vetty bean report on Morris - pancreatitis vs needing dental

YAY! Vetty bean called me with results!!!! fpl is a little high, but this test is not that reliable she said.....I then said that I heard it can show a lot of false negatives....she agreed & said it can also show false positives. She is not willing to diagnose Morris with pancreatitis just yet, but she says that he appears to be having pain issues even though he is not showing it (& didn't even complain as she poked & prodded yesterday). She would like him to start on some pain meds that you just need to put a drop or two on his tongue.....I said 'Is that Bupenex?"...she said yes (seemed impressed I knew what she was talking about!). Unfortunately they don't stock it but will order it in....she hopes it will come tomorrow, but it might not be in until Monday. I asked if there would be any other clinics in town that would stock it & she doesn't think so....she thinks everyone orders it in. As he is not in extreme pain, she thinks it would be ok to wait to start this.....if he was showing more pain symptoms, she said she would start him on another pain med to take the edge off while we waited for the bupenex.

Since he is starting to eat more on his own, we are only going to address the pain issue for now (not knowing for sure if the pain is from pancreatitis or from his teeth). She is, however, concerned about his overall intake. She wants me to be carefully monitoring his food & water intake (like I'm not already!!!) and be sure that he is eating a minimum of 270 kcals per day. She also wants him to be getting a minimum of 60 mls per kg of water per day (approx 300mls per day). She knows I only feed canned & that I add water to his food, but she wants me to learn how to do SQ fluids at home so that he won't get dehydrated.

She also would like me to do a full curve on him in the near future. She said that with Lantus, getting readings every 2 hours is just fine, but she wants the curve to run a over a minimum of 16 hours. I told her I would plan a couch night for 1 night next week.

Hopefully, with all of this, we will see marked improvement in him soon! If, however, he is not getting better, then the next course of action would be to try & arrange an ultrasound - that would need to be referred out & would probably mean a trip over to Vancouver!

I am going to the clinic this afternoon (after work) to learn about SQ fluids.....while there, I will try to remember to ask for a copy of his labwork. Anything else I should check on while I'm there?!?!

 

Gwen, are his teeth bad? Pain will cause Tucker's pancreatitis to flare.

Buprenex is not given on the tongue, but place it on the gum between the gum and cheek, it absorbs in.

Pain meds, sub q fluids and B12 injections is what we do for Tucker, however Tucker does suffer from IBD also. If that makes much of a difference, I'm not sure.

There are many vets that don't stock Bupe because of the paperwork involved, a large clinic in town may have it, but I'm sure your vet will have it in soon enough.

Is your cat not eating? Why does your vet think there's pain?

So your vet did a PLI and an fPLI test and now is thinking an US next? If the enzyme test was a little high and your cat is showing signs of Pancreatitis, why rule it out. Doesn't mean you have chronic pancreatitis, a cat with FD can also just simply have a pancreatitis flare once in a while.

But, really, what's going on with the teeth?

 

Gwen,
The SQuids are not complicated to give, so that's one thing not worry about at all. They make a huge difference with Shadoe afterwards too; I am positive that Morris will perk up after SQuids, kinda like a flower after it's watered!

Was Morris vomiting at all? If he seems to be feeling a bit nauseous, licking his lips/nose, you can use Pepcid. If you don't have any on hand, ask the vet about getting pepcid AC 10mg and give 1/4 tab to settle Morris' stomach when needed. That's one issue Shadoe had with her p-itis. It's good to have something on hand, just in case.

Ask the vet for some Codeine transdermal gel maybe. I had the buprenex for the first few days for Shadoe, then they gave me a syringe type tube of the gel which was for any later pain. The gel is just rubbed inside the cat's ear flap. Funny thing about the stuff - Shadoe did seem weirded out, but better after, but Booboo decided it tasted good so she kept licking the inside of Booboo's ears! I think it's best to have something on hand till you can get some of the bupe. There is no reason for Morris to be in pain; after all, if you were in pain and your dr said sorry no meds till maybe Monday, what would YOU do?? cat(2)_steam

I asked the vet about Shadoe's pain, how would I know. She said when you feel along the abdomen, she could feel Shadoe tensing up, and in the areas she touched, she could tell more of Shadoe's pain. Ask your vet about that as well. Cats are pretty stoic; they often don't let on when they are in pain, so it's hard to know.

I hope Morris is feeling better quickly.

 

Are you sure the pain med is Buprenex? As others have said, Buprenex is absorbed by the mouth's mucous membrane and is thus given either under the tongue or in a cheek pouch. Also, the dose of Buprenex is typically about 0.2 ml which is not a drop or two. Metacam, on other hand, is typically dosed in cats by drops and applied to the tongue.

 

When she looked at them yesterday, she pointed out some areas of concern. She also said she has seen worse teeth! We are just trying to figure out why he hasn't been eating.

I have a copy of his labwork results.....Spec fPL 14.0 (range 0-3.5) **then it has comments saying >5.3 ug/: serum spec fPL concentration is consistent with pancreatits. Consider investigating for risk factors and concurrent diseases (e.g. IBD, hepatitis, diabetes mellitus). Periodic monitoring of Spec fPL may help assess response to therapy.

No diarrhea or vomiting.

When she examined him yesterday, he did not show any signs of pain. We are assuming he is in pain for some reason (either teeth or pancreatitis) because he is not eating.