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

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miguel99nyc

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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?
Hello there,

Well oddly enough just 30 minutes ago I opened a different kind of food and he ate quite a bit again. Seemed like he didnt want the other pate (Sheeba which he used to eat) and instead his Friske Pate can...he kept on going back to his plate to eat.

His teeth were thoroughly checked during his visit and Xray was taken as well but nothing abnormal. he had a history of a tooth broken off in the past year or so but never got work done on it as it was deemed not the issue for him not eating in the past. Today while he ate his Friskies Pate, he does seem to make some kind of grinding nose with his teeth or Jaw? It sounds like when some humans grind their teeth but it was almost each time he would chew the food or bite down, but not every bite down. He used to make that noise in the past but not as often as now? Not sure if thats something new I havent actually told the vet that.
 
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miguel99nyc

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Also, is it possible by some wierd chance if ultrasound does not show anything, that it could be just behavorial? And I was also wondering, as I just got his Mirtazapine but he drinks and eats bit here and there so far in past few hours on his own... what if he was nausea? But if he was nauseous, wouldn't he be throwing up? Or for cats, does it just kill the appetite only?
 

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It is entirely possible that it could be nausea. He might not be eating enough to vomit. While you're waiting for that ultrasound, ask your vet if you can try cerenia or ondansetron.

The two most common reasons for a cat to not eat is nausea and pain. If you say his teeth are okay, then we have to look to the organs (ultrasound.) But you can always try the anti-nausea medications first. If they do work, that doesn't mean you can cancel the ultrasound though. You still need to find a reason for that nausea.
 
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miguel99nyc

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It is entirely possible that it could be nausea. He might not be eating enough to vomit. While you're waiting for that ultrasound, ask your vet if you can try cerenia or ondansetron.

The two most common reasons for a cat to not eat is nausea and pain. If you say his teeth are okay, then we have to look to the organs (ultrasound.) But you can always try the anti-nausea medications first. If they do work, that doesn't mean you can cancel the ultrasound though. You still need to find a reason for that nausea.
Oh and also, what I have noticed him aside from being lethargic and not walking around as much, is that whenever he just sniffs his food and walks away, he usually goes straight to lay down but he kind of goes into a Sphinx position and usually that will be his first position before he lays to either side. He seems to initially lower his body to the floor while his two front paws are stretched out but not far out like a true Sphinx, but just both sticking out bit going forward. I heard that's associated with being nausea I think as well.

And as to not vomiting well, he would eat almost the same if not slightly more in one sitting then his normal amount like last night and earlier this morning. Eating half of a 5.5oz Frisky can in one go is quite a bit to do one sitting, well for him at least. He never in his life ate more than that amount. Never was a big eater too which is why this has been so tricky because he's been usually a light eater anyway. But to just to sniff and turn away from his food almost right away was the concerning part.

Also just few hours ago he wanted to eat again, but I tried giving him dry food but he didnt want. I took his pate can from fridge and that he ate slightly more. So then its like is it picky to his food too but its so confusing and stressful :(.

Im awaiting a call from our vet tomorrow to let me know if he can squeeze my cat in with technician to get ultrasound next Thursday.
 

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That sounds like nausea. You can ask the vet for an anti-nausea prescription to see if that helps. But you still need to determine the cause of the nausea. I would write down all your observations and share them with your vet. Cats are cunning about hiding pain.

Halfway down this page are pictures of relaxed sphinx and nauseated "meat loaf" positions.

Pancreatitis – IBDKitties
 
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miguel99nyc

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Ive just barely managed to catch few photos of Charlie. My other cat knew was dinner time just few moments ago so I fed her. Charlie woke up to walk to his plate, gave his food just few licks and went back to taht same position. been sleeping there under that chair for entire day really. Only walked around to drink water and use his liter to urine. He was in a slight sphinx but as I went to get my phone, he had already folded his paws back in, then few moments later just went of sideways to lay down.
 

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miguel99nyc

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And also, unless he's getting worse, I wonder if him being on this prednisolone making him more lethargic? At least back Tuesday with the shot he ate but moved around and jumped around like his normal self. But now after 3 days, 2 days of pilling him in the morning, he's been just sleeping/lethargic in the same spot area the entire day. only walked a few times around to drink water but then returns to the same spot.
 

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Unforton

a



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?
Remember Prednisolone is NOT an appetite stimulant (cats will increase their water uptake however). It's used to manage the inflammation from IBS/IBD.
 
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miguel99nyc

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Remember Prednisolone is NOT an appetite stimulant (cats will increase their water uptake however). It's used to manage the inflammation from IBS/IBD.
Yes I know. What I was going to try is the Mirtazapine this morning...however he did manage to wake up and eat on his own again slightly (not full amount) then ate again about an hour or so after again. I'm going to hold off on the Prednisolone until tonight as I heard/advised from others cats system works overnight so he might benefit from the Prednisolone adminstered at night.

But this morning was slightly encouraging as he ate on his own and even greeted me at the door when I came from outdoors. However he still goes back to laying down to same spot underneath the table still. I'm still awaiting to see if i can get an ultrasoudn in next week. I have the mirtazapine incase he needs it.
 

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Yes I know. What I was going to try is the Mirtazapine this morning...however he did manage to wake up and eat on his own again slightly (not full amount) then ate again about an hour or so after again. I'm going to hold off on the Prednisolone until tonight as I heard/advised from others cats system works overnight so he might benefit from the Prednisolone adminstered at night.

But this morning was slightly encouraging as he ate on his own and even greeted me at the door when I came from outdoors. However he still goes back to laying down to same spot underneath the table still. I'm still awaiting to see if i can get an ultrasoudn in next week. I have the mirtazapine incase he needs it.
Every little bit of positive behavior counts.
 
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miguel99nyc

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Okay as an update as of 4:12 EDT today 9-11-20.

Charlie, I guess the effects of prednisolone from yesterday morning was wearing off? I know its not appetite stimulant or anything but again, each time we gave him past days in mornings, in the coming hours he would resume eating nearly normal.

Since we skipped his dosage to tonight, he didnt have this morning. Although he greeted me at door this morning, and ate some breakfast, throughout the day he kept going to his plate but just sniff food and walk away. Now Ive decided to give him Mirtazapine, what a difference! Within 30-40 minutes after the pill, he went back to my other cats plate to finish up the dry food left over, then he wanted some more food so Igave him the same can he sniffed and walked away from few hours ago, and ate that food. Even now he's just walking around exploring the bedrooms and such as he used to before.

So I know Mirtazapine is just an appetite stimulant, but I think I heard its also somewhat of anti-nausea? Because now his attitude is completely different, looks alot more lively as he walks around and such. So to me clearly means he was nausea this whole time and may possible need anti-nasuea medications which I will tell the vet. Ultra sound got scheduled officially for next Thursday.

But I just wonder now, since he's solely on mirtazapine, and based off how's he reacting thus far, if it did more then just stimulate his appetite? Im glad he isn't vocal, not yet at least but at the same time he hasn't really slept which I know is one of side effects of Mirtazapine too.
 

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Steroids have a host of side effects too. Worse side effects than the mirtazapine vocalization. If he's off the steroids now, don't put him back on them until after the ultrasound. For one thing, the steroids' anti-inflammatory effects can increase the likelihood of an inconclusive ultrasound. But for another, steroids are very hard on the body. They're supposed to be prescribed for a short-period of time to induce a remission and then tapered back to the minimum effective, preferably not a daily dose. Steroids last 36 hours in the body. So daily dosing comes with dose overlap. Also the longer the steroids come from outside the body, the less the body produces its own. The off day in every other day dosing allows the body to produce its own rather than relying solely on exogenous (outside the body) steroids.

I'm convinced the reason Krista never turned the corner even after we achieved a remission is because she had been taking daily steroids for too long. It worked her little body too hard. The remission came too late. The steroids were already increasing the amount she was peeing. When she got a bladder infection on top of that, and her eating slowed, she got dehydrated FAST. There just wasn't enough strength left in her body or enough body left at all (she passed at 3 lbs 4 oz) to mount one more fight. I will forever have some regret around her steroids. They did help her achieve remission. But they weakened her far more than the lymphoma ever did.

My point with all of that is don't play around with prednisilone. If it's not effective right now and your vet said it was okay to stop it (after giving steroids for a length of time, they can't be stopped suddenly), then hold off on it until after the ultrasound. If the ultrasound doesn't suggest a condition where prednisilone would be helpful, then stick with the safer appetite stimulant and anti-nausea drugs, if necessary. Use pred only when and where it would be helpful, only as long as it takes to achieve remission or the desired result, then formulate a taper or exit plan with your vet. Some cats may have to remain on a low pred dose, preferably not daily, the rest of their life to manage their condition. But we don't know that about Charlie yet. Better and safer to avoid steroids for as long as you can.
 
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miguel99nyc

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Steroids have a host of side effects too. Worse side effects than the mirtazapine vocalization. If he's off the steroids now, don't put him back on them until after the ultrasound. For one thing, the steroids' anti-inflammatory effects can increase the likelihood of an inconclusive ultrasound. But for another, steroids are very hard on the body. They're supposed to be prescribed for a short-period of time to induce a remission and then tapered back to the minimum effective, preferably not a daily dose. Steroids last 36 hours in the body. So daily dosing comes with dose overlap. Also the longer the steroids come from outside the body, the less the body produces its own. The off day in every other day dosing allows the body to produce its own rather than relying solely on exogenous (outside the body) steroids.

I'm convinced the reason Krista never turned the corner even after we achieved a remission is because she had been taking daily steroids for too long. It worked her little body too hard. The remission came too late. The steroids were already increasing the amount she was peeing. When she got a bladder infection on top of that, and her eating slowed, she got dehydrated FAST. There just wasn't enough strength left in her body or enough body left at all (she passed at 3 lbs 4 oz) to mount one more fight. I will forever have some regret around her steroids. They did help her achieve remission. But they weakened her far more than the lymphoma ever did.

My point with all of that is don't play around with prednisilone. If it's not effective right now and your vet said it was okay to stop it (after giving steroids for a length of time, they can't be stopped suddenly), then hold off on it until after the ultrasound. If the ultrasound doesn't suggest a condition where prednisilone would be helpful, then stick with the safer appetite stimulant and anti-nausea drugs, if necessary. Use pred only when and where it would be helpful, only as long as it takes to achieve remission or the desired result, then formulate a taper or exit plan with your vet. Some cats may have to remain on a low pred dose, preferably not daily, the rest of their life to manage their condition. But we don't know that about Charlie yet. Better and safer to avoid steroids for as long as you can.
Yes, I can have him of Prednisolone until Utlrasound since it didn't seem too effective. After all, my vet did say give him a day or two and if he wasn't responding to it to stop it instead and to have him on the appetite stimulant until ultrasound. It kind of doesn't make sense since he still was still feeling ill with just the Prednisolone alone. Secondly, vet did only prescribe one 5mg tablet for 7 days, then 1 tablet every other day after those 7 days - but assuming it was pancreatitis from the in office snap test he did showing positive. But since the PSL came back normal, I figured prednisolone may not work and wonder if the prednisolone shot he got made him feel worse these past 2 days. But now with just mirtazapine, he seemed like himself again.
 

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That's good news that he seems himself again. We still need to know where the nausea/anorexia is coming from. Certainly long-term mirtazapine use doesn't come with nearly the same risks as long-term steroids. But you still want to figure out the cause and address that. It could turn out that he does have inflammation that steroids would be helpful against. But that steroids alone wasn't enough to get him eating. Wait for the ultrasound and be prepared that he may go back on them afterwards. I want you to be diligent about them though. If the vet says to use them after the ultrasound, ask him for a game plan. How long before we taper? What's the exit criteria or maintenance plan? I don't want to see another mostly healthy cat run into the ground by overprescribed steroids.
 
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Definitely ate some more now. Just slightly worried he did not drink water I think all day...but have been giving him mostly wet food as I know it contains some water as opposed to dry food. I would say overall today so far he ate more then his normal amount slight but I know its due to Mirtazapine helping out. Again thankfully not making him hyper nor vocal. Maybe a bit restless as he isn't sleeping as much...but await to see how he further responds.

I emailed the Vet and he said he agreed taking him off prednisolone because I felt it wasn't helping as much and to keep up the Mirtazapine 1 1/4 tablet of 2mg - once every 48-72hours which seems right, hoping 1 pill holds him off to eat well for about 2 days or so. Of course all until Ultrasound, and I just pray to God that it will reveal something that will guide towards one specific road of healing adn recovery. Will definitely keep posted.

But another thing I noticed now that he is eating his Pate is that he is making quite consistent and loud grinding noise as he tries to chew his food.Again he used to do that in past but not as often as now where its nearly every bite. Such a horrible grind noise every bite down feel like his teeth is rubbing against each other. I checked his mouth but saw no blood or really like infected gums or anything. Still wondering if that is contributing to it too but will let Vet know by Thursday's ultrasound if that proves nothing else.
 

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If he's eating enough wet food of sufficient moisture (approx. 78% or higher), he likely won't need to drink any extra water.

If the ultrasound doesn't point to something, it can still be his teeth. I'd find yourself a dental specialist nearby and get on his calendar. Animal dentists are few and far between and have very long lead times (two to six months!) Get him on the calendar now. You can always cancel that appointment if he doesn't need it. But since you said he had a broken tooth and he makes grinding noises when he eats, I'd take that appointment whenever you can get it. General vets can only say so much about teeth. They get a course or two in dentistry. They can identify teeth that need to be extracted and perform those extractions. Much beyond that, like identifying how a cat's bite might be affected by a broken tooth, and you'll need a specialist's eyes and experience.
 
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Really and sincerely appreciate your responses, truly great insights.

It's kinda interesting how I was basing/assuming that this first Mirtazapine pill would not only make him hyper/vocal, but eat alot more like it did for my older cat 18 yrs old in the past, where now he isn't vocal, he isn't too restless, but now as he tried going to eat again he just sniffed yet again and walked away. He did manage to walk to his bowl though to drink some water which was good. But still goes back to the same spot under table to sleep. I just emailed the Vet about possibly getting Cerenia or some kind of anti nausea medicine he might recommend.

But if he was nausea (which I think so because why else he would sniff and walk away even with the mirtazapine in him unless not strong enough..) wouldn't he also be vomiting all the food he has eaten thus far or have diarrea? Because on that end seems all normal.
 

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Really and sincerely appreciate your responses, truly great insights.

It's kinda interesting how I was basing/assuming that this first Mirtazapine pill would not only make him hyper/vocal, but eat alot more like it did for my older cat 18 yrs old in the past, where now he isn't vocal, he isn't too restless, but now as he tried going to eat again he just sniffed yet again and walked away. He did manage to walk to his bowl though to drink some water which was good. But still goes back to the same spot under table to sleep. I just emailed the Vet about possibly getting Cerenia or some kind of anti nausea medicine he might recommend.

But if he was nausea (which I think so because why else he would sniff and walk away even with the mirtazapine in him unless not strong enough..) wouldn't he also be vomiting all the food he has eaten thus far or have diarrea? Because on that end seems all normal.
Not every nausea event causes GI disturbances. Mirtazapine might have anti-nausea. If it does, it’s a weak effect. It’s actually a serotonin reuptake inhibitor like Prozac. It’s an antidepressant that has an appetite stimulating side effect. It could be that the stimulating effect is more powerful than the nausea those times that he eats

It could be nausea.

It could be also be tooth pain/dental issue.

Because it takes so long to be seen by a dental specialist, I suggest you pursue this in parallel until you have something more definitive.
 
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miguel99nyc

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Hello,

Here's an update though a bit interesting.

So I know I was told by vet and suggested to stop Predniosolone and just have him on Mirtazapine and Cerenia until Ultrasound, but initially was also suggested to try out Prednisolone during the night? So Friday night I decided to try it one more time (he'd been on it since Tuesday - prescribed for only 7 days), Given him Friday as well his Mirtazapine in afternoon and began eating again. Saturday ate very well all day, walked around bit more and was jumping to windows to sleep by window or on brothers bed. His stool was a little loose yesterday but no blood - regular brown color. Gave him his Prednisolone last night but no mirtazapine as vet said to give him once every 48-72 hours.

So far even this morning he seemed more alert, not hiding so much anymore, ate alot this morning then his usual amount (though I dont think its the mirtazapine from Friday afternoon still working?) and now is just roaming around the apartment. So its making me wonder now if the Prednisolone IS working giving it to him in the nights? It's a vast difference compared to when I tried the first few days giving to him in the mornigs. But then I also read that the side effects of Prednisolone can be increast thirst and hunger which I don't see it as such good thing because then it could mean its just the side effect of medication...but at least he seems closer to normal as to his being himself. His eating has greatly improved but I did notice aside from his grinding teeth being far less yesterday too (odd?), but he doesn't really want his typical dry food as he used to eat.

Lastly other thing I noticed is his nose is usually dark red almost (not his typical very light pink) and hot/warm and dry. Usually its very cold and wet besides when sleepign normally, but now its remains usuallly very dry and darker pink/red. Usually to me that means he is ill because my cats always had cold wet noses but when they weren't well, its warm and dry. Did some research but it shows can mean nothing or something, not really conclusive.
 
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