? Pancreatitis-- when to do sub-Q?

Hello all!

I have a question for the folks dealing with chronic pancreatitis along with feline diabetes-- when (how often, under what circumstances) do you generally give sub-cutaneous fluids? On a regular schedule or just as-needed (and if as-needed, what's the trigger?).

My cat's history: two acute episodes in the last month or so (probably some undiagnosed earlier milder episodes before the diabetes diagnosis) with vomiting and a trip to the vet for fluids and pain and anti-nausea meds. On regular home B12 injections for the last month, no other regular meds between attacks. I have a bag of sub-Q fluids and all the gear at home, ready to go, but haven't tapped into it yet. I am considering it this morning-- Amber is overall in a very peppy mood (energetic and good appetite), but has vomited twice and her bg numbers are elevated, which makes me think she might possibly be heading into another episode.

So, do I start some fluids now because of the vomiting and (maybe????) to head off the worst of a developing attack, or wait until she shows signs of dehydration (she doesn't, currently)? Should I have been doing the fluids regularly all along as a preventative measure? I should say, I've done fluids at home for other cats (fosters, not for chronic disease) in the past, but I'm a little hesitant to start with Amber just because she's a bit of a diva and the fewer interventions I have to do with her, the easier the critical ones (testing and insulin shots!) are. But if there's some preventative value-- when I talked to my vet we only talked in terms of reactive care, so I don't know...

Thanks for any insights or suggestions!

 

See my signature link Secondary Monitoring Tools for 2 ways to check dehydration. If your cat is dehydrated, your vet should instruct you on the amount to give and on what schedule. By assessing the dehydration yourself, you can keep the vet informed and get instructions for adjusting amounts as necessary.

 

Thanks... Does this mean that the only time you'd ever want to give fluids is if the cat is actively dehydrated, that there's no benefit at all to giving them pre-emptively? My current instructions from the vet are to give a certain amount "as needed", I'm just trying to suss out how best to define "as needed" because she wasn't very specific about that (and if I call the vet's office about this today they will a) tell me to bring my cat in because she threw up, or else b) take several hours to return the call, by which time the situation will likely have changed). If it's just a straight-up dehydration test, though, that's pretty clear!

 

Nan, I hate to hear that you think Amber is about to have another episode!! Sending prayers and vines to you both!

 

Thanks! As it turns out, I'm now hopeful it's a false alarm-- Amber's bg numbers took a big dive at +2 so I'm thinking maybe the elevation at pre-shot was because she was just about to throw up, and it was "just one of those things" rather than the start of a new episode? Fingers crossed, and thanks again!

 

Good news! please keep us updated!

 

I've never given Saoirse sub-q fluids. When she had her really bad flare just after diagnosis I added a good bit of water to each of her tiny 'micro' meals. In a spreadsheet I tracked the food she ate, her water consumption her urine production (Cat's Best OKO Plus clumping litter or similar non-pellet, wood-based litter helps with this), her poops and her weight. With that info I was able to keep her properly hydrated.

Glad to hear that Amber's BG has improved.


Mogs
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I have give sub q before not with Magellan but another he was on daily fluids due to kidney failure. It is neither hard or scary trust your instincts and listen to your cat she will let you know when it is needed.

 

Thanks guys, that all makes sense. So, basically, the pancreatitis itself doesn't care about whether I give fluids or not, the fluids are just there to counterbalance dehydration if she's vomiting a lot during attacks. There'd probably be no value to giving the fluids early in an attack in that case-- I guess if they made her feel a little better it might reduce stress if that was the trigger for an attack, but that's about it.

Oh, and it was a false alarm on the possible attack yesterday-- after the vomiting and high bg, Amber threw me a swan dive into the 40's to keep me on my toes and is now happy and healthy by all appearances

 

Thanks for the very explicit directions
They are very helpful. Suggestions for.how to handle a cat who defends himself aggressively against being checked?

 

I'm new at dealing with pancreatitis but have learned quickly since dx on March 9. Smokey never received fluids.

He is getting cerenia for nausea and vomiting. He has always vomited even before knowing about p'titis. He was getting 16mg daily, then down to 4mg daily. Now trying every other day. He has stopped vomiting but he just isn't ready to give it up daily.

Also receives Buprenorphine for pain as it's a painful disease. We are trying one dose every other day now. Not sure how that is working yet as we just started the every other day and today he is not himself.

Is it possible for you to get a script for them and have them on hand when you need them?

 

I have discovered there are feline pain meds dosed through fentaynal patches (or a similar opiate based analgesic) and there is also a tube based opiate (ie the meds are liquified in a gel dispensed through a tube applicator) which can be applied to the inner side of the ear tip. Both the patches and the gel make it easier to insure the receipt and amount of the dosage. Also there is dependable research that questions the efficacy of Buph in feline chronic pain management.
If you have a trusting relationship with your vet you should be able to get an rx for these meds. However these are Class 2 controlled narcotics so a vet is going to use caution in prescribing them. They are cost effective and easy to apply.

 

Glad things are better. Having been an MD before I retired (although my practice was adolescent psychiatry) there is a medical reason to "get ahead" of dehydration... adequate fluids help prevent some of the damage caused by a severe pancreas flair by providing more vascular inner fluid space for accumulating enzymes thus limiting (not preventing) potential damage. It is prophylactic in nature.
The other thing I've learned in the last 2 months is that 3 or 4 meals a day of baby food jared meats keeps Sox from vomiting as much or at all. After a few days I return to his regular low fat diet.
It is so stressful watching these episodes occur!

 

Yes, the vet can be an obstacle. The ER vet would not order a bottle for me. But my vet did as well with a bottle of metronidazole for me to keep on hand. Diamondback pharmacy will ship direct to you. Make sure they know no flavor enhancements or sweeteners should be added.

 

Aha! OK, revising, then: it may actually be a good idea to give fluids early in an attack (esp. when vomiting is a player) in an attempt to limit the severity of the flare. Very good to know-- and yes, it is very stressful when the episodes occur, that's one reason why I was asking, I desperately want to be doing something to make her feel better faster!

Thanks!

 

Fluids will generally help to feel better.... if your cat has a history of heart issues or anything else that would contradict fluids would be a reason to check with your vet.... we go thru lots of fluids at our house
I agree it is not stressful or scary--just takes getting used to...
1 FD
1 CKD
fluids by the case
Litter by the truckload

 

Thank you very much for this valuable information. Much appreciated. (My girl has chronic pancreatitis.)


Mogs
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