Sebastian is Back at the Vet...Suspected Pancreatitis Again :(

GoHolistic said:

 
Okay, good to know what others have dealt with. I didn't realize that even the low dosages can cause such increased hunger. Thanks for the info and links. Since we do have an appointment this Friday and we'll have a full blood panel done, I'm going to wait and see what the results are before spending money on a blood glucose monitor.

I wrote my update on Saturday I think, and Sunday he didn't seem to be as ravenous. Of course.

  In fact, both Sunday night and this morning he didn't finish all his wet food right away like he normally does. And I think there were less "pee pods" in the litter box. Maybe it takes a week for the body to fully adjust to the decreased dosage of pred? 

  Otherwise, I suspect he might have a tummy ache or a soon-to-be hairball.

Click to expand...

I read it takes about 5 days for you to see the full effects of prednisolone when starting, so about a week for a decreased dosage makes sense. From the anecdotes I've come across online it's a quite common practice to start off high and then adjust down, so your vet probably won't be surprised at all to get a call inquiring about ravenous appetite and should I adjust.

For the blood sugar test, keep in mind that cats have stress induced blood sugar levels. All my vets (except for one that I deemed incompetent) told me testing out of range but in the 200's probably indicates stress. They said that testing in the 300's or 400's was more likely diabetes.

Thanks for the range on blood glucose, Raintyger.

So, in my post above I said I had a hunch that he had a tummy ache or hairball. Well, I guess mommy's intuition always prevails. He vomited 4 times tonight, wouldn't eat his dinner, and is sleeping and a little lethargic.    I gave him 120 ml of sub-q fluids. I'll give him Pepcid in the morning and Cerenia if he's still off. I know that I have to expect the ups and downs with this, and I don't expect you all to respond to every post I write. Typing it out helps me to deal with it and also knowing you are all there just a click away.  

Make that 8 times. He's not keeping anything down. He drank water earlier and just projectile vomited that everywhere several times. 

I'll have to call the vet in the morning. There's no sense in me giving him anything orally if he's still vomiting. He'll need the Cerenia injection.

For now, I've isolated him. NPO...no food or water til morning...maybe. He had sub-q fluids earlier so he's good hydration-wise.

14 times over the course of the night and morning. The last 5 were vomited blood.    He's at the vet now. My poor boy.

Oh no... So sorry to hear this. Just many many   for you and lots and lots of  for Sebastian.

Oh, no. Lots and lots of for Sebastian!

Oh no! Gosh I hope you find some answers soon!

Gee, I never had any of mine vomit blood before - or that many times in a single day.  Do you think he has an ulcer?  Is he in a hosptial environment currently?

Oh my goodness! for you and for Sebastian!!! PLEASE keep us posted!

Was the vomit blood? Or there was some fresh blood in it? If the second, it could be that all the vomiting irritated his throat. We have had that before.

Vomiting up blood if there are ulcers, it looks like coffee grounds. We've had that before too.

Poor Sebastian. I hope this isn't another round of pancreatitis.... :cross:

When Patches was really sick with a flair and was vomiting bile it would often be a rust color.  I think it was irritation especially since he was having dry heaves.

Oh, poor Sebastian!

He obviously needs these . . .

Adding more : for Sebastian and  for you. 

And more and some hugs for you  

Thanks so much everyone. It really means a lot. 
He was in a hospital environment all day yesterday. Took him in first thing Tuesday morning after a nightmare of an evening. They gave him fluids and Cerenia. Full CBC was done, and surprisingly, it looked good. His WBC and Neutrophils were on the high end, but still within range. His Glucose was 168 (out of a 70-150 range)...not bad, probably from stress.They didn't do the snap fPL test again, even though I asked about it. They palpitated his abdomen, and it felt fine. When he had pancreatitis before, his abdomen was hard and distended. They did a quick in-house ultrasound (although they don't have a radiologist on staff) to check his pancreas. Report was that it seemed okay. He vomited once at the vet, and they did say it was red. Doc said it is likely irritation, especially since he vomiting as many as 14 times in one night. I didn't think to ask about an ulcer.

Another disheartening bit of information was his weight. He lost weight. Was 12.04 on 9/13 and 11.14 on 10/15.     I'm almost thinking they got a bad reading on the scale. I was so confident that I felt extra padding around his ribs. I do the "rib test" quite frequently. I guess I'm going to have to buy a baby scale. And I also think I'm going to have to start those digestive enzymes. He was eating like a PIG for a month when he was doing well and should have gained weight. I fear that the continued weight loss means he has cancer. 

I picked him up after work. Doc thought he'd do better at home rather than staying at the hospital overnight. When I brought him home, he slowly walked out of the carrier, jumped up on the sofa and curled up in a ball. At 8:30 p.m., he vomited again; a light brown translucent liquid (a lot of it). This confused me, as he hasn't had anything orally AND he had Cerenia, which is usually great at stopping vomiting, right? Can cats vomit up sub-q fluids that are absorbed by the body?     He was very lethargic all Tuesday night. Wouldn't move. Wouldn't respond to key words or my voice. At one point, I had to check to make sure he was still breathing.     If he attempted to open his eyes, they were like slits. I'm really, really worried about him. Around 11:00 p.m. last night, he finally made his way upstairs to pee. Then curled up in a corner all night until the morning. He shifted a couple times, but otherwise laid there.

I called the vet first thing this morning (Wednesday) to update the nurse who saw him yesterday that he is not doing well. He won't eat and has ZERO interest in eating. His last full, digested meal was Monday morning, which means I'll need to start assist feeding him by Wednesday night at the latest. The problem is, he needs to go 24 hours without vomiting. She had the doc who is on duty today call me. He said he'd be happy to take a look at him, but I said that's already been done. Unless there is something different that's going to happen, there's no sense in me bringing him back to the vet. He agreed and advised that I really have to wait 24 hours for the vomiting to stop. That would be around 8:30 tonight. If no vomit, then he said I should give him all the things they would give at the vet - Cerenia, Metronidazole, Pepcid, Mirtazapine, Prednisolone, and fluids. I have all those meds, so I strategically got all the pills into two gel caps, which are all ready to go for pilling later if there is no vomit. I asked about pain management. Clearly Sebastian is in some kind of discomfort, if not pain. The doc called in a liquid pain med that is taken orally (I'm at work right now and don't have it with me, but it starts with a "b"). I ran and picked that up and gave that to him immediately.

I'll end with some relatively good news. When I came back with the pain meds and ran up the stairs, Sebastian was up from his spot and sitting near the doorway of my bedroom. He walked towards me and did a little leg rub on me. It's like he knows I got the pain meds in my hand!    I gave him the pain med, and asked if he was ready to try to eat something. He followed me down the steps and into the kitchen. I put down some wet and dry (RC rabbit). He turned his nose up at the wet, but ate a few morsels of the dry. Not enough, but a good start. I hope he'll eat enough for me tonight so that I don't have to syringe feed him.

That looks like what Patches would do when he had a flare.  He started out with the yellow bile and it stayed that way the first couple of years and then it would look  like that.  I think it is caused by irritation and probably some abrasions in the esophagus and throat.  Is he back on the daily steroid?  He may just need to stay on the daily steroid at least for a while.  I know you would like to have him off of it but he may need it.

Well, I'm taking it as a good sign that he is showing a little interest in his food.

Hopefully he has kept it down, and even eaten more since your last post

Yes, we decided to put Sebastian back on the prednisolone 5 mg every day. @Denice - How long would Patches' flares last? Would he go days without eating?

No more vomit when I came home from work, so I gave him all his meds. Of course, the mirt is making him nutty. So far tonight, he's eaten almost 1/8 can of wet and 2 tsp dry. He is preferring the dry, of course. I'm putting a little food down for him every hour, rotating between wet and dry. I'll try wet again before bed.

One thing I forgot to mention. He's been walking funny ever since I brought him home...with his butt end closer to the ground and back legs bent more. His back legs are also wobbly. I thought I read somewhere that this is a sign of something. I'll mention it to the vet in the morning. Could it be that he is just feeling weak?

Oh I don't know about the wobbly legs, but I'm glad he's starting to eat. It sure does sound like he was in pain, poor baby!

(Maybe the wobbly legs is from the pain meds? :dk: )

Keeping up the vibes!!!!!!!!!!!!!!!!!!!!

How is the poop situation?  With all that vomiting, I would be wondering if he is blocked somewhere and it can't get through.  That brown stuff is like intestinal juice coming back up, no?  One would think if he was bleeding, that would show up as anemia in his bloodwork.  Did the vet explain the red color?

Very concerned for you and Sebastian. 

Do I remember he is only 13?

The wobbly legs are probably due to mirtazapine. Poppy acted this way when she got a dose.

I'll be thinking of you and sending good wishes toyou and Sebastian tonight.