My cat is not eating right and we don't know why?

Guinness10, it definitely sounds like you have a wonderful vet who is walking you through this and supporting you. It does make a difference when there's a professional you can trust. 

I know all too well about the panic. When Sebastian would walk away from his food or not finish his food, I would immediately get that feeling of impending doom in my chest...a pit in the bottom of my stomach, and I'd feel sick. 

Under the care of our vet, we do keep supportive meds on hand in case of a flare up. I agree with LDG on the small, frequent meals. I do this for Sebastian, so meal times take like 3+ hours. I work full time so I have to pick up everything when I leave for work, but I do spread out his breakfast and dinner portions over the course of several hours. Another change I made was to give him 100% purified water (reverse osmosis), which was approved by two holistic vets I consulted with. I'm not sure how much of a difference it makes, but it was another small change I could make with minimal effort. Always discuss with your vet the changes you make and get their input.

I'll be thinking of you and Guinness through the Thanksgiving holiday and sending many good vibes that he perks up and stabilizes.

I havent been on here in a while but I wanted you to know that I appreciate the feedback I got from you very much.  I needed to stop getting on the computer looking for stuff and obsessing over this.  I needed to become more level headed as crazy as that sounds.  We have been trucking along with the Cerenia 1/4 tabs once a day, "meowzapan" (appetite stimulant) every 72 hours and were doing pretty well.  His levels for kidneys were tested before the Christmas holiday and looked good and well now......now we are having some issues AGAIN.  I believe with the Pancreatitis.  He has thrown up once in a while, just a bit of clear with a piece of food sometimes in it.  Not digested.  He also sounds like he is getting sick sometimes but nothing comes out.  Kinda like a dry heave I guess.  It seems like this is increasing and his appetite is not so great right now.  The other night he was up all night back and forth in the bed and out of the bed.  Usually he goes unconscious and you dont see him till 4:30am when he goes and uses the litterbox, eats a bit then goes back to bed.  He normally doesnt sleep with me but he did that night so I dont know if he has been doing this lately when he is with the kids or not.  He also has been trying to get into my room batting at the door and normally he doesnt do that.  When my husband comes to bed, I take him out and stick him with my son and he doesnt come around till I open the door in the morning.  He is lip smacking and sitting in the dreaded meatloaf position more.  I have been in touch with the vet wondering now what.  Does this mean he is going to have an acute attack?  Does it mean he is just having a rough go of it at the moment and may level out?  Does it mean I should try a different food as I havent altered anything for fear it would screw him up.  Not to mention when we thought this was all a kidney issue I tried 1000 different kinds of foods to no avail.  Does it mean we need to change meds?  Although I dont know what we would change too, we tried alot of stuff when he was not yet diagnosed but we had a suspicion.   Any incite would be greatly appreciated.  I am guessing this is the name of the game and one day we may lose. 

Is he on anything other than the cerenia and the appetite stimulant?  The thing with both, though they are great for discomfort and keeping a cat eating, they only treat symptoms.

Nope that is all he is on.  Is there something out there that would "treat" it?  I know prednisone is good for acute attacks but do they help the chronic kitty?

My kitty has been on a steroid for IBD for 3 years now.  He has also had cholangiohepatitis and fatty liver.  Of course there are risks with long term use, the main one being diabetes.  Patches has been fortunate so far.  Vets seem to fall into two camps they either don't want to give steroids at all or they give it to every kitty for everything.  I think it should be a last resort and of course the lowest dosage possible should be used.  It's something to ask you vet about.  Since he hasn't given it yet he probably falls into the camp that doesn't like to give them.

I'm sorry that Guinness isn't feeling well at the moment. Chronic pancreatitis can come in waves ranging from mild to severe. I can say that Sebastian has experienced all levels since the first attack in July 2013.

If you go back to my post # 26, I explain how Sebastian was/is treated (more than just Cerenia and Mirt). He is still on lose doses of everything except the appetite stimulant and pain meds - these are only needed when he is really bad. He is currently doing well, but I experience the lip smacking and meatloaf position from time-to-time. LDG also explains how her cat was treated in post # 40.

Here's a document from Idexx that is helpful in detailing how pancreatitis is treated:

http://www.idexx.com/pubwebresource...pec-fpl-treatment-for-feline-pancreatitis.pdf

It's important to get the inflammation under control, and Cerenia and Mirtazapine alone will not do that.

I am dealing with Chronic Pancreatitis in my own kitty DeeJay.  She is on Prednisolone right now in addition to an antibiotic for a possibly related Ecoli Bladder infection.  She is also on Pancreatic Enzymes as she was having issues with pale colored stools.  It has helped a lot.  I haven't noticed that DeeJay needs the acid reducer as she has done absolutely no vomiting with her condition.  Which is odd, but her test came back positive.  So basically she is on the Prednisolone and Simplicef with the Krill Oil for her Pancreatitis.  She is on a lot of other stuff too but she has a lot of other issues.  She was on Metronidazole but she was miserable on it and it was an absolute pain to give her (she is the WORST about medications) so we quit giving it.  From what I have read and researched about Chronic Pancreatitis is that you will have flares, but it is a chronic inflammatory process which is why DeeJay is on the Pred.  She may or may not also have intestinal cancer, we are just treating it symptomatically at the moment as she is 14 years old and I don't want to put her through surgery for a biopsy.   I haven't dealt with flare ups as we are hopefully on the tail end of her first episode.  I hope we can keep it under control for a long long time as this has been so stressful on both of us.

Denice - In the beginning, before the diagnosis, the vet did give me Prednisone pills for him thinking it was an attack.  I think he would do it again so I dont think he is anti steroid.  I have been texting him daily morning and evening with updates.   I think he wanted to watch over the weekend and maybe make a move tomorrow (Monday) with something else if necessary.  I may ask him about it tomorrow.

GoHolistic.  Thank you soooo much for giving me specific post numbers.  I had plans of reading through it all again but hadnt gotten to do that yet and now I can go straight to those posts.  If it is normal I can deal.  He is eating but not crazily like normal when he is on day 2 of the appetite stimulant.   Definately not enough.   I freaked this morning when I woke up and saw daylight and wasnt awoken by a meowing cat at the bedroom door.  Guess he was tired. 

CPRCheetah I hate the Mirtazapine but sticking to it for now.  I hate how it makes him act.  I give him 1/8th in the morning then 1/8th in the afternoon of the day he is due.  Sometimes the next day.  I try not to give him that 1/4 all at one time because of what it does.  We are still burping and sitting uncomfortably today but still eating - he is back to his gravy licking ways though.  By the time we get to Tuesday morning when he is due for his Mirtazapine I will be pushing him to eat if not baby fooding him.

Hello, I havent spoke on here it quite a while but I am dealing with a new problem with my Guinness.  He has been struggling to recover with this last bout of Pancreatitis and I went for bloodwork to see if the kidneys have started to get worse.  They have not, however, his gluclose levels were very high.  He is on Pred but the vet says even still they are higher than pred would probably do.  I go Monday for the urine test to see if he has it.  My heart aches at the thought because he takes so many pills and has so many highs and lows that this may put us over the edge.  The triple threat.  Kidneys, Pancreatitis and Diabeties.  I dont think I can do what is necessary with Diabeties on top of his other issues.  I dont want to play God, it makes me sad.  It rips my heart out - as it will my children.  OMG.

Guinness10 said:

 
Hello, I havent spoke on here it quite a while but I am dealing with a new problem with my Guinness.  He has been struggling to recover with this last bout of Pancreatitis and I went for bloodwork to see if the kidneys have started to get worse.  They have not, however, his gluclose levels were very high.  He is on Pred but the vet says even still they are higher than pred would probably do.  I go Monday for the urine test to see if he has it.  My heart aches at the thought because he takes so many pills and has so many highs and lows that this may put us over the edge.  The triple threat.  Kidneys, Pancreatitis and Diabeties.  I dont think I can do what is necessary with Diabeties on top of his other issues.  I dont want to play God, it makes me sad.  It rips my heart out - as it will my children.  OMG.

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I'm so sorry Guinness is having a setback and possibly a new issue. What were his glucose levels? Chronic pancreatitis has the potential to damage the pancreas in a way that it affects it's insulin and/or enzyme production. And, as you know, being on a steroid long-term can also contribute to diabetes. I don't know a whole lot about diabetes at this point, but my Sebastian is also on pred (among other things) for his chronic pancreatitis and we're on alert for any signs of diabetes. I don't recall what Guinness eats, but a zero to low carb diet could really help. Keep us posted.

Unfortunately all he is eating now and will eat is the gravy from Friskies and has all of a sudden started eating dry purina nf for kidneys...go figure? He isnt eating enough on his own even with the appetite stimulant...Cerenia and Pred. He has been on everything more than he hasnt lately. He would never make it even if I tried every other day with the pills like I used to. If he has diabeties I will know tomorrow. Not sure what the exact glucose levels were, just that vet felt he needed to check them with urine test because even on Pred they were high. I kind of dont think he has it. Just my gut feeling. However, I do feel like his pancreace is so scarred at this point his "good" days are becoming less and less. I will let you know what the results are tomorrow. I truly appreciate your getting back to me.

Unfortunately all he is eating now and will eat is the gravy from Friskies and has all of a sudden started eating dry Purina NF for kidneys...go figure - as this was the dry food he refused when I initially tried it. He isn't eating enough on his own even with the appetite stimulant...Cerenia and Pred. He has been on all the meds more than he hasnt lately. He would never make it even if I tried only pilling him every other day like I used to. He doesnt seem to get over his bouts of Pancreatitis for very long if he does.  It is up and down constantly.  Good day, bad day, good day.  If he has Diabeties I will know tomorrow. Not sure what the exact glucose levels were when they did his blood, just that the vet felt he needed to check them again with a urine test for it because even on Prednisolone he felt they were high. I kind of dont think he has it. Just my gut feeling that we are dealing with the worst episode of Pancreatitis since this whole thing started. I feel like his Pancreas is so scarred at this point that his "good" days are becoming less and less. I will let you know what the results are tomorrow of the test. I truly appreciate your getting back to me.  Tonight is bad.  He is on the pain meds also and they just make him so loopy.  I gave him baby food the last few days just to get us through the weekend so that I can go tomorrow for the test and have a consultation with the vet as to what to do.  When is he suffering to the point of no return?  My worst fear though all of this was to have to make a decision without feeling confident in that decision and I am so afraid it is going to come to that.  I know that there is no rush but I feel in my heart we are coming down the home stretch.  Then again that Pancreatitis has a way of laying low for a period and then boom I get my kitty back again.  Though for fewer and fewer days in between does that happen it seems.  The poor thing....I bring the baby food in to feed him tonight and he gags before it even gets near him.  He's bad.

So were Guinness' medications stopped when he was feeling better? FWIW, Sebastian's medications and supplements are never stopped. If I stopped them, he would flare. And once he's in a flare, it's hard to get him out and then the damage happens. We tried to reduce some of his meds to every other day and he flared (this was last year). Stress is another major aggravator, as well as certain foods. He's now on a strict limited ingredient protein rotation of canned and supplemented home-cooked with no issues. I'm not sure what your situation is, but sometimes a really bad flare warrants hospitalization and monitoring. Fluids are really important for a cat with pancreatitis (assuming Guinness does not have a heart condition). Sebastian gets sub-q fluids at home every other day. Our recent guest expert, @Dr Kris, even mentioned that fluids and food have been cornerstone for his IBD/pancreatitis kitty.

I know how scary it is when they are like this. I really hope that Guinness can turn the corner soon. 

No they never really were stopped all together.  I guess I thought they were supposed to be in between flares.  I just got the feeling that Sebastian was weened off of them when he was feeling better but I think you just meant that the doses were lowered and my vet always talked of downing Guinnesses doses too, and every other daying it when he started to feel better so I guess I thought that is how it was to be.  The Pred was only during a flare in the beginning and there were times where I didnt have to do the appt. stimulant.  The vet had spoken of trying every other day with Cerenia but he just couldnt do that and I could see the difference without it.  I am not sure what to do with regard to diet.    I had tried everything under the sun in the beginning food wise and he wasnt having it but he wouldnt have anything when he was feeling bad so I could try diet change again although he is feeling bad again.  I was quite afraid to change anything for fear it would make him worse, but that happened anyhow.  Hoping to run all this by vet today when I get there.  Mornings the last two days were OK but he still just licked gravy today so far and by evening he is horrible.  I think mornings are ok because his stomach is empty and doesnt hurt.  I will discuss the sub fluids.  He normally drinks alot of water (I know that is a sign of Diabeties).  When he is hurting the water comes in waves though but normally he drinks a way lot of water.  As far as being hospitalized, as much as my heart hurts and stomach is wrenched at the thought if it, if it comes to that we just cant do it again. 

I guess I should have been more specific because Sebastian isn't always on everything. Sorry for the confusion. The two things we adjust up and down the most based on how he is feeling are Cerenia and sub-q fluids. He's been getting the Cerenia Monday through Friday since October. The pred we only had to increase once or twice in the past (last year) to nip the inflammation in the bud, and it was only a small increase for a couple days. But he's basically been on the pred every day since September, as well as Pepcid. He's on a whole list of things now that have been gradually added, along with the new diet, over a six month period. Sebastian was eventually weened off metronidazole over the course of four weeks. He had been on that for four months when it was brought to my attention the possible neurotoxic side effects. He only gets the metronidazole (maybe), mirtazapine and buprenorphine during a major flare.

Hey GoHolistic, his Glucose is 600.  Already up from last Wednesday when he had blood drawn.  That is with only having a half a pred in the morning yesterday as opposed to an entire pred the first time he was tested.  not having much pred in him at all so it went up already.  So there it is....the vet said it is next to impossible to get insulin levels right with a Pancreatitic cat and I get that.  I brought him home to say goodbye.  I asked this vet who has gone above and beyond for me from the very beginning to let me know when he thought it was time both personally and professionally.  He did that yesterday.  I respect his medical and personal opinion as he has always had my baby's best interest on his mind.  Doesnt change the looming decision.  His personal preference is to let them go before they are suffering.  I do get that however I have two kids and myself struggling with taking a cat to leave this earth with life left in him.  I also dont want to wait till he shows suffering to ease our pain.  Tricky.  He stares at me now as I type this.  Dont think today is the day as he did nibble food this morning and is up and around.  Vet also said that it could be a week or a month at the most before the diabeties gets really bad.  Although he still feels like garbage from the Pancreatitis.  UGH.  Day by day, hour by hour we go.  Currently he is still with us and we love him.

Wow, that is really high.    The elevated glucose alone could be making him feel pretty crappy. It sounds like you have decided not to treat him. I'm so sorry it has come to this, and can only imagine how devastated you are. I agree that quality of life is a huge factor in any cat with a chronic illness. My thoughts are with you.

If you do decide to try to treat Guinness' diabetes, you may find this thread helpful. One of the posters, maewkaew, had a cat with both pancreatitis and diabetes.

http://www.thecatsite.com/t/270479/diabetic-cat-on-prednisolone

OK, that helped me right there.  To know the diabeties numbers are high.  I knew when I left the vet I would question - is he really that sick?  Even though I was told.  Are the numbers really high because of that and not Pred or stress?  I know me and how my twisted mind works.  He is still here, took him outside for some sunshine today, both boys had my furry robes on last night so that he could lay with them as he always did with me in the winter time.  He would push open my robes and burrow in.  He doesn't seem to feel terrible today - definately better than he was 3 days ago for sure.  I gave him Cerenia and apt. stimulant and Clavomox (Vet said to try it) this morning.  Tiptoeing through those decisions, such as baby food feeding him.  I dont want his life to get cut short by starvation.  I feel if he seems content and happy enough with us, purring coming around etc. then I have to make sure he eats, because I know he is hungry when he stands at that food bowl and licks gravy or nibbles his dry food.  Strange to treat a cat with pills and food that you know you are going to let go of.  Swore I wouldnt bring home a cat I knew was going to be put down due to an illness or something because it would eat my heart out.  However, we are still making memories, giving him fresh air and love.  When I will know the time is right is questionable to me but for now he is laying in a windowed door napping in the sun so for now he is here.  My young boy is going to give him pictures to take to the vet with him when he goes and I am giving them his lambs wool spot he sleeps on in the window to lay him on.  Thank you for the information.   I truly appreciate it.  I will keep you posted on him as you have been a help and comfort even though then end is going to be what it will be.  Oh here come the tears again.