Does anyone have a diabetic cat with Pancreatitis?

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jacereske

jacereske

Member Since 2014
Our Evie was diagnosed as diabetic 6 months ago. After seven days on insulin she went into remission and has not needed insulin since then. Her numbers have been great - 90 - 100 on average.

On Wednesday evening she threw up a hairball with lots of fluid, did not eat well Thurs am and threw up again.I tested her BG and it was 200.

We went to the vet and long story short she has Pancreatits. Her fPL test was 50 (as high as it goes) and 4 is normal. I am trying to figure out what triggered this.

Any info or experience with this would be appreciated.

thanks,
Jeanette
 
Jeanette,

My cat Lilly had pancreatitis twice. It can be mild or very bad. Lilly almost did pass away the first time and was in the hospital for about a week and was very sick. The second time she was so sick from it I had to have her put to sleep as she stopped eating altogether.
One of our senior members wrote a very good article on it that might be very helpful.

viewtopic.php?f=9&t=79693&p=1219206&hilit=primer+on+pancreatitis#p1219206

I don`t know what your vet has recommended for Evie but hopefully this article will help. I know pancreatitis is painful for the cat and a lot of vets will say that it is not and do not like to give pain meds but you must insist on it. Buprenex is the best. You cat Evie looks like my Lilly(GA). I hope she gets to feeling better.

Terri
 
Thanks very much Terri. I'm sorry your about your Lilly. I'm hoping we can get it under control for Evie.
 
We just went through a diabetic relapse of 6 weeks due to a second bout of pancreatitis (Spec fPLI 36). In the absence of injury or a medication issue, there is no known cause and no known cure. Since our furkids are diabetic I would suspect that it is the pancreas sputtering in insulin production. Just a guess on my part. Buprenex is what is needed for the pain. Please be sure to keep an eye out for anemia. Have you considered trying all meat baby food for periods of inappetance?

The internist also suggested to me that we test for pancreatitis at least twice a year to try to catch it early and begin to administer very low doses of insulin to counter the development if it appears as though pancreatitis is rearing it's ugly head. He said that the current thinking is that by giving insulin it is believed that it takes the load of insulin production off the pancreas allowing it to recover from the inflammation.

Hope things improve.

Anita and Squeaker
 
My Saoirse was diagnosed with pancreatitis and diabetes in June. Her pancreatitis symptoms were mild initially (vomiting white foam if she fasted too long) but she became inappetent after changing to wet food and she is still in the throes of a flare-up at the moment. I'm at a loss for what to feed her. She's subsisting on chicken & broth at the moment. I tried adding a balanced nutritional supplement to her chicken (not anything near the recommended amount) and she's getting diarrhoea again from it. Saoirse's currently on anti-nausea medication (metoclopramide), an appetite stimulant (cyproheptadine) and - very occasionally - buprenorphine for pain.

Here's a link to the IDEXX guidelines on pancreatitis treatment:

https://www.idexx.com/pdf/en_us/sma...pec-fpl-treatment-for-feline-pancreatitis.pdf

Also, some board members offered me a lot of advice about appropriate medications a couple of weeks ago on the following thread:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=123308
 
Have you discussed digestive enzymes with the vet? Pancreatitis can destroy some of the enzyme-forming part of the pancreas in addition to the insulin forming part . This results in loose, stinky, often gray-colored feces.
 
Max has chronic pancreatitis first diagnosed 4 3/4 years ago. I think it might have led to his diabetes which was diagnosed last November. His fPL has been <50 at times and in the 2-25 range as well. The number doesn't necessarily correlate with how he is feeling. When having an attack he gets ondansetron or cerenia for nausea and sometimes for a day or two a tiny sliver of cyproheptadine as an appetite stimulant. I have also tried buprenex for pain when he seemed really sick. My angel Tiffany had a few acute attacks and needed to be hospitalized a couple of times. The IDEXX article is a really good one.
 
Thank you for your replies and information everyone.

We hospitalized Evie on Friday night so we could take an aggressive approach to get the inflammation under control. Her BG stayed around 200 in the hospital and they did give her .5 cc of insulin to take the load off of the pancreas. They were also giving fluids and cerenia injections. She was doing really well, eating like a champ. We brought her home last night.

Because her fPL was so high her internist has put her Prednisolone, which I knew would send her BG up and it certainly has. I checked her BG this morning and it is 362. I didn't get the insulin last night so I'll be getting it this morning as soon as Walgreen's opens in about an hour.

She felt really well last night but I can tell she is not feeling as well this morning. She ate some of her breakfast (but not all of it). I've given her a Pepcid and also her pred - hopefull she will be hungry again in a few hours so I can give her the insulin. She was drinking water last night (most likely due to the pred they gave her yesterday) but I haven't seen her drink anything this morning yet.

The hope is that the pred will bring the inflammation in her pancreas down and we can get her numbers back to normal and most importantly get her feeling better.
 
Jeanette,

Sending prayers for Evie. Hope she gets to feeling better soon and eats something.

Terri
 
I manage to keep Saoirse hydrated by giving her a 50-50 mix of chicken broth (cooking liquid from poaching breast fillets - not as fatty as thigh meat). If it weren't for the broth she would not be drinking anything (hasn't touched her water bowl since transitioning to a wet diet). Does Evie like broth? Maybe that might help with her fluids. If you use some of BJM's tips on secondary monitoring (link in BJM's signature) it is a great help for monitoring hydration at home (i.e. keeping a log of all food (including its moisture content) & fluids consumed and also the weight of clumps from the litter box - simple but effective!).

I also give Saoirse cyproheptadine to help with her appetite after getting a recommendation for it from Elise and Hellen. It's an absolute godsend for her. She can get up to 36 hours beneficial effect from less than 1/8 of a tablet. (She was initially treated with mirtazapine but I neither like the side effect/adverse reaction profile of that medication (including risk of serotonin syndrome) nor the fact that Saoirse became mildly psychotic and completely crazed with hunger within 20 minutes of taking the single dose she received.)
 
I think the Pepcid must have settled her tummy. She just ate 1/4 can of Friskies (I added some water to it) and I gave her 1 unit of insulin. I tested before and her BG was 411. I'll test again in 6 hours and call her Dr.

Right now our priority is to get the pacreatitis under control. Her ultrasound showed some fluid in the tummy and her doc was worried that without a steroid it would only get worse.

Because of the pred I'm expecting to see her at her water bowl - before this when she was in remission she never drank because she was getting all of her fluids from her food.

Hopefully we can get her through this crisis and get the inflammation under control. If she has to be back on the juice we can handle that.

Thanks again everyone for your support and information.

Jeanette & Evie
 
Thank you I will do that.

She just ate again and although it was not with her usual gusto she did eat 1/4 can Fancy Feast. I'm going to check her BG again in 3 hours.

She still isn't drinking and that worries me because with the pred she should be thirsty. We may have to give fluids.
 
Thank you. She really is a sweetie - quite a character actually. Being blind is not an issue for her.

Her BG at 4 pm (6 hours after her 1 unit) was 254. I'm going to check it again in 6 hours and if she is over 150 will give 1 unit.

Her internist wasn't too worried about her not drinking. He said she was pretty hydrated when we took her home last night and she is probably getting enough water from her food since she is eating and is not vomiting.

So we will see what her BG looks like at 10 pm.
 
BG at 10 pm was 243 gave one unit
BG at 9 am was 387 gave one unit

She ate like a lumberjack this moring.

Hoping the BG will come down as the pred decreases the inflammation - it is such a balancing act.
 
Good news about Evie's hydration being OK, and I'm glad her appetite is good too. At the moment, all Saoirse can tolerate is chicken and broth (and she needs cyproheptadine & metoclopramide to support getting that into her). I tried introducing a tiny amount of vitamin & mineral supplement because she has not had a nutritionally complete meal for a couple of weeks. Unfortunately the addition of the supplement triggered diarrhoea.

It must be tough trying to manage with the steroid treatment. I'm in a heap with Saoirse's digestive issues. We went to the vets yesterday for her B12. She was prescribed Pro-Kolin to help stop the runs (which it seems to have done) and Stomorgyl to see if that will help with the digestive upsets. I'm desperate to find something to feed her that is nutritionally complete but won't make her poorly.

No doubt about it, pancreatitis is not easy.
 
Critter Mom said:
...I'm desperate to find something to feed her that is nutritionally complete but won't make her poorly.
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Hi Aine,
Forgive me if I've already asked you this (and you've already told me why it's not suitable (my memory is rubbish at times...)) but have you tried Liquivite liquid cat food? It's like a thick chicken soup and seems very palatable, especially so if warmed slightly. It's available from a number of UK outlets online. This stuff was an absolute godsend when I had two very sick kitties last year. The product details are here:
http://www.liquivite.co.uk/about-liquivite

Eliz
 
Hi Eliz,

Thanks for the link to the Liquivite. I had not heard of it before. I'll have a look at it to see if it might be something she could take.
 
Pancreatitis is definitely a challenge and with diabetes that does complicate it.

Evie is still eating well. I have been feeding her only Fancy Feast for now because she will eat it, but I need to spend some time with the cat food chart and give her some variety. I know they are high in phosphorous. But the priority is to get her to eat.

We had to up her insulin - she is still testing high. So she got 2 units last night because she was at 322. Her BG was lower this morning - 292 so she only got 1 unit.

Have you tried feeding Saoirse baby food? I've had good luck with that when my cats wouldn't eat anything else.
 
May I ask why you are giving such different doses morning and night? Lantus is a depot drug and is not meant to be dosed that way. Is your vet guiding you on this? I think from what I have learned here it will be very hard to regulate her this way.
 
Lantus doses are adjusted based on the nadir, the lowest glucose between shots, not the pre-shot test value. Lantus hits its nadir about +5 to +7 hours post injection. Aim to get some tests in during that period whenever you can - holiday, weekend, other day off, or setting the alarm to get up in the middle of the night (that one is tough!).

Sometimes, when the glucose drops fast or to an unaccustomed level, it triggers compensatory hormones that release stored glucose (glycogen) from the liver. This results in higher numbers than anticipated for as much as 3 days or so. It is the body's way of protecting itself from hypoglycemia. You just have to wait ito out.
 
jacereske said:
Evie is still eating well ... Have you tried feeding Saoirse baby food?
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Hi Jeanette,

I'm glad that you are getting Evie to eat. As you correctly say above, it is the priority.

I have not tried Saoirse on baby food. I took you up on your recommendation and had a look online today for something suitable but I could not find anything. Either they have all manner of non-species-appropriate gubbins in them, or they're packed with carbs. I've ordered some of the Liquivite that Elise suggested. It's low (allegedly no) carb and is supposed to be good for weaning kittens without triggering diarrhoea. I will post an update when I see how she gets on with it.

Finding the right diet for Saoirse is my biggest problem. It's wrecking my head that I can't get her the nutrition she needs to heal. :sad: If I could find a complete food that agreed with her it would make such a difference.
 
I'm so sorry, Elise. I meant to credit Eliz (Elizabeth & Bertie) with the recommendation for the Liquivite. Mea culpa, mea culpa, mea maxima culpa. :oops:
 
No problema. I just wondered if there was another Elise. Hope things are improving. if this is chronic p'itis be prepared for it to eventually get better but likely come back from time to time. I always have ondansetron around and cyproheptadine (appetite stimulant) in case it's needed. I buy both in bulk.
 
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