Pancreatitis and bad breathe

Hey everyone I would like to know your thoughts or experience with cat pancreatitis. My 17yr old male cat was diagnosed with pancreatitis Oct 2013 and we put him on Denamarin and a gravol type pill for cats. He took those for 2 months and went back to normal. He was eating and pooping normally. Happy and feisty. He started throwing up again in Feb 2014 so I went to vet and got same pills again. He hasn't had a follow up appointment though. He is still sleeping, not eating very much and not feisty at all. He also has horrible breathe.
Any suggestions? I am taking him in for blood work in a week or two but love getting advice on here too; everyone is soooo helpful and supportive.

Thanks so much.

My Sebastian has chronic pancreatitis. Unfortunately, cats with this condition can have recurring "flare-ups" at which point we can only provide supportive care.

Here's a document from Idexx that explains how pancreatitis should be treated: http://www.idexx.com/pubwebresource...pec-fpl-treatment-for-feline-pancreatitis.pdf

Sebastian was diagnosed in July 2013. He is still on a whole regime of supportive supplements and medications to keep his flare-ups under control as best we can. I've consulted with four vets so far. He gets sub-q fluids every other day, Cerenia for general nausea, Pepcid AC for nausea and discomfort caused by acid build-up, a steroid to keep inflammation under control, probiotics to replenish health gut flora, fish oil for omega-3s, and most recently, Chinese medicine.

I don't know what the "gravol type pill" is that you are referring to.    As far as the bad breath goes, I never heard of this correlating with pancreatitis. But you'll want to talk to your vet about this, too, as bad breath can be a sign of painful dental disease.

Do keep tabs on his eating. Cats that go too long without eating their normal daily caloric intake can develop hepatic lipidosis (fatty liver disease). You want to avoid this at all costs. If he's having a pancreatitis flare, he's most likely in pain and nauseous.

So, I guess my suggestion would be to have a plan for supportive care when he's not doing well. I always have Sebastian's medications and supplements "in stock" at home and have instructions from our primary vet on which things to increase and for how long to get him back on track.

Bad breath is usually a sign of some kind of periodontal issue.  Could be gingivitis or, more likely, a bad tooth (FORL).

FORLs are very painful, and can cause a cat to not want to eat.

Leaving FORLs (or any other periodontal disease) untreated can cause infection in the mouth.  The problem with this is that the blood vessels in the mouth are very close to the surface, and very "absorptive", for lack of a better term.  In other words, the infection gets easy access into the bloodstream from the mouth.  This can cause much larger issues in the long run, especially if you are already dealing with pancreatitis.

My first instinct is to have your vet do a good dental exam, including x-rays, to see if there are any broken or resorptive teeth.

Thank you so much Holistic for your info about Pancreatitis; it isn't a fun thing for a cat to have. The anti nausea medication that Domi is on is called Cerenia. It helps amazing and allows him to relax and eat some food. He has been on prescription food from the vet since last year. He has a special dry food to help his kidneys (allow they are good) and he is eating a wet food for cats that have just had surgery which he usually loves. He has eaten some food and is drinking well but it's not his usual food. He gets his Denamarin (aka Smurf pill) every evening and is very good about it.

Fur monster thank you for your advice. Domi has had a mouth exam and actually has pretty good teeth with slight tartar. The vet was so impressed with him considering his age. His brother lost his life in 2013 due to kidney failure so I have made a promise to take care of Domi as best as I can. I will keep a check out on his teeth and will get him a full exam and teeth cleaning soon.