2/15 Six's AMPS 213, PMPS 414 p-titis update

Good Morning LL

WCR: Hungry as usual. A little more chatty this morning. No coughing so far this morning. Too early to report too much else.

Yesterday's condo

viewtopic.php?f=9&t=6257

 

Re: 2/15 Six's AMPS 213

I noticed J.D. coughing a little too. Hope they both get over it real quick.
More blue..Six!

 

Re: 2/15 Six's AMPS 213

Amy,
That's a terrific morning report because it says some important stuff.

No coughing yet is a great thing, and so is the hungry because Six is a growing boy and needs to keep his strength up.
And as for chatty, that's good but don't let Six boss you around too much!

Six,
That yellow is pretty, but now we are expecting some nice blues please.
Come on down to join Shadoe; she seems to think blue is a good place to be this morning.

 

Re: 2/15 Six's AMPS 213

Hope the cough was just after effects from last night's party. What were Six and J.D. doing when they went out on the porch together????

 

Re: 2/15 Six's AMPS 213

It was a little cold in the night air last night...hmmm....was Six missing from the festivities long enough to catch a little cold?
Now, those AMPS are so close to blue....you can get there from that number so easily....gonna try for blues Six?

 

Re: 2/15 Six's AMPS 213, PMPS 414

Ok, I need some cheering up LL.

Six's PMPS is horrible. I knew it was heading up by by +3 he was at 240, +5 280. He is back to being more lethargic today, but it has been a challenging day for all of us. We (cats and beans) are STUCK in the house with yet another snow storm. The third storm in 10 days and we we just aren't used to this. The vet called this afternoon and his SPEC-FPL came back positive for pancreatitis. His value was 16 - should be 3.5 and under.

At this point she is not suggesting other treatment options through her at his current condition, but I have just posted on Health for more advice (you will find updates on his meds/nutritional supplements). His only major symptom is lethargy. His appetite hasn't been impacted a bit. He did show some slight dehydration, but some what I have read I am not sure fluids are called for with his case. HELP!

We have made an appointment to see an acupuncture/chinese herbal vet in March. It's the earliest we can get in. We have seen her before for two (GA)s - a CRF cat and our dog who suffered from cancer. It was a very positive experience. She works hand-in-hand with our vet.

 

The high numbers make them lethargic i think...but what about pain....does he seem to be in pain to you?
That's what I would be thinking....did the vet suggest anything for that?

 

Amy,
If you have fluids, I would give Six some. If he is dehydrated, I would think fluids would be helpful. Also, do you have anything for pain or nausea?

I had a horrible time with Shadoe and was so worried, like you are, I am sure.
Her results are 13.7 and she was not well at all. Around 1/15/10 on her ss shows what her numbers were like. In her case, she was vomiting and not eating at all, so she was a bit different from Six.

I gave her fluids, plus pain meds-bupe- for the first 3 days, then codeine Transdermal gel for after, and pepcid AC and cerenia for nausea and vomiting. She got fluids, a zofran injection and a hydromorphone injection. That was after I got the results. On the day of testing her, she got a Zantac injection and fluids.

I had to go back to the vet office a 2nd time to get all the above because the first vet who gave me the results said I should just change Shadoe's diet!

Shadoe was in pain at 13.7, so I was glad to have her given some pain meds. I would imagine that Six may be in pain, so I hope you have something for him. If not, I would be getting some from the vet.
I did not need to use the cerenia tabs, or all the codeine gel, but I am grateful that I have them on hand in case I need them.

I sure hope that Six feels better soon. Scratches for the big guy.

 

I have fluids but they are a year old and I don't think I am comfortable using them even though the date is June 2010. Six also has a possible heart condition (don't ask, don't know the name...just know it causes the heart to enlongate) and I would worry about using them on him until I got the ok for his heart. Grrr....

The vet said if I wanted to give him pepcid to go ahead and do that, but I do have to wonder if his appetite isn't impacted if I should treat that. In fact, he has gained some serious weight the past month (I'd say 1 pound...he had lost a lot in Oct/Nov due to his illness). I can't keep enough food down him - if I put down another bowl tonight he would lick it clean. What are your thoughts on the pepcid???? I wish he would lick his lips like Ms. Shadoe then I would know. I'll whisper the suggestion in his ear and see what he does.

On the to the pain meds...I agree with you regarding this. I asked my vet about pain meds and she stated that cats don't experience the pain like dogs/humans. We did talk about cats hiding pain. Either she said, or I read it somewhere tonight, that only 25% of cats have pain associated with p~titis. Pat - I don't notice that he's in pain. I've been carrying him around the house. Playing with him. He's just much more lethargic and after his great numbers this weekend in addition to more activity...so, I ask for guidance on this.

Regardless, I am going to follow-up and request pain meds. A few days to see if he's better on pain meds could help determine if his inactivity is related to pain. Pam and Lalya on health posted a conodo from the old board by JoJo that was very helpful. Even more reading to do tonight!

I won't be able to get access to pain meds immediately or anything else. My vet is 40 minute drive and with the snow storm, I doubt I'll be able to make it out there tomorrow. We're supposed to get more snow tomorrow 1-2 inches on top of the 6-8 we got today. She will mail me meds if we need them...that might be the best option. She's a great vet - that's why we drive - and I've worked with her for close to 20 years. She respects my decisions and will provide the support I request.

Gayle - I'm not glad you've gone through this with Shadoe, but it is a relief to have you to lean on in this situation.

 

Amy,
Did your vet actually say cats don't feel pain? No. It was posed that cats feel pain differently, so from that I would think they do feel some sort of pain.

What my nice vet did was feel around Shadoe's abdomen. I wish I knew whereabouts she felt, but the gist of it was that Shadoe tensed up when the vet felt in certain areas.
I compare that to your dr pressing in areas and asking if this or that hurts. That's why my vet said to give Shadoe some pain meds because better safe than sorry.

The fluids are not good with heart issues, is that right? I don't know anything about heart issues, so when you talk to the vet, ask how you can get Six hydrated. In addition to Shadoe's fluids, I made all her foods into soupy slops and she really did love it. The food tasted the same but she was able to lap it up, and maybe it was easier on her stomach.

I don't know how you would know to give pepcid or know when Six had a gassy, upset stomach; I guess I am lucky because Shadoe licks her lips alot and looks uncomfortable. I have the pepcid AC 10mg and give her 1/4 tab no more than twice a day. There was an extra strength pepcid for 20mg, so don't get that one.

Amy, I hope that Six can get some relief soon, and you are able to stock your feline medicine cabinet for all his needs.

 

sorry about the pancreatitis diagnosis, but there are a lot of cats here who have it and most find it very manageable. The flares will come and go, meaning that it's not necessarily something you'll have to deal with all the time, just when he's having a flare. You'll learn to recognize those signs in Six (ECID, some are very subtle).

IMHO pain meds are a must. As Jojo says, the best way to see if a cat is in pain is to try pain meds and see if there is improvement. I would get them as soon as you can. Pancreatitis is a very painful condition. Fluids, I agree with you, I wouldn't use them until you get an ok from your vet. Pepcid AC can't hurt and might help. Please step up your ketone testing too.

 

+ 3 362

So a nice drop from the PMPS. Paws crossed the trend continues.

No. I think she was referring to pain and pancreatitis specifically...not that they don't feel pain...that it isn't as prominent in cats as dogs and humans with pancreatitis. I don't know that I believe that, but wonders what others had read/seen in their own cats.

Good news - Six and I just had a play fest. He was as perky and feisty as he was this morning.

I actually started that last week. Just decided he wasn't drinking enough and took the idea from your conodo! Ha ha. He likes it too.

Thanks for the advice Libby. Would everyone agree to start with the buprenex? It looks like it has to be compounded. Is that true? If so, it's actually easier for me to get (closer) than my vets from a place the vet will call to compound it. I can pick up the pepcid tomorrow in town. Just checked the house for some leftover from last year, but it's gone. I sometimes take it too

I will give Six the keytones order! I have been trying, but this guy is crafty when it comes to peeing when I'm not around. I'll be home tomorrow - another snow day. I'll probably have to stalk him again. :lol:

Thanks for the advice and support. It's amazing what that and a feisty kitty can do to help the spirits!

 

I can't' imagine that someone (me?) didn't send this to you already. It's Jojo's post on pancreatitis.. Pepsid is a must and not just in the case of nausea.

Cats feel pain. They feel pain from pancreatitis. What cats do is isolate pain. They can function through levels of pain that a human would find crippling. What you are seeing as lethargy may easily be the way that Six is manifesting pain.

Bupe doesn't need to be compounded. My vet has it as a stock item. You can administer it either as a sub-q injection or orally (into the cheek pouch).

 

So sorry Six isn't feeling his best! I know nothing about pancreatitis -- and you have PLENTY of snowflakes already -- so Kitty and I will just send ((((hugs)))) and feel-better vines. Also sending vines to the postal service, in case you decide to have the bupe mailed!

 

IMHO, if this was my kitty and that was her spec fPL reading, I would start pain meds - buprenex being my preferred choice.

See Dr Scherk's paper on Feline Pancreatitis:
"Analgesia is of critical importance in the comfort of the patient, but also in the progression of the disease/inflammation through the negative physiological effects of pain. Pain causes disease and prevents healing. Even if obvious abdominal pain isn't present, use a "test dose" of 0.1-0.2-mg/kg oxymorphone IV to see if the patient improves over the approximately 6 hour effective period. If that is the case, then constant rate infusion of a narcotic may be considered or a transdermal fentanyl patch (DuragesicTM) for continuous relief. TorbugesicTM is not as effective for visceral pain as the opioid agonists are."

Also, a more recent paper: Idexx Lab's Treatment Recommendations for Feline Pancreatitis
"Pain Management
Abdominal pain is frequently recognized in dogs with pancreatitis; however it is rarely recognized in cats. Nonetheless, many cats will show clinical improvement if provided analgesic therapy. Because of this, many experts agree that pain management should be provided in all cats with acute pancreatitis. Opioid therapy is recommended. Fentanyl transdermal patches have become popular for pain relief because they provide a longer duration of analgesia. It takes at least 6 hours to achieve adequate fentanyl levels for pain control; therefore one recommended protocol is to administer another analgesic, such as intravenous buprenorphine, at the time the fentanyl patch is placed. The cat is then monitored closely to see if additional pain medication is required. Cats with chronic pancreatitis may also benefit from pain management, and options for outpatient treatment include a fentanyl patch, sublingual buprenorphine, oral butorphanol or tramadol."

Buprenex does not need to be compounded, although I've seen some folks here get the compounded version, not sure why they did so. (compounding is probably more expensive). It is a tasteless (yes, I've tried it) clear liquid, and is one of the few meds that does not turn Meowzi into a drool monster. Is your vet able to call the prescription in to a local vet hospital or ER closer to you? That's what our back-up vet (also 40 mins drive each way, in good weather) did; he called it in to our acupuncture vet (20 mins away) and we picked it up there.