Munchie- pancreatitis attack

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ewest

Member Since 2011
Hi All- Munchie seems to be having a panc attack. She's had once daily bile throw-ups starting on Thursday when we started the Levemir. She got Cerenia today and I already give Pepcid BID. I also gave her fluids daily (except Saturday) and was going to give more tonight. Her behavior actually wasn't affected until today where she seems more punked out and wanting to rest and much less appetite. Even though the insulin change shouldn't cause this directly- maybe the change was an extra stressor- and the fact that she isn't controlled with her blood sugar. Prayers that she will feel better soon. Thanks.
 
Oh no, poor Munchie. I hope she feels better soon! Sadly I've been through this countless times with my Harley and (civie) Princess and can totally relate. It sounds like you have things well in hand with the meds. Do you ever use buprenex for pain? I've found that a low dose (less than what the vet prescribes) can sometimes be helpful.

I have not tried this myself yet for my kits but I've been reading up on information from another diabetic cat Web site and L-Carnitine can be given as a daily supplement with the intent to help prevent pancreatitis attacks. (It must be L-Carnitine, not D-Carnitine or Acetyl Carnitine both of which are unsuitable for cats.) It is an amino acid that helps the digestive system break down fats to process them better. I guess it's another take on the limiting dietary fat concept except that instead of limiting dietary fat, it's given to help the cat better digest the fats they are ingesting so as to lighten the load on the pancreas. The recommended daily dose is 250 mg and apparently Nature’s Way has a suitable L-Carnitine product for cats available through Vitacost at a very reasonable price. I might give this a try so I thought I'd share in case you find it helpful.

Prayers and healing light are on their way. Here's hoping she feels better soon! cat_pet_icon
 
yes, pain meds are needed as pancreatitis is very painful.
If you can, it would be an idea to have the vet test for pancreatitis, fPLI test at the time of the attack will tell you for sure.... it may be something else, so it may be a good idea to have the vet check when you get the pain meds.
 
ewest said:
Hi All- Munchie seems to be having a panc attack. She's had once daily bile throw-ups starting on Thursday when we started the Levemir. She got Cerenia today and I already give Pepcid BID. I also gave her fluids daily (except Saturday) and was going to give more tonight. Her behavior actually wasn't affected until today where she seems more punked out and wanting to rest and much less appetite. Even though the insulin change shouldn't cause this directly- maybe the change was an extra stressor- and the fact that she isn't controlled with her blood sugar. Prayers that she will feel better soon. Thanks.

I am sorry for your baby. Earlier today I was looking at your spreadsheet and wondering why all the bile type throw up incidents. And that she is on a raw diet, and for a long time, is really strange.

I don't have any answers unfortunately. I looked and researched. My only thought was maybe to give her some cat grass, cats oftentimes heal their own bile type vomiting issues by eating grass. But now after seeing this tonight, I don't know. :(

Maybe time for a vet visit. I don't know when you had bloodwork done last and her liver values checked. Tigger was throwing up bile a lot when he was having some liver problems a few years ago. He was diagnosed with Triaditis which is not that unusual in cats. It simultaneously effects the pancreas, liver and intestinal tract, hence the bile issues. Maybe ask your vet if he feels this could be a possibility.

Sending prayers for your baby girl. :(
 
Poor Munchie. I hope she gets better soon. Sounds like you are doing the right things and others have offered more info that I have experience about. Has she had p-titis before? If not, then I would agree about a vet visit to rule it in or out as the cause of her symptoms. Beau never threw up bile. In fact that isn't something that has happened that often with my cats, but when it does it isn't related to ptitis. Usually it's furball related.
 
hi elizabeth, i was clearing out old messages and one about food carb management/bouncing from february 26th re munchie made me look at munchie's ss.

just wondering about munchie's dose on lev - have you increased it up from your last entry on the 24th that was 0.5u? i don't think high BG would cause the pancreatitis, but it isn't helping anything.

she was getting 2.0 on the lantus. while some people drop a little (say to 1.75 or even 1.5) to make the switch-over from lantus to lev, increasing as needed from there, dropping to 0.5 is huge. that's a 75% decrease in insulin being given to her. she may be needing more. if she needed at least 2 units on the lantus, she isn't going to somehow need only .5u on the lev. they are very similar in dosing and follow the same dosing protocol. when people are switching over, they transition using the same dose.

looking at all the blacks and reds on her ss, if she were my cat, i would increase rapidly and get her up to what she was getting on lantus, or at least very close.

just something for you to consider. i'm so sorry she's feeling crummy and hope she's better very quickly. hugs to you!
 
Elizabeth

I'm so sorry Munchie is not well. You can also ask your vet for ondansetron for nausea. If she has that on board, it might help her eat. The pepcid works only if she has an acid tummy.

I agree with Julie on the lev dose. I switched Gracie from lantus to lev; she was on .75u lantus and I started her on .5u lev and took her up relatively fast. I wish I had started her at a higher dose. I think you would have been fine to start Munchie at no less than 1.75u lev and I would have been tempted to start her at 2u. I also think you should take her up to 1u lev bid and then we can see how she does. My guess is you will need to eventually have her on close to her lantus dose. I actually had to go all the way up to 1.25u lev bid before numbers started coming down.

I hope you will like levemir. It has done wonders for Gracie and her curve is so much flatter. She also gets much, much better duration from lev.

Sending healing vines for Munchie.
 
Just would like to point out that it's very difficult to base the dose of a new insulin on the dose of the old insulin when there was virtually no regulation on any dose of the old insulin. Poor Munchie was all over the board on doses from 1U to 2U of Lantus.

While I agree that it's probably already time to go to 1U on Levemir, timing can be everything with Levemir. Not waiting long enough on a particular dose compounds the bouncing. Elizabeth has done a good job with holding doses on Lantus, but poor Munchie bounces hard. One of the keys to leveling out those bounces on Levemir is to stay the course with one particular dose for at least 5 days. Of course one should also consider the cat's history and a DKA survivor warrants perhaps more aggressive dosing, but surpassing the optimum dose won't help matters either.

Last year Munchie had lows that caused definite rebounds on 1.5U of Lantus and even 1.25U (early Sept.). Even her first day on Levemir at 1U produced a result which wasn't half bad. Going to 1U and holding it should give better results than jumping to 2U just because that was the last Lantus dose. And since we are seeing more cats switching to Levemir because of problems stabilizing on Lantus, basing the Levemir dose off the Lantus dose may be unreliable, for exactly the reasons I stated above - no regulation established on Lantus, (hence the owner's desire to switch) therefore no best Lantus dose upon which to base the Levemir starting dose.

Elizabeth, I am afraid that Munchie's other issues may make it more difficult to establish a good dose on any insulin. It would be worth diagnosing pancreatitis via the fPLI test and an ultrasound would be very helpful to determine if the liver and bowels are involved with the inflation, which could indicate Triaditis, as Pamela mentioned. Here's a good article on Pancreatitis and Triaditis with a lot of links to help understand the complicated relationship between the organs involved. http://www.harpsie.com/pancreatitis.htm

One more http://www.ibdkitties.net/pancreatitis.html

Hope that helps give you some options. Hang in there!
 
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