Tisha Update - Here we go again

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Tisha's_Person

Tisha's_Person

Member Since 2014
Tisha got home from the hospital from DKA exactly two weeks ago. Since then, she has been eating well, but not gaining weight. In fact she continues to lose weight despite eating 4 large cans of wet food everyday. Last night, she stopped eating again. We took her to the vet today to make sure there was no new infection. The vet found fluid in her abdomen around her organs that should not be there. She said that the ultrasound in the hospital 2 weeks ago indicated that Tisha has an infiltrative process in her liver. Basically, it could be from inflammation or it could be from cancer. We are going to try a week of steroids to see if that helps with the inflammation. If not, her prognosis is not good. The vet that if she has liver cancer, then she will just continue to get worse.

With the addition of an antibiotic and steroid, she is eating again. After stopping the prednisone from the hospital, her BG shot up to the 400's, but it is too early to change her dose. The vet is concerned that she may be bouncing. (Sorry - I can't get her spreadsheet to work, so I can't update right now.) We will be watching BG closely and spot checking the next couple of days, then try to do a curve this weekend if we don't have to change her dose before then.

If anybody has had something similar, I am open to suggestions. We just seem to have been taking three steps forward and two steps back for way too much of the last year.
 
What do the feces look like?
Pasty, "fluffy" or loose, huge volume suggest the GI tract is not digesting properly, for whatever cause.
If that looks like what you're seeing, ask the vet about using digestive enzymes to help the GI tract do its job.
 
I am sorry to hear you and Tisha are having such a tough time. I don't have any experience of what you might be going through but I do have experience of IBD and the use of steroids.

Just in case it might help when Remi had his most recent IBD flair he started vomiting, getting weak, going off his food, bloating, etc. restarting steroids helped within a few days as did switching (slowly) over to a novel single source protein low carb food. I began to notice a difference within a week or so.

I see that Tisha has pancreatitis, so perhaps the vomiting and lack of appetite be caused by a flair? I have found that if you can control one condition ie IBD, this often helps with other conditions.

Sorry I know it didn't exactly help you but maybe there was something in there that might be worthwhile considering.

I notice that you don't mention an anti nausea or anti vomiting medication. I have just managed to get my vet to prescribe cerenia for its anti inflammatory properties (for IBD) but of course it's usual use is for vi,icing and so maybe you could ask the vet if it would be appropriate for Tisha.
 
Thanks for the advice. Actually, the vet suspects that there may be an IBD component of all of this, but since Tisha randomly refuses to eat food, we have had difficulty getting her to a novel protein diet. We have tried Nutro Max Cat duck, lamb and venison, which she ate for a while, but then we put her back on her normal Fancy Feast and didn't see any difference. She is just very difficult to diagnose and deal with.

You are correct, though, that the working theory has been that the vomiting and lack of appetite are related to pancreatitis. I know this is sort of off topic for a diabetes forum, but the combination of the two has been exhausting for us and painful for her. It makes it so much harder to figure out what is going on. She kept having flare-ups in the fall and we almost lost her twice due to not eating, so we had some serious discussions about when it's time to let go. Then she had almost 7 months where she seemed to be basically back to normal. Her BG was always a little less predictable than other cats, but it seemed to be relatively well controlled when we did curves. I swear that she crashed within a day or two of a conversation that I had with the vet about how well she had been doing. And for what it's worth, our vet has been fantastic. She gave me her personal cell number so we could call when the clinic was closed and has come in after hours to dispense meds to us when we ran out.

Sorry for rambling. I'm just really frustrated with this whole process. To answer your question, Tisha is on Zofran, which is anti-nausea (designed, ironically, for cancer patients). There is a reason that she can't use Cerenia, but I don't remember what it is right now. It might just be that it's a pill and Tisha is a terror to pill. The hospital tech couldn't even get the pills to stay in her. (If you can manage to pry her mouth open to get the pills in, then she holds them in her mouth until you let her go and spits out the pill, even if it already dissolved. It's really almost impressive.)
 
I wouldn't worry, half the messages I post dont necessarily have diabetes as the main focus but it is always there in the background. This is why it would be great to have a co existing forum.

Okay I realise now Zofran is ondansetron. So are all the medications given by injection? Even the steroid? What doses is she on?

I agree with you pancreatitis flairs are the terrible and very stressful for everyone involved. My cat Remi has been diagnosed with triaditis and had a really bad flair a few summers ago. He was treated with the usual supportive meds for pancreatitis but just kept throwing up and getting worse to the point he could barely walk and became jaundiced. In the end he was diagnosed with cholangihepatitis and once he was started on both the steroids and an antibiotic he finally got better. Before that I thought I would lose him. I guess what I am saying is don't give up hope just yet. It might just be a case of finding the right combination or food and meds. No easy job I know.

Could the liver involvement be cholangihepatitis? In which case the addition of an antibiotic may be worth considering. What was Tisha 's liver values like?

Could you go to a specialist feline hospital or ask your vet to consult with one over the phone?
 
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