? Best canned food for pancreatitis

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Megan & Oren

Megan & Oren

Member Since 2015
Oren was just diagnosed w/ pancreatitis on top of the diabetes. He is NOT vomiting or refusing food yet, but my vet wants me to switch his diet from Fancy feast to the prescription DM canned food. He's not terribly lethargic, or dehydrated (I add water to his Fancy feast every meal). However, his BG has definitely been creeping up lately and this is a very likely contributing factor. She's also prescribed some Bupenephrine for pain and a probiotic to sprinkle on his food.

She claims Fancy feast is too high in salt and too difficult to digest. I've read the sticky Primer on Pancreatitis on this site, but it doesn't really go into diet much. The little i can find is that it should be high protein, low-mod. fat and easily digestible. I have to wonder if some commercial canned foods would fit that bill. Does anyone has specific experience w/ pancreatitis ?
 
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Per Cat Info, you can shift the concentration of sodium by adding 1 ounce plain meat or poultry to every 5 ounces if cat food, mix well and portion out. This will reduce the sodium, fat, and carbohydrate proportions while increasing the protein.
 
thanks BJ: i have already been adding 1 tbsp (about .5 oz) of cooked, skinless chicken breast to his meals. Vet knows and approves, but thinks the FF is not easily digestible.. Do you have opinion/knowledge on the Purina DM canned food specifically for pancreatitis? She is very sold on it...
 
It doesn't have any better ingredients than over the counter brands. I wouldn't buy it.
 
I am so sorry Oren has pancreatitis. I think the most important thing is, pancreatitis makes most kitties inappetant so it is critical that they eat whatever they will eat! When my Tiger had her first acute attack, she was inappetant and vomiting- we put her on Purina EN(a gastro forumula) to my relief, she loved it and ate it while she was in the hospital and for a week after she came home. I gradually mixed it in with her Wellness Core with no problems with her BG.

As for the Purina DM, on this forum prescription foods get a bad rap, but I will say this, when Tiger was first diagnosed with feline diabetes, she would not eat anything and had to be hospitalized for 5 days. Purina DM was all she would eat for months and I would not have changed her diet except that after the pancreatitis attack, she preferred Wellness Core. :rolleyes:

It may be an ECID thing, but Tiger vomits every time I have tried to give her Fancy Feast so she hasn't had it since last August, which is just as well because all the FF is super high in phosphorus and she is CKD.

One more thing, pancreatitis is very painful- but cat are very tricky and hide their pain. That may be why Oren has been hard to regulate, the pain can raise their BG. I hope your vet gave you pain meds? And anti nausea meds?
 
Hi Ruth; yes, i will pick up a prescription for Bupenephrine tomorrow; she's well aware (as am I) that they often hide the pain. He's not terribly acute yet I'd guess, because he's still eating enthusiastically and is not vomiting. So, no anti-emetics just yet. She did also suggest a probiotic to add to his food. And if FF is potentially bad for the kidneys, maybe it will be better to switch, but he does love it! I too suspect this is why he's suddenly having trouble getting regulated w/ the BG. I'm willing to try the DM prescription for a 3 wk. trial period as she suggests. I have no idea how expensive it is, but sure it's way more than the fancy feast, which is why I'm hoping after he gets over this bout to try and find a commercial diet that will work.
 
I found this in a document of a roundtable discussion on pancreatitis
http://www.idexx.de/pdf/de_de/small...ine_pancreatitis_roundtable_discussion_us.pdf
...
Robertson:
One disease mentioned earlier that often develops secondary to chronic pancreatitis in cats is diabetes mellitus. It is important to recognize if diabetes is present or develops in these cats, so that it can be managed appropriately. This usually requires insulin therapy, at least in the short term. However, the
diabetes in these cats may be transient and as the pancreatitis resolves, the diabetes may also resolve.
Managing these cats can be challenging.
Forman:
I agree. The pancreatitis is also a common contributing factor in insulin resistance in diabetic cats.
Williams:
Even if the diabetes mellitus is not caused by the pancreatitis per se destroying islet cells, the presence of inflammation in the pancreas can make diabetic cats more difficult to regulate and stabilize. Also, in rare cases chronic pancreatitis can lead to concurrent exocrine pancreatic insufficiency and diabetes mellitus, so that treatment with pancreatic extract supplements as well as insulin is required.
Steiner:
I think that it is pretty much agreed upon that pancreatitis and diabetes mellitus often occur together.
Managing the pancreatitis may alleviate the need for insulin therapy. I think that is quite significant for the catand the owner.
 
Bandit just had a bout of severe pancreatitis. It's really important in the early recovery phase to feed them whatever they will eat--and if that is Fancy Feast, then that is Fancy Feast. Low-moderate fat is good to have, but not necessary for most cats in recovery. Cats with pancreatitis can handle fattier foods better than dogs or people.

So when Bandit was still in his early stage of recovery, all he would eat is Fancy Feast or Sheba pates, so that is what he got. That went on for about a month. Once he started eating other foods again, we went back to a high protein, low fat, low carb diet. He currently eats a mix of Wellness Core (Beef/Venison/Lamb or Turkey & Duck) and Weruva (various flavors--usually Paw Lickin' Chicken, Steak Frites, or Chicken Frickasee). I would love to feed the Weruva full time and not worry about the mixing, but the caloric content is much lower than most foods so you have to feed nearly twice as much of it, and it's a bit too expensive for that. Mixing it with the Wellness keeps things within my budget, and keeps the fat content to less than 50%. All are also low phosphorus.

Feeding Fancy Feast short term to keep him eating until his appetite fully returns (which can take time) is not going to do harm. The Sheba pates are a little better in terms of phosphorus content than the Fancy Fancy feast. You can also try mixing the FF with other healthier, low phos foods to cut the phosphrous levels down if he'll eat a mix. The high protein/moderate fat/low carb diet may help prevent future flare-ups of chronic pancreatitis, but won't necessary speed his recovery in the present, so it's something you really want to consider for the long term.

Of course, if you can get him eating the better foods now, go for it!
 
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Thanks Julia; so far the thing is, Oren is still eating just fine. I don't yet have the DM food (supposed to pick up this afternoon), but Oren has never shown that he's a picky eater. Part of me is really hoping he won't like this food though, since so many here are against it. I am having a hard time thinking this is a 'serious' bout, because 1) he's still eating enthusiastically, 2) he's not vomiting and 3) he's not overly lethargic. but i have no prior experience with it to really know. He'll be starting Bupe this evening as well, so hopefully if he is experiencing pain and that's elevating his BGs somewhat, how quickly might I expect a response? I believe the vet only has him scheduled for 5 days/bid at this point.

ETA: Bandit is SO handsome!:cat:
 
Megan & Oren said:
Thanks Julia; so far the thing is, Oren is still eating just fine. I don't yet have the DM food (supposed to pick up this afternoon), but Oren has never shown that he's a picky eater. Part of me is really hoping he won't like this food though, since so many here are against it. I am having a hard time thinking this is a 'serious' bout, because 1) he's still eating enthusiastically, 2) he's not vomiting and 3) he's not overly lethargic. but i have no prior experience with it to really know. He'll be starting Bupe this evening as well, so hopefully if he is experiencing pain and that's elevating his BGs somewhat, how quickly might I expect a response? I believe the vet only has him scheduled for 5 days/bid at this point.

ETA: Bandit is SO handsome!:cat:
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If pain is elevating his BG, you should be able to tell pretty quickly once you give him the Bupe. I'd say within a few days at most, if not within 24 hours. Bandit's BG was up and down all over the place after he came home from the hospital, and his BG was lower on the Bupe at first, but it really was only for the first week or so until the Bupe wasn't really helping anymore, and seemed to be messing with his appetite. The effects on his BG were pretty immediate--but gradually his numbers crept back up despite the Bupe. But his situation was a bit different because he was also hospitalized for three days with severe pancreatitis in the beginning--there was lots of vomiting and very little to no appetite that we were dealing with. I thought were were going to have to get a feeding tube after the first week he was home until he finally starting eating the Fancy Feast the day before he was scheduled to go in to get the tube.

We tried the Bupe a second time after his bone marrow biopsy (about 3 weeks after we discontinued it the first time) because it seemed to lower his BG into a normal range--but that only lasted for about 5 days until we discontinued it because it seemed to again stop helping and made him feel gross.

Oren also seems to be on a significant dose of Lantus, though. I don't know if you'll see much of a response, considering that you say he doesn't seem to be acting very painful. Bandit was not yet on insulin when his numbers were up and down due to the pancreatitis, and he was in pretty obvious pain (not acting like himself at all, no appetite, extremley lethargic), so I think it was easier to see it reflected in his BG.

You'll have to forgive me because I'm not sure of Oren's history, but does he still have any possible access to dry kibble (e.g. it's still left out in your house somewhere)? Is he on any other meds besides the Lantus?

There's nothing wrong with feeding the canned Purina DM, it's just way overpriced for what it is (basically Fancy Feast with lower phosphorus). If you don't want to feed it, you don't have to buy it--just tell your vet you found another food with a similar protein/fat/carb content that is less expensive with better ingredients. Or bring it home, take a can out, and then return the rest for a refund the next day and say your cat won't eat it if you're worried about offending your vet. Just to comapare, the DM content percentages are 39% protein, 58% fat, 3% carbs, 263 mg/100kcal phos and contains byproducts. Wellness Core Turkey & Duck is 38% protein, 57% fat, 5% carbs, 265 mg/100kcal phos, and is mostly muscle meat. Weruva Paw Lickin Chicken is 65% protien, 32% fat, 3% carbs, and 196 mg/100kcal phos and contains only muscle meat.

I wish I had more advice to offer, but Bandit was back down to near normal numbers, so I think his pancreas wasn't severely damaged from the pancreatitis--it was still producing insulin, just a bit erratically. Unfortunately, I wasn't able to see his numbers return to 100% normal before we started the prednisolone and cyclosporine (and Lantus) to treat his myelodysplasia, so it's impossible to know how his numbers would have recovered without adding the other meds in the mix.
 
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Julia & Bandit said:
We tried the Bupe a second time after his bone marrow biopsy (about 3 weeks after we discontinued it the first time) because it seemed to lower his BG into a normal range--but that only lasted for about 5 days until we discontinued it because it seemed to again stop helping and made him feel gross.

Oren also seems to be on a significant dose of Lantus, though. I don't know if you'll see much of a response, considering that you say he doesn't seem to be acting very painful. Bandit was not yet on insulin when his numbers were up and down due to the pancreatitis, and he was in pretty obvious pain (not acting like himself at all, no appetite, extremley lethargic), so I think it was easier to see it reflected in his BG.

You'll have to forgive me because I'm not sure of Oren's history, but does he still have any possible access to dry kibble (e.g. it's still left out in your house somewhere)? Is he on any other meds besides the Lantus?

There's nothing wrong with feeding the canned Purina DM, it's just way overpriced for what it is (basically Fancy Feast with lower phosphorus). If you don't want to feed it, you don't have to buy it--just tell your vet you found another food with a similar protein/fat/carb content that is less expensive with better ingredients. Or bring it home, take a can out, and then return the rest for a refund the next day and say your cat won't eat it if you're worried about offending your vet. Just to comapare, the DM content percentages are 39% protein, 58% fat, 3% carbs, 263 mg/100kcal phos and contains byproducts. Wellness Core Turkey & Duck is 38% protein, 57% fat, 5% carbs, 265 mg/100kcal phos, and contains only muscle meat. Weruva Paw Lickin Chicken is 65% protien, 32% fat, 3% carbs, and 196 mg/100kcal phos and contains only muscle meat.

I wish I had more advice to offer, but Bandit was back down to near normal numbers, so I think his pancreas wasn't severely damaged from the pancreatitis--it was still producing insulin, just a bit erratically. Unfortunately, I wasn't able to see his numbers return to 100% normal before we started the prednisolone and cyclosporine (and Lantus) to treat his myelodysplasia, so it's impossible to know how his numbers would have recovered without adding the other meds in the mix.
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Julia;
No, Oren is eating NO kibble anymore (though I think he did get into a bit that his civie sister raided the other day, (the frickin original bag of DM dry that the first vet sent me home w/ on diagnosis day, that I never fed him) but not more than a mouthful or two, and that's the only time in 4 months since he's been diagnosed and he's been on wet food since.

He's never been on a pain med, so I don't know how this will affect him. I'm pretty sure she only has a 5 day course planned. Sure hope it doesn't make him feel worse and actually cause inappetance! so far he's eating quite well. She didn't prescribe a nausea drug yet; could the Bupe cause that? Is that what you mean by him feeling 'gross'? Wow, I'm about to explode from the stress of this...
 
Megan & Oren said:
Julia;
No, Oren is eating NO kibble anymore (though I think he did get into a bit that his civie sister raided the other day, (the frickin original bag of DM dry that the first vet sent me home w/ on diagnosis day, that I never fed him) but not more than a mouthful or two, and that's the only time in 4 months since he's been diagnosed and he's been on wet food since.
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How does his mouth look? Any teeth looking like they need attention? Inflamed gums? Sorry to ask all these random questions, but I'm trying to think of reasons other than pancreatitis pain that seems to be making regulating him difficult. I suppose it's not impossible, but based the way you're describing his behavior I'm not sure if its pancreatitis pain is your answer--could be, but Bandit seemed worse than Oren off in terms of pain and his numbers were much lower. But, ECID, so it's worth trying the Bupe to see what happens.

Megan & Oren said:
He's never been on a pain med, so I don't know how this will affect him. I'm pretty sure she only has a 5 day course planned. Sure hope it doesn't make him feel worse and actually cause inappetance! so far he's eating quite well. She didn't prescribe a nausea drug yet; could the Bupe cause that? Is that what you mean by him feeling 'gross'? Wow, I'm about to explode from the stress of this...
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Sorry, "feeling gross" isn't exactly a specific medical term, is it? :-P

What I mean is that it caused more lethargy and a bit of GI upset. Nothing serious, but we weaned him off it because at that point it was no longer helping. I was convinced he must have been in pain still the prior 3 weeks because it lowered his BG into the normal range after the bone marrow biopsy--he was having the best numbers we had seen since the the whole thing began a month prior. But then after a few days his BG started creeping all over the place again while on the Bupe, and then we had to start him on a whole slew of other meds (including a steroid which skyrocketed his BG anyway) because of his anemia, so we chose to discontinue the Bupe because it didn't seem to be helping anything anymore.
 
I guess I am lucky because my vet has never pushed prescription foods! If Oren isn't symptomatic, I doubt I would be looking to change his diet at this point! Please remember, you aren't being employed by your current vet Megan- it's the other way around! And since Oren isn't nauseous or vomiting, I don't see that your vet can justify changing his foods anyway. If you do decide to go through with the change, I would only mix perhaps one tablespoon of the DM into his regular FF and work your way up. I think people run into problems when they change foods incessantly and all at once.

I was paying $42.00 for a case of Purina DM(the last purchase I made was last October) I am certain I pay more for Wellness at Petco. Because of a finicky eater, I don't dare buy caseloads of any food she might quit eating- I've already donated countless amounts of uneaten cat food to the animal shelter. Nowadays I am hesitant to even vary Tiger's diet- she's a vomiter and I don't want to do anything to upset the apple cart!

I know at this point Oren isn't showing symptoms of pancreatitis, but you still may want to have on hand something for nausea as well as the pain because these attacks come on with no notice in our experience. Tiger gets Famatodine and Cerenia every day if I even suspect there is a flare up. One comment about the bupe, be aware, it caused Tiger to become very constipated! As well as making her very loopy! You might want to add something like pumpkin or squash as well as make sure Oren is very hydrated, that I would ask your vet about doing, because it happened quickly.

Megan, I know how you are getting really stressed about Oren's SS, (been there, done that!!) And now this pancreatitis thing comes up, that seems to be the way it is with Feline Diabetes, it's like being on a merry go round full speed....just remember, you're not alone, we're here for you anytime you need a sounding board!
 
Ruth; Thanks for your input too. Yes, I have felt more stressed since this last vet visit then anytime since the earliest days after diagnosis! just awful. Ran into the vet today when i picked up the stuff; she tried again to offer "don't want to get off on the wrong foot" and I heartily agreed, but she still won't budge on the dosing protocol. When I asked what she did base her dose decisions on she stiffened and said "my medical training and education", sputtered something about 12 hr. curves and only 2 or 3 tests a day otherwise. SIGH. I didn't mean it to sound rude, I simply asked if she didn't like the protocol I was following, how did she make her decisions about how to dose?! Anyway when i expressed concern about glucose toxicity, and what if his numbers continue to climb while on the 4U dose, she said I was not to change anything till i talked to her first! What is she going to do, fire me?! yell at me? She's already pissed at me I can tell. I pointed out that he hasn't gone below 300s in several days, and that would need to be figured into her calculation for the new dose effects, especially if he goes even higher... Again, a rather grumpy look and that's what prompted the "don't do anything w/o checking with me first".

Pretty sure I'm going to contact yet another vet in town, one I found that specializes in cats. Their website says regarding Diabetes, that they work to develop an individualized treatment plan... so I will contact them and start right off w/ asking if they know of or support the Roomp/Rand protocol. No point in switching completely again w/o some idea up front of whether it's another buzz saw/brick wall.

Anyway, tonight, to humor her (and me a little) I gave 4.5u (even tho she wanted 4) from the new vial. Gave him mostly FF w/ 1 tbp. of DM next to it in the bowl. Also 1/2 packet of Fortiflora. She also recommended that, 1 packet day. I ALWAYS add water to his food, and I also give him about 1 tbp. cooked skinless chicken breast w/ each meal.

She does think he should be a 9.5 to 10 lb. cat, and he weighed in at 8.9 at the last visit. So she said 228 cal. /day was the target, which according to her, is 1.25 cans of the DM /day. I did negotiate to only buy 1 wk. worth of the food, in case he didn't like it (little damn bugger eats everything tho, and tho he did eat his ff first, he ate the DM w/ little hesitation... but who knows in a day or two...). She wanted him on it for 3 wks.

I also use miralax in each of his preshot meals, because he was having constipation issues a while back; so hopefully that will maintain him while on the Bupe? It's only a 5 day course... I've used pumpkin before too, and he readily ate it mixed in (he's a hoover!)

@Julia & Bandit - diagnosis was last Fri, and i went in really asking for IAA and/or Acromegaly tests because of the constant dose uppings(he's past 6 now). He didn't have obvious symptoms then or now as I understand them. She wanted to do the usual bloodwork and Urine culture to rule out UTI or other issues. If you look at my spreadsheet, i added the lab results for bloodwork, best I could. Some things were expressed a little differently in my printout from the spreadsheet.
She did the SNAP fPL test, and all it says on the form is ABNORMAL.

(jeez, as I write, Oren and his sister are chasing eachother up and down the hall... so far no ill effects from the Bupe?!)
 
(((((Megan))) I hope you can find a new vet quickly- I'd be telling here that "We're done here!" after today's episode- you have more patience than I do! Great that you're on top of it with the miralax already, I missed that bit of information! I must say, you are very fortunate Oren is such a good eater! If he does reject the DM though, I would not hesitate to demand my money back!

Are you saying this vet refused to take blood and send out testing for Acro and IAA--Really?! :mad::mad:
 
Ruth; she didn't flat out refuse, just wanted to check these other more common things first. She did acknowledge that Acro. especially is under diagnosed and made the comment that all acros have diabetes, but not all diabetics have acro. When I mentioned getting the IAA test sent out when she rechecks the bloodwork in 3 wks (to see about the pancreatitis) she really seemed to poo poo it. But depending on how his numbers go in the next few days/wks. I will demand it at that point. Or perhaps I'll be at the new vet by then. Since I have a fresh vial of Lantus, I don't need a prescription for a few months again.
 
maybe when you are calling around, ask other vets if they would just do the acro/IAA test for you.

What dose of bupe did she give you?

if Oren gets wild eyed, and paces, and figity, that's dysphoria ( Shadow does that) and it means the dose is too high.
If Oren is happy and playing, sounds like a good dose.

I just have to give mine a token amount because she can't handle a normal dose.
 
he's getting .2ml , 2 x a day. Got the first dose w/ his dinner at 6:30. so far so good. he's not pacing, or fidgety as of yet. CUrrently lounging on the cool tile floor in kitchen (got hot here today already, ugh!)
 
Megan okay, I was just hoping your vet didn't outright refuse to have the tests run! Glad I was wrong about that! There was one member a few years ago who had to "teach" her new vet exactly how to get the tests run, i.e. where to send it, which carrier, everything! That vet didn't know that it could only be done at MSU, and a lot more. He may not be acro or IAA, it's just good to rule that out.

I wasn't sure if you were getting your insulin from the Canadian Pharmacy, Mark's? It is much less expensive than the pharmacy! I paid $300 for my first vial, then $400 for my first set of pens, which is a lot for a relatively high dose kitty like mine!
 
I agree with Ruth wholeheartedly that your vet works for you, not the other way around! When you explicitly asked her a very reasonable questions about what protocol she used to determine her dose, and your concerns about the effects of leaving Oren with too little insulin for too long, her answer should have been to explain to you the reasoning or research behind her decisions, not to shut down your questions with that "medical training and education" comment. Her medical training and education also should have included shared decision making and doctor/client relations! I'm sorry, but if a vet wants to put their ego up against my cat, my cat is going to win every single time.

I would say you have two options. Give her a copy of the Roomp/Rand protocol. Give her a copy of the article I've linked below. Tell her you understand she seems to like to use different dosing guidelines, but you really would like to use these ones because of their proven success in cats, and ask her if she will work with you using the protocol. If she is willing to read through the information and work with you (minus the attitude), then keep her. If she huffs and puffs about continuing her dosing course without giving you a good explanation why despite of the facts in front of her, I would go to another vet who will work with you on his treatment. Given Oren's numbers, there's no good reason not to do the IAA and acro tests at this point, so regardless of what you choose to do in terms of staying or leaving her practice, you can move forward on that aspect at least.

I am sorry you have to go through this, and I understand the difficulty. The vet who initially diagnosed Bandit was good about nearly everything (encouraged home testing, prescribed Lantus, gave me a list of low carb, canned commercial foods to buy), except the dosing. She was a good vet, but she insisted on dosing Bandit like her diabetic dogs (Telling me I should only test at pre-shots and do a curve once a week, holding the dose for a week at a time and then raising in whole unit increments, switching between SID and BID). I brought her the Roomp/Rand protocol and she insisted she had two diabetic dogs who were well regulated and that she simply didn't believe the protocol would work because diabetic cats going into remission was incredibly rare. So I left her for a different vet. Bandit's new vet was not any more familiar with TR or the Roomp/Rand study (this was 2009 still, right after it was published)--in fact, her office wasn't even encouraging home testing yet or prescribing Lantus for their diabetic cats. But she read all of the information I gave her, was excited that I was taking such a proactive interest in my cat's treatment, and worked with me every step of the way as we figured out the dosing protocol together. Their office changed their feline diabetes treatment recommendations the following year. I still take my other cat to their practice.

Bandit has another new vet at Cornell now because of his current complicated medical condition, and I can't believe how different the diabetes experience is this time around. His new vet is familiar with all of the current feline diabetes research, and he has even brought up issues in his dosing and advice on things that I know nothing about (like how steroids typically affect Lantus efficacy and BG and what I can expect moving up the insulin dosing scale with Bandit's current dose of Prednisolone). I was enthused to hear that Cornell now uses a modified version of the Roomp/Rand protocol with all of their newly diabetic cats--they start out with a simplified version as to not overwhelm the the owner, and then once the owner becomes comfortable with home testing and giving insulin injections, they adjust the protocol for the owner depending on what their lifestyle will allow them to do. And the vets make themselves available via email or phone to give dosing advice on a daily basis, whenever their clients need it. Kind of what FDMB has been doing here for years, but without the stress of having to constantly explain your treatment decisions to your vet, because your vet is the one experienced enough to to do the advising. I think it's fantastic. :)
 

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oh good lord Julia, I guess I need to move to Cornell!! I'm so envious, that sounds like the way it SHOULD be for all us sugar kitty parents. I guess, I just have to keep trying to find someone who is at least willing to be a partner. I did give her the short version of the protocol, pulled down from the sticky I think? and she claims to have read it but doesn't like it. Not sure if the actual published paper (which i have twice said I could provide) will sway her much. To me, it sounds more like she is threatened by me not rolling over and deferring to her superior knowledge, because shes the vet. A good doctor, human or otherwise, should be interested in learning more and expanding thinking. Or, indeed, give me solid reasoning of why what I've presented is wrong. All she will say is the lows are too low. and the changes too fast.
 
Ugh. Pancreatitis is a nasty thing to deal with. We tried to switch Bailey off of prednisolone and on to cyclosporine in the hopes that her newly diagnosed diabetes will go into remission. In fact, this has been the only approach so far. My vet was super cautious about this since cyclosporine was the first drug we tried when she was diagnosed with pancreatitis two years ago and it made her really sick. First we got her on an anti-nausea drug, then when she had been on that for a bit, we worked our way up the full dose of cyclosporine (which was still lower than usual) in quarter dose increments every two days, but she still wound appearing to have bouts of discomfort and eventually the vomiting happened. That was nearly a week ago and her appetite is only returning now. It was a major disappointment - Everything seemed to be going so well - my vet had even emailed me a schedule for tapering her off the pred. - then it all went down the tubes because she just doesn't tolerate cyclosporine. So we are back to where we started, except she has lost weight and is a bit weaker. My vet feels that since she is proving to be a difficult case, she will be better served by being seen by a specialist rather than him trying this approach and that approach trying to hit the right combination of treatment for her. However, the specialist only comes to the city I live in a couple of days a month. He thought it would be ideal if we get an ultrasound and new blood work done the same day we see the specialist, but unfortunately she and won't be here for another four weeks. I'm not sure if Bailey (and I) can last another four weeks in limbo. My vet wasn't in today but will be in touch tomorrow and will probably advise we go ahead with the ultrasound and blood work now. The results should let us know if we can wait for the specialist or have to try something else first. Anyway, I appreciate that my vet is willing to recommend someone else, rather than thinking he knows best. I hope you can find a vet more open to your suggestions or as you say, will at least give you solid reasoning why not. My vet, for example discouraged me from trying food like Fancy Feast (smaller tin - she seems to like the food best when it is really fresh from the can) because we are going to be trying to work out what will work best for her treatment and that would just introduce another variable. That makes sense to me. So Google other vets in your area or ask your friends. Maybe you will find a vet more suited to being a partner with you in Oren's treatment. Hope it works out for you guys. The stress is hard, but I will pass on (and take) some good advice a friend of mine gave, to be careful not get so bogged down in the details (did she eat? Has she peed etc.) that we forget to enjoy our companions. It is what I started to do, and I'm trying hard to stop that pattern of thinking. Take care.
 
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