PANCREATITIS?! (+PHOTO!)

So we had a GI panel done and sent to Texas A&M on Monday. The regular vet called to say the fPLI was elevated which seems to indicate chronic pancreatitis. However, we also had the results sent to the specialist and she states you need more than one set of numbers to know it is chronic.

"Based upon these results we can't say whether or not this is chronic pancreatitis. We would need repeated levels to determine that. Elevated fPLI can be indicative of intestinal disease, however the rest of the GI panel ISN'T supportive of intestinal disease."

So . . . . this is semi good news? but confusing . . . After further research vomiting is listed as a less common symptom of pancreatitis. However the vets all ask about it every time like its the worst possible thing. I'm pretty sure for Tigger it is a sign of chronic disease. He has vomited a lot over the years but the constipation is newer. So IF its NOT pancreatitis, and not Intestinal disease . . . what the hell is it? Last year the vet finally hypothesized that this vomiting was from chronic constipation. We switched him to fiber response food and the vomiting stopped, the need for miralax stopped, he was perfect. Then when it all came back - with new and worse issues, liver levels were elevated, we treated with denamarin and steroids and here we are at diabetes.

I don't really have a question I just wanted to vent. So far Tigger is doing pretty great for a kitty who almost died. I just want to get him as healthy and regulated as possible. He really is such a good boy!

 

What a cute little face! I know how you feel as I've gone through the same thing. I've needed to vent lately also. When Leo's IBD was flaring his fPLI was always slightly elevated. His protein was always elevated some too. His specialist said it was an indication of inflammation. Have you had ultrasounds done on his abdomen? This can show any intestinal thickening and any lymph node enlargement. It all seems to be inter related sometimes and one can effect the other- liver, intestines, pancreas. It is confusing and takes several tests sometimes. My Leo had an endoscopy done with biopsies and it showed mild inflammation so his diagnosis was IBD.
I really didn't want to have him go through all that but it did finally confirm what he had. (not that this was his only problem) When his IBD calmed down his fPLI went down too along with any inflammatory markers.
Unfortunately it can come and go which is what makes it so maddening. Food changes worked for a year at a time then all of a sudden it didn't. Search was on for another single protein limited ingredient diet again. He also had transient diabetes which went to remission after taking him off dry food. His glucose still spikes when stressed but so far not enough for insulin.
Good luck with your very cute kitty. I know exactly how you're feeling.

 

You cannot diagnose a GI condition just from a blood panel. I think the next step should be an ultrasound. My girl's results from the Texas A&M panel were normal. The ultrasound showed bowel thickening.

Cute face.

 

Ooh no, he can live.

Get him back on the Miralax - 1/8 for constipation, 2x daily - do this at least 2-3 days, and watch. My cat Fena had 4.5 days of Lactulose then 3 days of 1/8 Miralax - get your baby back on it, NOW - at this point my baby needed a mix, 1/8 in morning and 1/4 at night.

For food, blend it - in blender or food processor - FF food, Friskies 1/2 can, Special Kitty or 9Lives 1/2 5.5 can or 3oz FF - blend with 2-3.5 tablespoon hot water, doesn't matter if the food is 3oz or half of 5.5 - go with 3tbs at least. If you need to assist feed please contact me, I've done this before.

Can you get another RX of Cerenia? This will help him not throw up. Plus CBD oil.

Your baby WILL be okay, you can message me - I'll have a ton of questions, hope that's ok?

 

My boy had chronic pancreatitis for years that led to his diabetes. He was only in meds for nausea and sometimes appetite. He almost never vomited but some do. He didn’t have IBD. I agree with Wendy that an ultrasound is a good idea.

 

He had an ultra sound back in May before the Diabetes DX. It wasn't really definitive of anything ("probably Triaditis") and at the time the only thing elevated in his blood work was his liver levels. We tried the Denamarin which helped the levels but he still vomited maybe 1X a week. Vet suggested steroids Vs biopsy and we opted for less invasive choice. Boy was it the wrong one! After the hospitalization for DKA the emergency vet believes it was chronic pancreatitis, though was still not sure herself. He had another ultrasound (2 in fact) while in the ICU and neither confirmed any diagnosis. Again, there was "mild, general inflammation." Since we knew he now has Diabetes, they recommended we get him on the insulin and check a GI panel and that's where we are today.

He eats very well, drinks well, poops good as long as he gets the miralax . . . . . but he has still vomited. I'd say possibly a little less than before and often its just a hairball but with a full tummy there is sometimes food as well. He only vomited straight food twice in the past 2 months - both times I gave him a small dose of cerenia after and he seemed fine. He has on occasion spit up clear/slightly foamy water which I'm reading is acid tummy. Its interesting because both times it was 6 and he seemed really hungry but we T/F/S at 7. We're getting into our favorite season here in New England and the cold weather leads to more snuggles, which he seems VERY into. Next comes winter bird watching. He may not be as playful as our younger cat but Tigger really never was. He was an old soul when we rescued him from life in the ditch all those years ago. Even the regular vet who hadn't seen him since that dreaded day 2 months ago said we were doing an awesome job with him. He gained back almost an entire pound and he looked pretty darn healthy to her!

 

Leo would always spit up clear liquid in the mornings at one time. I found that putting food in a timed feeder so that he had some food in him over night helped a lot. It had something to do with the acid build up over night and having too empty of a stomach for too long. It sounds like other than the vomiting your kitty is doing pretty well if he's eating, pooping, and gaining weight!

 

He's so cute.

 

If it's a lot of foamy throw up, my Mao had this 3 days ago and I put a tiny pinch/sprinkle of baking soda on his food - it was tiny, and it seemed to help. That 1 time, no more throw up at least thus far. Cerenia is anti-vomit, but not anything to do with stomach acids, etc. so you might want to ask about that. Maybe Pepcid, etc?

Once my car's back from the shop, Mao is going in - since the schedule and diet change to wet I've been seeing things in him that worry me a bit.

 

Tigger seems to vomit once a week. Every week. For almost the entire 13 years we've had him. He likes to vary it too. One week its a massive furball, next its food, then maybe some foamy water. Normally if he gets his miralax without one missed dose he's fine. Lately though he's still having the acid tummy because he wants to eat at 6pm and I make him wait until T/F/S at 7. At night I can give him a midnight snack. During the day his auto feeder isn't timed - it opens per each kitty's microchip. Had to keep his fat brother away lol. I try to feed him his whole can of FF kinda slow in am - like take a whole hour since he's a grazer. Then last minute before leaving I put in a Sheba PP too, or even another half can of FF if he seems good and hungry. If he leaves it until lunch I have no idea.