Diabetic cat not eating; Pancreatitis - back to normal

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Re: Diabetic cat not eating; Pancreatitis flare

Tisha is still no better this morning. Still refusing to eat. Threw up nothing but fluid some time during the night. Even when she purrs, it sounds off, like a high-pitched clicking noise. So, I got up and took her straight to the vet's office as soon as they opened. She is still running a fever and her abdomen is very painful. Our vet is not in until noon, but the vet who was there took a look at her and said she's in no immediate danger. (My lethargic cat suddenly became much more animated when she realized where she was.) They are going to keep her all day, push fluids and food, and see if they can find a combination of medication that will get the pain, fever and inflammation under control. I will post when I know more, but I have to go to work, so it probably won't be until this evening.
 
Re: Diabetic cat not eating; Pancreatitis flare

I am sending prayers for Tisha. I can`t believe that the vet said she is not in danger. How long had it been since she had really eaten anything?
When my cat Lilly had pancreatitis the first time she was in the hospital for a week on IV fluids, pain meds and such. I am sorry she is so sick.

Terri
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi Lisa,

I'm sorry to hear that Tisha vomited overnight and that she's was sick overnight. If the vomitus was whitish foam it was possibly due to excess stomach acid and nothing in her tummy. It is good that she is getting fluids at the vet's.

terri1962 said:
I can`t believe that the vet said she is not in danger. How long had it been since she had really eaten anything?
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Tisha's_Person said:
They are going to keep her all day, push fluids and food...
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I'm on the same page as Terri here. Make sure that they are aggressive in their approach to getting food into Tisha. I know how worried you are at the moment and I don't want to add to that by appearing alarmist but I was in a similar position with my Danú a couple of years ago and the vets that I took Danú to weren't aggressive in the least in terms of getting food into her (didn't want to "stress her out"). They were so busy not stressing her out that they lost her on me (HL). I'm not implying in the slightest that your vets would be so cavalier in their approach to Tisha's treatment, but if you're not happy about their progess on the feeding front then go with your gut and tell them so. To my eternal shame I let the vets intimidate me in spite of how worried I was, I kept quiet and my little girl paid the ultimate price for my failure.

Fingers and paws crossed in the Shire that they will get the right prescriptions for Tisha straight away and, all going well, she will be able to eat under her own steam before the day is out. Will be checking in later to see how you are both doing.

((((Lisa & Tisha))))
 
Re: Diabetic cat not eating; Pancreatitis flare

Yes that's what concerns me at this point is that she may be in liver failure(hepatic lipidosis). I too lost a cat to this as well(Andy), they did not tell me at the time they he needed to eat, he had not eaten for two days. He was already to sick at that point I had to have him PTS. I know now that a cat needs to eat if they are not eating it is a grave concern.
If Tisha is not already is liver failure she may need a feeding tube.

Terri
 
Re: Diabetic cat not eating; Pancreatitis flare

Terri, I'm very sorry to hear about Andy. :sad:

Saoirse was in a similar situation as Tisha a few weeks ago. Hopefully Lisa's vet will get her eating today with an appropriate appetite stimulant and the other relevant supporting meds. Cyproheptadine helped (and continues to help) Saoirse enormously. It's not plain sailing, but I've been able to keep her eating steadily with the anti-emetic and the appetite stimulant combo. She's on a course of B12 and between that and the food she's looking better by the day. Fingers & paws crossed, Tisha will start feeling better soon, too.
 
Re: Diabetic cat not eating; Pancreatitis flare

Yes I have used Cyproheptadine as well for appetite stimulant. It works very well. B-12 shots work very well in cats with pancreatitis flares too. I hope Tisha can turn around and get better, sending prayers for her.

Terri
 
Re: Diabetic cat not eating; Pancreatitis flare

terri1962 said:
How long had it been since she had really eaten anything?
When my cat Lilly had pancreatitis the first time she was in the hospital for a week on IV fluids, pain meds and such.
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She didn't eat all day Friday, then ate a few bites a couple of times on Saturday. The only thing she voluntarily ate on Sunday was about 8 high carb treats, but we did get about 30 ml of food into her with the syringe. I'm sure that didn't help her BG, but I was desperate to get her to eat SOMETHING. I am happy that the vet will be handling that part of it today. If nothing else, I know that she is getting some food into her to prevent getting some other nasty condition to deal with like fatty liver disease.

The vet asked me if I wanted to pick her up tonight and bring her back tomorrow or just let her stay overnight. When I asked directly if she thought that she would need to come back tomorrow, she said they would have to see how she did today. So this may end up being a multiple day thing. They asked us to bring up the prescribed meds so that they don't have to charge us for them again. When my husband brought them up, he asked to see her. (Interesting, since he was griping about the cost of taking her earlier.) He said she looked pitiful in her cage, but they put her in one of the boarding condos, so she does at least have some room to move around and some shelves to jump on if she feels up to it. Poor baby.

They are going to put her under my vet's care when she comes in at noon (Central Standard time), so I don't think I'll hear anything more before then.
 
Re: Diabetic cat not eating; Pancreatitis flare

Sending purrs and prayers. You are dong all you can. It is very hard to leave them at the vet.
 
Re: Diabetic cat not eating; Pancreatitis flare

Okay, now that I've read all of the posts, I'll try to address any other outstanding issues. I'm sorry if I miss anybody! I do really appreciate the outpouring of support on this page. It helps.

The vet is very concerned about the lack of food, and explained that it can cause other serious illnesses. She told me Saturday that feeding her is very important, and they told me this morning that they will get her started on syringe feeding. They just start slow because she hasn't eaten and her stomach won't hold much, but the goal is to get her to 30 ml. at each feeding. She will get a syringe every hour, adding 5 ml. each time. They also told me that she will likely be more cooperative with them feeding her than she is with me. I'm just glad to have somebody else worrying about everything she does all day. The vet really wants her to get back to eating on her own as soon as possible, though, so they reward her every time that she eats something voluntarily. Basically, the way she explained it is that she is offered food every time before the syringe. If she eats ANY of it, she does not get the syringe right then. They are also giving fluids with vitamin B in them. FYI: This is a clinic and hospital that only treats cats.

The vet this morning said that she may still have the fever just from inflammation at this point. She is going to let our normal vet decide if they want to change the antibiotic to something different. They chose this one because it's injectable. If it doesn't work, we will have to pill her again. We did manage to get them in her last time. It was just a huge struggle for every single pill.

I think the vet was just trying to calm me down some this morning. I couldn't even give her a coherent update on Tisha without crying. I think she knew I needed some hope to get me through the day. So I asked if we got enough food into her to keep her from getting worse and she said it sounded like we did. I'm not sure she would have told me if we didn't, since I clearly was not handling things well this morning. I'm trying not to get too upset at work today, since I work with a bunch of men who really don't understand. They've already asked why I don't just put her down and get a new cat.
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi LIsa,

Delighted to hear that the vets are being very active with the feeding (my Danú was just put on a drip, given a pill and left with a bowl of food to get on with it - not a syringe in sight).

Re the pilling problem, it's well worth having a look at the Wedgewood Pharmacy site. They have all manner of solutions for making it more straightforward to administer meds.

I know it's hard to leave Tisha at the hospital but it will give you a chance to get some much-needed rest. (Remember the old maxim: you need to take care of yourself so that you can take care of those you love. :smile: )

I work with a bunch of men who really don't understand ...
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There are not sufficient expletives ... :evil: :evil: :evil:
 
Re: Diabetic cat not eating; Pancreatitis flare

I will ask about an appetite stimulant. Right now, I'm still waiting to hear from them. The bet typically returns calls late in the day when she is done with patients.
 
Re: Diabetic cat not eating; Pancreatitis flare

If the cyproheptadine works, Tisha will be able to eat without the stress of syringe feeding. She will probably need the ondansetron in conjunction with it. Did you get any feedback about Tisha's BG levels?
 
Re: Diabetic cat not eating; Pancreatitis flare

I have not heard anything yet. I will try to post as soon as I do (although the vet often seems to call me when I'm on my way home).
 
Re: Diabetic cat not eating; Pancreatitis flare

Meanwhile, in a quiet corner of the Shire ...

nailbite_smile nailbite_smile nailbite_smile nailbite_smile nailbite_smile nailbite_smile nailbite_smile
 
Re: Diabetic cat not eating; Pancreatitis flare

At this point, I would be exceedingly grateful to just get back a cat who is eating with a clear treatment plan that gives her some pain relief and puts her on the road to recovery. It's the uncertainty of having her home and not knowing what to do, or whether I'm making things better or worse, that is nerve wracking. But I will admit that I am carrying my cell phone with me everywhere I go today and I look at it about every 5 minutes to see if I've missed a call.
 
Re: Diabetic cat not eating; Pancreatitis flare

The 'better or worse' thing is awful.

When I was where you are right now, Hellen and Elise were sure to tell me that it does get better. It didn't feel like it for much of the time but Saoirse gradually made progress. When the vet saw her during the peak of the flare-up her coat was falling out in handfuls and she looked miserable & lethargic. It has taken a lot of nursing and it has been a real white knuckle ride at times but now she looks very much like her avatar picture. I think the B12 jabs helped her a lot. I didn't feel like I was getting anywhere with helping her most of the time, but gradually she has got better. I hope it helps you to hear this.

(I must confess to still doing the helicopter parent thang most of the time when she's eating ... :oops: :roll: )
 
Re: Diabetic cat not eating; Pancreatitis flare

I just heard from the vet. Tisha is still nauseous and refusing to eat, but they have been syringe feeding her today. (They were about to do it again.) When our normal vet arrived, she immediately changed her antibiotic. The new one is the same medication that she responded well to last time, but I will have to give her a pill every day for the next week. She is getting that now, and will likely need to be syringe fed through the night and tomorrow morning. She told me that they can keep her in the hospital overnight and make sure she eats, which increases the chance that she will be eating on her own when I bring her home. The extra charge is only $10, so I asked her to go ahead and do that. It breaks my heart to think of my poor kitty stuck in a cage in the hospital, but I really want her to have the best care and at the moment, she would benefit from more skilled care than I can give her. The vet tech there loves Tisha, though, so she will be in good hands.

So she is back in Cerenia, even though it makes her lethargic, because it helps her more. We will go home with more pain meds, a different antibiotic, and possible a different anti-nausea medication. I will ask about an appetite stimulant, but first we need to see if they can get the fever down. One step at a time. The vet said she would call me in the morning with an update and plan.

As for the helicopter parent thing, Tisha actually prefers to eat with us in the room anyway, so we usually know when she is eating. If she's hungry and there is food out, she will come meow at one of us until we sit down near her bowl, then she eats. She is a very people-oriented cat. She also follows me around the house and "talks" to us all day long. Her favorite game is to play fetch with her small toy mice, and she growls when someone rings the doorbell. (Who knew that cats could growl??) We have decided that our cat must be part dog.

As for the pharmacy: we've tried most of the compounding options. Our old vet push Tisha on Prozac for a while to address the litter box avoidance issues and she really hated it. Every time she figured out a way that we gave her the medicine, she would immediately refuse it. If we hide it in food, she will never eat that food again. When we tried rubbing it on her ears, she started closing her ears every time we got near her. She stuck her nose up at the fish flavored chews and "juice." The best option we've found is to crush the pill, mix it into the smallest amount of cream cheese that we can, then smear the cream cheese onto her paws. She gets mad about it, then spends several minutes walking around the house trying to flick it off (which is hysterical to watch), then she starts cleaning it off and gets the medicine in the process.

As for the Prozac, once we switched to the cat clinic, she was immediately taken off of that in favor of trying to figure out what was really causing the problem. The answer: very painful struvite crystals and an infection, plus the glucose in her urine, diabetes, and chronic pancreatitis. We really have spent a fortune in the last year on vet visits, all of which started with the simple question of "Why does my cat pee on my husband's side of the bed while we are sleeping?"
 
Re: Diabetic cat not eating; Pancreatitis flare

My, you have all been through a lot. I'm glad that you've got good vets.

It's lovely to hear more about the things that make Tisha Tisha. No wonder the vet tech loves her. cat_pet_icon
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi Lisa,

How's Tisha doing today? And how are you doing today? Did you manage to get some proper rest?

:YMHUG: cat_pet_icon
 
Re: Diabetic cat not eating; Pancreatitis flare

I did get some much-needed sleep last night. Thanks for asking!

I just talked to one of the vet techs. Tisha's fever has come down to 102.1, which is a normal temperature for a cat, so they think the antibiotic is working. She seems less painful this morning. They left two bowls of food in her cage after they assist fed her last night. The tech said that Tisha covered them up with a towel that was in her cage, but that it looked like she might have nibbled at one of them. They did assist feed her again this morning (and will do so again around noon if she's still not eating.) They gave her Buprenex and Cerenia again this morning to encourage her to eat. The vet tech said that she's being very vocal this morning, which sounds like it's probably a good sign. The tech said that the vet who examined her this morning thought she looked worse, though, so I'm not really sure what to think at this point. Tisha's vet comes in at 2:00 PM today, so I should here more this afternoon. I plan to pick her up around 4:30 or so. That way, she can maximize the syringe feeding at the vet's and get her next pill before I take her home.
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi LIsa,

Really glad to hear that Tisha's temperature is back to a normal level, that she seems more comfortable in herself and - best of all - that the vets have managed to get some food into her. I'm also really pleased and relieved to hear that you managed to get a good sleep last night. This has been very tough on both of you. I'm sure that the two of you will feel much better when she's back at home with you. :smile:

Looking forward to your next update.
 
She's HOME!!!

Tisha is home! Not quite back to normal, but home, which is an improvement.

She is now on orbax and penicillin to take care of whatever infection started all of this. The vet thinks she may have eaten a few pieces of dry kibble today, but did go ahead and syringe feed her one more time before sending her home. She's back on Cerenia today. (Our vet agrees that the Cerenia does not seem to work well with Tisha, but the other vet had already given it before she got there.) She will transition back to Zofran for nausea tomorrow morning, which means she will continue to get sub Q fluids. The vet said she is very hopeful that she will eat tomorrow, but if not, we are to syringe feed her 20-25 mls. of recovery food every 3-4 hours throughout the day. Once she gets back to eating regularly, then we will need to transition her back to wet food. (Honestly, she usually prefers wet food, so that shouldn't be a big problem.)

She did not give an appetite stimulant, but did say that the meds we are giving her include a mild stimulant. They also gave her vitamin B while she was there to help with appetite.

Tisha does NOT have any signs of liver failure. The vet said that since she is dramatically underweight, that actually delays the risk of developing liver problems. (Until this summer, she was consistently a healthy 12 pound cat. She is now down to 9 pounds.)

She does seem to feel better, but still not quite herself. She was grooming herself today, and she has been at her water cups a couple of times, although I'm not sure if she actually drank anything. (She kept smacking one of the cups with her paw so that it spilled. I'm not sure what that was all about.) She wants to be in the same room with us, but is sleeping on the floor instead of jumping on the couch. But, the Cerenia makes her really sleepy, so that may be due to the effects of the medicine to some extent.

I am really hopeful that she has turned the page and will start feeling better now! And that I won't have to syringe feed her tomorrow!!

Thank you all for all of your support and advice through this last few days!
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi I am new here and have hardly any experience of diabetes but I do have experience of managing a cat with chronic pancreatitis.

Although each cat is different for me I found the best thing was to stick to the same medication regime regardless as to whether he seems better or not.

For my cat that regime involved:
1/8 Zantac twice a day
1/4 ondansetron twice a day
1/4 destolite (ursodoil) for his bile fluid
Small meals four times a day or more to avoid an increase in stomach acid
Additional fluid added to his food or syringes into him
Pain relief when symptoms

When he was really poorly I found that royal canin convalescence support was excellent but remi wasn't diabetic and am sure that it would recommended. But I found that making up this powder into a liquid food that didn't taste or smell of normal food and make him more nauseous invaluable. It allowed me to get calories into him quickly with out all the syringe feeding mess and stress and also allowed me to give him his tablets (in a gel capsule) at the same time. Again this isn't a recommendation because remi wasn't diabetic then.

Hugs to you and Tisha

Sarah and remi
 
Re: She's HOME!!!

Welcome home, Tisha! cat_pet_icon

I'm so glad you've got your furry baby back. :-D

Great news about the liver function, Lisa. I'm sure you must be relieved. I'm glad that Tisha got some B12. I was going to mention that to you today because Saoirse has been receiving a course of B12 injections and they are helping her a lot. (I don't want to jinx anything by saying more than that at the moment but when I am more sure I will post an update. nailbite_smile )

Tisha's_Person said:
[The vet] did not give an appetite stimulant, but did say that the meds we are giving her include a mild stimulant. They also gave her vitamin B while she was there to help with appetite.
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Fingers and paws crossed that they will do the trick but if it doesn't seem to have much effect, I'd be inclined to go back to the vet sooner rather than later. As well as protecting her liver, Tisha needs nutrition to get better.

I gave Saoirse gently poached chicken breast plus 50-50 water & broth (either minced or blitzed into a soupy consistency). In the initial stages I was feeding her a very small amount once an hour. (I acquired several timed feeders so I could provide a large number of scheduled feeds and still get some sleep. @-) ) The chicken & broth wasn't a complete food but it was bland and Saoirse ate it fairly readily, it kept her properly hydrated and it got her through the early stages of recovery. Hellen and Elise (Shadowsmom & Tiffmaxee) gave me great advice to stick to the micro-meals even if Saoirse could have eaten more at any particular feed. It was hard on me but thankfully it worked for Saoirse (although it didn't really feel like it at the time nailbite_smile ). Tisha may need different. Hopefully the recovery food will continue to help her.

(FWIW, in addition to stimulating Saoirse's appetite (needed only a sliver of a tablet for hours of effect), she seemed more comfortable generally while it was active in her system. The Wikipedia article asserts that cyproheptadine has mild analgesic properties. I've not been able to find anything else online to confirm this, but anecdotally it seemed to do more for Saoirse than just stimulate her appetite.)

Sometimes Saoirse needs a little prompting to start eating. Sometimes I'll give her a crumbled freeze-dried treat or let her lick a little of the food off my finger. Once she gets the taste of food, she'll usually polish the rest off without further coaxing. I used some of BJM's great tips (e.g. playing, waking Saoirse up and offering food immediately).

She kept smacking one of the cups with her paw so that it spilled. I'm not sure what that was all about.
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'Playing' with water like that is a behaviour associated with nausea. Other signs include lip-licking / pulling faces when trying to eat (looks a bit like the way humans stick their tongues out and make "Yeee-uch!!" faces when they taste something disgusting). Licking the jelly/liquid/broth off food and leaving the rest (provided that this is not a normal behaviour in the individual cat). Sniffing the food and walking away is another nausea-related behaviour.

If you get time later, Lisa, it would be lovely to get an update on how ye are getting on.

:YMHUG:
 
Re: Diabetic cat not eating; Pancreatitis flare

Thanks, Sarah! I will see if I can find the Royal Canin powder. Do you know where to buy it? Since any food is better than none, I think it's okay for right now even if it's not ideal for diabetic cats. Thankfully, her BG levels have remained in a fairly reasonable range, although I probably need to check again tonight.

When I left this morning, she was about the same. Following me around, but still obviously not feeling well and wouldn't eat anything. We syringe fed her about 20 ml. this morning and hour after giving her the anti-nausea meds. I also gave her pain meds just a smidge early so that I could give them before I left for work. Even though she clearly isn't back to normal, she seems to feel better than she did when I took her to the vet.

I have to admit, though, that her weight is alarming. She was never a heavy cat, but now she's just skin and bones. Once we get her eating, we're going to have to make a concerted effort to get some weight back on.

I will be running when I get home tonight to try to get meds in her system, wait, feed her, and get back out the door to get to my evening obligation, but I will try to post an update again when I get back home. (You know, at some point, I probably need to start a new post, but this is still part of the same episode.)
 
Re: Diabetic cat not eating; Pancreatitis flare

Glad to hear that Tisha's a bit better. :smile:

Is the vet going to continue the B12 treatment? It helped Saoirse to regain the weight she lost. Our 'vetty bean' ( :smile: ) couldn't get over the difference in her today compared to how she was when she started the treatment a few weeks ago (narrow hips, muscle wastage, coat thin and in bits). He was really pleased with the improvements in both her coat and body condition. Maybe it might help Tisha, too?
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi.

I seemed to have lost the message I just wrote for you.

I live in the UK and used to buy the powder sachets here:
http://www.vetuk.co.uk/royal-canin-vete ... hets-p-254

Am sure you must be able to easily get them in the US. again the ingredients are really for cats that are not getting enough calories in any other way so the ingredient list is nothing like they suggest for diabetic cats. But if needs must I would recommend that you make up half a sachet at a time with boiled (but cooled to body temperature) water. You can add in Miralax if you are using that. I used to get the 10ml syringes and give him 2 at a go every hour or couple of hours. So I might give 40 mls before I went to work, 40 at lunchtime, etc. in the end I could even put down a bowl of the stuff and he would lick it up even if he didn't want food. It ends up the consistency of double cream and nice and smooth, very easy to syringe. I hated trying to get the diluted food through the syringe.this is much easier.

Don't buy the ready made up version of the food, it is too expensive. I would buy a box of the sachets. Bought individually from the vet they are very expensive.

Hope that helps. If you have trouble finding them let me know and I can send you some over.
 
Re: Diabetic cat not eating; Pancreatitis flare

I feel like I am dragging all of you through this emotional roller coaster with me.

Tisha is lethargic again. I couldn't find her at first, then finally realized she was lying on the floor of the kids' shower. When I picked her up, she didn't protest at all, and she felt cold. Her paws and ears were just cold, and her body felt sort of lukewarm. I checked her BG and it was 298, but I can't give her anything for it. She is just acting really strangely. She's walking weirdly, with her back feet turned slightly out, and like she's really stiff. She will no longer purr for us. She is obviously dehydrated, and she's down to just skin and bones. Every time I put her down, she crawls into a bathroom or shower and just lies there. The food from her syringe feeding this morning was still on her face when I got home. The vet's office is closed today, but happened to call me because their system didn't process my card right yesterday, so I told the person I was speaking to that she wasn't better and they got the actual vet on the phone. I had already given the ondansetron, so the vet asked us to syringe feed her, then get a thermometer to check her temp and call back in an hour. (She gave me her cell number.) She said that the low temp might mean her body is just shutting down.

When I got back, Tisha was lying on a wet shower floor. When I checked her temp, the first time I got 97.3, which the vet said is dangerously low. She asked me to check it again and I couldn't get a good reading, but the thermometer eventually said 98.7. The vet said that's okay, but not really high, so now instead of trying to control the fever, we are trying to get her temp up. Per the vet's directions, I gave her 150 ml of warm sub Q fluids. I also gave her pain meds, which were due. If her temp keeps going down, we are supposed to take her to the emergency vet.

I feel like I am watching my cat die very slowly, and all I'm doing is poking and prodding her and making her miserable. She is in so much pain that it's starting to look like the kindest thing that we could do is let her go, even though that will break my heart. Even my DH was in tears today watching her.
 
Re: Diabetic cat not eating; Pancreatitis flare

Have you got a hot water bottle? Or a rice sock that you can heat up in a microwave? Or a towel run in the dryer for a few minutes that you can wrap her in?

Also, a damp, warm wash cloth may be used to groom her face for her. It may stimulate her a bit.

If, however, you think it is time to let her go, it is OK to do that. You will know when it is time.
 
Re: Diabetic cat not eating; Pancreatitis flare

(((Lisa and Tisha))) We're here to support you!! How is Tisha doing now that it's been an hour since the dose of Ondansetron? Any change in temp? Did the vet have any further instructions? I'm so sorry this has to be so hard for you, but please hang in there! I cannot offer medical advice but I would take her back to the ER vet, so sorry to hear this. Forgot to add, I am sending tons and tons of healing vines and prayers for Tisha and you!
 
Re: Diabetic cat not eating; Pancreatitis flare

I tied to put her in a warm towel, which she refused. I turned on the electric blanket on our bed and moved her there. I tried to encourage her to stay, but she got up and moved back to the floor. I couldn't get another temperature because the stupid, brand new thermometer just isn't reading, but she feels slightly warmer. I gave her the antibiotic and another 20 ml of food, mostly because I don't know what else to do.

She still isn't purring, but she does at least move her head like she used to when I stroke her chin. At least I feel like I'm giving her some comfort.
 
Re: Diabetic cat not eating; Pancreatitis flare

We have discussed it and agreed to let her be for the night. She has had both antibiotics, pain meds, anti-nausea meds, food and sub Q fluids. There's not much more I can do to help her. We will reassess in the morning, with a strong chance that she is going back to the vet.

I am going to try to get some sleep and encourage my cat to snuggle with me.
 
Re: Diabetic cat not eating; Pancreatitis flare

Morning update: We made it through the night. Tisha is somewhat more alert this morning than she was last night. She is laying more in the "meatloaf" position instead of flopped on the floor. (Who knew I would consider this a good sign?) Her head and ears are up, she is watching us, and she fought me a little bit on her meds, but she clearly doesn't have enough energy to move very far, and even holding her head up seems taxing, because she holds it up for a few minutes, then lays back down.

I had a long talk with the vet this morning. She is going in to see if they can find anything else to make her feel better. The vet agreed that she seems miserable and none of this seems to really be helping her. If she is not better by tomorrow, then we will probably need to consider putting her to sleep. The only other option is to send her for an ultrasound to see if she has pancreatic cancer, but if she does, we're probably going to put her to sleep anyway. Pancreatic cancer is incredibly hard to treat and after watching one of my people friends suffer through it, I can't make my cat do it too.
 
Re: Diabetic cat not eating; Pancreatitis flare

Hi Lisa,

I'm so relieved to hear that Tisha has picked up but I'm sorry she's so lethargic. cat_pet_icon It's beyond scary seeing our beloved little ones like that. nailbite_smile

Tisha's_Person said:
The vet really wants her to get back to eating on her own as soon as possible, though, so they reward her every time that she eats something voluntarily. Basically, the way she explained it is that she is offered food every time before the syringe. If she eats ANY of it, she does not get the syringe right then.
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This has been bugging me since you posted it. Right now Tisha needs nutrition, not behaviour therapy.

For the life of me, I can't understand why your vet seems so reluctant to prescribe an appetite stimulant for Tisha. If mirtazapine were the only available option I could understand your vet having reservations because of the very real danger of inducing serotonin syndrome, but cyproheptadine is available and it seems to work very well for many of the cats here. I asked my vets for it specifically and they ordered it in for Saoirse. Getting Saoirse to eat little and often with the help of the medications was the turning point for her. It even helped with her low mood and lethargy. Saoirse started eating voluntarily less than 2 hours after getting the anti-nausea med and cyproheptadine (she only needs 1/8 of a 4mg tablet once or twice a day - frequently even less than that). Maybe if your vet got it for Tisha it might work quickly for her, too?

At the peak of Saoirse's flare-up, she was desperately lethargic. I was frantic with worry. She seemed to get worse every day. It was soul-destroying.

Saoirse is so much better now. The cyproheptadine for appetite together with the metoclopramide for nausea (aka Reglan - not ideal, but it got the recovery started) and the B12 injections have helped Saoirse so much. From an extremely lethargic, tatty-looking, poorly pusscat a few weeks ago she looks so much better now. Our vet could not get over the massive improvement in her yesterday, even in the space of a week. He made a point of telling me that there was no way anyone would now believe she's 14 years of age. She still needs help with the nausea and appetite but that seems to be showing improvement as well. I can't get over the transformation myself: she looks better than she has in years. I'm sharing this so that you can see what can be possible, Lisa.

I'd also also talk to your vet about giving Tisha weekly B12 supplementation to enable her to use what nutrients she is getting more efficiently, and most especially to help her nervous system (which in turn would help her digestive function). Is Tisha pooping ok, BTW?

Famotidine (Pepcid) is another medication that might help with excess stomach acid.

Praying like mad for you both... (St Francis has earache.)

((((Lisa & Tisha))))

:YMHUG:
 
Re: Diabetic cat not eating; Pancreatitis flare

I dropped Tisha off this morning with a list of all the medication we have given her. I also went through this post and wrote down all of the suggestions that people have made and left them with a note to the doc to ask if we could try them. I am hoping and praying that she feels better and starts eating some today. I asked them to do anything they can to help her while she is there today. I will be going back around 4:00 PM our time to see how she is doing and pick her up. I probably won't know more before then, but I will post an update when we get home. (Let me apologize in advance for the inevitable ups and downs that will go with it.)

I am also calling the rescue organization that we adopted her from today. From all that I have heard, they may actually try to help with the costs of an ultrasound if they don't agree that it's time to put her down.
 
Re: Diabetic cat not eating; Pancreatitis flare

I hope she's better when she gets home and I hope you're feeling as well as possible. I'm new here, but there is certainly no need to apologize for ups and downs. I think we all go through that.
 
Re: Diabetic cat not eating; Pancreatitis flare

I second Beth's post.

Keeping everything crossed here for Tisha.

I know that every cat is different but, provided that there's no medical reason not to try Tisha on the anti-nausea/appy stimulant combo, it might really help her. No word of a lie, a few weeks ago I was looking at an extremely poorly Saoirse, bawling my eyes out and praying (for the first time in years - I'm not very religious) for her not to be taken from me. The meds helped so much. Where there is life, there is hope. I'm praying for Tisha.


:YMHUG: cat_pet_icon
 
Re: Diabetic cat not eating; Pancreatitis flare

FYI: I asked DH to check the litter box and there were no stools, so I called and told the vet that. I still haven not heard anything. I figured I would give them until about 2:00 PM my time (about another hour), then call to see if I can get an update. As strange as it sounds, I would almost feel better if they figured out something else was wrong so we had some hope of treatment that might help her.

I hope and pray that she is feeling better, but I don't want to get my hopes up unrealistically. I will push for the appetite stimulant if she's still not eating. Even if the vet doesn't think it will help much, it certainly can't hurt at this point.
 
Re: Diabetic cat not eating; Pancreatitis flare

I agree.

If it's any help, Saoirse's stools are much more infrequent since she has been on the low-residue foods. At one point she went for over 100 hours without a bowel motion. ( nailbite_smile ) Unless she's a bit runny, she seems to only poop once every 2 to 2½ days at the moment (cf. about every 26 hours). FWIW, I ran out of Lúnasa's normal food and had to feed her Thrive Complete chicken breast in broth for a few days. She went longer between poops on the low residue diet, too. :YMSIGH:
 
Re: Diabetic cat not eating; Pancreatitis flare

I just talked to the vet. Tisha is still not eating, but her pain appears to be controlled. (A step in the right direction at least, even if a small one.) Her temp is at the high end of the normal range, which is okay. (The vet said she has never been so excited to see a cat that was at risk of fever in her life.) Her nausea seems less severe, but she still isn't eating. She is willing to try anything that might help her, so she will be giving her Cyproheptadine and Pepcid with her next round of fluids. She will also be offering different foods. (FYI: She said the reason that she hadn't tried cypro yet is because it works the same way as cerenia and Tisha did not respond to the cerenia.)

She doesn't know where we can get the Royal Canin Convalescence Support powder. Looking on-line, it looks like it's a product that's not readily available in the US. The only place I could find it was on Amazon for $65+shipping, and it wouldn't be here for a week or more. I will stop by Petco to see if they have anything similar tonight.

So, I am crossing my fingers that the cypro/pepcid combination will work. The vet thinks that if we can get her to eat, most of the rest of the symptoms will get under control.

Thanks for the advice from those who have been there. I really need to hear that it is possible to come back even from this. She just seems so awful right now.
 
Re: Diabetic cat not eating; Pancreatitis flare

Lisa,

Cypro is a very good medicine as far as appetite stimulant. I sure do hope it works for her. I had to use it for my cat Arthur several years ago.
We will all be crossing our fingers.
Oh, Cerenia is for vomiting and Cypro is an appetite stimulant, very different medicines.

Terri
 
Re: Diabetic cat not eating; Pancreatitis flare

Terri beat me to the punch about the medication properties. Cerenia and cyproheptadine have different mechanisms of action in the body. There is some overlap between ondansetron and cyproheptadine (they both block 5HT3 receptors (key to reducing nausea) but from my experience of Saoirse's response, the anti-nausea effect of cyproheptadine is very limited. I've not seen anything in my reading that claims any appetite stimulant properties for ondansetron or Cerenia.

Here are the IDEXX Treatment Guidelines for Feline Pancreatitis. It goes through all of the medications that are suitable for treatment of pancreatitis symptoms and identifies the need for both anti-emetic and appetite stimulant therapy. It might be worth using it as a basis for discussion of Tisha's treatment with your vet.
 
Re: Diabetic cat not eating; Pancreatitis flare

Sorry for the double post but there's a major electrical storm here and it's causing power brownouts. It took over half an hour to get that IDEXX link to you and this post has been as bad 'cause my computer keeps rebooting. grr_red

I note from your latest post that the vet is going to administer pepcid and cyproheptadine. Does Tisha already have a dose of ondansetron already in her system? The Pepcid will help with excess stomach acid but she will still need an anti-nausea medication.

FWIW, my vet explained to me that mirtazapine has anti-emetic as well as appetite stimulating properties. Cyproheptadine (an anti-histamine) stimulates the appetite but it doesn't have much in the way of anti-nausea effects. But mirtazapine is what my doctor brother would describe as a 'dirty drug' (I've been prescribed it - stopped taking it after three doses because it sent my system completely haywire) and it carries the risk of inducing serotonin syndrome. And it's not pretty in action. Saoirse became aggressive, mildly psychotic and was crazed with hungry. It was like she was possessed. Conversely, in Saoirse's case cyproheptadine works gently on a small dose and it also has a very positive effect on her overall comfort. Her mood improves (she gets purry) and looks a great deal more content and relaxed. And she enjoys her food (with the support of the anti-nausea medication).

There's another thing that your vet suggested that I was concerned about, namely the recommendation not to feed Tisha overnight. It's not good for kitties with pancreatitis to go too long without food because stomach acid can build up. The only symptom Saoirse had before the flare-up was that she would vomit if she didn't eat at least every three hours. Our previous vet instructed me in no uncertain terms to only feed Saoirse twice a day (just before her Caninsulin injections). After Saoirse experienced two very painful bouts of vomiting in as many days I completely disregarded the vet's advice and fed my cat in a way that was better for her health and wellbeing, instead of letting her suffer in order to comply with the preferred (canine-centric) treatment protocol preferred by the practice she was attending at the time. I don't doubt for one minute that they were trying to help Saoirse, but it doesn't automatically follow that their treatment decisions were the right ones for her.

I hope the power and phone lines don't get knocked out tonight. If they do, it could take days before I get back online, so if you don't hear from me know that you and Tisha are in my thoughts and I'm praying that your vet will get the treatments in place to make Tisha feel much, much better very soon.

:YMHUG: and cat_pet_icon
 
Re: Diabetic cat not eating; Pancreatitis flare

Sometimes, the standard doses are too much for a given cat. It may be possible to give some of these drugs at lower doses than the vets normally prescibe at first, so discuss that with the vet. Just say you want to start at a half dose in case there are adverse reactions.
 
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