Appetite stimulant given.... not a happy cat

Went to vet yesterday. This time saw a vet who is way in advnace of the other's in how he handles a cat. Took blood sooo easily. Looking for pancreatitis. $169 test. He told us LB will never come off insulin - said must give more insulin to accommodate dietary changes to help with other problems. He can't see the point in testing too much any more as LB will never come off insulin.

All this year LB's gone thru phases of not eating much - no interest. He's lethargic and vomits brown stuff.

So vet talked to us for a while. Then came in, took blood, then gave an injection of Vit B12. He gave him a Convenia injection - this would be his 5th or 6th one, and then dropped a pill down his throat. He said it was an appetite stimulant (from the anti depressant family of drugs). He said it would give him the muchies and make him talkative.

Poor little guy has been so miserable since he came home. Really awful last night. He wanted to eat way too much - which I thought probably gave him pain - he had such a 'dirty look' on his face - he was very unhappy and yowling all the time - even if I came near to pat him he would yowl.

I thought it was best to rest the pancreas when it's inflamed. Anyway he's marginally better today but still miserable. I think he copes with these episodes better than putting him thru this ordeal.

It's all so exasperating - the vet visit cost $350ish and now we have to wait for LB to feel better - not from whatever it was that was wrong with him but from what the vet did. I've read this thru: http://www.felinediabetes.com/phorum5/r ... msg-876821

Just needed to vent!!!

Marilyn

 

Marilyn,

just a couple questions/observations,

1) there is no way the vet can determine that your cat won't go into remission. It is always a possibility and whether the cat requires insulin for life or not doesn't mean you don't test. You need to test, so that you don't have other problems, such as giving too much insulin and the cat going into hypoglycemic shock. Or the cat developing ketone and DKA.

2) why was covenia administered? Are you aware of the dangers of using covenia? I know it's too late now, but in the future having this information to say no to the vet will help you.

http://www.felinediabetes.com/phorum5/r ... ?8,1905168

There have been more recent discussions on the board about this, but this is an informative and relevant read.

My civvie had mild pancreatitis recently and for me it was a difficult thing to go through. The refusal to eat, syringe feeding, etc.

Feed the cat as much as he wants, as it is important for him to eat. And if he is in pain, ask the vet about giving you buprenex to take the edge off the pain.

 

Thanks for your reply. I'm a little shocked and upset by all this. He's been given the Convenia several times before when he's stopped eating and been "off colour" as we say 'down under'. I will not stop testing - Vet has two other patients with parents who belong to FD forums. I think they find it irritating that we work on looking after our kitties without their omnipotent input. He said something like "it never ceases to amaze me how people can diagnose a cat from 4000 miles away without even seeing it". I probably should have come back with "it never ceases to amaze me how vets can get it wrong with a cat two feet in front of them!!!!

Pls don't worry about my being influenced by what ANY medical professional says. My mother died because of medical ineptitude - at least she lived 10 yrs because of the incredible women on a canadian breast cancer forum who told me what treatment she should be having when her doctor wasn't up with it. I had to threaten legal action which worked every time. Without the forum my mother would have died in half the time - I more than anyone GET shared information. It's a little like epidemiology - if you read enough cases you get a sense of where your kitty is at. ECID but at least here we get to hear about the possibilities and what can be bad and what can be good. BUT look how I got rail-roaded yesterday... Talk about 'live and don't learn'!

It's only this week that I've realised that his funny episodes smell of pancreatitis. I think I can nurse him thru these episodes without the kind of drama I put him thru yesterday. Just feel like I let the poor little guy down.

 

Marilyn,
If LB is still yowling, ask your vet if they gave him mirtazapene (Remeron). My vet prescribed that for Miss when she was dxed and not eating. After I read about it, I wouldn't give it to her. Yowling, being off balance...all kinds of weird side effects are possible and apparently it stays in their bodies for a few days. I was so stressed that I was afraid if she had those side effects, I would lose it totally. :arrow: Just a chance that is what is causing it...
I am also a Marilyn and had a beautiful Abyssinian named LB, too. But her name stood for Little B**ch! :lol:
Good luck with your LB!

 

Ha! Funny coincidence. I sometimes phone up our city council. (not sure what you call them in the US) One guy who answered the phone had the same name as my husband and his wife's name is Marilyn.

I imagine it was the same drug as you mentioned. He said it was an A/D. He called up and I told him he couldn't give that drug again. And he said that he won't need to as he's going to sort out LB's problems. Isn't that good? Wish I wasn't such a skeptic!

 

When I took my civvie in and she was diagnosed with mild pancreatitis (Actually I thought only diabetic cats can get this), anyway, they gave her some shots - anti nausea (reglan) and appetite stimulant (cerenia)

I was also told (and learned here too) that I can give her over the counter Pepcid AC (1/2 pill) generic name is Famotidine 10 mg (so 5 mg).

If I notice her not eating, I will give this to her, to hopefully prevent another episode.

Please don't feel bad or guilty about what happened. It's done and you can't go back to change it. But now you are armed with more information, that you going forward, you can instruct what to do or not do.

I know how much it sucks that we have to sometimes literally fight the professionals to get what we need for our cats. But if there is one thing I've learned since coming to this board, it's that I need to understand what is going on with my cat, what options are out there and the possible dangers of those options and make the informed decision of the action I will allow the vet to take or not take.

Good luck and I hope your guy is feeling better.

 

Marilyn,
How is your LB doing today? Hope all is well.
Marilyn

 

His numbers are high. Increased lantus to 5 units this morning. He's ok without being fantastic. (I had a melt down when the guy from the cattery emailed me those words!!)

One thing that makes me happy is that he's home in his beloved garden with kind weather and summer just around the corner - out of the cattery that he hated. He's home in his kingdom and he LOVES his kingdom and he's treated like a King. When we first brought him home as a kitten I took him out to the garden and you could see the look on his face... "oh yes, this will do me very nicely". He ran down the stairs and into the swimming pool. OMG, U turn and out of the water post haste! He never made that mistake again... He loves his home and is loving being home. The appetite stimulant has mostly worn off and though he's not fantastic he's enjoying himself - not so sick as to be miserable.

I notice on another thread about pancreatitis that a much smaller dose might work ok without the side effects.

thank you for asking,
Marilyn

 

Hi. My cat was given mirtazapine last week as an appetite stimulant but I'm sure the vet overdosed. He gave him a full 15mg pill instead of 1/4. Kusha yowled and was agitated for a while and his pupils were dilated for more than a day afterwards. I talked to an online vet who said this high a dose may take more than three days to leave his system. We gave him sub-q fluids the next day to try to flush the drug out of his system sooner. Maybe you should try that. Fluids never hurt and may help his overall state. You should ask your vet exactly what he gave and how much, and you should also check his liver and kidney values next time he has a bloood test to make sure no damage has been done. My cat seems to be OK now but I feel like we really dodged a bullet. Never again will I let myvet give him a drug without checking its side effects first.

 

Hi Marilyn,
Hope LB is doing ok. It can be so hard. Missy has had me on my toes for a while. She was dxed in March, remitted in April and relapsed (for no apparent reason) in Aug. I have had her on insulin since Aug. But she has been seesawing since then. She has been hanging at higher numbers than the first go 'round. I can understand the meltdown thing! I have had a few, myself. I am not as stressed this time around, stll, you hate to see them not at their best.... Maybe the weather change will bring him around. Our weather suddenly went from summer to fall and she is sleeping a lot more....so maybe the sun will get LB up and around. Both my cats are much happier when they can get outside and enjoy the yard,
Hope things continue to improve......you guys will be in my thoughts and prayers
Take care,
Marilyn and Miss

 

No word from the vet yet. I missed a couple of calls today - I will call him tomorrow. Lb's numbers higher still in-spite of increasing dose. Not constipated as evidenced by accident on carpet this morning - pay back for allowing vet to give appetite stimulant - bad, bad smell. Should leave litter box inside while we go for early morning walk. Lots of cuddles - even thru the night. Wake up to find him close to me - hungry or feeling vulnerable?

Have a sense that we're not making any progress.... better enter in numbers of last few days... and then off to bed @ 8pm. LB has us on a stupid hours - up so early to see to him....

How old is Miss?

 

Hi Marilyn,
How is he tonight? Hopefully better. Did you get to talk to your vet?
I am thinking I may need to increase Missy's dose,too, even though she is at 4 units, now.(she is a big girl...and overweight, although she is losing.) She puked and had diarrhea a couple days ago.....I think from eating too many dragonflies :roll: so I am waiting a bit, but she is hanging in the 200s too much for me....of course with an occasional higher number and then a few 110s and lower sprinkled in. Makes me crazy. I would SO love her to remit again. You could tell how much better she felt.
I kind of feel the same way....about not making progress. Maybe it is because of her acne...or maybe stress because her brother is a pill.(when he is frustrated for any reason Missy pays. I wish she would just whop him a good one!) whatever it is, it is not the sane experience as the last time. I barely had time to get used to testing, etc, and she was in remission. I know she can do it.....
LB sounds sweet...cuddling with you. Missy is sort of a 'hands off' girl. She likes to be near us, but is always just out of reach. :roll: My DH and I have a back scratcher on the coffee table so we can give her lovin' cuz we're too lazy to get off the couch and on the floor to pet her. My LB was a HUGE cuddler. We had a routine every night. She waited until I was settled down, dove under the covers, did a u-turn and laid right in front of my face every night of her life. I miss having a cuddly cat, even though Miss is the sweetest, most amiable cat I have ever had the pleasure to share a house with.
Her brother, Phoenix, is more cuddly, but he will rip you up when he has had enough, if you don't pay attention to that tail!
If LB's numbers are up, maybe he IS hungry. I guess that would be a good thing, huh, if he hadn't been eating well?
Well, sorry if I rambled (I have a tendency towards that). It is nice being able to connect with people who love their cats like we do....and who understand your fears and frustrations with this da*n disease.
Wishes for LB to start feeling better!
Marilyn and Missy

 

Marilyn, It must come with the name. I'm a talker too. Love it when others are responsive.

WEll I wasn't going to say anything as my vets advice won't sit well with FDMB. Vet wants to try a new diet. He said he would like to do an ultrasound but even if it told him more he would still recommend this diet. He wants me to give him royal cannon dry intestinal food (for IBD) along with raw kangaroo and rabbit. He says the bg numbers will rise 20% but he says the FD is not the issue at the moment AND that diabetes usually comes as a result of intestinal issues. He says I can keep going up with the insulin whilst we follow the diet for six weeks - he believes we will see an improvement in over all health and the numbers will come down when the tummy calms down. I also have to give B12 injections for six weeks.

This vet seems extremely knowledgable - I heard about him from someone on another forum.

He wants to break the cycles we go thru with LB not eating/vomiting/very lethargic. He's had many of them. Vet says the blood test didn't show much but it was typical of cats with mild pancreatitis. He said he's had a lot of experiences with cats feeling better with the diet he's recommending. He knows about the allergies etc.

With regards Missy, I think you need to increase the insulin until you get her regulated. My vet doesn't seem that bothered about increases. he says to increase every three days until the numbers respond. He overwhelmed me with his knowledge but I feel he might know a bit more than I do. Even though the golden rule on this site is no dry. I sure hope I can keep my resolve.

Actually LB isn't very cuddly either. That's why it's been so strange to find him nestled into me during the night. He never sits on our knee. I always say he doesn't do knees. Like Miss he likes to be near us. When he first returned from the cattery he wedged himself between us during the night. Also many nights he hangs around us waiting for us to go to bed. He wants us to go so he can settle for the night - a little o' man set in his ways. They are funny little things for sure.

LB is heavy too. I've seen worse but I would like to cut down his food a little too. He need to lose the belly - don't we all?

Marilyn

 

Hi,
Glad to hear you don't mind my going on :smile:
I don't really know anything about pancreatitis. None of my critters has ever had it, thank God. I guess you might have to do as your vet suggests, if there is an underlying issue and he can possibly get it dealt with. I would be a little nervous about it, though. I guess I would have to do some Internet research.....
Missy was really obese, but has lost about 5 pounds since March. More to go.....she probably needs to lose 5 more. :sad:
I was kind of down in the dumps, because her numbers weren't going down ( need to update my SS). So, I was thinking about going ahead and increasing her today......and low and behold, she was 102 this morning!! (can she read my mind?) that puts a monkey wrench in the plans. Guess I will see where she is at tonight. I checked her at +1 and she was headed up, but she had a good breakfast. She is on EVO Chicken and Turkey. When she was dxed and eating dry, she was always starving, since EVO, she and Phoenix are WAY more content. She did start to beg again and that is when I checked her and found she had relapsed.
If you go with that diet, let me know how it works out. It is an interesting concept to me. I hope LB is doing better.
M&M

 

Hi Marilyn, I want to encourage you with your excellent start in helping Miss lose weight. I personally believe weight loss is very important to get the FD under control. I am sure you know that you can't do it too quickly as that can be bad too. I think you are meant to cut their food down by 20% and once they are used to that then cut it down again. I think Lisa (Feline diet guru) has a section on obese cats and directions on how best to do it.

When you get Miss's numbers down she won't be so hungry. The lower the numbers the less hungry - was my experience when LB was well regulated.

Also the fact that you now have one low number shows progress is being made. I suggest you hold a steady for a while - but yes, keep the weight loss progress up. It took a long time for LB to respond to lantus in the first case - and in the second case (now)

As for our sitch? Mmmm - I'm not feeling too positive. 15.9 @ 6am. multiply by 18 for US people - and you will see the increase to 5 units ain't done much! :cry:

vet aslo told me that human meter is probably under reading. OMG!

Marilyn

 

Hi again!
How long have you been giving LB 5units? I think my vet said it can take a few days for them to settle in to a dose. Does he seem to be doing better? Those numbers are kind of where Missy has been hanging. It IS sort of depressing, isn't it? You just want them to feel good. But then, she is out laying on the back deck (they have a 'gated community' as my hubby says....1/2 acre of chain link fence) in the sun after catching and has caught and brought me two dragonflies today......so she can't be feeling TOO bad.
I have bought a baby scale and I weigh both of them weekly, so I can monitor MY progress, because I tend to overdo the treats. :roll: My vet said she should lose about 1/2 pound a month...and so far, so good. I am embarrassed I let her get so big before I did anything about it. I blame working and my MS on not dealing with it......but now look what we both are dealing with! I like to think we treat our furry kids well, but she should never have gotten so heavy....and it was all our fault.
She really is an enigma. When she would be low, like 90s or 100s, I didn't give her insulin a couple times. But then she bounced SO high. So my vet said to shoot her even at low numbers, providing I will be here to monitor her, but to lower the dose. I have done that a couple times now, and if I give her 2 units at a BG of 100(or so) she goes UP! It seems counter-intuitive to me. I make sure she eats well before I dose her, but jeez, today she was 102 AMPS, +1 was 139 and + 2 was 201! What the heck does that mean? Is her pancreas toast?

I guess I should post on the Lantus board, but I have been a little hesitant to, because I have not tested her mid-cycle very much. I was going to do a curve, but pulled my back out last week and it has been all I can do to bend over to test her before shots, till the last couple days. :sad: Maybe I will get a curve in this weekend (supposed to get nasty and she will be in more....easier to get hands on). I know I need to do one. Then maybe I will post there. haven't been doiwill hear about it. I know that is the way to go, but I hate to call her in, on a gorgeous day, to poke her in the ear. I guess I just need to practice some tough love.
Wow...so there I go again on a ramble!! It is nice to bounce stuff off people. My DH isn't all that into this stuff....he pretty much is content with me doing it all.....go figure.
Here's to hoping LB is going to start dropping down soon.
Marilyn

 

Sorry again!! I was trying to edit what I wrote and inadvertently hit submit. Hopefully you get the gist of that last paragraph. I know I need to do TR and just haven't done it. I hoped against hope that she would remit when we got her on antibiotics (for acne) so I put it off....then found an excuse to put it off every time I considered it. First, letting her settle in to the antibiotics, then settling in to 4 units, then she had a bout with vomiting and diarrhea (too many dragonflies, I suspect) then my back.....I just need to be a good human to her and DO it.
Thanks for letting me vent!

 

I visited Seattle a few yrs ago. 1996 about. I loved it. It's not unlike Melbourne where I live. That's what I thought at the time. What's the population there? We are about 4 million people in Melbourne.

I might answer your post privately but not right now as my DH is waiting for me to do some stuff. He's not as dedicated as I am - though he's very supportive. Do you have MS? Are you newly diagnosed or been living with it for a long time?

I know there is a bit too much pressure to conform over on Lantus. Some of the very clever ones assume that everyone is similarly blessed. One time I saw a lady being told to test more and then she explained she was blind. We are too one dimensional on forums and it's easy to forget that most people do their best. There are multiple variable to our lives. I am really p'd of that I cannot mentally get a handle on FD. I was always so sharp with anything medical. Argued the point with oncologists for yrs with my mother's treatment for breast cancer - convinced I kept her going years longer than her form of it usually permits. I'm now in my late 50's and my brain is being taken over with cotton wool. The whole thing about rebound - I don't get it - I can't seem to take it in; have no idea if this ever happens to LB. At one stage his numbers when down when he ate - up if I left it too long to feed him. What was that about?

Yes, I was going to keep this brief but already I've tapped away much more than I intended to. It's just that I relate to much of what you say - except I am able to test LB coz I can go out side in the sun and get down and twist myself around the bush he's sleeping under and take his blood. DH would never go to that much trouble - he would tell me that I'm testing too much and that I should leave the "poor little smella" (family term) alone. That's male speak for I can't be ar*ed to do it. It doesn't bother me I just do it myself as if I have a feeling to do it then it's like an itch - better to scratch it. But lately the numbers are so predicatable that there's not much point in checking too often. His hunger tells me he's up.

I agree that I need to leave it a while before raising the dose again. But I hate finding 285 at AMPs. Usually he's been hanging around me since 4am coz he's hungry. Oh and he's got this technique where he can inject just one claw into my face - not deep - just enough for me to feel it and wake up. I wish I could catch it on video as I'm sure it's a delicate manoever on his part, but what else does he have to do at 4am?

At the end of the day most of us who come to this site and hang around trying, care about our kitties a lot. They are blessed to have us as we are blessed to have them - BUT we have to have a life balance.

best
Marilyn

 

Ask the vet for the results of the pancreatitis blood test. Saying 'mild pancreatitis' and giving you no pain meds or mentioning fluids is wrong treatment.

The normal range from the PLI test is 0 - 3.5 ..... get a copy of the test results for all tests, and always ask the vet the name of the meds given to your cat.

My Oliver always tests as 'mild' with his numbers always between 3.8 to 4.0; Shadoe's are always over 13.9
When you get the results, tell the vet that you want to have pain meds on hand and fluids for his next issue with pancreatitis because it's an issue that is common with diabetics. Your cat has pancreas issues, not functioning so you need to help with insulin, so it's no surprise that the same organ may have inflammation issues.

What about fortiflora? Get a box of that for your cat to help with appetite; it works for Shadoe quite well.
Idexx Treatment for Pancreatitis

Chronic pancreatitis (or does my cat have a pepcid deficiency?)

Dr Lisa’s post on Convenia

 

A few things:

1) The part about "two feet in front of them" made me laugh.

2) I am continuing to receive more reports regarding adverse reactions post Convenia - including the death of a 1 year old cat that was given Convenia for a minor wound that was sutured. This young cat was a very outwardly-appearing healthy cat.

3) IF I ever use mirtazapine, I never use more than 1/8 of a tablet. Never 1/4.

 

Marilyn,
I tried PMing you...let me know if it made it, please....I can be technologically challenged sometimes. :roll:
M&M

 

In LBs case Convenia is past its use by date. LB is a BIG cat. He would be a perfect weight if he lost two lbs. He's a bit over 20lbs. Maybe his size has giving him some protection against the negative effects of Convenia? Also though it targets skin problems and he has those. We started using it (me and local vet) when we observed a significant drop in his numbers after an injection of routine antibiotics - not Convenia. (after a cat fight). Then the Convenia was trialled the next time he was unwell. Down came his numbers again. Discussed this with local vet and he could not account for the improvement in his numbers but figured if it was keeping him well then may as well use it; each time a return to wellness after the Convenia. This is no longer happening. Numbers remaining high regardless.

As for mirtazapine? Don't know the dose but it was a full tablet of whatever it was. The effect was dramatic. Vet can only play that card once.

Basically there's a problem. Most of us have a touch of 'control freak' about us. If a vet is very confident in his/her knowledge he/she is not going to want to discuss every scrap of medication in his ammunition pile - is there a touch of the magician lurking in every vet? Abrica dabra - please pay huge amount on way out for my magic! Even if I were to ask everything that has been suggested to me I don't know enough to use the information to protect my kitty on the spot. At present my knowledge is 'after the fact'. It's like learning a few words of German. Use a few words and they assume you know how to speak their language and start yabbering at you with a whole bunch of words you don't understand.

 

Were you able to find out the test result value for pancreatitis? It's quite important you know that value because if it's above 4.0, you should know that your cat is likely in pain. Also trying pepcid will help with any gassy nauseous feelings and you may see the appetite return. Pepcid always helped Shadoe when she acted like she did not want to eat as well as fortiflora.

 

Seeing vet for appointment/chat in one hour. No cat just chat. Will be writing down your questions. thanx