Mild pancreatitis-at my breaking point

Last Friday I took my cat in because he wasn't sitting down on his bottom.  Anal expression, he also was due for his check up.  He lost 1.5 pounds they ran some labs B12 came back fine so the vet says he has mild pancreatitis.  I am giving him a steroid once a day and sub q fluids.  He is not getting any better.  He was on sub q since Wed and was getting shots of steroid and anti-nausea.  We moved to pills yesterday that did not go well.  I was better off with the shots I think.  He is still barely eating.  I was just wondering if I am expecting too much too fast?  I spoke with th e vet on Friday and I thought we were okay, now of course it is the weekend and he is taking a bit of a turn.

Time for the emergency vet. If he's not eating he could have hepatic lipidosis started.

I'm surprised they didn't do more diagnostics before assuming it was pancreatitis.

He's been at the vet four days this week.  He has been barely eating since last Saturday.   They know all of  this.  What are they going to do at the emergency vet?  They ran the lab that is specific for pancreatitis and it came back negative.  They ran another lab that showed it is specific to his upper gi track.  I am just hoping that someone else on here has gone through the same thing and could maybe help with the timeline of how their cat did.

Tretred said:

 
He's been at the vet four days this week.  He has been barely eating since last Saturday.   They know all of  this.  What are they going to do at the emergency vet?  They ran the lab that is specific for pancreatitis and it came back negative.  They ran another lab that showed it is specific to his upper gi track.  I am just hoping that someone else on here has gone through the same thing and could maybe help with the timeline of how their cat did.

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My cat has ongoing pancreatitis and IBD and he is on sub q fluids twice a week, cerenia daily for nausea (normally its a 4 day on one day off med but he tolerates it 7xwk), B12, prednisilone and pepcid.  Sometimes he has a flare up and he gets some additional meds and he's usually better in less than a day.

Pancreatitis is very tricky.  But that's different with "Upper GI" issues.  Has your cat been diagnosed with anything else?  It is essential that he begin eating soon.  In your first post you say that he is "still barely eating"  What do you mean by "Still"?  When did he stop eating?

Last Saturday is when he stopped eating.  We have been able to get him to eat little everyday.  Not what he should be.  Boiled chicken some days out of desperation.  Only licks his wet food.  Eats treats and a little hard food.  Pilling him is an absolute nightmare and he is so stressed out from all of this he is hiding under the bed.  We just have to get to Monday but it is going to be a long road.  I can't get him to to sit for the sub q.  We keep trying but he is so stressed and now we are too.  

All his other labs were great.  The vet said he has a "mild case of pancreatitis" and it is located only to his upper gi track.  

Your vet's conclusion sounds a little bit confusing.  Okay, a lot confusing.  Pancreatitis and upper GI tract are two different things.  Kind of like humans.  We can have pancreatitis, involves the pancreas and we can have an upper gi tract inflammation.  Two totally different things.  I don't get it.

keyes said:

 
Your vet's conclusion sounds a little bit confusing.  Okay, a lot confusing.  Pancreatitis and upper GI tract are two different things.  Kind of like humans.  We can have pancreatitis, involves the pancreas and we can have an upper gi tract inflammation.  Two totally different things.  I don't get it.

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It has to do with the anatomy of the kitty.  These things are usually inflammation and the openings into the different major areas of the digestive system are very close together so especially since feline IBD is progressive even when well controlled,  it isn't unusual at all for other areas to become inflamed.  My kitty has IBD and one case of acute liver inflammation.  Even though his symptoms are well controlled he has lost some weight recently and his last blood work looked suspicious for possible pancreatitis.  He is getting weighed again at the vet's next month and if he is still losing he will have another ultrasound and probably the more sensitive blood test for pancreatitis.

Thanks Denise,

He ate some yesterday which is good but he is very much not himself this morning.  I am having a hard time getting him to take the pills, I could only get the steroid down yesterday so I think he is not feeling well because of no anti-nausea.  We are going to try that again today.  He doesn't want to be petted and his spending a lot of time under the bed.  Tomorrow can't come fast enough.  I just want him to feel better.

I'm so sorry you are going through this.

So come monday it sounds like its time for a full work up, and aggressive therapies to get this under control.  Ultrasound of the GI tract, PLI test for pancreas, full bloods etc, fluids, anti nausea meds like cerenia and zofram, injectable pepcid, possibly pain relief if indicated like Buprenex, and anything else they can think of.  You can also do injectable steroids instead of oral pred which may be easier to administer, and it even sounds like he may need to be admitted for nutrient support and monitoring.  

Picasso was admitted today.  They did an ultrasound.  Confirmed he has pancreatitis.  Said all other organs look good.  They have him on an iv drip, antibiotics and anti-nausea.  I get to visit him in a little while, we are going to try to feed him.  Said if he doesn't eat on his own then feeding tube.  Said we are to take it day by day.  Any success stories would be greatly appreciated. 

Thanks

I had a kitty with a feeding tube for fatty liver and he did well with it.  He tolerated feedings very well and it was much less stressful for both of us then trying to get him to eat or using a syringe.  I think we tend to have a negative feeling about feeding tubes because in people they are used when a patient is close to the end with a terminal condition.  With kitties it can be a very important part of treatment.  Kitties don't understand that they have to eat when they don't want to, people can understand that and eat even when they don't want to.

Thanks Denise.  I have a hope/fear of the feeding tube.  Scared for it but I know it could be what is needed for him to survive.  I'll do anything he needs to get him through it successfully and we told the hospital that too.  

If there is good news, its much easier on the cat to be fed through a feeding tube then to be syringe fed through the mouth, and the vet can teach you how to do it at home. Pancreatitis is a b**ch as there is no specific cause nor cure, just supportive therapies to get him past a crisis.  My cat has an ongoing  case and while he has occasional mild-ish flare ups he is mostly controlled through Prednisilone (also for his IBD), cerenia daily for nausea, twice weekly sub q fluids, pepcid AC, and weekly B12 injections (also for the IBD).  It's not very difficult to do all this, it just sounds like a lot but its fine.

If you're cat throws up because of the pancreatitis, the use of cerenia daily (a neural block for nausea) can be a wonder drug at low doses.  Note however that it is only supposed to be given 4 days out of 5, but cats can often tolerate a daily dose but vets are generally unsused to doing this and may be reluctant.  If you're cat benefits from and needs cerenia daily i would be happy to have your vet talk to my vet.

An alternative is to swap out the cerenia with injectable (or oral) Zofram once every 5 days, but that drug needs to be given 4 times a day.

ALso I have oral liquid Buprenex at home for those rare times when he is in pain.  For my cat, the key is providing daily supportive care to avoid the crises as much as possible.

I would have said many of the things @StephenQ has said since our cases are similar. Pancreatitis is a b**tch. My Sebastian has had it for 1.5 years now. The first time was the worst and treatment was aggressive. He was hospitalized overnight on an IV for 4-5 days and needed to be syringe-fed for two weeks. He took the syringe feedings well, so he never got the tube. The list of treatments @StephenQ already mentioned are the ones I am familiar with as well.

Here's a document that I referred to a lot for treatment of feline pancreatitis: https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf.

GoHolistic said:

 
I would have said many of the things @StephenQ has said since our cases are similar. Pancreatitis is a b**tch. My Sebastian has had it for 1.5 years now. The first time was the worst and treatment was aggressive. He was hospitalized overnight on an IV for 4-5 days and needed to be syringe-fed for two weeks. He took the syringe feedings well, so he never got the tube. The list of treatments @StephenQ already mentioned are the ones I am familiar with as well.

Here's a document that I referred to a lot for treatment of feline pancreatitis: https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf.

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@GoHolistic's article on pancreatitis may be the best I have ever seen.  A definitive resource. @GoHolistic  thank you for linking us to this, you have done TCS a great service.  As someone who is helping my cat battle this illness along with IBD, kidney disease and cardiomyopathy I am in your debt. 

Thank you  both so very much.  I will read the article.  We were able to visit him yesterday and today.  My hubby took off his sweatshirt and he slept in-between us for two hours.  He has a slight fever but he ate this morning when they gave him an appetite stimulant.  Holding off on feeding tube for now.  He was a super active last night when we visited but not so much today.  Played around us for awhile but the sweatshirt came out and he snuggled right in.  Vet said at least three more days in ICU.  I just really hope he pulls through this.  The waiting is taxing.  We are emotionally done trying to get through the holidays when family visiting.  My hubby left his sweatshirt with him.  We are allowed to visit again tomorrow, vet said visits are good and we are allowed to stay for a long time.

Visits can help with eating and motivating him to eat.  I wish you all the best and please keep us updated.  He's getting great care, he just needs a shot at getting through this.

Last night we  had a 70% chance, then he had a seizure in the morning.  We let Picasso go this morning.

Thank you for all the help.  I hope all your kitties stay well.

Sorry for your loss. My best friend lost her dog to pancreatitis last year. It is very tough especially with the holidays.