Pancreatitis

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Katsallday

Katsallday

Member Since 2021
After finding 3 piles of vomit in tunas room I rushed him to the vet. $550 later they find pancreatitis through the blood test. He got cerenia, subq's, and they want me to start antibiotics and probiotics tomorrow. They gave me forte. I'm a disaster of a mess right now. I don't know what to do. Is this life threatening, what else should I do to help him. I'm in an extremely bad place right now sobbing next to my poor cat. I don't know what to do please any information is helpful. I read the pancreatitis primer already but I feel like there's more I should do. I also read that worms can cause pancreatitis? When should I deworm him?
 
My cat has chronic pancreatitis which is actually why she is out of remission after two years. I find this guide from IDEXX to be the most helpful to me, personally.

https://www.idexx.com/files/spec-fpl-treatment-for-feline-pancreatitis.pdf

With pancreatitis, the main thing is to keep the nausea and pain under control and get them to eat. The Cerenia and subq fluids are good, but the Cerenia will likely wear off after 24 hours. Did they give you any to take home? If not, I would request some, or another anti nausea. Cerenia also comes in pills but they are very bitter. Another good anti nausea is ondansetron, which I use for my girl. It can be used with cerenia.

Did they give him any kind of pain meds? Pancreatitis is very painful so I would ask for some if not. From my understanding, antibiotics are not usually necessary for treating pancreatitis, unless they think there’s an infection happening from something else. Antibiotics can also be very hard on cat’s tummies, which is not ideal if they are already not wanting to eat.

Unfortunately pancreatitis seems to be pretty common in diabetic cats. It can be very frustrating to treat and manage, but most of the time is not usually life threatening with proper management. Just be sure you get Tuna eating and his pain and nausea under control. I let Sophie eat whatever she wants during a flare, which is usually forbidden dry kibble, treats, and tuna. Small meals or bites of food throughout the day are easier for her to manage than trying to get her to eat a larger meal.
 
They didn't send me home with cerenia or pain medicine of course. They have me feeding 1/4 a can of wet food instead of 2/3 that I usually do, does that sound alright? I'll call them back in a little and ask for the take home medicine. What do I do if they say he doesn't need it?
 
1/4 a can at a time or 1/4 total? I would definitely not withhold food if Tuna wants to eat, maybe just give smaller portions to be sure it stays down. The Cerenia should help with that.

I can’t imagine them not giving you anti nausea meds to take home, pain meds might be another story. They can be stingy with those, especially buprenorphine which is my preferred pain med for Sophie. They can do a 3 day injection of the bupe, if you feel inclined to take him back in.

If it were me and they refused, I would request the records to send to another vet that would do it. With a confirmed diagnosis of pancreatitis, there really is no reason for a vet to not prescribe those meds for him.
 
They agreed to do the cerenia but not the pain meds. I wonder if they think I'm gonna steal it for myself or something. I'm young looking with pink hair and tattoos, wouldn't by the first time someone thought so little of me.
 
Oh yes, they gave me the run around too when I asked for some to take home after the 3 day injection wore off. Bupe is a controlled substance, so they do not like giving it out. I would ask about the 3 day injection (no way to steal that for yourself!), or maybe even ask about onsior. Onsior is not my preferred choice, but it does treat inflammation and pain as well
 
Sarah&Soph said:
1/4 a can at a time or 1/4 total? I would definitely not withhold food if Tuna wants to eat, maybe just give smaller portions to be sure it stays down. The Cerenia should help with that.
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1/4 per shot so half a can just for today. I already fed him 1/4 since he just had his shot.
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Sarah&Soph said:
Oh yes, they gave me the run around too when I asked for some to take home after the 3 day injection wore off. Bupe is a controlled substance, so they do not like giving it out. I would ask about the 3 day injection (no way to steal that for yourself!), or maybe even ask about onsior. Onsior is not my preferred choice, but it does treat inflammation and pain as well
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Their response for "why" they don't want to give it is because there's no indication of pain. Idiots. I finally made some headway with them. They prescribed 4u of prozinc my first day with them, I knew that was too much so I cut it in half, then he went hypo on 2 and they wanted me to sign a waiver. Today I got a different vet in the same clinic and she was interested to see his spreadsheet so I printed it. And she said to stick at the 0.25 units too which is also cool.
 
Katsallday said:
Their response for "why" they don't want to give it is because there's no indication of pain. Idiots. I finally made some headway with them. They prescribed 4u of prozinc my first day with them, I knew that was too much so I cut it in half, then he went hypo on 2 and they wanted me to sign a waiver. Today I got a different vet in the same clinic and she was interested to see his spreadsheet so I printed it. And she said to stick at the 0.25 units too which is also cool.
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That is a very frustrating response, considering cats are notorious for hiding pain! :banghead: I don’t know about them, but pancreas enzymes digesting my pancreas tissue sounds pretty dang painful to me!

As for the feeding, I would use your discretion. You know how much Tuna eats, I would feed him what you feel comfortable with. It’s a balancing act between him getting enough calories, but not throwing up everything he eats as well.
 
Hi Katrina,

The pain meds are helpful if you think he's in pain. Have you seen this feline pain scale post? I found it really helpful. When I saw Ruby doing the meatloaf, droopy head, ears out and eyes squinting pose, I took a photo of it and sent it to the vet and then she agreed to prescribe painkillers after telling me Ruby didn't need them. :rolleyes: I give a dose of it to Ruby whenever I see her acting poorly and once the sedation wears off it does seem to perk her up and gets her eating again after a tummy flare.
 
You have a lot of company here in terms of people whose cats have pancreatitis:bighug:, me included. I’m sorry you are going through this. It is scary at first. Butters also vomits a lot and it's my sign that she is having a flare. When I see vomit, I start giving anti-nausea and pain meds immediately.

As others have said, it is painful. I have found a low dose of gabapentin also works well for Butters and maybe something your vet will be more open to providing since it is not a narcotic.

When I was on the hunt for a good vet, I looked for one who claimed to care about pain management. If pancreatitis is going to be a chronic thing for Tuna, you may want to consider this. Butters's vet still wants me to get her checked out when she has a flare, but he is fine with making sure I have enough pain, anti-nausea and appetite stim meds on hand to manage her flares immediately. I personally find that ondansetron works best for her for nausea, although sometimes I use cerenia in addition to that, I use buprenorphine for pain but occasionally gabapentin, and cyproheptadine with the anti-nausea meds if those aren't enough to get Butters eating.

How is Tuna doing tonight?
 
He is doing okay at the moment. We decided to feed him a fourth of a can of his wet food for lunch and he has just been laying in bed with me and my fiancé. We had called earlier and we had gotten them to provide us with a prescription for Cerenia, but that won't start until tomorrow, same with the other medications we got.
 
Oh I am so sorry!

I know you're overwhelmed, but Mr kitty's last flare was 3/18, I noted meds and doses and times in spreadsheet. I believe Lyla above does something similar in her spreadsheet.

Basically, give antiemetic like Cerenia or ondansetron well before a meal, and make sure pain meds are on board. When you think those are in the system, give appetite stimulant if you think he needs it. You want him to hopefully be pain free and not nauseous before giving an appetite stimulant. Let him eat however much he wants, just small amounts at a time so he doesn't get upset tummy.

If you have to syringe feed, he can develop aversion to the food being syringed. A lot of us use the Gerber 2nd foods meats because they're easy to syringe and low carb.

Fluids are given as needed, if dehydrated.

When you get done room to breathe, and if you can afford it, keep spare meds and fluids at home in case he flares again. I have a whole pancreatitis kit.
 
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Also, as for insulin, use your best judgment. If he's not eating or drinking a lot, you may want to reduce dose. BUT be careful with that, recipe for DKA is inappetence + not enough insulin + underlying inflammation/stress/infection. Pancreatitis checks two of those boxes.

Do not skip shots unless you have to. Try to stick to 0.25 if you can, if not then a drop dose. Monitor ketones a few times a day, I always do during a flare.
 
We're definitely still checking his blood sugar and giving him small doses atm. He seems to be doing well with the .25 units, staying roughly around the blues. He seems to still want to eat which is good, and he seems well hydrated as well. His skin is snapping back well, and it may be TMI, but when he pees, it seems to be a good amount and not just a few drops or something. How long do flair-ups seem to last? Can we expect this to continue for a while, and when can we tell it's better. (This is Katsallday's Fiance)
 
Katsallday said:
We're definitely still checking his blood sugar and giving him small doses atm. He seems to be doing well with the .25 units, staying roughly around the blues. He seems to still want to eat which is good, and he seems well hydrated as well. His skin is snapping back well, and it may be TMI, but when he pees, it seems to be a good amount and not just a few drops or something. How long do flair-ups seem to last? Can we expect this to continue for a while, and when can we tell it's better. (This is Katsallday's Fiance)
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Sounds like Tuna is doing pretty well right now :cat: How long a flare lasts really depends on the cat. Mine has gotten over them in as soon as 3-5 days, other times it has taken up to 2 weeks to completely get over it. In my experience, catching it early and starting treatment, as well as staying on top of the nausea and pain seems to help my cat get over it quicker. But again, every cat is different
 
Katsallday said:
We're definitely still checking his blood sugar and giving him small doses atm. He seems to be doing well with the .25 units, staying roughly around the blues. He seems to still want to eat which is good, and he seems well hydrated as well. His skin is snapping back well, and it may be TMI, but when he pees, it seems to be a good amount and not just a few drops or something. How long do flair-ups seem to last? Can we expect this to continue for a while, and when can we tell it's better. (This is Katsallday's Fiance)
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That's great! Usually the scariest part is them not eating or drinking.

For us, I continued with meds until I saw other signs he was feeling better as meds were wearing off - purring, moving about, just general "personality" changes. His last flare was about 4 days. I believe he had before that but I didn't know what it was, lasted 2 days.

The first med I drop is the appetite stimulant. If I skip that and he eats, I know it's getting better. So I give him a day off of that, and if he's ok then I drop the antiemetic. Give him a day or two off that, and if he's eating on his own then I drop pain meds. Obviously if it seems dropping a med made him feel worse I start it back up.
 
Also, if you do end up needing Mirataz, only give half of what the tube recommends. You do not need full dose, you'll end up with a cat who wants to eat everything in sight but gets pissy because you can only give small amounts at a time. Also I believe it was mentioned somewhere Tuna is overweight, don't want an appetite stimulant to make him overeat either
 
Honestly he was eating only a little less then normal for about 2 days. He ate about half a can of dm on his own and I would try to make him eat more (oops)

What is hard to believe is that there's no targeted anti-inflammatory for chronic pancreatitis. Before I met my wonderful fiance I was engaged to a human doctor. I helped him through med school making flash cards and listening to his lectures for 5 years (he failed a year lol) and through his first years as a an ER doc. From what I understand inflammation with no cause as most feline pancreatitis cases seem to have, can be managed through an extended low dose of any antiinflammatory tapering beyond the end of symptoms to ensure no bounce back inflammation. There are tons of antiinflammatorys that are not steroids. I feel like animal medicine is constantly overlooked and no one wants to make advancements in the field. My dream growing up was to be a vet, but when I figured out I'd have to see sick and dying animals everyday I couldn't do it
 
Katsallday said:
Honestly he was eating only a little less then normal for about 2 days. He ate about half a can of dm on his own and I would try to make him eat more (oops)

What is hard to believe is that there's no targeted anti-inflammatory for chronic pancreatitis. Before I met my wonderful fiance I was engaged to a human doctor. I helped him through med school making flash cards and listening to his lectures for 5 years (he failed a year lol) and through his first years as a an ER doc. From what I understand inflammation with no cause as most feline pancreatitis cases seem to have, can be managed through an extended low dose of any antiinflammatory tapering beyond the end of symptoms to ensure no bounce back inflammation. There are tons of antiinflammatorys that are not steroids. I feel like animal medicine is constantly overlooked and no one wants to make advancements in the field. My dream growing up was to be a vet, but when I figured out I'd have to see sick and dying animals everyday I couldn't do it
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As far as I know, there are only two anti-inflammatories approved for use with cats: Onsior and Metacam. Since most of the kitties here on the board are considered seniors, caregivers tend to avoid giving anti-inflammatories because of potentially causing kidney damage. I did give Onsior to my civvie who has no health conditions for a limp, but they advise you to give it for no more than 3 days.
 
PerfumedCatMom said:
As far as I know, there are only two anti-inflammatories approved for use with cats: Onsior and Metacam. Since most of the kitties here on the board are considered seniors, caregivers tend to avoid giving anti-inflammatories because of potentially causing kidney damage. I did give Onsior to my civvie who has no health conditions for a limp, but they advise you to give it for no more than 3 days.
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That interesting, thanks for letting me know.


Tuna is at a PMPS of 138. I know you guys said to try to push the insulin but it's so low, do I do a drop?
 
Don't look at these photos if you don't want to see TONS of cat diarrhea. At minimum 4 of my cats have diarrhea. Tuna is in isolation, they all eat the same food except tuna of course. I've cleaned their water bowls, no new cleaning chemicals infact I only buy natural cleaners because I'm sensitive to most. No disturbances in environment, what the hell happened

https://flic.kr/ps/3WFAji
 
Katsallday said:
Thank you so much Bhooma! I hope someone has an idea about this hell I'm living through! I have 16 cats in total, if all 16 get diarrhea I'm probably going to lose my mind
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Having one cat with diarrhea is bad enough! Any luck with getting the S.Boulardii and Flagyl?
Are they all indoor cats?
 
Bandit's Mom said:
Having one cat with diarrhea is bad enough! Any luck with getting the S.Boulardii and Flagyl?
Are they all indoor cats?
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Yep they are all indoors, I have a mini mansion for them so please don't think they're cooped up in a small house! 3 stories and 3000 sqft. No luck on the other probiotics, there's a specialty health store that I'm going to check this morning, but the vet did put tuna on forte starting tomorrow
 
Thank you! Im at -35 dollars in my bank so I'm going to find a way to order that!

Tuna is headed towards a hypo right now, 65 at +3

His PMPS was 137 so we only pushed a drop! I just gave him a teaspoon of wet dm, now I have to worry about hypo and pancreatitis too:arghh::arghh::arghh:
 
Max became diabetic after having chronic pancreatitis for a few years. Every cat is different but for Max the first sign was inappetence. I didn’t realize he was nauseous because he was willing to eat dry food and licked the liquid from the canned. I was worried he had lymphoma like my other cat. He got ondansetron at the first site of lowered appetite and after a day if he wasn’t eating enough, cyproheptadine, a human RX, as an appetite stimulant. It’s old school but I had used it as needed for cats for years before mirt and mirt made another cat too hyper and vocal. Once ondansetron started working it was often all he needed. My vet gave me buprenorphine at times too. You are right that cats hide pain. Max never showed signs of it. Feed small amounts often once eating or they start to associate not feeling well with their food.

With all your cats having diarrhea I wonder if you have recently changed food or perhaps got a bad batch?

I hope all the ideas mentioned help Tuna!
 
tiffmaxee said:
Max became diabetic after having chronic pancreatitis for a few years. Every cat is different but for Max the first sign was inappetence. I didn’t realize he was nauseous because he was willing to eat dry food and licked the liquid from the canned. I was worried he had lymphoma like my other cat. He got ondansetron at the first site of lowered appetite and after a day if he wasn’t eating enough, cyproheptadine, a human RX, as an appetite stimulant. It’s old school but I had used it as needed for cats for years before mirt and mirt made another cat too hyper and vocal. Once ondansetron started working it was often all he needed. My vet gave me buprenorphine at times too. You are right that cats hide pain. Max never showed signs of it. Feed small amounts often once eating or they start to associate not feeling well with their food.

With all your cats having diarrhea I wonder if you have recently changed food or perhaps got a bad batch?

I hope all the ideas mentioned help Tuna!
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Tuna is on a completely different food :arghh: I can't find a reason why everyone is sick right now!
 
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