12/17 Loose Lips Feline Liver Disease and Pancreatitis Notes

Well, many times promised and finally delivered ;-) Please let me know if the links don't work...

I scanned Dr Twedt's lecture notes in two batches separating Pancreatitis and Liver Disease. The information is a little heavy but SO interesting. And you can search within each document if you're looking for something particular like thoughts on a specific lab result.

Pancreatitis: https://docs.google.com/open?id=0B6G9STA1wAKBMThlZDUxMDQtY2U4Ni00ODgxLWEwNzItYmM2ZjU4Yjg2YjUy

Liver Disease: https://docs.google.com/open?id=0B6G9STA1wAKBZTQyODEzZDQtODFkNi00NjA0LWE4ZWItNTcyYjQyZjM2OTVm

Some of my notes on topics I've seen discussed here often:

Cerenia- Cats with liver disease can safely use Cerenia at half the normal dose that you'd give a "healthy" cat. Also, Cerenia has been proven to have an interesting "side effect" of blocking visceral (internal) pain. Many studies on this have been done and cerenia seems to do a better job of blocking internal pain than actual pain drugs!

Mirtrazipine- This is most commonly prescribed at 1/4 Tab every third day. However, the recommended dose is 1/8 tab every day. This dose stabilizes the level of the drug in the bloodstream and seems to also eliminate many of the side effects seen with the 1/4 tab dose.

Cats with Hepatic Lipidosis- Stress should be reduced or eliminated altogether during treatment. Cats should be released from the hospital ASAP as soon as they are stable enough so they can return to their home environment where they'll be less stressed. Studies found that 38% of cats with Pancreatitis have severe HL.

Chronic Pancreatitis- Long term recommended therapies for cats with CP are Denamarin, SamE, Milk Thistle.

Metronidazole- In studies, Metronidazole has been shown/proven to cause GI lymphoma in cats and should not be given. In cases where a GI antibiotic is indicated, Tylosin should be given, NOT Metronidazole.

Well, I hope this is helpful to at least some that come across it.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Very interesting Jaclyn! I know when the vet thought Leo had a pancreatitis attack a few months back and was puking his little guts out, the vet gave us cerenia and she had told me the same thing, that cerenia did take care of the pain as well.

Thanks for posting this

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Thank you for the info.

Would you have any links on the connection between Metronidazole and GI lymphoma?

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

wow...great info!!!!!!

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Hi Linda,

I'm pretty sure Dr Twedt said Cornell did that study and I found this http://www.vet.cornell.edu/labs/simpson/docs/metronidazole.pdf Here's a summary "Metronidazole kills target organisms by inducing formation of reactive intermediates within these organisms, resulting in disruption of DNA. This disruptive effect is not restricted to microorganisms, and both carcinogenic and mutagenic effects have been documented in experimental animals" and Here's an excerpt from page 66 under the discussion section "we have demonstrated that standard oral dosing of cats with metronidazole for 7 days disrupts DNA (genotoxicity) in PBMC as well as in PBMC and feline T-cell lymphoma cells incubated with metronidazole at concentrations within the therapeutic range".

If this isn't helpful, I could try to email Dr T for more info. Let me know.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

thanks for posting all of that, jacklyn. i've seen several people (but no idea who) mentioning their cats being given metronidazole. that's a little disconcerting.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Like perhaps me, for one.

Bear Man was an IBD kitty treated long term with metronidazole. Civie Teddy was an IBD kitty also treated long term with Metronidazole. He developed GI lymphoma but had a very long remission on Leukeran. He succumbed to pancreatic cancer two months ago.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Most of my cats have been on metronidazole at some point in their lives. I find this to be pretty disturbing, too...

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

I would love more info on this, if it is not too inconvenient for you or Dr. T.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Tawny has been prescribed this, 1/4 tab every 3 days as needed, however has had none for 4 days. Also, based on what Karrie posted in Tawny's condo yesterday (12/17/11), specific to cat's w/feeding tubes she will not be getting any more of it:

And if she ever has to have it again after her tube is removed she will be only getting the 1/8th. - Desi

Tawny was prescribed Metronidazole, 1/8 tab twice daily, during her last hospital stay and on her dischg pprs dated 12/11/11. There are 13 1/8th tabs left in the bottle. Can I pull her off of it? - Desi

You have NO IDEA how much help this is! - Desi

And me.

Tawny was also prescribed Leukeran, on her discharge pprs it reads: "We are starting her on oral Leukeran for suspected underlying intestinal inflammatory disease."

Do you think I should go ahead with this now based on the above?

I would like to stop the Metronidazole and not even do the Leukeran at all based on the above. She has not started the Luekeran yet, plans are for starting tomorrow.

I am going to cut & paste the above and cross post it in Tawny's condo today.

Desi

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Desi,
Tawny has been so ill that I don't think you should change anything at all with her Metronidazole or Leukeran without talking to her vet first. Her recovery from her serious illness in the short term is critical. Please ask the vet before you change or stop any meds. Leukeran gave Teddy 7 years of remission from his lymphoma.

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

OK, I will talk to Dr. Amanda when Tawny sees them for some after-care next week. Thanks so much!

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Just adding my concern, too. My Teddi Bear was on metronidazole for a month last spring....and then developed GI lymphoma.

I'm sending all this info to my vet.

Thank you so much Jaclyn!

 

Re: 12/17 Loose Lips Feline Liver Disease and Pancreatitis N

Metronidazole is a very commonly prescribed med for cats. Its common name is Flagyl. I think Smokey was on it for 2 or 3 months.