What to Do??

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It sounds like a vet visit is in order if she is not eating or drinking. You mentioned fluids and pain meds. Pancreatitis also requires anti-nausea meds. Do you have any on hand?

The risk of not giving insulin + not eating + something else going on is DKA which is life threatening and expensive to treat.


From Pancreatitis: A Primer On Pancreatitis
Steroids: Steroid treatment using such drugs as prednisone, prednisolone, or dexamethasone can be useful for treating chronic feline pancreatitis. Insulin needs “might” increase with the use of steroids if the veterinarian believes steroid therapy is required.​

The insulin dose can easily be worked around the steroids.
 
Pancreatitis is normally very treatable. I have not heard of cats needing high doses of prednisone for the rest of their lives following prednisone and I have seen some cats with really severe pancreatitis.
To treat pancreatitis the cats needs sub q fluids as they are almost always dehydrated, pain meds as it is very painful and antinausea meds such as cerenia and ondansetron. Has your vet prescribed these?

Have you tested for ketones? With pancreatitis, not eating or drinking CJ is a high risk of ketones and possibly DKA. So if you haven’t tested for ketones I would definitely do so now. If you don’t have any ketostix to test with, they can be bought at Walmart or any pharmacy.
It is really important that CJ is eating and drinking. When did he last have cerenia?
 
Bron and Sheba (GA) said:
Pancreatitis is normally very treatable. I have not heard of cats needing high doses of prednisone for the rest of their lives following prednisone and I have seen some cats with really severe pancreatitis.
To treat pancreatitis the cats needs sub q fluids as they are almost always dehydrated, pain meds as it is very painful and antinausea meds such as cerenia and ondansetron. Has your vet prescribed these?

Have you tested for ketones? With pancreatitis, not eating or drinking CJ is a high risk of ketones and possibly DKA. So if you haven’t tested for ketones I would definitely do so now. If you don’t have any ketostix to test with, they can be bought at Walmart or any pharmacy.
It is really important that CJ is eating and drinking. When did he last have cerenia?
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I know each cat is different, but when Buddy is having a serious flare the only way I can keep him eating is with a low dose of prednisolone 2 X a day. I give him a low dose every day 2 x and I would give him more if my vet would let him have it. I use all of the other meds too and I am sure it helps him some, but not enough. With out the prednisolone I have to force feed him every meal and that is for weeks.
 
Cat Ma said:
Am too stressed, @Diane. She's not on insulin yet.
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I am going to tag @Tomlin, who uses prednisolone at a higher dose and does fine. By the way you should be using prednisolone not prednisone, prednisolone works better for a cat. Buddy, would go weeks without eating, so I would force feed him, before he started taking prednisolone. Since he started taking prednisolone I have had to force feed him a few times, like a few times in a month and if his vet would up his dose that would not happen. Some vets are afraid of prednisolone with a diabetic cat because it causes BG to go up, but that means you up your insulin. A good food to force feed is Hill's I/D or Hill's A/D, A/D is higher in fat and Buddy cannot tolerate the fat. Your kitty needs to eat and if diabetic needs to be on insulin, both things right now. Without eating or insulin this puts your cat at a great risk for DKA. Why is your cat not on insulin.
 
Hi. I am very sorry to read about CJ :(. It is definitely very stressful when they are not feeling well.

At this point, CJ needs to go into the vet for labs to determine what is needed with respect to treatment.
While subq fluids are helpful, at some point, IV fluids are best if there is a pancreatitis flare. Something to keep in mind, very often, there is more than “just” pancreatitis going on with cats diagnosed with pancreatitis. This is especially true with cats who have been diagnosed with DM....even after they go into remission. The gut aka GI system is not normal. It is also not uncommon for initial ultrasounds to be “normal” but then repeat ultrasounds or endoscopy identify issues within the intestines &/or liver as well as the pancreas (aka Triaditis).

Prednisolone is actually used in cats with chronic pancreatitis. The lowest effective dose is the goal. Sometimes, it is able to be discontinued or used every other day, but for some cats, they are finding that the immune system must be suppressed in order to prevent future flares. Immune suppression using Prednisolone starts at 5mgs. The researchers at TAMU have actually found that for cats with this issue, a more moderate to severe form of chronic pancreatitis &/or pancreatitis with IBD &/or liver inflammation with DM, they are actually able to be better regulated with their DM WITH Prednisolone than without it. The reason for this is that inflammation &/or pain will oftentimes make it very difficult to regulate blood glucose. They are currently even studying the use of Prednisolone in combination with other low doses of immunosuppressive medications for cats that aren’t doing well on Prednisolone alone OR for cats who require a lower dose of Prednisolone but still need more immunosuppression. One sure telling sign of a cat who may do best and needs immunosuppressive treatment is a cat that is getting by with constant use of anti nausea meds, pain meds etc.. These are all simply Band Aids and symptom management vs actually treating the underlying problem (inflammation caused by the immune system) that is causing the pain, nausea, appetite issues. Not all cats will require immunosuppression. It is often a process to figure out what is required from one cat to the next. The length of the process will differ with every case. There is patience required :rolleyes:.

First thing is first, and that would be to get CJ to the vet to get the much needed labs &/or additional diagnostics in order to get the correct diagnosis and then the best treatment plan at this point.

Thoughts and prayers with both you & CJ :bighug:.
 
Hi there, I'm so sorry the ER vet was of no help
Just a thought, I see in the Supply closet Jim Martin is selling 4 Lantus Pens/good until 2023
30.00 each. He is also selling the U-100 syringes
Did the ER vet do any blood work .
Poor kitty broke my heart to hear he was crying all the way home
So he's peeing now?
Do you have a regular vet that you have been going to?
Here is the link for the supply closet


https://felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

Here is Jim's post below


https://felinediabetes.com/FDMB/threads/lantus-syringes-meters-for-sale.239613/
 
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Diane Tyler's Mom said:
Hi there, I'm so sorry the ER vet was of no help
Just a thought, I see in the Supply closet Jim Martin is selling 4 Lantus Pens/good until 2023
30.00 each. He is also selling the U-100 syringes
Did the ER vet do any blood work .
Poor kitty broke my heart to hear he was crying all the way home
So he's peeing now?
Do you have a regular vet that you have been going to?
Here is the link for the supply closet


https://felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

Here is Jim's post below


https://felinediabetes.com/FDMB/threads/lantus-syringes-meters-for-sale.239613/
Click to expand...
I hope it helps, start a conversation with him, hopefully he will check his post out and sees he received a conversation request
 
Cat Ma said:
@Diane prednisolone
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Wonder why this vet will not let this cat have insulin if he is diabetic, has this cat had blood work for diabetes. Prednisolone is what your cat needs to be taking, so this is the right thing. What food are you force feeding, some are easier to force feed than others and really water it down and make the food thin, that way kitty will get fluids. Try to force feed several times a day and you need a good syringe.
 
Teresa & Buddy said:
Wonder why this vet will not let this cat have insulin if he is diabetic, has this cat had blood work for diabetes. Prednisolone is what your cat needs to be taking, so this is the right thing. What food are you force feeding, some are easier to force feed than others and really water it down and make the food thin, that way kitty will get fluids. Try to force feed several times a day and you need a good syringe.
Click to expand...
I wonder the same thing, this was the ER doctor I see, I asked her if she has a regular vet she see's #19
 
If you truly can not wait to get your cat on insulin, than Novolin N is usually available at Wal-mart without a prescription, except in Indiana. You should call first, to double check, and see if it is in stock. (and how much stock they have) They call it something slightly different, as it's their own brand with the Reliion name on it, but it is NPH insulin. Available over the counter. Used to be $25 a vial.

Novolin N onsets (starts to work) really quickly and drops the BG levels like a rock. So you need to be home testing first. Plus it has a very short duration, between 6-8 hours.
You also need to feed your cat a good 1 hour before you shoot the Novolin N insulin.

Vetsulin is usually only available via prescription from a vet. So getting that quickly would depend on having a vet willing to prescribe it as well as having that insulin in stock.
Cats don't often do well on Vetsulin and Prozinc is recommended by the AAHA guidelines, as is Lantus.
But again, if Vetsulin is something your regular vet has in stock, then get that.
If they have Prozinc in stock, get that as your first option, Vetsulin as your second option.
 
Deb & Wink said:
If you truly can not wait to get your cat on insulin, than Novolin N is usually available at Wal-mart without a prescription, except in Indiana. You should call first, to double check, and see if it is in stock. (and how much stock they have) They call it something slightly different, as it's their own brand with the Reliion name on it, but it is NPH insulin. Available over the counter. Used to be $25 a vial.

Novolin N onsets (starts to work) really quickly and drops the BG levels like a rock. So you need to be home testing first. Plus it has a very short duration, between 6-8 hours.
You also need to feed your cat a good 1 hour before you shoot the Novolin N insulin.

Vetsulin is usually only available via prescription from a vet. So getting that quickly would depend on having a vet willing to prescribe it as well as having that insulin in stock.
Cats don't often do well on Vetsulin and Prozinc is recommended by the AAHA guidelines, as is Lantus.
But again, if Vetsulin is something your regular vet has in stock, then get that.
If they have Prozinc in stock, get that as your first option, Vetsulin as your second option.
Click to expand...
Thank you @Deb & Wink , have a good night :bighug::bighug::cat:
 
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