Acute pancreatitis

Hello all- I have been away from the board for quite a while (years? old username was glenej3) as Olive has been very healthy and her diabetes has been in remission. I see there have been lots of changes!

Unfortunately, we face a new health problem now...Olive has been diagnosed with acute pancreatitis. Last Friday, she stopped eating and vomited several times. Her vet gave her fluids and injections on Saturday morning, but we held off on doing diagnostics hoping that she would come out of it on her own. When she didn't, I took her to the ER vet Sunday morning, where they did x-rays and bloodwork. The bloodwork showed elevated liver enzymes, and the x-rays showed what appeared to be a mass in her abdomen. She saw her regular vet again on Monday for more meds and fluids, and we made an appointment for an ultrasound yesterday. The good news is that the ultrasound showed no mass, but the bad news is that her pancreas was so inflamed that the ultrasonographer said it was the worst pancreatitis she has seen in a long time. :sad:

Olive is at home now, and she is eating pretty well (the vet gave her Royal Canin Recovery RS, which she seems to like and is eating). She has a Fentanyl (narcotic pain med) transdermal patch on her, and she started an antibiotic this morning. All things considered, she is doing pretty well and is in decent spirits- not acting like herself, but much more like herself than she was this weekend.

I know some people have had experience with pancreatitis, and I'm just wondering...what to expect? We'll talk to the doctor again soon as she is having her patch changed on Friday, but I guess I'm wondering how we'll know she's "over it," and then how we'll know if it has affected her in any other way. Reading about pancreatitis online has provided some pretty scary possibilities, and I don't want to lose my little girl!

Thanks all,

Ellen & Olive

 

Hi there,

I will direct you to Jojos great post on pancreatitis. Jojo is a vet tech. Pain meds are the key for a lot of Pancreatitis kitties
http://www.felinediabetes.com/phorum5/r ... 722,876722
this will link you to the old FDMB board which is now read only archive.

This is also a good set of links for pancreatitis at Deanie and Boos site, because Boo became diabetic due to his pancreatitis.
http://cid-ab111d6420cd368c.profile.liv ... D368C!143/

There is a test for pancreatitis called the fPLI, it has to be sent out, and is only accurate during a pancreatitis flare up. Conor my civie has pancreatitis and IbD and sometimes its hard to tell which is flaring or if they feed off each other so we do the B12 shots sub q.
http://www.cvm.tamu.edu/gilab/research/cobalamin.shtml
its more for IBD but I feel it helped him during p'itis flares.

 

If your kitty does have pancreatitis what you should expect are most likely recurrent episodes of it. It will probably wax and wane. One of the treatments for it are steriods which can impact DM. H has pancreatitis [and GI lymphoma] and since prednisilone is supposedly the easiest of the steroid to metabolize [and helpful for the inflammatory effects of pancreatitis as well as helpful to his lymphoma treatment] we give it to him and as a result he is diabetic - but better than the alternative.

Make sure you have SubQ fluids on hand at all times.

When you get the fPLI done, try to have it done at the beginning of the week, and if your lab is Antec and or they ship to Texas A&M, pay extra and have the blood sent OVERNIGHT FedEx or UPS on a cool pack. NEVER send USPS. This will help make sure you get the most accurate result. Also this test requires a 12 hour fast.

The fat content of food may also have an effect on pancreatits [though this is controversial]. Ideally you want a food that is low carb medium fat and high protein [and no grain]. The link in my signature to "Home Cooked" was my solution to this. Since we started this special diet we have not had an episode where H was in obvious pain or discomfort like he had had before.

What is the nutrient profile of the Royal Canin RS?

 

Thank you for all the helpful information.

Olive seems to be hanging in there and acting a little more like herself. She is getting a new Fentanyl patch tomorrow, so I will ask the doctor some questions then.

The Royal Canin Recovery is high protein/high fat for animals that are recovering from critical illness. The guaranteed analysis listed on the can says crude protein min 10.0%, crude fat min 10.0%, crude fiber max 2.0%; moisture max 78.0%. I don't plan (or want) to keep her on this for long, but for now I just want her to eat something, whatever that may be. She has food allergies (not sure to what, though), and she normally eats Natural Balance duck and pea formula canned food. I have to be careful with what she eats because her food allergies make her vomit, and we don't want that...

 

Unfortunately "guaranteed analysis" is a poor way to understand the nutritional breakdown of a food.

Are you familiar with Janet & Binky's food charts?

The FAQ from there is helpful with learning how to get the "as feed" or "DM basis" info from pet food companies:
http://binkyspage.tripod.com/foodfaq.html

It can be difficult and some food companies will not release this info. The spreadsheet she has linked will help you convert the "DM" or "as fed" into "% of kcal from" which will help you compare to other foods in Janet & Binky's list.

As you are probably aware, dry food is a big no-no for diabetes [as well as not very desirable for other reasons].

I understand about feeding anything the cat will eat. I'm in a similar situation with H. H even gets appetite stimulants at this point. And even with appetite stimulants, I occasionally have found I must give H small amounts of dry food for short periods to get his appetite going again. I pay for this though in the level of regulation we are able to achieve. But I've also come to realize that feeding appropriate foods with his diseases in mind has really changed our outlook for H.

Good luck with you kitty. :smile:

 

Hi Ellen! It has been a long time. I'm happy to see you but sorry about Olive.

I am not much help but you might want to PM Jojo or Jess about this. You are sure it's AP and not CP, right? They are quite different from each other.

 

We've had two bouts of acute pancreatitis (fourteen years apart, so it's not anything I'd label as chronic).

I think the bouts lasted about a week. We did pain control (buprenex), daily subcutaneous fluids, and got up every two hours around the clock to offer food and water -- Gwyn wouldn't get up to go to the food bowl, but would eat if we brought it over to her. We also switched her food to one that she liked better (making her more inclined to eat), and made it less pate-like and more soup-ish, so that it was easier for her to eat. I think we may also have used an appetite stimulant (cyproheptadine), but cannot be positive of that.

There may or may not have been steroids involved in the treatment; Gwyn's been on steroids for the past 16 years, so I wouldn't have really registered/remembered a temporary increase in steroids. If we did use them, it would have been prednisone.

We also moved things so that Gwyn didn't need to make as much effort to keep to her normal habits. We moved the litterbox into the same room, so she didn't need to cross the room and go down the hall to pee. We tried to get her to sleep in a nest on the floor so she didn't have to keep getting on/off the couch, but she was Not Interested. So we used the encyclopedia set to construct a long set of low steps leading up to the couch (each step was maybe 3 inches taller than the last), so she could get up/down with minimal effort; there was even enough room on the steps to rest if she wanted. I was sleeping on the couch next to her, so I usually felt it if she got up, so she didn't have to use the steps much, but they were there for when she did.

When I did lift her, I was also incredibly gentle about handling; cats normally tighten their stomach muscles when you lift them, and I didn't want to cause her any more pain than I had to.

 

Thank you for the replies! It's good to see you again, Susie! :smile: (although I wish there were better circumstances!)

Olive is doing okay...it's been a week now since the worst of it, and she is eating all right and not vomiting, so that is good news. We replaced her Fentanyl patch on Friday, and she gets a new one tomorrow...she is beginning to act more like herself, so that is a relief. Thank you, JJ & Gwyn for telling me about your experience. My experience with Olive this week has been similar, so it is reassuring to hear how you and Gwyn got through it.

Olive's doctor said that as long as she remains stable, eating, and not vomiting, she will want to repeat blood work in a couple weeks to get a better idea of what we're looking at in terms of long-term prognosis, etc. I have my fingers crossed that Olive's values will all be back to normal... I'm glad that she at least seems to be feeling better, for now.

 

It's good to see that Olive is doing better, Ellen! Thank God for pain meds. Hopefully controlling the pain will keep the vomiting away and she'll be back to normal soon.

 

Oh! And you may want to talk with your vet about using either Pepcid A/C (not Pepcid Complete) or Zantac to help control any possible nausea / vomitting.