Do you know your vet is treating for pancreatitis? If so, the Prednisolone dosing your vet prescribed is not out of line. Keep in mind, up front, the focus is getting things under control and then the dose can always be adjusted. What you don't want to do is give a suboptimal dose that won't help because then symptoms can potentially worsen. It just so happened that when T had his first flare, which wasn't severe enough to require hospitalization, our regular vet started him on the 5mg and it was effective. When I sought additional diagnostics and an internal medicine opinion after getting the TAMU full panel GI lab back indicating pancreatitis, the prednisolone was not increased because he was responding well to the dose. After he was doing well and we were able to discontinue the subq fluids, cerenia (no buprenex required the first flare), we then made the attempt to reduce his Prednisolone to find a least effective dose &/or attempt to get to every other day dosing OR discontinue it. Unfortunately, as we reduced the dose, he began to become lethargic and eventually by Day 3 of discontinuation, he would vomit a small pile of spit and be in pain again. The time that a flare can last can vary. I have had times when Tomlin looked a little uncomfortable and I would increase the Prednisolone to 5 mgs for a few days and then he would be fine. When he is more significant flare, it has taken a few months to get him completely back to baseline where he is off all meds except for the Prednisolone and up and about doing his normal routine. Typically the worst part of the flare, when he doesn't want to eat and its lethargic, can be turned around within a few weeks if managed aggressively (aka IV fluids if needed OR if not requiring IV fluids, increase of the Prednisolone and use the anti nausea and pain meds along with sub q fluids depending on what is required).
Testing- A full TAMU GI panel is important. I am assuming they either did the full panel or just the Spec fPLI which is what is used to determine pancreatitis. With this particular test, fasting is preferred but NOT essential for accuracy of the test. I have done them fasting and non fasting and did not see significant differences even with tests repeated within weeks of each other.
With regard to acute vs chronic. There will be some cats that experience an acute episode that is so severe that they require hospitalization but then they recover, meds are slowly discontinued and they never have an issue again. Unfortunately, a fair amount of cats end up having chronic pancreatitis where either meds are discontinued and they are fine but then experience a flare again later or like my T require medication every day. The number of flares, how bad they are, what meds are required will differ with each cat. T had his first flare and then no additional issues or symptoms for a year and then he had another flare. He then did well with no additional issues for 4 years just taking Prednisolone and eating a low fat diet. Although fat is typically not an issue with cats with pancreatitis as it with dogs, it IS a very big issue for T. Again, trial and error to figure it out.
I will say that IF YoYo is experiencing a serious pancreatitis flare & is really not doing well, IV fluids are key and can really turn a cat with a more serious pancreatitis flare around much more quickly. I have done this and it helps significantly. Sometimes you can get away with doing 1 or 2 days of 12 hour IV fluids during the day at your vets office vs leaving the cat overnight. I know and completely understand and empathize with not wanting to take the cat into the vet given the experience you had, but IF there is someone you are able to trust and could help you with this that would be great. It is important that the pancreas is well perfused with blood and IV fluids are the mainstay of treatment to make sure this happens.
Buprenex is very helpful. Pain management is important. However, given that the prescription was given in the past I would want to run it by a specialist first. I say this because you want to make sure, as with any medication, that there is nothing going on clinically or with the labs that would make it not the best option for YoYo. Heart, thyroid health etc.. All of this comes into decision making regarding the use of any drug and the dose of a drug. Best to be safe!
Hang in there
Thank you again.....I have Yoyo on sub-Q fluids (lactate ringer) mixed with Complex B vitamins and he gets B12 injection once a week for about a month....He was in the hospital for IV drip on 5/26 for about 5 hours and then I returned him to the vet on 5/27 and he was supposed to have received IV fluidsall day but honestly I am not even sure if he did, they told me he did but that same day he had the ultrasound done as well. When he went home I asked for sub-Q fluids but I was told he did not need them!!
He has had full chemisty, CBC, T4, Urine culture and sensitivity(which came back negative ??) and the SPECfpl test which came back at 4.3 and he was fasted as I did not give insulin that day. They did full blood on 5/26 and 6/10. On 6/10 is when he started to have seizures when I got home from the vet. He was very weak. His blood wk is posted on his SS if you would like to look at it. His IDEXX SDMA has increased from 18 on 5/26 to 19 on 6/5/20....that concerns me....he used to be at 12 and 14 on the IDEXX SDMA. THe SS does not show this nor does it show his reticulocytes...I have all that if you want to know it.
His ultrasound report I can send to you as well, but it shows NORMAL pancreas and possible pyelonephritis.
Is Buprenex the same as liquid formula buprenorphine(bupe)? Vet said that I could give RX from last year but then when he started to have seizures I did not give the bupe. But now he has started pred on yesterday, 1/2 tab(2.5mg) 2x day, but today is the first normal dose of 5 mg 2x day.
He started fluids 3 days ago.
He urinates a large quantity and that makes him weaker, he has been urinating large quantities for weeks now and I tell the vet with no response back. I know the fluids now will make him urinate more too, but he has been urinating excessively way before the fluids ( I see his peepee come out).....he has started to drink and drink and doesn't want to stop. But eventually he does stop drinking.
He sleeps and sleeps. He will move locations, yesterday he surprisingly went upstairs, he hasn't gone up in over a week!
He will not eat. He shuts his jaws tight on me. But I finger feed him and when I get his mouth open he does swallow the food and he doesn't look sick eating it. He doesn't like when I add chicken liver to it but I do it for his anemia. I also put steak in his food and hard boiled eggs. He doesn't mind the hard boiled egg as it is all dissolved and mixed in his canned pure' food. He also gets pumpkin for constipation and he has been fine with normal stools. He likes pumpkin on a good day, when he feels good!
I gave him cerenia in the beginning, I don't think it did much, he still won't eat. He only vomited once about 2 weeks ago.
I tried ondansetron but again I only gave it once and I didn't see any relief.
I still have cerrenia and ondansetron to give, along with bupe and the pred. And he takes zeniquin 25 mg once a day. And he takes felimazole 2.5mg 2x day for hyperthyroidism.
On 5/26 he got an injection of Convenia, which I read can cause anemia too! That is why I waited to give zeniquin until I believe it was 5/31 because I din't want to mix the convenia shot with zeniquin. I aksed for zeniquin because he got very sick back in 4/2018 with a high fever and no one knew the cause. He had convenia then too and a snap fpl test was done back in 2018 and it was normal. But whatever he had back in 2018 cleared up with zeniquin.
Also 12/2017 Yoyo had his left front leg and shoulder removed due to cancer. After the surgery where hi did not lose any extra blood, he had to have a transfusion as his HCT went low, I think under 14.
Also as a baby when he was neutered he would not heal. His incision would not scab and he got anemic. Special blood work was run, a long funny name I can't think of, and all came back negative. Further testing rrquired that I send Yoyo to Texas. That was not happening!!
So Yoyo has a history of anemia that is unknown cause.
Please let me know if I can give you anymore info. You are GREAT and I appreciate all of your time and help. Many thanks!!
), anyway, the concentration was almost double his usual. I didn't notice and he acted like a drunken sailor until I halfed the dose. Neko was fine on her dose from the get go. Vetty said to give it at night the first dose, when they are going to sleep anyway.
