ehsuan
Member
Hello all you wonderful, kitty-caring people in FDMB. I know you know how incredible you all are for the support and knowledge and hand-holding you provide, and for caring for your wonderful kitties.
Writing with an update for Tableau. I'd like to say that things are improved, but unfortunately, they are not.
Tableau spent THursday and Friday in the hospital on IV fluids and electrolytes and perked up amazingly. So much so that this 16 year old cat was batting around cotton balls and swatting flies. He at like a little piggy, and when I got him home Friday night, he ate and ate and ate.
He was diagnosed with Pacreatitis . His fPL results were >50!!! WHich as some of you may know, is extraordinarily high. Additionally, his ALT was 647 (also extremely high). Kidney function is fine.
The vet sent us home with the following meds:
Metronidazole (50 mg 2x a day)
Ursodial (.3 mls 1 time a day)
Buprenex for pain 2-3 times a day
Cyproheptadine for appetite (1/2 tab once a day).
Additionally he is on 1 unit Lantus 2x day
1 ml amlodipine (high blood pressure)
cisipride for constipation
SUBQ FLUIDS
Wondering if anyone sees or suggests a different treatment plan or addition?
Unfortunately, since Saturday morning, he is back to not eating. He wants to eat but won't. Today he has been meowing so forlornly (and he's usually a quiet cat). We could put him back in the hospital, but even the vet thinks that it's a bandaid, and may not be worth putting him through anymore.
Basically he has so many uncontrolled health issues, that it seems insurmountable. He keeps getting worse and worse. His recent history (since April) is as follows:
Nasal carcinoma diagnosis (20 days of radiation)
Bortadella infection and ecoli in the nose. Those finally cleared up after three courses of antibiotic. But even with that cleared up, his nose is so compromised that he has chronic, significant, snuffy nose, so he can't smell and he has a lot of uncomfortable mucas in his throat.
He's had chronic constipation (although that's cleared up).
Uncontrolled diabetes since beginning of August.
Pancreatitis.
In the hospital they were able to control the diabetes with quick acting insulin and I wonder if that's why he was feeling so much better (in addition to the electrolytes).
He pretty much the last two days laying by the food bowls and staring at the wall. As I mentioned, he's also been meowing in what I assume is pain. He does get up and walk around, so he's able, but he doesn't really do anything (but that could be because of the pain medicine).
The last ditch effort she is suggesting is a course of prednisone. Again - last ditch effort. She says she's not recommending this lightly and that it may be the thing to get the inflamation under control so that we can then hopefully get the diabetes under control.
She doesn't, and I agree, want to do anything invasive (like a feeding tube) at this time. She feels he's too unstable. I forgot to mention he also has a heart murmur and asthma (controlled).
Anyway, I'm really looking for any advice or thoughts about all this. I know some of you have a lot of experience with so many feline issues. I also don't want him to needlessly suffer and it does seem like he is, for the first time, suffering.
THank you.
Writing with an update for Tableau. I'd like to say that things are improved, but unfortunately, they are not.
Tableau spent THursday and Friday in the hospital on IV fluids and electrolytes and perked up amazingly. So much so that this 16 year old cat was batting around cotton balls and swatting flies. He at like a little piggy, and when I got him home Friday night, he ate and ate and ate.
He was diagnosed with Pacreatitis . His fPL results were >50!!! WHich as some of you may know, is extraordinarily high. Additionally, his ALT was 647 (also extremely high). Kidney function is fine.
The vet sent us home with the following meds:
Metronidazole (50 mg 2x a day)
Ursodial (.3 mls 1 time a day)
Buprenex for pain 2-3 times a day
Cyproheptadine for appetite (1/2 tab once a day).
Additionally he is on 1 unit Lantus 2x day
1 ml amlodipine (high blood pressure)
cisipride for constipation
SUBQ FLUIDS
Wondering if anyone sees or suggests a different treatment plan or addition?
Unfortunately, since Saturday morning, he is back to not eating. He wants to eat but won't. Today he has been meowing so forlornly (and he's usually a quiet cat). We could put him back in the hospital, but even the vet thinks that it's a bandaid, and may not be worth putting him through anymore.
Basically he has so many uncontrolled health issues, that it seems insurmountable. He keeps getting worse and worse. His recent history (since April) is as follows:
Nasal carcinoma diagnosis (20 days of radiation)
Bortadella infection and ecoli in the nose. Those finally cleared up after three courses of antibiotic. But even with that cleared up, his nose is so compromised that he has chronic, significant, snuffy nose, so he can't smell and he has a lot of uncomfortable mucas in his throat.
He's had chronic constipation (although that's cleared up).
Uncontrolled diabetes since beginning of August.
Pancreatitis.
In the hospital they were able to control the diabetes with quick acting insulin and I wonder if that's why he was feeling so much better (in addition to the electrolytes).
He pretty much the last two days laying by the food bowls and staring at the wall. As I mentioned, he's also been meowing in what I assume is pain. He does get up and walk around, so he's able, but he doesn't really do anything (but that could be because of the pain medicine).
The last ditch effort she is suggesting is a course of prednisone. Again - last ditch effort. She says she's not recommending this lightly and that it may be the thing to get the inflamation under control so that we can then hopefully get the diabetes under control.
She doesn't, and I agree, want to do anything invasive (like a feeding tube) at this time. She feels he's too unstable. I forgot to mention he also has a heart murmur and asthma (controlled).
Anyway, I'm really looking for any advice or thoughts about all this. I know some of you have a lot of experience with so many feline issues. I also don't want him to needlessly suffer and it does seem like he is, for the first time, suffering.
THank you.
I have two suggestions to offer to the list of meds. based on my experience with Harley. 1) The cyproheptadine dose seems rather high and it's usually dosed twice a day instead of once a day. I'd suggest splitting the dose in half and give 1/4 BID or quite frankly. giving only 1/8 BID. Cypro. can make cats rather yowly and agitated or it can make the lethargic. Harley got agitated on only 1/4 pill, ate fast and vomited. 1/8 pill worked much better with fewer side effects. Finding the right dose for each cat is kind of an ECID thing. 2) You also mentioned that he acts like he wants to eat but doesn't. Pancreatitis is very nauseating and if Tableau is as sick as Harley was, Pepcid will not be able to address severe nausea. Pepcid works best for nausea caused by too much stomach acid, not for nausea due to severe pain. The two best anti-nausea meds. for severe nausea are Zofram (ondansetron) and Anzemet (dolastetron). Both are human chemotherapy meds. The only cavaet to them both is that they were withdrawn from the human market because of safety concerns in people with pre-existing heart conditions. I do not know if this also applies to cats so you might want to discuss the risks versus rewards with your vet. I've been using Anzemet with Harley successfully since April of this year even though he has an abnormal heart rhythm.