Update on Harley -> Diagnosis Pancreatitis

'Morning everyone, Please forgive the somewhat disjointed post but I've had very little sleep these last 36 hours. I-)

I ended up taking Harley to the ER vet last night/this morning. We were climbing into bed for the night when I started to pet him the whole length of his body and he growled at me when I got to his hindquarters. Seeing nothing overtly wrong, I picked up his tail to take a closer look and saw that his anus was distended. Trying to touch it nearly resulted in me losing an arm. I thought about it and realized that he hadn't had a BM in over 3 days. ohmygod_smile He'd been very lethargic the last two days, sleeping in my laundry basket (which is his general purpose catch-all hiding place for when strangers come into the house, he's sick, he's mad at me for something, his BG is dropping too low, etc.). His appetite had not decreased by much which was surprising. He had vomited clear mucus 4 days ago but it wasn't repeated so I'm not sure if that was in any way related to the constipation. Once I realized my boy was hurting, I was worried about complications and made my first trip to an ER vet, at night, no less.

The people were very nice and professional. The vet examined him and took an x-ray which showed that his large intestine was completely full but not obstructed or distended. No appearance of megacolon. There was a little gas in his stomach, but she said all his other organs looked fine including his heart. So they gave him 150 ml SubQ fluids, a shot of bupe for pain, and waited for the fluids to absorb and the bupe to take effect before doing an enema. The vet told me that sometimes they have to do a follow up enema and more x-rays to see if it passed, but he cooperated and produced three or four inch long feces on the first try. The vet said she thought he'd be OK from there and I could take him home. She recommended adding pumpkin in his diet for fiber, or Metamucil, and gave me a bottle of Lactulose with instructions to give 1 ml every 8-10 hours as needed. So, home we went - just in time to be 1/2 our late for his 4 a.m. shot. :mrgreen: After all the fun at the vet his AMPS was only 176.

After taking care of his shot, setting out his breakfast, cleaning his litter box (so I could see if he used it) Harley and I fell into bed. He was still loopy on bupe - I love that stuff!

Now later in the day, I notice the difference between yesterday and today. No more hiding, he's showing interest in food, playing with catnip and his favorite toy, and is being a little more "talkative." I notice he's carrying his tail at less than half staff though. He's normally a perfect 90 degree vertical tail boy. I called to ask the ER vet about that and she said he's most likely still feeling sore and wait a day or two to see if it resolves itself.

Keeping paws and tails crossed that he's over the hump an will improve with pumpkin and lactulose.

Wishing health, purrs, and happy surfing to everyone today. :mrgreen:

 

Re: 3/13 Update on Harley

Wow! What an awful experience for both of you. So glad he is feeling better and he and his momma is getting some much needed rest. If this is an ongoing problem, you might post on Health. I know there are a number of kitties who tend to get constipated and they will have hints about things that help.

 

Re: 3/13 Update on Harley

Thanks Sue! I've been using the forum's search function quite liberally this afternoon - searching up everyone's posts on using pumpkin, Metamucil, Miralax, Lactulose, etc. (Seems like there's difference of opinion on whether or not the Lactulose is good for diabetics or not.)

I've got LOTS of questions for my vet when I see her this Caturday... ;-)

 

Re: 3/13 Update on Harley

Glad it all worked out ( :mrgreen: ) fine. Hope you get more sleep tonight!

 

Re: 3/13 Update on Harley

LOL, we'll see if everything came out all right.

 

Re: 3/13 Update on Harley

Awww poor baby. Give him some scritches from me and a head but from brother orinch Harley.

 

Re: 3/13 Update on Harley

(((((hugs))))) hope he is all better soon!

 

Re: 3/13 Update on Harley

I had a rumpy Manx cat that died in 2000 that was born with a genetic defect that had megacolon. He would have to have enemas sometimes monthly to keep him from getting plugged up.
My vet told me to mix a teaspoon of pumpkin into his canned food daily and give him Laxatone. Tried the Metamucil too but it didn't work as well as the canned pumpkin. You have to be careful when giving Metamucil that they drink enough water or it can actually make the stool harder and drier. You also can give a baby suppository if the are getting constipated.
Glad Harley is feeling better today.

 

Re: 3/13 Update on Harley

Oh my...so sorry to hear about Harley. Glad things are better now. Hope you and Harley got plenty of rest today.

 

Re: 3/13 Update on Harley

Thanks Angela for the advice, I'm with your vet on using the pumpkin as it's a natural fiber. The problem I see with with Miralax, Metamucil, and Benefiber type products is hey either suck water into the colon or bulk up the stool and if the cat is already dehydrated or on the verge, either one can push them over the edge into dehydration or blockage.

Hmmmm, baby suppository - might need to get a few to keep on hand. And make an appointment with a plastic surgeon for face reconstruction after administration! :lol:

 

Re: 3/13 Update on Harley

Unfortunately I don't think Harley's out of the woods yet. He started to withdraw last night as the fluids wore off. He hasn't passed a stool since yesterday morning when he was still on pain meds. It seems like he wants to. He jumps into the litter box, turns around and then jumps out. I even heard him meow once right afterwards.

He has urinated 4 times since I brought him home so it's not a urinary problem. The clumps are very large too so it's either the SubQ fluids coming through or his kidneys. His fur was very dry this morning until he drank all the water that I put into his breakfast. He barely touched the food. I even broke out a can of FF ocean whitefish and tuna, he ate about 2 teaspoons but again drank the water and left the rest.

When my vets office opens at 8 a.m. I plan to be camped out on the doorstep.

Poor baby, I feel so powerless to help him, I feel like everything I do seems to make things worse and not better. I wish he could tell me what's wrong. I wish I could communicate that I'm trying to help him because I love him. Sorry for the blue Monday, but I'm feeling really dejected right now.

 

Re: Update on Harley

(((((Laura)))))

I really wish you and Harley could catch a break! Saying a prayer down here that Harley feels better soon!

Kris

 

Re: Update on Harley

Oh, I hope you can get him help this morning, Laura. This chart didn't copy too well, but maybe it will help. There are certainly lots of possibilities.


Remedy Mechanism Cautions
Extra water in food Hydration, lubrication
Subcutaneous fluids Hydration, lubrication Can overhydrate with bad effects, vet only.
Enema (various possibilities: water, or K-Y, or mineral oil, or soapy water) Flushing, lubrication Don't try this at home unless vet recommends it.
Canned pumpkin[6] Fiber and bulk Don't use if possibility of intestinal blockage
Soaked flax seed Fiber and bulk Don't use if possibility of intestinal blockage
Psyllium husks[7] Fiber and bulk Don't use if possibility of intestinal blockage
Lax-Eze[8] Fiber and bulk Don't use if possibility of intestinal blockage
Slippery Elm[9] Fiber and emollient Don't use if possibility of intestinal blockage
Vaseline/petroleum jelly Lubrication retards or blocks food absorption
Olive oil/butter/animal fat/tuna in vegetable oil Lubrication Not a regular diet.
Children's glycerin suppositories Lubrication administered anally
Lactulose[10][11] Osmotic stool softener, Lubrication Pulls water into the intestines osmotically -- can dehydrate -- give extra water with this, don't use long term. It is a form of sugar (and is quite sticky in solution!), and is not digested. It does not affect blood glucose level in most cases. It may be ineffective against existing blockages.
Docusate sodium/DSS[12][13] Osmotic stool softener, Lubrication Pulls water into the intestines osmotically -- can dehydrate -- give extra water with this, don't use long term.
Miralax (Polyethylene glycol)[14] Osmotic stool softener, Lubrication Pulls water into the intestines osmotically -- can dehydrate -- give extra water with this, don't use long term.
Exercise Prokinetic: increases intestinal contractions Likely to either raise or lower Blood glucose level, depends on individual.
Cisapride/Propulsid[15][16] Prokinetic: increases intestinal contractions Works best with stool softeners. Addictive. Causes cardiac arrythmia in some humans.
Sodium Picosulfate/Dulcolax Prokinetic: increases intestinal contractions Addictive, can cause bowel irritation.
Acidophilus yogurt Probiotic: rebalances intestinal flora May be irritating to lactose-intolerant pets.

 

Re: Update on Harley

Oh Laura, I am so sorry you guys are having problems I just checked the board this morning, we have been out of the loop with Tom’s parents visiting from out of state. We’re sending you all the best, and I hope the vet was able to help you out today.
(((((((Hugs)))))))

 

Re: Update on Harley

So sorry that Harley isn't feeling well again. Hope things go well at the vet this morning. Hugs to you both!

 

Re: Update on Harley

Laura, if he passed some large, hard stool while he was at the vet, he may have a little tear or be sore; when he strains to go it may be uncomfortable for him so he is avoiding going. With my Manx, vet also reccomended taking a qtip and applying some Vaseline to the outside of the rectum, seemed to help too. My cat was not bad with the baby suppositories and they really helped. saved him having to have enemas at the vet many times.
I hope you got to the vet ok and Harley will be pooping and feeling much better soon.

 

Re: Update on Harley

Wonderin how you and Harley are doin’...
Sending you prayers and good thoughts today too
cat_pet_icon

 

Re: Update on Harley

Well, we are home again. Thank you so much for everyone's hugs, kind thoughts and healing vibes coming Harley's way! And Sue - bless you for posting that table - I'd seen it before, forgot to bookmark it and couldn't find it when I needed it. ohmygod_smile

Angela, thanks for the great idea about the vasoline. I'll see if I can get him to let me do that tonight.

We went to my regular vet this morning and being a Monday, at 8:02 we were already the second emergency of the day so it was a long wait. (Turns out the emergency ahead of us was a cat with almost complete hard stool throughout the descending colon.) My vet took another x-ray and it showed that Harley still had a log-jam of stool between his pelvis which he could not pass. She said that the stool in the upper part of the colon appeared to be soft and normal (that's probably the food from yesterday when I was feeding the pumpkin and giving the lactulose) but the older stool at the bottom needed to be broken up. So he had another enema, this time I believe with KY jelly, the enema at the ER vet was soapy water. I do not know if he was given pain meds, but he was definitely sore and I could hear him vocalizing from the exam room. My poor baby! She said she was able to clear a few pieces, manipulate a few more so that he could pass them on his own, and he pushed out a couple more on his own during the procedure.

Follow-up care is still the same - pumpkin and lactulose. He also got another dose of SubQ fluids. When we came home he did hop into the litter box right away and push out 5-6 pieces which is very encouraging! But the real test will be if he can do it again when it's time. And talk about your vet stress - 196 this time.

He's been tired (I don't blame him!) this evening and more interested in drinking than eating so I've had to get creative with getting him to eat. Bonito fish flakes or his PureBites Chicken dust crumbled on his food spark his appetite a bit. I know I'll end up paying for this because he won't want to eat his food plain anymore but I figure he's entitled.

So, I'm a stool pigeon again tonight, keeping fingers, tails, paws, crossed that this works. I never thought I'd see the day when I would put my head on his side to listen for gut noises, or be ecstatic when he passed a little gas. I feel like a new mother awaiting her baby's first stool. :lol:

I've got to turn in early tonight as once again we are both beat.

Take care everyone and thank you again from the bottom of my heart for all the hugs and support!

 

Re: Update on Harley

Awwww, we have had those kinds of problems in the past - definitely not any fun. I found the Miralax seemed to work the best, with the least trauma in giving it (Lactulose can be a battle to administer). If you use the baby products, be sure to check first with your vet - I know I have seen some things before that have ingredients that are toxic for cats - I think maybe it was baby enemas that I saw that in reference too.

Hope he is feeling all better soon!!! Gotta say I love Bupe too - whoever invented that one gets my vote!!!

 

Re: Update on Harley

Hi Laura, thanks for keeping us filled in. Sorry you two are having such rough go of it. Hope tomorrow is bett with lots of smooth moves!

 

Re: Update on Harley

Poor Harley and poor you have had a rough time.
Hope he has a much better day tomorrow!
I believe the baby enemas are not safe for cats but the Fleet suppositories are, my vet recommended them to me; but always check with your vet first.
Sending prayers, reiki and healing light Harley's way.

 

Re: Update on Harley

Fingers, paws, and tails crossed that this last um clean out has done the trick and Harley feels better soon! Poor kitty. Sounds like you both need some much needed rest.

 

Re: Update on Harley

Another day and I'm cautiously optimistic here that this has done the trick. It looks like Harley did another stool overnight on his own. He was waking me up at 3:30 (a little early) for his food and shot. Well, the food anyway, not the shot. I had to go back to work today so I left out a frozen cat food cupcake that I'd made over the weekend for him to snack on. (Contents include 1/4 can FF Chicken Feast, pumpkin, H2O, and a garnish of Bonito Flakes)

I'm going home at Noon for his test, food and shot, and to check on him. BTW, as an aside, we started tid dosing last week and it seems to be going well. My vet was surprised that I switched and when I told her what I'd done and why she commented that 1) she's never heard of PZ being dosed tid and 2) that maybe it's not the right insulin for him. YES! Just what I was hoping she'd say. Because I want to make the pitch for Levemir or Lantus. But it helps if it's her idea...

 

Re: Update on Harley

One step forward, two steps back...the good news is that Harley passed another stool last night. Some of it was hard and the other pieces were softer. Phew!

The not so good news is that he is still feeling hind end discomfort if not pain (he "meow/moaned" while in the litter box) and is way down on appetite. His SubQ fluids have long since worn off and I fear he's dehydrated again. He doesn't want to eat - he just licks the extra water that I put in his food. He eats the toppers that I put on his food to entice him, but not the food. I offered him food without pumpkin last night - thinking that it's the pumpkin he's tired of and he ate a little but not much. I also changed flavors to entice him and it helped a little, but again he drank the water and picked at the food.

I'd ordered some Feline's Pride raw food last week and that is thawing in the fridge right now. I also have some Nature's Variety medallions thawing. I'm probably going to try the NV first as it's got fruits, vegetables, and butternut squash in it. The Felines Pride doesn't have any veggies and I'm afraid that would make his constipation worse.

My biggest concern is dehydration because he only drinks the water that I add to his food. I leave fresh water out for him to drink and he won't touch it. So I'm thinking of flavoring some water and leaving that out for him to drink. And with very little water intake, I skipped his lactulose because it'll dehydrate him even further.

I may have to post on Health pretty soon, but I hate to distract everyone's attention from the new kitties who are really sick and their worried beans who need everyone's help right now.

grumpy_cat

 

Re: Update on Harley

So sorry to hear you two are struggling. Post on health. Not eating is serious.

 

Re: Update on Harley

Dr Lisa swears by tuna juice:

Adding 1-2 TBS of water (plain or flavored – such as tuna water, clam juice, chicken or beef broth) per meal is also very beneficial, as is using water fountains. Make your own tuna water by taking one can of tuna and mixing the contents into 3 cups of water. Mash it around and let it sit for ~15 minutes. Pour the water into covered ice cube trays. Freeze to prolong the freshness. Use covered trays to keep the water tasting and smelling fresh.

Have you called the vet? Is it normal for him to still have pain? Should he maybe be given something for pain?

 

Re: Update on Harley

God what would I do without you two! I'll try the tuna water recipe when I go home for lunch (stopping to get a can in my way). I did crumble some PureBites chicken treats in some water and left that for him. Usually he goes mad for those treats. In fact he'll still eat them now, just not his food. So it's not like he's lost all appetite. If all else fails, I can break out the HC FF hypo food in my cupboard - and deal with the consequences later. ;-)

I have a call in to my vet, but the office is closed today and the emergency service is trying to page her. If I can't get ahold of her I'll call the ER vet he saw over the weekend, I have her card. She was really good about giving him pain meds. But my vet didn't give him anything when she did the enema. That really worries me.

 

Re: Update on Harley

I'm so sorry to hear Harley is still not feeling well. Sending healing thoughts your way.

 

Re: Update on Harley

You have probably already seen this: Getting your cat to eat

 

Re: Update on Harley

Sorry Harley is not feeling well today. Did you try putting some vaseline around his rear to help heal any tears and soreness and help the stool pass easier without hurting as much?
Hope the toona juice does the trick and perks up his appetite and gets him to drink.

 

Re: Update on Harley

Hi everyone, I'm sorry I didn't have the energy to post an update last night, it was a very busy day and Harley and I were both beat.

Angela, yes, I did manage to put some vasoline on the outside of his rectum (he was not inclined to let me touch him much or for very long) and it appeared normal.

Yesterday when I went home for lunch I made some tuna juice and he didn't touch it, nor did he eat any lunch (FF Salmon & Shrimp Feast - one of his faves). ohmygod_smile

I'd called my vet in the AM only to find that she was closed yesterday. But a co-worker of mine who had given me a box of ReliOn U100 needles from her diabetic kitty GA mentioned that she went to a cats-only clinic two towns over. The name and address of the doctor and clinic was on the prescription on the needle box. I called them and asked if they would see Harley, that he wasn't a patient, my vet was closed today, I don't have any records I can bring with me, and all about the events of the past few days yada, yada. They said sure, bring him in at 3 p.m.

The place is small and doesn't look like much from the outside, but the inside is warm and friendly and the office staff could not have been nicer. Leon, the orinch practice cat greeted us at the door.

I was very favorably impressed by the vet. (I'm not sure if he felt the same way about me, but he seemed to really like Harley and that's what counts. :smile: ) We went through Harley's history, both the events of the past few days and also the information in his profile. After a physical exam he said that Harley's colon was pretty well emptied out and he didn't feel any constipation. But he also said the anal glands were full and might be causing him discomfort while eliminating. He couldn't understand why two other vets hadn't picked up on that. He also noticed Harley's broken left fang. The tooth has been missing the tip ever since I adopted him and every time I've asked my vet if it should come out she said no, the dentin is not exposed and therefore it's still a healthy tooth. I disagreed with her on that point and still do. This vet said tactfully, that it may not have been time before but it is time now as there is a small abcess forming on his gum right next to the tooth. He feels it should be done as soon as Harley is stabilized.

As for the not eating, because Harley is diabetic, the first thing that he mentioned is that he might also have pancreatitis or IBD. (I've been wondering about this myself for a week now.) So I agreed to run the full bloodwork panel and the spec-fPLI. I asked to take home a SubQ fluid bag as I know how to give them and, surprised, he agreed. I'm supposed to give 100cc daily for the next 10 days or until he's better. He also gave a bottle of cyprheptadine (1/2 pill bid) to stimulate the appetite in case the fluids alone don't help. I'm supposed to call after 8:30 today to get the all the bloodwork results and we'll go from there.

In talking about the diabetes management, he wanted to run the BG and a urine test also because even though I told him I was home testing and what Harley's numbers usually were, I didn't have my spreadsheet with me (broken printer). The BG was 178, and there was no sugar in the urine. It helps when the vet's numbers support what you are doing! The vet was surprised I was dosing tid with ProZinc and when I explained about the short profile of action of the insulin in Harley, he mentioned that possibly another insulin should be considered. He was not exactly happy to hear I was using U100 needs with a U40 insulin but relented when I reminded him of the small doses I was giving. He reluctantly conceded on that point. He occasionally uses ProZinc but he mostly uses Lantus in his practice. So we left the insulin alone as I was mostly there for a second opinion. He threw out there for consideration that if we do the dental and get to the bottom of what's causing Harley not to eat, it may be possible that he won't need insulin. Paws crossed, antijinx, antijinx.

With a much lighter heart, we came home and I gave Harley his first fluid treatment which, you can imagine he was thrilled about. The first time with any cat is hard as both kitty and bean don't know what to expect from each other. Plus, they gave me 18 gauge needles which I'm not used to I've used 20s in the past. I think I got about 50cc inside him and 50 on his fur. The cyprheptadine did not go as well. I've never had to pill him before so I didn't get the pill in the right place for him to swallow without tasting it. He gagged, spit it out, frothed and foamed at the mouth and vomited. Poor baby!!! But the fluids alone perked him up so much he was able to eat a 5.5 oz. can of Friskies Poultry Platter in 4-5 small meals in the evening and overnight. YEAH!!!

This morning he ate 1/2 his breakfast, Friskies Poultry Platter. The fluids may be wearing off because the dose was so small. I may try to give them again before I go to work.

Thank you to all for the warm wishes and healing vibes coming Harley's way. He could sure use them right now.

 

Re: Update on Harley

Save yourself the headache and run, don't walk, to Petsmart and get the pill pockets.. duck flavour. I tried getting pills into Bud for a week before I got them. and it was like, "DUH... why didn't I follow FDMB folk's advice the first day and go get them?"

 

Re: Update on Harley

(((((((hugs))))))
So sorry you are having to go thru so much right now, but it sounds like this second opinion may have been really helpful. We’re lucky that god blows wind on things sometimes...
Sending out the healing and light to y’all.
cat_pet_icon

 

Re: Update on Harley

This sounds encouraging, Laura. Great that he is eating again.


I did have questions about the previous vet - didn't seem very proactive. I didn't understand leaving the tooth in or not following up after the bowel issues. It will be interesting if taking care of the tooth could take care of the diabetes. You are giving so little that it might do the trick.

 

Re: Update on Harley

The duck flavor pill pockets are the only ones without sugar. Sometimes rolling them in fortiflora helps too. Cats can be impossible to pill. Dr Lisa has info about pilling and probably it is in the stickies here, too (gator was so very thorough). She says it is very important to give water when pilling to protect the esophagus.

 

Re: Update on Harley

Cat info.org has stuff on pilling from Dr Lisa. I coulndn't find any in the sticky here.

 

Re: Update on Harley

I think this is it: http://www.catinfo.org/?link=pillingcats

 

Re: Update on Harley

I was able to give him 100cc fluids this morning. He cooperated this time because he knew it'd make him feel better. He still didn't like it though...

Doh! I have some in my cupboard - the greenies allergy duck & pea formula.

Good is indeed good! I think she's a cat. LOL

Thank you for the cat pilling link! This is one I hadn't read. Believe it or not I've never had to pill Harley before for anything so this is new to both of us. But I'll be putting this to work very soon because...

...we got Harley's lab results this morning and the good news is his kidney & liver values are normal. His spec-fPLI is 20 - and the high end of normal is 5.4. So he has a humdinger of a case of pancreatitis. The lab also got a BG of 178 so he said "just keep doing what you're doing for now with the insulin." :lol: I'll be going there after work to pick up prednisolone and buprenex and some more 3cc syringes. I told him about Harley's reaction to the cypro. and he said that the pred. alone might hep with the appetite due to the anti-inflamatory properties so I should watch and see if it's even needed. If he continues to not eat then call back. Otherwise if he improves I'm to give them an update in a week.

OMG, so much to do, but at least I feel like he has a fighting chance now. Thanks to the vet and thanks to all of you for your wonderful help and support!

 

Re: Update on Harley

It is great to know that he does have pancreatitis (that doesn't sound right - I mean it is good you have a diagnosis) and there are ways to help him. Have you seen this site: Pancreatitis Diet

If you have other questions, I know we have lots of people who are dealing with both pancreatitis and diabetes. You might post on Health to get some helpful hints from others.

 

Re: Update on Harley

Thanks Sue - you are such a font of information! Yes, I do have that one booked as I was doing some research last week.

This is going to be very interesting - Harley's first yellow day: AMPS 219, MDPS: 223. I shot a skinny 0.20u this morning and a 0.20u at lunch. It's because he's eating the higher carb. food but that's OK 'cause he needs to eat something, anything. I'll just have to work the insulin around it but I'm also nervous because I can't exactly count on him scarfing to avoid a hypo.

nailbite_smile

 

I'm glad you got some answers and that Harley has perked up and is eating again.
Continued prayers and healing for Harley.