pancreas flare up? ever had something like this?

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mirnta

Member Since 2015
Woke up yesterday to my kitty barfing and very lethargic...scared the crap outta me, he's been doing so well!! I couldn't touch him without him growling and he went and hid..never done that before. He was very upset. Went to the vet, waiting hrs and hrs to find out they thought it was a pancreas flare up from prolly eating something bad outside. They gave him anti nausea meds, he seems a bit better but still not himself.....i am worried! I actually found some gnarly deep fried squid on my deck he must've gotten into (EW?!) maybe the culprit..anyway anyone experience this? Any advice or help appreciated..scared he won't get better...his numbers have been so great recently!!! Thanks.
 
Nothing like this has ever happened before..i guess I'm just curious about how long it takes to get through this, tips, meds ? Etc..unfortunately a catio is not an option for my kitties...but I will make sure my neighbor's trash is better contained.
 
I actually found some gnarly deep fried squid on my deck he must've gotten into (EW?!) maybe the culprit..anyway anyone experience this?

Fatty food can trigger pancreatitis flares. (@phlika29's Remi is hugely fat sensitive.) Seafood doesn't agree with some cats either.

I've posted useful links and the treatment regimen that worked for Saoirse on the following post:

http://www.felinediabetes.com/FDMB/...ewly-diagnosed-diabletic.142173/#post-1469741

It takes as long as it takes to resolve. The sooner you get supportive meds in place, the better things go. Pain levels vary. It is wise to be a little conservative with bupe as it can cause constipation. Too high a dose can make some cats spacey, or possibly quite sedated (it's an opiate). Based on your description of clinical signs, I think pain meds (bupe) are a good plan. Your vet will be able to advise further. If you have any vet problems securing the right meds, having a copy of the IDEXX treatment guidelines ready as a basis for discussion of treatment options is a good idea.

Let me know if there's anything else I can help with. Pancreatitis flares are the pits.


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Squeaker has a flare of pancreatitis every six months and he has been OTJ for a year. His last was a couple of months ago with vomiting and explosive diarrhea.

The typical treatments are supportive:
Pain meds if needed
Sub-q to alleviate dehydration
Nausea meds (Cerenia)
Anti acid (Famotidine 1/4 of a 10 mg tablet daily)

I have also found with Squeaker that a B12 injection at the time of the flare helps him feel better and keeps his appetite steady. For Squeaker it usually takes about 2 weeks to fully resolve.
 
Thanks so much guys..hes still very spacy and not acting like himself..really seems out of it..is that a normal symptom? He does eat and drink..he just seems confused? And very lethargic....how do I give him b12? I wanna make sure it is this and not something else..i can't afford to keep going to the vet...
 
In the midst of a bad flare (and the lethargy points to it being a bad one) then I'd recommend a series of injections of B12 (usually the cobalamin is used). With the pancreas on the blink it will cause nutrient absorption issues. I've read that B12 deficiency interferes with B12 absorption, so there is a negative feedback loop. Delivering B12 via injection circumvents the absorption problem.

B12 really made a huge difference to Saoirse when she had the severe flare last year. She started turning the corner back to wellness straight from the first injection. It gives them a general boost and it seems to help appetite. Check out the IDEXX treatment guidelines for advice on how much supplementation is recommended.

Once this flare has resolved you might consider supplementing B12 in food (methylcobalamin) for maintenance. Zobaline and Vitacost are diabetic-friendly methylcobalamin supplements I've seen recommended here. Regular oral supplementation is probably much more wallet-friendly, too. :)

Symptom-wise, Saoirse spent all day every day in a wiped-out sprawl. No interest in anything; no energy; just flopped and out of it. It scared the living carp out of me. :(


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Word of warning. The B12 injections can sting a little. Saoirse mewls on and off shortly after she gets hers, but she's grand after that.
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Ok. So his numbers have skyrocketed..355 BS as opposed to under 200 usually. Is that normal for a flare up? Should increase his dosage?
 
With diligent nursing, he's got a good chance.
Insulin doses are adjusted based on the lowest level between shots (aka nadir) - what is the lowest level he's tested in this past week?
 
I dont know he just got sick so I have to see what they are now...he's been almost normal up til now..
 
B12 complex tends to sting but B12 cyanocobalamin does not

Saoirse has only been given B12 cyanocobalamin injections. Saoirse always reacts to them. I asked our vets about it and they told me that the cyanocobalamin jab can sting.

If the cyanocobalamin doesn't sting, do you know what else could be happening to make Saoirse react when she gets them. (She cries after them.)
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I now give B12 cyanocobalamin injections to three of my cats and I have not reactions. I have previously inject previous cats with no real reaction.
Are you using insulin syringes (fin needles)?
 
@Larry and Kitties - Our vet gives the injections at the surgery. (I've only ever given insulin injections to Saoirse.)

ETA:

The reaction continues for a while after the injection is administered.
 
Seems like Saoirse body reacts to the injections. That sometimes happens but is not common. Are yuu sure it is only a cyanocobalamin injection?
 
Definitely just the cyanocobalamin, Larry. The vets did say that it didn't affect all cats that way. I don't know whether it's a factor but Saoirse seems to be very sensitive to medications in general: little doses tend to go a long way with her.

Saoirse has not reacted like that to other injections she has received, bar the occasional 'peep' sometimes when she was receiving Lantus (only had tiny doses of this).
 
How and where do I get the b12 if I can't get the injections? What form does it come in? Also his numbers are still extremely high..does it take a while for it to go back to normal??387bs when usually under 200..this SUCKS. Sigh...
 
Also the vet said to only give him the anti nausea meds for 4 days, is it ok to give it longer?
 
Ok. So his numbers have skyrocketed..355 BS as opposed to under 200 usually. Is that normal for a flare up? Should increase his dosage?
He may need a little more insulin than normal. The inflammation of the pancreas can increase the need for insulin. Bear with it, things will get better.
Also, I don't know how bad the vomiting was but with Squeaker we were Rx'd 1/2 tablet every morning for 14 days. Ideally you could give 1/4 tab morning and evening for a 2-3 days then dose according to your sense of how well your kitty is feeling. I only gave it to Squeaker for 5 days as they can recover as quickly as they fall. Sometimes you just have to tweak the treatment.

Is your kitty getting sub-q fluids? Be watchful that he doesn't dehydrate.
 
Hes only vomiting a tiny bit and eating and drinking pretty normally now it seems, so I don't think he's dehydrated..they said only give it to him once a day..but ill just see how he's doing and dose if necessary I guess. He seems to be in better spirits so that is good. Thank you.
 
Great news about the eating and drinking. That's really encouraging! :)

How and where do I get the b12 if I can't get the injections? What form does it come in?

If you can't get the vet to dispense the B12 for injection, you could try oral supplementation. Zobaline and Vitacost methylcobalamin supplements are both diabetic-friendly (available online).

Also his numbers are still extremely high..does it take a while for it to go back to normal??387bs when usually under 200..this SUCKS. Sigh...

Out of curiosity, were you reducing his Vetsulin dose when this flare triggered by any chance (and if yes, how low did you get the dose down to before the flare)? Also what dose of Vetsulin are you giving now. Does he have a spreadsheet? It would be great if you could put a link to it in your signature.


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Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.
 
Yea hey guys...i do it all by hand, I've never started a spreadsheet, tho I've been on here awhile, I realize it would be helpful, and thx for the info..i just don't do computer stuff. But if I have time I will try. I was not reducing his dose. He's been at .5 for quite awhile, and been doing just great. now I'm doing 1 unit and seeing how that goes....hopefully it'll get him back to normal soon..fingers crossed..
 
My beautiful cat, Kuma, began suffering severe Pancreatitis attacks every few months before he was finally diagnosed with diabetes. I think he was getting the attacks BECAUSE OF the undiagnosed diabetes. He was very, very sick, completely stopped eating for about 4 days, and we nearly had to take him to the University Veterinary Hospital in our state, to put in a feeding tube (which I guess is not as bad as you think it is for your kitty, as it saves their life when they stop eating). The vet said a feeding tube is not painful for the kitty, it just looks kind of painful to you.) I was a nervous wreck. The very day we were ready to drive Kuma 2 1/2 hours to the Veterinary Hospital at the University, he finally began to lick some tuna fish juice. I think that's what began to pull him through, along with the following medications from the vet:

What helped Kuma during his pancreatitis attacks:
1. Medrol (4 mg. once a day - even though it can raise blood sugar, I think it saved his life);
2. The pain medicine called Buprenorphine (0.2 ml twice a day); and
3. Very, Very Important: Bringing him in every day (or every other day as he gets better) for fluids/electrolytes, as they are usually very dehydrated. Fluids are critical.
4. Took all dry food away in his diet, and began giving him low fat, low carbohydrate, high protein, canned cat food only (some water pack tuna and some boiled chicken with no skin also).

The vet also tried antibiotics on Kuma (Amoxicillin), but he actually got worse and this may have contributed to his nausea and not wanting to eat. We stopped those, and that's when he started to perk up. (The vet also tried Metronidazole, but it also did not help in any way). Shortly after, the vet realized Kuma was likely suffering from diabetes, and as soon as he got on insulin, his pancreatitis attacks stopped, so his undiagnosed diabetes was likely the cause of his pancreatitis attacks.

Also, here is a response I received to an email I sent to the Cornell Feline Health Center, outlining treatment for pancreatitis attacks:

We are very sorry to hear about your kitty's troubles. Pancreatitis in cats can be a difficult disease to diagnose and to treat, and the cause of this diseases is the subject of debate, as is the appropriate way to manage it. Most management recommendations, though, focus on three basic areas: appropriate nutrition and prevention of nausea, normalization of electrolyte imbalances that may arise secondary to the disease, and pain control. It is not possible for us to make treatment recommendations, as we do not have the luxury of examining your baby in person (or in kitty), but it does sound like your veterinarian is addressing the nutritional and pain components well. We recommend that you work closely with your veterinarian to assure that all of these areas are addressed. If you would like to speak about this in person, please consider using our Camuti Consulation service, which is accessible on our website. Please keep in touch and best of luck to you and your kitty.​
 
^ok thanks. His diet is fine tho, he just ate something funky outside..he seems much more alert and up and about! This is good! His numbers seem to be decreasing slightly..but still high..im praying he will be back to normal soon!
 
Great news! :)

My heart sank when Saoirse's numbers started going out of regulation during her pancreatitis flare. I really thought I'd completely blown her chance at remission. :( Thankfully, as she improved so did her numbers. Fingers and paws crossed for a similar result for your little one. :)
 
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