Pancreatitis Ongoing - Help.

[Charlie576]

My beautiful 11 year old kitty was diagnosed with pancreatitis just before Christmas. His symptoms were loss of appetite, vomiting white foam, lethargy and weight loss. Vet diagnosed with a Snap FPL, all his other bloods were fine. Clinical signs also fine, aside from weight loss/dehydration. He received pain meds, fluids, anti-nausea and an appetite stimulant and we were sent on our way. He reacted strongly to all the meds and didn’t sleep for 3 days.

That was around 6 weeks or so ago and we are still battling this. We’ve been back numerous times to the vet, where he has received anti-nausea/appetite stimulant, and seemingly got better only to relapse again. Eventually they did a full Spec FPL, and it was 7 (normal range 0-3.5) showing inflammation still. Finally this last week we have been given more consistent pain meds, anti-nausea and appetite stimulant. But he still is gloomy, not eating aside from cooked cod or chicken and quiet. I think the Cerenia (anti-nausea) hasn’t been taking away his nausea properly so we are addressing that.

I am just beyond worried, barely sleeping and scared I’m going to lose him. Now and again he’ll play and jump up on things etc but he’s like a shadow of himself. Is this because we didn’t hit it hard enough with consistent meds? Will it get better? Any experiences or advice welcomed.
Side note - they’re considering IBD as he has always been a ‘sickly’ cat over the years which I put down to fur balls.

 

[daftcat75]

Pancreatitis is more serious than IBD so that has to be addressed first. It's possible that he has IBD and that the inflammation spilled over into his pancreas. There is almost always a food component to pancreatitis/IBD such as a reaction to certain proteins. Your best bet would be to switch away from whatever protein you are feeding today to something he hasn't had before. If he's eating chicken and fish, switch him to turkey. You have to be careful of turkey recipes. They often still include chicken. Your best bet, and really the gold standard for IBD/allergy diets are the Rawz pates. You can get their turkey pate and be assured that it contains no chicken or fish ingredients. Their rabbit pate would be another excellent choice. If he's eating dry food, discontinue that. There's too many carb ingredients in dry food and cats don't digest carbs very well. You're asking a compromised pancreas to work even harder. Stick to wet food.

Where to Buy | RAWZ

The 3 day reaction sounds like the long-lasting buprenorphine shot (simbadol.) You can get buprenorphine compounded into a transdermal gel that you can rub in his ear. That would provide a more even dose with fewer side effects. Have a look at Veterinary Pharmacy for compounding medicine. You will need the vet to fax or call in the prescription. Once that's done, one of their pharmacists will call you for payment and shipping information or you can put both on your cat's profile to make it easier to fill and refill prescriptions. I believe his other medicines--Cerenia and the appetite stimulant--can also be compounded into flavored liquids or transdermal.

Finally, B-12 is very important for digestive issues like IBD and pancreatitis. This will need to be given as a subcutaneous shot (into the scruff of his neck, not a vein.) It's much easier than it sounds and you can even learn how to do it at home by simply watching a youtube video. Ask your vet about it. He can sell you a bottle of B-12 and send you home with the syringes, needles, and the Sharps disposal. A typical B-12 schedule is weekly for a month or two, then every other week for some time, and finally once a month maintenance. B-12 is water soluble and its toxicity is much greater than its dose. If he doesn't need B-12, he'll pee it out. It won't hurt him to give him B-12 if he doesn't need it. But it won't help him to not give it to him if he does. And most cats with digestive issues do need it.

 

[mrsgreenjeens]

Even if he has IBD, apparently at the moment he also has pancreatitis since the FPL came back high, correct?

Are you giving him sub-q fluids at home? From my understanding, pancreatic cats needs lots of extra fluids, so many "parents" give sub-q fluids at home. Also, are you force feeding him any cat food or is he strictly eating the cooked cod or chicken? Are you adding any supplements to the home cooked food? If not, that is not 100% nutritionally complete for a cat, so how long has he been eating that?

Is he still on antibiotics as well. You mentioned pain meds, anti-nausea and appetite stimulants are more consistent, but no mention of antibiotics this go round? How about steroids to reduce the inflammation? Was that ever discussed. I know with IBD that is a routine "med", and some cats get it for pancreatitis, but don't know how bad it has to be before they are used.

Here is a thread from another poster whose cat's FPL was 50! She discusses what was being done to help her furbaby, so maybe you can compare. Feline Pancreatitis--1 leap forward, 2 steps back

 

[Charlie576]

Thanks for both your responses. Unfortunately I’m in the U.K. so a few things seem to be a little different here. We aren’t given SubQ fluids for at home, the only time he has had some is when he was first diagnosed as he was dehydrated. We did a B12 blood test and he wasn’t deficient so he didn’t need that. We weren’t given antibiotics either as he didn’t have a temperature and nothing showed in his bloods, they didn’t see it necessary for another lot of meds on top. Steroids haven’t been mentioned yet as we aren’t sure on the IBD diagnosis, pancreatitis is the only definite
We have Bupe for at home now, half the dose he was given works better on him and he’s not so spaced but still comfortable. He’s very difficult to give meds to, he lashes out, hisses, bites, even when wrapped in a blanket.
In terms of diet, I’ve ordered a few novel protein foods, the problem right now is getting him to eat anything. He has only had the white fish and chicken for a day or so, it was all he would have so it was better than nothing. I’m hoping with the introduction of a new nausea med and an appetite stimulant we can encourage the eating and get him on the road to recovery. I’m terrified he won’t recover properly, I’m literally praying.

 

[mrsgreenjeens]

We are right there with you,hoping for a good reaction to the new meds. Keep us posted.

Oh, and being on the Cod and/or Chicken for a few days should be ok. If more than a week, perhaps you can add some supplements.