More pancreatitis questions.

So Obi had a bout of it last year, and he is having another mild bout now, apparently.  He is eating but his appetite is down some.  He tested positive on the PLI, I think it is called, and has an elevated liver enzyme.  The vet says the treatment is palliative.  She put him on cerenia; he has been on 5 mg pred for almost a year; and gets regular B12 injections, every 5 days.The only new addition as of today is the Cerenia.  The vet thought that even though he is not vomiting, he could be queasy.

So my question is, how does a cat recover from pancreatitis, if the treatment is palliative?  what is supposed to calm down his pancreas, etc? ( Please do not suggest raw food; I know many here swear by it, but I am not going to do that, as he also has IBD, and is on Nature's Variety rabbit.  That was the best 2nd choice I could find.)  TIA in advance for responses.

And you're probably getting tired of the same old people responding to your threads, eh? 

I'm sorry Obi's pancreatitis is acting up. 

Sebastian, as you know, has a pretty tough case of chronic pancreatitis. He has a maintenance regime that includes a whole long list of stuff. And he has a flare-up regime, which includes all the maintenance stuff (some at higher doses) and things that we use only for flares.

When he's flaring, I fast him for 24 hours as soon as he exhibits signs (he usually doesn't want to eat anyway), double the Cerenia, administer fluids every day (rather than every other day) ONLY IF they're being absorbed, add in Zofran if his nausea is bad enough, and feed bland food. In almost all instances, he won't eat the food he was eating when he's flaring up. If he's exhibiting signs of pain, I'll add in the pain meds. If he doesn't respond to these efforts, we may increase the pred for a short time and then slowly bring him back down. This protocol is approved by our vet. Sebastian went too long not eating during the last flare-up and I had to start assist feeding. He eventually started to accept freeze-dried turkey treats and slowly made a turnaround. A lot of people use slippery elm bark, but I never had much success with it for Sebastian.

While medications and symptom relief are important, I also feel strongly about additional efforts that aid in comfort and healing. From a mental health standpoint, I keep the house quiet and eliminate stress as much as possible within my control. I don't run the vacuum, I don't have visitors, etc. I limit my handling of Sebastian. He doesn't like to be petted or cuddled when he's sick. I do what I have to do to give him his medicines and fluids, but then I let him be. I let him sleep as much as he wants with minimal interruptions (sleeping = healing!). If it's hot or humid in the house, I turn on the air conditioning and run the ceiling fans on low/medium. Feeling his ears gives me a general idea if he's hot or cold.

Of course, you will have to determine what works best for Obi. I hope he feels better soon!   

ETA: I wanted to reiterate, based on your original question, that fluids are probably one of the most important things to help "calm down" the inflammation.

Hi, Go:  No, I am not at all tired of the same people responding to my posts, because you all are very helpful and knowledgeable.   I so appreciate this site and those who participate. And so appreciate your long thoughtful reply.

Obi is eating; but yesterday, when he did not finish his breakfast, I knew something was wrong.  This was coupled with him being under the bed on and off for a few days, as well as some waxes and wanes in general with his appetite.  And - I am sure you can appreciate this - just my sense that his big personality was somewhat "subdued".  It is t his sense of my cats that I trust and have almost never been wrong.  So he went to the vet.

My regular vet was not working and the vet who was there examined him and was content to just have him on Cerenia for two days but I asked about blood tests and she said we could do that .  So we did.  She sent him home with Cerenia to wait for the blood test results which came in positive on the PLI and an elevated liver enzyme.  She did not suggest fluids;  he seems to be spending more time at his water bowl anyhow, which I guess is  good thing. I will be speaking to his regular vet today, I hope.  

This morning I gave him a smaller amount of breakfast and he scarfed it down.  So that is good.  He is on pred, B12 injections, pepcid; I give him EYL for hairballs, and that has really helped a LOT; and a digestive enzymes/probiotic that I get at Tabby and Jacks.  What probiotic do you give Sebastian?  FYI, I read on line that domestic shorthairs and Siamese have a proclivity for pancreatitis. 

I tend to "hover" over my cats when they are ill, checking often and patting them; I think I need to not do that or not do that as much.

myrnafaye said:

 
I tend to "hover" over my cats when they are ill, checking often and patting them; I think I need to not do that or not do that as much.

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You're doing a lot of the standard treatments.  I agree that Sub Q fluids can be helpful, and I always increased the sub Q fluids my cat was getting during a flare up under my vet's advice to help flush his system and keep him well hydrated particularly because his bouts included lots of vomiting.

If my cat was in pain, and pancreatitis can be very painful, i had inject-able Buprenorphine standing by and would give him a dose.  It's a great pain med, safe when used correctly and very effective, but he only seemed to nee it occasionally.

While cats can go up and down on pancreatitis, there is no cure.  It's all palliative to hepl them through it, and as @GoHolistic said, reducing stress in the home if there is any, can be helpful too.

Hi, Stephen:  Obi has not vomited.  He is drinking.  I wondered about sub q fluids myself yesterday but she did not suggest it.   I will speak with the regular vet today, I hope, and see if she recommends it.  Then of course that need to be balanced with the stress of the car, the vet, etc.  Last year he had the pain med you refer to; but he does not appear to be in pain.  As always, thank you for your helpful comments and support.

myrnafaye said:

 
Hi, Stephen:  Obi has not vomited.  He is drinking.  I wondered about sub q fluids myself yesterday but she did not suggest it.   I will speak with the regular vet today, I hope, and see if she recommends it.  Then of course that need to be balanced with the stress of the car, the vet, etc.  Last year he had the pain med you refer to; but he does not appear to be in pain.  As always, thank you for your helpful comments and support.

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Sure thing.  If the vet recommends fluids they can teach you how to do it at home if you're up for that, it isn't hard (easier in many ways than thing like pills), i would do my cat while he sat in the carrier, and we have great training videos here at TCS we can link you to.  Keep us updated.

myrnafaye said:

 
Hi, Go:  No, I am not at all tired of the same people responding to my posts, because you all are very helpful and knowledgeable.   I so appreciate this site and those who participate. And so appreciate your long thoughtful reply.

Obi is eating; but yesterday, when he did not finish his breakfast, I knew something was wrong.  This was coupled with him being under the bed on and off for a few days, as well as some waxes and wanes in general with his appetite.  And - I am sure you can appreciate this - just my sense that his big personality was somewhat "subdued".  It is t his sense of my cats that I trust and have almost never been wrong.  So he went to the vet.

My regular vet was not working and the vet who was there examined him and was content to just have him on Cerenia for two days but I asked about blood tests and she said we could do that .  So we did.  She sent him home with Cerenia to wait for the blood test results which came in positive on the PLI and an elevated liver enzyme.  She did not suggest fluids;  he seems to be spending more time at his water bowl anyhow, which I guess is  good thing. I will be speaking to his regular vet today, I hope.  

This morning I gave him a smaller amount of breakfast and he scarfed it down.  So that is good.  He is on pred, B12 injections, pepcid; I give him EYL for hairballs, and that has really helped a LOT; and a digestive enzymes/probiotic that I get at Tabby and Jacks.  What probiotic do you give Sebastian?  FYI, I read on line that domestic shorthairs and Siamese have a proclivity for pancreatitis. 

I tend to "hover" over my cats when they are ill, checking often and patting them; I think I need to not do that or not do that as much.

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You're welcome!     It's hard not to hover. I worry about my boy, even when he's doing well and I shouldn't. And I notice everything. Like you said, I can tell almost immediately when something's not right. I'm glad Obi ate his breakfast. The Cerenia should help him feel better and less nauseous. That's one of the medications Sebastian is on regularly that I don't know what we'd do without. I also do fluids at home. The vet trained me at the clinic.

Funny you should ask about what probiotic Sebastian is on. Because of a new problem (soft stools), I've been experimenting with different probiotics over the past several months - various strains and strengths (CFUs), different brands, etc. - to see what might help. We're currently using Healthy Origins Probiotic 30 Billion CFU's, despite my adversion to the silicon dioxide in the product.