10/29 Butters AMPS 270/+3 229/+5.5 131/+7.5 76/+9 88/PMPS 268/

Yesterday high and flat. Overnight, I noticed Butters' tummy felt a little firm, maybe a bit distended.

This morning, I swear I could see pain on her face. She was doing a bit of twitching, felt hot, and her tummy was tense. I increased the gabapentin back to 50mg TID (original dose prescribed by IM) from 25mg TID. It's really the only tool in my toolbox for pain. Hopefully it is enough.

She is eating well. But so far has been keeping her distance from me since last night.

Interesting that I think her pain has increased, which means maybe some inflammation returning? And yet her numbers are trending lower today.

Have a good day.

 

how's she doing in the litter box?

 

Hugs to you and Butters Hope the gabapentin helps give her some relief. Looks like the increased insulin may be helping too. Hang in there, you are doing an awesome job

 

Could she be constipated? Do you have any buprenorphine?

 

Doing fine in the LB. Habits have remained unchanged since she came home from the hospital. She still BMs every morning, so I don't believe she is constipated. No straining or anything.

I still have nine prefilled syringes each containing 0.08mg of buprenorphine from the first ER I took her to. I remember it did nothing for her pain back then.

I didn't love increasing her gabapentin. I didn't know what else to do, though.

 

I was thinking since the patch plus gaba helped maybe the gaba plus bupe might too and you would not need extra gaba. Just a thought as I never used gaba.

 

True. The fentanyl would have been way stronger so I'm not concerned with mixing a tiny amount of buprenorphine with the gaba. I had been saving the buprenorphine for a rainy day, knowing I'm unlikely to ever get more of it.
Thanks for the suggestion.

 

I hope Butters feels better soon. Sending prayers.

 

Poor Butters. I hope the extra bit of meds helps relieve any pain she's in. Feel better soon, sweetie . Hope you have a good day, Lyla

 

Praying for Butters every day that this damn inflammation stops
Nice blue today
I hope going back to the original dose of gaba helps.
This poor girl needs a break and so do you.♥♥

 

Aw, I’m sorry to hear Butters isn’t feeling well.

I hope she feels better soon! Have a great day, Lyla!

 

Hi Lyla,

Hopefully the increase in gabapentin works. An alternative option for adjusting the gabapentin dose in the future is to keep it at 50mgs but q12 hrs vs q8 hrs. If you start to see any breakthrough pain before the 12 hr point (it happens) go ahead and give it. Sometimes the attempt at a decrease is tough. It wasn't uncommon for me to have to give the 2nd dose @ 10 hours vs. waiting until the 12 hour point. This would be a slightly smoother adjustment given that you would be reducing the medication from 150mgs per day to 100mgs vs. from 150mgs to 75mgs. Sometimes that small dosage amount makes a big difference. Once the 2X/day dosing is going really well, you could then try the next step down from 100mgs to 75mgs.

One issue you may have had with the Bupe is that how well it works not only depends on the proper dosing but also on the concentration of the Bupe. Typically, vets will prescribe 0.3mg/1ml vial however, for more severe pain they will prescribe 0.5mg/1ml vial.

Again, hoping the gabapentin will work well and Butters feels better soon!

 

Are you going to stick with the current ER clinic for now? Or you are starting to research general practice vets?

Nice to see green, innit?

 

Yes to question #3.

As for Qs 1 & 2....

I wanted to stick with that animal hospital. I thought I'd be able to book another follow up for Butters with the IM when she needed to see a vet. But at her final post-hospital stay appointment, the IM said she would only see Butters again if either something goes wrong (then I have to bring her to the ER) or if Butters gets referred back to her from a general practice vet. The hospital doesn't have any general practice vets and refused to recommend any citing conflict of interest. So I can't stick with them.

I called up to the animal health centre in Guelph that's directly linked to the OVC. They also will not see an animal without a referral from a general practice vet, nor will they recommend one that might be a good fit for a cat that has pancreatitis flares and FD.

So, I'm back to doing an internet search for a local general practice vet and so far they all come off as uninspiring. My questions for them pertain more to pancreatitis experience, how they manage symptoms particularly pain management, and whether they have active listening skills and are open to listening and giving serious consideration to my opinions and wishes in terms of what I think is best for Butters.

It's so disappointing.

 

Have you considered CBD? My Gizmo was hospitalized 3x (3-6 days at a time) with pancreatitis. I finally got to where I could manage at home, but it was a real struggle. Figuring out a maintenance plan (pain meds, nausea meds, and supplements) that will work for Butters will be an on-going process. You are doing fantastic.

 

I'm sorry to hear about her tummy and her pain...I sure hope the Gaba helped her with that today.

I wish you were having more promising results with the vet search too...nothing is going right at the moment is it?

I was looking for Butters' post earlier today...and now here it is the bottom of another very long day and I'm just catching up.

You're doing a great job Lyla! Just keep trying to find a better animal practice...sheesh..who knew in a major metro area there would be so few who are well versed in anything feline related?? So many are just too diluted these days. Still looking for an IM for felines at all? Or are there just none to be found?

Sending you best wishes! I hope you and Butters have a restful evening.

 

Yay for green

 

Thanks! I sure don't feel like I'm doing fantastic. Butters was in the hospital for pancreatitis for the first time for five nights earlier this month.

I looked at your SS and I can see you put a lot of work into figuring out a plan for Gizmo! It's amazing.

I have slippery elm powder, which I haven't started using. I want to use CBD but it's not entirely legal where I am. Possible to obtain, but hard to know what you're really getting. Basically out of the question until a trusted person quietly points me toward a safe, clean product.

I don't know enough about the meds and supplements to use both without some guidance from a vet. I think I have a phone vet for that purpose, she is a holistic vet and seems good. She has told me to not start with any supplements until Butters is doing better consistently.

 

ElleVet
They actually are science based and are actively involved in studies with Cornell University as well as University of Florida Vets:
https://www.ellevetsciences.com/

I have used it with my older cat for arthritis & there is quite a bit of data supporting it’s use for reducing pain and inflammation-not specific to cats yet. However, we did see a significant improvement with our cat . It can cause stomach upset so that is one thing you have to watch out for. I have not used it with T yet given I have chosen to go down the microbiome/metabolomic road instead for right now .

Also, I was wondering if you have heard of this clinic and if the clinic is reasonably close?

https://www.villagecatclinic.ca/facilities.php

The site says the are a current member of the CVO

 

Nice greens today Lyla, I'm praying every day for Butters and that each day you see a little improvement. ♥

 

Interesting info on CBD.

Yeah practically all practicing vets in Ontario are members of the CVO, including all of Butters' former and present vets. I've always checked that my vets are active members of CVO even though I don't think it means much in terms of quality of care, sadly.

I have spent every spare moment I've had this week searching and calling around and trying to find a decent clinic. That clinic hasn't come up in any of my internet searches. Though I have previously searched "board certified" vets and "diplomate vets" in the greater toronto area. Maybe it's my search engine (not a google fan lol). I found one in Guelph that looked kinda okay, but this one looks a lot better.

It actually looks almost too good to be true. Actually having "pain management" as a specialty is also on my list of must-haves and this is the first time I've seen it mentioned. Putting aside that they probably charge a fortune, I'm considering giving them a call. They aren't next door to me or anything but in no traffic it's not terribly far. Thank you so much for doing some research for me.

 

I did go with 50mg gabapentin q12 for today. But that has been making her act very dopey for hours and unable to walk a straight line. Next time I may try the leftover bupe with 25mg gabapentin.

I'll be posting at my more normal time once daylight savings time ends. I'd love an IM but I have to get referred to one by a general practice vet. Yes, even though she saw an IM in the ER.

 

She can't catch a break today. Huge bounce from being in green numbers for like 2 hours or so.

 

That will all fall into place with time. I know it’s hard but you are doing an amazing job managing it all !! Eating, pain management and some Butters love ❤️.

T does really well with the Bupe but just like with humans, if they don’t dose a drug properly—high enough concentration and high enough dose for the level of pain—it’s not going to work. The issue you are having with the gabapentin is why it was not used with T. I’m sure it works very well for some cats but for others, when you get to the dose that is effective, there can be side effect issues. Always a good and valid reason to try something else. A little sleepy is one thing, but to be unable to walk well and/or to be over sedated is not good

I’m hoping the clinic works out. Always interesting to search in another country...LOL. I saw another clinic that has a vet on staff who used to be the director, or in charge, of an emergency clinic, so that may be another option if you don’t end up liking the first one. I keep digging into the vet profiles to try to find someone who at least looks promising. There is another cat clinic but if I remember correctly it’s one vet & that can be an issue.

 

I really am trying to do the absolute best I can for Butters, basically putting every aspect of my life to the side, other than my paid job. That eats up a lot of my time.

Right?!?! Witnessing the gabapentin side effects in Butters is actually scary. There weren't any noticeable ones when I was doing 25mg q8. Argh.

I found a cat clinic with a solo vet and thought that didn't seem like a good idea. There are a few cat clinics around.

Thank you For all of the searching and the helpful info.

Thank you, Diane. I appreciate it so very much.

 

You are welcome . No doubt you are definitely doing the best for Butters. I hope you can find something relaxing to do at home. I remember having to sit with T with every free moment so he wouldn’t be on the bed all alone. I cannot remember—do you have other cats? I ask because they were very helpful with letting me know how we was doing as well. Our oldest cat, who is “nurse” Frasier, normally finds T to be a whiny, needy man who bothers him, BUT when T is sick he looks out for him, goes over and checks on him, won’t use his litter box if we put it in the bedroom. In fact none of the cats will go near it & they all check on him but leave him alone. It’s a good sign when big Frasier goes over and takes a huge pee in the box—-positive sign that T is doing better. It’s as if Frasier is saying “he can walk across the house now so I’m going to use it!”. It’s fascinating to watch how the interactions change!!

Solo vet clinics are tough or clinics where you only like or trust one of the vets or the vet you trust works limited days/hours. It’s one thing if there aren’t health issues, but it becomes a problem when there are and you need someone to be available....sometimes immediately, so that you don’t have to use an emergency clinic.

That’s a bummer about the gabapentin, but now you know. It happens quite a bit with human meds as well. They are fine at a lower dose but maybe not a higher one .

 

Your cats are so sweet! My heart.
Unfortunately, no other cats live here. It wasn't my plan but my home was devoid of cats at the time and my neighbour/rescue person badly wanted me to take in Butters. She'd had the saddest life. She needed to be the only cat. I took her in but I had to sign off saying I'd never bring another cat into the home with her. I thought I'd be able to get her to accept another cat. I tried twice. Everyone lived but it didn't work out. She will forever remain a solo cat.

 

That was so awesome of you to adopt her....especially under those circumstances. My Moms cat is similar and I have a close friend who wants another pet but cannot get one because her cat is similar to Butters and my Moms cat-Missy. I would say it’s a female thing but we have a little black female who is very passive & was super excited when my Moms cat initially came here (stayed briefly before a move). I think she was excited about another female in the house but Missy not only wanted nothing to do with her but also wanted to take her out ! Needless to say, Missy stayed in a bedroom with my Mom and was happy to be away from the others. The lone Queen—not sharing territory !