Pancreatitis And Inflammed Bile Duct??

Hi,im new here and this is my first post. My 6 year old cat, Apple started being ill in november last year. Took her to the vets straight away, she had bloods done and was diagnosed pancreatitis. Fast forward to now and several flare ups later, i decided to have her scanned. The scan showed she has an inflammed bile duct, bile sludge, a possible cyst and pancreatitis. They prescribed 4 weeks of Clavaseptin antibiotic and another scan in 10 to 12 weeks. The vets also said if she has another flare up then they will prescribe Tramadol, an antisickness drug and an antacid. Different stuff to what she has had in the past. Shes fed Royal Canin GI moderate calorie wet food and Hills ID biscuits, no treats, no tit bits.
I was just wondering if anyone had any advice or has a cat that has the same thing? Thankyou for reading x

Hi i'm bumping this for you

Thankyou x

I do not have experience with pancreatitis and cats. People, yes, my mother has it. I know for her flare ups are very much related to the foods she eats. Seems yours in on prescription foods? If he continues to have problems maybe ask the vet to try a different prescription food? I would guess there are other brands for the same thing? Might be that a different brand would work better for your cat?

From what i have read a low carb, lower fat diet is best for these cats, any cat really. we were discussing this in another post yesterday, for weight loss. My go to food for high protein, low fat and low carb is Tiki cat wet foods. Especially the koolina luau chicken, and the After dark flavors. they are low calorie as well, so you need to feed more cans, or supplement with higher calorie foods as well. The almo nature complete foods, not the supplemental foods, that you can get from Chewy are are also very low fat and carb, my guys like the salmon and apple, and the chicken and green beans. I am not recommending changing or adding food without your vets ok, but maybe something to think about or talk to him about?

I am sure others with more experience than me will come in with other suggestions or information. I just wanted to say i hope he feels better soon!

I do like this list to show the protein, fat and carbs with different wet foods.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

CatFoodDB - Almo Nature Cat Food Reviews

I have a newly diagnosed with pancreatitis cat and have done a lot of research.

As far as the drug "Tramadol" - it is a major pain killer, (an opiate) - I was given Tramadol when I had a 1/2-inch kidney stone prior to and after surgery. My Vet gives my cat, Olivia, Buprinex for pain flare-ups and it works very well. It is a synthetic opiate, but because the pain with Pancreatic flare-ups is so intense, it is needed.

My Olivia (in picture) will not eat any of the prescription diets (i/d, e/n, and one other I forgot), and we are having a hard time finding a moderate protein, low carb wet food for her. I am going to try the "Primal Chicken & Salmon, as well as the Turkey Formula Nuggets Grain-Free Raw Freeze-Dried Cat Food.

My neighbor and friend has had a cat with pancreatitis for 16 years and she brought me a couple of the freeze-dried nuggets of Primal cat food which is mixed with a little water, and Olivia ate the entire bowl. It is a very filling food. I plan to also keep in store chicken thighs to add to her food once a day.

Making sure they eat is very important with pancreatitis. My Vet did say not to force-feed. That is very hard not to do when they won't eat, but she said they can go 2 full days without eating, but no longer. Honestly, I'm not comfortable with that, so I'm paying the extra money to get her the Primal freeze-dried food which she will eat. (Believe me, I don't have a lot of money as I'm on Social Security Disability, but will change how I eat so that she will eat healthy and very nutritious food, which the Primal food is.

As for the bile duct issue, I have not had experience with that. Olivia does have IBD, and so needs food that will digest very easily as the IBD is the big source of her physical pain.

Although most Vets will never admit it, they do get kick-backs for selling the prescriptions foods - the digestive foods containing grains, carageenan (a known inflammatory), and other fillers. I do my own research on the foods and the disease to make sure Olivia is getting what she needs. The food is extremely important, as well as keeping them drinking water.

I have a Drinkwell fountain which she drinks often from and I highly recommend (any fountain should work, but Olivia likes the ones that come out like a water faucet as opposed to the ones that run flat against the fountain).

My 3 cats and I only drink bottled water as our tap water here is very smelly and disgusting.

Oops, I forgot to add the website for Primal pet foods. It's: Primal Pet Foods

Sorry to hear about your kitty!

My 9.5 year old cat, Kittybiscuit Jones, is weirdly in almost the same boat - the inflamed bile duct, bile sludge, inflamed gallbladder, and moderate pancreatitis (no cyst, though). This has actually been going on for nearly a year. Right now he's on 5mg prednisolone, ursodiol, Cerenia, and metronidazole daily. We didn't really see any improvement with him until we started the prednisolone. However, he had a setback in mid-March where he stopped eating and went jaundiced again (we had decreased his pred dosage to 2.5mg in January, so I don't know if that had something to do with it). He's back on his full 5mg pred, and doing somewhat better.

We still assist feed him right now, since he's not eating the way he should (we sometimes use Hill's A/D, but right now we're using Solid Gold chicken pate - both are smooth and easy to syringe, and Kitty actually sometimes likes the Solid Gold). He'll eat about 1/4 cup of dry food (right now it's Tiki Cat chicken luau, but he gets so many food aversions that it's hard to know how long he'll want to eat a particular food).

I hope Apple feels better soon. You might want to ask your vet about ursodiol for the bile sludge, at least. Prednisolone has also been a lifesaver for us, and the benefits thus far have outweighed the risks. Please keep us posted - I know how difficult it is to find much information on these conditions. I get the feeling that gallbladder issues in particular are rare and difficult to treat in kitties.

Dangerbunny, thankyou so much for your reply. Apple is doing very well and eating very well. Iv never noticed her being jaundiced at anytime which is what im confused about. She has a flare up then goes back to normal after a week.
Did you have Kittybiscuit scanned? I will mentiin the ursodiol when im in the vets next weekend with one of my other kittys.
Again thankyou for your reply,i was feeling very alone fighting this with my girl. Im in the uk, are you?x

Hi Nikki!

I'm glad to hear Apple is doing well. Eating is definitely a good sign, and so is not being jaundiced!

Kittybiscuit has had two ultrasounds: one last August that showed the inflamed gallbladder and sludge, moderate pancreatitis, inflamed bile ducts, and some liver inflammation; the other in April that showed the same minus the liver inflammation. The emergency vet that did his first ultrasound recommended immediate removal of his gallbladder (for $6k!), but our primary vet didn't consider that necessary at that point if medication could help control his symptoms (from my understanding, the surgery is fairly risky anyway but even more so for a cat with a lot of inflammation). However, our vet has also suggested exploratory surgery which we've elected to forgo right now because I'm not sure how Kitty will handle it, particularly post-surgery (he's been very kindly described as "fractious," and that is a massive understatement), and because it's expensive and poses its own risks.

Kitty's jaundice was hard to notice at first; I really only saw it because I was syringe feeding, and it appeared under his tongue before spreading to the skin in front of his ears. He was also very lethargic and not eating on his own at all. Even with ursodiol and metronidazole, he didn't significantly improve until we started prednisolone late last October. And thankfully we knew what to look for when he started to relapse in March, so we got him back to the vet asap.

There's another person here, kittymonsters, whose cat Stomper had some gallbladder issues (stones and sludge); he had his gallbladder successfully removed. It's one of the few relevant things I've been able to find. Gallstones, Pancreatitis, triaditis...anyone have experience?

We're in Texas, so I don't know how different treatment would be in the UK. I hope Apple continues to improve; you might have caught things earlier than we did so hopefully she can have a better recovery. In any case, I'd appreciate any updates and I'll let you know too if I find out any new information!

Dangerbunny, im writing today as Apple has started with another flare up this morning. Im so upset. I will have her to the vets today for medication. She refuses to eat today and has been sick. She isnt jaundiced tho from what i can see. I hate my girl being poorly xx

While my cat does not have the pancreatitis, my cat does have an inflamed biliary system with gallbladder sludge! My cat, Mika, is only 3 years old and they suspected an infection however, almost 3 weeks after diagnosis, I am still fighting to get her biliary system back to normal.

Mika has jaundiced-- and badly at some points during all of this. She was almost orange at one point with how high her levels were and it is causing her urine to turn very yellow.

Since getting her on a very high dosage of ursodiol and a liver protectant her values have gone down except for the bilirubin level which is what causes the jaundice. She is still not eating normally though. I have been speaking to my vet and they have mentioned removal of the gallbladder a few times if her bilirubin level does not go back down to normal. (.5 is considered normal, 2 or over is when they jaundice, Mika was at a 12 last we checked.)

I am so sorry you're going through this but you are definitely not alone.

Hi Nikki!

I'm so sorry to hear Apple isn't feeling well again. Just remember that you're doing the best you can for her by taking her to the vet asap - and don't be afraid to ask them questions! I'm not sure what medications Apple's currently on, but I'd at least ask about ursodiol, an antibiotic (we use metronidazole), a pain killer (pancreatitis is supposed to be very painful), an anti-nausea/emetic like Cerenia, and/or prednisolone. Subcutaneous fluids can help a lot, too, and your vet can do it there, or they can give you a fluid kit to bring home if you're comfortable doing it yourself (I've done it for both our cats, and as someone who is just the worst with needles, it's terrifying the first time but totally doable). Syringe feeding can help too if Apple still doesn't want to eat on her own (and she might not want to for a while if she's feeling badly).

I know how awful it is to see a relapse when your baby had been doing well. But like Mika's mom said, you're not alone!

On that note, mikameek, what information did your vet give you about gallbladder surgery? It's still something we consider but I can't find much out about it! I hope Mika improves very soon, too - she's so young! I think Kittybiscuit was too young to have issues at 9, but 3 is really just a baby.

Keep us posted on how Apple (and Mika) is doing, and I'm happy to offer my own tips and tricks for pilling/syringe feeding/subcutaneous fluids if you need them! It's hard, but try to stay positive - you're doing the right things and no one can ask for more than that.

The vet gave Apple Cerenia injection and sent us home with Famotodine and Tramadol for the next 5 days. She very quiet tonight which makes me sad. Hopefully tomorrow she will feel better. She hasnt eaten again yet but i keep offering her tuna and Royal Canin recovery food.
They did mention removal of Apples gallbladder but only if she continues to have constant flare ups. I hope Meka feels better soon. Thankyou so much for your replys xx

Dangerbunny said:

On that note, mikameek, what information did your vet give you about gallbladder surgery? It's still something we consider but I can't find much out about it! I hope Mika improves very soon, too - she's so young! I think Kittybiscuit was too young to have issues at 9, but 3 is really just a baby.

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I was told that its very expensive to do and it comes with lots of post-op complications. I was told that cats and dogs tend to have lots of complications like blood pressure dropping, biliary infection, bile in the abdominal cavity which requires another surgery to clean out. I was also told that it takes a long time to recover fully.

I know that cats that have had their gallbladder removed have to be on special diets for the rest of their lives and while my vet didn't go into more than that because these were just preliminary talks, I do know that the removal of the gallbladder is not an easy surgery on animals in general.

Kittybiscuit was suuuuper quiet and subdued for the longest time when he was first sick, and it made me so, so sad to see him like that. Poor Apple! Make sure she eats, even if you have to assist feed her all or part of her meals. It's important to keep up her nutrition so she has the strength to fight, and she may need your help with that.

Has your vet mentioned other medications to put her on, or what course of action to take if she hasn't improved over the next few days?

They have said theh will tube feed her if she hasnt eaten anything within 3 days. She usually picks up within 5 days tho. Iv syringe fed some recovery food into her tonight and she hasnt been sick yet ( touch wood ) I will continue to syringe feed until she eats by herself over the next few days as i dont want her to be put under more stress by tube feeding.
Are any of you ladies on facebook? Might be easier to chat on there if you dont mind x