Simon 8/24 | PM +10 68 +11 79 AMPS 102 +1 103 +4 119

Has Simon ever had Pancreatitis before? (I hope this is not what’s going on)
Lots of our kitties get it so I’m just trying to think of ideas why he might be nauseous. When not wanting to eat sometimes they just don’t feel well if something is brewing.

Do you have anti-nausea medications at home, like Cerenia, ondansetron and appetite stimulant (Mirataz)? They are all prescriptions so you will need that from your vet. (All available on Chewy)

The ondansetron is a human medication and you can get that at any pharmacy locally and ideally that can be given three times a day and is very inexpensive.

These meds are critical to have at your disposal in case something arises, the quicker, you treat something like pancreatitis the quicker you can get it resolved.

Sometimes when they are nauseated, they don’t want to eat. Another sign of pancreatitis can be loose stools (I don’t think you’ve mentioned anything about that).

Here is more information. You can discuss with your vet.
Info - A Primer On Pancreatitis
 
When Simon had his initial diabetes diagnosis the vet said he was not eligible for Bexacat because his pancreas levels were not in a good range. The vet did not mention pancreatitis, but I wonder if this could be an indicator?

If anything, he seems like he might be a little constipated. This weekend he had very little poop in the litter box between Friday and Sunday. And Sunday afternoon he had some wicked gas; it smelled so bad I had to check if he had accidentally made a mess on himself. The gas is not common for Simon.

I left a message with the vet about the nausea and maybe picking up medicine, but if they don't get back to me I might pick up some of that ondansetron. Thanks Staci!
 
Now I'm weighing his AM injection. Delayed about an hour, he's only at 102. This cratering in his numbers overnight is really concerning me, and I'm considering reducing his dose until we're back on track. I have an important appointment this afternoon so I hope nothing goes too off the rails by then
 
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Sorry you've had such a rough start to the day😔 I hope the vet will send you home with some meds so Simon can start feeling better soon.💜
I wonder if you could talk to the mentors sometime about a half dose or something for these lower pre-shots that you can't be around to monitor, so he's at least getting some insulin and hopefully wouldn't shoot up to reds. But that is a conversation for another time. Sending goodluck for the vet visit! 🍀🍀🍀🍀
 
Yeah, I hate skipping because I know he will skyrocket. But even a token dose at low numbers scares me when he's not eating. I don't know why I'm struggling so much to get a gentle curve, something like he had on 8/10. It's either huge bounces or hard crashes with him. I've got a follow up vet appointment at the end of the week for a blood panel and I'm going to ask about pancreatitis.

I did open a new box of Fancy Feast right before he started acting sick, so I wonder if it's a bad batch. Smells fine, but I'll buy another box just in case. I don't think he likes Fancy Feast that much anyway, so I might shop around for some other brands. Hopefully whatever is going on works out soon
 
Staci & Ivy said:
I hope it went well today. How’s he doing?
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Thanks for checking in! It’s been a crazy day. But Simon’s injection at the vet went well and he ate a little over half of his food at PMPS time tonight. He wasn’t licking at the air or otherwise looking nauseous tonight, so hopefully the injection is helping. The vet told me to skip when he won’t eat, but his level ended up at over 500 tonight for the PMPS test. He must feel awful with his numbers swinging around so much.

Another vet appointment this Friday, so I’ll have a chance to ask about pancreatitis and maybe get some tests in to see if anything else is going on with him. Really hope he feels better soon here
 
I hope the vet can figure out what is happening with Simon. Or he gets over this soon. Did you get any meds to take home so you have some supplies for tomorrow if this lingers?
Daniel and Simon said:
The vet told me to skip when he won’t eat
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Not the best strategy. Even cats who cannot eat because they are getting anaesthesia can get a half dose. Insulin does more in the body that combat carbs from food. A cat who might have infection or inflammation, not getting enough calories, plus not enough insulin is the formula for possible DKA. Make sure you are testing for ketones.
 
They said the shot will last for two days. I can’t believe I forgot to ask for some medicine to take home today, but the office is not far so it’s easy to swing by for a quick pickup. I tested Simon for ketones a few days ago and he was negative. I’ll try to continue catching him in the litter box.

I put some more food out for him overnight. He’s not interested in it yet but he did eat his entire dinner earlier.
 
Daniel and Simon said:
because his pancreas levels were not in a good range
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Daniel and Simon said:
They said the shot will last for two days
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Im wondering what test they were referring to when they said his pancreas levels were not in range. The Pancreatitis test is called Spec fPL, although they do have other less effective tests, this one is the most accurate for cats. If they did in fact run a spec fPL test and it was above normal range then he most likely had Pancreatitis then. And if he is now having symptoms, which these appear to be, then its probably chronic. Chronic Pancreatitis will have flares of inflammation which cause symptoms of nausea and pain. Some cats get other symptoms, but those are the main two. Vomiting can occur and the most effective treatment for that is Cerenia. Is that the injection he got? If so that lasts 24 hours, not 2 days. For a cat that isnt vomiting, but just has little to no appetite and is acting off (probably pain related), Ondansetron is a better anti-nausea med and Buprenorphine is the best pain med. You may need both along with an appetite stimulant to get him eating again and get through the flare. If you are interested in finding out more about Pancreatitis, I do run a group on Facebook called Cats With Pancreatitis. Which is why I know so much about it, along with the fact that since 2014, Ive had 13 cats with it. Two of my 4 cats have it now, one of them being my diabetic cat Karamelle.
 
Thank you for the detailed response @JoM. Yes Simon's shot was Cerenia. He has not vomited during this recent bout of eating less, but he's had times where he's thrown up spit before. Now I'm wondering if his low appetite for years before the diabetes was caused by pancreatitis - he's been a slow eater for his entire life, sometimes totally skipping meals. As far as I remember the vet has not mentioned the chance of pancreatitis in the past and didn't say anything about it after his test for Bexacat eligibility, so now I'm a little frustrated especially if this has been going on for a while without catching it.
 
Daniel and Simon said:
Thank you for the detailed response @JoM. Yes Simon's shot was Cerenia. He has not vomited during this recent bout of eating less, but he's had times where he's thrown up spit before. Now I'm wondering if his low appetite for years before the diabetes was caused by pancreatitis - he's been a slow eater for his entire life, sometimes totally skipping meals. As far as I remember the vet has not mentioned the chance of pancreatitis in the past and didn't say anything about it after his test for Bexacat eligibility, so now I'm a little frustrated especially if this has been going on for a while without catching it.
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Do you have a copy of the tests that were done for the Bexacat eligibility? Most vets will email them to you if you ask. Mine just does it automatically most the time. Although Pancreatitis in cats is becoming more familiar, a lot of vets still dont test for it or know how to treat it. Or they treat it like they do for dogs, which unfortunately isnt correct. I would ask if a spec fPL can be run with the next blood work. Its thru IDEXX, so it will sometimes depend on the lab the vet uses. Antech has a Pancreatitis test called Precision PSL, which unfortunately is not very accurate and its for both cats and dogs. Theres a new test thats not been out long called Catalyst Pancreatic Lipase Test but this is also for both dogs and cats.
If hes in a flare and not eating well, an ultrasound can detect inflammation on/around the pancreas, but sometimes if they arent in a flare or its mild, its hard to detect on Ultrasound. The pancreas is a tiny organ that sits behind and under the stomach and is very hard to see. For any ultrasound its best to see a board-certified veterinary radiologist. A regular vet isnt trained to see a lot of things on Ultrasounds. My vet told me this, but also they can see things if they are quite obvious. I watched my vet perform one once on my cat who had severe IBD. He showed me the thickening in the intestines. Quite fascinating.
 
JoM said:
Do you have a copy of the tests that were done for the Bexacat eligibility? Most vets will email them to you if you ask. Mine just does it automatically most the time.
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So I was able to get Simon's records sent to me. In April he had an IDEXX test and his Catalyst Pancreatic Lipase result was 38.3, and a note on the lab result says the level is consistent with pancreatitis. I'm pretty frustrated that I didn't have this result sent to me sooner, but I also wasn't totally aware of what the test was. I just understood it as a Bexacat eligibility test. I guess this is a sign that I need to advocate for Simon better and make sure I get clarification on these tests. But this test was also right after the diabetes diagnosis, so it was a lot to absorb and wrap my head around in the moment anyway.

If these lab results are pointing to pancreatitis that would explain a lot of what's going on with Simon. Thanks so much
 
Daniel and Simon said:
So I was able to get Simon's records sent to me. In April he had an IDEXX test and his Catalyst Pancreatic Lipase result was 38.3, and a note on the lab result says the level is consistent with pancreatitis. I'm pretty frustrated that I didn't have this result sent to me sooner, but I also wasn't totally aware of what the test was. I just understood it as a Bexacat eligibility test. I guess this is a sign that I need to advocate for Simon better and make sure I get clarification on these tests. But this test was also right after the diabetes diagnosis, so it was a lot to absorb and wrap my head around in the moment anyway.

If these lab results are pointing to pancreatitis that would explain a lot of what's going on with Simon. Thanks so much
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Please dont blame yourself. Its really up to the vet to keep you informed. But unfortunately sometimes they just tell you what they think is necessary and nothing else. One of the reasons why I always get the test results and question anything I dont understand. With a result this elevated, it most definitely is chronic pancreatitis. It really quite easy to manage if you have the right meds. But you do need a vet that understands this.
Pancreatitis is inflammation of the pancreas. When a cat eats, digestive enzymes, that are located inside the pancreas leave the pancreas and activate in the small intestine to digest food and distribute nutrients. With Pancreatitis, those same enzymes activate early, inside the pancreas and start digesting the Pancreas itself. This causes severe pain and nausea and the cat then doesnt feel like eating. Pancreatitis is managed with anti-nausea meds, pain meds and an appetite stimulant. Also fluids if needed if they arent eating to keep them from becoming dehydrated. You may not need all the meds and the dose will vary depending on the cat. It really just takes some experimenting to find the right meds/dose and frequency to keep the cat stable and eating. Usually you start out with all the meds and then just cut back one at a time to see what works. Karamelle has had Diabetes since Dec 2023 and Pancreatitis since July 2024. Shes been on a regular med schedule the whole time shes had Pancreatitis. It was rough at first when she was first diagnosed. But shes stable now. its her diabetes thats super wonky. She takes Bupernorphine 1x a day and Ondansetron 2x a day to manage her Pancreatitis. If she vomits I'll give her a cerenia dose (pill).
 
JoM said:
Please dont blame yourself. Its really up to the vet to keep you informed. But unfortunately sometimes they just tell you what they think is necessary and nothing else. One of the reasons why I always get the test results and question anything I dont understand. With a result this elevated, it most definitely is chronic pancreatitis. It really quite easy to manage if you have the right meds. But you do need a vet that understands this.
Pancreatitis is inflammation of the pancreas. When a cat eats, digestive enzymes, that are located inside the pancreas leave the pancreas and activate in the small intestine to digest food and distribute nutrients. With Pancreatitis, those same enzymes activate early, inside the pancreas and start digesting the Pancreas itself. This causes severe pain and nausea and the cat then doesnt feel like eating. Pancreatitis is managed with anti-nausea meds, pain meds and an appetite stimulant. Also fluids if needed if they arent eating to keep them from becoming dehydrated. You may not need all the meds and the dose will vary depending on the cat. It really just takes some experimenting to find the right meds/dose and frequency to keep the cat stable and eating. Usually you start out with all the meds and then just cut back one at a time to see what works. Karamelle has had Diabetes since Dec 2023 and Pancreatitis since July 2024. Shes been on a regular med schedule the whole time shes had Pancreatitis. It was rough at first when she was first diagnosed. But shes stable now. its her diabetes thats super wonky. She takes Bupernorphine 1x a day and Ondansetron 2x a day to manage her Pancreatitis. If she vomits I'll give her a cerenia dose (pill).
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Excellent advice from Jo!!! Thank you for all of your invaluable advice Jo 🥰🥰💞💞
 
JoM said:
Please dont blame yourself. Its really up to the vet to keep you informed. But unfortunately sometimes they just tell you what they think is necessary and nothing else. One of the reasons why I always get the test results and question anything I dont understand. With a result this elevated, it most definitely is chronic pancreatitis. It really quite easy to manage if you have the right meds. But you do need a vet that understands this.
Pancreatitis is inflammation of the pancreas. When a cat eats, digestive enzymes, that are located inside the pancreas leave the pancreas and activate in the small intestine to digest food and distribute nutrients. With Pancreatitis, those same enzymes activate early, inside the pancreas and start digesting the Pancreas itself. This causes severe pain and nausea and the cat then doesnt feel like eating. Pancreatitis is managed with anti-nausea meds, pain meds and an appetite stimulant. Also fluids if needed if they arent eating to keep them from becoming dehydrated. You may not need all the meds and the dose will vary depending on the cat. It really just takes some experimenting to find the right meds/dose and frequency to keep the cat stable and eating. Usually you start out with all the meds and then just cut back one at a time to see what works. Karamelle has had Diabetes since Dec 2023 and Pancreatitis since July 2024. Shes been on a regular med schedule the whole time shes had Pancreatitis. It was rough at first when she was first diagnosed. But shes stable now. its her diabetes thats super wonky. She takes Bupernorphine 1x a day and Ondansetron 2x a day to manage her Pancreatitis. If she vomits I'll give her a cerenia dose (pill).
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Wow, I did not know pancreatitis was so awful. I feel so bad that Simon is going through this (and Karamelle, I'm glad you were able to get her stable!). Simon's Friday appointment can't come soon enough, I'll be asking many questions to the vet about treatment
 
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