Advice on pancreatitis

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Camcat

Camcat

Member Since 2020
Hi All. My sweet girl was diagnosed with pancreatitis on Wednesday. She's on Onsior and Cerenia. She didn't show much improvement on Thursday, but Friday seemed much better - eating a bunch.

But this morning, she's back to bad. vomiting (strangely, down the side of the litter box), even water this morning, and not wanting to eat (trying to eat plants, if anything). She thankfully seemed to keep her next drink water down okay.

Ketones are normal (although on the high end of normal, 0.6 on blood ketone meter). BG is high bc I'm letting her eat whatever she wants to as long as she eats (including dry kibble), and I've lowered her dosage in case she vomits. I'm going to call the vet today.

Does anyone have any experience with pancreatitis? How long does it last? (It has been five days for her, with treatment beginning at about day 3), Should I ask for different anti nausea medication? Appreciate any insight, or guidance from your own experiences.
 
Sophie’s pancreatitis has lasted anywhere from nearly two weeks, to 3 days the last time she had it. The subq fluids really helped her a lot, so I would ask your vet about doing those again, especially to prevent dehydration as well. We did ondansetron along with the Cerenia injection this last time and that worked well too. I believe I’ve seen stuff about ondansetron being better for nausea, whereas Cerenia is better for the vomiting and inflammation. I asked for some bupe for pain too. Does she have diarrhea? That may explain the vomiting down the side of the litterbox, if she’s pushing really hard trying to go
 
Thank you both. I'm relieved to hear it can last for two weeks and still be okay. For the two weeks, did she have to be hospitalized?

I didn't mention in my first post, but when she was at the vet, she got subq fluids with, b12, convenia (antibiotic -- she had a suspected bacterial skin infection on her face and slightly infected toenail that she had been on Clavamox for the week before), cerenia and pain meds. I'm supposed to give Onsior and Cerenia at home for the next few days (which I have been doing).

Doing some research at home post vet visit, I came across a number of scary articles talking about potential adverse reactions from convenia, but this forum helped ease my mind as I saw several older posts where a number of cats had had convenia without an issue. I've pushed it to the back of my mind, but it could be this causing her to be ill.
 
Camcat said:
I came across a number of scary articles talking about potential adverse reactions from convenia, but this forum helped ease my mind as I saw several older posts where a number of cats had had convenia without an issue.
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Yes, like almost every drug, a very small population will have an adverse reaction to it. I only used Covinia once for an antibiotic after an extensive dental. He was very hard to pill and I risked disrupting the gum sutures by pilling an antibiotic. He would not eat an antibiotic hidden in food/treat. I have another cat, Snuffles who I would also give Covinia since he is basically impossible to pill and he has bit me more than once after testing his ear.
 
Camcat said:
Thank you both. I'm relieved to hear it can last for two weeks and still be okay. For the two weeks, did she have to be hospitalized?

I didn't mention in my first post, but when she was at the vet, she got subq fluids with, b12, convenia (antibiotic -- she had a suspected bacterial skin infection on her face and slightly infected toenail that she had been on Clavamox for the week before), cerenia and pain meds. I'm supposed to give Onsior and Cerenia at home for the next few days (which I have been doing).

Doing some research at home post vet visit, I came across a number of scary articles talking about potential adverse reactions from convenia, but this forum helped ease my mind as I saw several older posts where a number of cats had had convenia without an issue. I've pushed it to the back of my mind, but it could be this causing her to be ill.
Click to expand...

The first two times she had pancreatitis they didn’t know it was pancreatitis, so that’s probably why it took her so long to get better. She was only hospitalized for the first day and she basically just received fluids. Treatment is really just supportive care until the pancreas heals up, but managing the symptoms so she can rest probably helps that process. I found this page from IDEXX really helpful :cat:

https://www.idexx.com/files/spec-fpl-treatment-for-feline-pancreatitis.pdf
 
The only time Convenia is recommended is for skin infections. Some vets tend to use it for everything. under the sun because it lasts 2 weeks and they think they are doing you a favor by not having to pill your cat. I'd encourage you to look over this post on Convenia by Lisa Pierson, DVM. My vet won't use Convenia for all of the reasons Dr. Lisa outlines.

Please make sure that your vet is prescribing Onsior for no more than 5 days. Onsior is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs if used overly long or in high doses can cause renal failure in cats. The manufacturer of Onsior indicates the tablets should not be used for more than 5 days. If Cam is vomiting, I'm not sure if giving Onsior on an empty stomach may be irritating her stomach. With humans, it's typically recommended to take an NSAID with food.
 
You are citing its use in Europe -- where the dosing standards are very different than here in the US. The only indication that the FDA supports is for skin infections. Otherwise, the use of Convenia is off-label.

The major issue, the preceding notwithstanding, is that if a cat is allergic or sensitive to the drug, it lasts well over 2 weeks. Once it's in, there's no way to get it out and no good way to truly modify the reaction. It is rare that a vet will outline the risks in order for the caregiver to truly give informed consent.
 
Here is an NIH study:
Antimicrobial Activity and Spectrum of Cefovecin, a New Extended- Spectrum Cephalosporin, against Pathogens Collected from Dogs and Cats in Europe and North America
"In conclusion, cefovecin exhibited excellent in vitro activity across an extended spectrum of bacteria, encompassing all major pathogens with clinical relevance for common skin, urinary tract, and periodontal infections in dogs and cats."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489759/
 
@Larry and Kitties - I appreciate your pulling up a research article. It is a bit dated (published in 2006) however, that isn't my largest concern. The study was done in vitro on bacterial isolates. In other words, the research was done in a petri dish. While Convenia may exhibit good antimicrobial activity, which was not the issue in question, it doesn't address what is my overriding concern -- that if a cat has an allergic reaction, it's hugely problematic. A shorter acting antibiotic would be preferable if there is an allergic response. This is not solely my concern. As I mentioned, my vet who is a feline specialist, does not prescribe Convenia. It is the concern that Dr. Lisa has raised since I've been a member of FDMB (which is over 10 years). It also doesn't address that the FDA's only indication, rightly or wrongly, is for skin infections.
 
Sienne and Gabby (GA) said:
If Cam is vomiting, I'm not sure if giving Onsior on an empty stomach may be irritating her stomach. With humans, it's typically recommended to take an NSAID with food.
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@Camcat Sienne is correct. Do not give Cam the Onsior if Cam is not eating. It must be given on a full tummy to prevent irritation. I used to give Sheba hers at the end of the meal. She was a good eater so I would put it in a very small amount of food so I knew she had got it all. It can be given on its own as well but only after food.
 
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