Pancreatitis, Hyperthyroid, possible cancer? vibes requested, please.

I am starting a new thread to try to get more ideas about Buddy.  These are his results from the "full blood work-up" from Thursday, January 26th for his fPL and thyroid as well as the results from the last time the were tested.  I took him in Thursday because he has had a decreased appetite and soft stools that started with two BMs of soft stools and one of diarrhea within two hours on Saturday, January 21, 2012 .

1/26/12   T4   result: 5.0   reference range:  0.8 - 4.7   units:  ug/dL

7/23/11   T4   result: 3.2   reference range:  0.8 - 4.7   units:  ug/dL

1/26/12   special fPL   result:  3.6   reference range:   > or = to 3.5 ug/L    Serum Spec fPL concentration is in the normal range.  It is unlikely that the cat has pancreatitis.  Investigate for other diseases that oculd cause observed clinical signs.   3.6 - 5.3 : Serum Spec fPL concentration is increased.  The cat may have pancreatitis and Spec fPL should be reevaluated in two weeks if clinical signs persist.  Investigate for other diseases that could cause observed clinical signs.

9/10/11   special fPL   result:  2.1   reference range:  > or = to 3.5 ug/L

The vet, a new one to Buddy and my vet office, said she thought Buddy may have some other issue that is causing his values to be elevated.  She is concerned about the loss of weight from when he first came to this office in June of 2011, (14 lbs.) and on January 3rd of 2012, (11 lbs.) and Thursday, January 26th, 2012, (9.15 lbs.).

Buddy was prescribed METHIMAZOLE in 5 mg tablets for the thyroid.  Directions are 1/4 of a tablet per 24 hours.  PERIACTIN for the loss of appetite in 4 mg tablets.  Directions are 1/2 tablet/day for 2 days or when he is not eating. 

The vet said buddy appeared slightly dehydrated, did not admin sub Q's because she didn't know what the blood/protein levels were.  Today she said they looked fine but did not request Buddy come in.  I asked for sub Q's today when I picked up his meds, the would have given them but they were out. Supply comes on Monday, I'll get some on Tuesday if anyone here feels it is necessary OR Buddy doesn't begin eating better in the next day or two.  He IS eating and drinking, just not as much as usual.  Thursday I asked about using a high cal food, purchased Royal Canin Recovery (high cal) from vet but Buddy turns up his nose.  Am mixing some in Nature's Variety canned rabbit and duck, which is what he will eat.

1/26/11  Total Protein   result: 6.1   reference range:  5.9 - 8.5   units: g/dL

What are your ideas or experiences with either Methimazole or Periactin?  Thyroid and/or pancreatitis?   Good sites for information on either, don't need to be frightened by horror stories but want to know what to look out for. 

I believe Buddy is not ready to be given peace, this morning, as is usual, he cuddled and purred.  This evening, as I was changing the sheets he got "stuck" under them, when I went "looking" for him he began playing with my hands.  I think he is feeling something but is still hanging in there and enjoying me.

I will post any lab results anyone would like to know about and I will try to add anything else I can think of as it comes up. 

I drove to my mom's on December 28th, a 300 mile drive, and took Buddy with me.  He does not like the car and while at my mom's he did not want to eat.  I tried baby chicken food, different types of canned, including fancy feast, and boiled chicken.  I mixed a generic pedialyte in with his food and tried to make sure he ate something everyday.  I took him to the vet up there on January 3rd, and was given a tablet for nausea to try to get him to eat again.  That was a disaster as Buddy was strung as high as a kite all night long.  He drug himself up and down the trailer all night long and cried to me.  He wanted to lay down and sleep but could not remain in one place for more than a few moments.  After the dose wore off he still didn't want to eat.  As soon as I returned home he began eating as normal.  I figured it was all because of being out of his environment and being in the car.  He was good and seemed to put a bit of weight back on until Saturday, January 21st, when he had the soft stool and diarrhea.  Oh, he has only had the one BM with diarrhea, all others have been shaped but soft stools until Friday the 27th which was firm, the consistency of clay. (I "examined" it.) 

Wednesday night, before the vet visit, he ate two slices of ham, the best he has eaten all week on his own.  The vet said that was alright because he was eating, which is what I thought when I gave it to him.  After the appointment and the blood work, I wasn't told not to give him any more, but upon  researching pancreatitis, he won't be getting any more of it.  Unfortunately, last night I gave him one more before I found the information. 

Thanks for reading this, any thing you can offer, advice, vibes, would be appreciated.

Janice and Buddy

Carolina, you say the Methimazole has a 1/2 life of 12 hours???...if that is the case then 1/4 of a pill every 24 hours would put 3/4 if the pill 12, 36, and 60 hours past the 1/2 life.  Obviously the pill doesn't loose complete usefulness after the 12 hours but deteriorates until it is useless.  How much potency does is loose and how long does it take to go dead?  I did read somewhere last night that vets were starting cats on a low dose that wouldn't necessarily help the thyroid because it helped stave away the side effects of the medication later as the dose was upped.  I don't know if that is the case with my vet but it is a question I"ll ask.

What are the side effects that your cats get with the Methimazole?  Buddy usually gets the side effects that are more serious when he takes the meds so I worry and over think the negative aspect of medicating him.  I realize the thyroid is serious though.  Is there anything else that could make the thyroid level go up?

As for the pancreatitis, the vet is the one who said pancreatitis.  She originally began saying that the numbers indicate that he has something else going on that may be bumping up the numbers, both the thyroid and the PLI.  She may have thought that because he is paralyzed and there has been no definite cause for that determined.  (I cannot afford $1500-2000 for an MRI or cat scan to look for tumors.)  She also said something about IBD and something else because of the diarrhea but wanted to try the appetite stim to get him eating and the thyroid meds to keep that in check.  As of Friday, Buddy's BMs are now firm, like clay.  He is eating but not like usual. 

I did pick up more of the Royal Canin Recovery RC and am trying to mix that with his food he will eat.  I also picked up 2 of the feeding syringes with the intention of force feeding, I hate the idea but I know I might have to if the appetite stims don't work.  My concern is the side effects, Buddy always gets the rare side effects.  I am worried about the aggression and howling that I read about for the Periactin.    Has anyone had trouble with Periactin?  I was thinking about getting some Pepcid, he doesn't lick his lips but rather the roof of his mouth.  Sort of like when we lick peanut butter off the roof of our mouths or move our tongues like we are tasting something.  I thought maybe he has some stomach acid going on.  Should I try that first before the Periactin?

Thank you for your thoughts, I really appreciate the help.

Janice and Buddy

Like I said, Buddy gets all the atypical side effects and it would not surprise me in the least if his symptoms of thyroid were also. 

I am working on posting his lab results...
 

Also, I just gave him a 1/4 of the Periactin, rather than a half.  It is the first dose I have given him.  I want to see how it effects him and if it is enough to get him eating more.  I read somewhere it is more effective with cats who are still eating rather than ones who are completely not eating.  I'm hoping for mild side effects or none!

Here are the lab results from Thursday.

ADRChek PLUS W/SPEC fPL
   CHEM 25

Procedure                                results        ref. range        units
       

ALK. phosphatase                  22               0-62                   U/L
ALT (SGPT)                            42               28-100
AST (SGOT)                           26               5-55
CK                                          149             64-440
GGT                                       1                 0-6
ALBUMIN                               2.5              2.3-3.9               g/dL   
TOTAL PROTEIN                   6.1             5.9-8.5
GLOBULIN                             3.6             3.0-5.6
TOTAL BILIRUBIN                 0.1              0.0-0.4              mg/dL
DIRECT BILIRUBIN               0.0              0.0-0.2
INDIRECT BILIRUBIN           0.1              0-0.3
BUN                                       21               15-34
CREATININE                         0.9              0.8-2.3
CHOLESTERAL                    118             82-218
GLUCOSE                             87              70-150
CALCIUM                              8.6              8.2-11.8
PHOSPHORUS                    4.7              3.0-7.0
TCO2 (BICARBONATE)       16               13-25                 mEq/L
CHLORIDE                           121             111-125
POTASSIUM                         4.2              3.9-5.3
SODIUM                               154             147-156
ANION GAP                          21               13-27
A/G RATIO                            0.7              0.4-0.8               --------
B/C RATIO                            23.3             --------                --------
NA/K RATIO                          37                --------                --------
* HEMOLYSIS INDEX           N                 --------                --------
* LIPEMIA INDEX                  N
      *Index of N, +, ++ exhibits no significant effect on chemistry values.
   
CBC COMPREHENSIVE

WBC                                   7.4                 4.2-15.6             K/uL
RBC                                    7.70               6.0-10.0             M/uL
HGB                                   11.9                9.5-15                g/dL
HCT                                   36.7                29-45                   %
MVC                                  48                   41-58                    fl
MCH                                 15.5                11.0-17.5              pg
MCHC                               32.4                29-36                   g/dL
NEUTROPHIL SEG          73                   35-75                    %
LYMPHOCYTES              18  (L)             20-55   
MONOCYTES                   3                    1-4   
EOSINOPHIL                    7                    2-12   
BASOPHIL                        0                     0-1   
AUTO PLATELET            454                 170-600               K/uL
   Remarks:  Slide reviewed microscopically

ABSOLUTE NEUTROPHIL
                          SEG                5402           2500-12500      /uL
ABSOLUTE LYMPHOCYTE    1332 (L)      1500-7000
ABSOLUTE MONOCYTE        222             0-850
ABSOLUTE BASOPHIL           0                 0-100
ABSOLUTE EOSINOPHIL       518             0-1500
T4                                             5.0  (H)       0.8-4.7             ug/dL
   INTERPRETIVE RANGES:
   <0.8      subnormal
   0.8-4.7  normal
   2.3-4.7  grey zone in old or symptomatic cats
   >4.7      consistent with hyperthyroidism
   

Thanks Laurie,  I just finished PMing Violet.  In answering her questions I remembered that when I took Buddy to my mom's after Christmas I gave him a few drops of Bach's REscue Remedy for Pets.  I have never used it before but it seemed to work for buddy, instead of crying the whole 4 1/ hours he almost slept in my arms.  Now I wonder if that had anything to do with it.  It is supposed to be safe for animals.

Janice and Buddy

Thanks  Carolina,

It is good to know the numbers look good.  I was worried about things since he hasn't eaten enough,  the whole time I was at my mom's I focused on finding new foods for him to try.  I felt like I put more of my time with my mom on the cat.  It looks like it was well spent.  Mom understands though, she has two cats as well.I hate medicine and the side effects are always scary to me, even more so with Buddy since he seems to always develop the rare ones.  I gave him the 1/4 Periactin yesterday morning and he didn't seem to have any effects so he got another 1/4 in the early evening. Again, he did well.  I will give him the full 1/2 tablet this morning and leave food for him.  He WILL NOT eat anything that has the Recovery in it.  Yesterday he ate a full 3 oz. can in one hour, that's about what he's been eating in about 16 hours so I was happy.  I don't think it was the appetite stim, he ate right after I gave it to him, 20 min later.  This morning he is eating a 3 oz can of NV duck.  No recovery so he is going at it good! 

I also gave him the 1/4 tablet of Methimazole last night, he slept most of the night.  Cuddled up next to me.  HE slept, not me, oh well, I can live with that.  It's worth knowing he is still with me.  I will call the vet today and ask about the dosage and the potency. 

Do you think the Bach's Rescue Remedy/Pet had anything to do with any of this?

Thank you for the help!

Janice and Buddy

He is "licking" his lips, any ideas??

I did speak to the vet last night.  She explained a few things I had questions about. 

First, last week when I took Buddy in she thought he may have a blockage causing the small appetite and the diarrhea.  I asked if he was having firm stools would he have a blockage, she said it may be a small blockage which would also have the diarrhea. I told her he only had diarrhea twice and soft stools the rest of that week.  Since Friday of last week he has had firm stools.  So most likely he is not blocked.

Second, I gave Buddy a couple hand-fulls of garbage dry food in his wet food yesterday and the day before in desperation to get him to eat more. I worked and he ate about 3 ounces in about three hours.  Yesterday he looked like he was not comfortable at all and I thought the dry made his pancreas inflamed or bothered his stomach. He has bee grain free for two years.   I asked about how much Pepcid I could give him, and if the dry was a bad idea.  I told her he had been licking his lips a lot yesterday (he has for a couple of weeks, I DID already tell her that last week) and I had read that he may be nauseous or have stomach acid.  She said it would be safe to give him 1/4 of a 10 mg pepcid twice a day, every day for a week.  I also asked if giving him yogurt would be better since it was not a medicine but she said the bacteria in it wouldn't benefit cats the same as it does humans.  I also gave him a treatment of Bene-Bac last week, she said that was alright. 

Third question, if he does have IBD what kind of food should I be giving him and should be avoiding.  She said if he has it he should be eating anything that keeps weight on him that doesn't make him throw up or have diarrhea.

Next, I asked about how much he should be eating.  She said about 200 cals. would be what he should be eating.  I told her I had to syringe the high calorie food but she said that the Recovery does not have more calories than EVO which is what he prefers.  He has been eating between 2-4 oz a day.  He hates the Nutri Cal.  He is not off food completely, just not eating a lot.  That being said I have to remember that he is paralyzed and not active like he used to be when he was on the wet/dry diet of EVO before I put him on the raw diet.  While on raw he ate between 2 and 4 medallions a day.  He hasn't eaten the raw since the end of December when I took him to my mom's and he started having this issue. 

Lastly, I asked about the dosage of thyroid medicine.  I confirmed the dosage of 1/4 pill per 24 hours and she confirmed.  I told her I had researched and found the typical dosage to be 1/2 pill twice per day.  I diplomatically stated that I knew she had a reason for her dosage and would like her tell me so I could be on the same page with her.  She said  that because his level was only slightly elevated, she felt that the smaller dosage would be enough to begin with AND avoid the negative side effects of that medicine.  Especially since Buddy seems to be so sensitive to side effects of medicines.  She also said we needed to do another blood test the last week he was on the melds to see how his levels were doing. 

I am most worried about the food intake at this moment.  While he does not like to be syringe fed, but  he and I, did better than I expected the first time.  The second and third time was much harder, though we got it all in.  Because he is still eating partially, I don't want to put him through that IF I don't need to.  Any ideas for how to entice him to eat more would be great, I tried different foods but he is picky and prefers rabbit, chicken and occasionally duck.  What different things do you try to get your babies to eat.  I am going to try sliced , natural, oven roasted turkey slices today to add more to his intake.  His problem is that he will eat something like that for a day or two and then be done wit it for a while, I need a bunch of ideas to have in my bag of "tricks".  I looked at Trader Joe's yesterday for a natural ingredient chicken broth that was low sodium but it contained onion.  Does anyone know of a brand of low sodium broth that is onion free?  He is drinking water but I would like to have that to mix into his wet, to help it smell better and add moisture. 

Thank you, for the vibes and for staying with us,

Janice and Buddy

We were prescribed Periactin for two days last week it didn't seem to do much.  But we only got two pills so maybe we weren't on it long enough.  Are there any other kinds?

Thank you, Cool Cat, for the vibes, we take all we can get.

Sugar Cat Mom and Laurie, buddy was prescribed a nausea medicine in January while at my mom's.  I gave him one dose around 7pm and for the rest of the night and through the early morning he was miserable.  He wanted to lay down and sleep but he just couldn't sit still for more than about 5 minutes.  He cried and drug himself up and down the length of my mom's trailer over and over.  I have the whole rest of the bottle somewhere, I promised him I wouldn't do that to him again.  It was Metoclopramide,10 mg pills at half a pill per dose, but I looked up the side effects on-line after I gave it to him and he began having difficulty with it.  The rare side effects were anxiety and restlessness, just like Buddy to get those.  I am leery of trying another nausea med unless it doesn't have these side effects, it was just too stressful for him. 

Carolina, you are correct he hasn't eaten raw since my mom's.  Buddy ate a grain free can and kibble diet (EVO brand) for a year and a half.  I added various canned foods of a higher quality occasionally to change things up for him.  He has always been rather picky about his food.  When he began having trouble in June last year with his legs I began looking into the raw because the steroids he took caused his immune system to decrease and he got the ringworm and conjunctivitis.  The meds he took to clear that up and the depression he was in while wearing the e-collar didn't help.  I switched him over to raw around August or September.   He ate Nature's Variety raw chicken and canned chicken, rabbit and occasionally duck from that time with no problems, that I know of, until December 29th.  On the 28th I drove up to my mom's and Buddy doesn't do well in the car.  He didn't eat anything for that night or the next day, I figured he was stressed out from the 4.5 hour drive. After that he ate but not his usual amount, that is when I began trying different kinds of canned to get him to eat more.  I tried the raw there but he wouldn't eat it.  I did take him to the vet at my mom's.  He gave me the nausea meds. hoping they would allow him to eat more.  When we got back home a week and a half later, he began eating better and was acing more like himself.  That lasted for about 3 weeks, he woke up one morning and had the two soft bowel movements and then diarrhea.   From that day on he again has been eating just not as much.  I wrote about this in my thread "Buddy isn't eating and has diarrhea".  After that I took him to the vet.  Also, I did private message violet and she recommended I go back to the diet he was on before the raw, she called it his "safe" diet.  As a side thought, the last bag of raw has a frost on the pieces, I have wondered if that is why he wouldn't eat them but can't find any reason for it but I have been hesitant to give it too him again.  Now that I am thinking about it, the smell of the raw was slightly stronger with the last bag and it was difficult for me to not think it stunk.  Not a bad smell just the raw smell more strong.  We were on our second bag of the organic line of the NV chicken raw.

The Pepcid seems to be  working even after one dose, the licking is down today. 

Janice and Buddy

Hi all,

At this point Violet, who has been private messaging me, believes that the foods I have been giving him contain ingredients that are causing problems with the pancreas.  Whether or not they caused the problem or not, the issue is that they are absolutely, in her opinion, causing problems now.  She told me to stay off the raw, as it could have been the issue, however the canned diet also has ingredients that are suspect now.  Essentially I need to find a canned and/or raw diet that does not contain anything but the protein, bone and organ component and supplements only.  NO extras, no vegetables or fruit, nothing.  That doesn't seem so much of a challenge for the raw diet aspect but for a canned diet I am lost.  I don't know of any canned foods that don't have other ingredients added.  I won't feed him kibble and I try to get organic foods.  Does anyone have any ideas about the canned food?  I am waiting for a response from Violet about whether or not I can go back to raw or if she has suggestions about a canned diet. 

Basically it sounds like it shouldn't have anything in it except the protein, bone and organ component and supplements only...WHAT CAN I FEED HIM?  Is there such a diet.  I keep finding fish oil on ingredient lists and Violet said that too can cause an issue.   I'm not sure what to do now and feel like I am boxed in with NO choices of what to give him.

Hoping Violet and or someone else can get back to me soon

Janice