Bear's future health is unclear and I am treading water. (Updates with questions?)

[Bear & Lora]

I am not wanting to complain or vent on a cat forum. I am that person that others lean on and look to for logic and possible answers.
I find my situation reversed and it doesn't sit well with me at all.
I feel like it is necessary to share some of my situation so that others might understand how dire things are for Bear and I to write this.

Before Bear was diagnosed with diabetes I made the choice to quit my job, move my mother in with me and become her caregiver.
Her Cardiologist had told me that I would be lucky if my mother lives 5 more years, that was about 3 years ago. In short my mother's vascular system is a wreck and failing, with open wounds on her leg from mid shin to her ankles and left frontal lobe brain damage caused by past mini infarctions which has given her early severe dementia.

It took me over a year changing her diet, getting her to stop smoking, and getting her the medical attention that she was so remiss in having to realize I can't stop her decline nor really slow it down much.
When Bear was diagnosed last year with diabetes I began to educate myself and I followed a similar path, changing diet, medical attention etc.
Now after three years of basically being contained to a house in order to keep my mother safe with medical personal coming every day, multiple Dr's appts regularly, plus vascular procedures along with being Bear's caregiver my body and mind are starting to rebel.

My mother's health issues and Bear's health issues are starting to collide and I am putting off my mother's needs to take care of Bear and vice versa and I am starting to feel like I am doing a disservice to both.
At this point I just want desperately to get Bear to a healthier place so I can take care of both of my loves and keep them in my life for as long as possible.

The latest health issue with Bear is pancreatitis, lack of appetite and bouncing.
We have changed Bear's schedule to 6:30-6:30 versus 9-9 in order to allow me to have more sleep but that isn't working out well, I am still up till 2:30AM-3 because Bear's Bg is going lower at +7, +8, which is also causing some confusion as to his insulin dosage.

He is still suffering from lack of appetite nausea with some vomiting so I started giving him Cerenia again.
From past experience Bear has dived to lime while suffering a flare because of his lack of food and I have not been able to budge his BG with Carbs so a lower insulin dosage was recommended by the Vet until his appetite was fully recovered.
When I asked the Vet whether I should give him an appetite stimulant she said no. The Vet also recommended Forti Flora for his digestion but I thought I read that is used to entice cats to eat but not good for much else?

Every turn I seem to hit a wall, low dose = high bounces with green some nights, higher dose = low events with possibly no carb steering.
As for Bear's appetite it went up for a day or two then went down again.
He is eating about 3 maybe 4 ounces low carb wet in 24 hours and only if it has parmesean or chicken crumbles on top. He won't eat higher carb wet at all now. I hesitate to feed him anything different (meaning high carb kibble) and aggravate his digestive system anymore than it already is.

I will get some Levemir ordered within the week to try.
If Levemir could just lessen Bear's dives that would keep him safer & be an improvement for a rainbow cat.
I am open to all questions or ideas.

 

[Bellasmom]

First of all I want to say how sorry I am that you are going through all this, I was a caregiver for 9 years with people who had dementia, although I don’t know how it feels totally for 24 hr care I do know 12 hr care and dealing with a diabetic cat, it’s mentally exhausting, after a lady I had for 6 yrs passed, I did take on 1 more for 3 years, I had to quit, I was withdrawn and depressed.
First of all you DO NEED TO MAKE TIME for yourself, if maybe you could get a sitter to come a cpl hours, go for a walk read a good at library, do something you like and focus on you. Very important
Even with Bear, you need a break too
When Bellas sister was having problems with appy, I gave her 1/4 10mg Zyrtec and it did make her hungry
Wish I had more advice and please anytime you need to talk or vent that’s what we are here for
Sending prayers and lots of hugs!!

 

[Bobbie And Bubba]

Oh Lora! I can so relate as I’m my moms full time caregiver too. It is very draining at times. I’m glad you do have people coming into the house for care , you do need to get relief where you can get out a few days a week and go to lunch with a friend.

As far as Bear, could you try some all meat baby food while he has pancreatitis? It always works for me when one of my boys goes off their feed. It is pure and bland and might give his digestion system s break and keep him eating. I tried poaching turkey and chicken and blending it up it my Magic Bullet and Bubba liked that too. Baby food was just easier .

Some of the lev folks can help with the transition and hopefully that will help with the bouncing.

Take care of yourself and thanks for reaching out. We all need a little help from our friends. Even strong peeps like yourself need support. Sending hugs and vines.

 

[Krystina & Nelli]

I am not wanting to complain or vent on a cat forum. I am that person that others lean on and look to for logic and possible answers.
I find my situation reversed and it doesn't sit well with me at all.
I feel like it is necessary to share some of my situation so that others might understand how dire things are for Bear and I to write this.

Before Bear was diagnosed with diabetes I made the choice to quit my job, move my mother in with me and become her caregiver.
Her Cardiologist had told me that I would be lucky if my mother lives 5 more years, that was about 3 years ago. In short my mother's vascular system is a wreck and failing, with open wounds on her leg from mid shin to her ankles and left frontal lobe brain damage caused by past mini infarctions which has given her early severe dementia.

It took me over a year changing her diet, getting her to stop smoking, and getting her the medical attention that she was so remiss in having to realize I can't stop her decline nor really slow it down much.
When Bear was diagnosed last year with diabetes I began to educate myself and I followed a similar path, changing diet, medical attention etc.
Now after three years of basically being contained to a house in order to keep my mother safe with medical personal coming every day, multiple Dr's appts regularly, plus vascular procedures along with being Bear's caregiver my body and mind are starting to rebel.

My mother's health issues and Bear's health issues are starting to collide and I am putting off my mother's needs to take care of Bear and vice versa and I am starting to feel like I am doing a disservice to both.
At this point I just want desperately to get Bear to a healthier place so I can take care of both of my loves and keep them in my life for as long as possible.

The latest health issue with Bear is pancreatitis, lack of appetite and bouncing.
We have changed Bear's schedule to 6:30-6:30 versus 9-9 in order to allow me to have more sleep but that isn't working out well, I am still up till 2:30AM-3 because Bear's Bg is going lower at +7, +8, which is also causing some confusion as to his insulin dosage.

He is still suffering from lack of appetite nausea with some vomiting so I started giving him Cerenia again.
From past experience Bear has dived to lime while suffering a flare because of his lack of food and I have not been able to budge his BG with Carbs so a lower insulin dosage was recommended by the Vet until his appetite was fully recovered.
When I asked the Vet whether I should give him an appetite stimulant she said no. The Vet also recommended Forti Flora for his digestion but I thought I read that is used to entice cats to eat but not good for much else?

Every turn I seem to hit a wall, low dose = high bounces with green some nights, higher dose = low events with possibly no carb steering.
As for Bear's appetite it went up for a day or two then went down again.
He is eating about 3 maybe 4 ounces low carb wet in 24 hours and only if it has parmesean or chicken crumbles on top. He won't eat higher carb wet at all now. I hesitate to feed him anything different (meaning high carb kibble) and aggravate his digestive system anymore than it already is.

I will get some Levemir ordered within the week to try.
If Levemir could just lessen Bear's dives that would keep him safer & be an improvement for a rainbow cat.
I am open to all questions or ideas.

Hang tough. We are in boats side by side- becoming exhausted by rowing and the tide changes . You are not alone
I’m good with, your venting
I feel your pain

 

[Wendy&Neko]

Paws crossed from Peru that Levemir gives you the predictability that it gave me.

 

[Tracey&Jones (GA)]

I have no advice just

 

[Pamela & Amethyst]

Just HUGS

 

[Ti-Mousse (GA) Pepe (GA)]

Lora, we missed you! I understand how you feel.... I'm taking care of my 95 yo uncle, not even full time, and I feel overwhelmed! Not much time for myself anymore! Often a strong type person will tend to take too much because she thinks she can do it and have to !!! Take care of yourself first, otherwise there won't be anybody for little Bear and your mother! Start with an hour a day, just for you; at the beginning you'll feel guilty but after a few days you'll start feeling better! Keep venting!
Since on Levemir, Ti-Mousse has flatter numbers with no dives compare to when he was on Lantus. Hope it will be the same for your little Bear!

 

[JoyBee&Ravan]

I also took care of my mother for 5 years. She refused to move in with me so I had to drive 45 mins every few days to her house & back home again to take care of my 5 cats & my house & yard.
Took care of her house too,Cleaned & mowed the grass & whatever else was needed. I know what you're going thru!
The main thing that helped me was doing Yoga & meditation! It made me feel calmer & physically better.Even just 10 mins twice a day really helped.

I switched Ravan to Levemir & I'm glad I did. He was a BIG bouncer & the Levemir helped, BUT, it didn't happen right away.I wanted to stop the red & pink #'s It took about 7 months. (Ravan also has Kidney disease & high Blood Pressure)
Take a look at his SS from 2018 to now. I spent a lot of sleepless nights getting him here (Or maybe "HE" just decided to stop bouncing! )

If you stick with the dosing advice you get here (instead of from the vet) Bear will do a lot better! When you switch to Levemir you need to start with a "Reduced" dose. Please talk to one of the dosing advisors here!

Bear is still a young cat! He has a lot more years to go. If you can get his dosing straightened out there is a chance he could go into remission.

My last kitty,Daisy had a toe removed from cancer when she was 16 years old. She lived to be 23!!

I know it's very difficult but don't give up! It's so worth it when you look back & see how far you've come.

Everyone here wants to help! Keep asking questions! The more you understand how the insulin works the easier it becomes

 

[Bear & Lora]

Thank you all for the empathy, wishes, prayers and affection.
I was definitely at a low this morning.
Sleep always helps my optimism.

If you stick with the dosing advice you get here (instead of from the vet) Bear will do a lot better!

Ravan the data has proven that Bear's Vet was correct in this situation.
Without Carbs to use the insulin Bear's BG will and has plummeted and he requires a much lower dose until he is getting more carbs in his body.
Thank you for your response and support, it is appreciated.

 

[Giomax]

I am not wanting to complain or vent on a cat forum. I am that person that others lean on and look to for logic and possible answers.
I find my situation reversed and it doesn't sit well with me at all.
I feel like it is necessary to share some of my situation so that others might understand how dire things are for Bear and I to write this.

Before Bear was diagnosed with diabetes I made the choice to quit my job, move my mother in with me and become her caregiver.
Her Cardiologist had told me that I would be lucky if my mother lives 5 more years, that was about 3 years ago. In short my mother's vascular system is a wreck and failing, with open wounds on her leg from mid shin to her ankles and left frontal lobe brain damage caused by past mini infarctions which has given her early severe dementia.

It took me over a year changing her diet, getting her to stop smoking, and getting her the medical attention that she was so remiss in having to realize I can't stop her decline nor really slow it down much.
When Bear was diagnosed last year with diabetes I began to educate myself and I followed a similar path, changing diet, medical attention etc.
Now after three years of basically being contained to a house in order to keep my mother safe with medical personal coming every day, multiple Dr's appts regularly, plus vascular procedures along with being Bear's caregiver my body and mind are starting to rebel.

My mother's health issues and Bear's health issues are starting to collide and I am putting off my mother's needs to take care of Bear and vice versa and I am starting to feel like I am doing a disservice to both.
At this point I just want desperately to get Bear to a healthier place so I can take care of both of my loves and keep them in my life for as long as possible.

The latest health issue with Bear is pancreatitis, lack of appetite and bouncing.
We have changed Bear's schedule to 6:30-6:30 versus 9-9 in order to allow me to have more sleep but that isn't working out well, I am still up till 2:30AM-3 because Bear's Bg is going lower at +7, +8, which is also causing some confusion as to his insulin dosage.

He is still suffering from lack of appetite nausea with some vomiting so I started giving him Cerenia again.
From past experience Bear has dived to lime while suffering a flare because of his lack of food and I have not been able to budge his BG with Carbs so a lower insulin dosage was recommended by the Vet until his appetite was fully recovered.
When I asked the Vet whether I should give him an appetite stimulant she said no. The Vet also recommended Forti Flora for his digestion but I thought I read that is used to entice cats to eat but not good for much else?

Every turn I seem to hit a wall, low dose = high bounces with green some nights, higher dose = low events with possibly no carb steering.
As for Bear's appetite it went up for a day or two then went down again.
He is eating about 3 maybe 4 ounces low carb wet in 24 hours and only if it has parmesean or chicken crumbles on top. He won't eat higher carb wet at all now. I hesitate to feed him anything different (meaning high carb kibble) and aggravate his digestive system anymore than it already is.

I will get some Levemir ordered within the week to try.
If Levemir could just lessen Bear's dives that would keep him safer & be an improvement for a rainbow cat.
I am open to all questions or ideas.

I'm no expert, but what I learned with Max is that it's not always imperative to keep the BG as low as possible. If you're able to devote all your attention to your cat, then great. But most of us aren't. I found for my situation it was better to keep Max in the yellows or high blues rather than the low blues or greens. That way I wasn't worrying about hypo situations or teetering on the brink all the time. This was especially important toward the end when he became sicker and sicker and ate less and less. The most important thing is getting them to eat and keeping them hydrated. With a sick cat, I think worrying about BG comes second. Still test and shoot of course, but if you're ever concerned about a sick kitty going too low then I wouldn't shoot at all or I would shoot a lower dose. I know you probably know that, but still.

Also, forti-flora is a probiotic and does help with digestion. I actually gave Max a probiotic capsule from GNC every day.

 

[Sienne and Gabby (GA)]

Caring for a sick, aging parent is incredibly difficult. My mom was diagnosed with congestive heart failure after my dad died. If my sister hadn't been in a position to be able to move in with her, I'm not sure what we would have done since I lived several states away and had just started a new job. What we did learn was that her Medicare benefits covered having a home health aid come in for several hours which gave my sister some respite from being a full time caregiver.

As for Max, if you think a probiotic would help, you're correct, I would not use FortiFlora. ReNew Ultimate is one that I use as do several others here. It's available on Amazon (there are several different formulations) and I've seen it at Whole Foods.

If you've not seen Marje's Primer on Pancreatitis, I've linked it. Hopefully, your vet has tested Bear to make sure what's going on is truly pancreatitis. If Cerenia isn't fully helping, often a combination of Cerenia and ondansetron (Zofran) may help. Both are anti-nausea meds but they work differently. Once the nausea is controlled, an appetite stimulant can be very helpful. If this is pancreatitis, Bear needs pain meds. As far as pain goes, I wouldn't wish pancreatitis on anyone.

 

[Crista & Ming]

I am out and about so my response is not as detailed or as thoughtful as I want it to be but I’m dropping by to ask why the vet is saying no to an appy stimulant?

 

[Bear & Lora]

Bear needs pain meds. As far as pain goes, I wouldn't wish pancreatitis on anyone.

We just received the Bupe from the online Vet Pharmacy, Fed Ex yesterday and the Vet's office was closed so I couldn't ask questions.
It has some unusual directions that I'm unfamiliar with. Do you have any experience with Bupe administered transdermal.
So the latex finger glove is to apply it to the flap and would I have to hold him as to not have him shake it out, if so for how long? Bear shakes his head after every testing
@Marje and Gracie have you had any experience with this form of Bupe administration?
.

 

[Bear & Lora]

I am out and about so my response is not as detailed or as thoughtful as I want it to be but I’m dropping by to ask why the vet is saying no to an appy stimulant?

To be honest I am not sure and didn't think to question her further, my thinking process hasn't been up to par lately.
The way things are going I will probably give him the leftover mirtz I have from DKA anyway.
I have noticed on the forum many Vets give an Appy stimulant for Pancreatitis.
I will try to remember to ask her later.

 

[Giomax]

I have some appetite stimulant leftover from Max. I can ship it out if you want. Maybe talk to your vet and see what they recommend. It's probably the same stuff.

That bupe looks so cool. Inner ear flap? Never heard of such a thing. Let me know how it works!

 

[Bear & Lora]

What we did learn was that her Medicare benefits covered having a home health aid come in for several hours which gave my sister some respite from being a full time caregiver.

From my understanding in the past that was included in the Medicare package but was taken out due to cuts.
If you upgrade and pay for the Advantage program it is included in it.
There was controversy that Medicare was going to do away with Advantage but I think it is still available.
I will have to get more info because two hours of no worry that she'll unlock and leave the front door wide open, lock herself outside or turn the stove on again would allow me to do errands before Jeff gets home to watch her.
I have got to make myself write (to do) lists otherwise things get put on the back burner that aren't necessary for the day to day.

 

[Bear & Lora]

I have some appetite stimulant leftover from Max. I can ship it out if you want. Maybe talk to your vet and see what they recommend. It's probably the same stuff.

That bupe looks so cool. Inner ear flap? Never heard of such a thing. Let me know how it works!

I hope it is cool.
I am just not sure I can keep it in the flap long enough to be effective.

 

[Sienne and Gabby (GA)]

I've never used bupe as a transedermal. Is there a # for the compounding pharmacy? If not, call the pharmacy where you get your medications and ask the pharmacist there if you have a question. Buprenorphine is actually a human medication (suboxone) so a pharmacist should be familiar with its use.

 

[Joanne&TinySole]

try some all meat baby food

No ham, though! Stick with the all meat chicken baby food, or like Bobbie says, poach your own chicken use lots of filteted water to poach, a tiny touch of salt...miniscule really, then grind it up. Baby food is easier.

1/4 of a 10mg Pepcid and Cerenia, if you have it...it helped my Cookie.

As for loving your mom and Bear as you do, that's called devotion. BUT, try to take some time, even if it's an Epsom salt bath for 15 min, which will help you relax. Caretaking is exhausting, mentally, physically and emotionally, and we can relate. Vent all you'd like; you are going through a lot, and we understand. ❤

 

[Giomax]

Not to be discouraging, but Max especially hated when I gave him plain chicken baby food or cooked plain chicken with broth. He liked the super juicy, junky stuff. Let me know what Bear thinks!

 

[Bear & Lora]

@Crista & Ming
After putting more thought into why Bear's Vet didn't want me to give him Mirtz: It was shortly after the start of the flare up and Bear was still vomiting some.
It could be a cruel situation if Bear was medically stimulated to eat and then have to deal with vomiting episodes.
Just a guess though.

 

[Ella & Rusty & Stu(GA)]

I used ReNew Ultimate pro biotic capsules for Rusty. I opened a capsule and sprinkled half of it on his food. Rusty wasn't eating much toward the end, but I found that if I held him on my lap and held his bowl, he would nibble away on it and finish his portion.
I am very sorry that you are having such a rough time with your mom and also with Bear's pancreatitis flare. Bear's flare will subside in time. Just try to make sure that he eats. We used Beechnut Stage 1 all meat baby food when Rusty had a flare. I also pressure cooked a whole, small chicken in water--no other ingredients--to make broth. I froze the broth in small plastic cups and thawed them to add liquid and flavor to his food.

Best of luck with the switch to Lev.

As everyone has said, do take some time for yourself every day. I was the caregiver for my aunt for 9 years. Although she did not live with us, it was still a difficult time. Do the best you can and take comfort in the fact that you are helping your mother, who loves you.

 

[JeffJ]

I'm sorry to read about your situation. We just had major issues with Leo not eating. In short, he was going to die. The breakthrough for Leo was:
- bupe, twice a day
- kibble (cruddy) food

Instead of Leo dying, this past week he seems a lot better. The bupe really helps him. Maybe that will help Bear too. If we are faced with a cat passing away vs some unhealthy food, then I would rather have Leo eat something (vs nothing). Regulation will be more challenging though.

 

[Noah & me (GA)]

I can only repeat what Bellasmom said about making time for yourself. In the winter my mom died we lost four of our boys so I know where you're coming from.
It's a long story but my sisters are emotionally abusive and cat haters so that tore us apart. You need to save yourself before you can save someone else.
What you said about venting and complaining. If I had stood up for myself years ago I might still be welcome in my extended family. I waited too long and now they think I'm lashing out. We all have our limits.
I can't offer much help with Bear but I wish you peace my friend.

 

[Wendy&Neko]

After putting more thought into why Bear's Vet didn't want me to give him Mirtz: It was shortly after the start of the flare up and Bear was still vomiting some.
It could be a cruel situation if Bear was medically stimulated to eat and then have to deal with vomiting episodes.

Absolutely correct. You don’t want to give an appetite stimulant to a nauseous cat. Besides being cruel, you can create food aversion.

 

[Noah & me (GA)]

Sorry for the double post Lora, I just saw your question about transdermal BUPE. Noah was on this for years, he needed all his teeth extracted but cardiomyopathy meant he would not survive anesthesia. I would just keep his inner ear clean and smear it on alternate ears, I never really bothered with the gloves. Ours came from a compounding pharmacy and I could break Noah's dosing up throughout the day. He always had an appetite and never had problems with balance or cognition.

 

[AliceMeowliss (GA)]

We are in the same state. Maybe I could help with something? It sounds like you are overwhelmed with caregiver duties. My partner is transitioning out of home health, and I can only imagine how difficult being a 24hour caregiver can be. If you need any additional resources, I might also be able to help in that area. Feel free to send me a message.

And I was going to comment on the mirtazapine not being recommended yet, but you got that worked out. Also I have a TON of mirtazapine if you ever do need any, and I would be close enough to not have to ship it. (I noticed @Giomax offered.)

ETA: I went ahead and sent you a message.

 

[Sonia & Leo]

Laura, I’m so sorry about everything you’re going through with Bear and your Mom.
My wish for you is that somehow things turn around and get better for all of you.

 

[Noah & me (GA)]

This is also the perfect place to vent or come for a hug, I don't see this kind of compassion anywhere else.

 

[nslade001]

Hi, I can't help with dosing or insulin advice (except to say, have you considered switching to SLGS?) just another (former) caregiver (father-in-law with dementia and urinary catheter) offering empathy and hugs. You are amazing, you are loved. With love, Nikki

 

[Sybil and Zoe]

I am so sorry. Sending you many hugs. I know how stressed I get with just a diabetic cat to look after. I am wishing for you peace of mind and solid rest for your soul. Bless you.

 

[Amina&M'row]

Hugs & much love. Yes, you have enough time to take care of yourself: go get that you-time! With all the wise ideas posted re appetite stimulation, I feel a little silly saying that M'row is helped by having some catnip sprinkedspon top of his food--around a teaspoon, or two, or three.

 

[Bear & Lora]

I'm sorry to read about your situation. We just had major issues with Leo not eating. In short, he was going to die. The breakthrough for Leo was:
- bupe, twice a day
- kibble (cruddy) food

Instead of Leo dying, this past week he seems a lot better. The bupe really helps him. Maybe that will help Bear too. If we are faced with a cat passing away vs some unhealthy food, then I would rather have Leo eat something (vs nothing). Regulation will be more challenging though.

I absolutely agree desperate times call for desperate measures. If I was down to little to no possibilities I would do exactly as you have. I am so glad Leo is doing better.

 

[Bear & Lora]

I am exhausted but I wanted to post an update on Bear.
I believe Bear is very STOIC and was in much more pain than I ever realized.

Last night I was able to stuff his ear flap with 0.15ml of the 0.3ml dose indicated and the flap was overfull with some coming out.
This morning his demeanor was much better and since he hadn't vomited in two days he got a 1.8mg of the mirtazapine which actually brought about too much appetite.
When Bear had DKA and was given Mirtazapine it improved his appetite but never like today's dose.

I can only surmise that Bear's massive appetite today is due to a combination of Bupe with less pain and the Mirtazapine.
I gave him another dose of Bupe this afternoon, this time I put a lesser amount in both ear flaps 0.1ml in each flap which made his dose 0.2ml.

Current time Bear has eaten 8.7oz low carb and he would have eaten much more if allowed.
10oz of food is the max he has ever eaten when his appetite was at it's best.

I am only supposed to give Bear one dose of Mirtazapine every other day so we will see what tomorrow brings but I am so relieved to see Bear feeling better and eating.

 

[Crista & Ming]

What an AMAZING update, Lora. I'm happy to hear Bear is eating and that the bupe is working.

I hope this good news is able to give you some well deserved rest and relief throughout this difficult time.

 

[Amy&TrixieCat]

Great update! I’ve never used transdermal bupe, but I have used transdermal methimazole for my GA hyperthyroid kitties...it’s a great way to administer some meds but one thing you need to do is be sure you keep his ear flaps clean. The cream builds up on the skin’s surface and then the med can’t be absorbed. I just used warm water on a soft cloth every couple days.

 

[Sonia & Leo]

That's a great update Laura, I'm happy for you and Bear that the Bupe is working and that he is eating.

 

[AliceMeowliss (GA)]

Oh what a relief to hear that he is feeling better and eating again!

I hope you have been able to get some rest of your own. I know that when I am worn from caring for everyone else, things feel a little lighter again with some rest.

 

[Tracey&Jones (GA)]

That is a great update on Bear.

 

[Bear & Lora]

Great update! I’ve never used transdermal bupe, but I have used transdermal methimazole for my GA hyperthyroid kitties...it’s a great way to administer some meds but one thing you need to do is be sure you keep his ear flaps clean. The cream builds up on the skin’s surface and then the med can’t be absorbed. I just used warm water on a soft cloth every couple days.

Thanks Amy for the info. I will make sure to clean his flaps today before I put more Bupe in them.
I know now he really needs the Bupe.
I have no idea how I will be able to tell when he doesn't need the Bupe since he shows little to no symptoms of pain.

 

[Bear & Lora]

Bear update:
This morning Bear's appy was still going strong and with more Carbs in his system and an obvious rise in his BG yesterday, I increased his dose by .25.
Silly, but I was so happy to see him reach yellow today even if he took a dive to get there, (bounce in immediate future).

Tomorrow morning Bear can have another dose of Mirtazapine but I am concerned because today is his 5th dose of Cerenia and the Vet recommends only 5 doses in a row with at least a day or two break.
I don't want to give Bear an appetite stimulant if his vomiting might resume without the Cerenia.

@Wendy&Neko didn't you tell me the latest findings were that Cerenia could be given longer than 5 days?
Does anyone else have experience with dosing Cerenia longer than 5 days without it affecting their nervous system and causing tremors or shakes?

 

[Bear & Lora]

I have to say I really admire Bear's Vet, she is not stuck using the info that she was exposed to during her education and has been doing research for Bear and pancreatits.

I would like other's experience with pancreatitis to verify her findings.

This is the copy of her email and the course of action she recommends:
There is evidence that cats with pancreatitis will form choleangiohepatitis (liver and gall bladder) as well as have inflammatory bowel disease. They recommend that we run a GI panel on him, cost is $275. Then next step is abdominal ultrasound. Finally, possible gi biopsies taken. So, we need to focus on his gut, liver, gall bladder and pancreas health. Some people find that a hypoallergenic diet helps with IBD, pancreatitis and diabetes. Some add in the probiotics for the gut health. Some give weekly vitamin B12 injections. Most of what I found says no prevention for pancreatitis but we can find prevention for IBD with diet and vitamin B12 injections. I would refer him to Blue Pearl for the abdominal ultrasound. Dr. Emily Redden

I have already eliminated wheat from Bear's diet and would like to try the probiotic @Sienne and Gabby (GA) recommended ReNew Ultimate.
Bear takes Zobaline twice daily, are B12 injections different?

@Wendy&Neko @Marje and Gracie @Sienne and Gabby (GA)
I would appreciate any and all the input from others that have dealt with pancreatitis.

I put in my request for a Levemir script today and Bear's Vet will see it first thing tomorrow morning.

 

[Noah & me (GA)]

Stoic is the perfect word to describe a cat or dog's demeanor and their tolerance for pain. There is too much denial in the medical community about pain, thankfully my vet is not in that group. It's not an exaggeration to say Noah's transdermal BUPE made his last years more than just tolerable and since my vet wasn't an ogre about dispensing it I've also used it sparingly on Marco and Andy who are prone to UTI.
Noah's BUPE strength was 0.16mg/0.1ml and his dose was 0.05ml every 12 hours. It came with tiny spoons, I would smear the BUPE on the backside of the spoon and rub that on his inner ear, then fold the ear together and work it in. I never had what you describe as "overfull with some coming out". Does Bear have tiny ears?
Both Noah and Nigel had been on heavy doses of BUPE at one time. Both continued to have a good appetite, always knew where and who they were and never stumbled or got stoned. It was not anything diabetes related that took them from us.
Keep posting about both Bear and yourself and know that we are here for you.

 

[Tracey&Jones (GA)]

Jones was on cerenia every day for a year and half. No adverse affect.

 

[Sienne and Gabby (GA)]

Zobaline is methyl-B12.(methylcobalamin). B12 injections are a different form of B12 -- there are several different forms (e.g., cyanocobalamin, methylcobalamin).

There is a wonderful website and Facebook page for cats with IBD -- Raw Feeding for IBD Cats. Even if you don't opt to follow a raw diet, their information on IBD and recommendations for supplements, etc. are well researched and very solid. . Gizmo has IBD and I went through all of the steps, including a surgical biopsy to confirm the diagnosis. He's been on prednisolone (the dose has been tapered down considerably), a probiotic, and I switched him to a raw diet of novel proteins and he's doing great. The first thing you may want to consider is a switch to novel proteins. If this is IBD, think about it like an allergy to some of the additives that are in many cat foods (e.g., carageenan) as well as an allergic response to certain proteins. Giz was fed a steady diet of either chicken or turkey which I belatedly found out are common allergies for cats. He now eats primarily pork and lamb with some ZiwiPeak venison and I use a premix that I add to his raw food for all of the necessary nutrients.

As for pancreatitis, Gabby had one bout and that was when she was diagnosed. Once we got past the initial very scary time, she was fine. She was on antibiotics, pain meds (bupe) and I think something for nausea and an appetite stimulant, and I can't remember what else -- it was a long time ago.

 

[nslade001]

Hi, Willow has been on a low dose (1/4 of 24 mg tab) of cerenia daily for literally months with no nervous system issues noticed. I've tried to wean her off, but within a day each time she becomes nauseated and refuses food, and it takes a couple of days to get her back in track.
Just a quick comment...I've used transdermal codeine, and transdermal meds are meant to be smeared and rubbed on the underside (not as furry) part of the ear, not actually put into the ear canal...I'm not sure of how you're applying it, but the phrase "stuffed into" made me wonder. It's just that you can't properly clean it every day from the canal, and it may cause irritation over time.
I'm glad Bear is feeling better! With love, nikki

 

[Noah & me (GA)]

not actually put into the ear canal

Definitely, I should have remembered that. Noah would get a waxy buildup in his ears maybe from the BUPE? They were easy to clean with warm water and a paper towel.
He also had a problem with his basket buddy Andy seemingly attracted to Noah's ears after the BUPE, a lot of licking and grooming of the ear. Just something to watch out for.

 

[Ti-Mousse (GA) Pepe (GA)]

Zobaline is methyl-B12.(methylcobalamin). B12 injections are a different form of B12 -- there are several different forms (e.g., cyanocobalamin, methylcobalamin).

There is a wonderful website and Facebook page for cats with IBD -- Raw Feeding for IBD Cats. Even if you don't opt to follow a raw diet, their information on IBD and recommendations for supplements, etc. are well researched and very solid. . Gizmo has IBD and I went through all of the steps, including a surgical biopsy to confirm the diagnosis. He's been on prednisolone (the dose has been tapered down considerably), a probiotic, and I switched him to a raw diet of novel proteins and he's doing great. The first thing you may want to consider is a switch to novel proteins. If this is IBD, think about it like an allergy to some of the additives that are in many cat foods (e.g., carageenan) as well as an allergic response to certain proteins. Giz was fed a steady diet of either chicken or turkey which I belatedly found out are common allergies for cats. He now eats primarily pork and lamb with some ZiwiPeak venison and I use a premix that I add to his raw food for all of the necessary nutrients.

As for pancreatitis, Gabby had one bout and that was when she was diagnosed. Once we got past the initial very scary time, she was fine. She was on antibiotics, pain meds (bupe) and I think something for nausea and an appetite stimulant, and I can't remember what else -- it was a long time ago.

Thanks for the website on Raw !!

 

[Wendy&Neko]

Many kitties with GI issues can be off on either their B12 or folate, so a GI panel is a good idea, followed by an ultrasound. What you do after that, depends on what is seen there. I would get an ultrasound specialist to do it if you can, so you get proper measurements and diagnosis. I have now been through three cats and the IBD vs, something else scenario. Ditto what Sienne said about food. Of course, a diagnosis comes first. If kitty has bowel inflammation, an endoscopy can be used instead of surgical biopsy, depending where the inflammation is.