11/13 Billo AMPS 302, +4 135 - Pancreatitis vet update

yesterday

I received an update from the vet; a few things:

- blood and urine analysis confirmed pancreatitis

- vet wants to look over the protein sources in FF wet food to see if Billo is having triaditis or inflammation of her bowels, pancreas and possible gall bladder secondary to a food allergy or inflammation

- recommended continued use of famotidine since it has helped with the nausea, along with the introduction of B12 injections once weekly for 6 weeks then once monthly

- ultrasound to further investigate pancreatitis

- a potential antibiotic trial, in case the pancreatitis is being caused by an infection, and a possible dental cleaning


I'm glad to have gotten some clarification on the underlying issue with Billo's vomiting, its unfortunate but I have to keep up the effort and aim to regulate everything so that she can start functioning normally

 

Sorry to hear about the pancreatitis, not my area of expertise, so I'll link the Primer on Pancreatitis for you below, if you haven't seen it yet:

A Primer on Pancreatitis

and tagging Elise, as I believe she has experience with this @tiffmaxee

 

Thank you for sending this to me! I took a quick look through it and it has helped ease a little bit of the anxiety and stress. I'm ready to take the next step in bringing Billo back to full health

 

I'm sorry that Billo has pancreatitis but I'm glad you know what is going on.
Did you get a copy of the lab results? There is a sheet in billo's BG workbook for "labs" if you want to share them.

 

It always helps when you know what you’re dealing with with any luck this is a once off but if it turns out to be chronic then you will work out how to manage that for Billo too. Elise had it down to a fine art with Max.

If there are any dental issues then it would be well worth having those taken care of, dental problems make a diabetic cat difficult to regulate.

 

Hi. I have not been home and will be back later with my thoughts. A few quick thoughts though. Rarely are antibiotics needed for pancreatitis. Famotidine is not going to control nausea and it’s use is not used much these days, even for CKD. Much better is cerenia , a vet medication, or ondansetron, a human medication which requires a RX from your vet.

I will be back a little later.

 

Oh I didn't see that! I've uploaded the lab report now.

Thank you! I'm hoping its not chronic either, but I'll only find out these things as I proceed further.

Right! I was reading up on the article you sent me a few days ago. The vet had mentioned Cerenia as well, but in pill form. I read on A Primer on Pancreatitis that its available as an injection too. I think I'm going to consider the injection, Billo doesn't do well with pills, I had to give her pills once many years ago and it didn't go well lol. No worries take your time!!

I'm just waiting on the vet to give me a call back, I left a voicemail; I want to discuss the next step from here with her. I'll keep everyone updated.

Thanks for all your support guys! I really appreciate it

 

And pain meds. You'll need pain meds. Buprenorphine (bupe) seems to work the best though your vet may not want to give it to you. It is a narcotic. Push for this. A cat in pain does not want to eat.

 

Ask for a feeding syringe as well. Possibly a can or two of AD (it is very smooth and easy to syringe).

 

The injection of cerenia works better but it stings horribly. I tried it years ago with my lymphoma kitty and just couldn’t do it again. I was afraid to even try with Max as he never minded insulin injections or ear pricks and was afraid he might. If giving fluids I’ve heard if inject into the fluid bump it doesn’t right sting.
I think an ultrasound is a good idea to see if there’s any thickening or abnormalities. It really needs to be done by a board certified radiologist though. Max had one by a traveling vet that found all kinds of things wrong with him and recommended exploratory surgery. I went back to my internist who wanted one dine by his radiologist. His ultrasound was normal. Max did not have IBD or small cell lymphoma then and never did! Sissy just had one done by her bet and ended up with more questions and no answers.

Max had chronic pancreatitis for a few years before becoming diabetic. He did not have IBD or any infection. He rarely vomited from it or had diarrhea but did at times. He always became inappetent. When it was suggested to me he was nauseous, I was surprised. He was off his food and eating more dry food until one Christmas Eve he stopped eating completely. I treated him with mostly ondansetron for nausea but occasionally cerenia if vomiting, cyproheptadine as an appetite stimulant, and buprenorphine for pain. When not eating enough he had to have fluids at times. Once feeling better, I removed support one by one and gave it several days to make sure he was ready. That’s the only way to learn what works and what doesn’t. Once I learned what helped me his bouts lasted a shorter time.

The ultrasound will show if there’s any involvement with other organs. I would do that before trying an antibiotic that could further upset his stomach. Start with that and go from there. I’m going to look at the labs. I will be back.

 

I don’t see anything in the labs that shows infection. They look really good actually which is often the case with uncomplicated pancreatitis. Vets have no idea what causes pancreatitis. I’ve never heard dental disease mentioned. It is very common in diabetic cats though. It’s also way more common in all cats than once thought, even young ones apparently.

Has Billo had a history of vomiting? If not, if my cat, I would start with an ultrasound, ondansetron or cerenia, and buprenorphine and see if she starts feeling better.

 

Abdullah - She will give you pain meds just ask - she is good that way. You may find you only need to give a day or two. I am not sure on the anti-biotics, nothing in the bloodwork really indicates an infection. Ultrasound is a good idea to make sure there isn't an IBD or other issues. This clinic has a ultrasound specialist come in that does the US. I have used him a few times before. If all else fails, she is not adverse to getting a second opinion to look at it. Jones was sent to the specialist at another clinic once. When you are in, ask if you can see any images and she just automatically sends my reports by email now, just ask.

The cerenia shot stings and you still have to give it every 24 hours, the pills are not hard to give - it is actually quite small. She will be open to giving those if you ask. I think you will find the pepcid works for now but will not work for long. That was my experience with my CKD kitty.

I have found that food can seem to set off a flare. And Elise is right - no body knows why it happens but IBD and pancreatitis seemed to be linked in a way in my experience. My civvie is now being weaned off of FF as there is something in them that has made her pancreatitis worse with more flares.

I am sure she has gone off to think out her thoughts and she will come back with a good plan. She really hasn't let me down yet. AND don't be afraid to talk to her and ask questions...she is willing to listen to the caregiver as you know your kitty the best!

 

@Tracey&Jones (GA) I didn’t know you used this vet. I just remembered that she was a new one. That’s good.

 

She is the one I recommended to Abdullah when the last vet seemed a little lack luster. She was Jones' vet and I can't believe some of things she has been able to do for some of my animals. She has dealt with mammary cancer (administered the chemo), enlarged liver (it actually came back to normal size and function) which was probably due to Cushings that we were able to get under control, CKD, diabetes and the big one - IMHA. She saved my pup from that when everyone else said it was a lost cause. She lived another 4 years until cancer took her. There is also another vet at the clinic and they both work very well together and are not afraid to go outside for more answers.

She isn't perfect but she is pretty darn good! I have been with her for about 8 years now. I have recommended her three times now and the other caregivers have all liked her and had good results.

 

I made some mistake, I have no idea why the reply to your guys' messages showed up like the post above. My apologies!!

You're right!! I took your advice and I asked her about the Bupe and she was on board right away. We decided not to go ahead with the antibiotics, bc her report came back clean in that sense. Since a few of you are recommending the ultrasound, I'm thinking now that it may be a good idea to go ahead with it.

Yess! I decided to go with the Cerenia tablets instead of the shot, because I don't want it to sting so much. Billo is really good with the insulin injections but I don't want her to feel any pain.

What kind of food are you using instead of FF? If FF has some content that causes the pancreatitis to flare, I should look into other brands. Just yesterday Billo stopped eating the FF that I had been giving her for the past month or so. Thankfully I had extra flavours lying around and she ate those, but yesterday was honestly the first time where she began being picky with her food...don't know if that's cause of the pancreatitis or some other factor?


Thank you so much for recommending Dr. Sherry. The way she approached Billo and the way she is looking after her health is excellent, way better than my previous vet. I'm so grateful for you and your guidance.

 

Tracey is truly a blessing, her referral to this vet has truly helped us so much

 

It seems to be a side affect. They eat, then feel bad and nauseous then decide that it was all the foods fault.

I had Jones on Rawz Turkey - low carb, no gums, no food coloring, good calorie count. The issue is finding it right now due to covid...I have noticed it coming back in. Bone & Biscuit at the 17st & Whitemud shopping complex carries Rawz. Libby - I am trying the Turkey, Chicken (I think there maybe an allergy to this one which is common just too bad a lot of food has chicken), Tuna and Salmon. They do have duck, turkey and salmon as well. What does Billo like? I have some rabbit (none of mine will eat it) and turkey and salmon if you would like a couple of cans to try.
https://rawznaturalpetfood.com/cat/rendered-free-cat-food/#gum-free-wet

I would also try the First Mate (made in Canada-less issues with Covid shipping issues) - limited ingredients. I just don't know the carb % on this one. https://firstmate.com/product/free-run-turkey-formula-for-cats/

Did she say she felt anything "spongy" when palpitating the abdomen? With Jones she knew kinda of right away that something didn't feel right and pushed for an ultrasound (I should of listened to her) but for Libby she says it all feels good and wasn't concerned about an ultrasound. ECID. I have no wisdom to give on this one.

And please...I am just glad Billo is getting the care she deserves. You are making me blush!

 

If she doesn’t think an ultrasound is necessary, then I’d wait awhile. My only reason for doing it would be to see if she has IBD too. If the medication helps and she starts acting well I’d just assume it’s pancreatitis “only”.I did have to keep Max on ondansetron for a few months the first time but I think it was because it wasn’t a large enough dose for his weight. What Tracy said is true about eating. They start to feel better and eat. If they eat too much at one time they feel yucky and don’t want to eat again. They can develop food aversions to the foods they eat when feeling poorly. That’s why my vet said to feed small amounts often even if Max seemed really hungry. He sort of intuitively did that on his own though.

 

Not on a diabetic cat. The turkey is 20%. Great for HC. It has a lot of potatoes in it.

No problem with Rawz on the west coast, or Nature's Variety Instinct has some limited ingredient too. But not the duck and rabbit LID which are MC.

 

That's really close to me! I'll definitely check it out soon. And so when she was palpitating the abdomen, she said that everything 'felt' normal and that neither the kidneys, stomach, liver or pancreas felt inflamed or irregular.

 

Abdullah, I'm so sorry to hear about Billo's pancreatitis! Sending hugs and scritches...and feel better vines! Isn't this group of folks wonderful! So much knowledge among them! So glad to see that they were able to provide you with helpful information to share with your vet! It takes a village!!

 

P'titis, know it well. I had injectable cerenia and pills. The injections stings/burns awful. However, I gave through the iv line when giving subqs. It made a big difference. For the pill. I use the Delectable Squeeze Up treat. I put a dab of treat on plate, put pill on top of it then another dab of treat to cover it. Ollie ate it right up. I now do this for Trips thyroid med, she impossible to pill or give liquid meds to.

My vet was also good at keeping me supplied with all the meds, at home, Ollie was chronic. Ollie was a chow hound, the minute she was off her food or had the "miserable" look, I started the meds before it got out of hand.

 

Libby is like that...as soon as I see not all food has been eaten in a 12 hour period, I start with the Cerenia immediately and pain meds. Seems if I even wait another 12 hours things get ugly quick.

I am with Elise on this one, if she isn't pushing, maybe put it on the wait list to review if issues keep coming up - vomiting, diarrhea and weight loss even though the calories are there.

Good luck with your search, as Wendy indicated the First Mate was not a good option due to carbs. I don't know all the carb% of all the different proteins for Rawz but if you want to try the Rabbbit, Turkey and Salmon I do have some can give you to try, even if it is a little higher carb.