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Old 01-17-2013, 02:10 PM   #1 (permalink)
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Default Chronic Pancreatitis

My 11 year old cat Isabelle has been diagnosed with Chronic Pancreatitis, but she is only partially responding to treatment. The vet is running out of options and is planning going to consult with specialists on her case. Here are the facts: She has always been a cat that vomited on a regular basis. About 2 years ago we noticed that she was mowing her fur off her abdomen an hind legs. Needless to say she was also throwing up a lot more. At the time I attributed the vomiting to hairballs. The vet did too and believed that the fur mowing was behavioral in nature because she never broke her skin and never scratched her skin. Gradually she began vomiting more and more eating less and started losing weight. She used to weigh between 8.5 and 9 lbs. I then started to notice that she was drinking tons of water which was causing large clumps in the litter box and a few times she even vomited water. The vet ran every lab test in the book on her and they only issue they could find was that her urine was watery. the first thought from the vet was that she was developing early kidney issues so they had me start treating her wtih pepcid and try to have her eat prescription food. They did a GI scope and found nothing. The Vet then asked to send out for the FIP test for pancreatitis. The results were off the charts. The range was supposed to be 0-5. Her value was 37. She was then prescribed prednisone, antibiotic, pepcid, and pain meds. The vomiting has calmed down significantly and she is eating, but she will now only eat cheap canned cat food (fancy feast flaked tuna or purina one flaked tuna) and sometimes fancy feast dry food. I have tried every brand and flavor of cat food on the market from high end to low end and she turns her nose up at most of it. Her weight is now down to barely 6 lbs. Right now once per week or once every 2 weeks she has a major vomiting spell where she can't stop vomiting. I have to give her cirenia to stop the vomiting and pain med. A follow up FIP test was just completed as well as a cobolum (sp) test and the cobolum was normal, but the FIT was still to high at 14. The vet wants to try some allergan food (duck and pea formual) but I am not confident that she will eat it or that it will do any good. Right now she is still on the 1/2 prednisone 2x daily, 1/4 pepcid 2x daily and 1/2 cerenia tab when needed for vomiting. Does any one have any thoughts?

Thanks

Elizabeth
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Old 01-17-2013, 03:56 PM   #2 (permalink)
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Hi Elizabeth! The best I can offer is to tell you what I would do...

A long time ago, I learned that the very best advice for chronic conditions like this is to be found in the specialized online groups. There is one for Pancreatitis - you'll find it here: Feline_Pancreatitis_Support : Feline_Pancreatitis_Support

If you're unsure, you could join up and simply read the "goings-on", the back and forth questions and answers - take a test drive so to speak. To do that, see the blue "Join This Group!" buttons on the right side there.

From my experience with other such groups, I can assure you that's where I'd be.
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Old 01-18-2013, 09:02 PM   #3 (permalink)
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Thanks for the information. I am very surprsied, but Isabelle is actually eating the allergy food formula the vet prescribed. We will see if there is any improvement going forward.

Elizabeth
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Old 01-23-2013, 12:49 PM   #4 (permalink)
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Update: Isabelle surprisingly liked the allergen food. However, She vomited 2 days after introduction of the food, and then on her first day of eating only that food she vomited undigested food into the food bowl. I then started thinking back through all the other times she has vomited now that she is on medication to treat her problems and it has always been after she has been ingesting dry cat food. She has not vomited any wet food since she has been on her medication. The vet is conviced that there is a food allergy problem aggrivating things and she wanted me to try giving her the dry allergy food again, but I am not going to do that. The other option she also wants to persue is the prescirption canned foods they offer at the vet for allergies. After doing some research I do not want to put her on those foods either. Isabelle also has an issue at the moment with pate style cat foods. She will do one of 2 things when offered a pate style food: turn her nose up at it and try to cover it as if it were vomit or something in the litter box, or initially eat a small amount of it and then not return to eat any more of it. I have also been reading about a raw diet, which I think might help her alot, but I have a number of concerns about that. I need to go to the Raw forum to ask those questions.
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Old 01-23-2013, 08:20 PM   #5 (permalink)
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OMG taxcat, one of my cats (12 1/2 yrs old) is going through pretty much the identical process as yours, except she hasn't vomited in the past week and hasn't been on prednisone, and both I and my vet have gone through the same thought process as yours: vomiting = hairballs or eating too fast; licking all the fur off her abdomen and inner part of her hind legs = behavioral; drinking more water = early kidney disease (through her creatinine level is a little high); more pee = drinking more water, not concentrating her urine; not eating = currently still a mystery, because she's been getting Periactin since last week.

Was/is your kitty very lethargic as well? It's the lack of energy that's worrying me the most. We've been to the vet twice in the last week - most recently just yesterday. Bloodwork last week showed nothing, xrays yesterday showed just a little constipation. She was given Pepcid ac and Periactin, and got subQ fluids on both visits. After going through all of the results, the vet mentioned that they could test for pancreatitis but didn't seem to think that could be it, so I didn't request a test. But there's been no improvement. I called the vet today but haven't heard back yet.

She does the exact opposite with food, though: she only eats watered down pate, so prescription canned foods will probably be ok. So your kitty is eating the duck and pea?? I tried that with my other kitty several years ago, when the vet thought she might have a food allergy, and she wouldn't touch it.

Dry food she just inhales without chewing, and that's what she always throws up too.

I don't think she'd eat raw food. She just won't chew. I don't know much about a raw food diet - why do you think it would be better for Isabelle?
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Old 01-23-2013, 09:43 PM   #6 (permalink)
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I found this: http://www.idexx.com/pubwebresources...ncreatitis.pdf

It sees like the test you were referrint to is cobalamin. There's a section on it on the 2nd page of the document.
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Old 01-25-2013, 01:54 PM   #7 (permalink)
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Sprite, Isabelle has not been lethargic. She still wants to play. She drinks tons of water, is actually eating but doesn not seem to be gaining any weight. All of her kidney and liver labs were normal except that her urine was considered watery.

There is a test develped by Texas A&M specifically for diagnosing Pancreatitis. It is called FIP test. The blood has to be sent out to a lab in Texas for this test to be done. My cat has had the FIP test done twice and this last time they also did a cobalamin test. Her cobalamin was at 370 which the vet said is low normal. Her FIP was 14 after 2 months of treatment. Her FIP prior to the start of treatment was 37. So it is improving, but it needs to be below 3 to be good. I am considering a raw food diet because after doing some research it appears that many cats with IBD/pancreatitis respond well to the raw food because their conditions are suspected of being linked to commercial cat foods. This way I can control what she is ingesting. I can tell you right now the vet will not agree with this, but since no one seems to be able to figure this out I don't think I have anything to lose by trying. I realize this is not for everyone, but it really upsets me to see my cat suffering and wasting away.
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Old 01-25-2013, 02:31 PM   #8 (permalink)
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Raw may very well be what you need to do, but one thing to keep in mind...she'd on pred, which suppresses the immune system. A cat can normally handle any bacteria load that may be found in raw, but a cat with a suppressed immune system may run into trouble. If you want to go raw, I would recommend using a commercial product that uses a high pressure pasteurization process to eliminate bacteria. Nature's Variety is one that does this. Primal also uses it, but last I knew it was on chicken only. If it seems to do the trick and you can wean her off the pred...then a prey model should be fine if that's what you want to do. It may be over cautious, but better safe than sorry.
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Old 01-25-2013, 11:03 PM   #9 (permalink)
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Thanks for the information taxcat. We went to the vet this morning and they are doing a second CBC, senior panel, and a fPL test for pancreatitis. I couldn't find any information on the FIP test; everything I looked at associated it with peritonitis.

It's great - but surprising - that Isabelle isn't lethargic. I've looked at several sites and all say lethargy and lack of appetite are 2 symptoms that are always present. I know Margaux isn't feeling well, because she didn't try to kill the vet and didn't scream like a banshee on any of the last 3 visits. The last time she was that docile, the vet failed to get all of an extracted tooth out, so she was in pain. I read that pancreatitis is painful, so I asked the vet about pain management. He gave her fentanyl. She got subQ fluids for the 3rd time too. The last 2 times, nothing was different. Today, she is eating like her usual self for the first time in more than 2 weeks, which makes me think that it's pain that's causing her to be so lethargic. Total disinterest in wand toys. She can't see them, but she loves to stick her paw out and try to grab them. I'm going to try that later when she wakes up and see if I get a reaction.

The fact that Isabelle is eating but isn't gaining weight or is still losing weight isn't due to diabetes? Eating a lot but losing weight is one of the major symptoms of diabetes, and it's apparently frequent in cats with pancreatitis.

I really don't think I can do a raw diet for my kitties, but I'll look at the info that people have posted here. Doodlebug, Margaux isn't on prednisone, so I guess at least that's one risk that's ruled out. Geez. My kitties are going to drive me out of my mind with worry.
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