Ming Loy has pancreatitis

Ming Loy has pancreatitis. She went to hide under the bed after dinner, and that's where she stayed until we pulled her out to take her for an ultrasound this morning. She did not come to eat breakfast.

All of her blood work came in fine. No other issues with any of her other liver enzymes. Because it's not part of the standard (Senior, extended) blood work, an fPLI was not done. But it was apparent on ultrasound.

Oh, no. Poor baby. I know you'll be doing your research, but the low-fat meats recommended for Mogli's malabsorption/IBD were horse meat, rabbit, kangaroo and venison/reindeer, since he can't eat poultry. I'm not sure whether horse meat is still available in the U.S..

Lots of for Ming Loy.

Oh Laurie I'm so sorry for little Ming Loy!  

Did the vet say what her prognosis is?

Aw hun, I am sorry about the diagnosis of pancreatitis. I know nothing about it in cats but my daughter has it. I know diet is the main thing to control the pain and episodes in humans anyway. All my best to you honey and to your sweet little Mingle. Please keep us posted on what you find in your research of feline pancreatits. So sorry Ming is dealing with this. I hope she feels better very soon. Lots of love, hugs and kisses. :heart3: Mega monster vibes to you all.

mschauer said:

How strange. I guess it isn't uncommon then but how can food sit in a stomach that long and not be affected by gastric juices????

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Carolina said:

No clue....... All I can say is that it sure enough it happens :lol3:

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Yep. Mazy has proven it to me a couple of times.

LDG said:

Ming Loy has pancreatitis. She went to hide under the bed after dinner, and that's where she stayed until we pulled her out to take her for an ultrasound this morning. She did not come to eat breakfast.

All of her blood work came in fine. No other issues with any of her other liver enzymes. Because it's not part of the standard (Senior, extended) blood work, an fPLI was not done. But it was apparent on ultrasound.

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In what way? I don't really know anything about it, is why I am asking. For some reason I think it is related to diabetes?

I am sorry to hear about it anyway, for Ming Loy.

And of course will be watching this thread to learn more as you and Ming Loy go along.

Just now seeing this, I'm so sorry! Sending many warm vibes your way!

Aww poor Ming. She has a great guardian and is very luck to have you. Hope she is feeling better soon.

First of all, thank you all for the good wishes for Ming Loy, they are very much appreciated. :heart2:

otto, when there's pancreatitis, on ultrasound the pancreas is enlarged (inflamed) and surrounded by fluid. What happens is that when inflamed, the enzymes escape the pancreas - and they are digestive enzymes, they digest the surrounding tissue.

Here are some good articles on it:

http://www.veterinarypartner.com/Content.plx?P=PRINT&A=577

http://healthypets.mercola.com/sites/healthypets/archive/2010/10/05/pancreatitis-in-pet-cats.aspx

http://www.2ndchance.info/pancreatitiscat.htm

This one doesn't have a very comprehensive discussion, but it does have a list of symptoms and the percentage of cats affected by what with pancreatitis: http://www.manhattancats.com/Articles/pancreatitis_test.html (I did have to giggle at the incoordination - Ming Loy has cerebellar hypoplasia, so we'd never know if she was experiencing incoordination as a symptom of something. ).

Basically, when not managed, the long term damage can cause diabetes.

Pancreatitis can be acute or chronic. The vet believes Ming Loy has an acute form, which may resolve - though in cats, it often recurs. They do not know the cause.

Chronic forms are associated with other forms of chronic, long term inflammation, particularly IBD.

One of the primary risks of pancreatitis is fatty liver (hepatic lipidosis). The condition makes cats not feel well, they lose their appetite, and especially for overweight cats, if they are left to not eat, obviously they can develop fatty liver. So ensuring they get food is an important part of the treatment. SubQ fluids are also important - keep the system flushed (and keep kitty hydrated).

Ming Loy's white blood cell count is not elevated, and she does not have a fever, but we are treating with antibiotics "just in case." I don't like using antibiotics prophylactically, but given how serious pancreatitis can be, just in case the source of the problem is an infection, we're using the antibiotics. For Ming Loy, the vet prescribed clavamox. There are many options to choose from, but she prefers this one because it is easier on the liver than many others.

It is the proximity of the pancreas to the liver that is at issue. The fluid build-up and leaky enzymes can cause the liver to become inflamed. In Ming Loy, her liver does not appear to be inflamed, so that's good. Basically, it's looking like we caught this very early, knock wood.

Diet.... in cats, they just really don't know. The damage that can be done to the pancreas means that for sure they should be on a low fiber diet. I have been giving Ming Loy pumpkin because of her issues with constipation. The vet thinks that despite my concerns as re: miralax, I should use that, at least near term.

I am learning about pancreatitis now. I've never read much about it, only seen threads here on TCS. The one thing that stood out in my mind was people searching for low fat diets: high protein, low fiber, low fat. According to my vet (and several of these articles), that "low fat" thinking applies to dogs, not cats. Cats manage high levels of fat far better than do dogs; they also have a very high fat requirement vs. dogs. Current literature indicates that fat does not play a role in pancreatitis. I feed (mostly) prey model raw (I also feed some whole ground animal). The vet wants me to continue this. The way I feed it, it's a rather moderate fat diet anyway.

Right now, there's no reason to think that she shouldn't completely recover from this. The main thing is the next few days. I need to give her fluids daily, get the antibiotics down - and keep them down. Ming Loy has a little bit of an appetite, but with pancreatitis, it is important to feed small meals frequently. The vet suggested that I feed her 1/4 of a meal size 4x - meaning I feed her 12x a day for the next few days. I have the luxury of working from home, so this is do-able, even during the week.

She has not kept anything down today. We ran to the vet to get Cerenia injectible, which I gave her 30 - 45 minutes ago, and I'm going to go feed her now.

The vet says normally she recommends a bland diet - on raw, she thinks that means poultry, not fatty red meats. I concur. Right now, she doesn't want ground chicken breast (I have some from Hare Today). I gave her Beechnut chicken baby food earlier, and she ate that. But she didn't keep it down. So far, she's thrown up her antibiotic and her anti-nausea pill (cerenia) - which is why we went to get the injectible.

So that's where we are right now. :heart2:

Oh - totally forgot to mention. The vet recommends providing digestive enzymes, because hers are not necessarily reaching her stomach. Thankfully, I have the Mercola digestive enzymes here.

I'm also supposed to keep her on the probiotic (just make sure I don't give it within a few hours of the antibiotic), and the salmon oil (500mg daily). The omega 3s are anti-inflammatory.

why didn't you tell me Laurie? Did you read the pancreatitis page on my site? Please let me know if there's anything I can do! 

Lisa, I basically just got online for the first time maybe half an hour ago. I posted to TCS to give the update about Ming Loy's "maybe blockage" to let everyone know it is pancreatitis. I totally forgot you have info up on your site about it! Of course I'm on my way right now. :heart2:

http://www.ibdkitties.net/pancreatitis.html

And thank you, I will!

Aw Laurie, you certainly didn't need to worry about anything else. Poor Ming Loy. Give her a kiss for me and I'm sending you a hug! 

otto, the information from the ManhattanCats article concurs with the information on Lisa's page - for some cats, the Spec PLI (or fPLI) will indicate pancreatitis, yet it can't be detected on ultrasound: for others, it's the opposite.

ManhattanCats: "In feline pancreatitis, however, ultrasound detects pancreatitis only 11 – 35% of the time that it is present."

Here is the symptoms list:

Clinical signs in cats with severe pancreatitis

Sign / % of cats affected

Lethargy 100%
Poor appetite 97%
Dehydration 92%
Rapid breathing rate 74%
Low body temperature 68%
Jaundice 64%
Rapid heart rate 48%
Vomiting 35%
Abdominal pain 25%
Abdominal mass felt on physical exam 23%
Labored breathing 20%
Diarrhea 15%
Incoordination 15%
fever 7%


No pain meds were given to Ming Loy. She displayed no symptoms of pain on exam. As the pain meds can suppress an already poor appetite, they prefer not to give them unless "necessary." For Ming Loy, "necessary" was determined to be if she would not eat on her own by tomorrow morning, despite being given an anti-nausea med.

I fed her 3/8 of an ounce of chicken baby food a few minutes ago. She ate 2/3 of it. (I balanced it with calcium, added roughly the right amount of digestive enzymes, and one drop of salmon oil).

So far when unable to keep her food down, she throws up an hour or two later. I am not going to give her the antibiotic until I know she's keeping food down.

The last stool she had (yesterday morning? Pretty sure that was yesterday... maybe it was this morning. IDK, everything's blurring together) was basically normal, but liquid diarrhea was bubbling out around it as she passed the stool.

Basically, everything is pointing towards acute pancreatitis, though it's not clear whether or not she's in any pain. She's no longer in hiding though - she's crawled into my lap. :heart2:

The fact that she's not hiding is a big deal. You'll know if she's in pain. She'll stay in that meatloaf position most of the time and not want to do anything. 

She was such a good girl about getting her fluids. :heart2:

...she came to her spot when I called "dinner" for the late night meal. Unfortunately, she decided she didn't want to eat any. I'll give it a few hours, see if that last little bit she ate has stayed down that long. If so, if she won't eat, we begin syringe feeding. :rub:

...I'm just so thankful that since transitioning to raw last year she lost all that excess weight. :heart2: (It reduces the risk of fatty liver (hepadic lipidosis) from not eating, a common complication of pancreatitis).

...love this little girl... :heart2:

Do you have any appetite stimulants?

I have mirtazipine here. It worked really well for Lazlo, but I don't know that I want to try it on Ming Loy.

For those that don't know, the advantage of mirtazipine vs cyproheptadine is that it's longer acting and only needs to be given every three days. The downside is that it makes some cats really nutty, loopy, or disoriented... it can be unpleasant or very disconcerting. But the cypro only works for 12 hours, I think. It's at least a daily pill, but I think it might be 2x a day.

I'll call the vet tomorrow.

Poor thing's only kept down... 7/8ths of an ounce since dinner on Wed, as she threw up that late night meal the next day.

What I can't decide is if I should wake her up to try to feed her now. She's sleeping so peacefully. :heart2: The good news is it looks like the Cerenia injection worked.

Knock wood, I don't think we're going to need the appetite stimulant. On Carolina's advice, I woke her to feed her. She was hungry!

I gave her half an ounce. I think she would have eaten more, but part of the key here is frequent small meals.

Big sigh of relief! :cross: