UPDATES: Pearl diarreha vomiting

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Karen & Pearl

Karen & Pearl

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I posted over on General health but I think there are more eyes here. Pearl Got diarreha and threw up Sunday night late. Yesterday she seemed much better perkier and even today there was some pretty solid poo in the box and now tonight she is back to diarreha and she has thrown up several times. She wants to eat SO much when she feels this way but I took up the FF and put down turkey baby food. She threw that up! So, I gave her 1/4 a pepcid (I've never given her this before, but honestly, I don't think it can hurt, if she can keep it down) and dribbled some FF juice in a dish and mixed it with water for her to drink. Just enough to be a chaser. I will make an appointment in the morning but I just don't know what is up. I am wondering, can this be pancreatitis? She has gotten somewhat this way every so often but not for a long while now. Her BGs are pretty much par for her. Does anyone thing I should go buy some keto stix? I don't have any that aren't LONG expired on hand because we just have never had ketones. Any thoughts or ideas would be appreciated. I understand if there isn't enough info for any educated guesses. It's not much to go on. I am so tired and have a headache but if I go to bed she also might settle down. She usually does.
 
Re: Pearl diarreha vomiting

Awwww poor sweetie.

I know Abby had triaditis and she would throw up and get diahhrea and then go off food in that order when having a flareup. Giving her plain tuna, mushy with a little plain organic yoghurt, along with a 1/4 pepcid about 30 minutes before eating made a difference.
We did this after her diagnosis, so good you are seeing a vet in the morning as well.

Could it be pancreatitis? it could be, but it could be other things to so good to focus on keeping her eating and being able to keep it down until vet. is she dehydrated at all?

Are you getting a test when she throws up?

Hope everything passes quickly. A hairball has been known to send Fame into diahrrea also.

Hoping things improve very soon.
Kimmee
 
Re: Pearl diarreha vomiting

Hi Karen

Does Pearl ever eat things that are not food? String, plastic, etc.?
 
Re: Pearl diarreha vomiting

Jess & Earl said:
Hi Karen

Does Pearl ever eat things that are not food? String, plastic, etc.?
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No she really doesn't. She never has or even looked tempted. I *have* been putting some stuff call "Cool Skin" on her neck for a couple of days for her itchiness. (she doesn't clean much and I wiped it down too. I did give her a can of FF Chopped Grill Saturday and I think that might have been a problem. She *has* had some good poos though and yesterday and today earlier, she seemed back to normal. Until tonight :( I think so far she has kept the little bit of pepcid down. She *wants* to eat. She would eat like a horse if I let her and hork it all back up again, I'm sure. I hate withholding food, but I'm afraid to give her even more baby food since she threw that up too.
 
Re: Pearl diarreha vomiting

Sweetgrass&theFurries said:
Awwww poor sweetie.

I know Abby had triaditis and she would throw up and get diahhrea and then go off food in that order when having a flareup. Giving her plain tuna, mushy with a little plain organic yoghurt, along with a 1/4 pepcid about 30 minutes before eating made a difference.
We did this after her diagnosis, so good you are seeing a vet in the morning as well.

Could it be pancreatitis? it could be, but it could be other things to so good to focus on keeping her eating and being able to keep it down until vet. is she dehydrated at all?

Are you getting a test when she throws up?

Hope everything passes quickly. A hairball has been known to send Fame into diahrrea also.

Hoping things improve very soon.
Kimmee
Click to expand...

I got a test. She was 337 when this started. I don't think this is generally connected to bgs. Pearl doesn't clean enough to get hairballs anymore. Just her paws and face. She never was much of a "hairballer" actually. And far from going off food, all she really wants to do is eat (this, too, is not new. Even pre-diabetes, if she got diarreha she wants to eat like mad. LIke she thinks it will help or she mistakes the signals from her guts. :(
 
Re: Pearl diarreha vomiting

karen if you can bringing her in to get the fPLI test for CP in morning would be a good idea. you say she has had episodes like this before and being a diabetic cat...well the odds are pretty good that she could be a CP cat. worth getting the test and knowing one way or the other. if she isn't then know to look elsewhere for a reason for these episodes, if she is then know to stock a home CP toolbox so you can treat the flares and keep her comfortable. (they are 'suppose' to fast for test but since she is vomiting everything she eats, that can count as fast).

if the vomiting gets bad, bring her to ER and they can give her a shot to stop the vomiting and rehydrate her ~v/d dehydrates a feline quick and makes them more nauseous and they can get in a viscous cycle. the shot and fluids will break that.

must go to sleep....
feel better pearl!
 
Re: Pearl diarreha vomiting

Well, she hasn't thrown up since last night. Hasn't poo'd so I don't know if she still has diahrrea. I'll call this morning and see if we can get an appointment. I guess there's nothing else to do. She'll certainly throw up and poo in the carrier. *sigh* I wish she was a better "vet cat" like my Sugar. I wouldn't feel so bad then. I don't have great confidence regarding a vet trip though if it is CP. What's in a "tool kit"?
 
Re: Pearl diarreha vomiting

Vet agrees pancreatitis most likely. You could see the sucker on the xray. Came home with buprenex, pancreatic enzyme powder, and metrodonizole. I have to figure out how you break that needle off after you extract the buprenex dose. Any tips? I thought there was a device you could use, but Walgreen's didn't have anything. She's so hungry! I gave her a liiiitle food after the vet but I had to go back to work and didn't want her horking a bunch down quickly. I do want to give her some buprenex though. We are waiting for the enzymes to cook or whatever right now. She is not happy to wait another twenty minutes for supper. I can tell her legs hurt but I think that is from being poke, prodded, stretched for an xray. That arthritis hurts. She just tried to chase Sugar a bit though. Well, any tips on that syringe thing would be great.

DOH! The needle part just comes right off. HOwever, Man, I couldn't get it in! I might have gotten a drop in her mouth but not much. Hmmm. Maybe when she is sleepy. Dang. Any tips on getting it on the gums? She ate the food with the enzymes fine (of course she's *really* hungry. Poor girl, she is NOT patient tonight after a day of torture.
 
Re: Pearl diarreha vomiting

Oh, I wanted to mention, Pearl's blood panel was great (except the glucose of course, I skipped any shot this am. but 320 isnt awful for that). I mean, *everything* fell into a good range except that. Her kidneys seemed to surprise the heck out of the vet. They are in pretty good shape. She feels (and talked me into continuing) the enalapril may be helping there. I guess I have read articles about the possibility of ACE inhibitors preventing decay of kidney function. At 14 and diabetic, she really expected them to look bad. Her lungs looked *really* good. There is a slight slight thickening, the vet thought, of the heart wall (she was more specific, I can't tell you the term she used.) ANyhow, I guess overall, Pearl is doing well inside. Her teeth are another matter, but nothing we can do there. She may have to go on antibiotic treatment eventually here. :( I just so wish I could do something there :(

Now I need to stop going and checking on her every two seconds!
 
(((Karen))) I am sorry about this "episode" with Pearl but truly pancreatitis is not so bad once you know about it because there is so much that you can do to help her. Number one now being the pain meds.

I know exactly what you mean about the checking every two seconds though because I sure have been there. It gets better, truly, and you know that you have a lot of help and support here!
 
Susie and Moochie said:
(((Karen))) I am sorry about this "episode" with Pearl but truly pancreatitis is not so bad once you know about it because there is so much that you can do to help her. Number one now being the pain meds.

I know exactly what you mean about the checking every two seconds though because I sure have been there. It gets better, truly, and you know that you have a lot of help and support here!
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That's the thing I was unsuccessful at! Ugh. I think I was trying too hard.
 
Karen, you haven't been unsuccessful at all! Repeat after me, "It's not my fault".

Now you know what's wrong and you can move forward and help her.
 
And Karen, I forgot to mention before. You can shoot the bupe subQ if it's easier than getting it on her gums. The oral bupe can also be injected - it's the same formula either way. I inject Moochie when she needs it because I cannot get it in her mouth properly.



ETA - I knew that Dr Lisa had posted about bupe recently and how it can be administered - just found it

viewtopic.php?f=3&t=5871#p59536
 
Regarding Buprenex SubQ injection: Just be aware that although the Buprenex is initially sterile, it it was administered for oral use sterility might not have been maintained.
 
Thanks, Larry. I didn't think to say use a different syringe and needle each time because I am sure Karen knows that but somebody else might read this and take it differently.
 
Susie and Moochie said:
Thanks, Larry. I didn't think to say use a different syringe and needle each time because I am sure Karen knows that but somebody else might read this and take it differently.
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I think he means that if they didn't give Karen the whole vial, they may have put it into oral syringes rather than sterile syringes. They look very similar. Since she says the syringes had needles, I'd guess that they dispensed sterile syringes and used aseptic technique. She might want to check though.

Karen, regarding the pancreazyme, be aware that it can cause oral discomfort in cats as it contains active digestive enzymes (which can digest the oral mucosa). Dogs usually wolf their food (not to make a pun) but cats don't and they can get a sore mouth. I think this happened to Steve and his cat Minivan. Most cats will not eat food mixed with pancreazyme so if you use it you may need to put it in capsules and pill her. The capsules may not work as well since they need to break down before releasing the enzyme, but if it causes ulcers in the mouth there is no alternative (other than stopping the medication). A long incubation period may help reduce mouth injury.
 
Jess & Earl said:
Susie and Moochie said:
Thanks, Larry. I didn't think to say use a different syringe and needle each time because I am sure Karen knows that but somebody else might read this and take it differently.
Click to expand...

I think he means that if they didn't give Karen the whole vial, they may have put it into oral syringes rather than sterile syringes. They look very similar. Since she says the syringes had needles, I'd guess that they dispensed sterile syringes and used aseptic technique. She might want to check though.

Karen, regarding the pancreazyme, be aware that it can cause oral discomfort in cats as it contains active digestive enzymes (which can digest the oral mucosa). Dogs usually wolf their food (not to make a pun) but cats don't and they can get a sore mouth. I think this happened to Steve and his cat Minivan. Most cats will not eat food mixed with pancreazyme so if you use it you may need to put it in capsules and pill her. The capsules may not work as well since they need to break down before releasing the enzyme, but if it causes ulcers in the mouth there is no alternative (other than stopping the medication). A long incubation period may help reduce mouth injury.
Click to expand...

I was going to ask about that. I have only used it twice (she did eat the food pretty well). She was doing so well and even played in the middle of the night and now this morning she threw up again :( She seemed ok. She was even taken by surprise throwing up :( I had only given her a little bupe (not even the whole amount, half of the .1 cc) about an hour before. I really don't think it was that though. So I gave her a piece of pepcid. We'll see how the rest of today goes. She was doing so much better!

Yeah, they are sterile syringes in a packet. Two fresh vials. I draw it up then you can take the needle end off so you can squirt it.

I guess it's only natural to have set backs. I have not give her the metrodonizole yet. Haven't been successful getting it down. It's chicken flavored and she liked the smell but it must still taste bitter. I'm of two minds about that. It's only a precaution in *case* there is an infection. As I understand it, infection is only present maybe half of the time?
 
Hi Karen

RE: the metronidazole. I'm not sure why your vet prescribed it, but I can think of several possibilities. One is that pancreatitis doesn't occur in a vacuum -- there may be some GI or liver involvement. Metronidazole is an antibiotic that fights certain types of infections in the GI tract. The second possibility is that metronidazole does have some immunomodulating effects (may help calm inflammation). And yes, it tastes horrific.

When you say she was taken by surprise when she threw up, that sounds like regurgitation rather than vomiting. The classic is a dog that drinks a ton of water, turns around to walk away and "splats" it out. Or teh cat who wolfs his/her breakfast then a few minutes later gives one retch and out it comes. Vomiting officially starts with the "glug glug" noise and ends with the expulsion of stomach contents. Regurg just happens.

Use of pancreatitic enzymes is controversial in pancreatitis. It has one true use and that is in cases of exocrine pancreatitic insufficiency (EPI). Animals with EPI do not produce these enzymes in sufficient amounts and actually cannot digest food without them. For pancreatitis, the pro-enzyme camp says that the presence of pre-digested food (mixed with the pancreazyme) may make the pancreas produce less enzymes on its own and in that way help the pancreas to heal. Pancreatitis, as you've read, involves pancreatic enzymes being inappropriately activated and actually digesting the pancreas itself. The use of pancreazyme may cause less stimulation and therefore reduced enzyme production (says the pro-enzyme camp). The anti-enzyme camp says that for god's sake, there are enough pancreatic enzymes running loose, why add more??? And so they disagree :roll: Earl's internist was in the anti-camp but did tell me about the "pro" theory. Some of the cat people on VIN are pro-enzyme for acute flares.

By increased incubation I just meant that you can mix the food and enzymes for a longer period (1/2hr-1hr) before serving. Now just because some animals get oral irritation doesn't mean they all will, so I'm certainly not saying that Pearl is headed for trouble.

Regarding the enalapril, you may have seen me mention before that enalapril/benazepril can both harm and help the kidneys. Some types of kidney disease cause a loss of protein -- this is more common in dogs and seems to be what happens in acrocats. Enalapril helps these cases because it causes there to be less forceful blood flow and therefore less "blowing out" of protein. On the flip side, enalapril can cause elevations in BUN/creat because it reduces blood flow which almost always a bad thing. Studies of benazepril have shown that it is helpful only in cases of protein-losing kidney disease (glomerulopathy). It makes no difference in kidney diseases which are not characterized by protein loss. [Please note that I am giving generalized, crude explanations--kidney diseases are terribly complex!]

As always, I hope I'm helping more than I'm confusing ...

Jess
 
Re: enzymes, Pearl leaves quite a lot of food and will go back and nibble and I had wondered how that would be effected. Honestly, Like I said, I've only mixed a little in to two meals so far. I don't know, we just thought we should try it.

Yeah, it really sounds like she regurgitated,b ut I don't know why. I guess she ate too much. I'll just try to keep amount down. It didn't seem like it.

RE: enalipril, considering her numbers and the xrays looked so good, I guess it isn't hurting. I just don't know what all to do there.

Yes, that is why the metrodonizole was prescribed. I still don't know how to get it down her! I guess everything has a flip side. You just take a stab at it and go.
 
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