? 12/28 Jack amps 191 pmps 141 - need advice on nausea/not eating

condo

We've hit some big roadblocks with Capt. Jack. I took him into the vet on Saturday due to suspected pancreatits. Vet gave 3 shots, cerenia, mirtazipine and b12. I also got a 4 pack of cerenia and fluids. I gave some fluids, and thought they had absorbed, but they fell down to his pooch and made him look like a munchkin cat with the extra weight on his pooch. No more fluids after that.

Christmas eve he looked horrible, but then perked up and took a long walk outside. He barely eats right now. I've got at least a dozen cans of different food and one works, then it doesn't. He also will NOT eat food if I put the gaba or pred in it. On the plus side, I can finally pill a cat, but the cerenia isn't helping enough, even when I upped the dose to 8mg once a day. It's more then he needs, but reading up said short term it is not harmful.
I've tried all kinds of tricks, Parmesan cheese, mix a little fresh deli turkey in the food. The other night he liked the FF gravy lovers, he got as much as he wanted BG numbers are not a concern at this point.

Hoping he perks up a bit soon.

Happy holidays to the L&L'ers

 

Feel better Capt. Jack!

Sending vines!!!

 

Sending some healing & eating vines your way!

 

Wes, so sorry to hear Capt. Jack is enduring some rough days. Sending loads of vines and prayers it passes soon. Please give him extra scritches for me

 

when I’ve had cats go off their feed in the past, I’ve given chicken livers. I nuke them in the microwave for a few seconds until they are half cooked (no longer or they explode). It didn’t always work, but often did. Then there’s THIS. Hope his appy perks up.

 

Sorry about the lack of appy. I'd been stalking the SS and had seen that.

I would try to get a prescription for ondansetron from the vet. It's a people drug, so you just need the script and get it filled at a pharmacy. I hear Costco has a good deal on the generic version. Cerenia and ondansetron target different nausea receptors. Onc can work where the other doesn't. I would also consult with the cat vet or IM vet if you can.. The pred dose may not be enough.

One thing that sometimes worked with Neko was to assist feed her a bit first. Getting some food on board made her feel better enough that she was willing to eat more on her own. You do need to make sure Captain Jack is getting at least 2/3 of his daily calories or risk hepatic lipidosis. Crushed freee dried treats or bits of plain chicken turkey sometimes worked, as did sprinkling on catnip.

 

I'm willing to try pretty much anything at this point. He just can't afford to not eat with his weight loss. He seems nauseous, sniffs the food but just won't eat it. Thanks for the link Sharon, I will be trying that to see if it can stimulate him enough. I also got a chuckle from your microwave, um, knowledge.

His QOL seems to be going the wrong way and he's got me more then worried. I'm really fretting about if it is "time"

Doing a quick search on assist feeding and will try it first. He used to go bonkers for deli turkey, but even that is meh to him now. At this point any calories I can get in him is a good thing. I called the vet earlier today, but not about the nausea. I will stop by and see if I can persuade them to prescribe some ondansetron.
Of course the 60cc feeding syringes I bought have all been used in the tank and I don't want to use a contaminated one. I still have some sterile 10cc's and will try with one of those.

When I am there would asking for a small script for Mirtazapine be a good idea? Maybe the appy stimulant and anti-nausea would help. I know he got some Sat, but vet said it only lasted about 72 hours.

He isn't throwing up, but is a magnet for bathtub water. He drinks and then just kind of stares at it. Off to try a few things.

@Wendy&Neko , do you know if it is safe to dose pred and gaba directly into the mouth? I know he won't be happy, but he will not eat food with those in them. I'd really like to get some gaba into him first and then see how he does before the pred. He hasn't had either in 2-3 days.

 

You can keep up the fluids as needed. Often the fluids sink to the undersides of the cat, but it is still slowly absorbed. As to the eating, maybe Jack needs more Mirtazpine?

 

FWIW convenia seems to have worked wonders twice on Quintus's pancreatitis (in 2016, and now). Was an ultrasound done? Worth checking the state of his gallbladder, as it goes hand-in-hand with the pancreas (if the gallbladder is blocked up there are specific meds for it). Is pred = prednisolone? I was under the impression steroids for a diabetic cat were a no-no. I have definitely given prednisolone in pill format directly in the cat's mouth. Gaba = gabapentin? I think it's also given orally, but I could be mistaken.

 

First to answer questions - giving pred and gaba by popping the pills should be fine. If you had any blank gel caps, size #3, 4, or 5, you can put meds in there and pop that as a way to disguise if any foul taste. I prefer to stay away from the larger #3 if possible, due to throat narrowing from soft tissue growth. For appy stims, see if you can get mirtzazipine as a transdermal - much less likely to get any side effects that way. Cyproheptadine (another script for human pharmacy) is another option with less side effects. He definitely sounds nauseous with the water routine and the sniffing and turning away.

One more thing, just cause I'm paranoid and it happened to us. Heart conditions can cause nausea, and Neko's was brought on by giving fluids. Heart conditions are an acro thing, so I'm cautious about fluids unless the heart has been checked out. Could you test his resting respiration rate. When he's at rest, just count the number of complete in and out breaths a minute. You want it under 30. Although I do suspect it's SCL cause nausea is a symptom.

 

Sometimes a cat needs prednisone, nothing else will do the trick. In my experience, the key is to use as little as possible for as short a time as possible, and deal with any increased insulin needs

 

pancreatitis makes a cat seem on the verge of death. it's not the right moment to be wondering about QOL -- you need to hit the pancreatitis with everything you have first.
feeding tubes are also an option...

 

This post has a link to a good assist feeding video.

Convenia is an AB for skin disorders, not what we've got here. Sometimes kitties have other conditions that require prednisolone. In that case, you just work the insulin dose around it.

 

I hope Jack feels better soon.

 

That might be what it was initially designed and marketed for, but it does much more than that. Here it is used for any kind of post-surgery coverage, abscesses following fights, and yes, pancreatitis or even undetermined "we're not sure what's going on with kitty but let's throw everything including the kitchen sink at him". (Plus probably other things that I haven't yet experienced with my three last cats, including Quintus, who have all been on convenia for some reason or another at multiple points in their lives.)

 

It’s okay if the fluids collect wherever they collect, but you don’t want to give more fluids if the previous fluids have not absorbed.

 

unfortunately they are compounded liquid and he doesn't want food with them in it like usual.

Your "prime the pump" trick helped a bit. He did eat a little pureed low carb food and licked some FF gravy lovers. Not enough for me to be happy, but something at least.

RR is 22 right now, he doesn't seem dehydrated, but the vet did mention it could be good for electrolyte imbalance.

Agreed, Jack has had 2 flareups in the past and just like you said he was looking real rough. This one seems a bit different, vet treated 6 days ago with mirtazapine, cerenia and b12 shot. In the past he perked back up in a day or two, but so far he is up and down on food, more down then up the past 2 days. Sometimes he gets a little hungry and eats, most of the time he looks like he did with p'titis and wants to lay on cool tile or in the bathtub. QOL is a concern because of other conditions including pretty extreme weight loss and GI issues(suspected SCL).

He is on prednisolone now, but I don't know how to get it in him with his lack of eating.

 

It took a little over 24 hours for them to fully absorb, I could feel the bump in his abdomen/pooch. I'm not sure if they would help with nausea/appetite which is the only goal right now. Whatever he will eat he gets, regardless of effects on blood sugar.

 

I also second the ondansetron, I had HG with both pregnancies and they tried a couple other anti-nausea drugs before that, nothing worked, but Zofran (brand name) was amazing and very helpful, if it works in cats anything like it does in humans, it will make a huge difference.

 

Have you checked out the Facebook group "cats with pancreatitis"? might be helpful: https://www.facebook.com/groups/CatsWithPancreatitis/

 

And also: https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf

 

Dehydration can cause nausea.

 

Maybe you can use a syringe or dropper?

 

Have you tried Fancy Feast Turkey & Giblets?

Another is Meow Mix Tender Favorites in Sauce
Salmon & Crab
Tuna & Shrimp

^ on the Meow Mix try and heat it up in the microwave for just a few seconds to release the aroma.

Do you have any Canna (CBD oil, etc.)?

Do you have syringes to force feed? If not, see if you can get a couple from your vet. I could not locate any at any of the local pharmacies.

https://smile.amazon.com/dp/B010BWOOXA/_encoding=UTF8?coliid=I16SRLP6KIH3CR&colid=VIDIU965QO24&psc=1

On force feeding, I always give Gizmo the chance (opportunity) to eat on his own before I forced food (association).

 

One more thing, Cerenia has anti-inflammatory properties. You can use both Cerenia and Ondansteron together, they target nausea differently.

Jack needs pain meds. Pain treatment is #1 in treating pancreatitis.

 

Have you tried Baby Food? Whenever Bubba has a GI upset and won't eat, baby food usually gets him back on track. Beechnut is the brand without any cornstarch. Use all meat and broth either Chicken, turkey or ham ( lots of kitties will go for the ham since it's something different. Have you tried Flortiflora sprinkle on top? Also, ground oregano works for Bubs when he's off his feed. I think it smell like cat nip......

Sending appy vines to Capt. Jack! Hang tight Daddy.

 

I always forget about that because Gizmo turns his nose up at baby food.

Petco now carries Tiki foods. You can try these also, they have the consistency of baby food, it is complete nutritionally and can be syringed.

https://tikipets.com/product-category/tiki-cat/velvet-mousse/

 

ondansetron and mirtazapine are in the kitty, hopefully they will kick in soon. He ate a little more FF gravy lovers earlier too.

Thanks Stephanie, I had that IDEXX link bookmarked. My old vet was a little behind the times and I left that one with her since she was against pain meds for pancreatitis.

Thinking back, he did seem to do better about 6-8 hours after fluids. I think tonight before pmps I will give 50-100ml since I still have the fluids ready to go.

I can get it in, my concern was safety. There are a few drugs out there that need to be mixed with food and can burn the mouth if given by itself. I know he wouldn't be a happy camper getting the gaba and pred taste, but it is for his benefit.

 

I would do 50ml to start and another 50 tomorrow if he absorbs it. Less, more frequent.

Give fluids on different side from shot.

 

He is nibbling at ones with gravy in them and one cheesy one. Not the best for a diabetic, but any food is ok with me at this point.

40 bucks worth of "good" food including some weruva and tiki cat.... he won't touch them, he wants his FF junk food. He has a 4 bowl buffet out right now
I picked up some cbd oil last week, I've been giving a little bit to him, but was light handed with it when he was being picky with food. I just tried some gravy lovers with some oil in it and it seems acceptable to him so I'll keep adding in a little.
We are on day 5 of cerenia(at a larger dose then normal), so I think he needs a little break? I think it was 5 days on 3 days off? I'm fine dosing together but I thought the cerenia needed a break due to building up in the system.

I did syringe feed a few tastes to see if it got his appetite up and he did eat a few bites on his own afterward. He seemed to be getting tired of it at the end and stopped licking his lips, I figured that was a sign to take a break and let him try it on his own.

50ml sounds like a good idea to me as well. The so-so vet said 200ml, I'm glad the folks here educated me a bit!

I was thinking about it before and somehow it completely slipped my mind. If the meds don't help tonight, I will give that a shot. I did try some catnip topper, he loves to eat nip, not roll in it. Not much help unfortunately. I also tried some fd chicken and Parmesan cheese, he is being super picky right now which is a first for him.

 

I backed of all meds (including pain, Mirtz, nausea) around day 5 and went with just the Canna. Not sure what did the trick but that was a turning point for Gizmo. I think you might be wise to try that also. Gizmo did NOT like the oil at all. He doesn't mind the powder from the capsule.

I know my pain meds for migraines kills my appy, I think it can in them also.

Know the smorgasbord well . I don't know what they put in that FF but it is definitely kitty crack. Let him have anything he wants. Once Gizmo started eating I started mixing bad food (FF) with his regular (good) food until he was back to eating regular. Most important is getting him to eat on his own.

 

Good advice! Eating is the most important thing right now.

 

Jack doesn't seem to mind the canna oil, but turns his nose up at the gabapentin and prednisolone compounds. Good idea on mixing in some good food to transition.

Was surprised to see a blue pumps after eating only gravy lovers today. Guess it wasn't enough to spike his bg too much. Reduced the insulin more until his appt improves.

 

No advice here, but good thoughts and  to you and Jack!

 

I can get it in, my concern was safety. There are a few drugs out there that need to be mixed with food and can burn the mouth if given by itself. I know he wouldn't be a happy camper getting the gaba and pred taste, but it is for his benefit.[/QUOTE]

Prednisone is not one of them.

 

Prednisone is not one of them.[/QUOTE]

Prednisone also increases the appetite -big time.

 

most of the time he looks like he did with p'titis and wants to lay on cool tile or in the bathtub. QOL is a concern because of other conditions including pretty extreme weight loss and GI issues(suspected SCL).

QUOTE]

Is it hot where you are now? If not, I wonder if Jack' running a fever? By the way, what does the acronym SCL stand for?
Hope Jack's eating for you now.

 

Actually a bit cooler then usual. About 74 in the house, usually 76 or 77
Laying on cool tile is common for pancreatitis flare ups.

He has malabsorption issues. He was getting about triple the calories he should and was still barely maintains weight. IBD(irritable bowel disease) and SCL(small cell lymphoma) are 2 common causes for it. SCL is slow growing cancer that responds well to treatment.

 

Ah ok. Maybe it soothes the inflammation? Small Cell Lymphoma, that I know -I'm not so good with acronyms. Lol.
I have a cat, Bamboo, whom I tought had IBD. She had massive diarrhea, and ate tons of food but remained skinny, After a few years, I gave her chicken and rice (people food that I cooked up for her). Miraculously the diarrhea subsided, and then disappeared. She was allergic to wet and dry cat food - all of it. She's pleasingly plump these days. I only mention this cuz I'm wondering if he's ever been suspected of having allergies to food.

 

Cerenia can be given every day indefinitely. The five day thinking is old school. Neko got it every day along with onda two or three times a day. What onda dose are you giving?

If you are assist feeding, give a different food from his usual, so he doesn't d below food ad versions. Glad to hear he's eating a bit.

 

How much are you giving?

 

5-10 drops. Mine is about 20% weaker then yours. I skipped a few doses when he wasn't eating foods with meds in them

 

I am giving Bronx 8 drops 2x/day. Maybe increase the oil a bit?

 

Members here are generally more cautious about convenia. Once it is in, you can’t get it back out. It caused my Gracie to go into anaphylactic shock. I don’t give my cats anything that doesn’t wear off in 24 hours. There are far too many other broad spectrum antibiotics available.

@saltycat Wendy is right that you have to be careful about the condition of the heart when giving fluids and that’s why we felt 200 mls a day was excessive given at once. But even 100 mls a day can quickly overcome a weak heart and steroids can also further weaken a heart. However, @Stacy & Asia is correct that fluid can easily go down around the chest and even down the front paws so it’s critical you make sure it is all absorbed before you give it again.

While fluids can be supportive during pancreatitis, if I knew my cat could potentially have a heart issue (which, admittedly we don’t know about Jack), I wouldn’t give fluids.

After Gracie was diagnosed with SCL, the specialist started her on prednisilone. Even though she had had an echo and her heart was normal, the steroids did weaken it (unbeknownst to us) and when we gave her fluids to get her bilirubin down and upport her, it overwhelmed her heart and put her into transient cardiomyopathy. So I’m cautious.

Many vines for Jack to eat.

 

Hey there @saltycat I give phoebes the gaba, cerenia and zofran daily. I try to not give cerenia one day and she's puking the next. Appy vines sent your way c'mon Jack eat your fuds

 

I also give Murphy 4 mg cerenia daily except during p'itis flare when I increase to 8 mg daily and keep him on that until the flare has subsided. Also give ondansetron 2-3/day during flare along with cyproheptadine. Pain meds (bupe) too - and fluids prn.
Murphy develops food aversions during flares and goes off all his regular foods and I hate to say it- but during a flare, he won't look at wet food - only kibble. I keep small amounts of kibble in the freezer for such occasions - and I agree with Wendy - frequently just a small amount of food - in his case -kibble (as little as 1 teaspoon) seems to kick start his appetite. Pancreatitis flares are very, very scary. You just have to keep up the meds until the flare ends and then for a few more days. Prayers for you both