Experience with Pancreatic Abcess?

So, it never fails, our rescue is known for having cats with odd, unusual or rare medical issues. We're just trying to help our vets stay on top of their game. [emoji]128521[/emoji]

This is going to be long, so the quick question is...has anyone dealt with this before? It appears we are likely headed to surgery soon (meaning this week.)

Background:
I want to preface by saying we are looking for a new clinic to work with, and that this whole ordeal has been very trying.

So, the cat in question has had issues since we've had him (about 9 months). The cycle goes like this...excellent eater (wet only), has an episode or two of vomiting (massive, and typically projectile) and drops off food completely.

It never fails, he has pica associated vomiting (we eat carpet, litter mats, hard plastic place mats..you name it.) We've had close calls in regards to foreign bodies, but have never required surgery. He is kept in a contained area that is as safe for him as possible (in regards to things he has access to that he can eat.) He ALWAYS goes off his food for 3-4 days. During which time I usually resort to syringe feeding baby food (it tolerated it really well.) He is also treated with Cerenia and Famotadine until we are eating well on our own for 3 consecutive days. He has always gotten back on his normal food (Instinct) after about 3 days...until our most recent episode.

This most recent episode took place about 4 weeks ago and I could find no evidence of anything eaten. Got him into the vet's when he vomited even with Cerenia on board. X-rays taken were inconclusive and we made the decision to take him to our local emergency clinic for overnight care. Once there, they started him on IV fluids, IV Metronidazole and IV Famotadine.

He's had ups and downs ever since. He was doing better when I picked him up from the e-clinic to transport him to vet clinic #1. I love wanted an abdominal ultrasound done on him for further diagnostic purposes, so transfered him to clinic #2 that was suppose to be equipped to do this. They didn't see the need for u/s and wanted to do surgery to look for a foreign body (understandable due to this kitty's history). We opted to wait and try feeding kitty (by this time it had been 36 hrs since he had eaten) and see if he vomited.

Clinic #2 opted to not continue with fluids or metronidazole.

Kitty ate on his own, no vomiting and was sent home around 3 pm. He did well for about 36 hours after discharge and then appetite started to dwindle.

Due to his decreased appetite, we made the decision to try and get him into another clinic for an u/s (this was 2 Sundays ago). U/s showed 2 pockets of fluid, possibly cysts (the fluid appeared clear) and the Dr. Wanted to consult with some specialists to determine the appropriate next step.

Fast forward to today. Opted to do an aspiration of the fluid pockets and found the fluid to be thick and opaque. This would point at the likelihood of these areas being abscesses.

We are awaiting consult with a board certified surgeon to determine if surgery is our next step.

I don't have any experience, but wanted to give your rescue major props for helping the neediest of kitties. I have a soft spot for special needs cats.

Thank you cinqchats , we've been very blessed to be in a position to provide this level of care to all of our rescue cats. Most rescues simply don't have the funding to do so (though most/all would, given the opportunity!) Hoping that our funding continues to be at a level we can continue for many years to come!

I don't believe I have heard of this until now.  Pancreatitis happens sometimes with IBD but I hadn't heard of an abscess.  I know it is common to give an antibiotic when either the pancreas or liver is inflamed because they are more vulnerable to infection but this is the first I had heard of an actual infection.

Yes, our vet that finally gave us the suspected diagnosis hasn't seen this issue in many years. It appears to be a pretty rare occurrence. Surprisingly, I am told (by board-certified surgeon) that most of these abscesses are sterile in nature.

Hoping to hear back tomorrow in regards to the consult of the surgeon.

What a scary thing to have happen- My Tiger had one acute attack of pancreatitis and it turned to chronic pancreatitis but your kitty is the first I've ever heard that has pad an abcess.  I'm sending the strongest postive healing vibes for kitty.

Just dropped Atticus off for surgery. His prognosis is good; but, guarded. There are several reasons for guarded:
1.) Our surgeon hasn't seen this particular issue in a cat, but has in dogs. The dogs have had a 50% survival rate; BUT, many, if not all, have been critical due to severe pancreatitis and inappetence. Atticus is not in a critical state right now and his appetite is good (especially since getting some of the junk out during his aspiration on Monday.)

2.) They aren't sure how his body is going to respond once they get in and start messing with things. Especially with the suspected abcess.

3.) The surgeon thinks Atticus may have a genetic defect with his pancreas. He is hoping that removing the affected part with ultimately fix the underlying problem.

The surgery plan is to clean/remove any infection/affected issue and pack it so that infection doesn't set in. They will remove any affected pancreatic tissue. Samples and cultures will be sent out. They will also take biopsies of his large and small intestine to send out to check for IBD or any other inflammatory diseases.

The hospital he is at provides 24 hr care, so he will be monitored throughout the night. The plan right now is to pick him up in the morning. Recovery time is estimated at 2 weeks and will require strict cage confinement (medium to large size dog crate.)

There is also the possibility that he will require a feeding tube; but, hoping that since he went I with a good appetite, he will leave with one as well.

Will post more when I get an update (likely this evening.)

sending healing thoughts and wishes for a full recovery

Just a quick update to say that Atticus is out of surgery and doing well. Will give a more detailed update tomorrow.

Atticus is home and resting comfortably. Prognosis is still guarded, primarily due to his risk of infection.

Remember what I said at the beginning of this post that our rescue is known for odd/unusual diagnoses?....

So, as it stands, the surgeon believes the suspected cyst/abcess is more likely an underdeveloped second gallbladder. This would make the issue congenital and explain why he has had issues since we got him (imagine all that gunk just sitting in his abdominal cavity for 1.5-2 yrs!) We are awaiting pathology reports to see they think it is something else. Should get results back in about a week.

If this is the case, we expect a full recovery with no further issues.

Will update when we get the full report back.

My boy has an abcess on his pancreas. When it was originally discovered 2 years ago, they at first thought it was cancer. The u/s was sent for 2nd opinion where it was determined to be an abcess. He had been throwing up off and on for a few weeks. I was assuming it was typical fur balls or eaten grass. When his vomiting bacame more frequent and it was obvious that he felt bad afterwards, we brought him in. Fluids, pain meds and anti nausea med got him perked up and feeling like his normal energetic, playful self. Diagnosis was pancreatitis with the abcess.

The next day we were sent to the emergency hospital to consult with a specialist surgeon that was willing to try to remove the abcess. We were told not too many surgeons would attempt any type of pancreas surgery because it is so fragile and often cats do not survive. We were given a less than 25% chance of successful abcess removal and about the same for recovery afterwards due to complications and infection and the overall fragility of the pancreas. When I asked how many surgeries similar to this had been successful, we were told "none". Just the surgery, not including aftercare was $6000. Aftercare could be $2000 up depending on how well he did. With such a dismal success rate and the cost of surgery, we declined the surgery. At that point it was suggested our boy be euthanized and that we would be cruel to let him suffer! Seriously? Here our boy is, active, playful and not showing any signs of distress. How could immediate euthanasia be suggested before considering any other treatment plans???

Well, that was 2 years ago this very week. I'm happy to say our boy has done quite well overall through most of that time. Although his pancreatitis is chronic, between episodes he is loving, playful, and shows no signs of discomfort. We give him a digestive enzyme twice a day and Hills Science I/D dry - he won't eat anything canned. When he has an attack, I give him cerenia for nausea. If he trys to hide I know he's feeling really bad and give him buprenex for pain. Within a few days he's back to normal and eating again.

That was status quo till a few months ago when his attacks became more frequent and severe. They would last longer and it would take him longer to bounce back. I wish at that time my vet would have suggested regular doses of antacid, probiotics, or a day on day off of the cerenia to manage his attacks. I feel like there is more I could have been doing to help him daily, other than just the enzymes and food. After reading here about what others have done with their pancreatitis kitties, I feel like I have not done enough.

Now he can no longer tolerate the cerenia which was the biggest factor pulling him out of his attacks. After 9 consecutive days of cerenia, he began hyper salivating for most of the entire dose period which is 24 hrs. I was never told not to exceed 5 days of cerenia. That was a HUGE MISTAKE and I have been beating myself up since. Now reading some threads I see 4-5 days on then skip 1-2 days. Or even every other day. We've tried 3 other anti nausea meds but nothing works as well as the cerenia did and he still vomits.

He just spent two days on IV fluids with pain med and antacid and antibiotics, but just can't perk up. They tried valum to stimulate his appetite, but it didn't work. They suggested a feeding tube could be placed, but if we can't control the nausea any longer, I don't think we should put him through it.

So this is how our journey with chronic/acute pancreatitis with an abcess has been. We have never regretted our decision to decline the ridiculous advice 2 years ago to euthanize. He's had a pretty good last two years. Many, many more good days than bad......until these last two months. I love him so much!! He is my favorite, (not supposed to have favorites- but he's the one who always sleeps next to me and wants to be by my side). I love my other two cats, too, but my big guy is special. He purrs the loudest and loves the most! We are very attached. For now he is comfortable with pain meds and fluids, but still won't eat. It's the hardest thing to let him go, but I know it's time. I am so thankful to have had him these last two years and have cherished every moment.

My cat just recently been diagnosed with pacreatitis. Vet prescribed 16 mg cerenia daily. I felt like it was too much after reading the medication guide sheet that comes in the box. I only gave her 16 mg pill one day, then reduce it it to half a pill the 2nd and 3rd day (today). She hasnt been vomiting since. I also read to only give every 5 consecutive days then take a break. 1. Should I reduce her dose to a quarter pill (4mg) daily? She was 7.7 pounds 2 days ago.
2. How many days Of break from cerenia should she take?
Thank you so much for your help