Xuxu, 3/23/13, 750, more tests

For a couple of weeks, Xuxu has had about an 18 hr curve on PZI and has been feeling pretty well. But I ran out of Zithomax for 2 days and his URI started coming back, we got him back on Clavamox, but it doesn't seem to have cleared it back up as fast or as completely. His curve seems to be back to less than 12 hrs, he's burning up the insulin more.

I took him to the vet Fri and he's lost another .25 pounds, even though he's eating well. So as BJ explained to me, he can eat all he wants but if it's not getting into the cells, he's still starving. He's so responsive to insulin, in fact supersensitive, so it isn't that his insulin receptors aren't working. So I was talking with the vet and her techs in between her other appts. (I'm in there so much, I have the run of the back of the clinic. I go on in, do his temp, weight, etc myself before she checks him. She's the go to vet for emergencies, so is always busy.)

Anyway, we went back to the pancreas. It seems like someone here mentioned Exocrine Pancreatic Insufficiency (EPI), and my vet is sure she mentioned it to me before, but I just don't remember it. The Pancreatic Lipase Immunoreactivity (PLI) Serum trypsin-like immunoreactivity (TLI) tests will apparently tell us if his pancreas is functioning and if he is getting the enzymes he needs to digest his food. The symptoms are loosing weight while still eating, diarrhea, anorexia, vomiting, lethargy, dehydration. He has all but the vomiting and diarrhea, but not all cats have that. He does have huge stool, and my vet said that was a sign that less of the food was being digested. Even when he's drinking a lot, I have to keep giving him fluids every night. So a lot of it fits. The TLI and PLI tests are very expensive, so perhaps I turned then down in the beginning and just don't remember. My vet swears she mentioned them, but maybe I was just more concerned with getting his bg stable rather than trying to figure out what the problem was. At that time, I didn't know he would be so hard to regulate.

It's too bad the test have to be 12 hr fasting, the poor boy was famished before he could eat and starting to look really weak a couple of hours before. If these tests are positive, then perhaps the supplement of digestive enzymes will help.

We talked with yet another specialist at ANTECH who said we should start him on steroids as well. Other vets had said don't touch steroids, but that was earlier in the situation. This guy said there is a lot of contention about it, but we are going into 8 months of this yo-yoing, so maybe it's time to try it. So we may try that after the test results come back.

He's a 10.5 pound cat that is now down to 5.75 pounds while eating 2 6 oz cans of frisks a day. Somethings got to give here before he gives out.

 

Oh Deb! I didn't realize he was so thin!

Voluminous stool is definitely a sign of exocrine pancreatic insufficiency, especially if they are light colored, almost pasty.

If it won't hurt, and it'll be a while before you get the results, maybe the empirical approach of just giving the enzymes could be tried.

This is what I bought:

Dr Mercola Healthy Pets Digestive Enzymes 5.26 oz
Has Betaine, pancreatin (protease, amylase, lipase), Ox Bile extract (45% cholic acid), Bromelain, and papain.

Amylase breaks down starch
Lipase breaks down fat
Protease and papain break down protein (papain comes from papaya and is found in meat tenderizer.

 

Another idea for food,though pricey. There are hydrolyzed protein diets for cats with food allergies. Hydrolyzing breaks the proteins down to their amino acid building blocks, which is why it reduces the food allergy (no complete allergic protein in the food).

Maybe that little bit of pre-digestion would help Xuxu to use it better. Worth asking the vet.

Another idea to ask the vet is if parenteral nutrition could be helpful. Its basically IV nutrition, by-passing the GI tract. If the GI tract isn't working well, this may help.

 

Merck Veterinar Manual on EPI

Abstract on feline exocrine pancreatic insufficiency and comorbidities

http://www.ncbi.nlm.nih.gov/pubmed/19553151

I also came across some recent articles that mentioned low levels of Vitamin D (which could be due to malabsorption) are associated with diabetes.

http://www.ncbi.nlm.nih.gov/pubmed/23468072

http://www.ncbi.nlm.nih.gov/pubmed/23242734

http://www.ncbi.nlm.nih.gov/pubmed/22763025

 

Deb - I'm sure it's a little different, but my old dog used to have an enzyme deficiency, and behaved much like you described. She ate ravenously, and continued to lose weight. It was dx'ed as Maldigestion/Malabsorption. SHe was given Pancreazyme, mixed with her food and allowed to soak in for 15 min before she ate. It turned her life around. Wishing you the same with Xuxu.

 

Another resource if its EPI.

 

Thanks so much everyone, especially BJ for all the links. I'll order the Dr. Mercola stuff tonight. I hope it's as easy as giving the enzymes. My vet said something about a prescription enzyme and she didn't want to give that before getting the test result. I have him on a supplement for immune system, but can't tell if it's helped.

 

Deb

I've got some of the Mercola left; I could ship it to you. Pm me your address. These may not be as good as the prescription ones. Also, several listed at the link in my last post.

Folate & cobalamin may be low, plus the oil-based viamins A, D, & K. The first 2 are injectable.

SIBO- small intestinal bacterial overgrowth - may happen too. May be why the antibiotic was helping.

Have you got Forti Flora? It tastes great to most cats and provides good bacteria for the digestive tract.

 

Thanks, but the Mercola from Amazon is supposed to be here tomorrow. I have Prime shipping. We have been giving him B12 about every month for 3-4 times. I did get Forti-Flora a while back. Xuxu didn't seem interested in it, so I sort of forgot a bout it. But maybe it was during a time when he wasn't feeling well, I don't remember. I'll dig it out and start using it again.

 

Maybe a general pet vitamin, or something which includes folate (different from B-12). Some are liquid and may be put in water or food.

I hope something helps him.