Obi has an appt. with internal medicine today - He has Pancreatitis

[arinlars]

Myrnafaye when you say hair balls you means like the cat hairballs or food? Is he a long hair kitty? I'm trying for Mimi holistic vet to go together with the normal vet. If you can afford it go for it too. For vomiting also helped tiki cat food at first the chicken flavor but it does not have many calories so be careful and then probiotics helped too. Ibdkitties.net has tons of help on pancreatitis and ibd ! Give it a try.

 

[abbyntim]

In my opinion, the definition of "treatment" for pancreatitis is no different than the definition of treatment for IBD or any other type of GI disease. There is no one pill specifically marketed to treat these conditions and no one protocol that works for all cats. The main goals are usually to 1) decrease inflammation, 2) control symptoms, 3) promote healing, and 4) encourage weight gain (if weigh loss exists) or some variation of such. These can be achieved by any combination of diet, Western medicine, alternative medicine (homeopathics, herbs, acupuncture), supplements, and mental support. Sebastian has a long list of things he's on to manage his chronic pancreatitis, and in my eyes, everything together makes up his "treatment." 

I agree with this. Two different veterinarians have tossed out the possibility of pancreatitis with Tim. Others have tossed out the possibility of IBS/IBD. When he started showing more symptoms, my primary goal was to decrease inflammation by changing Tim's diet and promote healing with the same dietary changes and bone broth. We've had to use medications to control symptoms. We are also using supplements to decrease inflammation and control symptoms. It's been a long process and we're not there yet, though he's definitely improved.

 
What the fear is is LYMPHOMA.  I dont want Obi to have cancer.  That's what it is.

No one wants Obi to have cancer. I can totally understand your fear. It sounds to me like it's the uncertainty that really frightens you. If that's the case, perhaps you should do more diagnostics so you know what you're dealing with. Unless you would treat the same no matter what. But from reading your posts over the past couple of days, it seems that not knowing exactly what you're dealing with is causing the most anxiety.

 
I know this a frustrating journey to be on, but you have to keep in mind that if Obi has pancreatitis, or IBD, that this is something you are likely going to have to manage, long-term. The process will involve trial and error until you find a combination that works for Obi, but there are bound to be a few ups and downs along the way, so it helps to know this in advance, stay calm, and temper your expectations.

This is a tough place to be in, one that many of us who regularly visit this site are in. It took me a while to come to terms with the fact that I will likely have to manage Tim for life. He is a young cat, he will be 5 at the end of July, and that sometimes depresses me. Trial and error has been tough, but I'm getting better at dealing with it. My husband still gets mad at me when a trial doesn't go as expected, though, and that's hard on all of us. I guess I am telling you this to assure you that you're not alone.

 

[myrnafaye]

Arinlars, I mean hairballs, solid hair.  Looks like stool, often but it is hair.  he is a black domestic shorthair, and has always been a very fastidious groomer.  I asked the vet about probiotics and she said there is not much evidence that they help.  I realize that companies do not fund studies that will show - or not - that probiotics help, because there is no money to be made in this.  I may add a probiotic back into Obi's regime eventually, but since  he had the flare-up so recently, I feel I should just give him his food and his meds.  For now.

Does anyone know, does the (powdered) egg yolk lecithin increase motility at all?

No, AbbyNTim, it is the diagnosis of lymphoma that scares me.  I know it is not rational.  I know that pancreatitis can be more acute and life threatening.  I know lymphoma is treatable.  And I know I am looking at a long term management issue, and that is often the case as cats - and people - age.  I can cope with that.  I guess every one has a sort of "blind spot", something we fear that may not be rational.  Cancer is that for me. 

 

[abbyntim]

I've lost track. Are you using probiotics? My regular vet thought probiotics would not help, while the holistic vet strongly suggested them. Tim's been on them since early March and I think that's one of the best things we've done. When he had diarrhea in early May, I temporarily stopped the probiotics and he had hairballs for a couple of days. He had diarrhea again just a little over a week ago and this time I kept him on the probiotics; no hairballs.

I believe Obi could not tolerate Vet's Best? And you're concerned about slippery elm interfering with medication absorption. I wanted to try Vet's Best but was worried about the chicken. I made a blend that approximates the active ingredients of Vet's Best (psyllium, marshmallow, slippery elm). I started giving it to Tim on Monday. I give it late in the evening, at least two hours after he's eaten (Tim always seems hungry and I'm concerned about possible interference with nutrient absorption). Yesterday morning, he had a fantastic hair clean-out poop.

I understand your fear of cancer. Doesn't matter if it's rational or not. It is what it is. I hope, in time, you are able to cope with either the diagnosis or the possibility of cancer, and I mean this in a kind way.

 

[myrnafaye]

Could you post your recipe that is an alternative to Vets Best?  yes, you are correct, he threw up immediately, but I dont know if it was t he Vets Best, or the duck formula food I gave him.  As I said, he almost never vomits food - just hair.

 

[abbyntim]

It's in my cisapride thread: http://www.thecatsite.com/t/274139/cisapride-regular-vet-vs-holistic-vet/90#post_3583526. Start small, less than a dose, and good luck!

 

[stephenq]

Arinlars, I mean hairballs, solid hair.  Looks like stool, often but it is hair.  he is a black domestic shorthair, and has always been a very fastidious groomer.  I asked the vet about probiotics and she said there is not much evidence that they help.  I realize that companies do not fund studies that will show - or not - that probiotics help, because there is no money to be made in this.  I may add a probiotic back into Obi's regime eventually, but since  he had the flare-up so recently, I feel I should just give him his food and his meds.  For now.

Does anyone know, does the (powdered) egg yolk lecithin increase motility at all?

---
I've read that it does help (lecithin) but I don't know this for a fact. You can google articles on it.

 

[arinlars]

Myrna I know you are afraid of cancer and if you look into my threat with the ibd you will see that I am totally freaking out too. Or I did when I first found out about the whole thick intestines thing and we still don't know what it is ibd or lymphoma.I annoyed the vets so much they won't even respond my calls anymore. But! Over some time dealing with the ups and downs I realized that whatever it is, there is nothing more I can do other than to give her everything she needs, and keep my kitty happy. Other than meds, holistic approaches etc etc there is always that "but what if she has cancer..." And I cannot help myself thinking that, and actually having guilty feeling that "oh I should have done the exploratory surgery " but you know what? We are doing the best we can, who knows even if the kitties did the surgery or this or that who can promise us that they are going to be alright? So.. Be strong for your kitty and remind yourself you are doing the best and kitty knows that.

That goes to @missmindy too and everyone that is dealing the same issues, you guys are great! I always keep remind myself :make every day in your life to be the most awesome day and spend the days with kitty as happy as you can be instead of worrying too much.

 

[myrnafaye]

arinlars:

Thank you for sharing your thoughts and your anxieties.  Sometimes I think I am the only one who gets tied up in knots when my kitties are sick.

I know you are right, we are doing the best we can, and we are doing everything we can.  "Everything" is different for everyone, too - there are things I will do and things I wont do, as is true for all of us.

I can relate to "pestering" the vet - I am sure my chart is tagged with "Client with special needs", or something like that. "Client with anxiety disorder".  "Client with obsessive compulsive disorder".  Any number of diagnoses - of me.

But yes, we do the best we can and try to make our babies comfortable. 

 

[quiet]

Hi,

I am sorry, but I couldn't read all the posts. So...if I say something that doesn't apply to you and Obi, or if I am way off base...just ignore me.

If it was me and Obi was my cat,

I would not give any chemotherapy drug without a diagnosis of cancer. So, no Leukeran.

If Obi had already been started on the Prednisolone, I would not do any biopsy.

I would not do an endoscopy with biopsy

If I couldn't do it I wouldn't do an ultrasound.

If I could afford it I would consider it just to see what the internal organs looked like etc. I would only do this with a board certified internal medicine veterinarian that I trusted.

If I thought that an ultrasound would stress Obi out (they have to be held upside down on their back while the probe goes all over their abdomen with them sometimes having to push the probe into them firmly, and it takes about 20 to 30 minutes) I wouldn't do it. Stress is never good for anyone.

I would not do surgery at all.

I would continue with whatever food seems to work the best canned preferred.

I would continue with the Prednisolone at the minimum dose of 5 mg once a day.

I would discontinue the Reglan (read about the side effects of long term use)

I would give the Pepcid 20 minutes before meals.

I would continue the vitamin B12

I would look into them doing a cobalamine test

I would be sure to groom Obi every single day even if only for 5 minutes.

I would start keeping a ledger on everything.

I would stop looking at him like he is a sick cat.

I would also be aware of any signs of pain in him which could be hiding, antisocial, anything out of the ordinary for him.

I would keep his stress level as low as possible.

So, that is what I would do.

The vet that thinks he has lymphoma, does she have a magic crystal ball?

The blood test she says shows inflammation of the ilium. What magic test is that?

IBD is a disease of exclusion there is not a diagnostic test for it. You have to rule everything else out.

I think it is a highly misunderstood disease.

Make sure that he gets Prednisolone not Prednisone. It works better in cats.

Inflamation can lead to cancer. That is the connection between IBD and Intestinal Lymphoma. Many cats will live a good long life with IBD and never ever develop lymphoma. Some will. Worry does nothing to prevent it.

I would say observe how Obi is behaving and how he is feeling, but try not to stress over him or around him. Sometimes all of this can and is overwhelming and you get frustrated etc, because you have vets with magic balls running around.

You are kind of stuck because once you start the pred you shouldn't really stop it. You can but it doesn't seem to work as well the second time around. If you treat with Leukeran you really need to have a lymphoma diagnosis.

I think you are doing fine with Obi.

So, sorry if I am way off base with my comments and suggestions,. And they are just that. I don't know, not a vet, just worked with allot of them and worked a long time in internal medicine and saw way to many IBD and LSA kitties.

I hope you both are doing better by now.

 

[myrnafaye]

How wonderful that you took the time to write such a long and thoughtful post.  I am very grateful.  Nothing you said, nothing at all, is off the mark.

I have discontinued the reglan.  And I kind of dose him with pepcid as needed.  He gets B12 injections because the TAMU showed low B12.  the chem panel showed all organs working fine.  The diagnosis of pancreatitis was "mild".

He is on 5mg predisolone, and yes, I do understand that now we know there is a difference between that and predisone.  I am sad we did not know this years ago when I had a badly asthmatic cat who was treated with predisone, could not get him off it (probably was not metabolising it), became diabetic, and passed away at 10.  He was a wonderful cat.

I am curious to know - and I am fairly certain others here are also - what you mean when you say IBD is a very misunderstood disease, as so many of our kitties seem to have it. 

Again, thank you, your comments are most helpful.

 

[myrnafaye]

I did a "bad" injection to day of Obi's B12.  I dont think all of went subcutaneous; I found a wet spot on his fur where I injected him, and then I found a pink spot the size of a nickel on my bedspread.  Any thoughts about what if anything I should do?  re-inject?  wait another week, since the injections are weekly?  wait a few days?

 

[stephenq]

Ask your vet.
Alternatively you could administer an estimate of the missing dose or wait until next week.

 

[quiet]

Ask your vet.

What is going wrong when you are giving the injections? Are you going through the skin and out the other side? Cats have very thin skin and it is easy to do. What size needle are you using? What color is the cat? When you inject grab allot of skin if you can and hold it so as there is enough area between the first layer of skin and the second to cover the needle length. Hard to explain. Go into the skin with the bevel up on the needle, once in the skin give the injection quickly and don't spend to much time screwing around with the drawing back to be sure you are not in a vein etc. Chances of your being in a vein are highly unlikely. Allot of times this is when the needle slips. Can you give the vit b into the sub q fluid bubble after the sub q fluids are given? Can you put the injection into the sub q fluids. Would have to replace them more frequently. Are you giving sub q fluids? I forget.

 

[myrnafaye]

Hi, Quiet:

I think I did it right, just too fast.  I had a diabetic cat so I learned how to give injections but for insulin the needles are somewhat different.  In any case, I did call into Internal Medicine, and was told just to wait till the next injection, which is sunday.  No, no sub Q fluids - his hydration is good, and just for good measure, I mix a little water in with his canned food.

He's a black cat, very handsome.

obiwhiskers.jpg

• myrnafaye
• Jul 1, 2014

 

[goholistic]

Aw...look at him. He is handsome. 

 

[quiet]

What a nice looking cat.

 

[myrnafaye]

Thank you!  Yes, he is a handsome fellow.  When I got him he was skinny, and his coat was rough, he was in a desperate situation and he sure communicated that to me.  a few months later, he had a beautiful shiny patent leather looking coat, and he had become the kind, dominant cat of my household.  I had three then.

Although  I must say, I have never seen a cat I did not think was beautiful.

 

[abbyntim]

Very good-looking boy!

Although I might be biased because Obi looks an awful lot like Tim, even the white hairs on the chest. Did Obi always have the white whiskers, or did they change as he grew older?

 

[myrnafaye]

He's always had the few white chest hairs, maybe a few more as he gets older.  But, he also has a couple white whiskers; and on one side, one falls out but the other one does not.  He has a very "big" personality.