Pancreatitis again?

[BellaBlue82]

Hi all!
I'm back, it has been a little while. I posted back in July when Nico had a pancreatitis flare up. I think he's had another, as he's seemed off since Tuesday.

Just for reference, here's my previous post.

Suggestions for pancreatitis

Hi all! I know this a subject that consistently pops up around here, but I wanted to see if I could Garner some suggestions for pancreatitis and what worked/didn't work for your furries. Nico is a diabetic, with HBP (though we'll controlled on a low dose of Amlodipine). Last week he threw up a...

thecatsite.com

I have Cerenia on hand now, and think I may need to continue to give to him until he seems normal again. It does not seem as bad as last time, but I'm curious if there's anything additional I can do to help him. He goes through ups and down during the day; he wants to sleep mostly, but at least he is still eating on his own (though not as much at once) and drinking. Sometimes he is really hungry and comes to me on his own, other times I have to bring him to his food. He does eat in both instances, which I know is important for him to eat and drink as regularly as possible.

I also have corn silk and B-12 to help with inflammation and digestion.

FYI when I had the vet perform a follow up exam in August his flp test was normal. We also checked for CKD (which his kidneys actually showed improvement!) And CBC was fine no signs of infection.

I appreciate any tips to help him get better!

 

[FeebysOwner]

Sorry to hear Nico is having another flare-up. From what I know, making sure he eats and stays hydrated are the biggest factors in helping get passed a flare-up. Have you considered sub-Q fluids? Do you check to see if he is dehydrated? Maybe he also needs a pain med? That is often considered part of the treatment.

As was mentioned in your previous post, you might consider ondansetron as opposed to Cerenia. Some cats do better with the former. Mirtazapine was also mentioned as well to help stimulant his appetite. If he needs extra calories, try baby food meat (Gerber Stage 2 or Beechnut), many cats - even those with low appetite - find them very appealing.

Long terms dietary changes might be needed to lower the fat content in his food, as it is sometimes thought that fatty foods help trigger recurring pancreatitis.

 

[BellaBlue82]

Sorry to hear Nico is having another flare-up. From what I know, making sure he eats and stays hydrated are the biggest factors in helping get passed a flare-up. Have you considered sub-Q fluids? Do you check to see if he is dehydrated? Maybe he also needs a pain med? That is often considered part of the treatment.

As was mentioned in your previous post, you might consider ondansetron as opposed to Cerenia. Some cats do better with the former. Mirtazapine was also mentioned as well to help stimulant his appetite. If he needs extra calories, try baby food meat (Gerber Stage 2 or Beechnut), many cats - even those with low appetite - find them very appealing.

Long terms dietary changes might be needed to lower the fat content in his food, as it is sometimes thought that fatty foods help trigger recurring pancreatitis.

Thanks for these suggestions! I do check him for dehydration, so far he's not dehydrated. I've been adding extra water in his food. If it starts to look like he's heading in that direction, I can obtain fluids from my vet for administration at home. I'll ask about trying ondesetron, and refilling the mirtazipine.

I did have a conversation with the vet about pain meds; her initial reaction was that she doesn't like to give them to her patients. In a normal scenario I can understand that, but I'm going to take my findings back to her to push for these. I think he does better when he has them, and luckily I'm the type to document everything.

I'll try the baby food, I noticed he seems hungry but then I have a hard time getting him to eat more than a little at a time. He's on a low fat high protein diet now for his diabetes, but anything to help him eat a little more in one sitting.

 

[neely]

I second using Mirtazapine as FeebysOwner suggested. It did wonders for our cat when he was diagnosed with Pancreatitis. He had a second flare up approx. a year later when our vet was closed which led us to the Emergency vet and ultimately an ultrasound. This definitely proved helpful and once again Mirtazapine got him back on the road to his normal appetite. I would also recommend talking to your vet about Prednisolone. It helped our cat greatly with his flare-up. I revisited your initial thread and noticed I had posted in it. I hope other members' experiences with Pancreatitis will help Nico and you. Best of luck, please let us know how he's doing.

 

[BellaBlue82]

I second using Mirtazapine as FeebysOwner suggested. It did wonders for our cat when he was diagnosed with Pancreatitis. He had a second flare up approx. a year later when our vet was closed which led us to the Emergency vet and ultimately an ultrasound. This definitely proved helpful and once again Mirtazapine got him back on the road to his normal appetite. I would also recommend talking to your vet about Prednisolone. It helped our cat greatly with his flare-up. I revisited your initial thread and noticed I had posted in it. I hope other members' experiences with Pancreatitis will help Nico and you. Best of luck, please let us know how he's doing.

Thank you so much!! Yes, I was wondering if adding prednisolone might help him too. I do have to be careful with his diabetes, but sometimes the pros outweigh the cons.

I was strolling through the store looking at baby food; I picked a few up to try for him. He does seem a little better than yesterday, I'm hopeful I can get a refill tomorrow for mirtazipine as it does seem to be helping.

 

[FeebysOwner]

I was wondering if adding prednisolone might help him too. I do have to be careful with his diabetes, but sometimes the pros outweigh the cons.

Ask the vet if Budesonide would be a good replacement for Prednisolone. It has less impact on diabetes, although it is usually intended for gastrointestinal inflammation, so it may not work as well for pancreatitis. Worth asking about anyway.

 

[BellaBlue82]

neely Hi there, just curious what dosage of prednisolone was your kitty on when they had their flare up? I plan on calling my vet tomorrow, but in case she can't or won't prescribe the budesonide I will ask if I can administer prednisolone.

 

[neely]

neely Hi there, just curious what dosage of prednisolone was your kitty on when they had their flare up? I plan on calling my vet tomorrow, but in case she can't or won't prescribe the budesonide I will ask if I can administer prednisolone.

I honestly can't remember the dosage other than he had to be weaned off. But I save some of the meds he's been on in the past and will take a look later. Fingers crossed I still have it.

 

[neely]

I went in the cabinet where I keep some of his older meds and can't believe I found it. The label says give 1.2 ml every 24 hrs for 10 days - then give 0.8 ml every 24 hrs for 3 days - then 0.8 ml every other day for 3 days. Note: please keep in mind the directions are based on my cat's particular health situation. Each and every cat is different. I hope Nico feels better soon.

 

[BellaBlue82]

Unfortunately Nico got worse this morning. We're currently waiting at the urgent care vet clinic waiting to be seen. Poor guy just can't catch a break. I'll keep you all posted.

 

[neely]

Unfortunately Nico got worse this morning. We're currently waiting at the urgent care vet clinic waiting to be seen.

Oh my, I'm terribly sorry. Prayers and special thoughts going out to Nico and you.

 

[BellaBlue82]

Quick update!
Sadly we had to wait a few hours, and it was not a great time. All in all, he had both a flare up of pancreatitis and cystitis which resulted in another UTI. Sub Q, Onsior shot, Cerenia shot, more mirtaz and antibiotics. His pee sample will be sent out to the lab as well to check and see if his antibiotic needs changed at all.

What I find odd, is that I continue to encounter the statement of "I don't like to prescribe pain medicine for cats." I might understand if they don't like to prescribe because of potential over use or something, but in cases where a patient needs it to stop spiraling into a worse condition I don't see why they can't provide a small amount. Any who, just part of my gripe today.

I plan on having a conversation with my vet later this week. In my mind, if I had medication on hand with instructions for administration when he gets a flare up, all of this could have been avoided. He hates car rides, he peed and pooped all over himself in the cage, he got so worked up his heart rate went through the roof and I was told he has a heart murmur (he doesn't), and his glucose was 380 (normally around 140). We waited a total of 6 hours. I need to find an alternative route so that we don't continue to go through this each time he gets a flare.

Ugh sorry for the rant. I know the vets were so nice and could not help the current situation going on with clinics right now, I just think there are better ways for me to help Nico and avoid days like today.

 

[neely]

Ugh sorry for the rant.

It's perfectly okay, we understand completely and everyone needs to rant at one time or another. I'm so sorry Nico had to be put through a long wait and various procedures. I think you're absolutely right to have a serious conversation with your regular vet this week. Regarding pain medication, has he ever had Gabapentin before? That might be a good choice for starters but talk to your vet and see what they recommend. I know you will pamper Nico tonight and please give him a hug from my boy, Carleton, and me.

 

[BellaBlue82]

Well, got a call yesterday late evening that Nico's culture came back as a pretty significant infection. We switched antibiotic and he's now on Baytril. It must be working because he ate tonight and came to cuddle with me!
His regular vet is coming to check on him tomorrow, I know she'll be happy to see him doing better. We're going to discuss game plan for potential future flares.

 

[neely]

We switched antibiotic and he's now on Baytril. It must be working because he ate tonight and came to cuddle with me!

That's fantastic news, keep up the good work! What did your regular vet say when she came to check on him and what did you decide about a game plan for future flare-ups?

 

[BellaBlue82]

That's fantastic news, keep up the good work! What did your regular vet say when she came to check on him and what did you decide about a game plan for future flare-ups?

Thanks! Yeah it's been a slow go of it, had to stop the Baytril for a few days, he was getting so sick. We restarted him on it, but at half the dose so it's taking longer but I do see improvement.

As for future flare ups, his regular vet said she has no issue prescribing me medicine to have on hand so we don't need to run to the ER vet on a weekend. Now I have antibiotic, anti nausea, and appetite stimulant on hand in case he gets another bout. I can also pick up a ringers bag from her with B12 if I need to in the future, which honestly has helped a lot! She totally understands with his medical history I need to act quickly. Her support has been a tremendous help, I'm so grateful.

 

[neely]

Thanks for the update on your regular vet. She sounds both knowledgeable and caring. She definitely took the time out to do what's best for Nico and you.

 

[BellaBlue82]

Boy, it has been a rough few weeks.
Nico is still not feeling better, last Friday he had a seizure like episode and we had to stop the Baytril plus the gave him a shot of convenia to cover him until we could start it back up. Well we finished the Baytril but he's still battling nausea and lethargy. I think the convenia may be contributing.
Sometimes he comes out and meows like he wants food, and other times he just goes under the bed or on the dining room chair.
Hopefully he'll start feeling better soon.

 

[fionasmom]

My cat had severe lethargy and inappetence after receiving Convenia a few weeks ago. He did come out of it, but it took another visit to the vet.

 

[BellaBlue82]

My cat had severe lethargy and inappetence after receiving Convenia a few weeks ago. He did come out of it, but it took another visit to the vet.

Oh goodness, I'm glad your kitty is finally feeling better!
I've been updating my vet weekly, and luckily still have a ringers bag with B12 just in case. I'm keeping my fingers crossed he starts to come out of it in a few days. Thursday will be the two week mark from receiving the Convenia shot.