? Pancreatitis - is this normal?

Jester's been doing pretty well the past couple of days - his food intake has been increasing and yesterday he ate about 2.5 cans on his own.

But mornings he seems to need a *lot* more prodding to eat what I would consider a reasonable amount of food. It took about three hours to get just over 1/2 a 5.5 ounce can into him, and that was with me encouraging him a lot.

I wouldn't call him exactly lethargic, but today he was sitting a lot in a crouching loaf position and he slept on my lap for over an hour before noon. (Right now, he's snoozing under a chair on top of one of my sweaters that fell behind it. It seems to be his favorite place to nap lately.)

Is it normal for a kitty recovering from pancreatitis to backslide?

Info on his current medical regimen:
He had been on cerenia Wednesday through Friday (usually in the evening), along with one injection on Monday, but I decided to take him off with yesterday's feast as it started around 3:00PM.
Also. he had an injection of B12 yesterday morning.
He's about halfway through the antibiotic prescription.
This morning, after a bit of a lackluster appetite, I decided to give him another cerenia dose - which doesn't seem to have made much of a difference.
His BG generally has been on the low side and I haven't given him any insulin since last Saturday.The highest reading he's had in a week was a pre-bed 213 on April 22nd. But on April 21st his PMPS had been 185 and after I gave him .25U the next day's AMPS was 107 so I haven't been comfortable dosing him. (His BG for the most part has been going down steadily even without insulin until the last couple of days when he began to eat a bit more.)

@Marje and Gracie and @JanetNJ - do either of you you have some time to weigh in?

 

If it’s chronic pancreatitis it cones and goes. Were you or are you still giving something for nausea? I always would start Max back on ondansetron if his food interest started to decrease.

 

Here's the thread with all the previous information regarding Jester's pancreatitis.
http://www.felinediabetes.com/FDMB/threads/jesters-latest-labs.194686/

 

Okay. I just looked quickly at your previous condo. It sounds like chronic pancreatitis to me. Max had his first bout when he was 12 and his sister was dying from lymphoma. He lived to 19 and was only hospitalized for it once or twice. My vet told me that it’s best to feed small amounts often, as in at least 3-4 times a day. The reason is when they start to feel better, if they eat too much at one time they start to feel bad and stop eating. Max rarely vomited. His nausea manifested as inappetence. I always had ondansetron around which he got at the first sign of his appetite starting to wane. I hope this helps. Have you heard back from your vet?

 

This sounds like he might be in a bit of pain-- is he on anything for that?

 

No.

He's eaten almost two cans now. It just takes a few sittings to get there.

And he did eat more in one sitting in the evening again.

UPDATE
He's cuddling on my lap now.

 

. I have a 16 yr old non diabetic cat with chronic pancreatitis and she gets 1/2 cerenia tab every day and 1/4 Mirtazapine every 3rd day. She's doing well and eating. She has had a couple ill bouts but it seems like keeping her on these meds without fail keeps her stable and eating. On top of this she's also blind and almost completely deaf but she's still very happy.

 

Are you all suggesting that it's possible Jester should be on both these meds permanently?

 

Possible, but I don't think it's all that common? I'm not really sure. My own Amber has had a few pancreatitis flares serious enough to need meds, but she has long (months/years) gaps in between with no meds needed.

 

If he needed those permanently he could be on those meds permanently. Trial and error would tell you what he needs I guess. In my case my cat will vomit if I stop the Cerenia. I buy it through PetSmart to get a cheaper price. She recently got the fPLI test and was found to have a high degree of pancreatitis that appears to be chronic. She's doing very well now.

 

Max was on and off his meds. I found that when he got the correct dose of nausea medication he didn’t need an appetite stimulant. At first I was giving ondansetron and cyproheptadine both. Once I got the ondansetron dose right the cyproheptadine wasn’t needed. He was a large cat so he needed a larger dose. I went months without needing to give him meds and if caught early enough when I did need to give them it was for a short time. Every cat is different. You will learn what works. I did wait until he was back to normal for several days before weaning off ondansetron and if his appetite decreased started him back on it immediately. I always had a supply here.

 

Phoebe has pancreatitis and has to take cerenia and zofran everyday. Actually zofran is 2x a day. If I try to go every other day she pukes. You'll learn what he needs.

 

UPDATES:
Sunday, while Jester ate a total of just about two 5.5 cans of cat food, I had to do a lot of persuading, encouraging, and breaking the rules of where the kitties can and can't eat. (A lot of his feeding happened in the living room - which is normally taboo.) I also had to switch foods a few times from pate to textured.
He shows no problems with stretching and sharpening his claws on the rugs.
He also wanted to sleep on my lap a *lot* on Sunday (at least three to four hours total over three different sleeps) - which I indulged because he's my baby and ESA and I'm still incredibly worried.
FYI - This isn't something that happens on a regular basis. He does like to sleep in my lap, but not for over an hour at a time. He usually comes over for such snuggles later in the evening / night.
Also, he sits in a crouched position a *lot* - even when he's eating. Sort of like the loaf position, but with his front paws visible as though he's going to get up at any moment.
Sometimes I'll go up to him to stroke his skinny body and he'll relax, lay on his side, then roll over and let me skritch his belly and neck. Much purring ensues.

This morning (Monday), Jester's appetite was back and he ate over half the 5.5 ounce can with little prodding from me, and nearly the rest of the can with some encouragement. And I didn't have to change food textures at all.
However, I get the feeling he's associating something negative with his usual eating places as the majority of the time he ate underneath the dining room table.

As an FYI - Jester is still on antibiotics. I dosed him with B12 on Saturday morning and skipped the Cerenia because his appetite was good. But after he seemed less inclined to eat on Sunday morning, I gave him his quarter pill of Cerenia around 9:30AM. It didn't really seem to make any kind of difference.
The vet is prepping more B12 syrnges for Jester free of charge, but wants me to limit it to just a couple of times a week.

 

Have you already run a course of trying lots of foods to see which ones appeal the most? I think for Pancreatitis they aren't supposed to eat the higher fat foods . I found my Cali can't eat fish and strong smelling foods anymore. She seems to find one food she likes and eats only that for a while, then gets board and I find another selection. At least now I know what not to feed her. This is just my opinion but I think the Cerenia isn't what controls their appetite it helps stop them from vomiting. So I would just keep giving that regularly every day whether Jester eats well or not. That way you don't let it get to the point of feeling bad. Have they ever told you to try Mirtazapine for appetite? It seems to affect all cats differently. With my Cali it makes her feel happy and playful.

 

That's a sticky situation. Whenever I experiment with Jester on different foods, he has a tendency to stop eating entirely. While I do try some different flavors and textures with him, the only brand I currently feed him is Friskies.
We had a bout last fall when I experimented heavily trying to get him on lower carb foods. His BG went down and he went into remission, but he stopped eating almost completely for ten days.

Jester's a picky boy. I can't argue with him about foods. He'll either eat it or he won't. And right now the food that he will eat is a Friskies flavor with turkey, gravy, and cheese.
Considering his last weigh-in was less than 8 pounds (and his normal weight pre-dx was 12.5), I'm not messing around with his food.

 

Is Jester diabetic too? Yes, I was saying the same thing.....it's about trying a lot of foods and seeing which ones they will eat. They can sense what makes them sick and what doesn't. When you get a sense of what they like you can look for foods in that range. I think usually it's not the fatty rich ones. With my Cali she liked Friskies Indoor Salmon Pate for a long time and right now she really likes FF Chciken and Tuna in a sauce with rice and spinach. She's not diabetic though.

 

As I stated before, I can't experiment with Jester on foods. He will simply stop eating and that can last for days.
I don't mean he won't eat the items in front of him. I mean he will cease to eat completely.

Yes, he's diabetic. His info and SS are linked in my signature.

 

OK, I thought it sounded like you were having a hard time getting him to eat, and just wondered if he'd eat better if you happened to find just the right food. But maybe it's about the pancreas healing first.

 

Ah. I see.
No - he's been "off his feed" off and on for a while now. I generally have a good handle on the choices of what he'll eat. It's just figuring out if he isn't eating because he doesn't feel well or if he isn't eating because he's being intentionally picky.....

 

How is Jester doing now? From what I've read it's important to keep a cat with pancreatitis eating at all costs. The pancreatic enzymes can eat away at the pancreas itself if they don't have food to digest. That's why I would say to even try Mirtazapine if you think Jester isn't eating enough. Once they get on to eating very regularly then they do feel better. When they feel better they eat better too so it's like a circular problem.

 

He's doing a lot better from all indications. Eating much more normally and finished with his antibiotics.
We have a followup with the vet on Monday. If he's gained any amount of weight back at all, I'll call it a success.

Thanks for asking!

 

That's good. You are lucky you got him diagnosed too. Cali was a mystery to the vets here. For a year my one vet thought she was hyperthyroid and had her on thyroid med ! I hope all goes well for Jester !

 

My cat also has chronic pancreatitis and has random bouts of not feeling well. I don’t give him anything for meds but I do make sure he finishes all food and keep an eye on his BG levels. I also keep an eye on water intake and coax him to drink to stay hydrated. Hope he feels better!