we were away.

Wish us both luck! Thankfully my bf is coming with me bc he’s off today which is making it much easier. Even just carrying his carrier is hard for me bc it must be at least 20 lb of total weight.

I decided not to feed any of the pets until Frosty is in the car so he doesn’t get upset, so everyone was hangry this morning, lol. Right now Dan is feeding everyone while Frosty and I wait in the car.

Will post an update later tonight.
 
So the US didn’t show any stomach or bowel thickening, and no mass or lymphadenopathy, but the pancreas is enlarged and abnormal looking, so the IM vet thinks he may have some degree of chronic pancreatitis. It seems to flare up once a month so I don’t know if it’s acute on chronic or what they call it in veterinary medicine.

Anyway, since there seem to be some stomach emptying problems, she prescribed reglan (which also helps with nausea) as well as Bupe for pain. Bupe is for 3 days only and reglan is BID for a week and then I’ll call and update her.

She said we can try giving it to him at the first sign of a flare up and see if it helps. She didn’t feel an endoscopy was warranted at this time bc the stomach and intestines looked grossly normal.

She also drew the exocrine pancreas function panel to see if he needs pancreatic enzymes. I have noticed in the past that occasionally his stools are light in color (clay colored) but I thought it might be related to the wet food. Since his belly was never tender and he was gaining weight I figured it wasn’t anything to worry about.

I guess this makes sense though given that he has Cushing’s and had poorly controlled DM for god knows how long. Pancreas just got beat up.

So we will see. He didn’t eat this morning for the test, and when we got home I gave him 1/2 can FF with the meds. He’s been less active than last night and today, and he ended up not even needing anesthesia for the ultrasound bc he’s so out of it.

Dr. Demarco agreed that he does look like he has gained some muscle and his fur and skin looks a lot better. She said she wishes she took before and after Vetoryl pictures because the difference is pretty striking. He also weight more today than the last previous visits, and has gained 1 lb since he started the Vetoryl treatment (in 3 months).

She said if he continues to be lethargic and the meds don’t help or if he continues to throw up to bring him back in for IVF. So far he’s held down his snack and drank some water so I’ll keep monitoring him. He’s rly sleepy now so I’ll just let him rest until dinner at 6 oclock, and then we will see.

So that’s that. Good news I guess.
 
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tiffmaxee said:
Reglan helps with motility but NOT nausea for cats. Cats don’t have the right receptors. Get cerenia or ondansetron. I’ve posted articles on this and one is in the pancreatitis handbook here. Max had chronic pancreatitis for years. Ondansetron worked well for him. Others do better with cerenia.

Read page 7 of this article.

http://www.felinediabetes.com/FDMB/threads/article-vomiting-cats-and-puppies.202587/
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Thanks. To be honest, he was eating just fine until I gave him the Bupe. Now he’s stoned and won’t eat so I think I won’t be giving him that tomorrow. I think he has a motility issue because he would grow up food as late as 8-10 hours after eating. Even 2-3 hours after eating he would throw up his entire meal (during his “flare ups”) It’s as if it didn’t move at all. So I think we will start with the reglan and see how it goes. He never refused food even when he would throw it up. But bupe is making him Super lethargic and he won’t eat and this is the cat who will steal food out of your hand after he just ate his meal. I am not sure if he’s in pain, but if anything I won’t be giving it to him before meals anymore - maybe before bedtime or something.
 
@tiffmaxee was your cat on chronic antiemetic medication or just during flare ups? How did his chronic pancreatitis present - did he have flares up? How often? I’m just curious. Working with humans I’ve seen human pancreatitis but have no clue how feline pancreatitis works. (Humans don’t get usually pancreatitis from diabetes either)
 
Ana & Frosty said:
@tiffmaxee was your cat on chronic antiemetic medication or just during flare ups? How did his chronic pancreatitis present - did he have flares up? How often? I’m just curious. Working with humans I’ve seen human pancreatitis but have no clue how feline pancreatitis works. (Humans don’t get usually pancreatitis from diabetes either)
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Max didn’t need antiemetics except during flares. At first he needed an appetite stimulant with ondansetron. It turned out he wasn’t dosed correctly. Once that was straightened he only needed ondansetron during flares. He always became inappetent. Max got diabetes after years of pancreatitis. Some cats on the Pancreatitis board do need constant antiemetics. I think they likely have triaditis.
 
tiffmaxee said:
Max didn’t need antiemetics except during flares. At first he needed an appetite stimulant with ondansetron. It turned out he wasn’t dosed correctly. Once that was straightened he only needed ondansetron during flares. He always became inappetent. Max got diabetes after years of pancreatitis. Some cats on the Pancreatitis board do need constant antiemetics. I think they likely have triaditis.
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Interesting. What is triaditis?

Thanks. Our plan is to try this then I’m gonna call her at the end of next week (or sooner if he doesn’t improve), and if it doesn’t work I can always ask about an antiemetic. I think with these things sometimes you gotta find the perfect treatment which may be different for different cats. She said it IS possible that when the pancreas is inflamed the stomach doesn’t empty properly. Because of his Cushing’s, his appetite usually isn’t a problem, but we gotta figure out how to help him food down during flare ups.

Thanks for the info! It’s good to know that if this treatment plan doesn’t work there’s other things we can try. :)
 
ECID applies to pancreatitis too. Gizmo used to have inappetance (probably due to nausea), now it seems his is more on the pain side. I use both Cerenia and Ondan during a flare. Last one I treated with both for about 3 weeks. Pain meds are as important as the nausea meds but with Gizmo it can be a double edged sword because he becomes so doped up he won't eat (plus they can kill the appetite just like they do in humans). I give the pain meds right about nadir (mid cycle) and not nearly the prescribed dose. This seems to work best for him. And of course appy enhancer but I try and hold out as long as I can with it.

A completely different food (protien) has helped to get him eating a couple of times. Hills a/d is a last resort which I free feed (leave out in several bowls around where he is sleeping).

:bighug::bighug:

I hope you can figure out what will work for your Frosty. Pancreatitis is such a cruel disease. I absolutely hate it.
 
LizzieInTexas said:
ECID applies to pancreatitis too. Gizmo used to have inappetance (probably due to nausea), now it seems his is more on the pain side. I use both Cerenia and Ondan during a flare. Last one I treated with both for about 3 weeks. Pain meds are as important as the nausea meds but with Gizmo it can be a double edged sword because he becomes so doped up he won't eat (plus they can kill the appetite just like they do in humans). I give the pain meds right about nadir (mid cycle) and not nearly the prescribed dose. This seems to work best for him. And of course appy enhancer but I try and hold out as long as I can with it.

A completely different food (protien) has helped to get him eating a couple of times. Hills a/d is a last resort which I free feed (leave out in several bowls around where he is sleeping).

:bighug::bighug:

I hope you can figure out what will work for your Frosty. Pancreatitis is such a cruel disease. I absolutely hate it.
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Yeah, good call about the dose. I was just talking to my bf and he also said to give him half tomorrow. He had the meds 6 hours ago and he’s still sleeping. He didn’t eat his 6:30 dinner. I gave him 1/2 of his usual insulin dose since his sugar is going up and above 300 now, but I’m hoping this medicine wears off later tonight and he will eat the food. Poor guy.

He did get up and drink some water a few times, and he held down the 1/2 can FF I gave him with the meds and reglan at 1 pm, so thats good news, but this is kind of crazy. This cat eats everything and anything normally and is super active and vocal. Hopefully tomorrow will be a better day!
 
My previous kitty had pancreatitis, believed to be chronic, untreated long before I got him . He always ate through it though. But always vomited also. Once it was figured out he definitely had it (story I won't go into now) to keep him from vomiting he was put on a high dose of cerenia. He needed to be fed small meals every 2 hrs for a few weeks. Eventually we got him to every 3 hrs. We could never get past that 3 hrs if it was just 30 minutes late, up came the bile. Auto feeder was a godsend. His bupre started out high also. Eventually after quite some time the doses for cerenia and bupre were tapered down to life time maintenance doses.

You will figure out what works for Frosty. It might take a bit of time, trial and error, but you will find the right combination. :bighug::bighug::bighug:
 
Also, more recently, I am giving sub-q fluids. Small amount (50) no more than every other day during a flare. If not esting well, they aren't getting the moisture from the food even if they are drinking water. Dehydration will make them feel bad too.
 
Oh wow, thanks for reading guys.

Update - he threw up again at 8:30 and I decided maybe this lethargy isn’t all bupe-related and maybe he’s just getting worse. I also realized he hasn’t peed since at least 9:30 this morning. He’s been drinking water but when he threw up it was mostly water with a tinge of food so I called the specialist but decided I’m not to wait for a call back from them and will take him to an EM vet here in town (he also comes here for his regular vet visits).

Hoping for some IV fluids and anti nausea meds since reglan didn’t seem to work. Also want to double check his bupe dose.

I really hope he doesn’t have to stay overnight :( he didn’t have ketones at PMPS and his sugar is 316 which for him isn’t bad, but I wanna get ahead of the game before he goes into acute renal failure.

Ugh. This sucks. Thanks for the support everyone.
 
Ana & Frosty said:
I really hope he doesn’t have to stay overnight :( he didn’t have ketones at PMPS and his sugar is 316 which for him isn’t bad, but I wanna get ahead of the game before he goes into acute renal failure
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Prayers. Hospital may be the best place right now. Be sure to take a t-shirt you have worn or a used towel from a shower so he will have your scent.

:bighug::bighug::bighug:.
 
I really wish you would get cerenia for the vomiting. I’d have the vet give an injection and go home with pills. You can inject yourself as it’s sub-q but it stings. It should stop the vomiting. Reglan won’t. And several small meals a day.
 
Healing vines for Frosty. It sounds like you are honing his ongoing treatments. That is great news he gained a pound and that he appears obviously healthier to your vet since the start of the Vetoryl.

It's no wonder someone dumped him. Many owners are not as conscientious as you (and FDMB members). With all the care you have given him, he looks healthier in the pictures to me too. I like the updated pics of Frosty. He looks real comfortable.
 
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