Pancreatitis and Cerenia

Trying an experiment in mid-July putting my boy on Levemir caused me to spend some time looking at his BG readings a bit closer than I had been. When I saw him getting high, flat numbers for an extended number of days, I soon thought that his Pancreatitis might be flaring up. (he is now back on Lantus, as there is a rationale for this. Background posts here and here)

I had been giving him 100ml sub-qs regularly approx 3x a week, and also 300mcg B12 injections once a week and transdermal codeine 4 days a week, so I thought that this might have been enough to stave off another flare-up.. but the aspects missing were some more in way of pain control and more importantly, inflammation control. He was on prednisolone at a low dose, EOD, for nearly 2 years since he was hospitalized for p-titis for the first time in Jan 2011, and it made his blood sugar regulation untenable. So, last December he had to come off the pred, and he had a few pretty good months after that.

Now, last week Thursday I took him to the vet, where we confirmed a positive test for Pancreatitis, with a specFpl of 6.5. My vet gave him a 10mg/ml injection of Cerenia. He had been in the pinks, high and flat for close to 7 days. We gave him tablet form of Cerenia 1.5mg/kg for the next four days and are opting to keep him on a 2x/week maintenance dose.

The nest day, the inflammation broke and after a few days, its straightened out now by the looks of it.

Apparently Cerenia works by blocking a chemical messenger, "substance P" which exacerbates the negative feedback loop between pain and inflammation, which cause nausea. It is thought that Cerenia is not only a powerful anti-nauseant, but also that it has anti-inflammatory properties as well. It is suspected that it does this by working in the gut and brain to break up this self-perpetuating negative feedback loop between pain and inflammation (and the buildup of inflammatory cytokines)

Although this is symptomatic, and there is no established causal link for p-titis, we are looking at some dietary changes, as I suspect it is (contrary to what many believe) that it is fats in the diet (or rancid fish oils in the canned FF-type foods) causing it.

Either way, I am grateful for Cerenia and posted this so that it might help someone else with this issue - diabetes and Pancreatitis.

Am starting to get some nice blues and today a green (120s-80s).

 

What made you suspect the FF had rancid oils in it?

 

Oh, at the bottom of this article, one vet suggests this and points to some research

I keep thinking that there must be a trigger for this somehow.

 

Sorry what do you mean by "trying an excrement?" ..?

Nice healing numbers today!

Wendy

 

funny spell checker in my text editor @-)

 

Perhaps trying an "experiment"?

 

Ah yes, the vet that has been suspended from practice by the Texas State Board of Medical Examiners.

 

Seems more like bureaucrats with a axe to grind against him (ie, if this is true -- that all he did was posting online, its nothing different than many other vets we've listened to have done wrong).

 

After reading the article on pancreatitis he wrote, my impression is that there is good information in the article, but 1 reference and an observation/comment about cat food production may be insufficient for the claim that it is rancid oils causing pancreatitis.

To me, the article is providing information, not attempting to act as a veterinarian.

 

I had the same experience as you with Cerenia-works great!!
BTW- where do you order the b-12 shots from?

 

I am in Canada, and we can buy a 10ml vial of b12 (cyanocobalamin) for under $10 over the counter. I would imagine you could get this OTC in USA (Walgreens?)

 

In the USA you tend to need a script;
http://www.thrivingpets.com/index.php/v ... -vial.html

 

My Ozy has pancreatitis and his is pretty bad. He has had it for three years. They say caused by too much prednisalone. Now they say the pancreatitis caused the diabetes.

I give him buprenorphine and Cerenia. I think the bupe does more for his pain though the Cerenia helps with nausea. I am also giving him B12 injections but just started those.

I wish we had a pancreatitis sub-group here to share what works for our kitties.

I definitely think the pancreatitis kicks his glucose up.

Today is a good day. He seems pretty pain free and his numbers aren't so bad either.

 

Thanks for adding this - I agree, as there is a seemingly common comorbidity between p-titis and diabetes. Worse, they can complicate the treatment of each other (ie, when they go high all of a sudden, is it because they need a dose adjustment, or is it a flare-up again?...sometimes the BG readings can be the only "canary in the coal mine" in terms of warning that a flare-up is impending).

Chingis was on a low dose prednisolone for 2 years (5mg EOD since his first p-titis flare) until last December 2012. I think that this is the reason he seems to have some impaired insulin sensitivity now. Before he had been in tight regulation for a year. With the pred, he bounced between 150-350 all the time.

He has been dealing with chronic p-titis since Jan 2011. It never really goes away for any substantial length of time. Even things that some others swear by, like b12 shots, haven't turned out to the a "silver bullet" in terms of abating these flare-ups. Maybe this explains why he can't eat some things which other cats can w/o it negatively affecting his BG, like any canned cat food with even low-level carb %, like Wellness chicken..

He is getting Cerenia a few times a week, transdermal codeine, and 100ml sub-qs both almost daily.

After I normalize him from this current flare-up, I think I might investigate pancreatic enzymes to see if that helps. I keep thinking there is a connection with the food somehow, either some of the ingredients, or that the pancreas isn't producing enough digestive enzymes. (would be interesting to know how many cats with EPI also have p-titis)

 

I think Ozy is very sensitive to food. We ended up with Wellness grain free which agrees with him better than any other canned food we tried.

I really believe that real food is the best medicine he can have. How can it not be better to have real food? I have been cautioned not to change his food right now, just to keep out too many variables.

I make him "lunch" every day. Lately it's been an ounce or so of ground turkey cooked in a little duck fat. That lunch is the best part of his day. He loves it.

For the most part, the best part of his day is in the mornings. I think digesting food is hard on him. By mid afternoon, he doesn't usually feel very good (whether he has real meat for lunch or not).

Ozy was on prednisalone for an autoimmune disorder. He didn't do well on prednisalone and they say it gave him pancreatitis.

 

Do you ground the meat yourself? I've been thinking of buying chicken and baking it till half done and then either grinding it, or shredding it with a knife and adding it to his canned food, gradually, to see how he does with it.. If he does good, then I would start to add those mixes one can get online and feeding him ground chicken exclusively.

I wish I could feed him Wellness chicken without his BG going high - even though the stuff is only 4% carbs. That is what gets me wondering about this business of digestive pancreatic enzymes; what if its not high BG spiking as a typical post-prandial glucose spike, but more so if he cannot digest those carbs in it (sweet potato, carrots etc), and that is what is spiking his BG - poorly digested carbs?

 

I give Ozy grain free turkey and salmon... the first five ingredients in all the flavors are the same. He has done much better on the grain free Wellness... he has had fewer skin issues and he isn't asthmatic any more.

I have been buying high quality people ground turkey and cooking it lightly for him.

I also have been thinking of getting something like that link you had. I am still thinking of cooking his and adding supplements, like they do for cat food. He likes some raw food but I have been warned by the vet that he is delicate and would not do well with any contaminants in the food... not that I think vets are nutrition experts. Far from it.

I think food is the answer BUT I don't think it is so easy to find the right food. I can't believe how difficult it is to figure it out.