Pancreatitis diagnosis?

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Marci and Buddy

Marci and Buddy

Member Since 2009
Buddy, 16 y. o. had to have his teeth removed last week as a result of gum infection. he is recovering well.
However, his bg #'s are still all over the place, from 50-500. This is not any different from his #'s in the last 4 years, or after other dentals.
The vet suggested he may have pancreat. but he shows no signs of being unconfortable, except for the fact in the past month or 2
I can hear his stomach growling , so i started to give him Pepcid A.c.
The vet wants to do a frutosimine test and an ultrasound.
Since his diagnosis 4 years ago i learned how little vets know about this disease, so i turn to you guys for verification.
Does this sound like the correct course of action in order to diagnose pancreatitis?
As always , thanks very much.
 
I have a kitty with chronic pancreatitis with many acute flare ups. He was diagnosed by ultrasound back in October of 2010 and we did an ultrasound just because I wanted to in November of 2011. The radiologist both times had a differential diagnosis of pancreatitis. There is some blood tests they can do to check for pancreatitis that are sent out to Texas A&M. I'm not sure that these tests are 100% conclusive. Back in 2010 I had a test sent out but I'm thinking it was inconclusive. With Vandow his primary symptom was a poor appetite. He would seem like he would want to eat but would just smell the food and walk away. He was also getting dehydrated too. Most likely he was also in pain but cats can hide pain very well. Back in 2010 he almost ended up with a feeding tube. I really don't know anything about a diabetic cats and pancreatitis. I would think that if a diabetic cat has pancreatitis you would probably be checking sugars frequently. Yahoo has a great group for feline pancreatitis.


Sandy
 
Marci

Be very careful with pancreatitis it go downhill very quickly. It can be mild or very bad. They can do a test at the vet for it and I would suggest you have it done. Sometimes cats will require pains meds, anti nausea and vomiting medicatitions.
Marci, I think you post on the Lev forum and I went through the same thing with my Arthur, he did not want to eat and I had to give him pain med and antibiotics for two weeks but he did recover, I also had to force feed him at first, but he is NOT diabetic. Please have then test for the pancreatitis. Best wishes.

Terri
 
I think you need a new vet.

Unless there's some anorexia, inappetance or vomiting, I don't know where the dx of pancreatitis is coming from.

Abdominal ultrasound frequently yields false negatives for pancreatitis. There's a specific blood test for pancreatitis (can't remember the name & if your vet is as much of a boob as he sounds, he won't either).

Fructosamine will give you an effective average blood glucose for the past 2 weeks. That's what it does.

Hope that helps.
 
And the fructosamine test is what we call a curve.
If you start hometesting right away, you can do this yourself with much more accurate numbers since cats are stressed at the vets office.
The numbers they get aren't so true because of that stress and they tend to charge $200 or more for the test.

Let's get you a meter and strips and start a spreadsheet for you like we all have and you can share this information back with your vet.
If this vet won't support you home testing, then you will want to find one that does.
They should partner with you in treatment of your cat, not dictate to you. You hire them for what you need.
I'll be back with the name of the meter.
 
Thanks so much everyone... i have been home testing often, since his diagnosis 4 years ago, so i thought a curve was not in order.
As per the ultra sound, I really appreciate this information regarding a blood test. i just spent 1000 for the dental , and if the US is not the right way to go this really helps. Plus, there are no signs of any pancreatitus, his appetite is good, even without teeth.
I think she is stabbing in the dark looking for reason why he is unregulated. Unfortunately, even here in Manhattan , i have had alot of trouble finding a vet who knows more about diabetes than you all here.
 
Giving insulin without home testing is flying blind into the storm, particularly if you're going for tight control. And to get the best possible outcome or a remission, that's what you need to do.

Last time I was at my vet, my boy was up 3/4 of a pound and with normal blood sugars off insulin for the past week. His answer in that setting was to have me bring him in a few days later for a glucose curve & fructosamine. That made absolutely zero sense to me, since my cat had been controlled for maybe a week with some hellaciously high BG numbers the week prior.

I emailed another vet (the head of the clinic) & told him I was holding off for another week & would bring my cat in for a fructosamine as a screening test only, since I figured after 2 weeks in remission it will have reverted to normal. Only run the glucose tolerance if the fructosamine is abnormal. He agreed that was a very reasonable course.

Veterinary medicine is all such a scam. Sounds like a very questionable pancreatitis diagnosis here, then proceeding with a test that yields a whole lot of false negatives. How much did they plan to charge for that abdominal ultrasound??? And what use is the fructosamine where you know the cat has had horrible control...

If I practiced medicine on humans like this, I'd get sued, get my license revoked or both.
 
Marci and Buddy said:
Thanks so much everyone... i have been home testing often, since his diagnosis 4 years ago, so i thought a curve was not in order.
As per the ultra sound, I really appreciate this information regarding a blood test. i just spent 1000 for the dental , and if the US is not the right way to go this really helps. Plus, there are no signs of any pancreatitus, his appetite is good, even without teeth.
I think she is stabbing in the dark looking for reason why he is unregulated. Unfortunately, even here in Manhattan , i have had alot of trouble finding a vet who knows more about diabetes than you all here.
Click to expand...

Reason he is uregulated... How about surgical stress... Catecholamines. Epinephrine. Cortisol. Good grief, any 3rd year medical student knows that. Same thing in humans. When you hear hoofbeats think of horses, not zebras. Beyond that, I'd be looking for an infection (his mouth, UTIs are common in diabetic cats,...).

If his appetite is good, he's not vomiting, I'm no vet, but a diagnosis of pancreatitis impresses me as a real stretch.
 
Fructosamine test is merely an average of your cat's BG over the last few weeks.... if you are home testing, you can get that number from your meter. Say no to that test.

An ultrasound for pancreatitis? That's kind of drastic and expensive... if you want to know what is going on, ask the vet for the cost of the ultrasound, and the cost of the blood test fPLI..... go with the blood test. A result under 3.5 is negative, 3.5 to 4.0 is an iffy grey area, and above there is a positive.

How to treat pancreatitis?
1. Give subQ fluids... you can do that yourself at home; just get a kit from the vet and many of people here, along with lots of youtubes, can help you give fluids..... easy peasy.
2. Give pain meds..... pancreatitis is VERY painful; just ask any human who has had pancreatitis. Get some buprenex from the vet.
3. Give Pepcid AC daily max for cats is 5mg, so get the pepcid or even the generic brand and cut the 10mg tabs in quarters, giving 1/4 tab am and pm... aim for just before you are going to feed and it will have any upset stomach calmer and the cat will eat more readily.

You can spend the cash on an ultrasound and even the blood test, but the treatment will be the above.

One of my cats had horrible chronic pancreatitis with flares quite often. I found they were eliminated for the most part when I started giving her weekly B12 shots at home. The B12 helped to bring down the inflammation of the pancreas, and no more big attacks.

There is no justification for an ultrasound; the expense is something your wallet does not need and your vet's wallet has not earned.

If you want to get the fPLI test done, it would be an OK compromise.
Tell the vet you are giving pepcid, and you would like to have a fluids kit for at home plus some buprenex because you are aware that pancreatitis is very painful.

ETA:
What's the vet logic behind the guess of pancreatitis? I do know that some cats don't have any symptoms or none that are very noticeable; my own cat Oliver never showed any signs, eat fine, etc, but any fPLI test registered in the grey area with him.
 
We have a few New Yorkers here.
You might want to create a new post asking if anyone knows of a "good " vet or at least a cooperative one.

I know Rusty and Ella ( TR Lantus forum) are in upper NY state but they go to the city occasionally.
 
Sorry, but I need to chime in regarding the ultrasound.

I finally bit the bullet and did one, and the results were actually a surprise. My kitty also has CKD for over a year now. Turns out her kidneys don't look all that bad, but her pancreas showed she has suffered multiple attacks and healing (vet said the scarring looks like bubble wrap). The vet also said she didn't see any signs of cancer, and that as long as the diabetes is controlled, kitty's prognosis is not that guarded.

It bottom-lined it for me that baby's pancreas most likely will not heal completely and thus not function properly for the duration. I have prepared myself for her to be on insulin probably for life. Who knows what will happen, but at least now I fully know what I'm dealing with, and I have no dilusions that I will ever see a normal fPL.

Had I not done the ultrasound, I would have been chasing windmills. At least now, kitty is getting the treatment she needs and I'm not flying blind.

It's not cheap, but it's the only way to get a true snapshot of what's going on.

Good luck to you.

DZ and Sarah
 
I'm glad your kitty has a good appetite. Your sugars can also have been all over the place because of infection/dental issues. Now that the teeth are taken care of maybe the sugars will be more stable. I'd probably see how your kitty's sugars are over the next few weeks and make a decision. If you're home testing I don't see the point of a fructosamine test. I'm all for ultrasounds though. I don't like chasing windmills either. I love information. My kitty Brie had a kidney infection at the end of June. The US in June showed enlarged kidneys but nothing else. He was treated for the kidney infection. I wanted to do another US in the beginning of October to just check his kidneys since his BUN and creat were still slightly elevated. The numbers were better than they were in the summer. My vet thought he was probably CRF as a result from the kidney infection It was my choice to do another US. My vet didn't push me to have the US. Here they found cancer. I did another US in November and the cancer has progressed even more. I'm not happy about the findings but I'm glad that I know what is going on inside of him. Brie is still assymptomatic right know as far as the cancer. If your kitty is eating fine, not vomiting, having normal BMs, not dehydrated, not losing weight, not acting any different they are all good things.

Sandy
 
Sandy-I'm really sorry about the findings of your cats US.
my Buddy has everything good,no signs of illness, only he has never been regulated. i do everthing right and follow Tilley.
i give him Fortiflora every day with raw rabbit. his recent blood tests before the dental all were fine-nothing abnormal
(should have asked her to run a pancretits test ) .the only possible sign is that his tummy gurgles . it doesn't prevent him
from eating 6 oz. a day.i now started to give pepcid ac. i guess the vet is trying to find out why he is hard to regulate.But she doesnt have to pay for this exploration. I called Dr, Lisa and she said some older cats just are this way. guess i will wait a few weeks and see. Thank you all very much.
 
Marci and Buddy said:
Sandy-I'm really sorry about the findings of your cats US.
my Buddy has everything good,no signs of illness, only he has never been regulated. i do everthing right and follow Tilley.
i give him Fortiflora every day with raw rabbit. his recent blood tests before the dental all were fine-nothing abnormal
(should have asked her to run a pancretits test ) .the only possible sign is that his tummy gurgles . it doesn't prevent him
from eating 6 oz. a day.i now started to give pepcid ac. i guess the vet is trying to find out why he is hard to regulate.But she doesnt have to pay for this exploration. I called Dr, Lisa and she said some older cats just are this way. guess i will wait a few weeks and see. Thank you all very much.
Click to expand...

My cat had horrible frequent pancreatitis problems. I gave her pepcid BID for months, has bupe on hand and needed to give her fluids often.
I switched vets and he said to try giving her B12 shots. After giving her 25u B12 shots weekly, she had very little pancreatitis type issues. I was able to stop the pepcid, and no more problems with her belly growling issues.

Ask your vet about getting a bottle of B12.
 
I'm glad he's eating. It does sound like your vet is just trying to figure the numbers out. Waiting a few weeks sounds like a good plan. Maybe the sugars will be better since the dental was done.

Sandy
 
Marci and Buddy said:
Yes, i agree. i will also give him the b12 shots, can't hurt, right?
Click to expand...

All I can say about the B12 shots is that it helped my Shadoe a great deal; she had no further flares.
There are many advantages to the B12 shots, so it will definitely help.
 
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