The Roller Coaster Ride of Pancreatitis

Hi,

My cat, Simon, was diagnosed with Chronic Pancreatitis at the end of December. It has definitely been a roller coaster ride. The days that he eats and feels well I'm ecstatic and convinced he is getting better. However, on the days he hangs his head and only sniffs at the food before walking away makes me so sad and stressed, not sure if I want to cry or scream more.  So, I have a question re: feeding. Do you stop feeding your cats with pancreatitis at a certain time in the evening? I am wondering if Simon feels worse in the morning if he goes to bed with food in his stomach. I would just hate not to give him food if he is willing to eat it, but I wonder if it make the mornings worse for him. He gets a Pepcid injection AM and PM. Often he will wake up and not feel well, but after a nap, Pepcid and pain med he feels better. I was feeding him until 12 midnight, then 11 and now 10:30. However, I'm not sure if i notice any difference. Any words of wisdom? 

Hi and welcome to TCS. Sorry to hear that Simon has pancreatitis. There have been quite a few cats lately on this site with pancreatitis. goholistic has a long thread on how she has been treating her.

Since the Pepcid helps with excess stomach acid, I think that going longer between meals would be counter intuitive since Simon seems to feel better after Pepcid.

Just out of curiosity, why is Simon getting Pepcid injections instead of pills? Is he very difficult to pill? I guess I would worry about the frequent injections.

When Sebastian was diagnosed (July 2013), the next four months were torture...the ups and downs...the good and the bad...eating and not eating. I thought I was going to lose my mind. I know exactly how you feel when they sniff and walk away. I got that sinking, sick feeling in my stomach every time this happened.

Regarding feeding, I have a very specific approach with Sebastian. It is a pain, but it works for him. I feed him his canned food in 1/8 can increments every 15-20 minutes. Based on calorie counts, he should get about 1/2 of a 5.5-6 oz. can at every meal (give or take, depends on the food and how high calorie it is). So, this means, he gets four 1/8 can feedings at 15-20 minutes apart. This means mealtimes take at least one hour plus. He knows the routine now, and goes to clean his face after every feeding, and comes back in about 15-20 minutes like clockwork. By the way, he has a REALLY clean face when we're finally all done.    I do give him some supplemented home-cooked meat as the last serving before cleaning up. On the nights that he gets sub-q fluids, I give this afterwards as his "reward."

Anyway, this approach works for two reasons: 1) it prevents regurgitation from eating too fast and/or too much at once (you do not want to start a vomiting episode with a pancreatitis cat), and 2) he just can't eat any more than that at one sitting. I tried to increase the amount a little so that we could end up with 2-3 feedings (easier on me), but he wouldn't finish, the food would sit there and get all nasty and then he wouldn't want it. 

There are two schools of thought that I have come across when it comes to the frequency of feeding a pancreatitis cat. The first is that you should feed the cat in frequent small meals throughout the day to keep the stomach from getting totally empty and causing excess stomach acid and other discomforts (some cats vomit clear liquid or bile when gone too long without food in their stomach). The second is that a pancreatitis cat should have a fast in between meals to give their system a break. Eating food (even the smell of the food before they start eating it) triggers the pancreas to produce enzymes and the thought is that we need to let the pancreas rest. I have gone with option 2 and I give Sebastian's system a break in between meals. I think this works for him, but I think every cat is different. You may want to experiment and see what works best for Simon, but be sure to pick a routine and stick with it for at least two weeks before deciding if it's working or not. If you're switching it up every day, and doing different times frequently, you could be throwing him off.

Try to give the Pepcid injection the same time every day and work that into his feeding schedule, whether it's an hour before mealtimes (gives it a chance to kick in) or whatever. Sebastian gets 1/4 tablet of Pepcid twice a day and I give it to him a half hour before mealtimes (it's in his gel cap with many other things).

One last thought...  If Simon's pancreatitis is acting up and he doesn't feel well, chances are no perfect feeding schedule will help. He just won't want to eat...period. This is where supportive care comes into play and doing what you can to keep him comfortable enough to eat. When it comes to this, you feed him whenever - when he's ready and even when he's not ready by encouraging him and enticing him. Always keep tabs on whether or not he's getting enough. You want to avoid hepatic lipidsos (fatty liver disease) at all costs.

Sending lots of vibes....