Pancreatitis (on cerenia and metroclorpramid, refuzes to eat even after mirtazapine)

[Adelina R]

Hi all, sorry for the long title, I just wanted to make the story clear from the start. So my boy, Bandito, 15, started having some breathing problems a few weekg ago.
We took him to vet 1 who scared the sh!t out of us telling that he us for sure what he has but he might not mkae it 2 more weeks (as we were planning to travel for 2 weeks and leave Bandito home with a friend). Vet said he needs tests and scans. We did some blood & urine test asap and we were supposed to get results in 2 days max. On the second day we called to ask about the results and to ask when we can come for the scans just to be told that they connot do the tests sooner than 2 weeks time because the anesthesiologist goes on holiday... ok
We went urgently to vet 2, told the entire story, got the results, they did scans -came back clean, they followed with X-rays and found a mass in his larynx. They took a biopsy and we will know more in about a week... but in the meantime we got pancreatitis.

We are giving him metroclorpramid and cerenia for it but he doesn't eat so yday morning went to the vets and she gave him a mirtazapine but he still doesn't eat. OK in all fairness yday he ate 3 tiny spoons on food and 5 pieces of dry food. Is that enough?
Since last night he has diarrhea too. I feel so hopeless and lost.

* vet 1 said he did not know for sure what he has

 

[FeebysOwner]

Hi. Poor Bandito. Metroclorpramid can cause diarrhea, so that might be what is happening. Are you getting the meds down him OK? There is a transdermal mirtazapine that you could use instead. And, for cerenia, there are alternatives to try, such as Elura.

Did either of these vets perform a blood test called feline pancreatic lipase immunoreactivity, or fPLI? It is the most specific one, which is a rapid test that looks for pancreas inflammation markers - but it can still miss some cases. Some pancreatitis patients also need sub-Q fluids to help 'flush out' their systems, so you might need to ask about that as well.

For now, get him some baby food meat (Gerber Stage 2 or Beechnut) to help get some food into him. Most cats love them and will eat them even when they don't feel well. It is not a complete meal, but will certainly help out, especially if this mass in his larnyx is presenting any issues with eating, or even from the biopsy impact. There are also mousse foods that are similar in texture to the baby food meats - Tiki Cat is one of the most common ones I know of - and they are 'complete' nutritionally.

Keeping food in him, and meds, and possibly sub-Q fluids are the primary ways to reverse pancreatitis. Some cats also require some pain meds during this process, so another thing to check with the vet about.

 

[mrsgreenjeens]

I'm sure you are beside yourself with worry . I wish I could tell you something to alleviate your worries, but until you get the biopsy results back on that mass, there isn't much to be done. I'm just wondering if that's the cause of him not eating. It may be causing him issues swallowing. Did the Vet think that was possible? Also as mentioned above, pancreatitis can be painful, so pain meds could be helpful, but with the other meds, can have bad side effects so not sure you want to go that route. Just keep the Vet in the loop as to what is going on and see if they can give you any advise .

 

[Adelina R]

Hi both and thank you. The diarrhea stopped yesterday in the afternoon. I tried to call the vet and the most I got was a response from the nurse that the diarrhea is normal.
About pain - He was also given buprenorphine for his pain (.12ml every eight or 12 hours the vet said). In the first 2 days I gave this to him every 8 and since yday every 12. I'm wondering if we should slowly decrease the dose in time because I found that its not good to be taken off opioids all of the sudden and the vet mentioned nothing about it.
Food - He ate yesterday about 3 teaspoons of food and mostly dry food (about 30 pieces). I'm quite happy with that! The vet said that he should eat wet food but he is not interested and I'm happy to give him any food as long as he eats something. Will look into mousse textured food although I did not recognised any of the names suggested (maybe because we live in thd uk)

I skipped the metroclorpramid dose last night (told this to the vet nurse and she said that i could) and gave him only a quarter (instead of half) this morning.
He ate very little this morning (about 5 dried pillows) and seems to be upset on us because of all the pills we are giving him. He will not eat them in pill pockets.

I hope I'm doing OK.

 

[Adelina R]

Ok, I just googled the baby food meats and will try to find these or similar brands, thank you again!

 

[Adelina R]

Bandito looks a little better, I'm trying not to get too excited yet, but he looks more like himself. He is eating little portions every few hours (still no luck with the wet food, he wants just dry) and he is finally sleeping deeply (before he was in an alert state, waking up at any noise).

 

[FeebysOwner]

Glad to hear it would seem Bandito is a bit better!!

I think you will have some issues with the foods, including baby food meat, based on where you live. But hopefully you can find some equivalents in terms of mousse-based food options. I am not sure if it is possible to find plain baby food meat in the UK. You could also try to mix the dry food he likes with some water just as a test to see if he would eat it that way.

Regarding weaning him off the pain meds - the vet probably didn't suggest it since Bandito hasn't taken them but for a few days. However, there is no harm in doing a gradual reduction on your own. Just make sure that you don't start this process prematurely.

Pills are no fun, I know. I have a cat that won't do pill pockets - or, even pill masker. So, most of what I give her can either be crushed and hidden in food or compounded to a liquid form - which I still have to force syringe feed her, because the taste is nasty regardless of what the pharmacies try to do to it.

Hang in there! And continue to keep us posted.

 

[Adelina R]

Hi all, Bandito is almost fully recovered but I just got the worst news.. the biopsy came back malign. I'm broken in thousands pieces. The veterinar clinic referred us to a specialist and we will go for a consult but I don't have much hope. I love him so much and it hurts more than I can say.

 

[mrsgreenjeens]

I'm so sorry the news isn't better. I've had three chronically ill cats so I know how much this hurts I wish there was something, anything I could say to make it less painful, but no words can help, I know. Let us know what the specialist says.

 

[Adelina R]

We went today for a check up. The vet was so touched by Bandi that she had tears in her eyes. She told me that she can see how much I love him and that he looks like me. I know he does.. people told me that before.

We are continuing with the pain killers and have no plans of stopping them. He will also take Omeprazole and Mirtazapine if he isn't eating (he eats, but very little).

On Tuesday we are seeing an oncologist to discuss what can be done. We are preparing ourselves for the worst... and both me and my partner cry several times a day. This forum is helping me a lot. Thank you

 

[Adelina R]

My boy, waking up from his nap

 

[Adelina R]

Last Saturday we gave him mirtazapine and that was followed with a long night with diareea. That got better in Sunday and start eating but I don't think it was the mirtazapine (the reason for eating). We stopped, as he was eating.

Yesterday the vet advised us to give him again Mirtazapine (as he is not eating enough).We gave him 1 Mirtazapine and 1 Omeprazol at 9 am and at 4 in the afternoon the diareea started again. I'm sure it's because of the Mirtazapine (cant be the Omeprazol,no? plus is the same story like last week). We have asked for the gel version - do you think that will have the same effect? It's still Mirtazapine.

This evening, he needs to get another dose of Omeprazol (along with the painkiller)... thay shouldn't make him worse, no?

We already called the vet practice but the vet that seen him yday is off today so they asked us to take him in if we need an opinion... but i don't want to put him though another car journey.

 

[FeebysOwner]

We have asked for the gel version - do you think that will have the same effect? It's still Mirtazapine...This evening, he needs to get another dose of Omeprazol (along with the painkiller)... thay shouldn't make him worse, no?

I've not read anything to suggest that diarrhea is common with Mirtazapine, but I guess anything is possible. The gel might not have this same effect as it isn't being processed directly by the stomach, so it would be worth it to try. Or you could lower the dose of Mirtazapine and see if that helps any.

Was he given Omeprazol last Saturday too? Diarrhea is a possible side effect of it.

Bupe, if anything would tend toward constipation rather than diarrhea, so that shouldn't be part of the issue either.

If there is another occurrence of diarrhea after this next dose of Mirt., ask them to switch to Mirataz. Or ask what else could be given to him in lieu of the Omeprazol. Both of those types of changes should be able to be accomplished via a phone call with your 'regular' vet.

Hang in there!

 

[Adelina R]

Bandito just had serious spasm after bupre, i was sure that we are loosing him.He callmed down now. Is it time... is it?

 

[Adelina R]

We called the vet and they want us to go there in 2 hours. Bandi calmed down and seems to recognise us again. We were planning to keep him stable until Tuesday when he sees a specialist to make sure we did everything we could... but if he is already suffering i want to save him from the pain. Did anyone been through smth like this?

 

[Adelina R]

btw, he was ok today, he ate, drank, socialised. I simply don't understand

 

[FeebysOwner]

Maybe it had something to do with the Bupe administration? If he has calmed down and is returning to where he was before the spasm, I would wait to see what happens. As you said, you are just a couple of days away from visiting with the oncologist.

Perhaps, if he is not drinking well a round of sub-Q fluids might help with that. Maybe some CBD oil would be in order? It also serves as a pain reliever if you think this is related to pain. You'd just have to find out if he can have that on top of the Bupe you just gave him, or how long you would have to wait.

 

[Adelina R]

I'm puzzled... he recovered, asked for food and ate, start washing himself, his pupils are OK now, no more twitching, nothing. The vet won't give me an opinion or answer over the phone (is a large clinic and they never help over the phone) but I don't know if should take him there now (and put his through an unpleasant car journey) or let him recover.

The main issue is.. am I giving him the next bupe dose? (I give them to him every 8 hours)

 

[Adelina R]

We are going...better to be safe

 

[FeebysOwner]

I hope they are helpful, and this doesn't prove to be a wasted trip. Will be waiting to hear the outcome!!