Cat diagnosed with chronic pancreatitis. Need advice

PatJ

PatJ

Member
My cat has been diagnosed with chronic pancreatitis and I just wonder if anyone with experience of it with their cat could give me any advice about it . He was diagnosed last week. I took him to the emergency vet on the Sunday morning and I didn't give him his insulin because he wouldn't eat and he'd vomited, but my vet said I should have given him his insulin even though he wouldn't eat, because his pancreas was playing up, but I didn't know then that he had pancreatitis and I thought it was dangerous to give insulin on an empty stomach. She said that in future, if he doesn't eat to still give him his insulin.Was the vet right? Also, another thing that's bothering me is that he had to go back for a few days every morning for two injections, one anti-inflammatory and the other antibiotic, but I've read since that antibiotics aren't necessary with pancreatitis and can actually make the cat feel worse, because it's not an infection so it should be avoided. This week, I was given Synulox antibiotics to give him twice a day, but I haven't give him any because of what I've read. I'm worried to give them and worried not to give them. He's had no fluids at all, I told the vet that if he needed them then I could give him fluids at home but she didn't answer. He's stopped vomiting ( she gave me Cerenia for three days) and wants to go out and he eats all right during the day
but it's sometimes a struggle to get him to eat enough in the morning for his PMPS although we get there somehow. Should I really give him his insulin if he doesn't eat much or doesn't eat at all? She gave him Onsior anti-inflammatory once a day but told me to cut it down to every other day unless he's in pain, which I think he is, so I give it every day but has he been given enough treatment? I know you can't tell me what to give him but with all the experience here I just wondered if it seemed like enough treatment. Would be so grateful for an opinion. I've got to take him back to the vet tomorrow.
 
Pancratitis is usually treated with cerenia for nausea and bupe for pain and sub q's for hydration. Unless there's an infection antibiotics won't help.
 
Onsior (generic name is robenacoxib) is for pain and inflammation. So yes, this is an appropriate medication for a cat with pancreatitis, which is an inflamed pancreas.

The cerenia (maropitant) is for nausea and sometimes vomiting. It is an anti-nausea medication. With pancreatitis, nausea is often present and a cat will not eat when their stomach is upset.

Bupe (full name buprenorphine) can also be given in the cheek pouches of a cat for pain. It is absorbed by the mucus membranes in the mouth, not swallowed. Needs to be given very slowly. It's a controlled substance in the US but I don't know the laws in France where you live.

Some of these medications can make your cat very sleepy and can depress the appetite.

Yes, it's very important that a cat with pancreatitis still receive their insulin. But, you may have to give the anti-nausea medication first, before William is willing to eat on his own. If he will not eat on his own, you will need to hand feed him or assist feed him with a feeding syringe to get food into him.

No insulin + not enough food + inflammation/infection (for example, the pancreatitis) can lead to ketones. Ketones are a toxic by-product when there is not enough food and a cats body will start to break down fat and muscle tissue to provide energy.

Please test for ketones every day, since more than a trace of ketones is extremely life threatening for William and could lead to diabetic ketoacidosis (DKA). Even a trace of ketones requires some treatment.

From our A Primer On Pancreatitis
"Antibiotics: Antibiotics are not typically prescribed for pancreatitis as it is generally an inflammation as opposed to an infection. However, if bacterial infection of the intestinal tract or liver (cholangitis) is present, antibiotic therapy is appropriate and your vet should inform you as to the appropriate type of antibiotic and course of therapy. Some antibiotics can cause nausea and vomiting and diarrhea so it is important the CG work closely with the vet to determine the best antibiotic to address any infection."

"Synulox is the most commonly prescribed antibiotic in the UK (and other European countries). It contains amoxycillin and clavulanic acid which act together to provide a safe and effective antibiotic with activity against a wide range of bacteria."

If there is a UTI or other infection also, then antibiotics would be appropriate.
 
Thanks Deb for the information. I haven't given him antibiotics since the vet told me that the antibiotics were for chronic pancreatitis and I read that there is no need for
 
Sorry Deb, Don't know what happened there.

I just need to know that he's being given the right treatment, because she's never mentioned giving him fluids and gave him antibiotics which I read shouldn't be given as it's not an infection. I test for ketones every day at the moment and touch wood, he's all clear. All his tests were clear the day he was diagnosed except for his pancreas and his cholesterol and blood glucose was a bit elevated, so it doesn't look as though he had any infection, but I'm still having a job getting his numbers down which makes me wonder if he's still in pain . which might be why he's still so high. Going to the vet tomorrow so will ask if I can have some more cerenia in case he's sick again. I've bought a syringe for feeding him if necessary.

Thank you for the advice, you've really helped. it's really appreciated. Thanks Deb.
 
Any time Pat.

Except this coming weekend. I have 3 cat sitting commitments, so I will not be around much Friday evening 3/6 through Monday afternoon 3/9 (evening where you live).

Post in the Feline Health (Welcome & Main Forum) for quicker help.
 
Pat,

My Ollie has chronic p'titis. I'm in the states so don't know what you can get there.

If your vet will allow you to keep supply of meds at home is the best route to go. So you can start treatment the minute you see it's needed.

Cerenia or equivalent in pill and injectable forms. If Ollie is off her food but will nibble I can get the pill in her food. If not the injectable is given in her subq fluids. Some people have luck with Pepcid (OTC here). It doesn't work for me.

Ollie now requires low dose bupre for pain every 8 hrs long term. Every couple of months we try to lower at least one dose, but she will flare up.

Subq fluids twice a week. Because of HCM the amount she gets is limited. Cardiologist limited her fluids to no more than 200 ml per week, divided up as needed. I give her 70 ml each time.

I give her insulin regardless. Since its a depot insulin, I have time to get her to eat or assist feed (which I've not needed to do so far).

She was given antibiotics the very first time but It was suspect IBS, before we knew it was p'titis.

The minute she stops eating or vomits, I give the cerenia and subqs, maybe up her bupre dose a bit and she will be better the next morning. I try to stop the episode before it gets out of hand. So far we've been lucky.
 
Hi Paula,

Thank you so much for replying.He had to go to the vet for ANOTHER check up this morning so I wrote down the medication that you use for Olive and asked the vet for it but she said that the only one she could give me was cerenia. She wouldn't give me the bupre because she said it zonked him out for hours after they gave it to him after he'd had a dental, which was true because I went to collect him in the evening and they said he was still sound asleep and would have to stay for the night. He was apparently falling about all over the place when he woke up. Wanted to say that I would only give him a tiny bit but it wouldn't have made any difference because she was convinced that I could kill him with it.
She didn't want to give me the fluid which I really wanted, because she said it wouldn't last long after opening and would have to be thrown away:banghead: He's having his pancreas tested on Monday morning so maybe if it's still not good, she might change her mind.


Thanks so much for the info. It's really appreciated.
 
Pat,

Your vet does have some valid points. However, I question the reasoning. If William was given bupre right after dental, he was still under the influence of anesthesia. The 2 together could really zonk him out big time.

Just for reference. Ollie is 13 pounds. She gets 0.12 mg of bupre. It does come in different concentrations. Maybe there is a different pain med vet is more comfortable with, such as gabapentin again in small dose, less than 25 mg. P'titis is more painful than a dental. A lot of vets use gab to sedate just for office visits, they give much higher doses. You don't want to sedate, you want to lessen pain.

Fluids, they come in smaller bags, 500 ml and in 250 ml (this size might be tough to find). Since Ollie doesn't get much nor on daily basis, I get the 500 ml bag. I order lines that allow accurate measurements since Ollie only gets 70 ml at a time. I was told I can use the lines 6 times (different needle each time) but not more than a month. When I asked for opinions I never got answers. The bags of fluids I was told not to use after one month of being opened. Again I never heard otherwise.

Of course people will have their opinion. I haven't found any info on fluids and to specific protocols of use. I just want you to know there are options and choices that you can discuss with vet. I just know it works for Ollie and although not 100% well, she never will be, she is 100 x better than she use to be.
 
Thanks for that, Paula.

I'm going back Monday morning so I'll take this information with me. I really want to try these fluids because they are part of the treatment, so I don't know why she doesn't want me to use them. I think she's a really good vet, but I don't think that diabetes is her strong point, and she doesn't like to be contradicted, so I have to be a bit diplomatic, which doesn't seem right when you know she's wrong.

I'm sorry poor little Olive isn't 100% well. She's re
 
Sorry Paula, this computer has a mind of its own. It's always cutting me off. Just wanted to say I think your cat is a beauty.
 
Thank you. I think so. William is a very handsome lad.

Hoping they drew blood sample for p'titis test. And hopefully it's negative, then again you still have to figure out what's wrong.

Just wish cats could tell us.
 
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