Gastroenteritis/pancreatitis questions.

[sos2484]

Oliver was diagnosed with gastroenteritis and pancreatitis. They told me to feed him boiled chicken to get the inflammation down. He’s not on any medicine except zofran and Pepcid. I’m reading here that they should be eating. He’s hungry. He did eat the chicken but I didn’t give him too much. How much should he be given and for how long?

 

[silent meowlook]

Hi. Honestly, I would consider a consult with an internal medicine veterinarian, or a feline only veterinarian. I say this because pancreatitis is very painful for cats and I think he could do better medication wise. How was he diagnosed with pancreatitis? What diagnostics were done? Did they do any imaging, like an ultrasound?

Of course your Veterinarian has examined your cat and is a Veterinarian, so they are going to know best. But usually with pancreatitis, pain is treated with something like Buprenorphine. ( sadly there are not any over the counter pain relievers for cats) Where I work, depending on the cause and the patient etc., we use Cerenia as well as other medication. Fluids and a balanced diet for cats.
Often veterinarians that see cats and dogs seem to think that pancreatitis in cats is treated like it is in dogs. Dogs can develope it from eating a fatty meal and they are put on low fat diets. The fat doesn’t have the same effect on cats, so you don’t need to feed a lean meat diet.

 

[sos2484]

Hi… they did an ultrasound. It’s very confusing because he’s not in pain at all. My regular vet, the ER vet and the internist that did the ultrasound all remarked on that. I didn’t understand why he wasn’t put on any meds. I almost feel like they wanted to start with diet. The ER vet told me gastroenteritis. He never told me pancreatitis. I read the report and it said pancreatitis: moderate.
I called the ER earlier and she said feed him every four hours, boiled chicken, very bland.

 

[beckbjj]

My big old boy Quincy (the blonde one in my profile pic) was diagnosed via ultrasound with pancreatitis and IBD about five months ago. He has thankfully been stable for probably close to three months now.

My vet said it probably wasn't necessary to change his diet, but also when I first brought him in he had started to refuse food. In addition to an injection for pain, Quincy was prescribed 5 mg prednisolone once per day at first, both to get the inflammation down and to stimulate his appetite. It did stimulate his appetite but unfortunately he was still nauseous so he was still throwing up. I asked him to prescribe Cerenia and he did so. Cerenia is a real pain, BTW. It is expensive and needs to either be obtained in the proper dose from a compounding pharmacy or the very tiny manufacturer pills need to be quartered. Ugh. But it is a fantastic drug that works great. Anyway after a few days on 4 mg Cerenia, he stopped vomiting and hasn't more than once or twice since. I also give 2.5 mg famotidine just to be safe.

Quincy has regained the weight he lost and it's really obvious he's feeling much better. He still eats the same food he has always eaten. He was even able to go down to a maintenance dose of 2.5 mg prednisolone once per day. At some point we may try reducing the pred once again, but for now I'm just happy that Quincy is happy.

Anyway, in my opinion your cat would be better off on some meds. I know lots of people are scared of pred and I agree it's not ideal, but it really works, and as my vet says, "is well tolerated in cats". I've also got an asthma cat and she's been tested and has zero signs of early diabetes or anything else from being on pred. The only issue has been a little bit of loss of muscle tone, but that's it.

 

[sos2484]

My big old boy Quincy (the blonde one in my profile pic) was diagnosed via ultrasound with pancreatitis and IBD about five months ago. He has thankfully been stable for probably close to three months now.

My vet said it probably wasn't necessary to change his diet, but also when I first brought him in he had started to refuse food. In addition to an injection for pain, Quincy was prescribed 5 mg prednisolone once per day at first, both to get the inflammation down and to stimulate his appetite. It did stimulate his appetite but unfortunately he was still nauseous so he was still throwing up. I asked him to prescribe Cerenia and he did so. Cerenia is a real pain, BTW. It is expensive and needs to either be obtained in the proper dose from a compounding pharmacy or the very tiny manufacturer pills need to be quartered. Ugh. But it is a fantastic drug that works great. Anyway after a few days on 4 mg Cerenia, he stopped vomiting and hasn't more than once or twice since. I also give 2.5 mg famotidine just to be safe.

Quincy has regained the weight he lost and it's really obvious he's feeling much better. He still eats the same food he has always eaten. He was even able to go down to a maintenance dose of 2.5 mg prednisolone once per day. At some point we may try reducing the pred once again, but for now I'm just happy that Quincy is happy.

Anyway, in my opinion your cat would be better off on some meds. I know lots of people are scared of pred and I agree it's not ideal, but it really works, and as my vet says, "is well tolerated in cats". I've also got an asthma cat and she's been tested and has zero signs of early diabetes or anything else from being on pred. The only issue has been a little bit of loss of muscle tone, but that's it.

Hi… Quincy is a big boy! So cute, all three! Oliver was on prednisolone when this whole mess started in November. I’d did not agree with him and in my opinion, madd everything worse. I don’t think he needed it but I think sometimes these vets don’t actually listen to the pet parent and throw meds that maybe aren’t necessary. They also gave him cerenia by injection once and he barely ate for a day and a half. And I would give it to him but he’s not consistently throwing up. It’s one time a day, no food in it. Yesterday for some reason he drank a lot of water. He’s always been a really good drinker and loves his water fountain, I think he drank so much water, took a nap and threw up water. It had been 24 hours since the last vomit. He has a better than good, not great appetite so I don’t want to chance the cerenia stopping that.
He’s definitely not in any pain. I just don’t know why the ER vet didn’t say pancreatitis. He only said gastroenteritis and gave me hills ID. He didn’t make it sound like there was anything serious going on. It looks to me that he’s treating the gastroenteritis mainly and I’m sure they go together a lot but Oliver is hungry and I just don’t know how or what to feed him. He’s alert, playing, snuggling, bird watching, everything normal.

 

[neely]

It is standard procedure to run an fPLI test if your cat has symptoms of Pancreatitis. Did your vet do bloodwork and was this test included? Our cat has had Pancreatitis twice in the past and fortunately it was not severe but he did stop eating. He was on Prednisolone but also Mirtazapine to stimulate his appetite. In addition, the vet gave us Urgent Care A/D canned food which helped him a lot: Hill's Prescription Diet a/d Wet Dog/Cat Food

Sending special thoughts for Oliver. I hope he feels better soon but it you have any concerns please contact your vet.

 

[10thomer]

My boy Lewis has IBD as well as chronic pancreatitis and my understanding is that cats really should be eating as regularly (regularly meaning same amount & frequency, perhaps not the same type of food) as possible regardless of gastroenteritis/pancreatitis due to their propensity for hepatic lipidosis, which is a serious condition that occurs if they're not eating.

I second neely ' s comment about the fPLI test - this is the current gold standard for non-invasive diagnosis of pancreatitis in cats and you should likely request that your vet runs this test. If your cat has been experiencing IBD-like symptoms, I wouldn't be surprised to learn that your cat also has pancreatitis because it's a common comorbidity.

If it ends up being that your boy has IBD & pancreatitis, Tiki Cat Luau food has been a total life-saver for my two kitties (who both have severe IBD). It seriously is basically just shredded chicken with other added nutrients. I have to add a little pumpkin to it because it contains no fiber and one of my cats has trouble passing hair without a bit of fiber, but other than that it's great. We no longer need any steroids or cerenia. Could be worth a try for you as well!

 

[sos2484]

It is standard procedure to run an fPLI test if your cat has symptoms of Pancreatitis. Did your vet do bloodwork and was this test included? Our cat has had Pancreatitis twice in the past and fortunately it was not severe but he did stop eating. He was on Prednisolone but also Mirtazapine to stimulate his appetite. In addition, the vet gave us Urgent Care A/D canned food which helped him a lot: Hill's Prescription Diet a/d Wet Dog/Cat Food

Sending special thoughts for Oliver. I hope he feels better soon but it you have any concerns please contact your vet.

He was at the ER. They only did an ultrasound and X-rays because he had bloodwork done 4 days before.

 

[sos2484]

My boy Lewis has IBD as well as chronic pancreatitis and my understanding is that cats really should be eating as regularly (regularly meaning same amount & frequency, perhaps not the same type of food) as possible regardless of gastroenteritis/pancreatitis due to their propensity for hepatic lipidosis, which is a serious condition that occurs if they're not eating.

I second neely ' s comment about the fPLI test - this is the current gold standard for non-invasive diagnosis of pancreatitis in cats and you should likely request that your vet runs this test. If your cat has been experiencing IBD-like symptoms, I wouldn't be surprised to learn that your cat also has pancreatitis because it's a common comorbidity.

If it ends up being that your boy has IBD & pancreatitis, Tiki Cat Luau food has been a total life-saver for my two kitties (who both have severe IBD). It seriously is basically just shredded chicken with other added nutrients. I have to add a little pumpkin to it because it contains no fiber and one of my cats has trouble passing hair without a bit of fiber, but other than that it's great. We no longer need any steroids or cerenia. Could be worth a try for you as well!

I actually bought that today but he wouldn’t eat it. I have mirtazapine here. I have the ribbon. What do you think about giving him half the dose? The last time I gave him the whole dose, it was definitely too much.

 

[10thomer]

I actually bought that today but he wouldn’t eat it. I have mirtazapine here. I have the ribbon. What do you think about giving him half the dose? The last time I gave him the whole dose, it was definitely too much.

Unfortunately I don't have any experience with/knowledge of mirtazapine so I can't speak to that But I can say that if you're able to stimulate his appetite and get him eating the Tiki Luau, it's about as plain as plain can get so your cat is unlikely to have an inflammatory response to it (unless he's sensitive to the proteins in chicken, of course).

 

[sos2484]

My boy Lewis has IBD as well as chronic pancreatitis and my understanding is that cats really should be eating as regularly (regularly meaning same amount & frequency, perhaps not the same type of food) as possible regardless of gastroenteritis/pancreatitis due to their propensity for hepatic lipidosis, which is a serious condition that occurs if they're not eating.

I second neely ' s comment about the fPLI test - this is the current gold standard for non-invasive diagnosis of pancreatitis in cats and you should likely request that your vet runs this test. If your cat has been experiencing IBD-like symptoms, I wouldn't be surprised to learn that your cat also has pancreatitis because it's a common comorbidity.

If it ends up being that your boy has IBD & pancreatitis, Tiki Cat Luau food has been a total life-saver for my two kitties (who both have severe IBD). It seriously is basically just shredded chicken with other added nutrients. I have to add a little pumpkin to it because it contains no fiber and one of my cats has trouble passing hair without a bit of fiber, but other than that it's great. We no longer need any steroids or cerenia. Could be worth a try for you as well!

It’s so complicated because he never had symptoms of IBD. He never had symptoms of anything. He got into potting soil during the night and I woke up to two small piles of vomit in soil. And he didn’t get sick again. This was an acute event that happened three months ago that I feel he wasn’t treated properly. He got better after I took him off the steroids. While he was on them, he wouldn’t eat and lost weight. He wasn’t vomiting or diarrhea.

 

[sos2484]

Unfortunately I don't have any experience with/knowledge of mirtazapine so I can't speak to that But I can say that if you're able to stimulate his appetite and get him eating the Tiki Luau, it's about as plain as plain can get so your cat is unlikely to have an inflammatory response to it (unless he's sensitive to the proteins in chicken, of course).

He’s not sensitive to anything. He never has been. I can’t get a straight answer. Four vets have four different diagnoses.

 

[sos2484]

He was at the ER. They only did an ultrasound and X-rays because he had bloodwork done 4 days before.

And they didn’t run that test.

 

[10thomer]

He’s not sensitive to anything. He never has been. I can’t get a straight answer. Four vets have four different diagnoses.

Hmm okay I think I'm a little bit unclear on the series of events here... would you mind spelling out the events that have happened since his first symptom(s), to his vet visits & associated diagnoses, any treatments he's received, up to the issue that you're having with him today? We call this a "patient journey" in healthcare and can help people better understand what could potentially be going on with a given patient.

 

[neely]

And they didn’t run that test.

I'm sorry but if they think it could possibly be Pancreatitis he needs a fPLI test to confirm it. Regarding the Mirtazapine I would suggest calling your vet before reducing the amount because he could have a relapse of symptoms. I'm also sorry you have four different diagnoses, that makes it even more confusing for you.

 

[sos2484]

Hmm okay I think I'm a little bit unclear on the series of events here... would you mind spelling out the events that have happened since his first symptom(s), to his vet visits & associated diagnoses, any treatments he's received, up to the issue that you're having with him today? We call this a "patient journey" in healthcare and can help people better understand what could potentially be going on with a given patient.

How long do you have? Lol. I posted a few other times in detail but I’ll try to narrow it down here.
10/27. He got into a plant that I repotted with soil that may have had fertilizer or fungus in it. He threw up but wouldn’t eat a lot. (This also happened 7 years ago and they wanted to hospitalize him but he started eating.) he started eating on his own.
11/3 he did it again. Threw up two times. wouldn’t eat. (Plant is gone now)
11/5 Wento the the ER. Cerenia injection. Wouldn’t eat much.
11/7 back to the ER. Bloodwork is great. X-rays showed inflamed intestines and a lot of gas. US - IBD/lymphoma. If he didn’t throw up with the soil, I would’ve accepted this diagnosis but I couldn’t accept it. He never had diarrhea a day in his life and very rarely throws up. Put on prednisolone. He was acting very normal until the Pred. Then everything went downhill. It was so scary and so bad and they kept saying he needed to be on it. He wasn’t the same cat.
11/14 oncologist visit. She diagnoses him with either FIP OR HISTIOCYTIC SARCOMA. She will not treat him for anything unless I get a biopsy.
I talked to the ER doc and begged to lower the dosage. Now he starts feeling better.
his weight stabilized and he was eating again. Personality started coming back.
took him to his very from when he was a kitten, I moved an hour away so I left him regrettably. He looked at all the records and Oliver and agreed something wasn’t adding up.
took him off all meds. He was eating great, gained a pound back.
everything was going smoothly. I was only concerned about the noises in his belly. He’s always had them but they got worse.
I got him cat grass which he threw up from for three days before I realized it and took it away.
Two weeks ago he ate the ribbon from a toy. Very short piece that I made sure after he threw it up that it was all there. Then he started throwing up every day. Once or twice there was food but mostly yellowing brown liquid.
took him to the ER last Friday. Us showed gastroenteritis, pancreatitis cholangitis. I asked if they saw any cancer and they DID NOT. my head is now spinning.
they gave him fluids and gave me zofran and hills ID.
we have finally gone 24 hours without throwing up but regurgitated water after drinking very fast. His appetite is not good and he’s losing weight. Please ask me anything I wasn’t clear about.. I know this was long. Oliver is 14.

 

[sos2484]

I'm sorry but if they think it could possibly be Pancreatitis he needs a fPLI test to confirm it. Regarding the Mirtazapine I would suggest calling your vet before reducing the amount because he could have a relapse of symptoms. I'm also sorry you have four different diagnoses, that makes it even more confusing for you.

The ER vet never said he had pancreatitis. He told me the diagnosis was diffuse enteropathy. He never said pancreatitis. There are no words to explain how confused I am.

 

[fionasmom]

Pancreatitis is hard to diagnose without the requisite tests and can be missed; having said that, I understand that you have a report which lists it as a condition. Did you ask the vet specifically about why it was noted and not addressed?

You may be looking at a number of coincidental issues. He ate soil, but is happened at the same time that something else presented and no one has been able to separate all of this for you. I know that I brought this up in your other thread, but I still wonder.

 

[sos2484]

Oliver ate this morning and threw up. We went 2 days with no throw up. I know this shouldn’t be happening and took him to the ER this morning. Since I was there last week, I was able to get an appointment with the internist. Bloodwork, GI panel, CBC sent out to lab, 4th US, second FNA of his spleen. Initial blood shows his BUN increased from 2.2 to 3.1 since 2/1. He has a kidney infection. WBC are high. They started him on fluids, antibiotics, cerenia and an acid reducer. She thinks GI disease, possibly kidney disease and possibly cancer. I am not a vet but I am very involved in all of my cats health and sickness. Obviously if there is cancer, the soil was not the cause but I will never accept that the soils didn’t play a huge role in this. It doesn’t matter because we are dealing with these issues no matter the cause. But 7 years ago, I watched Oliver have the same EXACT symptoms after getting into something outside. I saw how he reacted. He was hours from being hospitalized and then he just started eating again. I’m just happy he’s getting treated. I can’t stand not being with him. I’m so sad without him next to me. They let me see him. He had a cone on so he didn’t get the catheter out. It was so stressful for him that I called the tech to bring him back. He needed to be in a confined space where he felt safe. They told me to be prepared that they may suggest he stay another day. I can’t stand the thought but if it’s best for him, he’ll stay.

 

[neely]

I'm sorry about the possible diagnosis but encouraged that they are treating him and fingers crossed he will be able to come home soon. I completely understand the feeling of the house being lonely without him next to you. Sending special thoughts for both of you.