Mild pancreatitis, BS numbers are now high again, He's really not feeling well. Not sure how to help

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Sudio3

Sudio3

Member Since 2019
Hello,
Nudi has been in remission from diabetes for a little over 3 months. He was diagnosed with "mild" pancreititis about a month back but was still in remission. I had the vet give him a shot of pain meds for the pancreatitis but it just made him loopy and his eyes were dilated and he didn't seem like himself so I didn't give any more pain meds after that. It honestly didn't seemed like it helped much. He's always eaten so I didn't give him anti-nausea meds and he didn't seem dehydrated so I didn't get him fluids. I got an ultrasound a few weeks ago of his belly and nothing was found to be a problem. They did say his liver was a little enlarged but weren't concerned. He now has a drippy left eye and is limping on his right leg pretty badly. I have a vet appointment on Tuesday and I'm going to try to get this changed for Monday. Last night his sugar was 295 and tonight was 250 (when he was in remission it was always in the 100's). He seems like he is definitely not feeling well and he looks in rough shape too. I'm wondering if I should give him a low dose of insulin (.5?) to see if that helps him feel better? Also how do I know if his pancreatitis has gotten worse? Does this go into remission? The previous labs to test for pancreatitis were really expensive. I was under the impression that there were flare ups but then it would go away? Thank you for any information you have that may be helpful.

I wanted to add the pain med that was given was liquid Buprenex .2 twice a day (he only got one dose) and also that I have been giving him b12 shots for 6 weeks (we are on week 5) and it seemed to be really helping.

Thank you!
 
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I would try to move up your vet appt. before resorting to insulin. The drippy eye makes me wonder if he has an infection of some sort. Definitely have the vet check his teeth as sometimes runny eyes are a symptom of dental problems given the anatomy of a cat's skull.

Chronic pancreatitis will come and go and could also cause elevated BG but if Nudi is still eating and doesn't seem to be in pain, then whether that's at play or not is questionable.
Not sure what to make of the limping. Is it possible he twisted his leg jumping or landing? If the leg is inflammed and causing him pain, that too could cause elevated BG.

Please keep us posted.
 
Hi and welcome.

Bupe can make them loopy.. .that happened with my Sheba. You may have been given too big a dose.
I'm not sure what the dose strength is in the US so I don't like to comment on what amount to give.

I would also move up the vet apt and I would get a snapfPL pancreatitis test....they are not usually all that expensive I didn't think.

Looking at the SS it looks as if you did not go down to a lower dose beforehand stopping the insulin.it is really important to keep giving insulin until you are getting low numbers for at least a week and then going onto a 14 day OTJ trial. You need this for a strong remission.

I would not start insulin yet before seeing the vet. BUT I would test for ketones in the urine until you see the vet. If you dont have any Ketostix at home I would buy a bottle from Walmart of a pharmacy and test the urine. Just collect a urine sample and dip the test strip on and read exactly 15 seconds later against the colours on the side of the bottle. Anything above a trace needs vet attention.
 
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Pancreatitis can make a kitty feel awful. It is terribly painful. If they were saying it was a mild case, it may have gotten worse. There are 2 ways to test for pancreatitis. There is an in-office test called the Snap fPL, which Bron mentioned. It's like a pregnancy test -- you get a + or - result. The Spec fPL is sent out to a lab.

This is information on pancreatitis that one of our members, Marje (& Gracie) put together.
 
MrWorfMen's Mom said:
I would try to move up your vet appt. before resorting to insulin. The drippy eye makes me wonder if he has an infection of some sort. Definitely have the vet check his teeth as sometimes runny eyes are a symptom of dental problems given the anatomy of a cat's skull.

Chronic pancreatitis will come and go and could also cause elevated BG but if Nudi is still eating and doesn't seem to be in pain, then whether that's at play or not is questionable.
Not sure what to make of the limping. Is it possible he twisted his leg jumping or landing? If the leg is inflammed and causing him pain, that too could cause elevated BG.

Please keep us posted.
Click to expand...
Thank you. He definitely does seem in pain but he is eating and doesn't seem dehydrated. I will definitely have the vet check his teeth and also check for pancreatitis. Yes, I do think he probably injured his leg while jumping off of something. I'll have the vet look at that too. Thank you so much I seriously appreciate the help.
 
Bron and Sheba (GA) said:
Hi and welcome.

Bupe can make them loopy.. .that happened with my Sheba. You may have been given too big a dose.
I'm not sure what the dose strength is in the US so I don't like to comment on what amount to give.

I would also move up the vet apt and I would get a snapfPL pancreatitis test....they are not usually all that expensive I didn't think.

Looking at the SS it looks as if you did not go down to a lower dose beforehand stopping the insulin.it is really important to keep giving insulin until you are getting low numbers for at least a week and then going onto a 14 day OTJ trial. You need this for a strong remission.

I would not start insulin yet before seeing the vet. BUT I would test for ketones in the urine until you see the vet. If you dont have any Ketostix at home I would buy a bottle from Walmart of a pharmacy and test the urine. Just collect a urine sample and dip the test strip on and read exactly 15 seconds later against the colours on the side of the bottle. Anything above a trace needs vet attention.
Click to expand...
Thank you. If he does still have pancreatitis I'll ask for a smaller dose or maybe even try another med. I will ask the vet about the snap fPL test thank you. The test I originally got was $200 and I can't afford to spend that much on a regular basis to keep checking him. So good to know there is another option.

I will hold off on the insulin for now. Yikes I did not know that about the remission. I hope I didn't do much damage. Nudi HATES using the litter pan inside but now that he is not feeling well he may just use it so I will do my best to test for Ketones. Thank you I really appreciate the help.
 
Sienne and Gabby (GA) said:
Pancreatitis can make a kitty feel awful. It is terribly painful. If they were saying it was a mild case, it may have gotten worse. There are 2 ways to test for pancreatitis. There is an in-office test called the Snap fPL, which Bron mentioned. It's like a pregnancy test -- you get a + or - result. The Spec fPL is sent out to a lab.

This is information on pancreatitis that one of our members, Marje (& Gracie) put together.
Click to expand...
Thank you so much. I will definitely ask for the Snap fPL really good to know there is an inexpensive test available. I will also check out that info on pancreatitis. Thank you! Really appreciate it.
 
MrWorfMen's Mom said:
I would try to move up your vet appt. before resorting to insulin. The drippy eye makes me wonder if he has an infection of some sort. Definitely have the vet check his teeth as sometimes runny eyes are a symptom of dental problems given the anatomy of a cat's skull.

Chronic pancreatitis will come and go and could also cause elevated BG but if Nudi is still eating and doesn't seem to be in pain, then whether that's at play or not is questionable.
Not sure what to make of the limping. Is it possible he twisted his leg jumping or landing? If the leg is inflammed and causing him pain, that too could cause elevated BG.

Please keep us posted.
Click to expand...
Also, yes I will keep you posted. I will let you know what happens at the vet. Thanks again.
 
The SNAP fPL is good in that it is in office but the problem with just doing SNAP fPL vs Spec fPLI is only the Spec fPLI will determine the level of pancreatic lipase elevation. It is needed to help determine if it is getting better or worse, whether it is mild or moderate. The reliability with it is better with moderate to severe pancreatitis but it is also reliable with mild cases.

The fact that the liver was slightly enlarged is a concern. A significant number of cats with chronic pancreatitis also have IBD & inflammation of the liver—called triaditis (https://www.ibdkitties.net/feline-triaditis/) It is not uncommon for IBD to be missed on ultrasound, especially if it is more mild at the time of the US.

Pancreatitis is extremely painful so it is important to manage the pain even if there are side effects from the pain medication. Ultimately, getting the inflammation under control is key. It may require diet change & in some cats, diet change will not be enough so medications will be required.
 
Hello everyone, so here is an update. I got the SNAP fPL test and it showed that he does not have pancreatitis? I got the Spec fPl originally and that showed he had mild pancreatitis. This time I got he SNAP and it showed no pancreatitis? So does this mean he does not have it?

TSP thank you for the info. Yes the ultrasound we got did NOT show any IBD. I wonder if it was missed? I will look into your link regarding the enlarged liver and triaditis. Thank you. I had blood work done as well and his liver blood work was normal?

Nudi also has very bad arthritis so I would like to put him on pain meds for that as well. The vet offered these options, liquid Buprenex (I originally tried him on .2, I can't remember if the vet gave him a shot or if he did the liquid in his cheek, but it was too much he was loopy and eyes were dilated it didn't seem like it helped.) So I can try this again at .1 or lower or the vet offered Gabapentin or injectable Adequan she said it's labeled for dogs but that it's also used in cats. Does anyone have any opinions on which to take? Hopefully if he's on the meds he'll not only feel better but his sugar levels will go down too they have been in the mid 200's. Will he need to be on pain meds for the rest of his life?

Also if Nudi does have IBS and pancreatitis does anyone know what the best food for him would be? Right now he has FF classic pate and also Tiki velvet. I was going to try and switch him to Primal freeze dried nuggets but he's doesn't seem interested. Right now I'm taking half a nugget and sprinkling it on either his FF or Tiki Velvet.

Thank you all again!! I appreciate the help so much!
 
I also wanted to add that Nudi love PureBites Salmon freeze dried treats. I give him a lot of these. I also wanted to ask about giving him antibiotics? If he has a bacterial infection in the liver maybe this would help? Also what about steroids? My vet was very against steroids when I brought it up. Thank you!
 
I forgot to mention he was tested for Keytones and does not have them and his teeth were also fine. We ended his last B12 shot (we did 6 weeks one shot a week) and now per the vet will are giving a B12 shot once a month. He did lose a pound since his last visit in August and has more arthritis. Arthritis used to be only in his elbows now it is also in his knees and hips but not as severe. The Xray report said this about his liver in case this gives any info "The liver is enlarged with a rounded caudoventral margin" Thanks again!
 
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