Ups and Downs of Pancreatitis

Hello All,

New to this site and have found loads of useful information and support but was wondering if anyone who has gone through pancreatitis with their cats could give us some advice.

Our 13 year old cat Sergio was diagnosed through radiographs and ultrasound at the emergency clinic with pancreatitis and possible IBD a little over two weeks ago.  His illness seemed to come out of nowhere!  He was fine one minute and then critically ill the next.

After an overnight stay in the hospital and trips everyday to our regular vet for sub q fluids, appetite stimulants (that didnt work) and pain medicine (that made him VERY LETHARGIC, so scary) and anti-nausea medicine (that helped) he is now down to just taking 5mg of prednisolone (tablet, given by the worst cat pillers in the world, me & my husband) prescribed by the emergency room vet who is also an internist.

We will be discussing the the next step today which is a feeding tube because he just doesn't seem to be eating enough now that his appetite has come back a tiny bit.  The vet said to stop syringe feeding him as he had started to eat a little FF canned a couple of times a day/night....whenever he steps in to the kitchen I whip it all out and he will start licking and eating.... and I have also heard him rooting around the kibble (that he used to LOVE) at about 3 a.m. or so crunching a few times but mostly he just sniffs at the dry and walks away.  He is drinking on his own but even that looks tentative to me sometimes.  He seems uncertain, but then starts lapping it up after a few tries.  

Anyway, my question is that I am wondering if other cat moms and dads have experienced the highs and lows or ups and down of this disease??  It seems like every day we are taking one step forward in his recovery but then the very next hour we have taken two steps back.  It is heartbreaking and I feel so terrible for him and we are hoping that we are making the right decisions for his care.  Sometimes I think he is going to be okay because he shows interest in an old habits, playing, watching out the window alertly, jumping up to his favorite piano bench, etc.  But then sometimes he seems lethargic and "out of it" and disoriented...going in rooms he never goes in, sleeping in a strange position, NOT sleeping during his normal sleeping hours....etc.  He used to "talk" to me all the time, now he hasn't meowed at all since this all started!  He's been pretty clingy too, sitting on my lap a lot more than he ever did before.  He used to be content to lie next to me.  Now he will head right for my lap and want to sit there for hours.  Which is okay by me but I am hoping that doesn't mean he's in pain since it is kind of a new thing.  He has been grooming himself but seems a lot more jumpy then he ever was.  Sorry, don't mean to go off on a tangent.  

So, yes, I came here to see what others have experienced with their kitties to see if we just need to be more patient and he will start to feel better and act like his old self or if he should be feeling better by now and we should try another form of treatment.  The vet and clinic are being very helpful but I was hoping to get some feedback from all the cat lovers out here that have actually gone through this.  Every time we think he has turned the corner and is getting better, it seems like a couple of hours later we are right back to where we started.  Is this normal for cats that have pancreatitis and IBD?  

THANK YOU for reading this and thank you for any input, support, ideas, etc.

Alan, Kim and Sergio

Hello!

I'm new to this site just like you, but not new to nursing a cat through pancreatitis.

Not to alarm you, as she had other on-going health issues as well, but my (female) cat got pancreatitis at about the same age as your Sergio did, during what turned out to be the last year of her life. So, I have indeed experienced the roller coaster which you are starting to ride! (Please know that my cat also had diabetes the last four years of her life, and, in the end, succumbed to gastrointestinal cancer of two-months' duration, so her road was a tough one -- but she did not die of pancreatitis, although it certainly did not help.)

If pancreatitis is Sergio's only, or main, illness, I think you'll be able to nurse him through the hard, painful times and still give him good quality of life. You need to decide how much you want to invest in this. One of the (many) issues is pain control, another is nausea control. Please realize, pancreatitis is painful, it causes abdominal cramping and distress, and often (if your cat is not on pain meds), your cat will seem to do things that don't seem "normal" for him/her. Also realize that pain meds additionally do not make your cat seem "normal"! They can make your cat seem zonked out (the anti-nausea meds can do the same!) Only you as the pet owner, having been around the pet the most, can have the best sense of what is "normal" behavior for your cat. Please google "how to tell if a cat is in pain", and read input on that. If you've had him for 13 years, you most certainly know him best, and know what his "normal" behaviors and patterns are, and hence, will know if and when you choose particular meds or foods or treatments to help him through rough times. Your cat may go through healthier times, when the foods and stress levels and days are going "just right", but then will go through bouts of "pancreatitic flare-ups", when everything seems to be heading south and you are pulling your hair out. It is indeed a roller coaster.

Speaking of the pain issue, I actually decided, along with my cat's vet, that being on pain meds was to be part of her on-going care. This is expensive and an individual choice for pet-owners, but for me it was worth it. It is true that the doses that the vet might initially prescribe can seem to drug your cat into a state of lethargy and "zombie cat-ness". What I myself decided to do (since I KNEW she was in pain when she was having her bouts of illness, since pancreatitis is painful and cats hide pain fairly well) was to experiment by finding the smallest pain killer dose for her that still kept her happy and alert and "herself", yet still seemed to obviously medicate her enough to ease her pain. I knew her best and I also knew I could not accurately judge her state of health (her "normalness" in behavior) if she was konked out by a strong pain killer all the time, and totally inactive. So I came to learn what her "signals" were indicating that she was in pain, and I learned to try to help her through that with her own "goldilocks" dose of pain med. The "right" pain med dose might be individual for each cat, and/or individual to the early or advanced stage or level of illness your cat is in (deciphered via tests and ultrasounds, etc). But giving my cat the full prescribed (by the vet) dose of pain killer really zonked her out. What I wanted was to ease her pain, but not zonk her out. I wanted to see her do "normal" eating, drinking, playing, sleeping, and hence know she felt ok (or, at least, ok most of the time). That way I could try to judge her diabetes AND her pancreatitis and stress levels, activity levels, etc. Again, I recommend reading up on how to tell if a cat is in pain. Your cat may have particular ways of showing it (or ways of showing it is nauseated, too!) which you do not yet recognize.

In my view, (certain) wet/canned food works better for the cat's system than dry food - personally, I would avoid the kibble. (NOTE: It was dry food in her early years that helped make my cat diabetic later in life in the first place, and I avoid dry food like the plague now, for any cat, having learned that hard lesson.) When my cat was really sick (w/ bouts of pancreatitis), I'd make her canned food into a food slurry, so that it was even softer for her to digest. The food that worked for my cat her during her last year of life, and also worked for her diabetes, was Wellness CORE Grain-free Chicken, Turkey, Chicken Liver canned cat food. She loved it chopped up a bit, sometimes with added water. Giving fluids, sub-Q, was something I had the vet/vet techs teach me to do so that I could give my cat fluids at home when needed. Finding the right anti-nausea med took a while (cerenia caused quite ill effects in her --a long story-- , so we used anzemet); sometimes getting her to eat was an issue (a very lite sprinkle of grated fresh parmesan cheese as a food topper got her to eat at times, just fyi); she could not be on prednisone because of her diabetes; finding the "goldilocks dose" of her pain med took some effort and experimenting (and $$ budgeting); sometimes dealing with diarrhea, irritable bowel was an issue... et cetera. Life could be all over the map! So, just get ready for a roller coaster, and yes, get ready to feel some level of stress within yourself! Depending on the happiness and health of your Sergio overall, you might decide all the extra stress and efforts are worth it. You know him best, just as you know yourself best. The efforts were worth it for me and my cat -- although I ran myself ragged at times, taking care of her. Be careful of your own health and well-being during all of this! At some point, both you and your cat will "tell" the other when enough is enough, and the quality of life just isn't there. Looking back, I think that if I had known of her fast-moving cancer at the last months of her life, I would have put her to sleep sooner. There was one vet visit when I could have gotten an x-ray or ultrasound when we were going over some of her symptoms, and I did not do so -- if I had gotten that x-ray then, we would have probably discovered her cancer much sooner.... and at that point, knowing she may have had only a few months or weeks left, I may chosen an earlier, fork-in-the-road Rainbow Bridge choice sooner. As it was, we only discovered her cancer in her final days. By then her cancer was quite advanced, and pancreatitis was the least of her worries!

I hope I haven't rambled too much, and if you have questions, I'll try to answer them! Trying to help a cat through pancreatitis can seem pretty rough at times, but for me, the more successful times were all about trying to find (or coming to know) the right foods, the right meds, and then also, decreasing household stressors for my cat. I doubt I have been through everything that dealing with pancreatitis entails, but I have been through some of it for sure. I will not say it was anything other than a roller coaster. (note: Having a good vet you trust is also so important.) Best of luck to you and Sergio!

Thank you so much for sharing your experiences and knowledge with me.  You will never know how much you have helped by taking the time to reply.  I know I will refer to what you have written many times as the days go by.

I will be talking to our vet and internist tomorrow to go over Sergio's progress so far and to discuss next steps in his treatment.  I composed a list of questions to ask him after reading what you wrote and most of it are things I would never have thought to ask.  Especially about restarting him on anti-nause medicine.  I had been thinking that since he was no longer vomiting that the nausea had ceased.  Now I know that's probably not the case.  I want to get him on something right away so that may increase his appetite.  

We had kind of a crazy night tonight - I am finding out that no two days/nights are the same.  More ups and downs!  Whenever I think he may have turned the corner for the better I find that in most cases, it hasn't happened yet.  I remain optimistic, but as you know, it is hard sometimes to keep going forward when you are not sure you are doing the right thing for the pet you love.

He is in my lap right now for our nightly computer session and I see flashes of his old sweet happy self and I know I will do everything in my power to ensure that he has every chance imaginable to return to that old sweet happy self.

Thanks again for taking the time to reply and for speaking frankly.  It is much appreciated.  Thank you too for the well wishes for our Sergio - it has helped us in so many ways.

THANK YOU for reading this and thank you for any input, support, ideas, etc.

Alan, Kim and Sergio

Click to expand...

My cat went through severe IBD and pancreatitis, neither are curable but both can be controlled.  As far as pilling goes, have you tried pill pockets?  Or sometimes putting the pill in something he really likes, cheese whiz can work, or velveeta cheese can work too.  If none of this works, there is a steroid that can be applied transdermally (you rub a gel on the cats ear) and another steroid that can be given easily by sub q injection (much easier than a pill), but the first choice is prednisolone orally.  If giving a liquid medication in the mouth would be easier for you, there is a liquid form of Pred.

Because IBD is connected to a reaction to foods, sometimes a special diet like a novel protein, novel carb diet like rabbit and peas can control IBD because the cat's body has never been exposed to these ingredients, but at a certain point in the disease (and generally it doesn't come on quickly) you can only control it with prednisolone.  

Pancreatitis is in the words of my vet, a bi*tch.  Cats with it (like mine did) tend to have flare ups and the goal is to control and reduce these flare ups.

Other things that help both illnesses are various combinations of:

B12 injections - nutrient absorption

Pepcid - reduces vomiting

Sub Q fluids - reduces dehydration from vomiting, helps flush toxins, generally supportive especially for pancreatitis.  And during a flare up SubQ fluids can also be given with anti nausea drugs (see below) as a "cocktail" to help kitty feel better.

Cerenia - neural block for nausea, wonder drug. Can be given as a pill to control vomiting and for mild anti inflammatory properties and sub Q (after giving fluids to avoid stinging)

Zofran - also a great drug for nausea, can only be given sub q injection, and works faster than Cerenia, good for flare ups, does not need to be given with fluids, no sting, but if used regularly needs to be given every 6 hours.

Buprenorphine - a good pain medication if the pancreatitis is painful, but will have a sedative effect.

You mentioned a feeding tube.  If that is indicated then your cat is quite ill, but a feeding tube is a great way to deliver nutrients, easier than syringe feeding.

I've listed the drugs and therapies above in order for you to have a conversation with your vet.  Hopefully you can get your cat out of crisis and into remission.  My cat struggled with severe IBD and pancreatitis for a little over a year, and despite setbacks we were able to keep it under control for most of that time.

Sending vibes. 

Thank you Stephen!  We will take all the vibes we can get!

We will be hearing from the internist/vet within the next hour or so and I have added your suggestion of B12 to my list of things to ask him about.  I am also going to ask if he will prescribe more Cerenia for him since before thankfully finding this site and hearing from all the wonderful people out there that have gone through this, it never crossed my mind that he might STILL be nauseated and that's why he doesn't want to eat that much!!!  It looks like he wants to at first but then he turns away after only a few licks and bites

I thought that since the Cerenia had stopped his vomiting and they did not send us home from the emergency clinic with more than 3 days worth of doses, that his stomach was feeling better!!!   OMG, How wrong of me to think was that??  

So now, I will race back to the clinic for more as it makes so much sense that he MUST still be nauseated and just maybe he will feel better if we get that under control.... and then start eating more .  Hoping and Hoping our vet doesn't say that he shouldn't have any more.  

Now I am also wondering if I should have kept on with the last days dose of Buprenorphine.  I was SO worried while he was on it because he was almost comatose and I couldn't think that could be right.  I was worried I had killed him.  I called the clinic and they said to go ahead and stop giving that to him.   Before coming here I didn't question it, but now I think I should have asked if a REDUCED dose was okay??  I could have given him a quarter of it and maybe he wouldn't have been that out of it but still feel better from his pain.  Oh my, I just don't know.  Life as we know it will never be the same and this had just really thrown us for a terrible loop.  

I do feel A LOT better though since reaching out here and everyone that has responded has given me new ways to approach this and I really appreciate it and am very thankful.

Sorry for the run on paragraphs and sentences.  I haven't slept much lately and I am holding it together by threads!!

Thanks again.

Kim and Serge

SergioBooboo12 said:

 
Sorry for the run on paragraphs and sentences.  I haven't slept much lately and I am holding it together by threads!!

Thanks again.

Kim and Serge

Click to expand...

You're doing good!  I hope the vet consult went well, and i agree asking about a lower dose of Bupe is worthwhile.  My cat Simon was on Bupe occasionally and a good dose for him made him a slittle "slow" but he was still, up and mobile and cognizant of his surroundings.

Checking in on you to see how Sergio (and you!) are doing... :kitty2:

Sorry I have been out of touch here the last few days (don't even know what day it is!)....we have had a scary couple of days...fighting for his life....things are stable now....he is doing okay and we may finally be on the right road to getting better....still a long way to go as I'm finding out....but Thank God, Thanking God, and all the people like you that have helped me by sharing and advice, etc.  

I have many questions about some of the new medications he is now taking, in addition to what the vet said, and also need advice about different foods to try and I haven't had time to read the forums here lately, but hop;fully will be able to catch up tomorrow.

Thanks again for checking in on us....it means a lot.

I will update soon.

I'm glad he is stable at the moment, so happy for that! I had a feeling you & Sergio were swooping down into a trough of that figurative Roller Coaster ride... now heading upwards, so good to hear. I know we've PM'd a bit, and I just wanted to make sure to check in with you. Try to get some rest, if you are able!