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Remission & diagnosed with pancreatitis? Looking for help/information

Discussion in 'Feline Health - (The Main Forum)' started by Sudio3, Aug 13, 2019.

  1. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Hello,
    My cat has been in remission for about a month. His sugar is usually in the mid 100's, however, I could tell he still wasn't feeling well and his bloodwork came back that he has pancreatitis. The vet said it was mild, a rating of 5.5 and I guess the healthy range is between 1-3? He's an older boy around 15 years old. Just wondering if anyone else has dealt with this and has any advice for my boy?

    Thank you so much!
     
  2. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    I am sorry Nudio isn't feeling well and has a dx of pancreatitis. I haven't had to deal with that myself, and to get more eyes of members who have, please change your title to ask the question, such as use the ? icon then Help, Nudio has pancreatitis. Many members have dealt with pancreatitis and I'm sure will be willing to chime in if they know what you are asking for.

    Here is information on pancreatitis:
    http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

    What treatment did your vet advise?

    @Bron and Sheba (GA)
    @Tracey&Jones (GA)
    @Jill & Scooter
    @Marisa Licata
    @Marje and Gracie
     
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  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    My Sheba used to get bouts of pancreatitis after she went into remission the first time.
    Has the vet given you pain meds and anti nausea medication?
    How is his appetite? And hydration?
    Sheba’s BGLevels would go up for a couple of days initially then go back to normal after treatment started.

    Looking at your SS it looks like you could have stopped insulin too soon. It would have been better to reduce the dose to 0.5 then 0.25 then a drop before stopping the insulin. To get a strong remission it is best to aim for BG levels to be in the normal range 68-150 for 2 weeks without insulin before saying he is in remission.
    Nudi has several higher than that numbers.
    Have you tested his BG level lately?
     
    Idjit's mom likes this.
  4. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Thank you I will do that. The vet said we could get an ultrasound to make sure there is no cancer. Then she said we could try weekly B12 shots and try to switch to ID diet which I guess is supposed to help with inflation. I think she also mentioned enzymes if needed. That is all she said. She said we just manage symptoms if needed. He is not drinking a lot of water and he’s still eating but not as much as normal and he has lost one pound. Thank you so much!
     
  5. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    No pain meds or anti nausea medication. She didn’t even mention them. Is that something he should have with this diagnosis? He’s eating but not as much as usual and he did lose a pound from the last vet visit a few months ago. He’s a big boy though and not skinny. He’s not drinking a ton like he used to when he had diabetes. The vet said we could get an ultrasound to make sure it’s not cancer, that we could do weekly vitamin B shots, change his food to ID or perhaps give him enzymes. That is all she mentioned.

    It’s been a month without insulin and he’s numbers have been steady always in the 100’s usually around 150? Today it was 160. Maybe I’ll check more often just to be sure it’s not going in the high range. He’s been testy about us pricking his ear lately and gives us a hard time though. Thank you so much. I appreciate any info you can give regarding his diagnosis.
     
  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    The usual treatment for a pancreatic flare is pain meds (often an injection at the vet) then pills to take home, antinausea injection at the vets and pills to take home and some subQ fluids if the cat is dehydrated. The fPl of 5.5 is above normal but not a severe pancreatic flare. Sheba sometimes got a result like that and she needed a pain injection, antinausea injection and subQFluids on the first day and often that was enough for her to recover. Other times she needed extra oral pain meds and some oral cerenia or ondansetron for the nausea.

    I would definitely not let your kitty be put on Hills ID food. It is very high carb (30 carbs and that is the canned food).. the dry would be higher.
    Ordinary low carb canned food is suitable for cats with pancreatitis.

    I would check his hydration to see if he is a bit dehydrated. Cats witha pancreatic flare are often a bit dehydrated and some subQ fluids make them feel much better. You could try adding some extra water to his food if he will eat it that way.

    I'd keep checking the BG daily at the moment. If you can keep the SS up to day that would be helpful. Up to 150 on the Alphatrak 2 is within normal range. Try taking his BG, feeding him and then taking the BG again 2 or 3 hours later. If the pancreas is working, the BG should drop after food.

    He shouldn't need enzymes with pancreatitis..
     
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  7. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    As far as I know enzymes are used for Exocrine Pancreatic Insufficiency (which is different from pancreatitis) and it is highly recommended that testing for this condition be done before giving enzymes.

    Enzymes are not used for pancreatitis flares.
     
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  8. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    Jones was put on B12 shots, Cerenia for the vomiting when he was diagnosed with pancreatitis. Prednisolone was added and metronidazole was added when the IBD was diagnosed. He become diabetic due to the prednisolone and then insulin started. We ended up adding bupe for pain later on one when his symptoms progressed. I wish I would of started the pain medication earlier as pancreatitis is quite painful. Jones lost a tremendous amount of weight when he had a flare - it almost seemed to happen overnight. And it is all supportive care that you can provide - there is no "fixing" it with surgery or such.

    You should get the EPI test done just to make sure - if you are getting blood drawn it is easy to add and takes one issue off the table. You don't use enzymes without that test being positive as it will not help.

    The IBD food will not help with pancreatitis and is high in carb. I wouldn't go that route. If you do get an IBD dx - I would try raw or novel protein over the IBD food from the vets.

    The ultrasound was done on Jones as the pancreatitis just didn't seem to end his issues, which is how the IBD dx happened. That said IBD can not be determined without a biopsy. If this issue comes up...don't start any steroid until you decide on the biopsy. Any steroid will skew the results of the biopsy and may give a false negative on whether it is IBD or SCL.

    :bighug::bighug::bighug:
     
    Last edited: Aug 14, 2019
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  9. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Wow thank you all so much for this info. A few questions:

    - Do you think I should ask the vet to give him a shot of pain meds and a shot of the anti-nausea? Any specific meds (shots) preferred especially for cats with a history of diabetes? I wonder if the vet will even do it as she doesn't seem to be familiar with this kind of treatment for pancreatitis?
    -Nudi is not vomiting so maybe he doesn't need the anti-nausea?
    -How do we test for dehydration to know if he needs the SubQfluids?
    -What is SCL?

    Thank you again for all this info. I'm taking it all in and will do whatever is necessary to help Nudi. I really appreicate it.
     
  10. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    How is Nudi this morning? You could ask the vet for the injections and oral pain and anti-nausea meds to take home. Even if he isn't vomiting, he might not be eating much. Panc is painful and will affect the appetite. Even "mild" as the vet says and I am a little dubious about that..pain is pain and needs to be alleviated.

    Print off that information about pancreatitis and take it with you to the vet, maybe it can be educating and help some other kitty down the road.

    You can lift Nudi's skin at the scruff and see if it snaps back quickly to check for dehydration. Is he eating/drinking? Have you tried watering down LC food to make a soup, and warming it so that it might be more appealing?

    You should be testing and recording his BGs now, and see how he's doing. It's possible that he will need a little more insulin support and you won't know if you aren't testing.

    I think SCL is small cell lymphoma.
     
  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Anti-nausea meds are to get rid of nausea so that the cat will eat. A cat that is feeling nauseous won't eat. They may show some interest, like walking towards the food bowl, but nausea gets the better of them.

    Here is a video I grabbed off the web to show you how to do a dehydration test:

    Also check his gums. Do they feel moist or tacky?

    Non-regulated diabetic cats drink water to help flush the excess glucose out of their system. Regulated and non-diabetic cats do not drink a lot of water. That said, you do need to watch his numbers. If they creep up much more, he should go back on insulin.

    Pancreatitis is not all about the numbers. It is about managing the symptoms and the pain. I had pancreatitis a few years ago. My numbers were not scary high. It hurt like crazy. They gave me morphine.

    Talk to your vet. IMHO, your vet is looking at two things. 1. The weight loss over a month. 2. A pancreatic flare. The pancreatic flare (if your cat is not feeling any better yet) needs to be treated right away so that your cat will eat. Then you investigate the weight loss. If your vet does not know the standard treatment for pancreatitis, you need to start looking elsewhere for a new vet.

    Ask for a copy of the lab results and post them. There are people here experienced with reading lab results.
     
  12. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Thank you all so much. I will try the dehydration tests, both the pulling of the skin and the gums. He seems to not be feeling great today it’s hard to tell with him because he’s such a trooper but I can tell he’s not feeling great but he is definitely eating! I did try to put some water in his food but he seems to prefer without the water. I will get back to checking his BG more often and I think I’m going to call the vet and see if they can give him a shot of pain meds. I might hold off on the anti-nausea meds as he is eating or maybe it can’t hurt regardless just to be safe. Depending on how long the injections last I will ask for some to take home too. I will ask for fluids based on the dehydration test. If I’m missing anything let me know. Thank you all again. I so appreciate it.
     
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