Help! Sick kitty, Pancreatitis and IBD. Needing advice <3

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Captain Mauser

Captain Mauser

Member Since 2019
Hey all,

Mauser is an 11 yr old Siamese with a history of DKA, Renal failure stage 2, chronic Pancreatitis, IBD, and Diabetes.

He's been sick for the past 3 weeks (loose BM) so I took him to the vet to find out he has IBD (ultrasound/inflamed lining). So we changed his RX foods to try to get his recently diagnosed IBD in check. Please see thread for detailed history:
http://www.felinediabetes.com/FDMB/threads/captain-mauser-a-sick-kitty-introduction.213932/

So after 1.5 weeks on the dry food with zero improvements (Hill's Prescription Diet z/d Original Skin/Food Sensitivities Dry Cat Food) He went to the vet yesterday and it looks like its pancreatitis combined with his IBD. So our main goal is to keep him hydrated and get the diarrhea under control. With all of his complications I had to initiate a real talk conversation about when medication and hospitalization is no longer helpful for my little one. It was a really rough day yesterday.

Here is what the little guy is on starting yesterday:

-IV fluids w/medication (nausea Cerenia)
-Also added to IV fluids via catheter Metronidazole
-Buprenorphine 0.3mg/Oral
-Metronidazole 50mg /Oral (just started today)
-B-12 CYN 1000mg/weekly injection

and because he HATES the vet
-Gabapentin
@Tracey&Jones (GA) @Idjit's mom @Bron and Sheba

Thank you all so much for this information on raw brands, I'm a bit over whelmed honestly and hesitant to change his diet in the next two weeks. As we are monitoring his BM and watching for improvements, I'm worried another food change would make things worse(?). Our hope is with the steroids and back on his regular RXfood to get the diarrhea/dehydration under control.

@Idjit's mom @Bron and Sheba

He gets cow heart as a treat from time to time and LOVES it so I think he'd eat raw. Cooked turkey he's picky about...especially now.

@Tracey&Jones (GA

Yes! He was prescribed one. Its not on his print out as it hasn't been administered or sent to the drug store yet. I just emailed them to confirm the name so I can post it here.
 
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Jones was on metronidazole, helps stop diarrhea and is actually an anti-biotic. Jones was on that long term so I ended up supplementing with the pro-biotic I told you about in the other thread. If you can get him off the metronidazole and use the saccharomyces boulardii instead- it is a more natural anti diarrhea method but if the metronidazole works - don't worry about keeping it long term.

Cerenia, helps with nausea, Jones was also on this one long term. He never could go off it due to the pancreatitis, I tried to go every second day but then he just puked every second day.

Buprenorphine is a pain relief. This is good to have on hand in case he has a pancreatic flare. I would see if you vet is willing to give you some to have on hand once Mauser is over the immediate and home care takes over. I didn't have any to start but had it on hand at the end. It helped his quality of life and I think extended it.

Gabapentin is like a mild sedative for cats, also seems to help with pain for some. Jones was never on that as he was an absolutely wonderful patient at the vets and at home.

B-12 - very important for the IBD/pancreatitis patient. The B12 is used in the process of nutrient absorption during digestion. Jones was on a maintenance dose for over 2 years after his initial diagnosis. This should be a regular item checked on the blood work that is done as you move through the process.

Fluids - I ended up giving Jones fluids at home at the end. When he had a bad bout of the runs, I would give him some fluids to keep him hydrated.

Steroid - they will either offer Prednisolone or Budesonide. Pred is known to cause increased glucose (it did with Jones), bude can go either way. The steriods may cause Mauser to be more difficult to regulate. Just a note before you start the steroid, if you want to do a biopsy now to determine if it is SCL (small cell lymphoma) vs. IBD you will need to do that procedure before you start the steroid therapy. Any medication before the biopsy will skew the results. You may want to discuss that with your vet. I opted out of the biopsy as Jones was in such rough shape at the time of dx but I wish I would of understood the impact of that decision. As his IBD most likely progressed to SCL, however due to being on the steroids I couldn't get an biopsy at that point without taken him off the steroids for at least 2-3 weeks, which of course I wasn't going to do at that point.

I can tell you that Jones was first diagnosed in Aug 2016 and it took me about 3 months to stabilize him. He was 4.1kg and should of been 5.5kg, puking everyday, liquid poo and dropping weight every time you looked at him. Took another year to get him back to a ideal weight.

What insulin do they have Mauser on? Or is he getting any at this point?

Just a note on the food - watch anything with chicken in it...no matter how small of an amount. Chicken is in almost every cat food and is the #1 food allergen per my vet. It is hard with IBD as you need to take food changes slow but if something isn't working you need to make fast changes. It is a fine line on that.

You can do this, a lot of people have here and have some great advice.

Some sources https://www.ibdkitties.net/; https://groups.io/g/Feline_Smallcell_Lymphoma
 
I have no experience with pancreatitis let alone pancreatitis combined with IBD, but cats are more resilient than most vets give them credit for, and I think in this kind of cases the best you can do is try and get them out of the emergency that would be to a point where maybe you can keep him at home with subq's instead of IV fluids and him eating something that more o less doesn't make the problem worse and after that then try and get each of the problems back in control,
 
Tracey&Jones (GA) said:
Just a note before you start the steroid, if you want to do a biopsy now to determine if it is SCL (small cell lymphoma) vs. IBD you will need to do that procedure before you start the steroid therapy.
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Yes I spoke with the Vet about this and also doing a chest xray (he is wheezing and they think there could be any number of issues) I have opted out of pursing further tests I just dont have the funds for it :(

Tracey&Jones (GA) said:
What insulin do they have Mauser on? Or is he getting any at this point?
Click to expand...

He is on lantus, We went from 1 unit slowly up to his current @ 4.5, its high (before he was sick this amount was helping with his water intake and output and hunger was regulated. Theres is more info in the linked thread on this as well) and the vet is concerned that the "gastro issues" he has is causing the insulin to be ineffective.
 
Tracey&Jones (GA) said:
Just a note on the food - watch anything with chicken in it...no matter how small of an amount. Chicken is in almost every cat food and is the #1 food allergen per my vet. It is hard with IBD as you need to take food changes slow but if something isn't working you need to make fast changes. It is a fine line on that.

You can do this, a lot of people have here and have some great advice.

Some sources https://www.ibdkitties.net/; https://groups.io/g/Feline_Smallcell_Lymphoma
Click to expand...

This is good to know about the chicken, I plan on switching him over to raw perhaps in a few days or a week it just depends...I think you placed up suggestion in the other thread? I will have to go there when I get home and re-read your lovely advice.

this as well

"Jones was on metronidazole, helps stop diarrhea and is actually an anti-biotic. Jones was on that long term so I ended up supplementing with the pro-biotic I told you about in the other thread. If you can get him off the metronidazole and use the saccharomyces boulardii instead- it is a more natural anti diarrhea method but if the metronidazole works - don't worry about keeping it long term."

This is helpful to know, thank you for this

Also your poor little nugget kitcat!
 
My vet recommended pancreatic enzymes to help my kitty with pancreatitis. He had a flare up when I tried to switch from Purina dm to Tiki cat chicken. I thought maybe the Tiki cat was more difficult to digest.
 
I’m sorry Mauser is so unwell with pancreatitis again. I’m sure you had a tough day talking through all the scenarios. It’s a horrible illness for them but as Veronica said cats are very resilient especially with the correct treatment which Mauser seems to be getting. I hope you can get the diarrhoea under control. Don’t forget to try the pumpkin. Sheba had numerous pancreatic flare ups but I found being prepared with things at home very helpful because these things often flare up when the vet is closed.
Keeping the meds going at home until he’s better is important. Don’t stop the anti nausea meds too soon.
Try and have cerenia and ondansetron (another antinausea med) at home, some oral pain relief, and ask about doing subQ fluids at home for when you need them.

There are other meats to try apart from chicken and turkey. I use lamb, pork, veal, beef.
When you get a chance, can you set up you signature. It is easy. Just go to your username at the top right of this page and click on it. Choose signature. Tell us yours and Mauser name. Date of diagnosis (Dx), type of insulin and meter, other health issues and meds, diet and weight. Then save. There’s only limited space so abbreviate where possible as you have quite a bit to put in.
Please keep us update on how Mauser is going. Wishing him a speedy recovery.
 
Margie and Jackson said:
My vet recommended pancreatic enzymes to help my kitty with pancreatitis. He had a flare up when I tried to switch from Purina dm to Tiki cat chicken. I thought maybe the Tiki cat was more difficult to digest.
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Pancreatic enzymes should never be given to a cat that has not been diagnosed with exocrine pancreatic insufficiency (EPI). That requires a a GI Panel through Texas A&M University.

Pancreatic enzymes are very caustic; they can cause additional issues if not given correctly and they will not help a cat that doesn’t have EPI. Digestive enzymes are different and are very warranted for every cat and even specially cats with IBD.

I would just add that ondansetron (zofran) is better for nausea but it works great when given in combo with cerenia as they address nausea from different modalities.

As stated above, digestive enzymes are helpful. If you are on Facebook, there are two great IBD groups: IBDKitties and Raw Feeding for IBD Cats. You don’t shoe to be feeding raw to join the latter although raw can really help these kitties.

The last thing is if his Vitamin B12 levels are normal and he doesn’t have EPI or hyperthyroidism, Saccharomyces boulardii is a great probiotic to give for diarrhea. Probiotics, in general, are good for cats to have but S. boulardii really helps with diarrhea.
 
Bron and Sheba said:
@Marje and Gracie thanks for adding your very helpful knowledge of this. I wasn’t sure you’d be around but knew you’d be able to help :bighug:
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It really is helpful, thank you both for weighing in on this
Marje and Gracie said:
I would just add that ondansetron (zofran) is better, for nausea but it works great when given in combo with cerenia as they address nausea from different modalities.
Click to expand...

This is great to know, he only had the cernia via the IV and hasn't had it since. Have you any experience with using pepto bismol and kitty's? I've had a few vets mention it but have yet to try it..makes me a bit nervous. I'm assuming its best for emergency scenarios? If I dont have anything on hand?

He isn't experiencing such a high lvl of diarrhea, however (i think) that's mostly due to the metronidazole that he is on and has been on since wensday last week. The plan is to stop it in about 6 days and hopefully once he's on his steroids it will help keep him at this stage of comfort.

Marje and Gracie said:
As stated above, digestive enzymes are helpful. If you are on Facebook, there are two great IBD groups: IBDKitties and Raw Feeding for IBD Cats. You don’t shoe to be feeding raw to join the latter although raw can really help these kitties.
Click to expand...

I'm planning on going raw, its intimidating but it sounds like a great idea after we stabilize him a bit.

Marje and Gracie said:
The last thing is if his Vitamin B12 levels are normal and he doesn’t have EPI or hyperthyroidism.
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Unfortunately his B12 levels aren't at a healthy lvl, he has been prescribed B12 Cyn 1000mg to be giving weekly.

Getting you the test results would be really helpful, however the printer @vet is down from a recent storm and it wont connect to the network :(
 
Captain Mauser said:
This is great to know, he only had the cernia via the IV and hasn't had it since. Have you any experience with using pepto bismol and kitty's? I've had a few vets mention it but have yet to try it..makes me a bit nervous. I'm assuming its best for emergency scenarios? If I dont have anything on hand?
Click to expand...
I would never give Pepto Bismal to a cat. There are too many species appropriate options.

Just remember when you transition to raw, you need to do it very slowly.
 
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