? New Pancreatitis diagnosis.

[Dallas boy]

Dallas has been unwell since yesterday. He vomited quite a large amount of fluids 3 different times, would yowl right be vomiting (which I've never heard him do before), was very restless and wasn't interested in food which is very abnormal for him. I brought him to the Emergency Animal Hospital and they ran some blood work (see SS). They did a snap fPL test which came back abnormal Not sure what to do with this diagnosis or really what it means. The vet said it's common to see this is cats his age, especially diabetics (he's been OTJ since Oct). He was sent home with a shot of Cerenia and SubQ fluids to give at home. We're going back on Saturday for a re-check, but he is still very lethargic and just wants to sleep. I'm sure there are others on this page with kitties with Pancreatitis. Just wondering how they are doing? I'm not well educated on this.

 

[Bron and Sheba (GA)]

Pancreatitis is quite common in diabetic cats. My Sheba used to have flares about twice a year.
It is managed by supportive care.
Sub Q fluids, pain meds, antinausea meds and sometimes antibiotics. It doesn’t sound as if they gave Dallas any pain meds. I would definitely ring up or go back and ask about them because pancreatitis is very painful and I’m not surprised he is still lethargic. And he probably won’t want to eat if he’s in pain. An injection of bupe usually makes them more comfortable and something to give at home.
Did they give you some oral cerenia to bring home because he could be nauseated for a few to several days? And you will have to make sure he eats….sometimes you may have to assist feed if needed.
Also you may need to look into an appetite stimulant.
Sheba used to respond very quickly to the treatment (mostly) but a lot of kitties take longer to respond and feel better.
You want to get on top of this quickly as you don’t want him falling out of remission.

 

[Bron and Sheba (GA)]

LINK TO A PRIMER ON PANCREATITIS

 

[Dallas boy]

Pancreatitis is quite common in diabetic cats. My Sheba used to have flares about twice a year.
It is managed by supportive care.
Sub Q fluids, pain meds, antinausea meds and sometimes antibiotics. It doesn’t sound as if they gave Dallas any pain meds. I would definitely ring up or go back and ask about them because pancreatitis is very painful and I’m not surprised he is still lethargic. And he probably won’t want to eat if he’s in pain. An injection of bupe usually makes them more comfortable and something to give at home.
Did they give you some oral cerenia to bring home because he could be nauseated for a few to several days?
Sheba used to respond very quickly to the treatment (mostly) but a lot of kitties take longer to respond and feel better.
You want to get on top of this quickly as you don’t want him falling out of remission.

Thank you for this info! No, he definitely was not sent home with pain medication. The Vet Clinic is open 24/7 so I am calling now to see if they can dispense buprenorphine.

 

[Dallas boy]

I phoned and the Tech told me that they normally don’t send Pancreatitis patients home with pain meds. This is the emergency vet he went to. I’ll phone his regular vet tomorrow morning and see what she says. She is amazing and has been treating my boy for atleast 10 years now. I almost had to bring him back tonight because he hadn’t peed since yesterday, but I brought his litter box to him and he thankfully just peed. Thank god!

 

[Bron and Sheba (GA)]

I can’t believe the vet tech said that…..she has obviously never had pancreatitis. It is painful.
I hope your vet will give you some pain meds. It is definitely needed.
Is he eating at all.you will need to make sure he is eating some food.
Did you read the Primer on Pancreatitis?…..it addresses the need to eat.
Im glad he peed. That might make him feel better.
Please keep us updated on his progress.

 

[Dallas boy]

Pancreatitis is quite common in diabetic cats. My Sheba used to have flares about twice a year.
It is managed by supportive care.
Sub Q fluids, pain meds, antinausea meds and sometimes antibiotics. It doesn’t sound as if they gave Dallas any pain meds. I would definitely ring up or go back and ask about them because pancreatitis is very painful and I’m not surprised he is still lethargic. And he probably won’t want to eat if he’s in pain. An injection of bupe usually makes them more comfortable and something to give at home.
Did they give you some oral cerenia to bring home because he could be nauseated for a few to several days? And you will have to make sure he eats….sometimes you may have to assist feed if needed.
Also you may need to look into an appetite stimulant.
Sheba used to respond very quickly to the treatment (mostly) but a lot of kitties take longer to respond and feel better.
You want to get on top of this quickly as you don’t want him falling out of remission.

Sorry, I forgot to answer one of your questions. They gave him an injection of cerenia that’ll last 24 hours, not oral. He is eating fine now and keeping it down. He’s just not himself. I also had to give him Gabapentin before his appointment, so maybe that’s still in his system, but this was 15 hours ago.

 

[Dallas boy]

I can’t believe the vet tech said that…..she has obviously never had pancreatitis. It is painful.
I hope your vet will give you some pain meds. It is definitely needed.
Is he eating at all.you will need to make sure he is eating some food.
Did you read the Primer on Pancreatitis?…..it addresses the need to eat.
Im glad he peed. That might make him feel better.
Please keep us updated on his progress.

I really think she will give him some pain meds if I ask. She’s not the one who diagnosed him with pancreatitis, but since she did his dental surgery 3 weeks ago, she should have no issues writing him a prescription. Hopefully anyway. I did read the Primer on Pancreatitis. I will keep you updated!

 

[Bron and Sheba (GA)]

Sorry, I forgot to answer one of your questions. They gave him an injection of cerenia that’ll last 24 hours, not oral. He is eating fine now and keeping it down. He’s just not himself. I also had to give him Gabapentin before his appointment, so maybe that’s still in his system, but this was 15 hours ago.

Gabapentin can make them feel very drowsy. I don’t like it.
I would also keep an eye on his BGs while he’s sick. Shebas BGs always went went up when she got pancreatitis (I’m talking now when she was in remission) and then settled when she felt better.

 

[tiffmaxee]

I’m so sorry to see that Dallas has pancreatitis. Max had chronic pancreatitis for several years. I agree with Bron that he should have been sent home with buprenex for pain and cerenia pills as he will likely need both for at least several days. I’d ask your regular vet for an RX for ondansetron as it works best for nausea. Cerenia works well for vomiting. Some cats need both as they work differently. Gabapentin is given by a lot of vets for pain so it’s good that you have it.

 

[Dallas boy]

Gabapentin can make them feel very drowsy. I don’t like it.
I would also keep an eye on his BGs while he’s sick. Shebas BGs always went went up when she got pancreatitis (I’m talking now when she was in remission) and then settled when she felt better.

Gabapentin was only given to him because he is not a cooperative boy at the vet. The first time we took him they couldn’t touch him, so we had to go home, give him gabapentin and go back the next morning. His BG was checked at the vet and it was still in normal range, which was surprising because he was very stressed.

 

[Dallas boy]

I’m so sorry to see that Dallas has pancreatitis. Max had chronic pancreatitis for several years. I agree with Bron that he should have been sent home with buprenex for pain and cerenia pills as he will likely need both for at least several days. I’d ask your regular vet for an RX for ondansetron as it works best for nausea. Cerenia works well for vomiting. Some cats need both as they work differently. Gabapentin is given by a lot of vets for pain so it’s good that you have it.

He isn’t vomiting anymore and he is eating again. Should he still get something for nausea? He might be making another trip to the vet tonight if he doesn’t pee again. He peed about 5 hours ago, but a smaller amount then usual.

 

[Bron and Sheba (GA)]

He isn’t vomiting anymore and he is eating again. Should he still get something for nausea? He might be making another trip to the vet tonight if he doesn’t pee again. He peed about 5 hours ago, but a smaller amount then usual.

He could be eating because of the antinausea injection. I would ask for something for a few days.
Try putting him on the litter box to see if he will pee….five hours isn’t a long time inbetween pees for a cat.

 

[Candy&Company]

No pain meds for pancreatitis? WOW. They NEED pain meds! My Fena had flares, and this is what worked for her, especially since COVID.

1.) Always keep some regular Pepcid 10mg a pill on hand. NOT Pepcid Complete, etc. Just plain Pepcid, 10mg. You can cut the pill into 4ths and give a 4th every 12 hours. This is good to have on hand because vets are so swamped it can take awhile to get in, ER vets too plus they're more expensive. This is just a "tide you over until the vet".

---Once at the vet, get Cerenia pills to take home, at LEAST a 7 day supply. Fena's flares if caught early usually lasted 7 - 12 days.

2.) WATER. If your baby is on wet food, try and slowly incorporate water right into their food in addition to having their water bowl separate. Fena only ever liked pate, so I'd smoosh it all up with a spoon and then I started slowly. Adding a tablespoon, then 2, then 3, etc. You want a "soupy" kind of consistency but not all cats like this or take to it. Even if they do sometimes you still might need subQ.

3.) PAIN MEDS. Pancreatitis IS painful for them. I always demanded bupe. I'd get at least a 5 day supply measured out at .2ml in syringes (oral), 2x a day. Fena was a big cat though (not fat just BIG) so is .2ml makes your baby sleepy, cut it down to .1 - aka just give half the dose if they give you .2ml syringes.

4.) If you suspect a flare and can afford it, ask for new blood work. Watch the CBC section and get antibiotics as needed. Sometimes Covenia would work but sometimes amoxicillin, depending. Fena's last flare, she had a URI and a UTI so we used amoxicillin. This WILL give diarrhea, so have a probiotic on hand like Purina's Fortiflora, etc.

For Fena when implementing everything together, the first thing to clear up was the nausea/vomiting, then the pain, then any infection (if it was present which it isn't always).

Also be aware that if you increase your cats water intake (by switching to wet food, or they drink more from the water bowl or you mix added water into their food) that they WILL usually pee more. If a cat is fully hydrated and in good health they usually pee 2 - 4 times in 24 hours. Increased water intake they could pee 4 - 6 times a day like Fena. Or more, it depends on how long they hold it before going pee. You want to see kinda the same size pee clumps in the litter. If you see bigger ones and that's not usual for your cat, they might have a UTI and are holding it because it's painful for them to pee. Likewise if you're seeing a lot of little ones, it could mean they bladder is having some incontinence issues and is triggering to pee too fast.

If your cat is dehydrated, you might see longer times in between peeing because the body is desperately soaking up that water to run it through the body.

Good luck!

EDITED TO ADD = Watch their food intake. Sometimes when the Pepcid or the Cerenia kicks in and their pain is null they can really eat TOO MUCH, TOO FAST at once because they're hungry again which, medicine or not, they CAN still throw up. So watch your cat if you're able. If they want to chow down too much/fast, break their meals up into smaller portions throughout the day or use a timed feeder.

 

[Dallas boy]

His regular vet received the emergency vet’s notes and she called me right away. She has some pain meds, Cerenia tablets and fluids put aside for me to pick up. She agreed that he definitely should have gone home with pain medication. She wants me to keep the cerenia and unopened bag of fluids on hand in case this happens again, so we can treat right away until he can see a vet. She asked me if they discussed with me that he has early kidney disease. Umm…nope! So we had a 40 minute conversation about kidney disease and how we’re going to proceed. I swear this boy has had medical issues from day 1, but there is nothing I wouldn’t do for him.

 

[Candy&Company]

Oh bless, good I'm glad you'll be getting pain meds, Cerenia and fluids. Pick that ASAP. Have you done subQ before?

Stage 1 CKD is actually good, it means you caught it early so fingers crossed you can have years with your baby.

Check out Tanya's site, http://felinecrf.org/just_diagnosed.htm - I recommend this one rather than the main/home page since it's a HUGE site with a TON of info. They have an amazing forum too that you can join. If you have Dallas's latest labs, this site can help you go over those too.

I also just made a post on another thread here, about a CKD cat - https://www.felinediabetes.com/FDMB...or-info-on-diet-and-meds.256324/#post-2886815 with many others weighing in too.

Just know that various conditions are going to feed off each other.

Fena was OTJ too but with every infection or pancreatitis flare, etc. it WOULD sometimes raise her BG so I would always keep testing her here at home. She never needed insulin again, but it can get hairy sometimes especially with pancreatitis so I always advocate continued home testing.

I tested Fena once a week when she was in good health, but during an infection or a flare, I'd test her every morning. Her night numbers were usually better than her morning numbers due to overnight and just keep an eye on those. For Fena, the numbers never got "too" high but they were elevated and usually dropped back to normal once the infection/crisis was past.

Your Dallas is a beautiful boy, based on your profile picture. Much love. xx

 

[Dallas boy]

Oh bless, good I'm glad you'll be getting pain meds, Cerenia and fluids. Pick that ASAP. Have you done subQ before?

Stage 1 CKD is actually good, it means you caught it early so fingers crossed you can have years with your baby.

Check out Tanya's site, http://felinecrf.org/just_diagnosed.htm - I recommend this one rather than the main/home page since it's a HUGE site with a TON of info. They have an amazing forum too that you can join. If you have Dallas's latest labs, this site can help you go over those too.

I also just made a post on another thread here, about a CKD cat - https://www.felinediabetes.com/FDMB...or-info-on-diet-and-meds.256324/#post-2886815 with many others weighing in too.

Just know that various conditions are going to feed off each other.

Fena was OTJ too but with every infection or pancreatitis flare, etc. it WOULD sometimes raise her BG so I would always keep testing her here at home. She never needed insulin again, but it can get hairy sometimes especially with pancreatitis so I always advocate continued home testing.

I tested Fena once a week when she was in good health, but during an infection or a flare, I'd test her every morning. Her night numbers were usually better than her morning numbers due to overnight and just keep an eye on those. For Fena, the numbers never got "too" high but they were elevated and usually dropped back to normal once the infection/crisis was past.

Your Dallas is a beautiful boy, based on your profile picture. Much love. xx

Thank you for all the information. I appreciate it so much! I picked up everything from the vet and gave him the pain medication right away. I already see a difference. He is purring up a storm, asking for food and moving around a lot more. He even ran up and down the stairs.

I had been giving him fluids at home since his visit to emerge. He’s very good for it. I worked at an animal hospital for 3 years quite a few years ago, so I’m very comfortable with these things. I’ve also trained my boyfriend on giving fluids, pills and everything diabetes related as I’m away for work a lot. He’s definitely # 1 cat dad lol.

I will definitely keep an eye on his BG. He was last tested Monday and his number was still good. I’ll test him again tmr.

Thank you so much! He is very handsome. I’m sure his OTJ party video is kicking around the Lantus group somewhere

 

[tiffmaxee]

I would not give hm Pepcid. It does nothing for pancreatitis. I’m glad your vet is giv8ng you tge correct meds. I always kept the
nausea meds going until eating normally fir a few days and at the first sign the appetite wasn’t right started them again. I’m glad he’s doing better.