Dehydration, possible pancreatitis and/or UTI

Hi. My Buff has been diagnosed with a possible UTI but doc says she probably also has a bout of pancreatitis.

I don't know when the results of the urine will be back. In the meantime, she had a rough night and I ended up giving her a torbutrol that I had from last summer. She was very lethargic. She kept getting up a stumbling around to get to her bowl, but then couldn't drink. I was so worried. She was dehydrated at the E-vet. They administered fluids and her vet sold me a bag. Question, the stumbling could be the dehydration, but could the stumbling also be a reaction to the torbutrol? When should the fluids begin to help?

I'm giving her subq fluids and just checked her temp and she's 99.5, but I wasn't able to insert the therm very well - could make a difference in not accurate temp? She had her fluids about 20 minutes ago. Would that lower her body temp to 99.5? Is there anything I can do to raise her temp, would wrapping her help?

She's gotten through these things before but I'm so worried! Appreciate any advice from those who have been through this or know anything about it.

 

My cat had flares of Pancreatitis. The best test for that is a SPEC fPl and it has to be sent away, and you'll get the results back in 1 to 2 days.
My vet prescribed some pain medicine called Buprenex, and J.D. was wobbily when on it, so I closed the door to the basement so he couldn't go down the stairs and I closed the door to the bedroom, so he wouldn't be inclined to try to jump up and down from the bed.

Here's a link I found for you on Torbutrol side effects.
Common Side Effects
The most common side effects of Torbutrol are sedation and a corresponding lack of coordination. It can be used as a mild tranquilizer.

Uncommon Side Effects
Torbutrol can cause lack of appetite or diarrhea in some pets, although this is not typical.

Slow Heart Rate
Torbutrol also can slow the heart rate but not to a significant degree in pets with no underlying health issues.

Respiratory Issues
Unlike other opiate medications, Torbutrol does not suppress the respiratory system and does not cause slower breathing. But if used with antihistamines or tranquilizers, this effect might occur.

Considerations
Some pets might not be able to tolerate Torbutrol without the risk of serious side effects. These include dogs and cats with Addison's disease, liver or kidney disease, head trauma, hypothyroidism, or any animal that is very debilitated.


If your regular vet is open today, I would take your kitty in, especially if you are worried.
And, she needs to eat, so if she is not eating, you may ask about getting some anti nausea medicine like Ondansetron.

 

Hi. Thanks for your help.

When your kitty was wobbly, was he still able to drink? She goes to her bowl but just hovers there. She just now peed on the rug where her bowl is.

I'm getting dressed to take her to the vet now. Her temp seems too low to me, but it may be from the subq fluids she just had. Not taking a chance.

I'm not going to have a chance to read your link about the pain med, as I'm trying to get ready to go. Do you know how long the effects are with the med? She had it at 9:45 and is still not doing well as far as walking. Does the pancreatitis have that effect? She goes a few steps a lays down. Thanks.

 

We're back from the vet. Her temp was fine. I asked for a shot of cerenia and they gave her that. Also said the torbutrol would make her lethargic for up to 12 hours. It's now been 12 hours and she's walking better.

She's no longer dehydrated, which is good, but she's hovering over her water dish for several minutes and is not drinking. I have to pick her up and move her away. It's heartbreaking. Has this happened to anyone else? What did you do?

I just gave her a cyproheptadine and then force fed her some baby food chicken and some rice. Then she hovered again. I got a dropper and gave her bits of water, which she really didn't seem to appreciate. I was offered mirtazapine but I had the cyp from last summer. Is one better than the other? Thank you.

She's back hovering over her water *sigh*

 

Did you get the SPEC fPL test done?
I believe I have heard of cats that are in pain (from pancreatitis or whatever) sitting in the meatloaf position in front of their water dishes and not drinking. Does the vet still think it's pancreatitis, and if so did you get some more pain medication?

I have both cypro and mirtz, but prefer the cypro as I can give it once a day, where as the mirtazapine can only be given once every 3 days, and the mirtz would make my cat seem kind of agitated and kind of hyper. I did find out one year on vacation when I had just given my cat some mirtz and he I saw him twitching a little, about the serotonin syndrome which is rare but can be caused by mirtz, and that (the other appetite stimulant I happened to have on hand) cyproheptadine is the antidote for it.

I too have gotten a low reading when trying to take my cat's tempurature, and went to the vets because of it, just to find out that it was normal, and I must not have placed the thermometer in far enough.

I'm glad you got some anti nausea drugs in her. I hope she starts to eat for you soon. You can always add some extra water to her canned food, too.

 

Her regular vet wasn't there and they close early on Sat, and no, I forgot to ask for the pancreatitis test but she'll go back Monday. They assume she's having pancreatitis because of the way she's acting but don't want me to give her the torbutrol because of the side effects she's having from it - didn't offer any other pain med and I couldn't think to ask :sad: I'm going to call and see if they'll call in something.

They'll have her UA back Monday and will decide on an antibiotic if she has a UTI. I asked if the antibiotic would help the pancreatitis but my brain is so tired I can't remember what they said. Anyway, I'll take her back to the E-vet today if necessary.

When offered the mirtazapine, I told doc I thought she had a bad reaction to it last year, so maybe it made her agitated too. Thanks for your help and encouragement.

Called the vet and was told the torbutrol was all they had to offer. :?:

 

Both torbutrol (butorphanol) & buprenex (buprenorphine) are opiate analgesics.

In fact, the active ingredient in buprenex, buprenorphine, is the exact same drug that is used in subutex/ suboxone, which is a drug prescribed as a substitute medication for human opiate addicts. This shows just how strong it is.

If you've ever been prescribed morphine or oxycodone for pain relief, you'll know that these drugs do make you rather wobbly and sedated; it's no doubt the same for cats.

Just keep an eye on little Buff, maybe confine her in a room so she doesn't have to move too much, and surround her with soft things like blankets and pillows so she doesn't injure herself if she does fall over.

H

 

Hi. Thanks for your comments. I do know how it feels to be sedated and I feel so badly for her. She just takes a few steps, then goes into the meatloaf position. I thought it would have worn off by now as it's been about 14 hours.

Yes, I'm trying to comfort her, but when I try to put something around her, she moves away. She seems to want to be left alone and I feel helpless watching her misery :cry:

I hoped the cerenia would make her feel better, but it doesn't seem as though it has -- :cry:

 

Has she been checked for ketones? If not, it would be good to rule that out as soon as possible. Do you have ketone test strips? If not, please go buy some, and let us know the results.

 

Yes, they checked for ketones at the E-vet and it's all good, and her urine looks clear, no blood. I keep test strips as well and try to be careful about that.

Would you happen to know how long it takes for the appetite stimulator to kick in? She's only had it twice so far, so maybe it takes a while. At any rate, I'll continue to force feed. Is there any rule of thumb as to how often I should do that?

I have to say I've always dreaded coming here because I get so sad about everyone's kitties, but I have to get over my dread in order to help her in all the ways I know of. Thanks again. You're all such a help.

 

Hi. What type of insulin are you using? You can always update your spreadsheet and go to the insulin specific forum for the insulin you are using, as I don't think there is as much sadness in the forums.
I've always found both mirtz and cypro to start working in about 20 minutes to a half hour.

Since it doesn't seem to be working, that bothers me.

If you're going to force feed her, I would use a food that she doesn't normally eat, so that she doesn't create an adversion to her normal food.

I'll try to PM Karrie and Maverick to stop by. She knows a lot about assist feeding, so I would advise listening to her.

 

She's dribbling pee on the carpet, that doesn't sound good.

 

I have been helping on a board dedicated to assisted feeding for many years. Please join the Yahoo Feline Assisted Feeding group right away. They saved Maverick's life in 2008 when the vet tried his best to kill him. He ended up having a feeding tube for 10 weeks. Here is the link to the board: http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/ There are many members to support you while you are assist feeding.

I would also recommend you join the pancreatitis support board. Pancreatitis can get very bad and they can advise on how to best manage this. Chances are she will have repeat flares. Diabetes and pancreatitis together are very common. Here is a link: http://pets.groups.yahoo.com/group/Feline_Pancreatitis_Support/

I will say from my experience on FAF, the critical piece of advise is to discontinue the cypro and the mirtz immediately. You have unaddressed nausea and are making your cat miserable. Giving an appetite stimulant to her is just like giving you one when you have an all out flu. You would be forced to eat and feel like killing yourself. And you can be causing long term food aversion issues with her. Some cats don't eat on their own for years at a time. Raider and Chez's mom on FAF are perfect examples. Raider had a feeding tube for three years.

Focus on assist feeding by syringe. You have to get a lot of calories in though. Feeding low carb fancy feast and meat baby foods are perfect. I would buy a shipping/pet/baby scale on line that weighs by the ounce. This will make sure you are feeding enough to maintain weight - helping to avoid dealing with feline hepatic lipidosis and helping to avoid Diabetic Keto Acidosis. The baby scale actually caught Maverick's diabetes before any symptoms other than his starting to lose ounces instead of maintaining. Its worth the money.

The second piece of critical advise is to push your vet to prescribe an anti nausea medication. This is commonly prescribed to cats but many vets don't believe cats can be nauseated. Hovering over the water bowl and not eating are two classic signs of nausea. So is teeth grinding, lip licking, lip smacking, and swallowing a lot. Ondansetron is the most prescribed on FAF and is a true anti nausea medication. Cerenia is for acute vomiting, and can be used with ondansetron. Push your vet for ondansetron/zofran. The sister med is zolasetron at the vets. Ondansetron can be bought at human pharmacies - costco can be affordable and you don't have to be a member. But get two prescriptions because thrivingpets online sells them for 80 cents a 4mg pill. The common dose is 1mg twice a day. If your vet prescribes a higher dose, great because you can use it with future flares METOCLOPROMIDE/Relgan is NOT effective in cats for nausea - it is for dogs though. It only helps with cats where nausea is due to slow stomach motility - seen when a cat throws up food many hours after eating food. Food should pass through the stomach within an hour mostly. Pepcid is also not an anti nausea medication. It is good to help with stomach acid but not the nausea you are seeing.

When you join the FAF site you will be able to read this article. http://f1.grp.yahoofs.com/v1/cNyeUA... Vomiting - Signs, Causes & Treatment Options It explains nausea in cats so you can push your vet for what you need. Ask her/him to humour you and look it up in plumbs guide. It can't hurt but can only help. Maverick didn't eat for 9 weeks and finally started eating after the bully ego head vet we had finally relented and prescribed this. He pulled his tube out at week ten so thank God he was eating enough before Maverick got it out.

When you go to the vets you can also bring this technical article written by a renowned vet. Ondansetron is listed here for cats. Do not stop until you can get this medication or dolasetron. Cerenia is rarely enough if its just nausea and not acute vomiting. http://veterinarycalendar.dvm360.com/avhc/content/printContentPopup.jsp?id=676860

I am starting a new job and helping my mom pack so I'm not as available as I usually would be. So please ask any questions about these meds or assist feeding on the FAF site. There are always people on there to help. We have been where you are and they are an amazing group. I will always be grateful for them and FAF and Maverick's asthma group also.

Karrie and angel Maverick.

 

oops double post thanks Dyana.

 

I hope Buff Puff is feeling better now. I am a member of the Feline Pancreatitis Support Group and you can join them here: http://pets.groups.yahoo.com/group/feline_pancreatitis_support/ They are very helpful.
Here are a couple of links about Pancreatitis written by experienced board members here: http://www.felinediabetes.com/phorum5/read.php?8,876722,876722
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=79693

 

To Everyone:

Thank you for all the great advice and the links. I'm not able to absorb it right now as I've had about 4 hours of sleep since Wednesday, but when I'm better able to concentrate I'm going to educate myself on pancreatitis and force feeding. I really appreciate the expertise of this board :smile:

I did want to post an update before having a short nap. I just got back from an E-vet visit, the second this week, and the news is not all that bad actually, considering the vet thought she was a very sick kid when she first saw her. They ran a lot of tests and for the most part, Buffy is healthy. The two areas that stood out as high are the TBIL and her glucose. Also, her potassium is low. Pancreatitis is not suspected according to the vet, and she's not suffering from kidney/renal problems.

But something has happened that has gotten her system run down. She definitely needs a dental and the thought is that bacteria there may have started the downward spiral. She's suffering from exhaustion but she's mentally alert.

Anyway, I'll be force feeding her every 3 hours, a 12-mL tube, with a high calorie food mixed in with her regular FF Tender Beef. She was given an antibiotic shot and will start the antibiotic pill tomorrow. She's to remain on fluids - 75 mL once/day to get her through this. She was also started on vitamins [Hi-Vite Drops]. I hope they taste good to her because they smell bitter.

Unfortunately she has lost 1/2 pound since her visit to the E-vet on Thursday morning, so we've got to get some calories into her; thus, feeding every 3 hours. She also needs electrolytes in the form of diluted Pedialyte or Gatorade, not sure which is best. Also don't know how dilute it needs to be...I'm sure the vet told me, but there was just so much to remember and the notes that were given aren't clear on that point either.

Vet said no appetite stimulant is needed, she just needs some stinky food to stimulate her to want to eat again. Also, the lethargy and stumbling may have been caused by my carelessness :sad: Apparently the Torbutrol and cyproheptadine should not be mixed. I wanted to help her pain and did something without researching. Tough lesson learned. :!:

Whew!! We've had a rough few days so I apologize if this is rambling or difficult to understand. Buffy is laying under her stool fast asleep and looks like she's somewhat comfortable at long last

 

You need to feed a MINIMUM of a 5.5 oz can of food per day. If your cat has increased bilirubin and has lost weight already you need to make sure she maintains her weight. If she loses weight she can get Feline Hepatic Lipidosis - which is liver failure. Cats get this when they don't eat enough and their body processes body fat to make up for the gap in calories. This is what Maverick almost died from. Calories are critical. Most cats can handle 40 cc's of food per feeding. Watch for signs she can't handle this though. Use room temperature food - never cold. Go 1cc at a time. Teeth grinding, lip smacking/licking, hard swallowing - all signs of nausea (and of course stomach lurching). Keep an eye out for this.

I'm not sure about the electrolites. Someone with more diabetes experience has to help here. This is high carb so I'm not sure of the impact.

PS. Don't call it force feeding. Call it Assist Feeding. This is about attitude also. We also don't want to scare others away from assist feeding if they need it. Forced feeding sounds negative when it is an amazing thing and saves so many lives.

Here's to more sleep. Many of us have been where you are.

Hugs.

Karrie and angel Maverick.

 

I've mixed together a 5.5 oz can of her FF tender beef with almost 1 can of A/D (high calorie). I only had one can of the A/D - any suggestions for a high-calorie food when this is gone? I was up most of the night doing Assist Feeding every 3 to 4 hours and haven't yet looked at the Assist Feeding info link; however, I did watch a video I found about this last year when I needed to do it, so I'm comfortable with doing it.

She isn't having the signs of nausea you mentioned, but she does clench her teeth to keep the syringe out - is that the grinding you mentioned? If so, what can I give her for this? She does relent and swallow after a couple of seconds. I'm pretty sure she won't take 40 cc. I'm feeding her 12 cc/mL every 3 to 4 hours. I believe I was told 12 cc is equivalent to 1/4 of a small can, but I'm on info overload and may not be remembering. Does that sound right?

Hoping someone else knows. I'll try and do some research in the meantime.

I certainly don't want to be negative - Assist Feeding it is :!:

She's perking up but is still not herself. I was worried all night because she didn't use the litter box [which I had placed nearby so she wouldn't have to walk]. Then I saw where she went behind the screen where her box is normally located! They are creatures of habit for sure! :razz:

Thanks for your help :smile:

 

Every cat is different. Are you feeding her more or less than she ate on her own before she got sick? If she's losing weight you need to increase calories. High fat food is actually hard on a pancreatitis cat. You could stick with normal cat food - you don't need to use AD at all. Its just prescribed by vets because of its texture but any food can be syringe fed as long as its blended well enough. Some need straining through a fine metal sieve. Its actually recommended to syringe a different food that you she wasn't eating before. This way she won't associate assist feeding to her favourite foods and form a food aversion to it. So using Binky's charts you can find a new food or a new flavour that is fairly low carb. Wellness Chicken or Turkey has 220ish calories per can but its fairly high in fat also. Just an idea.

The goal is to make sure you are feeding enough that she has no calorie gap. By ensuring she maintains her weight you lessen the odds of battling liver failure and DKA. If she can handle more than 12 feed her more than 12. Feeding through the night is a good idea for the first couple of weeks. Once you get into a rhythm it goes quicker. You can make up sleep after the crisis is over.

A tip is to prefill a days worth of syringes. Ten minutes before you feed you can stand them in warm water and they will warm up. Saves some time.

Also Make it a bonding experience. When Maverick had his tube I brushed him in between little breaks, told him how beautiful he was, and even sang to him once he started getting better and wanting to get away. Anything to keep him still. Maverick ended up being a cuddly lump of love. Prior to our tube feeding bonding sessions he was a very independent ornery kitty.

 

ALso I don't think teeth clenching is classic nausea. Teeth grinding is hard to describe. Its a grating of the back teeth and sends shivers down my spine when ever I heard it with Maverick. You'll know what I mean if you ever hear it.

 

I'm sure she's eating less. She's lost 1/2 pound this past week, but I'm working hard to reverse that. The E-vet does not believe she has pancreatitis. She did x-rays and blood work and saw no evidence.

I have some Wellness Turkey and Chicken & Herring on hand from her crisis last year. But you say this is high in fat, so in case she does have a bout of pancreatitis, do you have any suggestions as far as a high-calorie diet without high fat?

I'll try feeding more than 12 cc. I'm mixing in very little water - just enough to draw - so the food is mostly as it comes from the can.

Yes, I prefill the syringes and place in warm water. Definitely saves time!

Great tip about the brushing in between - I'll do that! Although never any problems with The Buff not being loving from day one! :mrgreen:

 

Thanks for clarifying what you meant. I know what it sounds like when humans grind their teeth so I imagine it's a similar sound. I was just sitting here wondering what to do about her nausea.

I was actually thinking of taking her back to the E-vet and see if they could give her something other than Cerenia, like the ondansetron, but they probably don't have that on hand and I don't think they'll give Rx to have filled.

 

If you aren't seeing signs of nausea, keep up with the cerenia and focus on assist feeding. Without the appetite stimulants she may start feeling better in a week or two> You have to really work on upping the calories. If she doesn't have pancreatitis - give Wellness a try. I'm not sure how many calories are in the heron forumula. You should look it up to see how it compares with the other flavours.

 

About the pancreatitis, can you ask the vet for the test result from the fPLI test? My Oliver never acted like he had pancreatitis issues, but he always tested in the grey area when tested. Shadoe was always high on her fPLI tests, in the teens and higher, but she did show signs of pancreatitis. Once I started giving her weekly B12 shots, she was alot better.

I know that many once felt that the fat should be decreased with pancreatitis, but I don't believe it makes any difference.
http://www.idexx.com/pubwebresources/pd ... itions.pdf
A portion of the above...
There are no studies to support dietary choices for cats with pancreatitis.
High-fat foods are not implicated in causing pancreatitis in cats; however, some internists avoid feeding high-fat diets when treating these cats.

 

Blue: There was a complete blood profile done but I don't see anything specifically called fPLI test - so not sure what the E-vet was referring to when she said she saw no signs from her blood work or x-rays. She's going to her reg vet tomorrow and I'll ask about it then.

A possible concern that just came to my attention: We don't feed her from the table, but I'm a bit worried that she may have gotten ahold of food scraps (roast beef) from a dinner plate left on the table, and that it may have had dry onion and/or garlic - if that is in seasoned salt (not sure). Is anyone aware of the issue with Heinz body anemia? I read it's irreversible and am very worried. Although her blood work shows RBC in the middle range of normal and HCT almost as high.

Carrie: I just now fed Buffy 1 tube of 12 mL and 3 tubes of 5 mL - so roughly 22 mL -- as not much ended up on the towel. She still isn't able to drink from her bowl - did you have to give water with a dropper? I've been putting it on the side of her mouth and she's getting a little bit to help with her dry mouth at least. I did have a time getting her antibiotic down. She gets 1/2 pill, but even that was large, so I cut them in 1/4 and wrapped in pill pocket, but she kept spitting it out. Any tips on that?

Also, the video on Assist Feeding I watched last year showed the lady very quickly feeding one tube after the other. I'm not doing it that fast, but I feel I may be rushing her. I'm thinking I may be able to get more food into her per feeding if I take longer to do it. But I used your tip and brushed her in between giving each tube. Is that how you did with Maverick, or were your breaks longer?

Dyana: Sorry, I just noticed you asked about her insulin and updating her chart. She's on ProZinc and has been since dx. As far as the chart: I'm caregiver for my elderly mother and the chart fell by the wayside when she was hospitalized 4 different times and needed much additional care for weeks or months after, so I gave it up. I'm still taking care of my mom, along with other time-consuming family things, but I'll try and update the next time I do a curve on her so I can get input on getting her regulated.

She still doesn't use her litter box but she's peeing on a rug or her blanket. I just change them out so it's no problem, but is this a common thing?

Again, I appreciate you all so much!

 

Re: Dehydration, possible pancreatitis and/or UTIs

Regarding the antibiotics pills - crush the pill into a powder between two spoons, and mix it in with a small amount of the food you are using. Then assist feed as usual. Less chance of choking / gagging on any pieces of pill, if your little kitty still isn't too keen on chewing and/or swallowing chunky bits of food on her own.

Back when my Cleo was only a few months old she stopped eating completely after an infection. I had to syringe feed her for a few weeks as she was rapidly losing weight. The method described above was how we successfully dosed her with antibiotics and appetite stimulants.

Best of luck, I hope you reach a turning point soon.

H

 

Helene & Cleo:

Thank you so much - I was wondering if it would be okay to crush but I've made so many bad decisions lately nailbite_smile Crushing will make it less stressful for me and The Buff. And yes, she had a lot of difficulty swallowing and was definitely "not keen" on doing it - kept spitting it out, even though it was in a pill pocket [which she loves when she's herself].

This is very scary. I'm so glad to know Cleo made a full recovery from her infection :smile:

I'm also very concerned about her not having BM. It seems she's eating enough for that. Could that be why she's balking about being fed? Any advice regarding this?

 

Strangely enough, I only recently remembered that we had been through this with Cleo, the whole syringe feeding thing. It was a long time ago, over 15 years ago. I was only 11 at the time, but I was the only one she'd allow to syringe feed her, so I just got on with it and did it. It was very frightening though, as no-one knew why she wasn't eating, and the weight was just falling off her. We got through it though, she started eating again eventually, and got all round and chubby again!

The only pills that you need to be wary of breaking up or crushing are controlled time release pills; these are usually things like heart medications, psychiatric meds or painkillers. Anything that states 'extended release' (ER) or 'sustained release' (SR) on it shouldn't be crushed. Or any med that has the word 'contin' in the name (like oxycontin, for instance). As a general rule, if the tablet is scored in such a way that enables you to break it in half, it won't be an extended release formulation (or if it is, it is formulated in such a way that breaking it up won't interfere with the extended release mechanism). Additionally, if the drug is prescribed to be taken many times throughout the day, it'll most likely be an instant release formulation.

Best of luck to you both!

H

 

Back from yet another trip to the E-vet. Buffy is not constipated - nothing in her bowel - but her bladder was medium full.

Also, today the doc felt liver edge. She's never had this finding on any of her exams. Praying hard but extremely stressed right now and tearful, knot in stomach.

There are so many thoughts about the food high in fat not good for the liver. The vet said cont feeding the high-cal feedings as her LFTs are not elevated.

Edit: Just tried to feed her and she wouldn't take it. She's still dehydrated after all the fluids. Not doing well at all.

 

I'm praying with you, and sending you (((hugs))). Keep thinking possitive thoughts. Keep thinking possitive thoughts.
It's good that she wasn't all backed up. She'll probably do a poop soon, when you're not looking.
Sending feel better vines to your kitty, and to you too.

 

Dyana: Thank you. She's fought long and hard but this is getting to her. Won't take an Assist Feed, won't take water, but vet said she is maintaining her weight - hasn't lost any more.

Is anyone on tonight?

 

I'll try to find Karrie and Maverick for you.
You can send her a PM if you like, too. That's what I'm going to do.

Have you tried offering her her favorite foods of all time? Any food is okay at his point. She needs to eat. Tuna, steak, chicken or deli meat (without any spices), high carb food, baby food (without onions or garlic). Vanilla Ice cream, dry food even. Let's see if we can find Karrie, okay? Did you register for the Feline Assisted Feeding Group? I would do that, now, if you haven't already.

(((Hugs))).

 

Thank you Dyana. I finally got her to eat [with the assistance of the best husband ever]. I mixed more water into the food because the vet said she found about 1/2 teaspoon underneath her tongue when she was there today. So we took it nice and slow and spoke to her, stroked her, and cleaned her mouth, and I brushed her. It took nearly 1/2 hour but I got 46 mL into her. So far, within just over a 24-hour period, she's had 1/2 can of the A/D and 1 can of FF tender beef. She doesn't look comfortable - laying on her belly with her head facing forward - not natural looking at all, but she's trying to rest.

I read Karrie's post about F&F but not sure where to find it. I just re-read her post above regarding and just noticed a link with something that helped Maverick, but the link wouldn't open for me. Do you know what it is that helped Karrie's Maverick?

I'm going to lay down for a while but will check back. Thanks!

 

The link that I think you're talking about in Karrie's first post is to a document that is only available when you join the assisted feeding forum she recommended. I can't open the link either. I imagine once you join that forum you will have access to the documents Karrie referred to.

This is the Yahoo assisted feeding forum link that Karrie provided:

http://pets.groups.yahoo.com/group/Feli ... d-Feeding/

No doubt when Karrie next posts she will provide you with more info on how to find said document, and what it relates to, if you are still unable to access it.

Rest well, you need your sleep.

H

 

Karrie, I joined the forum but am not able to open the link. Is it an article I could look for on the forum?

In the meantime, I read the articles on pancreatitis and the info really fits to a "T," including such symptoms as dyspnea and problems with coordination from one article, and this from another:
"as a CP flare up begins cats will eat less in the days leading up to it and often not eat at all when the attack is in full force." This is a very familiar scenario to me, but I didn't know what I was seeing. When you notice the signs, can a flare be headed off?

Also, the Triaditis fits as far as CP and the IBD that I've suspected: "there is a close link between CP with IBD and Cholangiohepatitis." Although I'm unsure about the cholangiohepatitis, with her TBIL being the only thing in the high range other than her BG, the Triaditis may be something to consider.

Anyway, huge appreciation for the links. :smile:

Trip to her reg vet today. She did not feel an enlarged liver, no liver edges palpated. As far as the fPLI test - her vet mentioned doing a test, but she said Buffy would have to be fasting in order to have it; however she didn't mention the name of the test. Is 8-hour fasting necessary for the fPLI? If so, that may be the one she's thinking about doing but said we'll hold off for now.

Vet said continue what I'm doing with feedings, fluid, vitamins, antibiotic, and she added metaclopramide to begin this evening. E-vet gave her another Cerenia injection yesterday, along with a B12. So that's the state of things right now. Any further advice you may have is certainly appreciated when you have time! Thanks!

Edit: I asked Buffy's vet about giving her a high-cal liquid such as CliniCare. She didn't have any but said I could add vanilla Ensure to her food for extra calories. Has anyone ever done this?

Also, is there anything I need to be careful of as far as giving subq fluids? Do I need to limit amount of liquid I put in her food - or does it matter?

 

Some useful links on the fPLi test:

http://www.vetstream.com/felis/Content/ ... b00524.asp

http://www.idexx.com/view/xhtml/en_us/s ... ec-fpl.jsf

Those sources attest that a fasted sample is preferred - but not essential.

There's a lot of further relevant info linked from those pages, which you may wish to read, but I don't want to overwhelm you.

You're in my thoughts.

H

 

Thanks for the links Helene & Cleo. I'm trying to read all the articles I can find, but my brain and body are so tired I'm not sure I'm learning much yet, but I'm trying to absorb. Some of it I know from the research I did last year when she was sick.

An update:

Buffy was given metoclopramide for nausea and I started it last night. I think it's making her drowsy. She's to get it 3 times a day, but I'm not sure if I'm doing it right. The info I can find says to take it 30 mins before eating, but it's tough to coordinate the dosings with her feedings.

She's been sleeping well since last night and isn't in the scrunched up position as much, so her tummy was hurting. She has used her litter box 3 times in the last couple of days, but she's mostly having accidents on her bed, so I'm having to keep her blankets washed up. It's okay though, I don't want her uncomfortable with a heavy bladder, and she's still having a hard time climbing into the box. Maybe I should improvise with a tray for now.

She's walking much better, not as wobbly as she was, so I'm hoping and praying her dehydration is getting better, or whatever is causing loss of coordination/muscle strength.

My husband went to get a warm air humidifier to help put moisture in the air - its so dry in the house with running the heat even a tiny bit. Maybe that will help with her dehydration as well. I'm also giving Pedialyte mixed with water.

Her BGs are staying elevated and I'm not sure if it's the illness or maybe the meds. Maybe it's something I've fed her in trying to get the calories in. She's not wanting much in the way of solids - only tolerates them if they're thinned pretty well. I attempted chicken baby food at her last feeding. She wasn't happy but I did manage to feed her two of the 5-mL tubes.

Thanks so much for the good thoughts!! We're hangin' in there :smile:

 

Metoclopramide works poorly in cats. I would ask you vet about using Ondansetron (Generic Zofran). It is one a day dosing.

 

I'll ask about the odansetron but it will have to be tomorrow. Do you know of the problems associated with the metoclopramide that I should be watching for? She just had a dose and now I'm worried.

 

See:
http://www.webmd.com/drugs/drug-8679-me ... amide+Oral

 

Okay. I just talked to the vet who happened to be open later than I thought. She's calling in the odansetron right now to CVS. She said to give it twice a day, and she also said it will cause sedation, but I think that will be okay, although it's hard to feed her when she's sedate.

Having trouble getting her to eat, hard swallowing even with water, so maybe she's still nauseous even with the metoclopramide *sigh*

Possible she''s getting too much subq fluid (50mL twice day)? Her mouth is staying dry and I'm having to syringe her water.

 

Metoclopromide can have serious side effects in cats. It is only helpful if the stomach isn't moving food through properly. You would see vomiting food many hours after eating food.

Ondansetron is worth its weight in gold. You give it twice a day 1mg per dose. If it isn't working you can go up to three times a day. And then a higher dose.

Pancreatitis can hit cats extremely hard. I really want to push you to join the pancreatitis group. They are amazing and very geeky. They are very knowledgeable on assist feeding too. The sphynx position is classic for pancreatitis also.

Focus 100% on assist feeding - not her eating on her own. Get her through this crisis. Cats will eat on their own when they are feeling better.

Let me double check my nausea file link - I assume that's the one thats not working. Sorry life is so hectic for me this week.

 

Does this work? http://tinyurl.com/nausea-file

 

Karrie: Thank you for the helpful link. Went to the drug store earlier and the Rx for ondansetron wasn't at there, and they said no Rx was called in. I just called them and they now said, yes, the vet called but left a message and they couldn't understand the med or the dose. So it will be tomorrow before I can get it. The vet did have some concern about motility because no stool was palpated, so that was the reasoning for the metoclopramide.

I'm sure I'm not doing the assist feeding right. I'm not getting anywhere near what she needs in. I have to mix the food with a lot of liquid or else she just leaves it hanging on her tongue and lips or pushes it out. But mixing with liquid just means I have to feed her more often, and she's not tolerating what I'm doing as it is.

She was sitting by the water bowl for at least 20 mins this evening. She put her mouth against the water tension several times. I was watching closely a few feet away and I heard what sounded like little sipping or slurping sounds, not licking, and the water was moving slightly, so she wants to drink. She's so miserable and nothing I've done for her has worked. The metoclopramide seems to help, but it makes her drowsy, although I'm told it doesn't have that side effect. And I have only seen that side effect listed in the linked article you posted.

She's in spinx cat mode once again, hanging her head down in front, and looking straight ahead. Her eyes are so sunken it makes me cry. I'm desperate for something that will help. She does seem to have a little more energy, but she's still dehydrated.

Is the pancreatitis group on this board or on yahoo? BTW, I joined the FAF yahoo site. Okay, I'll try to go to the pancreatitis site in the morning, if I can wake up.

 

Please do post on the pancreatitis group right away. Pancreatitis can make a cat very ill. http://pets.groups.yahoo.com/group/Feline_Pancreatitis_Support/ You will probably have to do home fluids.

They can help you get through this crisis.

Would you consider a feeding tube? They are life savers. Many cats on FDMB have had them and recovered. On the FAF site thousands of cats have had them. It is a non invasive procedure and the cats adjust quickly. Maverick was critically ill and recovered with a tube. It bypasses their mouth and ensures they can get the medicine and food they need.

Please post tonight.

And are you checking for ketones? Not enough insulin, infection and not enough calories are the combo for this.

Sending you and your sweetie big hugs. You two can get through this. Every tear and lost minute of sleep is worth it. Keep hanging in there.

 

Hi Karrie, I tried to join the group but I got an error page and said try again tomorrow.

I would consider a feeding tube if done without putting her under. I don't think she could get through any type of anesthesia in her present state.

I made myself a makeshift bed beside Buffy's bed. When I fell asleep around 10:00, she was in complete misery, in spinx mode and hanging her head down. I woke up at 11:30 to find her sitting in the doorway. I picked her up and carried her into the kitchen where we gathered her midnight snack. We also took a quick tour of her domain, aka the house. She wanted to look out of the windows in her favorite spots in the dining room and entry hall. She tried to hide behind some furniture, but I was able to maneuver her away. She did pretty well with her feeding -- managed to eat four 5-mL tubes of FF tender beef mixed with water. I know she needs to do better than that but she wouldn't have any more. I suppose I could do more frequent meals with less quantity. Also, I dissolved a famotadine tablet into it as well, so hopefully that will give her some comfort in the short term.

No, I haven't been able to check for ketones as she never goes near her litter box while I'm watching. Actually, except for 3 times this week, she's peed on her bedding. I wonder if I could check ketones with her wet blanket? It's pretty well soaked when she goes. I'll take her in and have the vet check her if I can't do it.

Thank you for the encouragement. You're absolutely right, getting her through this is worth way more than my comfort and I don't mind at all doing without sleep, etc.!

Edit: She went in her litter box **YEA** but again, I wasn't watching so couldn't catch a sample. I did try to check ketones with the pee in the box, but of course it didn't register. :roll:

 

Pancreatitis is very painful; what pain meds are you using. I looked but did not see any mention of something for the pain. What is usually given - buprenex - will make a big difference.

 

Blue: I did give her an Torbutrol on the 9th and after that she went into a downward spiral.

She had been to her vet that day, had been given cerenia and fluids because she was dehydrated, and when she got home, she went straight for her water bowl, whereas she had not been drinking, just hovering. I thought that meant that her nausea was gone, so I gave her a cyproheptadine to see if it would help her appetite.

A little later she seemed in pain and I gave her a Torbutrol that she had been prescribed back in August. I didn't realize the two meds were bad when used together. This sent her into a downward spiral where she became even more dehydrated and it took several days for the meds to clear, so I haven't given her another Torbutrol out of fear and vet said there was nothing else to prescribe.

 

She is a very sick kitty please join and post on the pancreatitis board. Do what ever you can to get a ketones test in fresh urine. Hugs.

 

You can get a naso gastric feeding tube to get her through this crisis without putting her under. They clog often and you can only feed a liquid diet. Climate is like twenty five percent carbs. But it can help save your baby.

 

I have always checked for interactions... easy enough tool to check which meds don't mix well.
http://www.drugs.com/drug_interactions.html

I had always given Buprenex to my cats for pancreatitis issues; maybe you can ask your vet about it for pain... pancreatitis is very painful, so if your other pain med interacts with other meds, get something different from your vet.

 

Thank you, very helpful tool. Here's what I get when I enter cyproheptadine with either the torbutrol or the buprenex:

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

 

if you look just above the MONITOR notes, you will see that the interaction shows as moderate for both.

if you add another drug, tramadol, which is also used by many for other pains, you will see a very different interaction ... MAJOR and there is a fair amount of details below that red MAJOR ! to explain.

if you add another common pain med used for everyday chronic pains, gabapentin, you will see that it does not interact as badly with the rest of the meds in your list.

the drug interaction checker is a very good tool; I check any new med before giving any to my cats.