Maggie is 11, was diagnosed with diabetis about 1.5 yrs ago. Always been hard to regulate. Has had periodic bouts of not eating, vomitting, lethargy but never ketones. Regular vet treated with fluids, anti-nausea med, and antibiotic. 11 days ago while I was out of town she had a bout on a Sunday and petsitter got really worried about hypoglyc because she hadn't eaten all day. Did not give evening insulin (Lantus), gave corn syrup, and took to vet the next morning. Ketones were really high. After about a week (Monday) she finally started eating some instead of having to be force fed. Monday night while I was out to dinner she threw up multiple times. BG was 51 when I got home. Gave corn syrup. Raised bg to 93 but would not eat. I syringed a little food into her (a mistake) and she started vomitting again. BG down to 63 again. Took to ER. Gave her fluids and anti-nausea. Recommended abdominal ultrasound at Specialist's. BG 249 the next morning but was not eating. 349 mid day. Ultra-sound showed pancreatitis and kidney infection. He gave her (yesterday) steriod injection and take home 10 mg prednisone twice per day and continued the Orbax 22 mg 1 per day. BG 306 last night but not eating. BG 438 this morning. Regular vet said give 4 units Lantus. Specialist upset. said should only be 2 even though 4 is her normal. Mid-day BG was 538! Not eating and now NOT DRINKING. Specialist said take again just before closing time and I'll tell you how much insulin to give tonight. It was 536 still. Took to regular vet as she seemed dehydrated and those 500 numbers SCARE me. She gave sub-Q fluids. Specialist says only 2 units insulin tonight and gave cyproheptadine 2 mg twice a day to increase appetite. Said to continue prednisone and antibiotic. Still not eating or drinking. Hiding under couch. Saw post here that steriods BAD for diabetics. Is he prescribing the right treatment for pancreatitis? How can I help my Maggie. I'm afraid I'm going to lose her. I've spent $1400 in the last ten days on her. I'm broke and I love her. Please help me! Thanks, Kathi P.S. apologies if this is too long or anything. It's my first post and I haven't had time to read as much of your site as I should.
steriods for pancreatits? PLEASE HELP
- Thread starter kathik9
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julie & punkin (ga)
Very Active Member
hang on - there are people on the lantus forum who have tons of experience with pancreatitis. just a minute and i'll try to flag one.
Kelly & Oscar
Very Active Member
steroids are a very common drug to give for pancreatitis since it helps to bring down the inflammation. Usually during pancreatitis flares kitties will get steroids, fluids, and an anti nausea med (sometimes pepcid AC). Did your vet give you any fluids to do at home or tell you to come back at specific intervals to get her fluids? Some kitties also get pain killers (like bupenephrine) since it can be painful too.
If she was getting 2u before the flare, then I actually agree with the vet suggesting a higher dose right now since steroids will increase the insulin needs. Think of it as only a temporary increase in the dose until the steroids are weaned off. If 2u was her regular dose, then I personally would go to 3u right now if she were my cat (you ultimately make those decisions obviously. mine are only suggestions). If she isn't eating, then you will need to syringe feed or find something she will eat. Tuna water is good (the water you drain from a regular can of tuna). All meat baby food is another staple for many people. If she isn't getting an anti nausea med daily right now, then I'd suggest giving her a 1/4 pill of pepcid AC before feeding her to help calm her stomach. If she feels nauseous, then she won't want to eat either. With any food you give her, water it down as much as she will tolerate so you can get enough fluids in her.
Orbax is a good broad spectrum antibiotic. With kidney infections, the usually need a longer course than other types of infections, so I would expect for you to have to give it for at least 3-4 weeks. If the vet says otherwise, ask for another course "just to cover all the bases".
If she was getting 2u before the flare, then I actually agree with the vet suggesting a higher dose right now since steroids will increase the insulin needs. Think of it as only a temporary increase in the dose until the steroids are weaned off. If 2u was her regular dose, then I personally would go to 3u right now if she were my cat (you ultimately make those decisions obviously. mine are only suggestions). If she isn't eating, then you will need to syringe feed or find something she will eat. Tuna water is good (the water you drain from a regular can of tuna). All meat baby food is another staple for many people. If she isn't getting an anti nausea med daily right now, then I'd suggest giving her a 1/4 pill of pepcid AC before feeding her to help calm her stomach. If she feels nauseous, then she won't want to eat either. With any food you give her, water it down as much as she will tolerate so you can get enough fluids in her.
Orbax is a good broad spectrum antibiotic. With kidney infections, the usually need a longer course than other types of infections, so I would expect for you to have to give it for at least 3-4 weeks. If the vet says otherwise, ask for another course "just to cover all the bases".
julie & punkin (ga)
Very Active Member
it's not too long - no worries.
i think the concern with steroids in cats is that it can bring on diabetes. once the kitty's got diabetes i don't know what the effect is.
i've flagged 2 people with a lot of experience who are online and hopefully be here soon. keep refreshing your browser to see if anyone's responded.
i think the concern with steroids in cats is that it can bring on diabetes. once the kitty's got diabetes i don't know what the effect is.
i've flagged 2 people with a lot of experience who are online and hopefully be here soon. keep refreshing your browser to see if anyone's responded.
I can't comment on all the meds and issues with kidney but I can comment on the pancreatitis as both of mine have problems.
For pancreatitis, you need to give fluids, pain meds, and pepcid will help with the nausea.
Pancreatitis is painful, so tell your vet you want something for the pain, like Buprenex.
You can get regular strength 10mg pepcid and cut the tabs into 4 pieces. Give 1/4 tab or 2.5mg twice a day.
The max dose per day is 5mg for cats. Don't get the extra strength 20mg pepcid.
Fluids are very easy to give at home so you can ask your vet to show you how to give them on your next visit, or just get a fluids kit from your vet and many people here can help you to give fluids - it's much cheaper for you, and less stressful for your cat if you give the fluids and pain meds at your own home.
For Lantus, you want to keep a steady dose and not jump all over the place with dosing or you will get BG numbers all over the place too. If you can post your testing numbers and the dose you give am and pm, people here can help you sort out what dose will be safe for your kitty.
As this post is your first, I am not sure if you have read the info on Lantus, so here are some links to some great info for you.
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
Don't worry about your post being long because the more you tell about your situation, the easier it is for others to help and offer some suggestions.
Ask any questions you like; someone will have a reply for you.
For pancreatitis, you need to give fluids, pain meds, and pepcid will help with the nausea.
Pancreatitis is painful, so tell your vet you want something for the pain, like Buprenex.
You can get regular strength 10mg pepcid and cut the tabs into 4 pieces. Give 1/4 tab or 2.5mg twice a day.
The max dose per day is 5mg for cats. Don't get the extra strength 20mg pepcid.
Fluids are very easy to give at home so you can ask your vet to show you how to give them on your next visit, or just get a fluids kit from your vet and many people here can help you to give fluids - it's much cheaper for you, and less stressful for your cat if you give the fluids and pain meds at your own home.
For Lantus, you want to keep a steady dose and not jump all over the place with dosing or you will get BG numbers all over the place too. If you can post your testing numbers and the dose you give am and pm, people here can help you sort out what dose will be safe for your kitty.
As this post is your first, I am not sure if you have read the info on Lantus, so here are some links to some great info for you.
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
Don't worry about your post being long because the more you tell about your situation, the easier it is for others to help and offer some suggestions.
Ask any questions you like; someone will have a reply for you.
Welcome, Kathi.
Please take a look at the link to this post on pancreatitis. There are a couple of things that we see that are different than what your vet(s) are recommending. First -- giving a cat Pepsid (famotidine) will help with the nausea.
The use of steroids to treat pancreatitis is not unusual. Many people and vets will be somewhat reticent to use it given that steroid will raise BG numbers. It really varies from vet to vet and how severe the flare up is. Insulin can always be worked around the steroids. Treating what the the most important issue is best and deal with the insulin dose secondarily. There are any number of cats here who are on long-term use of steroids for conditions like inflammatory bowel -- the insulin dose is worked around the steroid.
Pain meds, often buprenex, are recommended since p'titis can be very painful.
Kelly's information is very good. Fluids is something to ask your vet about. Many cats just plain feel better if they get fluids. It also helps with the dehydration from vomiting.
How are Maggie's ketone levels at present? It sounds like you may be testing. If not, please get Ketostix from any pharmacy. You dip the stick in Maggie's urine stream and then follow the instructions on the package. Fluids are also a good way to combat ketones. Please do test for ketones. Infection + not eating +not enough insulin are a recipe for diabetic ketoacidosis.
I suspect where your vets are differing about insulin is based on the antibiotics vs. infection. The pancreatitis and kidney infection (and steroids) are raising BG numbers. Once the Orbax kicks in and the infection starts to clear, numbers should come down. With some cats, levels come down quickly. The specialist, in all likelihood, is fearing that Maggie's numbers may drop too low. However, it seems like you're home testing. As long as you're around to keep an eye on her numbers, it makes sense to raise the insulin dose.
Do you know if the vet ran any blood tests? An fPLI is the diagnostic test for pancreatitis. (Much less expensive than an ultrasound.)
Here's some additional info on pancreatitis:
Please take a look at the link to this post on pancreatitis. There are a couple of things that we see that are different than what your vet(s) are recommending. First -- giving a cat Pepsid (famotidine) will help with the nausea.
The use of steroids to treat pancreatitis is not unusual. Many people and vets will be somewhat reticent to use it given that steroid will raise BG numbers. It really varies from vet to vet and how severe the flare up is. Insulin can always be worked around the steroids. Treating what the the most important issue is best and deal with the insulin dose secondarily. There are any number of cats here who are on long-term use of steroids for conditions like inflammatory bowel -- the insulin dose is worked around the steroid.
Pain meds, often buprenex, are recommended since p'titis can be very painful.
Kelly's information is very good. Fluids is something to ask your vet about. Many cats just plain feel better if they get fluids. It also helps with the dehydration from vomiting.
How are Maggie's ketone levels at present? It sounds like you may be testing. If not, please get Ketostix from any pharmacy. You dip the stick in Maggie's urine stream and then follow the instructions on the package. Fluids are also a good way to combat ketones. Please do test for ketones. Infection + not eating +not enough insulin are a recipe for diabetic ketoacidosis.
I suspect where your vets are differing about insulin is based on the antibiotics vs. infection. The pancreatitis and kidney infection (and steroids) are raising BG numbers. Once the Orbax kicks in and the infection starts to clear, numbers should come down. With some cats, levels come down quickly. The specialist, in all likelihood, is fearing that Maggie's numbers may drop too low. However, it seems like you're home testing. As long as you're around to keep an eye on her numbers, it makes sense to raise the insulin dose.
Do you know if the vet ran any blood tests? An fPLI is the diagnostic test for pancreatitis. (Much less expensive than an ultrasound.)
Here's some additional info on pancreatitis:
Hi! Thank you all for responding! The Specialist has DECREASED her Lantus even though her BG is sky high. That's what I don't understand. (Also the man is steriod happy. He gives steriods for everything and it may have contributed to the death of my beloved Lab, something I don't think I'll ever get over.) It's good to hear that's an appropriate thing to do. I will ask for pain meds (she does seem to be in pain), fluids, and anti-nausea first thing in the morning. Just syringed (most) of 45 cc of Wellness Core canned food into her. Watered down enough to be syringable but not run out of the syringe, if that makes any sense. Once she has even been offered a food when she is nausious she never wants to eat it again so it's always a battle to get her eating again. Sound like a plan? Thank you again so much. It's so good not to feel so alone with this. I wish I had found this web site a long time ago. Thanks, Kathi
Baby food may also be an option. Gerber and Beechnut both make food that are just meat and broth -- no onions, garlic, or veggies. One brand contains cornstarch though and is about 7% carb.
If you're not enthusiastic about the care from the specialist, why not use your regular vet? You know your cat. Trust your gut.
If you're not enthusiastic about the care from the specialist, why not use your regular vet? You know your cat. Trust your gut.
Regular Vet doesn't have ultrasound so she referred me to specialist. I think he is probably brilliant but I worry and he has prescribed steriods everytime I have been sent to him--4 or 5 different pets. It's difficult being between two vets and the emergency clinic. It's also difficult reliving past losses at both places. Lack of sleep on my part is also a contributing factor. Too many nights getting up to check on her or take her to ER. I'm exhausted. So my plan is to take Maggie back in for fluids and to have her checked for ketones first thing in the morning. I will ask to be taught to take care of both things myself. I will ask for pain med buprenex and to extend the orabax for 3-4 weeks. I will tell the vet that I plan to get 10 mg pepcids and quarter them. I will give 1/4 tablet morning and night. I will ask about the fPLI--is it necessary since we had the ultrasound?
What do I do about the Lantus? She has been on 4 units twice a day for a while and we were about to increase it as her BG was in the 300's and 400's. She had once been on 5 units but BG dropped to 20 one evening--scaring us half to death. I get the drift that if I can get the pancreatitis under control so her appetite stays consistent it will help with regulation. Also should ask for some dip sticks for detecting blood in urine. Bladder/Kidney infections have also been a recurring problem and they send her BG up high. Specialist says the current BG number is only because of the predisone and with her not eating it is too risky to give her more than 2 units. Maybe he is not taking into consideration that she is usually with me 24/7 and I can check her BG as often as her poor ears can stand it?
Thank you, thank you, thank you! Kathi
What do I do about the Lantus? She has been on 4 units twice a day for a while and we were about to increase it as her BG was in the 300's and 400's. She had once been on 5 units but BG dropped to 20 one evening--scaring us half to death. I get the drift that if I can get the pancreatitis under control so her appetite stays consistent it will help with regulation. Also should ask for some dip sticks for detecting blood in urine. Bladder/Kidney infections have also been a recurring problem and they send her BG up high. Specialist says the current BG number is only because of the predisone and with her not eating it is too risky to give her more than 2 units. Maybe he is not taking into consideration that she is usually with me 24/7 and I can check her BG as often as her poor ears can stand it?
Thank you, thank you, thank you! Kathi
Vicky & Gandalf (GA) & Murrlin
Very Active Member
Much of pancreatitis care is palliative - pain meds, nausea meds, fluids, as has been suggested. Mild steroids is not unreasonable treatment.
And just want to clarify, the type of Pepcid you can give cats is Pepcid AC, generic name famotidine. I know how it is when someone here recommends something, then you go to the pharmacy to get it and can't remember what you were told! Just remember Pepcid AC and you'll get the right kind, in 10mg tablets. Wal-mart's generic Equate brand of famotidine is fine, so you can save money.
And just want to clarify, the type of Pepcid you can give cats is Pepcid AC, generic name famotidine. I know how it is when someone here recommends something, then you go to the pharmacy to get it and can't remember what you were told! Just remember Pepcid AC and you'll get the right kind, in 10mg tablets. Wal-mart's generic Equate brand of famotidine is fine, so you can save money.
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