Pancreatitis (bloodwork diaganosed) with almost no symptoms - need to do anything??

In the midst of the health issues with Rexy and Toffee, Murchie kitty was diagnosed with pancreatitis. Basically he lost a bit of weight (not visible weight loss, but caught because I keep a baby scale at home) and did not eat his soft meal for a few days. But clinically he was actually doing overall well even at this time. Nonetheless, I took him into vet clinic for bloodwork just to ease my mind, and the test for pancreatitis came back with a definitely positive high value (I was actually a tad surprised). He was very stressed during the taking of blood - can this affect the result at all?? Anyhow, apparently the value is quite high (I do not have the value at hand but can find it out). We put him on subq fluids for a few days, and during that time his weight stabilized again (he did not regain weight but is holding the weight) and he began eating very well again. I have taken him off fluids.

My regular vet has been away so she has not been around to talk to, but she returned to work yesterday so we will be talking soon. In the meantime, other than modifications to suitable diet and such, does one need to do anything to treat a cat with pancreatitis who is showing no symptoms?? Murchie almost never throws up (even when I brought him into the vet last week, he was not throwing up at all), pees and poos perfectly fine and is a happy cheery guy overall.

Pancreatitis is such a strange thing.  Some kitties have virtually no symptoms and some kitties get extremely ill.  Some kitties do well with digestive enzymes others get worse with digestive enzymes.  I do know that the sub-q fluids do universally help kitties with pancreatitis.  I would continue doing what you are doing and count yourself lucky.  He would probably benefit from fluids when his appetite seems to wane a bit and just see what the vet's suggestions are.

That is reassuring that some cats do not show symptoms. With my hands full with so many cat issues, I can only hope for Murchie's sake (and mine too) that he remains largely symptom-free.

Just keep an eye on it.  My kitties bloodwork was fine other than her pancreatitis test.  Her only symptoms were not eating as much, she wasn't nauseated, no vomiting or anything.  Your kitty could have Chronic Pancreatitis which could be why she isn't showing the classic signs of pancreatitis.

cprcheetah said:

 
Your kitty could have Chronic Pancreatitis which could be why she isn't showing the classic signs of pancreatitis.

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Is the kitty in some degree of pain with chronic pancreatitis? I know cats can hide their pain very well - but that being said, I am sensitive to the smallest behavioural changes in my kitties and nothing to me seems to suggest pain.

Scarlett 001 said:

 
Is the kitty in some degree of pain with chronic pancreatitis? I know cats can hide their pain very well - but that being said, I am sensitive to the smallest behavioural changes in my kitties and nothing to me seems to suggest pain.

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I really don't know the exact answer to that, just have read that they can benefit from pain medication.  DeeJay didn't do well on the pain meds so I quit giving them.  But I do know other kitties who have chronic pancreatitis do well with the pain meds.

Oh my! You are juggling a lot!     I'm so sorry to hear about Murchie now.  

Sebastian has chronic pancreatitis (confirmed through blood test and multiple ultrasounds) and the vet suspects IBD as a cause and/or concurrent condition. It wavers anywhere from zero to mild, moderate, or severe. His first pancreatitis attack was severe (violent, continuous vomiting, anorexia, lethargy, hypokalemia) and required hospitalization for a few days and syringe feeding. Vomiting is not as common in cats as it is in dogs. Cats usually display anorexia and lethargy. Since the first severe episode (July 2013), Sebastian has had two moderate attacks (September and October 2013), some days with mild symptoms (sleeping a lot, walking away from food before finishing), and there are times when he feels great.

I would just like to say that just because a kitty does not show symptoms, does not mean she/he is not in discomfort. Losing weight and not eating [as much] ARE symptoms. Pancreatitis is generally painful, but it all depends on how bad the inflammation is. The problem with not treating chronic pancreatitis is that the inflammation is damaging and can cause permanent thickening and may even lead to exocrine pancreatic insufficiency (EPI) or diabetes mellitus.

It sounds like Murchie's case is currently mild (or "low-grade"), but like @cprcheetah said, I would keep an eye on this. And like @Denice said, fluids are great. Sebastian still gets fluids every other day. He's also on prednisolone (for inflammation) and low doses of Cerenia (for nausea), metronidazole (for bacteria control and inflammation), Pepcid AC (for stomach acid), probiotics (to replenish gut flora), and fish oil (for omega-3s). Sebastian only gets the appetite stimulant and pain meds when he is really bad.

Since some people like references, here you go: 

Cat Hospital of Chicago: Pancreatitis in Cats

ManhattanCats.com: Pancreatitis in the Cat

Cornell University College of Veterinary Medicine: Feline Pancreatitis: Serious

VCA Animal Hospitals: Pancreatitis in Cats

The Conscious Cat: Feline Pancreatitis

Idexx: Treatment Recommendations for Feline Pancreatitis (PDF)

Lots of vibes for Murchie!   

Thank you for information.

My regular vet finally returned to work this week, and she wants to read all of the files of all that has happened with my kitties since everything fell apart over Christmas. Another vet at the clinic did the bloodwork while my vet was out of town, but any longer-term treatment plan etc. will be devised with my regular vet. So hopefully, we will talk sometime tomorrow about all of my kitties issues, including Murchie. It might take my vet a century to read about my 15+ vet visits, including 3 sets of xrays, 2 ultrasounds, about 8 bloodwork panels, surgery for tooth and bladder stones. We can then make a plan for him, probably consisting of some of the things that you mention (similar to some of Rexy's plan). So from what you said, to have the positive blood test basically means inflammation and inflammation = pain - did I get this right? Rexy's situation is immediately more precarious so I've not yet done my homework in enough detail for Murchie.

One thing that is really handy is having that baby scale. I can almost guarantee no other owner would have picked up on the weight loss as we are talking literally only a few ounces, not pounds (but I know Murchie's normal ranage and fluctuations so I know exactly when to get concerned). I think that I took action so quickly last week as I was hyperalert to everything given all the issues I was confronting last week. I like to think that we have caught this early enough that we can forge a way to ensure it never reaches a critical attack. The good news is that I have weighed him every day since I took him into vet, and his weight has been completely stable for over a week now - he has not even lost another ounce. So that is something to hold onto.

Scarlett 001 said:

 
So from what you said, to have the positive blood test basically means inflammation and inflammation = pain - did I get this right?

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Their logic is that a positive spec fPL test means there are elevated levels of pancreas-specific lipase, a digestive enzyme. Elevated levels of lipase indicate pancreatitis. Pancreatitis is inflammation of the pancreas. (http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/fpl/abcs-feline-pancreatitis.pdf)

Inflammation is, generally speaking, the immune system’s response to stimulus. It has the potential to cause pain and discomfort, depending on the severity of the inflammation. So, I can't really answer your question on whether or not Murchie is in pain, because I can't really know for sure. Sebastian's inflammation was severe, so he was in quite a bit of pain.

So difficult to know, isn't it? I don't want to push steroids etc. at him if not needed. I do find my baby scale handy, as I can detect subtle weight shifts that could indicate a minor problem even if nothing is obvious in his outward demeanor. Will give this lots of thought and watch him like a hawk.

For cats with pancreatitis, what kinds of amounts of fluids are you doing? It seems as if it is just a bit of guesswork, even after talking to vet. Is something along the lines of 50ml every other day the kind of amounts other people are doing?

Scarlett 001 said:

 
For cats with pancreatitis, what kinds of amounts of fluids are you doing? It seems as if it is just a bit of guesswork, even after talking to vet. Is something along the lines of 50ml every other day the kind of amounts other people are doing?

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I would ask your vet what they recommend based on Murchie's status.

Per my vet, Sebastian gets 100 ml every other day. I do check each time to make sure the previous session is fully absorbed. I had a hard time getting to the vet this week before they closed to pick up more fluids, so it had been four days. Coincidentally, Sebastian wasn't feeling 100%, and it was my fault.     I gave him fluids last night, so I'm hoping her perks back up.

I'll be talking to my vet. But Murchie is not eating much the past few days, and is losing a bit of weight. I am worried enough that I did a bit of syringe feeding to ensure we don't lose too much ground here. For what I am doing for him, he has subq fluids and VitB12 shots at the moment. What is usually the next course of action for pancreatitis that is no longer being managed by these simple things?? Does one generally turn to prednisolone next, or to appetite stimulants/pain meds?? Of course, anything I do will be determined by my vet, but just curious what the usual line of action is...

Disheartened and overwhelmed. I have 4 cats now that need careful management (hopefully a couple of them are issues that will pass within a few weeks to a month). But right now, I just feel overwhelmed. I hate it when you offer them food and they just sniff and reject.

Ugh....I'm so sorry Murchie is not eating much now. I know the sick feeling we get when they walk away from their food or don't finish.    I know I already provided this above, but it really is a great document that outlines the treatment options for pancreatitis (chronic or acute): Treatment Recommendations for Feline Pancreatitis (PDF)

Sub-q fluids and B12 injections are great, but pancreatitis is inflammation. The inflammation is what is causing pain and anorexia, so IMO the next course of action would be to get the inflammation under control. Ask your vet what they recommend as the next steps. Sebastian wasn't started on prednisolone right away. His first pancreatitis attack was at the end of July 2013 and we didn't start the prednisolone until early September 2013. We went this route because his symptoms kept coming back and we realized that this wasn't just a one-time deal, unfortunately. And yes, sometimes anti-emetics such as Cerenia and appetitie stimulants need to be used to help keep them comfortable and eating. Sebastian only gets the appetite stimulants and pain meds when he is really bad. His pancreatitis regime is prednisolone, Cerenia, metronidazole, Pepcid AC. His current regime is on page 16, post # 457 of his thread (http://www.thecatsite.com/t/264363/...suspected-pancreatitis-again/450#post_3482256).

Vibes for Murchie... 

Murchie is stabilized (thank goodness). After a lot of learning and working with my great at-home vet, Murchie was put on regular buprenorphine and ondansetron (anti-nausea) about 3 weeks ago and it has done wonders for him. We also gave him an antibiotic as his chronic respiratory has flared up and that has really settled down again too. Murchie has stopped losing weight (weight has stabilized) and he is much perkier and happier than he had been before this adjustment to treatment. He continues to get vit b12 injections and subfluids every other day.

I know that with pancreatitis, we may have downturns again but it was important to figure out what kinds of things work to give Murchie quality of life. Please send wishes to my wee man that he continues to do well.  

Great to hear Murchie has stabilized. Yes, the anti-nausea works wonders for Sebastian, too.

I was just saying how Sebastian has been doing SO well for three weeks and without warning he vomits this morning and doesn't want to eat.

There are going to be ups and downs. But you're right...it's a matter of finding what works for Murchie to keep him happy and comfortable.

Sending lots of vibes and well wishes...