Any experiences about dealing with gall stones?

[MMM]

Hello. It has been a month since Bailey was diagnosed with diabetes (feels a lot longer) and it has certainly been a saga. My vet had hoped changing her diet and getting her off prednisolone would be enough to get things under control, but pancreatitis is a complication and the other drug of choice for that condition made her quite sick, so we have now abandoned that option. My vet has been puzzled by how Bailey has improved in some areas but not in others (like how she is exhibiting intermittent pain). He wants her to be seen by a specialist, but in the meantime, to get some answers, she had an ultrasound and new blood work done. Today my vet emailed me a report on the results.

The good news is that the ultrasound indicates the pancreas and area around the pancreas is more normal. Her blood tests also indicate that the diabetes and pancreatitis have improved. Her numbers are not yet in the normal ranges, but they are way better than they were four weeks ago. And that's just with diet change alone, since getting her off the steroid never happened and she's not yet receiving insulin.

But this rollercoaster ride we've been on continues, because my vet went on to advise that the ultrasound also "revealed the presence of gall bladder stones, small foci/stones radiating throughout the biliary tree within the liver and a thickened/enlarged duodenum papilla." Sigh. As if things aren't complicated enough.

My vet went on to advise that the gall bladder stones are a potential problem because they could cause an obstruction at any time. He also suspects the waves of pain she sometimes seems to have could be due to stones in the biliary tree and gall bladder. She also has an elevated ALP level which he says probably reflects inflammation in the biliary tree secondary to the stones. However, he then said that "the increased duodenal papilla could be a result of chronic inflammation most likely from the pancreatitis but could also be due to an infiltrative process that is in the early stages of forming a nodule or mass." I sure don't like the sound of that.

Before these tests, my vet had also recommended Bailey be seen by a specialist, again because he was puzzled by some of her symptoms (the intermittent pain, for example). He still thinks that's the best option, and as long as she "is stable and doing okay" he thinks it best to wait (the specialist won't be here for another three weeks). I want as little disruption in her life as possible (and taking her to the clinic is bad enough, the animal hospital really stresses her out) so I'm on board with that.

I guess I'm just hoping someone here has dealt with a cat with gall stones and it all went well. I'm feeling a little overwhelmed at the moment. My vet also detected a heart murmur at her last visit (level 2 - he didn't seem alarmed by it) but I am still finding myself stressed, wondering what else can be wrong with her. Anyway, I understand there are some treatments that "may" dissolve the stones medically, otherwise surgery is in order. I don't think I want to put her through surgery. Sigh. So has anyone else dealt with this? Did dissolving the stones medically help?

 

[rhiannon and shadow (GA)]

As I understand it, stones are quite painful, especially passing them.
It would probably help if he would give you bupenorphine for her pain. ( i recommend diamondbackdrugs.com for that prescription... he can fax it to them... it's $40 for 10mL. ) I give bupe for my cats pain....many here use bupe for pancreatitis pain. And the stones would also need it.
Mine gets a tiny dose of 0.1 mL because she's really a lightweight with pain meds.

I understand your stress level. Mine has new dx's of other issues as well. It's often overwhelming. You just have to do the best you can, one day at a time.

I'm sure someone will come on tomorrow with some answers more specific.
It's been a quiet night thus far.

 

[MMM]

I had to give her buprenorphine when she was first diagnosed with pancreatitis nearly two years ago. She was in a lot more pain then than she is now and the pain then was constant. This time the pain is intermittent. She will be running around, playing with her toys without any apparent discomfort, then and twenty minutes later she will be sitting all curled up, looking quite miserable. At first, every time she improved, I thought it was over. I would start feeling hopeful, then she would have another spell. Sometimes a day or more goes by without any evidence of discomfort, other days, not so much. I now realize this isn't "over". So in my response to his email tonight I did ask my vet for suggestions in this regard. My main concern about using buprenorphine is that I remember it being a pretty strong drug (she seemed stoned most of the time) and I'm not sure she needs to be constantly medicated. However, controlling the pain (whether it is there or not) is a prime objective, so if he recommends buprenorphine, so be it. Also, I didn't consider the fact that back at the start of all this, she may have been on a fairly strong dose (I don't remember what it was). Maybe given the nature of her pain this time, she would need a much lower dose. We will see. Thanks for the support and the advice (one day at a time). It is hard to be in the middle of the process - I look forward to when she and I are on the other side and she is getting some type of treatment that gives her good quality of life. But looking forward to that time doesn't make it so - we still need to go through the process of getting there. Words of support are helpful though. Thank you.

 

[BJM]

There is a prescription medication, ursodiol, which may help dissolve gall stones.
Meanwhile, if you can reduce the fat content in her meals, which provokes bile release that may push the stones into the duct, it may help reduce the symptoms some. Per Cat Info, you can add 1 ounce of plain meat or poultry to 5 ounces of cat food, mix well and portion out, to increase the protein content and reduce the fat and carbohydrate content, without significantly altering the needed vitamins and minerals.