Severe Pancreatitis

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AlyMcF

Member Since 2014
My cat Sketch was diagnosed with "severe pancreatitis" and fluid in his abdominal cavity just last week. They think it started because his diabetes (which had been in remission) returned a few weeks ago and we didn't notice. The diabetes led to pancreatitis which led to the return and worsening of the diabetes. Now we have a very sick kitty at home.

We first knew something was wrong on June 28 when he threw up green liquid, was breathing rapidly, had a BG of over 300, and generally seemed out of sorts. A visit to the urgent care cat clinic revealed normal vital signs, so they took blood and urine and sent him home and we waited for results.

On the night of June 29, he seemed worse. His BG was over 500 and we rushed him back to the hospital. His temp had shot up to 105 F and they decided he need to be hospitalized and given IV fluids.

The next day we learned after getting test results back (blood, urine, chest xray, abdominal US) that his diabetes had returned and he had severe pancreatitis and fluid in his abdomen. He spend three nights in the hospital. On the last night he had trouble breathing at one point and they put him on oxygen. They believed that he had gotten too much IV fluid and it overwhelmed his heart.

He came home the night of July 2, with the following Rx’s:

buprenorphine for pain

mirtazapine for appetite

cerenia for nausea

clavamox and zeniquin antibiotics (I think this was either because they thought there was bacteria in the pancreatitis or that he had aspiration pneumonia, or both)

tumil K (potassium…I forget why but it is the low priority pill)


and of course, lantus glargine


So we have been struggling every morning and night to get these meds into him and to get him to eat. Last night a neighbor came over (who had experience with force feeding a cat through a syringe) to help get some food into him. I had to resort to giving only 1/2 cc of insulin twice yesterday because he had eaten so little.

It doesn’t help that we are having a heatwave and it gets to be 80 degrees in our house by mid afternoon. It doesn’t help that I just had laparascopic gallbladder surgery June 30 and can neither lift him nor stoop to feed him. I’m relying a lot on my husband and ten year old daughter this week. And because of exhaustion from recovering from surgery, I haven’t been able to research or make much sense of what I have read about pancreatitis.

I’m not even entirely sure why I’m posting, except to share what Sketch is going through and to see if anyone else has a similar story or advice.

Background: Sketch was diagnosed with diabetes in Nov 2014. Switched to a low carb canned food diet and after just two weeks of glargine, he went into remission. A few months later his roommate Max started boycotting the low carb canned food diet and in an effort to find something they would both eat happily, we found low carb dry food by Evo (12 % carbs), and supplemented it with the low carb canned foods that mostly only Sketch was eating. This was going well until a few weeks ago.
 
We have a Primer on Pancreatitis you may find helpful.
Right now, getting him to eat is the important thing, regardless of carb content. If that means syringe-feeding, go for it.
 
If Sketch is drinking a lot, one thing I have found helpful is to add water to the food and liquefy it. When I employ this technique for Squeaker he always laps it right up.

Just one question right now, did the vet not advise daily sub-q until the crisis is over?
 
Hi

I am sorry you are going through this with Sketch.

When my cat remi was having a bad flair we actually ended up giving him both cerenia and ondansetron as one worked better for nausea and the other for vomiting. Could you ask your vet to supply some ?

Have a read of the idexx pancreatitis treatment recommendations For other suggestions for treatment.

https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf

I would also recommend that join the yahoo pancreatitis support group.

https://groups.yahoo.com/neo/groups...zZWMDdnRsBHNsawN2Z2hwBHN0aW1lAzE0MzYwODM5MDU-

Best wishes
Sarah
 
If Sketch is drinking a lot, one thing I have found helpful is to add water to the food and liquefy it. When I employ this technique for Squeaker he always laps it right up.

Just one question right now, did the vet not advise daily sub-q until the crisis is over?
The vet just gave us a syringe to give him water by mouth if needed. They didn't give us any materials for injecting water into the skin (sub-q?)
We have been adding water to the syringe to liquidfy the food.
 
When my cat remi was having a bad flair we actually ended up giving him both cerenia and ondansetron as one worked better for nausea and the other for vomiting. Could you ask your vet to supply some ?
He only vomited once in this whole ordeal and that was right at the beginning. I'm afraid to ask for more drugs as we can't even handle pilling him all the pills they supplied. We have had to skip the Tumil K for a couple of days. Then today I read he should probably get probiotics because of the antibiotics. :P

The latest symptom is diarrhea. The vet said that's not unexpected considering his diseases and the antibiotics.
 
He only vomited once in this whole ordeal and that was right at the beginning. I'm afraid to ask for more drugs as we can't even handle pilling him all the pills they supplied. We have had to skip the Tumil K for a couple of days. Then today I read he should probably get probiotics because of the antibiotics. :p

The latest symptom is diarrhea. The vet said that's not unexpected considering his diseases and the antibiotics.

You *MAY* be able to get some of these meds compounded at a compounding pharmacy and inject them. You could ask your vet about that possibility. We had to do that with a previous cat with both antibiotics and Zantac.
 
With the diarrhea, now, ask your vet for subcutaneous fluids and instructions on using them. He may not be able to get enough water in by mouth and dehydration can be deadly.
 
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Hi Alyssa

I'm glad to read that Sketch is feeling so much better. Bad pancreatitis flares are horrendous. I hope you're feeling better, too. :)

Going forward, I hope that your vet has prescribed some supportive meds for you to keep at home (e.g. ondansetron, cyproheptadine, famotidine). Having them to hand and being able to intervene quickly at the first signs of a flare can help to stop it in its tracks. Regular B12 supplements are good for maintenance (see IDEXX guidelines).


Mogs
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Hi Alyssa

I'm glad to read that Sketch is feeling so much better. Bad pancreatitis flares are horrendous. I hope you're feeling better, too. :)

Going forward, I hope that your vet has prescribed some supportive meds for you to keep at home (e.g. ondansetron, cyproheptadine, famotidine). Having them to hand and being able to intervene quickly at the first signs of a flare can help to stop it in its tracks. Regular B12 supplements are good for maintenance (see IDEXX guidelines).


Mogs
.
They never said anything to me about a possible future flare and I don't recognize any of those medicine names. They thought the pancreatitis was brought on by the return of the diabetes, so maybe that's why? Now he's back on insulin again. If he goes back to the whole "not eating and hiding all day" routine, I figure it could be anything and I would just take him to the vet. Luckily they are only a few blocks away and we have a 24 hour emergency plan only 20 minutes drive away.
 
It may be that it was just an acute flare. I hope this is the case.

I'd be very interested to hear how your little one does back on insulin because I think that Saoirse's not doing as well without hers. Maybe you might PM with an update some time? I'd really appreciate it.

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Sketch's insulin requirements creeped up from 1 unit to now 3 units and we are holding steady with good BG numbers at 3 units of insulin. He is doing well. However, with his past history of eventually needing less insulin and going into remission, we have to spot check his BG numbers. This process just started as of today. We will see how things shape up in the coming weeks.

I think one factor in his BG numbers being good at the moment is that he is back on a mostly low carb diet. The highest carb thing he eats now (as far as I know) is Evo dry food which is 12% carbs. He's also on these wet foods: Wellness grain-free, BFF and Fancy Feast Classic. The treats he gets are Wildside Salmon.
 
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