Help requested, possible pancreatitis episode happening - is it possible to manage at home?

[hellolucy]

Lucy is a diabetic and has had several bouts with pancreatitis over the past few years, but her most recent one was just before Thanksgiving via an ER visit. She was also diagnosed with a UTI (via the ER) and has been on antibiotics now for over a week. She has had multiple visits to her regular vet as well to manage all of this. She seemed to be feeling off last night, and sure enough, when I wake up early this morning to check on her and give her some food, she throws it all up. I tried giving her Cerenia but she threw that up as well (at least it looked like the pill). She is definitely feeling nauseous.

My questions are:
- I am almost positive she threw the Cerenia up, but is there any risk if what I saw was not actually a pill and I give her another dose? Can a cat 'overdose' on Cerenia?
- Is pancreatitis ever possible to 'get ahead' of or manage at home? Lucy has had a pretty intense year, and I've already taken on a fair amount of debt, and am feeling quite overwhelmed. Today is Sunday so the only option would be the ER. I have Cerenia, Buprenex, and fluids.

 

[Nan & Amber (GA)]

Oh no, poor Lucy!

I don't think I'd try giving more Cerenia unless I saw the entire actual pill in the vomit. That's just based on a general unwillingness to over-do medication, especially in little cat bodies, but perhaps someone else will be able to give more specific guidance on that. Maybe that's something to ask a vet over the phone (if they'll answer questions like that on the phone-- probably not).

As for managing the pancreatitis at home, yes, you definitely can assuming the symptoms don't get worse (and assuming that this is pancreatitis and not something else that needs a vet to diagnose/treat). The Bupe will be critical in helping with the pain, and the fluids should make her more comfortable. That plus anti-nausea meds are pretty much what the vet would be doing anyway.

The only thing you could add that you don't have now is another anti-nausea-- ondansetron is a human med that can be given at the same time as Cerenia. They work by different mechanisms, sometimes one will work when the other doesn't.

I hope she's feeling better very soon. Pancreatitis is the worst .

 

[Nan & Amber (GA)]

One other thought: some antibiotics can cause nausea. Any chance that was what caused the vomiting?

 

[JanetNJ]

I wouldn't give more cerenia until next dose, but you could give the fluids and see if the bupe helps

 

[Sienne and Gabby (GA)]

I agree with what Nan and Janet posted, I would not give more Cerenia.

This is our Primer on Pancreatitis. In most cases, you can manage this at home. You need the medications but it's not usually a condition that requires hospitalization unless there's more going on.

 

[Larry and Kitties]

How many mg of Cerenia did you administer? How much does Lucy weight?

 

[tiffmaxee]

Larry took the question right out of my mouth? Cerenia by mouth needs to be a higher dose as it doesn’t absorb as well as the injections. Unfortunately the injections sting so I refused to give them at home and let my vet be the bad guy. Depending on the dose you gave you may be able to give more.

 

[hellolucy]

The only thing you could add that you don't have now is another anti-nausea-- ondansetron is a human med that can be given at the same time as Cerenia. They work by different mechanisms, sometimes one will work when the other doesn't.

Thank you for this recommendation! I had read about ondansetron somewhere while researching pancreatitis, and will definitely need to add this to the arsenal.

I wouldn't give more cerenia until next dose, but you could give the fluids and see if the bupe helps

We did end up giving her the Buprenex and some fluids we had on hand, and she did eat more this morning (fed her in small portions spaced out) and kept it down each time, so that is a huge plus, especially because the antibiotics she is on are supposed to be given with food (what a combo this all is!). She is just laying down at the moment, so I guess time will tell how she ends up feeling. On this note, at what point can pancreatitis no longer be managed at home, and she would need to go in...I'm assuming not eating anymore, becoming very lethargic, etc.?

This is my first time not taking her in to the ER for this, so am carefully watching. I have to say that this board and all of you are lifesavers, especially these last two months between her 'new' IBD, pancreatitis, UTI...I appreciate all of your help and wisdom more than you know.

How many mg of Cerenia did you administer? How much does Lucy weight?

Her tablets say 24mg each, and the instructions advise a half dose, so 12mg. She weighs 13 pounds.

Unfortunately the injections sting so I refused to give them at home and let my vet be the bad guy.

This is really good to know regarding the stinging, as I was wondering if I should ask the vet for injectable Cerenia to have on hand just in case we are unable to give her the tablet and/or she can't keep it down, but I am guessing at that point I'd probably be off to the ER.

 

[tiffmaxee]

You were given a good dose of cerenia. I would not want to give another dose. Have you tried using ondansetron?It worked really well for Max, can bd given every 8 hours and can be given in addition to cerenia if needed.
I’ve been told if you inject cerenia into the fluid bubble it won’t sting but never tried myself. It does work faster and better when injected but I tried it and it did sting so never did it again.

 

[JanetNJ]

On this note, at what point can pancreatitis no longer be managed at home, and she would need to go in...I'm assuming not eating anymore, becoming very lethargic, etc.?

I've only had one cat that got a flare of pancreatitis. Within a few hours of her first dose of cerenia and bupe he ate and then passed out sleeping for like 4 hours straight. Poor thing was so tired from being in pain for a few days. I brought him in on his third day of not eating right so I think I caught it early. He was already on fluids because he had kidney disease so he wasn't dehydrated, we just increased his fluids for a week. He was back to himself within the week. How much fluids are you giving?

 

[hellolucy]

Have you tried using ondansetron?It worked really well for Max, can bd given every 8 hours and can be given in addition to cerenia if needed.

I haven't! Another member had mentioned this one as well, and I also stumbled across it in my research - I will definitely be asking the vet for some to add to the pancreatitis arsenal.

I've only had one cat that got a flare of pancreatitis. Within a few hours of her first dose of cerenia and bupe he ate and then passed out sleeping for like 4 hours straight. Poor thing was so tired from being in pain for a few days. I brought him in on his third day of not eating right so I think I caught it early. He was already on fluids because he had kidney disease so he wasn't dehydrated, we just increased his fluids for a week. He was back to himself within the week. How much fluids are you giving?

That sounds stressful (I feel like everyday watching these fur babies to see if they get better is an eternity), glad you were able to get him back to feeling like himself and all turned out okay!

We gave her just under 100cc's this morning. Is that an adequate enough amount to give daily during a pancreatitis flare? During her prior trip for pancreatitis, the ER vet had us giving 200 - 250 daily, but her regular vet bumped that down to 60 - 80 once or twice a week (but that was just for 'maintenance'), so I am never actually sure how much to give.

 

[JanetNJ]

I haven't! Another member had mentioned this one as well, and I also stumbled across it in my research - I will definitely be asking the vet for some to add to the pancreatitis arsenal.


That sounds stressful (I feel like everyday watching these fur babies to see if they get better is an eternity), glad you were able to get him back to feeling like himself and all turned out okay!

We gave her just under 100cc's this morning. Is that an adequate enough amount to give daily during a pancreatitis flare? During her prior trip for pancreatitis, the ER vet had us giving 200 - 250 daily, but her regular vet bumped that down to 60 - 80 once or twice a week (but that was just for 'maintenance'), so I am never actually sure how much to give.

So the rule of thumb is 10 ml per pound. You said she was 13 lbs, right?

 

[hellolucy]

So the rule of thumb is 10 ml per pound. You said she was 13 lbs, right?

Ah, good to know! Yes, 13 pounds, so it sounds like we need to bump it up a bit from her regular vet's recommendation but also below what the ER had mentioned. I would guess during a pancreatitis flare, we should probably do that daily until she seems back to normal?

I had also asked my vet previously about giving fluids once a week just as a general precaution, and they recommended against it. She does not have kidney issues that would require it. Curious if anyone does something like that on here, or if it truly is a bad idea to give fluids for general support/without specific cause?

 

[JanetNJ]

Ah, good to know! Yes, 13 pounds, so it sounds like we need to bump it up a bit from her regular vet's recommendation but also below what the ER had mentioned. I would guess during a pancreatitis flare, we should probably do that daily until she seems back to normal?

I had also asked my vet previously about giving fluids once a week just as a general precaution, and they recommended against it. She does not have kidney issues that would require it. Curious if anyone does something like that on here, or if it truly is a bad idea to give fluids for general support/without specific cause?

If there's no kidney issues then no reason to do the sub q's unless there's a flare. If your cat seems dehydrated you could probably do up to 150 ml, but 100 or 125 is good is probably good. You can check if he's dehydrated by feeling the gums. If they a dry or sticky he's dehydrated. If they are wet he's not.

 

[tiffmaxee]

I haven't! Another member had mentioned this one as well, and I also stumbled across it in my research - I will definitely be asking the vet for some to add to the pancreatitis arsenal.

We gave her just under 100cc's this morning. Is that an adequate enough amount to give daily during a pancreatitis flare? During her prior trip for pancreatitis, the ER vet had us giving 200 - 250 daily, but her regular vet bumped that down to 60 - 80 once or twice a week (but that was just for 'maintenance'), so I am never actually sure how much to give.

That’s a gigantic amount of fluids unless divided between morning and night. Max rarely got fluids for pancreatitis because he wasn’t dehydrated. Giving fluids once or twice a week for maintenance makes no sense at all. If she needs fluids during a flare it makes sense to give some every day. The moment his appetite was not normal I started giving him ondansetron and I added water to his food. I would continue cerenia until Lucy has been eating normally and not vomiting for several days. I always had nausea medication in hand.
With pancreatitis you treat the symptoms which can vary with each episode.How is she tonight?

 

[hellolucy]

How is she tonight?

She seems to be doing much better as of this morning, no more vomiting. It seems like catching it right away with the meds, fluids, and advice from all of you did the trick! She was actually playing this morning and went outside to roll around in the sun

 

[tiffmaxee]

That’s wonderful news. Keep up the support and withdraw one thing at a time in case she’s needing support and so that you know what’s needed! I always found swift support prevented bad flares.