Re: Sick cat.... she is in ER with DKA ..pancreatitis
One thing to know about pancreatitis... it is painful, so be sure you don't bring her home without pain meds. Get bupe as it's great for easing pain from pancreatitis. Also, giving fluids at home is another thing you can do to treat it. You already have SQuids, so you're fine there.
Pancreatitis is like a fever in that you can't say 'she was fine last month'. You know that you can't say that about a fever, right? And the same goes for pancreatitis. If you ever suspect it, have the vet get the fPLI test done to confirm or eliminate it as a cause. Pancreatitis is like a fever.... once the flare has passed, the test won't tell you a thing. Once the fever is down, the thermometer will say 'no problem here'!
Chronic pancreatitis (or does my cat have a pepcid deficiency?)
Info from Cheryl / Winnie – steroids and pancreatitis tx
steroids are actually considered to be a front line treatment for p-titis. The pancreas is inflamed and steroids are potent anti inflammatory drugs.
It is important to treat p-titis flares aggressively.
I have experience steroids w/ 2 different p-titis kitties.
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Most cats w/ p-titis flare experience a degree of nausea-- which could explain the inappetence. Although
pepcid can help in mild cases, it often isn't enough for nausea of p-titis.
I had great luck w/ ondansetron for kitties w/ ptitis and lymphoma. it is very inexpensive prescription med. it comes in either pill or injection. I had easy pillers, so I went that route. The *big* p-titis vets ( zoran,marks, scherk) all recommend its use. If your vet is unfamiliar, i would be happy to post the dosing ranges for you .
If there is vomiting -- then cerenia shots can really help. They can only be used so many days in a row though.
and to note, they can be used along w/ the ondansetron. ( and yes you can give the pepcid with both of them. )
If your kitty is not eating, appetite stimulants are often used.
mirtazapine is a very effective medication and only has to be dosed every 3 days.
http://www.veterinarypartner.com/Content.plx?P=A&A=2552
another commonly used med is cyproheptadine.
http://www.marvistavet.com/html/body_cy ... adine.html
note: appy stims will not work if your cat is nauseous.
There are also various ways to entice your kitty to eat. and that sounds like it is a problem ( although certainly the pred should help-- and getting rid of nausea and pain and appy stims
more tools the better !
If you scroll down on the following link's thread you will see a post of suggestions for appy enticements:
viewtopic.php?f=28&t=26965
Pain control for p-titis is extremely important. buprenorphine is a med that is commonly used for kitties with this problem and is very effective. If your cat has p-titis it is generally assumed to be in pain. Sometimes the only way to know if treating pain will be effective is by trying. Please talk to your vet about this.
You can refer him or her to this by margie scherk, dvm:
Feline Pancreatitis: Underdiagnosed and Overlooked
Margie Scherk, DVM, DABVP (Feline)
Analgesia is of critical importance in the comfort of the patient, but also in the progression of the disease/inflammation through the negative physiological effects of pain. Pain causes disease and prevents healing. Even if obvious abdominal pain isn't present, use a "test dose" of 0.1-0.2-mg/kg oxymorphone IV to see if the patient improves over the approximately 6 hour effective period. If that is the case, then constant rate infusion of a narcotic may be considered or a transdermal fentanyl patch (DuragesicTM) for continuous relief. TorbugesicTM is not as effective for visceral pain as the opioid agonists are.
in other words, buprenex or fentanyl patches are best options for home care.
denosyl is a powerful antiox and can help the p-titis and GI issues as well as be a prophylactic for a kitty who is in danger of HL from not eating. If the liver looks like it is an issue, then I would use the denamarin. Try to dose this as far apart from pepcid as you can. It has a thick coating and needs some acid for the thick outer coating to dissolve in the gut. We had a few whole pills show up in the LB. The folks at nutrimax suggested smashing the pill and giving immediately. we would lose a little potency, but enough and better than coming out whole ! just something to make sure you look for in the LB if you use denosyl or denamarin.
prozyme is a veg. based prebiotic and helps to break down food and ease digestion. i recommend that too.
and if there is diarrhea ( and with gi issues, some probiotic like culturelle or fortiflora can be of help )
The thing w/p-titis flare, is it really needs to have all the *guns* thrown at it to knock it down.
Sub Q Fluids are a key component in treating p-titis flares. (s. Marks, dvm has it on top of his list, as does scherk who states : "Therapy for pancreatitis is determined by the type of pancreatitis. Fluid therapy and pain relief are the cornerstones in supportive care. Sustain blood and plasma volume, correct acid-base and electrolyte disorders."
