Pancreatitis flare up help
- Thread starter AggyBear
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Bron and Sheba (GA)
Member Since 2015
Yes I would reduce the dose to 1.75 units.
Samantha, I would strongly advise you to get at least one test in during every cycle.
At the moment we have no idea what Aggie is doing. By the look of the range of preshot numbers, I strongly think that she is dropping low during the cycles the. bouncing into high numbers. It is very possible she is dropping into dangerously low numbers during some of the cycles.
Try and always get a before bed test in every night. If that test is much lower than the preshot I would recommend you get up later and test again to see she is not going too low. The same with during the day.
Samantha, I would strongly advise you to get at least one test in during every cycle.
At the moment we have no idea what Aggie is doing. By the look of the range of preshot numbers, I strongly think that she is dropping low during the cycles the. bouncing into high numbers. It is very possible she is dropping into dangerously low numbers during some of the cycles.
Try and always get a before bed test in every night. If that test is much lower than the preshot I would recommend you get up later and test again to see she is not going too low. The same with during the day.
AggyBear
Member Since 2021
Hi Bron, I've been trying my best to get 4 tests a day + as you can see I've done much better but not perfectly. I've kept notes but for the last couple weeks it would seem Aggy is in pain. At first she was grumbling if I moved her or picked her up. Her appetite stayed strong but she just didn't seem herself so I started giving 25mg gabapentin twice a day. Could this be pancreatitis flaring up? She follows me a lot, I know it is for food. At the water bowl frequently (and lots of wet urine clumps, and urinating on the rug outside the box). Are our kitties doomed to constant hunger? I try my best to just give her food at feeding times and she can eat whatever is left after she and my other cat eat, after I do the mid-cycle test I try to give her some treats. I had probably two or three weeks left in my original bottle of Prozinc, but it did not seem to be lowering her numbers enough so I threw it away as I had dropped it several times. I got a mostly used and full bottle from a friend on FDMB + the partially used one is what I am using now. Do you mind taking a look at her chart and letting me know what you think? I appreciate your time and help, hugs from Aggy and me!
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Diane Tyler's Mom GA
Member Since 2018
See #3
AggyBear
Member Since 2021
FrostD
Member Since 2020
Are you able to do a curve once a week? Preferably on a day that doesn't have a PS of 400+, I suspect those might be bounces. Like Bron said there's not a lot we can tell you without more tests, especially full curves.
Is she at her ideal weight? Underweight? Diabetic Unregulated diabetic cats do not process food properly, and often need many more calories than their ideal weight would call for. When unregulated/in high numbers, Mr Kitty eats about double his usual amount to maintain his weight.
About the pancreatitis, does she seem nauseous at all? Is she drinking enough?
Is she at her ideal weight? Underweight? Diabetic Unregulated diabetic cats do not process food properly, and often need many more calories than their ideal weight would call for. When unregulated/in high numbers, Mr Kitty eats about double his usual amount to maintain his weight.
About the pancreatitis, does she seem nauseous at all? Is she drinking enough?
JanetNJ
Member Since 2016
How is the pancratitis being treated? When my cat Zimmy had it we did daily sub q's for a few weeks, cerenia for nausea and bupe for pain.
Your cat may not be stepping into the box because pancratitis is very painful. Maybe put a puppy pad outside of it to save your rug.
Your cat may not be stepping into the box because pancratitis is very painful. Maybe put a puppy pad outside of it to save your rug.
?
AggyBear
Member Since 2021
I can definitely do a curve test with her once a week. I think she weighs 11 lb, although she could have lost weight by now. She's extremely nauseous had been drinking until today, not drinking anything as of tonight. I sat with her for about 7 whole minutes before I took her away from the bowl because she was just staring ahead, her chin in the water.
AggyBear
Member Since 2021
I'm very sorry to know that my baby is in such pain. For the past couple weeks I've been giving her 25mg of gabapentin twice a day because I noticed she seemed to be in pain, other than that she was eating and drinking as usual and no apparent nausea. Inhabitants started this morning, she didn't go for the food I had to point her in front of it she took maybe two bites and went to the water and has not touched food since. I gave her fluids tonight. I have to get her to the vet which is an hour drive for me in the morning.
AggyBear
Member Since 2021
I'm afraid I have to make The Decision tomorrow. She needs immediate help right now + I don't think I can put her through this any longer. I just don't know what I could be doing differently for her. I can't stand to see her struggle like this. I try so hard to be here for her and do it all to the best of my ability and it doesn't look like it's enough. The stress it puts on me is exhausting and intense. I don't know if the degree to how it's affecting me is "normal" or I'm very sensitive. It almost shuts me down completely, it feels like my brain switches off, I'm paralyzed, I need someone to hold my hand and help me think to make decisions.
Right now she's not eating or drinking, she's purring very loudly, has diarrhea + urinating outside the box, her whole body feels warm/hot to the touch.
@Bron and Sheba (GA) @JanetNJ @Pabs&Ro
Right now she's not eating or drinking, she's purring very loudly, has diarrhea + urinating outside the box, her whole body feels warm/hot to the touch.
@Bron and Sheba (GA) @JanetNJ @Pabs&Ro
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FrostD
Member Since 2020
I know it can be overwhelming at times, so just take a deep breath and reset
You're doing just fine! A lot of us, even the long timers, still post and ask for help and opinions.If it's pancreatitis it's very treatable. The gaba will help with the pain, but she needs nausea meds, possibly an appetite stimulant. Can you take her to the vet to run a SnapFPL to confirm pancreatitis? They can also give her fluids if needed. Ask for Cerenia and/or ondansetron for her nausea.
When was the last time she ate or drank? You may need to assist feed to help get something in her, but know that she may develop an avoidance to anything syringe fed (so maybe don't use her usual food, a lot of us use Gerber 2nd baby foods, the meat ones). To help encourage her to drink, you can add chicken broth or tuna water to her water, just make sure it doesn't have things toxic to cats like onion and celery in it. It may also help to raise her bowl up.
If pancreatitis seems to be an ongoing issue, see if the vet will let you keep a supply kit at home. Fluids, pain meds, nausea meds, and appetite stimulant. I have a little pancreatitis kit at home so I don't have to worry about trying to get to the vet or emergency vet if he has a flare.
AggyBear
Member Since 2021
Thank you for your kind response, Melissa. I have fluids I administered today, give the last 25 mg of gabapentin tonight and I do have a new tube of Mirataz. I know I could get more Cerenia + gabapentin from the vet. Emotionally, I cannot sustain this. Everyone on here has been nothing but supportive + loving, I am trying so hard....I feel like I've done everything I can. I cannot stand to see her like this. I think this is the 4th or 5th flare up of pancreatitis since her January diagnosis.I know it can be overwhelming at times, so just take a deep breath and reset
If it's pancreatitis it's very treatable. The gaba will help with the pain, but she needs nausea meds, possibly an appetite stimulant. Can you take her to the vet to run a SnapFPL to confirm pancreatitis? They can also give her fluids if needed. Ask for Cerenia and/or ondansetron for her nausea.
When was the last time she ate or drank? You may need to assist feed to help get something in her, but know that she may develop an avoidance to anything syringe fed (so maybe don't use her usual food, a lot of us use Gerber 2nd baby foods, the meat ones). To help encourage her to drink, you can add chicken broth or tuna water to her water, just make sure it doesn't have things toxic to cats like onion and celery in it. It may also help to raise her bowl up.
If pancreatitis seems to be an ongoing issue, see if the vet will let you keep a supply kit at home. Fluids, pain meds, nausea meds, and appetite stimulant. I have a little pancreatitis kit at home so I don't have to worry about trying to get to the vet or emergency vet if he has a flare.
If there is an a way to see it coming or do better by her I want to know. I just laid with her for 2½ hours with her in my arms, crying.
I'm taking her to the vet in the morning and if I remember correctly my doctor said last time he could not do that test...$300 later with an ultrasound proved the pancreas was inflamed and that was the culprit.
Butters & Lyla
Member Since 2020
I'm so sorry, Samantha. Butters has recurring pancreatitis flares too so I know how hard it can be to manage them. I have found that she needs supportive care for a long time with each flare, at least several weeks if not well over a month. Is it possible that of the five flares she has had since January, maybe a couple of them were the same flare not resolved? If that's the case, maybe the meds treating Agatha's symptoms were stopped too soon or maybe they aren't quite cutting it for her? I'm just trying to think of other ideas for you and I say this because with Butters she has needed supportive care for many weeks if not well over a month when she has flared. They are tough to get through in the beginning. Figuring out the right combo of meds can be soooo difficult and frustrating, but I found that once I had the right combo of meds, it is more manageable. Can you talk to your vet about giving Agatha buprenorphine? Maybe gabapentin isn't cutting it for pain relief. 25mg is a smallish dose. I give butters a combo of 25mg gaba and some bupe as well, which I figured out with her vet. But others just give bupe and they say it works the best for their cats. Also, how about asking the vet whether they'd prescribe ondansetron for nausea? I find it works better on its own than cerenia, you can give it up to every six hours, AND you can use it in combination with cerenia when needed. I'm not sure whether ondansetron can be used with Mirataz, though. I use cyproheptadine here for appy stim. I've found that it just takes very little to get butters eating, provided she has enough ondansetron on board.I know you're trying everything you can for Agatha and it's evident from your posts how much you love her. You're both in my thoughts. Sending her a boatload of healing vines.
Diane Tyler's Mom GA
Member Since 2018
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AggyBear
Member Since 2021
I think I did last night and he didn't know what it was but I'll ask again.
Thank you so much for your message. Is very possible that one or two of the flares could have been connected. I know I've done my best but I've been trying to navigate this with limited but growing knowledge. It's hard for me to think straight at the moment and also didn't get much sleep, but yes ondansetron can be given with Mirataz. I will ask for ondasetron, buprenorphine, Cerenia. I have a new tube of Mirataz + like 300ml fluids which should be enough for 3 days bc a Chewy order is on its way now. If he doesn't have buprenorphine I will ask him if someone else can give it to me for her.
Noah & me (GA)
Member Since 2016
I can't offer any medical advice, sorry. I've had many cats dealing with pain and transdermal BUPE is a lifesaver. It's not the BUPE itself, it's just one less thing you have to jam down a sick cats mouth. You just tickle their ears and you're all done. The details are always at the top of my profile.
Sarah&Soph
Member Since 2019
Try asking for Buprenex. The ER vet I go to never knows what I’m talking about when I ask for bupe or buprenorphine, but they know what buprenex is which is just the brand name
AggyBear
Member Since 2021
And our vet's office now, he cannot prescribe buprenorphine but I think is presently checking if another vet has access to it. Update: we can't get ahold of it but he did say it's a very good drug... We are leaving with Cerenia, ondasetron + gabapentin. I have Mirataz + fluids at home. She weighs 9.9lbs.
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JanetNJ
Member Since 2016
Buprenorphine is the full name of it. He'll know what it is.
JanetNJ
Member Since 2016
I'm so sorry you're going through this.
I had a cat with pancreatitis once but It resolved itself after just a few days after starting treatment.
Diane Tyler's Mom GA
Member Since 2018
Poor baby, I know nothing about it but can your vet call an ER vet by you to see if they have it.
Or call a compound pharmacy near you
Please ask him to keep searching for it
Edit try googling compound pharmacy's close to where you live , if you find one infirm your vet
Or call a compound pharmacy near you
Please ask him to keep searching for it
Edit try googling compound pharmacy's close to where you live , if you find one infirm your vet
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They should be able to write an Rx for Suboxone. It's carried at most pharmacies. It's a different name for buprenorphine. It would be unusual for your vet to not have a DEA number since they do need to prescribe pain med post-operatively. Buprenorphine is the generic.
AggyBear
Member Since 2021
Thank you all for your messages. Last night was terrible bc I thought I was truly having to say goodbye today. I feel like I've lost her so many times.
I called my local grocery store pharmacy where I get my medications + they have:
Suboxone 2mg ($11.35/pill) or 8mg tabs (I didn't get the price) and buprenorphine tablets 2mg ($9.80) + 8mg (didn't get the price).
This seems very costly? I think if I ask my vet he will write a script for this, how much is a dosage + frequency for a 10lb cat?
I called my local grocery store pharmacy where I get my medications + they have:
Suboxone 2mg ($11.35/pill) or 8mg tabs (I didn't get the price) and buprenorphine tablets 2mg ($9.80) + 8mg (didn't get the price).
This seems very costly? I think if I ask my vet he will write a script for this, how much is a dosage + frequency for a 10lb cat?
Most of us use a liquid version that is absorbed by the mucus membranes in the mouth. It's likely expensive in pill form because (a) it's a narcotic and (b) it's used for the treatment of opiate addiction. You may need to check with a compounding pharmacy for the liquid. However, all of the vets I've used have had it in the office and dispense from there. One of my cats recently had a dental cleaning with extractions and they sent me home with the oral bupe.
Sarah&Soph
Member Since 2019
I’m not sure about the pills, I have always gotten it in liquid form as Sienne mentioned above, but it is a little costly. For my 9 ish lb cat, I believe the dose is 0.5mL every 12 hours as needed. They always give me prefilled syringes and for 10 syringes (5 days) it is $43.
AggyBear
Member Since 2021
Thank you, this is helpful. The associate I talked with said there was an oral form but she kept calling it a "film" which is confusing.
AggyBear
Member Since 2021
For reference, I live in central Texas, USA. I don't know where to look for a compounding pharmacy- why is what is actually potent + effective never really available? It's like jumping through hoops.
Larry and Kitties
Member Since 2009
With GoodRx you can get sixty, 2mg subling tablets for about $14. 30 pills is about $12
https://www.goodrx.com/buprenorphin...uprenorphine&quantity=60&sort_type=popularity
https://www.goodrx.com/buprenorphin...uprenorphine&quantity=60&sort_type=popularity
Noah & me (GA)
Member Since 2016
Just following up with what I said in post 17. Cats and dogs are terrible patients and will live with almost indescribable pain. It places a terrible burden on them, the healing process and ultimately you. I've been through this circus of denial myself and many times with animals.
Pain is pain, to deny it is almost unethical. We just never seem to learn.
Pain is pain, to deny it is almost unethical. We just never seem to learn.
AggyBear
Member Since 2021
Very cool! Thank you! It says free 30 day trial, do you have to pay to get their discount?
This is what I'm afraid of. I will try to get the buprenorphine from the website @Larry and Kitties suggested!
AggyBear
Member Since 2021
Here's our full update for today:
AMPS/9:57am BG 313 + Cerenia- very weak + tried to take 2 bites pate, 11:30am appt w/ Dr. M- 9.9lbs, fever, breathing sounded normal- he gave us 24mg Cerenia 4 pills, 8mg ondansetron 15 pills to halve, 50mg gabapentin 20 pills, 1 lactated ringer + .25 Metacam injection, +5h/4:26pm BG 348, gave 4mg ondasetron, 100ml fluids + .25 Metacam injection, 6pm Mirataz, woozy/drugged/delirious acting + determined to get to water bowl but doesn't drink + then wants to drink water out of sink, PMPS/10:36pm BG 377- gave insulin bc she ate a couple bites + drinking out of my cup!
The vet still suggests 200ml a day + last time many on FDMB suggested only 100ml- is that correct?
Because I don't have buprenorphine, should I continue with the 50mg gabapentin twice daily?
How often do I give Cerenia, ondansetron + gabapentin? I'm wondering how quickly + how long the Metacam works?
AMPS/9:57am BG 313 + Cerenia- very weak + tried to take 2 bites pate, 11:30am appt w/ Dr. M- 9.9lbs, fever, breathing sounded normal- he gave us 24mg Cerenia 4 pills, 8mg ondansetron 15 pills to halve, 50mg gabapentin 20 pills, 1 lactated ringer + .25 Metacam injection, +5h/4:26pm BG 348, gave 4mg ondasetron, 100ml fluids + .25 Metacam injection, 6pm Mirataz, woozy/drugged/delirious acting + determined to get to water bowl but doesn't drink + then wants to drink water out of sink, PMPS/10:36pm BG 377- gave insulin bc she ate a couple bites + drinking out of my cup!
The vet still suggests 200ml a day + last time many on FDMB suggested only 100ml- is that correct?
Because I don't have buprenorphine, should I continue with the 50mg gabapentin twice daily?
How often do I give Cerenia, ondansetron + gabapentin? I'm wondering how quickly + how long the Metacam works?
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Chris & China (GA)
Member Since 2013
We actually don't recommend using Metacam due to the black box warning about kidney problems so I'm not sure if you'll get a good answer for that question. In other countries, it's dosed differently so you really can't compare them.
Some cats get really drugged on Gaba, even a small dose. It concerns me that he was acting so "out of it". You might try a lower dose...you can always give more if it's needed.
It's usual dosage is 1mg per pound once a day.
Orally up to every 8 hours.
Why are you giving fluids? Is there any history or problem with her heart? Is she dehydrated? (you can test by turgor testing or feel her gums...they should be moist and slick, not gummy or sticky)
Generally, 100-150ml per day is about right unless they have heart issues. It can be given all at once or divided into 2 sessions.
GoodRX doesn't require any payment to use although they have added a new Goodrx Gold program...that's the one that has the 30 day trial but then it's a monthly fee.
Some cats get really drugged on Gaba, even a small dose. It concerns me that he was acting so "out of it". You might try a lower dose...you can always give more if it's needed.
It's usual dosage is 1mg per pound once a day.
Orally up to every 8 hours.
Why are you giving fluids? Is there any history or problem with her heart? Is she dehydrated? (you can test by turgor testing or feel her gums...they should be moist and slick, not gummy or sticky)
Generally, 100-150ml per day is about right unless they have heart issues. It can be given all at once or divided into 2 sessions.
GoodRX doesn't require any payment to use although they have added a new Goodrx Gold program...that's the one that has the 30 day trial but then it's a monthly fee.
tiffmaxee
Member Since 2013
A cat that weighs 9.9 pounds should not get more than 100ml fluids unless you are sure there’s no heart issues. If early in there would not be symptoms. You could give 100 ml twice a day IF the fluids are completely absorbed but why was even that much suggested? My internist will not give metacam to cats ever due to the black box warning. He used buprenex.
How are things today?
How are things today?
AggyBear
Member Since 2021
I have no evidence that she may have heart issues. She was not eating or drinking for at least a day and a half which is why she needs fluids, I gave her 100ml Thursday night and by Friday morning she was still considered dehydrated when he did the skin turgor test.
During her last flare up, he also suggested 200 mL a day, which everyone on here said was dangerous so I didn't do it.
This is very upsetting, I also don't know what a black box warning is but now I'm wondering if the drug is hurting her!
I will try the 25mg but I just really need to see her eating.
She slept all night with me in the bedroom (no jumping bc when she's sick/weak/drugged she will fall off the counter where she usually eats) and I saw her eat a little last night. I'm going to get her from her resting place to test, give insulin + offer food. I'll be back with an update. Thank y'all for your responses + help!
AggyBear
Member Since 2021
AMPS/11:28am BG 373 + gave 1.75u insulin, 50mg gabapentin, 12mg Cerenia + tried cleaning diarrhea from her tail- didn't want food or water + is warm to the touch, very lethargic.
Strong inappetence. Should I syringe/assist feed or see if the meds kick in? My poor baby had some diarrhea on her tail area and I have combed + washed with a warm cloth but the sickly smell is lingering. Would it be ok to wash with warm soapy water? I just don't want to bother her any more than is necessary. She's making little groaning noises that I'm just going to assume it's because she feels badly, doctor said her breathing sounded good.
Sarah&Soph
Member Since 2019
Not sure if you’ve tried this, but a lot of times when Sophie has pancreatitis I can get her to eat off my fingers or off of a spoon. No idea why it works, but it does sometimes
Chris & China (GA)
Member Since 2013
Yes but be sure to get it all rinsed off. The best thing is Dawn dishwashing liquid (the one with a picture of baby ducks on it). It's used on all kinds of animals that need to be cleaned up (it's what they use on birds that have been stuck in oil spills to get the oil off)
tiffmaxee
Member Since 2013
I would give the meds about an hour and if he won't eat I would assist feed a very small amount hourly. I'm glad the breathing is good. Sometimes if you can get them to eat a little they will eat more on their own. Avoid the temptation to feed more at one time. Small amounts often is what my vet always says with pancreatitis.
AggyBear
Member Since 2021
I am running some errands and as soon as I get home I will assist feed her a small amount. I've been through this several times but it just seems like she can't start feeling soon enough, I'm trying to be mentally strong because I know I'm doing everything I can for her. I appreciate y'all very much!
Diane Tyler's Mom GA
Member Since 2018
Any luck locating the bupe?
Just Google compounding pharmacys where in Texas you live ,maybe put in your address , compounding pharmacy close to then your address , town/texas
AggyBear
Member Since 2021
As per @Larry and Kitties recommendation to try GoodRx, I just need to email my vet to see if he can prescribe buprenorphine for Agatha + then I can get it at a local Walgreen's pharmacy, supposedly 60 2mg tablets for $14.69. I hope he can write a prescription so I can get what will really help Agatha!
Olive & Paula
Member Since 2015
You stated above she has a fever and diarrhea. Was a pancreatitis test done? She will get or stay dehydrated because of the diarrhea. With a fever, my thought is an infection vs pancreatitis somewhere. Is she getting any antibiotic?
Alana & Fatty
Member Since 2020
Pancreatitis flares are so distressing ... sorry you are going through this again/still. I just used gaba for Fatty's first flare up and didn't get bupe until his second flare, and it made such a difference. Sounds like it's tricky to get where you are but if you can find it, I really hope it will help your kitty as much as it helps mine.
Chris & China (GA)
Member Since 2013
The feline use of Metacam received the FDA’s strongest safety alert known as a “black box warning,” named for the unmistakable black border surrounding a cautionary statement on a drug’s insert or packaging. The product insert for Metacam now reads: “Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional doses of injectable or oral meloxicam to cats.
It's OK for 1 time injection, usually prior to surgery to help with pain, but a lot of vets send it home to continue to use and that's where the problem arises.
In Europe, they have Metacam but there's a canine version and a feline version and it's at a much lower dose so it's safe in those cases, but in the US, we still worry about it's use due to the problems with kidney failure.
AggyBear
Member Since 2021
Yes, she had a fever as of Friday and still has diarrhea. She laid with me all last night and had awful, sick smelling gas and when she went to the bathroom earlier she had diarrhea with the same smell. The doctor didn't give an antibiotic. During her last flare she had a persistent fever that after antibiotics + a week's time finally broke (she didn't have diarrhea then tho). If this sounds like infection again, I need to get antibiotics tomorrow morning.
Please for the love of God can someone tell me what pancreatitis IS? I don't even understand it so how can I know best how to fight it?
AggyBear
Member Since 2021
Thank you, it is extremely distressing for me to see her so weak, head dragging in the bowl of water, can't eat, can't drink, eyes distant. I swear to God it's like she's telling me, why? why are you putting me through this???
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