Frankie: Pancreatitis and Diabetes Treatment

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Jay

Jay

Member Since 2010
Frankie has had recurring bouts with Pancreatitis.

Some of you may know him and his diabetic history and the struggle we had switching to Lantus almost 2 years ago.

A brief background.
Frankie was diagnosed over 6 years ago with Diabetes and he is now 14 going on 15. To all those "newbies" reading this, there is a life after the diagnosis.

At the end of Sept he had an attack of accute pancreatitis, after a week at the Vet (avoiding the use of steroids, just fluids, diet, antbiotics and vitamin supplements) he came home.

He was showing me symptons of Pancreatitis (although not as severe) vomiting and looking "off". Back to Vet, this past Friday. Again, FPLi test showed elevated levels and as opposed to thinking I was just being paranoid, I was right to bring him in to the Vet

Question for those of you who have had to deal with Pancreatitis and Diabetes at same time.
We know (or at least thats what I keep hearing) that the best treatment for Pancreatitis is Steroid Therapy (I heard my vet mention Prednizone), however I know that the use of Steroids to control Pancreatitis will negatively effect his Diabetic condition, yet as painful as Pancreatitis is, running to the Vet every month, for a week of treament and care till the attack passes, is not a very efficient option either logisitically or financially.

Are there any treatment options that Frankie and I should be looking into.
 
This is information that Jojo provided about pancreatitis. In situations where it's hard to manage the bout of p'titis, steroids can be used. There are a number of cats here that have chronic medical conditions (e.g., IBD, asthma) that require steroids on a regular basis whereas with p'titis, steroids are used to manage the episode. The insulin can be worked around the steroid -- in other words, you raise the insulin dose to offset the effect of the steroids. FWIW, not all cats have increased BG levels due to the influence of steroids.
 
Sienne and Gabby said:
This is information that Jojo provided about pancreatitis. In situations where it's hard to manage the bout of p'titis, steroids can be used. There are a number of cats here that have chronic medical conditions (e.g., IBD, asthma) that require steroids on a regular basis whereas with p'titis, steroids are used to manage the episode. The insulin can be worked around the steroid -- in other words, you raise the insulin dose to offset the effect of the steroids. FWIW, not all cats have increased BG levels due to the influence of steroids.
Click to expand...

I read somewhere (wikia, maybe, searched on Feline Pancreatitis in cats with Diabetes) that a slightly higher carb food with lower fat would be preferable to a very very low carb food but very high in fat.

It's worth a try.

Right now I feed him only 3 flavors of FF. Beef Feast, Turkey and Giblets, and Chopped Grill, all of which are under 5% carbs per Janet's food chart. Do you know of a higher carb wet food with lower fat content that we can switch too. I can deal with increasing his dose to offset the higher carbs, just as you suggested if and when we have to start using steroids.
Steroids??? Is he going to get PUMPED UP" like the CATENATOR? at his ag?? gee
 
Jay said:
I read somewhere (wikia, maybe, searched on Feline Pancreatitis in cats with Diabetes) that a slightly higher carb food with lower fat would be preferable to a very very low carb food but very high in fat.

It's worth a try.
Click to expand...

Here's an old thread with a list of low fat/medium carb foods: http://www.felinediabetes.com/phorum5/read.php?8,1259368

Check Bink'ys "new" canned food chart for other foods that may be suitable: http://binkyspage.tripod.com/CanFoodNew.html

And also check this more up to date chart: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50
 
Do you give any subq fluids and pain treatment such as buprenex. You can give both at home by yourself altho you need a prescription for both. The fluids you can get on line which would be cheaper for you. But the bupe you need to get from your vet. However if you had them at home and you recognize the symptoms you could start treatment earlier perhaps and prevent things from going to far. Also are you giving prednisolone - not prednisone? Cats really can't break down the prednisone to the elements they need. They need prednisolone - they really are 2 different drugs.

Do you give Denamarin at all? The cat's GI system is so interconnected that protecting the liver could be helpful also? This is a supplement - not a prescription. The vet sells it but it too is cheaper on line.

I've had a cat with acromegaly - Merlin - (with diabetes) and Boris with diabetes and I have another kitty with liver disease that had triaditis that involves the liver, pancreas and gut. I hope this helps a little.
 
The issue of the fat content of food and pancreatitis is more an issue for dogs than cats. There's an excellent roundtable discussion of feline pancreatitis on line. I'm having trouble accessing it but if you Google "feline pancreatitis roundtable" you should be able to track it down. It discusses diagnosis and management.
 
I have two cats with pancreatitis issues.

Shadoe had frequent issues, so I keep 3 things on hand at all times: Pepcid, fluids, and pain meds, usually buprenex.

If you watch for the signs, obvious ones like lip licking and meatloafing, and being 'off' food, you can nip it before it gets too far.

As soon as I see Shadoe licking her lips, she gets 1/4 tab of pepcid (regular strength pepcid AC 10mg). She's a gassy girl as per her vet, so she often gets pepcid twice a day.... daily max is 5mg for cats.
If she is still having problems in an hour, I check to see if she's a bit dehydrated - pull up scruff and if it falls slowly, you could give some fluids.... even 50cc is enough. Shadoe has a bit of a growl when her abdomen is palpitated and that's her big sign that she needs pain meds right away, so I'll give her 0.1 to 0.15ml Buprenex.

if you give fluids, feel the bump from the fluids and keep track of how quickly it disperses which lets you know how dehydrated Frankie is.

Now, I changed vets awhile ago and the new vet had me start giving Shadoe B12 shots.... cyano not methyl, pink in color, and in the past 2 months, she has had only 2 very minor bouts when she once needed pepcid BID.
If you are having frequent issues with pancreatitis, get pepcid, fluids, and some buprenex, plus talk to your vet to see if giving B12 shots weekly at home could help Frankie.

My other cat, Oliver, is always just above the range max of 3.5, around 4.0 on each fPLI test, so I have been giving him the B12 shots as well and he has had no issues since starting the shots.

I have not changed foods; I feed both of them fancy feast and/or friskies pate flavors.
 
Gayle

What is meatloafing? My cat Lilly is in the hospital now after and episode last night of not eating, vomiting etc. She has had pancreatitis about 4 years ago.
I noticed yesterday she was not eating seemed irritated and was milling around in general like she could not get comfortable, then last night she actually growled at me when I picked her up to test her BG like she was in pain.
I supsect pancreatitis told the vet that today but they did not listed to me. Does this sound like it might be to you ?

Terri
 
terri1962 said:
Gayle

What is meatloafing? My cat Lilly is in the hospital now after and episode last night of not eating, vomiting etc. She has had pancreatitis about 4 years ago.
I noticed yesterday she was not eating seemed irritated and was milling around in general like she could not get comfortable, then last night she actually growled at me when I picked her up to test her BG like she was in pain.
I supsect pancreatitis told the vet that today but they did not listed to me. Does this sound like it might be to you ?

Terri
Click to expand...
You ever have bad stomach cramps and you sort of double over, you curl up small, yes?
You may normally see your cat lying on its side, legs casually stretched out, but if you see you cat sitting 'like a meatloaf' with paws under neath body and tail wrapped around side, often head down, you could call that position 'meatloafing'.

Can you get some pepcid? Give a 1/4 tab to her, and also pull up her scruff..... when it falls back to the body, does it fall splat fast, or does it seem to slowly fall down to the body.. does it seem 'gummy' or fast like elastic?

When you apply some pressure to her underside, does it feel like she is tensing up, and doing a sort of gutteral growl?
Will she eat or drink at all? You can try to sprinkle some fortiflora on her food, some people sprinkle cheese.
What about LB activity? If she is constipated, you may have similar issues where she may growl.
You can get something like miralax or restoralax and mix some into food, if she will eat, but be sure to add lots of water as the powder draws water from the body so you can cause dehydration if you don't add extra water.
I add restoralax and water to make the first meal of the day for the cats almost like soup.

If your vet is not listening, try again, or go to another vet.
What has your vet told you so far and done so far for Lily?
 
hi jay. sorry to hear frankie's been having problems.

here's the link to the "feline pancreatitis roundtable discussion" sienne mentioned: http://www.idexx.com/pubwebresource...es/feline-pancreatitis-roundtable-article.pdf.

we treat alex's CP flares with:

  • 1/4 10mg tab Pepcid AC (not Pepcid Complete) given 30 minutes before meal time twice a day (every 12 hours). chase with 4ml - 6ml water.
  • 50ml - 100ml sub-q fluids administered at home daily (during a flare). if frankie has any issues with his heart check with your vet before administering.
  • 0.1ml - 0.15ml buprenex for pain every 8 - 12 hours (usually every 12 hours)
  • i do cut the fat in foods during a flare (not sure it's necessary, but figured she had nothing to lose) by mixing half of what she normally eats with half Merrick's Before Grain 96% Turkey (only 34% kcal from fat and 1% kcal from carbs).
she also gets 1 tab Denamarin with SAMe (90mg tabs for small dogs & cats) and 0.5ml - 0.7ml Super B Complex Liquid (Regular not Herbal) daily... whether she's having a flare or not. the Denamarin should be given on an empty stomach... at least one hour prior to a meal. i mix the Super B Complex Liquid in her food.

i'm also quick to up her insulin dose if necessary during a CP flare. so far, we've been able to manage at home without the use of steroids.


hope this helps...
 
They have given her sub cu fluids and something for upset stomach, starts with a Metronoizale, does that sound right? I know thats not spelled correctly.
Yes she was meatloafing yesterday. Curled up with paws underneath and kept changing positions like she was miserable.

Terri
 
OK have the vet show you how to give fluids before you leave or if you are already home with Frankie, just contact the vet to say you want to give fluids yourself at home. There are plenty of youtube videos you can watch and many people here who can answer any of your questions. Since you are already giving insulin shots at home, there is no reason for you to have the added expense of taking Frankie to the vet to get fluids. You are perfectly capable!

You don't need to give fluids all in one sitting; you can split it and give 50cc am and pm, but please note that fluids can bring down BG numbers so if Frankie's is falling, wait to give fluids till higher or rising.

Also, if you were not sent home with pain meds, tell your vet you want some and will pick it up.... pancreatitis is painful.

The vet may have given cerenia for nausea, but you should ask exactly what was given so you can look up if there are any side effects from it.

Pats for Frankie and hope you see a happier cat soon.
 
Metronidazole is actually a GI "antibiotic" commonly used during times of Pancreatitis or liver issues. Flagyl is it's other name. As bacteria that's normally in the gut can "backflow" so to speak it's given to prevent infection elsewhere. It's not really for upset stomachs.
 
Re: Frankie: Pancreatitis and Diabetes Treatment Update

We just got home from the Vet.

Thank you for all your advice.

My vet gave dn I worked out a plan
Prevention:
He gave me 6 pre-measured doses (1x per week) of B12 shots.
Based on testing he didnt think that Denamaarin or Flagylwas necessary however, my vet and I plus his vet techs who are my cat sitters, will be working closely on this.
He suggested I feed Science Diet id (wet and dry), not sure, but will try some flavors of higher carb, lower fat content food, even though he mentioned that the jury is still out on that conversation.

Managment
Cypro for appetite stimulation
Cerenia for anti vomiting,,,we start tomorrow morning
6 pre-measured does of Buprenex (he wouldnt give me a script, but will be giving us Lantus at no charge) in case he has anotehr attack.
I have the Pepcid AC here and ready.

I have to go back tomorrow (between negotiating the bill which we will do tomorrow, and the medz, dosing and care, I was on sensory overload) to wathc a vet tech give subq fluids once and I'll get a script and keep in on hand, to use if needed.

We are waiting prior to going to steroids for treatment/mamangement as a last resort.

Hoepfully we can control this thing, so flareups and pain are on existant, if they are though we will be ready to deal with it.
 
Patti and Merlin said:
Do you give any subq fluids and pain treatment such as buprenex. You can give both at home by yourself altho you need a prescription for both. The fluids you can get on line which would be cheaper for you. But the bupe you need to get from your vet. However if you had them at home and you recognize the symptoms you could start treatment earlier perhaps and prevent things from going to far. Also are you giving prednisolone - not prednisone? Cats really can't break down the prednisone to the elements they need. They need prednisolone - they really are 2 different drugs.

Do you give Denamarin at all? The cat's GI system is so interconnected that protecting the liver could be helpful also? This is a supplement - not a prescription. The vet sells it but it too is cheaper on line.

I've had a cat with acromegaly - Merlin - (with diabetes) and Boris with diabetes and I have another kitty with liver disease that had triaditis that involves the liver, pancreas and gut. I hope this helps a little.
Click to expand...
We just got home from the Vet.

Thank you for all your advice.

My vet gave dn I worked out a plan
Prevention:
He gave me 6 pre-measured doses (1x per week) of B12 shots.
Based on testing he didnt think that Denamaarin or Flagylwas necessary however, my vet and I plus his vet techs who are my cat sitters, will be working closely on this.
He suggested I feed Science Diet id (wet and dry), not sure, but will try some flavors of higher carb, lower fat content food, even though he mentioned that the jury is still out on that conversation.

Managment
Cypro for appetite stimulation
Cerenia for anti vomiting,,,we start tomorrow morning
6 pre-measured does of Buprenex (he wouldnt give me a script, but will be giving us Lantus at no charge) in case he has anotehr attack.
I have the Pepcid AC here and ready.

I have to go back tomorrow (between negotiating the bill which we will do tomorrow, and the medz, dosing and care, I was on sensory overload) to wathc a vet tech give subq fluids once and I'll get a script and keep in on hand, to use if needed.

We are waiting prior to going to steroids for treatment/mamangement as a last resort.

Hoepfully we can control this thing, so flareups and pain are on existant, if they are though we will be ready to deal with it.Frankie
 
Jill & Alex said:
hi jay. sorry to hear frankie's been having problems.

here's the link to the "feline pancreatitis roundtable discussion" sienne mentioned: http://www.idexx.com/pubwebresource...es/feline-pancreatitis-roundtable-article.pdf.

we treat alex's CP flares with:

  • 1/4 10mg tab Pepcid AC (not Pepcid Complete) given 30 minutes before meal time twice a day (every 12 hours). chase with 4ml - 6ml water.
  • 50ml - 100ml sub-q fluids administered at home daily (during a flare). if frankie has any issues with his heart check with your vet before administering.
  • 0.1ml - 0.15ml buprenex for pain every 8 - 12 hours (usually every 12 hours)
  • i do cut the fat in foods during a flare (not sure it's necessary, but figured she had nothing to lose) by mixing half of what she normally eats with half Merrick's Before Grain 96% Turkey (only 34% kcal from fat and 1% kcal from carbs).
she also gets 1 tab Denamarin with SAMe (90mg tabs for small dogs & cats) and 0.5ml - 0.7ml Super B Complex Liquid (Regular not Herbal) daily... whether she's having a flare or not. the Denamarin should be given on an empty stomach... at least one hour prior to a meal. i mix the Super B Complex Liquid in her food.

i'm also quick to up her insulin dose if necessary during a CP flare. so far, we've been able to manage at home without the use of steroids.


hope this helps...
Click to expand...

It doe34s help as now we have a sense of how to treat him when he has flare up (if he has a flare up) without running to the vet. We will use the vet as a last resort on this.
 
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