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

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Adelina R

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We just returned from the vet. His blood pressure is a little low (110), but she said it might be from Bupe. She advised us to reduce the dose to 0.06 (from 0.12) and maybe give it to him only twice a day if he looks alright (and to skip the one tonight). He had an injection of Vetemex. His lactic acid and glucose were both OK. He also had a chest and tummy scan and both look fine.

We couldn't find a reason for the seizure other than it might be related to the carcinoma. We are planing to sleep next to him and in shifts as much as we can. I know we could have left him there overnight but I really think he feels better at home and the vet agreed that he will feel safer and calmer with us.
 

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Thanks for the update! Sounds like a reasonable plan, and I hope all goes well with instituting it!! So, will the Vetemex replace the Mirtazapine - at least in the short term?
 
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Adelina R

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No, my understanding is that the Vetemex is instead of Cerenia.
We were told to continue with Mirtazapine (if needed) but to reduce the dose to half (as he seems to be very drowsy after it). He ate well today so I'm not planing to give him any Mirtazapine tomorrow morning.
We were given more Cerenia for the evenings (starting tomorrow).
 
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Adelina R

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Hello. We took Bandito today to been seen by a specialist. He reviewed the test, diagnostics and checked Bandito. We discussed all options. We rolled out surgery as the carcinoma is in a very delicate place and it would be a very difficult operation.
We were presented with the options of doing radio therapy, chemotherapy or only palliative care.
We are struggling to decide what should we do. Radio therapy is quite pricey and we have no guarantee that would work.. plus he would need to be in hospital. Would chemo put him though a lot of pain? We want to keep him with us for as long as possible but we don't want to do this regardless of his pain. Basically we want to act in his best interests. We want to say goodbye only when the time is right.
We decided to perform a CT to see of the cancer has spread and if chemo would work. The specialist said Bandito's hearth is strong and he would be ok during general anesthesia.
I know you cannoy tell me what to do.. but how can we take a decision? Did anyone had a cat on chemo?
 
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Adelina R

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Also.. the specialist was against continuing with Buprenorphine. He thinks the seizure might be related to it. He recommended something else, will tell you later what.
We are going now to take him home. I'm hoping he will be as good as he can be considering what he had to go through for the CT.
 

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There are a ton of members who have given their cats chemo - and for the most part, it seems to go very well, and their cats have not had much in the way of side effects. The doses that are administered to cats are much less potent than what is given to humans, so the effects aren't as drastic. The key in humans is to try to cure the cancer, the goal in cats is to slow the progress and make them feel better overall. A lot of times, prednisolone is given along with the chemo to help with symptoms related to the cancer itself.
The symptoms, diagnosis, and treatment of lymphoma in cats (webmd.com)

I can do a search on this site and provide you with a link to previous posts, but I will tell you the list will be long. Let me if you want me to and I will.
 

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I agree with what FeebysOwner FeebysOwner said. Many, many cats here on TCS have gone thru chemo, some with little to no side effects. Others have felt the side effects for a few days, like people. I think it really depends on the cat.

I think you first need that CT to see if chemo is feasible, then ask how much time they think it will buy him to help make your determination whether or not to try that route. Then make your pro and con list. For instance, many people have driven for an hour or two for each chemo session. Is that what will happen here? Is that a problem? If not, then it doesn't need to go on the list. If it is, then it needs to go on the "con" side. If you need to administer pills yourself, is that a problem? etc. And don't forget the financial aspect too. Not everyone can afford it since most cats don't have medical insurance. All these things need to be taken into consideration when trying to make the decision. And there is Bandito himself...what do you think he would want to do? For example, I currently have two cats with two totally different personalities. One is the happiest little guy, always has he tail straight up in the air and seems to love life. The other is just the ,opposite. His entire life he just kind of hangs out but doesn't seem to have a zest for life (but he's still my little lovie). If threatened with something like this, I might handle it differently depending on which cat it was trying to think of it from their point of view. I will tell you this, one member actually had an animal psychic ask her little guy if he wanted to go thru chemo before she stated him on the protocol. They said he did and he lived another 4 1/2 years before he ended up dying from something other than the Lymphoma he was diagnosed with!

When is the CT scheduled for? Keep us posted :hugs:
 
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Adelina R

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Hi both, you can't imagine how much I appreciate your messages. :redheartpump:
Bandito had his CT today (we left him there after the morning discussion with the specialist and we picked him up at 5pm). Happily he was ok, dizzy and confused from anesthesia, but ok.
The mass goes from the larynx through the trachea, but they couldn't find any other tumours or warning signs on his chest. I've asked the vet if he thinks that putting him through chemo would give us weeks or months and he said that he is hoping for months.
We decided to go ahead with the treatment and to reconsider the situation if he will show signs of massive disconfort or suffering. The vet recommended Palladia, a drug that we should guve him at home, 3 days a week. He will also be given something against inflammation and a painkiller, but I don't know exactly what, he will email us tomorrow.

Bandito is a very social, lovable cat. He has a very friendly character and I would say that he is a fighter!
He comes from the streets (i mean his mom was somone's cat, but the owners did not care for her nor her kittens), where he was left outside to wonder around eating boiled potatoes... until a friend saw him and took him home as a gift for me (he knew that I really wanted a ginger cat).
For the first 2 years he lived with me and my parents until I decided to move to Cyprus, moment when my parents took him to our second home, in a village, where neighbours cared for him, but he was basically an outdoor-only cat as my parents only went there for the weekend. I know it was a bad decision, but I was 22 and poor, I couldn't take him with me. After 2 more years, when I was finally able to bring him to live with me, he moved to Cyprus where he became a very spoiled, indoor cat. We lived in Cyprus for 4 more years until we relocated to London. He filled out home with love and joy and we want to make sure we are here for him now, when he needs us.
While are not insured, I'm grateful that we can afford his treatment. 10 years ago we couldn't even consider paying for a vet, let alone all the scans and treatments that we had to cover now. It's not cheap at all, but I'm not sorry for paying for these, if I can help him in any way.

I will read everything you are sending me so thank you again for all the advices and websites.
 

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Adelina R

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Thank you for the articles, I will read them on my way to work. In the meantime, Bandito has a lot of air in his tummy from all the mouth breathing (the specialist saod is because of tha, do you have an idea of what we can do about it? He is also constipated (still, since Saturday evening).

Will also ask the vet but checking here too in the meantime :touched:
 

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I have no idea how to resolve the air in Bandito's stomach - maybe an anti-acid might help? As far as the constipation, you might try Miralax - 1/8 tsp mixed in a little bit of water and then added to his food. Start out with just once a day and see if that helps. If not, increase it to twice a day.
 
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Adelina R

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yes.. the ver also said he can recommend some things for the constipation but he needs to eat first and he doesn't eat. We tried today to tempt him with everything we had. He only ate 4 treats (dreamies) from my hand when I came from work. I know it's not great, but we are trying everything. Those 4 were better than nothing.
My bf is at the supermarket to buy all kind of foods..


omg.. while i typed this he woke up and ate some more dreamies <3
 

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The constipation might not actually be constipation if he isn't eating much - there may not be much in his system. Have your bf pick up some baby food meat - Gerber Stage 2 or Beechnut. Most cats will eat those when they don't want to eat other things - sometimes it can even jump start them into eating again.
 
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Adelina R

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So he has about 10 dreamies in his belly at the moment, which is much better than yesterday when he didn't eat a thing. He wasn't allow in the morning before seeing the specialist and he did not feel like it after the general anesthesia. He does drink a lot of water (in the last 24 hours I mean), like a lot more than he used to even when we had kidney issues.
We will try to offer him some more food options later (not now as we are trying not to push him and make him sick of the ideea), we bought foods that we wouldn't normally give to him (like Sheeba just because it's a mousse).
The specialist said that he will post the tratament today (Palladia, steroids and mirtazapine gel) and we should have it by Saturday morning.

The only thing that changed since yesterday was that he is prescribing now steroids while yesterday he said he wants to give him some anti inflammatory drugs. He is saying that this should make him to eat more. What do you think about this?
 
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Adelina R

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The constipation might not actually be constipation if he isn't eating much - there may not be much in his system. Have your bf pick up some baby food meat - Gerber Stage 2 or Beechnut. Most cats will eat those when they don't want to eat other things - sometimes it can even jump start them into eating again.
We couldn't find those, we only found some organic chicken baby food from Hipp but he wasn't interested in that. I'm sure that we might have some alternatives in the UK, buy everything I'm seeing are baby dishes with meat and vegetables etc.
 

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I don't know about the anti-inflammatory drugs, but everything I have read says steroids do increase appetite. Feeby currently gets Mirataz (the transdermal gel) and it helps her eating sometimes, but not all the time. I do know that her oncologist said once we start a steroid with her, she probably won't need the Mirataz.

Oh, yeah, it seems the UK doesn't offer plain baby food meat - just as you said, it is all mixed with pasta and whatnot. Have no idea why that is. I don't even think you have Goya available (made by Beechnut).
 
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Adelina R

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Bandito's belly is very loud and reminds me of the sounds that my stomach does when I have acid. Although we have stopped the medication we were giving him before, we decided to give him an Omeprazol for this and I hope it will help.

He ate a little more (some slightly cooked beef) before going to bed.
 
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Adelina R

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The Omeprazole helped, he was up all night but the sounds got better an hour after he had an Omeprazole, he managed to fall asleep in the morning, around 9:30, and now he is sleeping deep. I think it will be best to give him another 5mg of Omeprazole in 12 hours from the first one (he got one at 3 AM so we were thinking that the next should be given at 3 PM). Will also try to contact the vet to see if he has any objections about this.

In the meantime, we got the medical letter from the specialist ad the treatment given is:
Toceranib (palladia): 15 mg on Monday, Wednesday and Friday.
Mirtazapine (ointment): apply 1.5 inches once a day. Please alternate the ears of administration.
Prednisolone 5 mg: Give 1 tablet daily for one week and then reduce to 3/4 for a week and then half for one week. Do not stop until otherwise directed.
Maropitant (Cerenia 24 mg): give half a tablet once daily if vomiting.

So the vet said not to give more Omeprazol but to start with Prednisone (as we already have some in the house). He said to give him 1.5 tablets (of 5mg) until we receive Palladia.
 

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Most acid blockers interfere with medications, I'm guessing that's why the Vet said to stop it. I know it's a fine balance when there is tummy acid involved. My hubby gets ulcers but also needs a lot of medication for other health issues, so he HAS to take some acid blockers. It's just a matter of them finding ones that give the least interference. With cats, there aren't that many that can be used :sigh:

I'm guessing they are hoping the Pred right away will increase his appetite enough to help with that. Hoping they are correct!
 
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