What Could be Wrong With my Meezer? :(

Amythyst said:

Yes, a meezer is a pet name for Siamese cats.

. He is a blue point. I just feel so helpless in that all I can do is give him fluids and wait and see if he gets better. I did end up force feeding him 5 cc's of science diet a/d. He appeared to keep it down but the crazy drool started again like he is feeling nauseous. I don't see how he can be so nauseous with the anti nausea medicine they have been giving him. He is walking around a bit better but still just wants to bury his head in my arm and sit in my lap.

I will give him some more of the liquid pain medicine when it gets closer to bedtime. Then more fluids tomorrow. Sigh. This is so hard.

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When Sebastian was having his flare, the vet was giving him fluids, Pepcid (antacid), Cerenia (antiemetic), Metronidozole (antibiotic), and they put a Fentanyl pain patch on him (which lasts for three days). Sebastian didn't get started on the prednisolone until later, but some vets use it right away. If your cat does, in fact, have pancreatitis, pain management is important. It's very painful. IF he is not vomiting, ask your vet about some of these things you can give him at home that aren't as expensive. At some point, he may need an appetite stimulant such as Mirtazapine or Cyproheptadine. Fatty liver disease is a secondary concern if he isn't eating, but it seems as though you've already started syringe-feeding him.

P.S. If your vet gave him an anti-nausea injection (was it Cerenia?), it will probably only last for 24 hours.

Thanks Holistic, I'd have to go look at the paperwork to see what the anti nausea is but it does only last for 24 hours.  They gave him one injection yesterday and one today at 11:30.  I mentioned the steroids and the antibiotic but they would not entertain either one.  She said she has never heard of anyone giving prednisone for pancreatitis and I was like I'm consulting other people that have had this happen to their cats and she was like well this would be a very rare thing... she said she didn't want to put any strain on his kidneys.

He isn't vomitting like doing the heaves or anything but he still has the crazy saliva/drool after he visits the litter box.  She said since he is not overweight at all, that the fatty liver disease isn't a huge concern... yet.  I did start him on the syringe and he seems to have kept the food down.  I was pleasantly surprised a little while ago he gave himself quite an extensive bath... he hasn't cleaned himself in two days... so I thought maybe that was a good sign?

I do feel like he could be in pain... they gave me some liquid pain medication to squirt in his mouth twice a day but of course I have no idea if it is actually working well.  They gave him some about noon today and I was gonna give him some more before bedtime.

I feel like this vet is nice and caring but I dunno it just seems like all they wanna do is push hospitalization to get continuous IV fluids and stuff...but I don't see how that would be more helpful than me giving him daily fluids at home.  I've already spent over 400 dollars at this vet and I'm not sure if its worth it to seek a second opinion or not?

My husband had ulcerative colitis and I know we didn't just sit around giving him fluids hoping he would get better... we gave him steroids and medications... I don't like pushing medication but it just seems like an antibiotic or something would be benefical than just trying to manage his pain and "wait it out".

It seems like vets fall into two camps when it comes to steroids.  They either don't want to use them at all or they want to use them for everything.  My cat has probable IBD that's where the possible pancreatitis diagnoses came from.  I did the vet hopping thing for six years.  He had the sub-q fluids. the metro alone, x-rays looking for a foreign object, and the hospitalizations.  The vet that I take my cats to now figured it out and used the steroid along with metro while he was really sick then dropped the metro.  She was the one who also sent a blood sample to Texas to check for pancreatitis.

Yes, I would think grooming is a great sign! I know Sebastian won't groom at all if he's not feeling well. The pain meds could be making your boy a little loopy and feeling good, but that's certainly better than being in pain!

If, at any point in time, you feel like your vet isn't listening to you or helping your cat in a way that you'd like, you may want to consider seeking another opinion. In my experience, and from what I gathered from my vet, prednisolone for pancreatitis and IBD is a frequent discussion among peers. They don't all agree with it's use, like @Denice mentioned, but it is known. The other thing is, I don't think prednisolone affects the kidneys.    I could be wrong. Does your cat have a kidney issue? Pred is processed by the liver. Perhaps you should show your vet the document I linked to above?

In a way, I understand their push for hospitalization. I completely trust my vet and they did the same thing. I think the reason is because if the pancreatitis isn't brought under control quickly, it can cause permanent damage. The IV fluids are continuous. They adjust the flow.

My vet decided to withhold food and water for 24-36 hours to help the system rest (not that he wanted to eat anyway). This method is debatable among vets. But in all honestly, I understand the logic here, and 24 hours is not unreasonable. However, fatty liver IS a concern regardless of weight. Any cat that goes over 48 hours of not eating is at risk for fatty liver. Sebastian was over 48 hours but they kept drawing blood to check his liver enzymes. But, again, since you were able to syringe feed him, it buys you time. To truly avoid fatty liver, he should be getting at least 50% of his daily caloric intake, preferably more.

I know prices vary by area, but for Sebastian's three days of hospitalization, meds, fluids, monitoring...everything...it cost about $1,200.

For all other animals including humans fasting is the preferred method for initial treatment of pancreatitis.   The cats liver is unusual in how it works and for them fasting can create problems.  Of course if a cat is hospitalized they can fast them and keep on eye on their liver enzyme levels.  The levels would show a problem before they actually developed fatty liver disease.

Thanks guys... I actually think I will get a second opinion on Monday.  He actually does seem better today... he's more alert, walking around more, rubbing up on me and just seems better.  He is acting slightly stranger though about the litterbox.  He constantly walks up to it and just kinda stares at it like its his nemesis.  I also caught him just sitting down in it today.  He seems to be peeing fine and I thought the crazy nausea drool was gone but he tried to poop this morning and just a little bit of the drool came out again.  He is still only pooing in small pools and its still very liquidy.

Today is day three and he has only had 5 cc's of a/d last night and I gave him about the same amount this morning.  They also gave me a tube of high calorie vitamin and mineral stuff to put on his tongue which I have given him a few times.

I still think its odd that he only seems to get nauseaous when he tries to poo... if he strictly had diarreah, wouldn't he not have to strain?  His tummy does feel a bit tight.  Could he have a blockage and still have diarreah?  At any rate, I want a second opinion to see what another doctor would say.  He did have almost 48 hours without any food at all before we started force feeding him and while he does seem like he feels better... I just think some sort of medication should be given to help with the inflammation and irritation.

And is it normal for this to just happen magically overnight?  He has never had any sort of issue like this before and even the night before he was eating normally.  Can pancreatitis just happen overnight?  I guess it is possible I'm just reaching for as many straws as I can.

The vet I'm seeing now said hospitalization would cost me 800 dollars a day.  I've already spent 400 bucks between 2 doctor visits and I really have no money for hospitalization.  I found a vet called "just cats" that only treats cats and seems to have some good reviews online.  So, I'm hoping they might have a fresh take on the subject and be more in line with what a lot of you guys are saying.

For those of you that had cats with pancreatitis, how many days did it take for them to start feeling better?  Whether hospitalized or not?  And Holistic, did your cat go back to normal after 3 days of them treating him?

He could be constipated even with the small amounts of diarrhea.  The diarrhea could be going around the constipation.   Yes these types of flares can happen overnight.  Patches would be constipated and vomiting bile when he had a flare.  He would be fine when I left for work.  When I came home I would find the spots on the carpet where he had been vomiting.  He would get over it the same way, be very sick and the next day be back to normal.

it probably didn't just happen overnight but cats can be very good at hiding it when they don't feel so well.  and in cats, pancreatitis often doesn't have very obvious symptoms.

 Even though he is getting along with the kitten,  adding the kitten had to have caused SOME stress in the household,  maybe less between your blue point meezer boy and the kitten than between him and the 8 year old female.    and the stress could have started the inflammation some time ago.

I had a Siamese mix  who had diabetes and chronic pancreatitis.   Most of the time I learned to treat the pancreatitis flare-ups at home,  but a few times over the years he did have to be hospitalized.  Of course the diabetes made everything more complicated,   and he also ended up later being diagnosed with IBD.    So his other conditions were part of why he needed to stay in the hospital. 

But I was able to do most things for him at home,  and learned to be very sensitive to how he was feeling ,  so we could nip flare-ups in the bud.  with an arsenal of pain medicine (buprenorphine) , anti-nausea, anti-acid ,  sometimes appetitie stimulants,  occasionally  antibiotic  (esp metronidazole),  subcutaneous fluids,   syringe feeding as needed.

You do need to get food into him, both so he does not starve and so he does not develop liver damage from not eating,  but  you need to address the nausea or it will just make him more miserable.    I would get some Cerenia for the nausea.   That can be extremely helpful.   

  I also gave famotidine (Pepcid AC)  or 2 x / day    

I give the medicines  30 min before feeding.    At first feed in small meals several times a day

In addition to the bloodwork ,  you might consider an  ultrasound ;  if done by an experienced ultrasonographer, it can give very good diagnostic info about what is going on with the organs

Did the testing include a blood glucose test?  It probably did;  if they did any bloodwork they probably did a blood chemistry panel which would include glucose.  I am just asking since the pancreas is of course associated with diabetes,  and I am not sure what to make of your comment about his mouth smelling funny.   Diabetic cats  often have a sweet. rather fruity smell to the breath.   I don't know if peanut butter would fall into that , though.

 I second ( or third or fourth or...)  the suggestion of looking at that Idexx pancreatitis paper.  

In a very severe flare-up,  we found that a plasma transfusion worked wonders but it was not cheap I think it was about $550.   I can't remember if that included the blood type test.

I am not sure about your cat producing copious amounts of stringy saliva after using the litterbox.    I would hope the vet might try to do some research on that if its not familiar.

 If it is just diarrhea there could still be straining,  because of a feeling that he can't get it out.   it doesn't feel like a normal poop so he might keep pushing . 

re a 2nd opinon , you might want to look for a specialist in internal medicine.   American College of Veterinary Internal Medicine "Find a Specialist".    For Specialty,  select SAIM  ( Small Animal Internal Medicine) .

   I hope your meezer  will be feeling completely recovered soon.

Thank you, Mae!  That is a very helpful post.  He is eating... by me syringing it but he is.  I am not seeing the saliva anymore today and he is meowing again too which I haven't heard for like 3 days.   He was getting the anti nausea medicine via injection for 2 days.  He didn't have it today cause the vets are closed though.  I could get some pepcid for him I used to give it to him when he was younger for the barfing.  I guess you are right that he probably always had something going on.  When he was younger and they couldn't tell me why he barfed all the time and just said he was a "barfer" that is probably where it started.  He would always barf when he was hungry but he hasn't really barfed like that in over a year.

I assume they did check that in his blood work, but I'm not sure.  The only thing she mentioned to me in his results was that his calcium was low.  On Monday, I'm going to request a copy of the bloodwork for myself and of course seek a second opinion.  I checked out the link you gave me but there are no specialists near me.  I can't really afford the ultrasound right now but I may break down and do the blood test to Texas A&M to see if I can get a defiinitive diagnosis. I'm eager to see what the new vet will say.  I'm still thinking he may not be on enough of the right medications.

I did read that paper but maybe I'm just dumb and I didn't really see anything different in there than what I'm either already doing or what the vet had said?  Is there something in there that should have stood out?

The vet told me the saliva was from the nausea and I'm assuming trying to go to the bathroom was making him feel sick.  But he has gone to the bathroom today without it happening.

How long would it take your kitty to get over the flare ups?  I am doing the fluids, the feeding, the pain medication and letting him lay with me all day.  His entire life he's been a momma's boy and wants to be on me or near me all the time so I can't really judge how he is feeling by him wanting to be laying on me.

The only wierd thing he is doing now is wanting to just sit in the litterbox.  He has never done this before and I'm not sure if I should let him do it or make him get out?  Did anybody else's kitty cat do that when they had a flare up?

Oh and that link didn't work.  But I can probably do a search for it.

I don't think anyone else's experience with duration of flares will predict how long this will last.  Patches had flares over a six year period before a vet finally got things under control.  They were different both in terms of duration and severity.  He would have mild flares that only lasted 3 days and didn't even require a trip to the vet.  He had some where he would be very sick for at least a week, some lasted longer than a week.  The last major flare that turned into fatty liver lasted over a month but I think that was more because of the fatty liver.

I think getting the definitive test for pancreatitis is a good idea.  It doesn't change things as far as initial treatment but it can make a difference in terms of long term diet.

Actually, like Denice said, constipation will cause small pools of diarrhea because the straining causes it to go around the impacted stool. When was the last time you saw him have a normal solid stool of decent size? None of my cats have ever spent extra time in the litter box beyond their normal bathroom duties. If they did, it would concern me greatly.

This normally does not happen overnight. I agree with maewkaew in that signs can go undetected for some time. I didn't pick up on Sebastian's "pickiness" with food right away. He was also vomiting up hairballs frequently. In my experience, cat only clinics seem to have a better understanding of cat physiology.

Sebastian did not fully recover after the three days of hospitalization. On the final day, I picked him from the hospital to take him to a specialist for an ultrasound. I brought him home after that and was advised to do at-home supportive care. I syringe-fed him for several days, so I would say that it took two weeks for him to start feeling better.  Every cat is different, though, and recovery time varies. Sebastian has had additional flares after the first one, although not quite as severe.

Cerenia also comes in tablet form that you could take home and give orally.

  I have to agree with Denice that the duration of flare ups varied.   just about the same as what she said.   usually the trajectory was about a week.  but sometimes shorter and sometimes longer.

 If the stuff in the Idexx paper is what's being done,  then just look at that as confirmation that your vet is probably pretty up to date on the treatment  and use that info to help you understand it.     There probably are some things in there not being done at the moment since it is pretty comprehensive.   for example I think the plasma transfusion is mentioned? 

 and it mentions some things like cobalamin (Vitamin B12)  supplementation   but I don't know if your cat needs that.

 I agree it's a good idea to get the confirmation test from TAMU to make SURE it is pancreatitis.  

re lying in the litterbox,   there are some cats who do that when they feel ill or in pain or stressed.    Someone suggested to me maybe it is because it is the place that really smells like them .     or maybe they just want to be in a small box like a little den.   Louis did not lie in the litterbox but he did lie in a box or a pop-up cube.

Re the pain med:     If this is buprenorphine  ( which is a common choice)  it is very important not to just squirt it quickly in his mouth so that he just immediately swallows it.   This is a medication that is absorbed very poorly from the GI tract,   but it's absorbed very well through the oral mucosa ( lining of the mouth).   So to give it in a way  that it will really help him,  you need to drip it out very slowly into the pocket between his cheek and his teeth so it will be absorbed through that tissue of the mouth.  ( It would also work under the tongue but I find that is harder to manage and it's not going to work better anyway.  )  

It can also be given via injection.  and I have done both ways.  but I think if you give it via the transmucosal route correctly it really seems to work quite well.

Here is another link,  to a discussion between several vets about treatment for feline pancreatitis. Feline Pancreatitis Roundtable  

I would think with him having a fever like this, an antibiotic may be warranted.  I know Louis used to get metronidazole  and occasionally also Baytril ( depending on how bad it was.)

Amythyst said:

 
Oh and that link didn't work.  But I can probably do a search for it.

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I have found the link to the Idexx Pancreatitis Protocol intermittantly working or not working if that is the link you are mentioning.

Idexx Laboratories has several very well-written articles (incl. the one mentioned above) accessed from their whitepaper index page here: http://www.idexx.com//view/xhtml/en...on/reference-library/whitepapers-articles.jsf, then select Pancreatic from the topic list.

These are really worth the read..

Day 4, we're still doing ok.  He seems better.. hasn't gone and sat in the litterbox and is actually meowing like normal again!  Before he got sick it was actually quite horse.  Still doing IV liquids, still force feeding him.  He still has bad diarreah.  Its really thin and liquidy and only a teeny bit comes out at a time.  I think he feels like he needs to go a lot.  I really hope he doesn't have a blockage.   Come on Monday and get here....

Also thought I'd share a pic of my guy.... he is laying here with me on my computer desk.

He is such a handsome boy even though he feels really bad right now.  I love Siamese cats, they have so much personality.

Thank you!  I love them too... they are my favorite.

I think he actually feels a lot better today.  He's jumping up on stuff and just went nuts on his cat post sharpening his front claws.   But I won't truely rest easy till he has normal poo again.

He is a handsome boy. I'm glad you're getting a second opinion. The only time any of my cats sat in the litter box or looked at it with dread was when they had a bladder infection or constipation. It's already been said that when a blockage is present they can still have diarrhea. It is important for him to get the fluids and the syringe feeding if he won't eat on his own. I'm not suggesting you do this, but it was mentioned early in the thread about the dosage of prednisone. One of my cats was on 10mg twice a day. Another one was on 5mg twice a day. I'm not sure if they go by weight or by what's wrong with the cat. It's sad that the vet didn't have an open mind about the different treatments. Goholistic and a lot of the others that have posted have been through this and can tell you what worked for their cats. I hope he gets well soon. I hope the cat vet can give you more insight to the problem.

Thanks Roxie, appreciate the support.  He is starting to act like he's hungry... when I'm feeding the other cats he is coming over and he will sniff the bowl like he's interested but still not ready to try it.  So, the syringe feeding will continue.   Hopefully they won't charge me an arm and a leg to get a second opinion.

I actually have a whole bottle of 5mg prednisone from my husband's surgery... I'm tempted to give it to him but I will wait till I see the other vet.

Is there anything I can do in the mean time for his diarreah... would it be beneficial for me to syringe him some canned pumpkin or plain yogurt?

@Roxie, my name is actually Roxanne....

That's neat! Mine on my birth certificate is Roxanna. I go by Roxanne except on legal documents. My dad still calls me Roxie. That's a good sign that he's at least sniffing the food. In people, rice is good. When my kids were still babies the doctor told me to boil some rice, drain the water off and put it in their bottles. Give me just a minute on what to do in the meantime. I'm researching in my veterinarian books.

Don't give pumpkin! It's used to prevent constipation. You can give a cat kaopectate. Give 1/2 to 1 teaspoon once every six hours for every 5 pounds your cat weighs. If your cat weighs ten pounds then you would give him one teaspoon every six hours. I wouldn't give anymore than one teaspoon, even if he weighs 15 pounds. Do not give it for more than a day and don't give pepto-bismol without a vets recommendation. The book I got this out of was written by veterinarians. I may have missed it, but have you changed food recently? Is there a chance he could have swallowed something like a string or ribbon? I have given my cats kaopectate just until I could get them to the vet the following day. I also gave them pedilyte for babies in a dropper. You're already giving fluids, so you shouldn't have to do that. Yogurt has a good bacteria that can help rebalance the intestinal upset that caused the diarrhea. The only problem with that is milk products can make the diarrhea worse. You might want to wait and give the yogurt after the diarrhea is under control.