Re: Diabetic cat w/diarrhea not eating/drinking..prayers nee
Hi Kelly and Babee,
You did the right thing to take her in, thank goodness Hillary lives close by and was able to point you in the right direction to get her some help right away. It is lonely when they spend the night away from us, but rest assured she is in the right place to begin her healing. My apologies for the "drive-by" post earlier, I was at work and needed to give the cliff-notes version of what to look for/ask for when dealing with a cat with pancreatitis in case your vet called you back.
In order to get such quick results, the ER most likely ran a Snap-fPL test which is a test which returns instantaneous results and is positive if the cat is either borderline or actually has pancreatitis. The test is negative only if the cat does not have pancreatitis. The Snap test does not give an actual number. I'm guessing that after running the Snap test they are now running the full spec-fPL test and you should get a number tomorrow.
When she does come home she may still need some supportive home care from you so I'm going to give you a quick crash course in pancreatitis.
Here are three articles which will help you understand what pancreatitis is and the current recommended treatments:
Pancreatitis in the Cat
I found this to be the single most useful page in understanding in laymans terms exactly what was going on in feline pancreatitis.
Pancreatitis: Cats Are Not Small Dogs
This is the quickest most concise article on pancreatitis and it's written in vet-speak. The chart on page 2 is awesome and will give you and your vet a snapshot of symptoms, conditions, and possible causes if you should choose to explore them. Sometimes there is no cause, it's just idiopathic.
Treating Feline Pancreatitis: Reccomendations for managing this disease and concurrent conditions
If you are running out of paper or ink and can only print 1 article for your vet - this is it.
It also includes a case example - cats do recover from pancreatitis. My Harley was dx'd in March and is still with me today.
As I mentioned in my first post, treatments for pancreatitis include ensuring that Babee is adequtely hydrated, is treated for pain since pancreatitis is very painful, and it is very important to stop any vomiting or nausea so she can continue to eat. Unlike dogs, cats cannot be fasted through pancreatitis so Babee must eat one way or another. If is far more comfortable for both you and her that she eat on her own of her own free will. If this is not possible, you may have to consider syringe feeding/dropper feeding her or getting a feeding tube. Another reason to keep her eating is that since she is diabetic she still needs her insulin. If she does not eat and does not receive her insulin she is at risk for developing diabetic ketoacidosis (DKA) which is life threatening. So it's great that she's at the ER right now because she's most likely receiving fluids which will restore lost hydration from her vomiting and diarrhea, perfuse her pancreas which will help begin the healing process, regulate her electrolytes (especially postassium as Jenifer mentioned above) and keep any possible ketone formations at bay.
You may hear the doctors talk to you about medications in the next few days, so here is a list of the most commonly prescribed medications to treat pancreatitis and/or IBD which you may hear about:
Stomach acid reducers:
Pepcid AC (famotidine) - This is really useful if kitty is vomiting white foam due to too much stomach acid. It's not an anti-nausea drug though so it won't handle the really strong nausea. A typical dose is 1/4 of a 10 mg tablet 2x daily. If you need stronger doses, it does come in injectible form as well.
Zantac (ranitidine) - Not all cats tolerate Pepcid very well. If they don't, try Zantac 75 tablets instead. Zantac also stimulates gastric motility. A typical starting dose is 1/8 - 1/4 of a 75 mg tablet 2x daily.
Options for nausea medications:
These first 2 are both human anti-nausea drugs used for chemotherapy patients. Quite frankly they are off label use for cats but they are used quite often for cats with IBD and/or pancreatitis and they are very effective. I currently use Anzemet for Harley (it saved his life durring his acute pancreatitis attack earlier this year) and ondansetron for my civvie, Princess, who has cancer.
Zofram (ondansetron) - comes in both injectible form or pills. If you decide to go with pills, get the 4 mg pills, not the 8 mg pills. The usual starting dose is 1/4 of a 4 mg pill (1mg) 2x per day. If you need to start somewhere, start with this drug and be sure to ask for a prescription for the generic. It's A LOT cheaper than the brand name Zofram.
Anzemet (dolasetron) - this comes as an injectible. It's mostly dosed once per day (but can be dosed twice per day if necessary) and dose is based on weight. There is no generic available so it's pretty pricey stuff but is stronger than ondansetron.
Cerenia (maropitant) - This is the drug that is used to stop vomiting and it lasts in the system anywhere from 24-36 hours. It is approved to treat nausea and vomiting in dogs but is off label use in cats. It really works well though plus I've been reading that it has some antinflamitory and antioxidant effects which is really helpful for GI disease. It comes in injectible and pill form. 4mg per day in the pills is a reasonable starting dose.
Options for appetite stimulants:
Cyproheptadine - comes in pills. Vets for some reason almost always overshoot the dose on these when prescribing. 1/8 to 1/ 4 of a 10 mg pill 2x daily is all that is typically needed to get a kitty eating again. This is VERY bitter so it's best to give as a pill in a gelcap (not a pill pocket) so that kitty doesn't taste it going down.
Mirtazapine - This is actually a human tricyclic anti-depressant drug (Remeron) which is used to stimulate appetite in cats. It's usually given only once every 3 days because it acts on a cats seratonin levels. I personally have not used this drug in my cats.
When Babee is ready to come home, I suggest that you ask the ER staff to show you how to administer SubQ fluids, request pain medication (buprenex) and anti-nausea medication. Ondansetron would be a good choice to start with.
Hugs to you :YMHUG: :YMHUG: :YMHUG: and healing vines to your Babee. cat_pet_icon cat_pet_icon cat_pet_icon
