Help! Kitty with Pancreatitis won't eat. Stomach swollen!

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Claic

Claic

Member Since 2016
Hello everyone, sadly two days ago our Luna came down with Pancreatitis and stopped eating after throwing up white foam several times we decided it was time to hit the vet up. I'll give you guys a time frame and the medicine he is currently on:

1st Vet visit (Feb. 2): Bloodwork/X-ray, Pancreatitis diagnosed. FortiFlora Feline, Dexamethasone, Cerenia, and some B12 vitamens. We were told to contact the doctor if he didn't start eating on his own. We are given special Royal Cain recover food to try and have him eat, he would not sadly. When he arrived home he ate somewhat like normal and then again just once more in the middle of the night. He doesn't eat again really at all so we call the Vet.

Luna Update: Luna is acting normal besides not eating and being a little lethargic. He will drink water but not much and hasn't went number 2 yet. He has peed twice at this point.

2nd Vet visit (Feb 4-5): This was an overnight stay for poor Luna so with heavy hearts we left him for his slumber party. After about 1.5 days the doctor said we could bring him home and see if he will eat here because he is stressed there. They were syringe feeding him often and gave him Mirtazapine for appetite, Diazepam, and some more Cerenia.

Luna Update: Luna at this point does not eat on his own but we syringe feed him maybe 23 ML. We had no idea at this time what exactly the massive amount we needed to give him or that we were falling so far behind. After reading several other stories I see I need to be hitting him up with a can, or around 168 ml, at least!

3rd Vet visit (Feb 6): We are worried with him not eating on his own and not drinking enough so we return that morning to our vets for tests to rule out possible fatty liver etc. After blood work it is revealed that he is fine in all categories besides the pancreatitis one. The vet fears Pancreatic cancer at this point. After another X-Ray and Ultrasound it is revealed that his stomach is somewhat bloated, with air from not eating, but also that there is some sort of white stuff around his belly. The vet said it wasn't fluid but rather inflammation? She then told us that although she couldn't see a tumor or growth that it was the best possibility. Comparing it to the Feb 2 X-Ray the stomach looks much more full of air along with the white stuff being all around the outside. We are given a 15% chance that it isn't cancer and sent out with Metoclopramide, some Sub Q fluid to do over the weekend, and heavy hearts.

Luna Update: Since returning home we have been syringe feeding him every hour to two and trying to get him up to the amount needed. We are not giving up on him as I somewhat believe it may be the 15% chance and just his Pancreas being extremely inflamed and swollen because she did not see a growth due to the Xray being covered in the weird whiteness. He is actually being more affectionate now and seems to be perking up! I am going to try my damnedest to get this little guy healthy I just need to understand the xray....Can anyone help me with the below picture of Luna's Xray from today and maybe give me a second opinion? I did not get his Feb 2 Xray but at the bottom of his belly that white like foamy stuff is what we have no idea what it is and it wasn't there Feb 2. All help is needed and just looking for something to do! Thanks everyone!
 

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I do not recall seeing whiteness like shown.
What did the ultrasound show about the pancreas?
What is the last time Luna had a bowel movement? He looks backed up
 
Claic said:
We are given a 15% chance that it isn't cancer and sent out with Metoclopramide, some Sub Q fluid to do over the weekend, and heavy hearts.
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Hi,

I'm sorry that Luna is having such an awful pancreatitis flare. They are tough going. :bighug:

Ask your vet about prescribing generic ondansetron for nausea. Metoclopramide isn't much use in the treatment of nausea in cats because they have very few of the receptors it targets. It might also be worth asking your vet about cyproheptadine for appetite stimulation. A weekly course of B12 cyanocobalamin injections are a great general boost (and may help appetite). Famotidine can also help to control stomach acid. You'll find lots of information on treatments at the following link:

IDEXX Pancreatitis Treatment Guidelines

Also try feeding something bland and easily digestible. When Saoirse had a bad flare I fed her very small meals every hour. During the worst of the flare I gave her home poached chicken (in water only). I gave it to her either finely minced with some of the poaching broth and water, or blended with broth and water to a soupy consistency. Keep the poaching broth and use it to flavour Luna's water (50:50 mix will help you stretch the broth further). It can be a great aid to keeping a cat hydrated. Timed feeders are a godsend for overnight feeding (e.g. Petsafe 5).

Raise Luna's food and drink bowls up a few inches; it can help greatly when a cat is nauseated.

Here are some useful links:

Nausea Symptoms and Treatments - learn the signs of nausea, as they will help you to help Luna better. If you stay on top of the nausea it's half the battle.

Watch Luna with the FortiFlora. See if he shows any signs of nausea. There have been human studies which suggest it may not be a good thing to give probiotics to humans with pancreatitis. Saoirse certainly can't tolerate it. If you're only using it to tempt him to eat, try using some crumbled up freeze-dried chicken treats on top of his food to whet her appetite. Sometimes if you can get a cat to eat a few protein treats they may eat a bit of their normal food after. More tips on persuading a cat to eat at following link:

Persuading Your Cat to Eat - sleepy eating is a good trick.

Sorry I can't write more at this time. My own cat is quite poorly at the moment. If you look in the FAQs you should find a pancreatitis primer. Also if you search my post history you may find additional info on pancreatitis and nursing through a flare.


Mogs
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Thank you so much Critter Mom I have read several stories on this site and I have seen how much you help everyone I appreciate it greatly. I am sending good vibes Saoirse's way and hope for better health!

Larry and Kittens, from what we know it has been several days. However comparing the Feb 2 graph to the one we have now the bowls are moving stuff along so not sure if we missed him going or not! The vet told us the ultrasound was hard to see due to the pancreas being so swollen, not much information given. We are seeking a second opinion come Monday.

Squeaky I appreciate the support! We are trying our best and love that this community is so strong!
 
Thank you for the good vibes for Saoirse. My little one needs all of them she can get and they're really helping both of us.

I hope Luna feels better soon. :bighug:

.
 
Is Luna diabetic (helps us know if he needs to stick to low carb foods and if we have the added worry about diabetic ketoacidosis) and where are you located? I'm only asking the latter question because there is a difference of availability of drugs depending on where you live.

There is a lot of valuable information within this Primer on Pancreatitis including a video on how to give subq fluids at home since your vet prescribed them.

Yes, you do need to get calories in him but I agree with Mogs that it should be small amounts over the day. The suggestion for ondansetron is a good one to discuss with your vet because ondansetron and cerenia can be used together as they provide different modalities to address nausea and a nauseated cat is not going to eat. I also agree that the cyproheptadine is generally better as an appetite stimulant than mirtazapine because you can give it more often and you might only need a sliver. But the nausea must be addressed first.

I'm not qualified to read X-rays so couldn't begin to guess what they mean. I'll check back in a bit to see your answers and then I might have other thoughts as well.
 
Claic said:
However comparing the Feb 2 graph to the one we have now the bowls are moving stuff along so not sure if we missed him going or not!
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Secondary monitoring is invaluable when going through a pancreatitis flare. Keep a log of how much food and water (especially water) Luna is managing to get down. Also, keep track of how much he pees (clumping litter's good for this) and keep a record of the appearance and odour of stools plus the time they were produced. It'll help you to know much better what's going on.


Mogs
.
 
Hey guys I am located in West Virginia. He is not diabetic and didn't show it in his two blood works. We are currently feeding him 13 ML every hour or so with a break around 6 ML for 5 to 10 minutes in between. Luna will rush to the restroom and pee or at least throw litter around after each feeding and then drink water. His butt was very wet after the last one but it didn't smell like pee to us even though it clumped. Can the sub q fluid cause the pee to just not smell like normal cat pee?

He has not went number 2 in quite sometime and I wish he would because I feel like it would help tremendously.

On the day we are at about 30 ML of Royal Canin Recovery with our goal to get him at about 160 or so before bed. When he went for his water he did go to the dry food next to it first smell for a while then drink lots of water.

Thanks guys I hope I got everything.
 
He also doesn't ever seem to be able to get comfy. He is constantly rotating and moving around you know? That's like the most heart breaking right now for me...
 
Claic said:
His butt was very wet after the last one but it didn't smell like pee to us even though it clumped
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Only conjecture, but it might be watery diarrhoea.

I feel for you seeing your little one so uncomfortable. Going through similar here right now.

:bighug:
 
There seems to be a lot of stool in his intestines on the x-ray. If there is a constipation issue on top of the pancreatitis this would really be a barrier to him eating. Sometimes with obstructions, you'll get some watery liquid stool leaking around the blockage. Maybe ask about miralax, and keep a close eye on the litter box. The metoclopromide will also help move things along, but has some neurological side effects.

Do you have recent labwork too you could post?
 
I just had a friend of my sisters, who is a vet, look at the xrays and they are saying the same thing. He needs to un pack that colon of his. Is this hard to accomplish? I was told to get a baby sepository to help him along.

Also should I not use metoclopromide? I don't want to damage him anymore you know?

Thank Thank thank you guys so much. This guy was brought in off our front porch and was homeless his whole life. He even had his ear clipped to show neutering. He has had a really tough life....let's make it longer and better!
 
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As for the labwork I have no actual copies of the results however I will be getting them Monday! I sure can rub his belly he doesn't mind at all. I think we are going to go with that baby suppository, if he can handle it, and go from there. Monday we will be going to a vet about 20 minutes away to attempt and get a fresh set of eyes on his case since the family friend said different.
 
Here are his lab results from the 2nd:


WBC 8.05 10^9/l 5.50-19.50
LYM 1.07 10^9/l 1.50-7.00
MON 0.35 10^9/l 0.00-1.50
NEU 6.57 10^9/l 2.50-14.00
LY% 13.3 % 0.0-100.0
MO% 4.3 % 0.0-100.0
NE% 81.6 % 0.0-100.0
RBC 9.06 10^12/l 5.00-10.00
HGB 13.5 g/dl 8.0-15.0
HCT 39.11 % 24.00-45.00
MCV 43 fl 39-55
MCH 14.9 pg 12.5-17.5
MCHC 34.4 g/dl 30.0-36.0
RDWc 19.6 % 0.0-0.0
PLT 99 10^9/l 300-800
PCT 0.13 % 0.00-0.00
MPV 13.1 fl 12.0-17.0
PDWc 38.4 % 0.0-0.0

ALB 3.1 g/dL 2.2-4.4
ALP 47 U/L 10-90
ALT 58 U/L 20-100
AMY 1377 U/L 300-1100
TBIL 0.3 mg/dL 0.1-0.6
BUN 25 mg/dL 10-30
CA 9.5 mg/dL 8.0-11.8
PHOS 4.1 mg/dL 3.4-8.5
CRE 2.1 mg/dL 0.3-2.1
GLU 195 mg/dL 70-150
NA+ 142 mmol/L 142-164
K+ 4.8 mmol/L 3.7-5.8
TP 8.2 g/dL 5.4-8.2
GLOB 5.1 g/dL 1.5-5.7
Suffix QC OK <br />HEM 1+ LIP 0 ICT 0 -
 
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Just to keep you guys updated I didn't use the actual baby suppository but instead used a warm water enema that we made with KY Jelly and just warm water. I only got about 5 ml into him before he was upset and nothing else would really go in. I was shooting for 7-9. I am going to give it an hour or two and see what happens.
 
Also how much food in CC or ML should I be trying to make him eat? Just need reassurance....
 
jayla said:
will he let you massage his tummy/bowel area at all? Tara recently had some issues with Ivana being blocked up, I will tag her, maybe she can help :)
@Tara & Ivana
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Poor Ivana had terrible problems with constipation last month. Long story short, she ended up having to have two vet-administered enemas (we tried and failed to do it at home), and we added some supplements to her diet - 1tsp pure mashed pumpkin added to one meal per day, 5ml slippery elm bark slurry added to one meal per day, 1/8t Miralax added to two meals per day. Of course, lots of water available - we added an extra bowl of water in the room she spends a lot of time in.

Good luck to poor Luna, it sounds very stressful for you at the moment - paws crossed for a quick recovery.
 
Thanks so much for the information! Did she use the kitty box directly after the vet enemas? Also was she eating even with the constipation?
 
Claic said:
Did she use the kitty box directly after the vet enemas?
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Yes, she pooped in less than a minute after the enema. The vet only just had time to put her in the litter box!

Claic said:
Also was she eating even with the constipation?
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Yes she was still eating. No idea what was happening to the food because it was going in one end, and not coming out the other. She had no symptoms of feeling awful from the constipation.
 
Update:

We took him to an Emergency Clinic and they decided to give him an enema there. He did have a bowl movement and the first few that came out were hard as rock so its great that he is going now. We are still now in the same position waiting on him to eat on his own. At what point do you guys think we should be considering a feeding tube? Thanks all.
 
Not sure if this is a prelude to megacolon or not. If his stomach distends any more, he may have a blockage or a bowel folding in on itself...in that case you need to get him to the vet before a portion of his intestine loses circulation. Please please, if he gets ANY WORSE, get him to the vet ASAP. It could save his life.
 
A typical weight and activity cat needs about 200-300 calories a day. That's about 1 5.5 oz can of food for most brands. I'd try syringe feeding first before feeding tube, and you liver values are still looking ok. Also enemas only help blockages from the low end of the intestine. Something like miralax and the metoclopromide will help things move along higher up. The metoclopromide isn't the ideal medication because of side effects, but one or two doses might really wake your cat's GI system up. It's a very effective medication.
 
I’m glad you got an enema through the vet. That is the best course of action. Constipation can cause a lot of the symptoms you are describing. Here is a great website on Feline Constipation.

His labs look pretty good although his creatinine is pushing the upper limit. I would definitely be keeping an eye on that in the future regarding potential kidney disease. If he’s getting a lot of fluid, it will cause his urine to be less concentrated so it will not smell as strongly. I also think if you can syringe feed him 200-300 calories per day, then you could just take it day by day on the feeding tube. Just try very hard to not water the food down very much at all.
 
Thanks for the help everyone Luna did throw up earlier today for the first time since being diagnosed with Pancreatitis, he threw up before hand which is why we took him in.

What is a good naseua medicine I should get from my vet? Sorry if it's been posted but I keep getting "bad side effects" from the medicine they gave me now.
 
Constipation can cause nausea and vomiting. I believe you said they gave him cerenia? While cerenia is excellent for vomiting, and can treat nausea, I prefer ondansetron (typical dosing is 1/4 of a 16 mg tab twice a day) but you will have to get a prescription from your vet as it is a human drug and it’s not cheap. Best to get it at Costco if you have one. You can also get some pure slippery elm bark powder from a health food store. Be sure it is loose powder and make sure it’s organic. You only need a tiny bit....1/8 of a cup will work. Then mix 1/4 tsp of SEB powder with 1/2 tsp of purified water and get it to a little more liquid stage than a slurry. You want to be able to syringe it but not get it too liquidy. You can give him this 2-3 times a day separated from meds by either giving it two hours before meds or 1 hour after. It helps to soothe the digestive tract and could also help with the constipation a bit.
 
We are about to attempt the syringe feeding again today start here in an hour or so and keep it up for 12 hours at 13 ML every hour. If this sounds good we will have him at 168 ml which is around 5.68 and where we need to be.

Quick question though if he throws up again after feeding what do we do? Continue the feedings anyway?
 
Also Luna's butt is still somewhat "leaky" everywhere he goes he is leaving a little bit of wet gross. My wife picked him up and I cleaned his bottom and saw it like leaking a bit. What does that mean? Is that just a side effect of the enema?
 
It means there's something blocking the passage of stool. The leakiness is from the body trying to flush out the obstruction. Sort of like when a plumber flushes out a drain pipe.

I can't remember..did this cat get Xrays to see if there's a foreign body in his gut?

This is real important. Is the stomach any more distended? Can you 'thump' it, with your finger, and hear a sound sort of like when you thump a football or other hollow ball? If there's a blockage his stomach or intestines could rupture. If a portion of his bowel has gone septic, the tissue will die. There's a condition called megacolon..ask your vet if it could possibly be this condition. Please go here and read. Please read this also.

Also, please make an "in and out" notation when you feed him. How much food he's been given, and how much, if any, he's thrown up or passed out. Weigh him. A baby scale works great..a big scale that you stand on, will have too much 'flux'..it won't be nearly as accurate.

And if he can't rest..if he's pacing, getting up and lying down, more than he normally would with a tiny bit of gas...if he starts to cry or scream..if he starts to pant..get him to the vet..NOW. Make them listen. I don't mean to sound curt..but this could be extremely serious..
 
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Yes I have linked the xrays in ny original post. He was being very restless until the enema and now he sleeps well. He did not throw up after his first feeding today but we only got 8 ml in before he started to really squirm to get away.
 
Ask your vet about using miralax to help the constipation. The metocopromide can cause abnormal movements called tardive diskenesia because it acts on the dopamine system. These can be permanent when this medication is used for a period of time. One time or two time use should not cause these symptoms, and may be very helpful in your situation. I would however, avoid using this med for more than a couple days.

The miralax should help soften things up and move them along. You can also use plain canned pumpkin that will soften things up as well.
 
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