Pancreatitis flare up help

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You may want to pick up S. boulardii for the diarrhea. It's a probiotic that is very effective for diarrhea. You start with about 1/4 of a capsule in food or dissolve it in water and syringe it into your cat's mouth..

Primer on Pancreatitis - Marje put this together and it will help to answer your questions. I'd assumed someone had already linked this for you.
 
Sienne and Gabby (GA) said:
You may want to pick up S. boulardii for the diarrhea. It's a probiotic that is very effective for diarrhea. You start with about 1/4 of a capsule in food or dissolve it in water and syringe it into your cat's mouth..

Primer on Pancreatitis - Marje put this together and it will help to answer your questions. I'd assumed someone had already linked this for you.
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Thank you Sienne, it was linked to me and I have read it and I still don't fully understand why it happens. Where is the infection coming from if it's not from the pancreatitis? I don't think she's ever had diarrhea before either. Do you get that probiotic from the vet or a to health food store?
 
AggyBear said:
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?
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“Pancreatitis refers to inflammation of the pancreas and is caused by activation of the digestive enzymes within the pancreas due to pancreatic damage or blockage of its outflow duct. This results in pancreatic auto-digestion, whereby the enzymes destroy the pancreatic tissue”

It is basically inflammation of the pancreas that causes the pancreas to start digesting itself, which is why it can be very painful. I don’t think they know why it happens still, but it does seem to happen more often in diabetic cats, maybe because there’s already an issue with the pancreas. It also seems to go hand in hand with IBD as well, which is also an inflammatory disease. Diarrhea isn’t as common of a symptom with pancreatitis, but my cat always get it when she has a flare
 
Today's update: AMPS/10:35am BG 309 + 50mg gabapentin, 4mg ondansetron + orally syringed 5ml water, +4h/2:30pm syringe fed 15ml a/d + gave 4mg ondansetron + 12mg Cerenia.

I have had the worst couple days (huge fight with family member, my phone was factory reset without any notice bc of a new sim card + my Aggy bear is so sick). I should've started syringe feeding her Thursday morning when she ate almost nothing but I didn't. When she gets sick I mentally shut down, emotionally I'm panicking but feel in paralyzed. I saw her try her best yesterday to eat little nibbles + I was waiting for medications to kick in (they don't seem like they're helping fast enough). Last night after one of the worst days in a very long time, I fell asleep with the lights on and Agatha in my arms, crying. She jumped down several times but kept getting back in my arms. I didn't do our PMPS testing, insulin or feed (medications + fluids I got done). I know how important this is, but please be gentle with me. I truly am doing my best. I know y'all will understand. I have been through this so many times with her, 2 different times with feeding tubes + straight up assist feeding since January DX. I put it off for far longer than is loving but I got 15ml a/d in her + will get another 15ml now. I have a very light internet presence and am not prone to spilling my guts to strangers but even if we've never met or talked on FDMB I feel like we are all bonded in our love and dedication to our pets and are friends.
 
Here's our full day: AMPS/10:35am BG 309 + 50mg gabapentin, 4mg ondansetron + orally syringed 5ml water, +4h/2:30pm syringe fed 15ml a/d + gave 4mg ondansetron + 12mg Cerenia, +6/4:30 syringe fed 15ml a/d + 4mg ondansetron, PMPS/9:55pm BG 473 + 50mg gabapentin + 4mg ondansetron + Mirataz + 100ml fluids but was EATING ON HER OWN! + went back several times!
 
Olive & Paula said:
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?
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I will email my vet now but bc he didn't check it often I'll call his office in the morning to ask for or see if he think I should give her antibiotics. Is there any particular kind she shouldn't have or should have? (It seems he only prescribes the ones she shouldn't have *facepalm*).

Do most cats get fever when they have a pancreatitis flare? This is at least the second flare with fever.
 
AggyBear said:
Here's our full day: AMPS/10:35am BG 309 + 50mg gabapentin, 4mg ondansetron + orally syringed 5ml water, +4h/2:30pm syringe fed 15ml a/d + gave 4mg ondansetron + 12mg Cerenia, +6/4:30 syringe fed 15ml a/d + 4mg ondansetron, PMPS/9:55pm BG 473 + 50mg gabapentin + 4mg ondansetron + Mirataz + 100ml fluids but was EATING ON HER OWN! + went back several times!
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Eating on her own is great!!
 
I don't know about the fever. Neither of mine had fevers or diarrhea. Smokey had really stinky poo and boy do I mean stinky. Ollie's bs would spike, nausea and look sick, not eat that well but did eat. And was uncomfortable. Didn't like her belly or sides touched.

Antibiotic I can't answer. I do not allow certain ones for my own personal reasons.
 
Buprenorphine: what kind + what dose should I see if my vet can prescribe? I prefer a pill to give her just bc it's more straight forward + the pharmacy seems more likely to have that. It's an hour drive one way but I need to pick up a new vial of insulin anyway. Just helping to make my blows count.
 
Also, she had been peeing outside the litter box and falling off counters. I thought it was because she was weak but now I'm wondering if it's diabetic neuropathy and she needs methylcobalamin b vitamin?
 
AggyBear said:
Buprenorphine: what kind + what dose should I see if my vet can prescribe? I prefer a pill to give her just bc it's more straight forward + the pharmacy seems more likely to have that. It's an hour drive one way but I need to pick up a new vial of insulin anyway. Just helping to make my blows count.
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It comes in different concentrations so vet would to figure it out. Bet should have some in the office and give you a few days worth. Liquid is better as it works so much faster. Then vet can call it in to compounding pharmacy and have it shipped to you. I believe Wedgewood, Roadrunner, Diamondback are 3 I remember. Ollie's vet use to order 60 day supply for me as she got maintenance dose every 8 hrs. I think she ordered from Roadrunner.
 
AggyBear said:
Also, she had been peeing outside the litter box and falling off counters. I thought it was because she was weak but now I'm wondering if it's diabetic neuropathy and she needs methylcobalamin b vitamin?
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Have you thought of increasing insulin dose? She has been on this dose for a long time and still in the 300s. Was there a reason you skipped the dose? Any chance you can get a mid cycle test? And one before you go to bed at night? It's hard to see what's happening without more tests.

Any brand of methylcobalamin is good as long as it's the only ingredient. Sundown Naturals is one brand that has the 5000 mcg strength. Crush and mix in food.
 
AggyBear said:
Also, she had been peeing outside the litter box and falling off counters. I thought it was because she was weak but now I'm wondering if it's diabetic neuropathy and she needs methylcobalamin b vitamin?
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I might suggest upping to 2 u, but i'd like to see more mid day cycle tests before I would do that. Having bg lower would help if it was neuropathy
 
Besides a little bit of back and forth about antibiotics and the diarrhea and fever, this is what he said about buprenorphine:


I called HEB (pharmacy), I left the rx for the ondansetron 8mg tabs- 1/2 tab by mouth twice daily, you could use it 3x per day if needed. They did not have the buprenorphine injectable (1ml 0.3mg/ml vials) he said. I've read some articles about the sublingual tablets and the general conclusion is that it is likely not very helpful in cats due to variation of absorption. It is intended to slowly absorb into the bloodstream through the oral mucosa and NOT by swallowing. Once swallowed, it is broken down in the stomach and the liver does a pretty good job of clearing it, and none really gets to the cat. And since you can't really tell a cat to hold it in their mouth until it dissolves....well, that's the limitation.

---so guess we're not getting it... This is so frustrating.
 
I also suggested
Just Google compounding pharmacys in Texas, the town you live in
Google compounding pharmacy's near put your town, Texas
 
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Thank you guys, I have called a lot of pharmacies and literally none of them have the injectable AKA oral version of it. If all else fails will pills work?
 
AggyBear said:
Thank you guys, I have called a lot of pharmacies and literally none of them have the injectable AKA oral version of it. If all else fails will pills work?
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I think something is lost in communication. Human pharmacy maybe only have pills. Pet pharmacy and compounding WILL have the liquid. Vets use it for surgery. Some vets stock the liquid. However, it is a controlled substance so some vets might not be licensed to script or order it. It's the most common pain med for pets.

https://www.wedgewoodpharmacy.com. Does have oral solution. The full link does not show up.

Click the link then choose Pet and horse owners link on the right. Then type in Buprenorphine in the search box. It is there. Wedgwood will not give you prices, they will only give to vet. I know for a fact they have it.

They even have it in transdermal gel now.

Maybe ask pharmacy about liquid you put in mouth and not mention injectable.

Another thought is to call ER vet and ask them where they get their supply from as your having trouble finding someone to fill your script.

Did you read this: https://www.marvistavet.com

Right at the top it's says usually given orally or spray.

The pill will work, just takes so much longer to kick in and I don't know what it will do to the stomach if long term. I always opt for liquid meds when possible. My kits are so hard to pill.I

There is also a Fentyl patch, maybe that's an ootion. It's good for 3 days maybe 5. I don't remember. Tux had it when he had intestinal surgery. It was a bugger to get off though.

I just can't believe you are having such an issue with this.
 
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First 2 links are pet pharmacy in Texas that have it.

https://www.svpmeds.com

https://petscript.net/product/cat-medications/buprenorphine-for-dogs-and-cats/

https://www.bcpvetpharm.com

Google pet pharmacies in Texas. That's where you are correct? Some sites you can search for Buprenorphine. Some don't have search option and have to call.

They are out there. It is available. Just have to search. You might not get it close to home but that's okay. It can be mailed. In meantime I guess pills are better than nothing.
 
Olive & Paula said:
I just can't believe you are having such an issue with this.
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Hi Paula, I just had to say I can't believe this either lol
Thanks for giving her some places to call
I mentioned to her to google compounding pharmacy's close to where she lives
It was irking me that her vet doesn't know how to find it
 
Diane Tyler's Mom said:
Hi Paula, I just had to say I can't believe this either lol
Thanks for giving her some places to call
I mentioned to her to google compounding pharmacy's close to where she lives
It was irking me that her vet doesn't know how to find it
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This is ridiculous. Is vet a new one out of school and no experience? Extremely old and only knows "old" thoughts. I saw your posts also. Maybe it's me, I just push and demand (nicely most of the time) what I want. Do my research go in with documents, unless the can prove otherwise, I get my script. And I have changed vets when it seems they are not vested in my cat. Just recently I took Trip to new vet because I was getting no where with current vet of the last 12 yrs.
 
Olive & Paula said:
This is ridiculous. Is vet a new one out of school and no experience? Extremely old and only knows "old" thoughts. I saw your posts also. Maybe it's me, I just push and demand (nicely most of the time) what I want. Do my research go in with documents, unless the can prove otherwise, I get my script. And I have changed vets when it seems they are not vested in my cat. Just recently I took Trip to new vet because I was getting no where with current vet of the last 12 yrs.
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I don't mean to laugh about this but I can't help it lol
It might be time for her to start looking for a new vet. If she does look at what places you listed I hope the vet knows how much to tell her to give
I hope all is well with you and Trip :cat:
 
I got the Veraflox antibiotics at the vet yesterday, giving to her now. I just found 3 different accidents on the rug in the living room- their litter box is in the bedroom. She has literally never pooped on anything other than the mat outside the litter box. Will the antibiotics take care of the diarrhea?
 
@Diane Tyler's Mom + @Olive & Paula thank you very much for the help with the compounding pharmacies. I don't think anything was lost in translation. My head isn't quite on straight and trying to get all this taken care of is a lot to handle. I will look into the compounding later today. Address also going to need methylcobalamin for her hind legs. I have a screenshot of where @Bron and Sheba (GA) was talking about how she got her baby better but it took 6 months. Does anyone know where my friend Bron is? She knows our situation well + I miss her!

As for my vet, I used to live where he practices. He's been our family vet of choice for about a decade. He's kind, calm + good with animals (not all vets are!). He helped take care of Agatha when she first got fatty liver/ hepatic lipidosis in 2014. My sister worked at the vet he was at at the time + saw him swaddling her + babying her as he was entering info into the computer. I think this is still the image I have in my head of him. Someone to take care of my baby girl when I couldn't. Six years ago I moved an hour away and she didn't need a vet until 2018 when she developed fatty liver again. It was always on a Saturday (3 different times!) and I couldn't get ahold of any of the vets my local friends suggested + I had to go to a vet that caters to the rich people who gave vacation homes in a community nearby. Two words: highway robbery. I won't even get into that right now. I had to go to an emergency vet (highway robbery steroids)- after much debt + nursing Aggy night and day she fully recovered! Fast forward to January 2021. My vet had left the practice he was at and purchased his own. I took Agatha to him and this is where we're at now. He is probably in his early forties, he's neither an old or new veterinarian. Although I like and respect him in certain aspects, it is very difficult and I speak from experience, to find someone in the medical field that you trust in respect and is open to helping you how you want. I would love to find a vet nearby that I can trust simply because when we need to go to the vet is is usually urgent and making a 2 hour trip is not at all expedient. I hope this gives you insight into my vet and our relationship.
 
If the reason for the diarrhea is pancreatitis, probably not. If it’s something else, maybe. Veraflox did stop my cats diarrhea when she had colitis. Be aware though that it is a pretty strong antibiotic and it might cause stomach upset/nausea or decreased appetite
 
Olive & Paula said:
Some of it makes sense now that you explained it. However, vet should know about Buprenorphine liquid and pharmacy they can order from. That is what seems off.
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I agree.
Sarah&Soph said:
If the reason for the diarrhea is pancreatitis, probably not. If it’s something else, maybe. Veraflox did stop my cats diarrhea when she had colitis. Be aware though that it is a pretty strong antibiotic and it might cause stomach upset/nausea or decreased appetite
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Olive & Paula said:
It depends on the reason for the diarrhea.
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It seems like a toss up then... I will continue giving it to her + look for the probiotic S. boulardii @Sienne and Gabby (GA) suggested.
 
AggyBear said:
I agree.


It seems like a toss up then... I will continue giving it to her + look for the probiotic S. boulardii @Sienne and Gabby (GA) suggested.
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You can also get Renew Life probiotic. Make sure it has a lot of units and covers many strains. Renew was easier for me to find than s boulardii, but I am extremely rural. Don't even have a vitamin shop around so I have to get it at grocery stores or walmart who have the most to choose from. Now we have a RiteAid and CVS so its easier. Still no s boulardii though.
 
Here's our info for today: AMPS/12:21pm BG 370 + 50mg gabapentin + 4mg ondansetron- appetite returning! + actually drinking water!, +4/4:16pm BG 137 + 1st dose antibiotics + treats, +9/9pm Cerenia, PMPS/12:17am BG 318, Mirataz, 50mg gabapentin, 4mg ondansetron, 100ml fluids

Overall, she seems to be getting a bit of life back in her, she sat on the sunny balcony twice today + followed me around a bit. However, now I'm wondering if both my cats have diarrhea. My civilian Freya, was in and out of the litter box a couple times tonight and seem to be straining and yowling a bit. I've never witnessed her do this so I just watched and instantly the room was filled with the same sickly smell the Aggy has been having. It's clear Aggy is having a pancreatitis flare up but now I'm wondering if the Friskies pate I feed them or something else could be making them sick?
 
AggyBear said:
Here's our info for today: AMPS/12:21pm BG 370 + 50mg gabapentin + 4mg ondansetron- appetite returning! + actually drinking water!, +4/4:16pm BG 137 + 1st dose antibiotics + treats, +9/9pm Cerenia, PMPS/12:17am BG 318, Mirataz, 50mg gabapentin, 4mg ondansetron, 100ml fluids

Overall, she seems to be getting a bit of life back in her, she sat on the sunny balcony twice today + followed me around a bit. However, now I'm wondering if both my cats have diarrhea. My civilian Freya, was in and out of the litter box a couple times tonight and seem to be straining and yowling a bit. I've never witnessed her do this so I just watched and instantly the room was filled with the same sickly smell the Aggy has been having. It's clear Aggy is having a pancreatitis flare up but now I'm wondering if the Friskies pate I feed them or something else could be making them sick?
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They can share intestinal virus too.... Certainly sounds like something going on. Probiotic would do them both some good. If she was crying out out could have been constipation as well.
 
JanetNJ said:
They can share intestinal virus too.... Certainly sounds like something going on. Probiotic would do them both some good. If she was crying out out could have been constipation as well.
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I was trying to figure out this all night, because when I went to the box even though she was scraping to cover it up there was nothing there. So I think you're right! I've never had a cat be constipated?
 
My cat has chronic constipation. There are several things you can try. Many people use canned pumpkin, which can sometimes help. You can also try giving her more water. For mine, she gets Miralax for it, in her case daily.

Something to keep in mind for Aggie, ondansetron can be constipating, as can bupe although I know you’re not giving that one yet. If she’s dehydrated, that could contribute as well.
 
Thank you for the information, I will get some pumpkin to see if she'll eat it. What causes chronic constipation like with your kitty?
 
I think it depends on the cat probably. Sophie has IBD which I’m sure contributes to it, but I think a big part of it is also her food. As bad as dry food is for cats, it does have quite a lot of fiber whereas her very high protein wet food does not have very much at all. But the daily Miralax is a small price I’m willing to pay for the better diet overall.

I’ve actually noticed quite a few cats that were switched to wet food start having constipation issues. I can’t say for sure that it’s related, that’s just my observation. Pumpkin can add fiber and help with both constipation and diarrhea, so definitely worth a shot if your kitty will eat it! Be sure to get just plain canned pumpkin, not pumpkin pie filling. You can also get it powdered which Sophie likes a little bit more but she still does not like it lol
 
I give pumpkin but 1/8-1/4 tsp of Miralax might be needed. I like the pumpkin baby food because it's blended really smooth. Put like a tsp of it mixed in the food. If they don't eat the food with it you can syringe it in. The Miralax has no flavor and can be mixed in with food also.
 
Update: AggyBear is making steady progress. She's eating + drinking well, has more fire in her, walking around more and that miserable, distant look in her eyes has disappeared + her beautiful calm green eyes sparkle back at me with love. I will be doing a curve test this weekend. Is there a sticky for specifics on doing a curve? I can't remember if I do it every hour or ever other hour? I appreciate y'all so much, Aggy does too!
 
So excellent to hear she is feeling a bit better today :cat:

A curve is testing every 2 hours for 12 hours, or every 3 hours for 18 hours.
 
AggyBear said:
Update: AggyBear is making steady progress. She's eating + drinking well, has more fire in her, walking around more and that miserable, distant look in her eyes has disappeared + her beautiful calm green eyes sparkle back at me with love. I will be doing a curve test this weekend. Is there a sticky for specifics on doing a curve? I can't remember if I do it every hour or ever other hour? I appreciate y'all so much, Aggy does too!
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I love this update! Keep healing, Aggy!! try to get a mid day test between 4-7 hours each day.
 
Today's update: AMPS/10:48am BG 325, 50mg gabapentin + 4mg ondansetron, +9/7pm put out new can of pate, PMPS/10:15pm BG 586, 50mg gabapentin, 4mg ondansetron + antibiotics.
 
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Hi Sam, I am just seeing that Aggie hasn’t been well again. I haven’t been online for a couple of weeks. How is she doing?
Are you able to get any tests in during the cycles? At the moment there are very few to see how well the insulin is working.
How are her bowels working now?
 
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