My Cat Charlie - Pancreatitis? Lost alot of weight and Little appetite

miguel99nyc

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Hello Everyone,

I have taken my cat Charlie - 14 years of age, to vet yesterday and was told he had Pancreatitis. I had brought him in because he wasn't eating well in past few weeks but even more so past few days he'd just lick his food barely and walk away. He'd come to kitchen but then just not want to eat - I figured he was sick, not well and he did lose alot of weight but so hard to tell because he has alot of hair...but was feeling his bones def more. He wasn't throwing up nor diarrea anything. Just not eating. Upon his visit, Doctor was concerned bceause used to be around 10.5lbs but now was aroudn 7.8lbs so its alot of weight lost for a cat, I know its very alarming my heart dropped when I heard that. He was sleeping bit more too but most part was walking around or laying around in bed stretched out like his good ol' self so it was hard to see if anything was really wrong other then appetite. Most of the times NORMALLY he'd eat little but he ALWAYS would come back to finish his food in the hours to come after feeding. So it was never an issue, he'd just eat in little portions which he has in past years as I can recall.

He was diagnosed with Pancreatitis last year and was back then deemed as cuase for his illness and lack of appetite but he was still in 10lb range so it didnt affect him as much.This time around he had lost alot of weight. Bloodwork showed all his other organs are perfectly fine and Xrays were taken too to see any cancer/tumors but all was clear too back last years visit and yesterdays. So he was given Prednisolone 5mg to take every day now for a week, then 1pill every other day. I could have sworn though last year vet took him off because we re-tested him and his values for that Pancreatitis test was normal range. So since I had stopped giving him pills and since then he had been eating just fine up to about few weeks ago.

So now this time they gave him so IV Fluids to hydrate as he was about 09-10% dehydrated as well vet said, plus an injection of the anti-inflammtory to get him started. What a difference? He was clearly eating so well yesterday After the visit, he ate so much and I was shocked. Vet said don't expect a miracle when I asked when he'd start eating again. He said wait about 24-48 hours and he should start to eat as we reduce that inflammation. This morning he was back to hill-self just licking a bit of his food, wanting to eat but I guess he still felt ill. I had to pop in a pill which he wouldnt eat with his food so I did that manual technique - raising his jaw back and opening up his mouth to place pill at his throat. So he took it in and now await see how he responds after.

My questions is, while I await the next day or so to see how this Prednisolone kicks in, I wonder if he still feel nasuea that won't allow him to eat like this morning? Maybe he will need Mirtazapine to stimulate it? I feel like the injection was powerful enough that it helped him greatly yesterday after the visit but now I guess sort of worn off or something. I remember last year he still had somewhat of his appetite so he was still eating along with taking his pill with his food. Now its tougher because he may feel nausea or something else. He had no fever as well. I think tomorrow Vet will call he said to determine how severe his Pancreatits is because the one test they do in office is to see if he has the disease or not so it confirmed yes, but to see how severe it is will find out tomorrow and determine next steps. I just feel so saddened by amount of wieght he loss let alone not eating well :( it hurts. Almost seemed like he was on his way to death which freaks me out but I'm so hoping this medication like last year, will turn him around and he will start eating well and gain some weight back.

If any one has thoughts would greatly appreciate it.
 
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miguel99nyc

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So i just got called by the vet And sort of good news but bad news too...

The Precision PSL test came back normal? He said it's not severe enough to be contributing to his lack off appetite apparently. But what I don't get is the Snap Test or soemthing they did for his Pancreas came back positive In office, but this Precision PSL was to determine how severe it was but it came back normal he said. So now he thinks it may not be pancreatitis but something else maybe intestinal inflammatory or something else but now recommends Ultrasound...hence more money. I swear this vet is always out to get my money but thankfully I got Charlie on Pet Insurance...so it should be covered. I just don't get how his In office test shows positive for his Pancreatitis but the PSL being normal.

So Vet now thinks could be something else...I just hope the Ultrasound works/determines once and for all what he has. My concern was that even with his Pancreas acting up last year, sure he ate less, but he never lost 3 lbs like that in short span. That worries me the most. Vet said if he isn't reacting to the Prednisolone then to stop it and just have him on the appetite stimulant for now.

This is all strange to me hard to figure out but looks like that Utlrasound will be needed. I just know its also for money...because aside from Bloodwork, then Xrays which were normal (whats different Xrays from ultrasound??) then comes the ultrasound. Last step from there if its "inconclusive" is that it needs endoscopy/Biopsy. Which is horrible for a cat to go through and will NOT let it get to that point.
 

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The snap test does sometimes have false positives. The test isn't as sensitive as the lab test.

I think an ultrasound is an excellent next step since X-rays, bloodwork, and the Precision PSL came back normal. Ultrasound can reveal the shape and texture of soft organs in ways that X-rays cannot. It is not just a play for your money. And you're right. There is a possibility than the ultrasound comes back inconclusive. It can reveal intestinal wall thickening consistent with IBD or small cell lymphoma. The difference between those two can only be determined by biopsy. But an ultrasound can also rule in or rule out tumors that the X-ray can't pick up or irregularities in other organs. If the ultrasound does come back "IBD or small cell lymphoma", you can try treating IBD with pred first and adding chemo therapy for lymphoma if that proves ineffective. I got my Krista to remission that way convincing her doc that the diagnosis (endoscopy/biopsy) was riskier than the chemo drug.

I think that's sound advice from your vet to give the pred a little longer to see if it's helping with inflammation. If it's not, switch to an appetite stimulant. Prednisilone should not be used as an appetite stimulant. It's a nice side effect if it's needed. But there are drugs with fewer side effects/long term risks that should be used instead. Mirtazapine is one of them.

The injection he received in the office that could make a difference here, can you find out from your vet? Was it Cerenia? Mirtazapine is an appetite stimulant. But it sounds like he might be having nausea. Treat the nausea and you may find the eating returns to "normal" (normal for him.) Cerenia itself makes some cats inappetent. It did with my Krista. To get her through pancreatitis, she needed both Cerenia and mirtazapine.

If you're going to be giving medication regularly, see what can be compounded to easier forms like chew treats, flavored liquids, or transdermal gels.
Veterinary Pharmacy

Another possibility here is his teeth. When's the last time he's had mouth X-rays? A lot of teeth problems can happen below the gum-line and cats can be very stoic about pain. When my Krista's teeth were bothering her, often the only notification I got was her eating slowing way down.
 
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miguel99nyc

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The snap test does sometimes have false positives. The test isn't as sensitive as the lab test.

I think an ultrasound is an excellent next step since X-rays, bloodwork, and the Precision PSL came back normal. Ultrasound can reveal the shape and texture of soft organs in ways that X-rays cannot. It is not just a play for your money. And you're right. There is a possibility than the ultrasound comes back inconclusive. It can reveal intestinal wall thickening consistent with IBD or small cell lymphoma. The difference between those two can only be determined by biopsy. But an ultrasound can also rule in or rule out tumors that the X-ray can't pick up or irregularities in other organs. If the ultrasound does come back "IBD or small cell lymphoma", you can try treating IBD with pred first and adding chemo therapy for lymphoma if that proves ineffective. I got my Krista to remission that way convincing her doc that the diagnosis (endoscopy/biopsy) was riskier than the chemo drug.

I think that's sound advice from your vet to give the pred a little longer to see if it's helping with inflammation. If it's not, switch to an appetite stimulant. Prednisilone should not be used as an appetite stimulant. It's a nice side effect if it's needed. But there are drugs with fewer side effects/long term risks that should be used instead. Mirtazapine is one of them.

The injection he received in the office that could make a difference here, can you find out from your vet? Was it Cerenia? Mirtazapine is an appetite stimulant. But it sounds like he might be having nausea. Treat the nausea and you may find the eating returns to "normal" (normal for him.) Cerenia itself makes some cats inappetent. It did with my Krista. To get her through pancreatitis, she needed both Cerenia and mirtazapine.

If you're going to be giving medication regularly, see what can be compounded to easier forms like chew treats, flavored liquids, or transdermal gels.
Veterinary Pharmacy

Another possibility here is his teeth. When's the last time he's had mouth X-rays? A lot of teeth problems can happen below the gum-line and cats can be very stoic about pain. When my Krista's teeth were bothering her, often the only notification I got was her eating slowing way down.
Hi there!! I can try to find out what shot it was but on the invoice it showed anti-inflammtory injection in which the Vet also told me to start him on that medication of Pred, he said he'd give him a shot once yesterday and to start the pills today after 24 hours. So I'm guessing it was that Pred form of a shot. I've told him earlier today because he asked how Charlie was doing - that I guess it was because of that shot he started to eat a lot more yesterday. He made that sound of his voice like- agreeing like mmmm, then he said it was the shot that may have helped reduce that inflammation. So he said to continue on the prednisolone for few days see how he reacts. From what it seems like after I gave him this morning, I heard fro mmy family he began eating few times little by little hours past the medication so I guess it worked somewhat.

In addition like i explained to my vet - in addition to the lack of appetite or little appetite, he has been troubled passing stool in past weeks. Maybe from eating less, but he would do very narrow stools, not like his normal amount either. He would also at times becurled up random spots in our apartment and just past some droplet of stool liquid or even sometimes drops of blood but that was just maybe once or twice. But other times would see some blood stains in his stool he did in his litter but that I've been noticing such a long time ago prior to losing weight and not eating. He was still eating well back then and that blood droplet or in stool was minor and maybe just once in two weeks time, not all the times. But lately he been leaving some liquid stool drops (Not a whole bunch) both in litter and outside litter box.So that I don't know if its indicator of something else.
 

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The blood in the stool, the liquid stool, and the weight loss, that all could be lymphoma. Or it could simply be constipation from not eating enough. What does the vet think?
 
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miguel99nyc

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The blood in the stool, the liquid stool, and the weight loss, that all could be lymphoma. Or it could simply be constipation from not eating enough. What does the vet think?
Well I've seen that stool blood marks at times even maybe a year ago but would be on and off. I explained to doctor back then too but definitely don't recall doing an utlrasound or him bringing up lymphoma. He did bring that up now however that the ultrasound would rule that out? I mean if that is the case then I would certainly opt for that ultrasound to rule it out. But I read up online there would be much more symptoms then blood and weight loss. In fact as of this morning, Charlie did pass an actual good amount of stool, at the chocolate colored normal with no blood in it, and was not narrow or anything, was literally a normal amount. It was the first time Ive seen him to that amount in a while let alone, solid and brown colored.

In a way I was hoping it was just pancreatitis because I know it must be dreadful for a cat to undergo so many tests. But also since I knew he had it last year, I hoped that giving him medication just this one type would be suffice and get him back on track. And maybe he lost so much weight rapidly since I thought him not eating as much (though otherwise acting normal when awake) in the past weeks, maybe I waitied bit too long to take him. I kept on saying give it few more days to turnaround. THere were other days he ate normally so that is what threw me off. It was only as of the past maybe 4-5 days where he had been eating far less and was lethargic and just sleeping mostly.
 

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GI lymphoma can be small cell or large cell. I believe large cell lymphoma looks different enough on the ultrasound to be distinguishable from small cell and IBD. But small cell and IBD cannot be distinguished from each other on the ultrasound. For that, you can do a biopsy but that's not well tolerated by older cats. It's also hard on them because they have to recover from this procedure and you likely still haven't addressed the original cause of lack of appetite yet. Large cell lymphoma is more aggressive. If it was that, it probably would have progressed to something more obvious by now. Small cell lymphoma can sometimes show up as only weight loss. Rule out everything else with an ultrasound. If you're left with "IBD or small cell lymphoma" diagnosis, try the pred for a period of time and then ask about adding the chemo drug if he's not responding to the pred alone.

Thyroid, kidneys, teeth? are these all good?
 
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miguel99nyc

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GI lymphoma can be small cell or large cell. I believe large cell lymphoma looks different enough on the ultrasound to be distinguishable from small cell and IBD. But small cell and IBD cannot be distinguished from each other on the ultrasound. For that, you can do a biopsy but that's not well tolerated by older cats. It's also hard on them because they have to recover from this procedure and you likely still haven't addressed the original cause of lack of appetite yet. Large cell lymphoma is more aggressive. If it was that, it probably would have progressed to something more obvious by now. Small cell lymphoma can sometimes show up as only weight loss. Rule out everything else with an ultrasound. If you're left with "IBD or small cell lymphoma" diagnosis, try the pred for a period of time and then ask about adding the chemo drug if he's not responding to the pred alone.

Thyroid, kidneys, teeth? are these all good?
So...where do we get to after ultrasound? Because if it is about the "money" as I tend to think with that vet, theres a good chance he will say its nothing on the ultrasound all looks good. Then what? You know what I mean? I'm emailing him now again to see what else he can tell me.

And to your point, even he's on prednisolone (is prednisone and prednisolone the same thing?) would that be for ever? Again to me that shot he got yesterday seemed to have worked...oddly enough and guess it wore off by this morning where he didnt want to eat again as much...but combining that with Mirtazapine would be enough to reduce whatever inflammation he has and allow him to eat? It's such a hard and stressful thing because as much I want him to normal or real normal, I wouldn't want to be just covering up his symptoms but just giving prednisolone and mirtazapine. It's as if I cheat his body you know what i mean? Again doctor did say ultrasound would rule in or out about that lymphome part or IBD he mentioned but he's certain he has some kind of inflammation that the shot while temproary had worked.

As for his Thyroid and kidneys, per the bloodwork he said they are in perfect shape, including liver and heart. Teeth...he had problems in the past where a tooth broke off and needed cleaning, but nothing MAJOR for them to say he "isn't eating" because of it. Though every yearly visit they would mention his teeth and teeth but up to last year with the pancreatitis diagnosis, they finally mentioned it's NOT his teeths giving him problems but instead that pancreatitis. And now he was checked as well (though the tough part is that I COULDN"T be inside with charlie or vet because of Covid restrictions so who knows if it can be trusted? all vets here in NYC area are like that, only drop off at door only...) and did not bring up anything about his teeth. He was also dehydrated about 8-9% he said so they gave him fluids too.
 
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miguel99nyc

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GI lymphoma can be small cell or large cell. I believe large cell lymphoma looks different enough on the ultrasound to be distinguishable from small cell and IBD. But small cell and IBD cannot be distinguished from each other on the ultrasound. For that, you can do a biopsy but that's not well tolerated by older cats. It's also hard on them because they have to recover from this procedure and you likely still haven't addressed the original cause of lack of appetite yet. Large cell lymphoma is more aggressive. If it was that, it probably would have progressed to something more obvious by now. Small cell lymphoma can sometimes show up as only weight loss. Rule out everything else with an ultrasound. If you're left with "IBD or small cell lymphoma" diagnosis, try the pred for a period of time and then ask about adding the chemo drug if he's not responding to the pred alone.

Thyroid, kidneys, teeth? are these all good?
Also just got confirmatino from vet, the name of the Appetite Stimulant is called Entice? Its a liquid form. Would be that or Mirtazapine. I know my other cat with kidney disease Sassy - she was on the lowest dose of 2mg, 1/2 a table so I guess would be 1mg. But even that made her restless and made her cry alot for like several hours I hated it, but at least she kept on eating. I don't know how Charlie would react as it would be his first time.
 

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Also just got confirmatino from vet, the name of the Appetite Stimulant is called Entice? Its a liquid form. Would be that or Mirtazapine. I know my other cat with kidney disease Sassy - she was on the lowest dose of 2mg, 1/2 a table so I guess would be 1mg. But even that made her restless and made her cry alot for like several hours I hated it, but at least she kept on eating. I don't know how Charlie would react as it would be his first time.
Entyce only worked once for Krista. And only for one meal. I had Krista on 1/4 mirtazapine. She'd still have her meow moments. But they weren't as bad and didn't last as long. She'd seek out my lap and I'd comfort her for 30 minutes or so before she was good to eat. You can also get mirtazapine as a transdermal gel ("Mirtaz") to rub into his ear. The dose was 1 inch ribbon. But that was too much for Krista. I converted that inch to millimeters and then marked off 1/4 and 1/2 dose with a pen on an envelope edge. Then I used those smaller lines to calibrate her dose. Krista responded to 1/4 dose in the transdermal gel as well. Ask about Cerenia. See if you can administer the Cerenia first to see if this is a nausea issue.
 
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miguel99nyc

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Entyce only worked once for Krista. And only for one meal. I had Krista on 1/4 mirtazapine. She'd still have her meow moments. But they weren't as bad and didn't last as long. She'd seek out my lap and I'd comfort her for 30 minutes or so before she was good to eat. You can also get mirtazapine as a transdermal gel ("Mirtaz") to rub into his ear. The dose was 1 inch ribbon. But that was too much for Krista. I converted that inch to millimeters and then marked off 1/4 and 1/2 dose with a pen on an envelope edge. Then I used those smaller lines to calibrate her dose. Krista responded to 1/4 dose in the transdermal gel as well. Ask about Cerenia. See if you can administer the Cerenia first to see if this is a nausea issue.
Yes I can certainly try asking about Cerenia along with waiting a few days see how prednisolone works out at once a day currently 5mg little tablets.

But would Cerenia/Prednisolone and/or Mirtazapine, would just be covering up sort of and get him to eat right? Because then would be once he's off it say after, then he'd most likely return to not eating again. or could it actually work similarly like it did for my older cat Sassy and her lack of appetite? She had lost only though about a pound or two previously but gained it back.

With my cat Sassy, while she'd go few days without eating hardly anything in past,I had no choice but to give her Mirtzapine. Sure she was restless and cried alot, but of course her appetite came back strongly and began eating more and more. I also had given her Cerenia for like 2-3 days only as after literally one mirtazpine dosage, she didnt need it again. Then after 2-3 days Cerenia, she was eating like her self again as well so I had stoppped the medication. So then it becomes,did it cure her what she had since medication for few days worked? I was at that point with her appetite that ultrasound was needed to determine her cause of not eating and vomiting since bloodowkr and Xrays were normal. so Cerenia and Mirtazapine for a few days then she became good as new. But in that instance I don't think it was just a temporary fix? She does have her spells here and there where she doesnt want to eat as much but then gains it back after a day or two. Maybe age? Shes 18 years old so shes older than Charlie.
 

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Yes I can certainly try asking about Cerenia along with waiting a few days see how prednisolone works out at once a day currently 5mg little tablets.

But would Cerenia/Prednisolone and/or Mirtazapine, would just be covering up sort of and get him to eat right? Because then would be once he's off it say after, then he'd most likely return to not eating again. or could it actually work similarly like it did for my older cat Sassy and her lack of appetite? She had lost only though about a pound or two previously but gained it back.

With my cat Sassy, while she'd go few days without eating hardly anything in past,I had no choice but to give her Mirtzapine. Sure she was restless and cried alot, but of course her appetite came back strongly and began eating more and more. I also had given her Cerenia for like 2-3 days only as after literally one mirtazpine dosage, she didnt need it again. Then after 2-3 days Cerenia, she was eating like her self again as well so I had stoppped the medication. So then it becomes,did it cure her what she had since medication for few days worked? I was at that point with her appetite that ultrasound was needed to determine her cause of not eating and vomiting since bloodowkr and Xrays were normal. so Cerenia and Mirtazapine for a few days then she became good as new. But in that instance I don't think it was just a temporary fix? She does have her spells here and there where she doesnt want to eat as much but then gains it back after a day or two. Maybe age? Shes 18 years old so shes older than Charlie.
Proceed with the ultrasound. And mouth X-rays if he hasn't had those recently.

Until he has a diagnosis, you're right. The meds run the risk of just covering up the problem. But he has to keep eating while you're looking for that diagnosis. If he responds to the meds, you can always discuss tapering the meds to see if one medication is more useful than the others for getting him/keeping him eating. That might provide clues to what's going on.
 
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miguel99nyc

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Proceed with the ultrasound. And mouth X-rays if he hasn't had those recently.

Until he has a diagnosis, you're right. The meds run the risk of just covering up the problem. But he has to keep eating while you're looking for that diagnosis. If he responds to the meds, you can always discuss tapering the meds to see if one medication is more useful than the others for getting him/keeping him eating. That might provide clues to what's going on.
Yes I think I will. Charlie this morning did not want to eat and just goes off to hide under table. He seems to eat ok after taking the pill yesterday morning, he ate very well his dinner last night, but now seems like it wears off again like the shot. From tuesday ? Is this any clue?

Also, what if ultrasound doesn't show anything? Then what? Vet didn't really say what afterwards but I guess hed remain on mortazpine? Because he had told me to stop the pred if he isnt responding. I want to say he is but then it just seems to wear off by next morning. Doesnt seem right also.
 

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Mirtazapine - Is an anti-depressant and a side effect is an increase in appetite. This side effect is why it's prescribed for cats.
Prednisone is converted into Prednisolone via liver enzyme. Prednisolone consequently is usually more expensive because it's biologically active. There's a theory that you want to give cats Prednisolone because they lack the quantity of liver enzyme needed to convert Prednisone into a the required quantity of Prednisolone.

From my own anecdotal experience and research cats which have IBS/IBD are on "Pred" for life because it's used to manage the disease rather than cure it. The trick is to reduce the dose down to the bare minimum. You also want to administer it at night so that it works in conjunction with their nighttime fluctuation in hormonal levels.
 
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miguel99nyc

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Mirtazapine - Is an anti-depressant and a side effect is an increase in appetite. This side effect is why it's prescribed for cats.
Prednisone is converted into Prednisolone via liver enzyme. Prednisolone consequently is usually more expensive because it's biologically active. There's a theory that you want to give cats Prednisolone because they lack the quantity of liver enzyme needed to convert Prednisone into a the required quantity of Prednisolone.

From my own anecdotal experience and research cats which have IBS/IBD are on "Pred" for life because it's used to manage the disease rather than cure it. The trick is to reduce the dose down to the bare minimum. You also want to administer it at night so that it works in conjunction with their nighttime fluctuation in hormonal levels.
Thank you for the info!

Oh didn't know or was told about giving it in evenings, been giving it to him past 2 days now in the morning since he was last given his shot of anti inflammatory on Tuesday. In some way I hope it's IBS IBD because although there is no cure for it, its managable I'm sure and would get him back up to his normal weight hopefully and somehwat a normal life. Again this morning he did not want to eat , he just comes to sniff his food and just walks away. But about 30 min ago I popped in the pill into his mouth like in the videos where I tilt his head backwards and insert into throat. I will be picking up mirtazapine soon as well from the office. Only unfortunate thing is that The soonest available Ultrasound appointment was possibly next Thursday as technician only goes in on Thursdays. So I may have to have him on prednisolone and mirtazapine at least until then to have him eat.
 
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miguel99nyc

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It just boggles my mind so much on how Charlie became so ill. Now that I think of it (though trying to get an Ultrasound schedules which seems to be a week from now), how could the Bloodwork at LEAST show any sort of indication of something going on his body? I know cats are not humans but, if it was cancer of some sort, surely something would be off in his blood work? Although may not say its Cancer for sure or something else but something should have shown up and not be normal? I can even recall up to a week ago, Charlie was still walking around like the cool cat he is, jumping around, enjoying the sun and window views, laying in bed, petting us and all. And just suddenly within the past week just took a sharp decline - more lethargic, just sleeping more and eating far less. Like, can Lymphoma or IBD, or mysterious unknown Pancreatitis, act THAT fast to affect him that severly and rapidly? Let alone the rapid weight loss that appeared to have occured as well. Just scares me and saddens me so much. I was almost borderline thinking was maybe a Kidney failure that just came up SO fast but he wasnt known to have kidney disease up to last January 2019 check up. And all of last year and up to several weeks ago he was perfectly fine. USUALLY he would eat little, but he always ate small amounts and would come back to finish up food later in day. He was always small amounts of food throughout the day so that in itself was hard to notice his appetite beind less until few days ago - where he eat very little almost like his usual, but instead going back to his plate, he just went straight to sleep. Let alone he tends to now want to hidde underneath bed or like now, he's sleeps underneath our dining table.
 

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Thank you for the info!

Oh didn't know or was told about giving it in evenings, been giving it to him past 2 days now in the morning since he was last given his shot of anti inflammatory on Tuesday. In some way I hope it's IBS IBD because although there is no cure for it, its managable I'm sure and would get him back up to his normal weight hopefully and somehwat a normal life. Again this morning he did not want to eat , he just comes to sniff his food and just walks away. But about 30 min ago I popped in the pill into his mouth like in the videos where I tilt his head backwards and insert into throat. I will be picking up mirtazapine soon as well from the office. Only unfortunate thing is that The soonest available Ultrasound appointment was possibly next Thursday as technician only goes in on Thursdays. So I may have to have him on prednisolone and mirtazapine at least until then to have him eat.
No problem. I myself am considering a similar exam for one of my guys. I preferred prednisolone because it was a liquid and consequently easier to adjust the dosage.
 
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Unforton
No problem. I myself am considering a similar exam for one of my guys. I preferred prednisolone because it was a liquid and consequently easier to adjust the dosage.
a
No problem. I myself am considering a similar exam for one of my guys. I preferred prednisolone because it was a liquid and consequently easier to adjust the dosage.

Unfortunately, this morning Prednisolone may not be working :( yesterday morning about an hour or so after administering he began to eat but now he isnt again. I'm going to pick up shortly the Mirtazapine. Is it also anti-nausea too? Because I think my vet told that once last year that it can help them with nausea?
 

daftcat75

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Prednisilone is powerful medicine that comes with long-term risks. This is why it's recommended to use it as a boost, and then taper it to the minimum effective dose, preferably not daily, as quickly as possible. But if it's not effective right now, there are better and safer appetite stimulants that don't carry the same long-term risks. You should never change his prednisilone dose without vet consultation and approval. Sudden changes in pred administration can come with uncomfortable side effects. Your guy hasn't been taking it for long. But make sure with your vet that if you are going to discontinue it, that it is safe to stop right away or if you need to more slowly taper him off of it.

Mirtazapine can help some with nausea, but that's not it's primary job. Cerenia or odansetron (Zofran) are more effective for anti-nausea.

When was the last time his teeth were checked out? mouth X-rays?
 
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