5/15 Noogi - AMPS 103, +2 99, +5 79, +9 117, PMPS 153 - pancreatitis confirmed

[Helen + Noogi]

Yesterday

Thank you all for your kind wishes yesterday. Noogi is still poorly and I have a vet appointment later today.

I made contact with the vet first thing and he said to try him on prescription digestive care food. It's high in carbs of course but I think it is more important he eats.
He ate a little of that this morning and a very little of his normal food so I have him a reduced shot (0.5u instead of 0.75u).
The only way I could entice him to eat is with a Churu-type tube puree. First he eats out the tube, then I put some on his food and sometimes he then eats a bit.

I just checked on him now and he ate a tiny bit more (maybe a tablespoon).
And he's had another BM, just a small one, soft and stinky.

Hope the vet can help. I'm so scared is the p-word

 

[Staci & Ivy]

Yesterday

Thank you all for your kind wishes yesterday. Noogi is still poorly and I have a vet appointment later today.

I made contact with the vet first thing and he said to try him on prescription digestive care food. It's high in carbs of course but I think it is more important he eats.
He ate a little of that this morning and a very little of his normal food so I have him a reduced shot (0.5u instead of 0.75u).
The only way I could entice him to eat is with a Churu-type tube puree. First he eats out the tube, then I put some on his food and sometimes he then eats a bit.

I just checked on him now and he ate a tiny bit more (maybe a tablespoon).
And he's had another BM, just a small one, soft and stinky.

Hope the vet can help. I'm so scared is the p-word

Hi Helen, you’re doing all the right things and the best thing to do is to try to convince him to eat if you can
If it is the P word, the best thing you can do is act quickly, which you are, and get him on pain, medication, fluids, if they think that would help, Cerenia and possibly Ondansetron for nausea. Buprenorphine is the med for pain you want.

Remember, the way they treat it is based on the symptoms and it seems like just assuming they have it and jumping on the treatment is the best way to get rid of it

Unfortunately, when Ivy had it in February, there was a delay in time and I didn’t really know what I was doing since it was the first time I encountered it. So it went on longer than it needed to.

At least you have an idea that it could be that, so in my opinion, assume that it is and treat as fast as possible to get rid of it.

I would be inclined to not even wait for the lab results to come back to start treating it (if your vet agrees) I don’t think there’s any real harm in treating right away.
Just my opinion from having gone through it and that’s how I intend to deal with it if it comes back again.

Wishing Noogi a quick recovery and sending prayers your way

 

[Laurie & Petey]

Keep us posted. I hope he is ok and it is not the p-word. Also made me think did they do blood work when he was last in, I couldn't remember?

 

[Helen + Noogi]

Keep us posted. I hope he is ok and it is not the p-word. Also made me think did they do blood work when he was last in, I couldn't remember?

Thanks Laurie. He hasn't blood work done in ages. Maybe not since his diagnosis in Oct last year. Or maybe in Dec last year - I took him to a specialist then as we were struggling so much and my normal vet wanted his colleague to check for Acromegaly and other possible complications and also advise on treatment. He had an ultrasound with that vet which confirmed his pancreas was okay (he had pancreatitis in Oct, which is when we got the diabetes diagnosis). I'll ask the vet today about more tests.

 

[Helen + Noogi]

Hi Helen, you’re doing all the right things and the best thing to do is to try to convince him to eat if you can
If it is the P word, the best thing you can do is act quickly, which you are, and get him on pain, medication, fluids, if they think that would help, Cerenia and possibly Ondansetron for nausea. Buprenorphine is the med for pain you want.

Remember, the way they treat it is based on the symptoms and it seems like just assuming they have it and jumping on the treatment is the best way to get rid of it

Unfortunately, when Ivy had it in February, there was a delay in time and I didn’t really know what I was doing since it was the first time I encountered it. So it went on longer than it needed to.

At least you have an idea that it could be that, so in my opinion, assume that it is and treat as fast as possible to get rid of it.

I would be inclined to not even wait for the lab results to come back to start treating it (if your vet agrees) I don’t think there’s any real harm in treating right away.
Just my opinion from having gone through it and that’s how I intend to deal with it if it comes back again.

Wishing Noogi a quick recovery and sending prayers your way

Thank you so much for your advise and support Staci. I agree about treating early and will discuss with vet.

Noogi actually had pancreatitis last year (Oct) - that's how we found out about the diabetes. Or maybe the pancreatitis triggered the diabetes - the vet says they are linked but that it is hard to know if pancreatitis causes the diabetes, or if having diabetes causes the pancreatitis (a sort of chicken/egg situation). Not really important.

He was so sick then I was scared I was going to lose him. He had lots of treatment then but I have no memory of the names of the meds he was prescribed!

I'll report back after my appointment today.

 

[Staci & Ivy]

Thank you so much for your advise and support Staci. I agree about treating early and will discuss with vet.

Noogi actually had pancreatitis last year (Oct) - that's how we found out about the diabetes. Or maybe the pancreatitis triggered the diabetes - the vet says they are linked but that it is hard to know if pancreatitis causes the diabetes, or if having diabetes causes the pancreatitis (a sort of chicken/egg situation). Not really important.

He was so sick then I was scared I was going to lose him. He had lots of treatment then but I have no memory of the names of the meds he was prescribed!

I'll report back after my appointment today.

I didn’t realize he had Ptitis before. I’m sorry to hear that.
Hopefully he will recover quickly and you know what to do as best you can, Helen!!
Make sure to get extra meds so you have them at home for no delay in treatment.
Sending Noogi healing vines

 

[Mary & Jude]

I'm sorry he's still feeling poorly. Praying you can get on top of this immediately!

 

[Helen + Noogi]

Update: when I checked on him at 2pm and again when I collected him at 3pm he was noticeably more listless and would not even consider food. He was sitting in 'the misery crouch' (IYKYK). So glad I had made the vet appointment.

Vet says he thinks it might well be ptitis. I have left him there for a couple hours so they can take bloods, administer fluids and give him meds for pain and nausea (so treating as if it is ptitis). Will fetch him after work.

I'd appreciate any guidance on what to do about his insulin this evening.
@Bandit's Mom @Wendy&Neko @Angela & Cleo And anyone who has experience of ptitis. What do I do??

He got a reduced dose this am. He last ate 11am (only about a tablespoon). So far his BG is as it usually is.

 

[SqueeM3]

Leroy got a slightly reduced insulin dose when he was in hospital for treatment of his p-itits. The techs couldn't measure 2.25 units so they gave 2 units instead. For Leroy, when he's had p-itits before, he gets his usual dose of insulin. Note: Leroy is a complete weirdo so what works for him may not work for other cats.

Let's see what Wendy, etc says about dosing for Noogi.

 

[Helen + Noogi]

Leroy got a slightly reduced insulin dose when he was in hospital for treatment of his p-itits. The techs couldn't measure 2.25 units so they gave 2 units instead. For Leroy, when he's had p-itits before, he gets his usual dose of insulin. Note: Leroy is a complete weirdo so what works for him may not work for other cats.

Let's see what Wendy, etc says about dosing for Noogi.

Thanks SqueeM3. I was thinking that might be the course of action. Did Leroy continue to eat throughout or was he off his food?

 

[SqueeM3]

Depends. With his most recent p-ititis (not last weekend but weekend before), he wasn't eating at all so he had to be hospitalized. I was worried about fatty liver disease. The vet was able to get him to eat after administering fluids and anti nausea and pain meds. He stayed 2 days before going home. Then he had to go back 2 days later because he stopped eating again. He got more fluids with Cerenia and got sent home with a bag of fluids. He was better later that day and was able to eat. He seems to have fully recovered now.

Sometimes when he has p-ititis he eats but not very much and I can sometimes head off a full attack with anti nausea med and pain med at home.

 

[Staci & Ivy]

Update: when I checked on him at 2pm and again when I collected him at 3pm he was noticeably more listless and would not even consider food. He was sitting in 'the misery crouch' (IYKYK). So glad I had made the vet appointment.

Vet says he thinks it might well be ptitis. I have left him there for a couple hours so they can take bloods, administer fluids and give him meds for pain and nausea (so treating as if it is ptitis). Will fetch him after work.

I'd appreciate any guidance on what to do about his insulin this evening.
@Bandit's Mom @Wendy&Neko @Angela & Cleo And anyone who has experience of ptitis. What do I do??

He got a reduced dose this am. He last ate 11am (only about a tablespoon). So far his BG is as it usually is.

It sounds like it could be, Helen
Ivy’s BG went down quickly when she had it so I had to drop her dose so not too much insulin, plus she was barely eating and I was syringe feeding.

I know Bron is so knowledgeable about pancreatitis. Does anyone know if she’s made it over here?

I assume you’ve read the info about pancreatitis before?
Info - A Primer On Pancreatitis | Feline Diabetes Message Board - FDMB

Glad to hear Noogi is getting good care today and hoping he will feel better tonight.
Sending you both lots of prayers and healing vines

 

[Laurie & Petey]

What the heck is causing chronic pancreatitis in so many kitties.

 

[Laurie & Petey]

Thanks Laurie. He hasn't blood work done in ages. Maybe not since his diagnosis in Oct last year. Or maybe in Dec last year - I took him to a specialist then as we were struggling so much and my normal vet wanted his colleague to check for Acromegaly and other possible complications and also advise on treatment. He had an ultrasound with that vet which confirmed his pancreas was okay (he had pancreatitis in Oct, which is when we got the diabetes diagnosis). I'll ask the vet today about more tests.

I'm guessing you may postpone the dental next week, and in my opinion a senior blood panel is super important before anesthesia.

 

[Helen + Noogi]

Another update: Noogi is back from the vet and it is indeed pancreatitis

All his other blood results - kidney, liver, white blood count, bacterial infection etc. - are normal.

He had fluids, something for nausea (cerenia), something for pain (Dolorex - which I see is butorphanol tartrate) and vit B12.
He also needed something to calm him down as he was not cooperating with blood being drawn. He is still very out of it, walking a few steps, staring into space etc. Poor baby

Absolutely not interested in food, even churu-type treat. I'll try again later.
It's already 40 mins past shot time. Do I give him a tiny token dose, or skip altogether?

Edited to add: he ate a churu-type treat!

 

[Helen + Noogi]

I'm guessing you may postpone the dental next week, and in my opinion a senior blood panel is super important before anesthesia.

Yes, dental postponed.

 

[Helen + Noogi]

It sounds like it could be, Helen
Ivy’s BG went down quickly when she had it so I had to drop her dose so not too much insulin, plus she was barely eating and I was syringe feeding.

I know Bron is so knowledgeable about pancreatitis. Does anyone know if she’s made it over here?

I assume you’ve read the info about pancreatitis before?
Info - A Primer On Pancreatitis | Feline Diabetes Message Board - FDMB

Glad to hear Noogi is getting good care today and hoping he will feel better tonight.
Sending you both lots of prayers and healing vines

Thanks for the link Staci - I hadn't actually read that as I only found the board long after his first bout had cleared up.
Appreciate the wishes

 

[Mary & Jude]

Oh, I hate that it's P-titis! Staci mentioned this, but are you able to syringe feed?

 

[Helen + Noogi]

Oh, I hate that it's P-titis! Staci mentioned this, but are you able to syringe feed?

Hate it too. Seems like it came out of nowhere!

I don't have a syringe. Can get one tomorrow.
He did just eat a churu. I presented him with his bowl again but no luck. He is so out of it

He's going back to the vet in the morning for more fluids.

 

[Mary & Jude]

Hate it too. Seems like it came out of nowhere!

I don't have a syringe. Can get one tomorrow.
He did just eat a churu. I presented him with his bowl again but no luck. He is so out of it

He's going back to the vet in the morning for more fluids.

Poor baby! What have you decided about shooting?

 

[Staci & Ivy]

Hate it too. Seems like it came out of nowhere!

I don't have a syringe. Can get one tomorrow.
He did just eat a churu. I presented him with his bowl again but no luck. He is so out of it

He's going back to the vet in the morning for more fluids.

Maybe the vet can provide you with a few syringes (they tend to wear out quickly and get "stuck" so I try to have at least a dozen on hand (I know, I'm obsessive).

 

[Helen + Noogi]

Maybe the vet can provide you with a few syringes (they tend to wear out quickly and get "stuck" so I try to have at least a dozen on hand (I know, I'm obsessive).

I'm sure he will. I'll definitely ask. What food did you give Ivy?

Poor baby! What have you decided about shooting?

Nothing yet. I'm stalling. It's +1 now, so I guess I have another hour? Hoping I can get some food into him but probably not. He's just sitting at the window staring into space

 

[SqueeM3]

I have a mini vet hospital at home: syringes, needles, general first aid items, a bag of sterile saline, bag of LRS fluid, e-collars, random stuff for the rats, meds

Do you have anti nausea meds and an appetite stimulant to give at home? If Noogi is nauseous and / or in pain, he won't want to eat. You might want to ask the vet for some to have on hand in case Noogi has another p-itits attack in the future. Meds are good for a few months at least. The label should indicate the expiration date.

Any food is better than none at all right now. Offer anything: cat food, plain cooked chicken, treats, deli meat, can of tuna, etc.

The sedative will wear off soon. Just keep Noogi from climbing and jumping off things. Leroy did that while still on hard sedatives when he came home last week and basically went splat on his side on the floor

 

[Laurie & Petey]

Sending you both big hugs and healing vines. I'm so sorry this came up, he was just at the vet too.

 

[Mary & Jude]

Helen, since you aren't getting a response here, you might consider posting on the FB group. I believe Bron is over there, but she's likely sleeping right now, as it's the middle of her night. I think her name is Bron Orr, but I might be wrong about that. (I sure wish we had more experts here to help--though I think those who are familiar with treating P-titis, like Staci, SqueeM, and even you, bring a combined wealth of knowledge.)

 

[Helen + Noogi]

I have a mini vet hospital at home: syringes, needles, general first aid items, a bag of sterile saline, bag of LRS fluid, e-collars, random stuff for the rats, meds

Do you have anti nausea meds and an appetite stimulant to give at home? If Noogi is nauseous and / or in pain, he won't want to eat. You might want to ask the vet for some to have on hand in case Noogi has another p-itits attack in the future. Meds are good for a few months at least. The label should indicate the expiration date.

Any food is better than none at all right now. Offer anything: cat food, plain cooked chicken, treats, deli meat, can of tuna, etc.

The sedative will wear off soon. Just keep Noogi from climbing and jumping off things. Leroy did that while still on hard sedatives when he came home last week and basically went splat on his side on the floor

I have tried ALL the foods. All he has eaten is one churu and half a dozen crunchy treats. Will NOT have a bite of anything else. It's so hard.

He's back at the vet in morning. Presume he will send my home with whatever he needs for over the weekend. The vet said he is happy to give me meds for future use too,

Luckily Noogs isn't a climber, but I am watching him! Currently he's whining at a gate he hasn't been allowed out for eight months.

 

[Helen + Noogi]

Thank you Laurie, thank you Mary
I think I will just skip tonight's dose and hope he eats something in the night.

Hoping some of our advisors hop online while I am asleep and give me some idea of what to do in the am if he HASNT eaten.
And what to dose if he has just eaten a TINY BIT.

 

[Mary & Jude]

I'll tag a few more that I know are here: @Sienne & Gabby (GA) @Marje and Gracie @Chris & China (GA)

 

[Wendy&Neko]

Three links from FDMB on feeding when cat's don't want to eat:

• Suggestions on How to Stimulate Kitty's Appetite
• Syringe/Assisted Feeding (Video and Tips)
• THE '~LIVER SHAKE~' FOR SICK CATS

It does sound like poor Noogi is in some pain and nauseous. I find ondansetron best for nausea, but Cerenia can help some too. They target different nausea receptors so can be given together. If you give an anti nausea med, you can also give Mirataz which is an appetite stimulant. Though it targets the same nausea receptor as ondansetron and will make it less effective.

Neko got p'titis as part of the package deal with her GI issues. The cat currently purring in my face wanting me to stop typing and make a lap also is a GI issue/pancreatitis cat. Pain/inflammation from pancreatitis can raise the BG. I would give insulin, at least a half dose. Cats undergoing anaesthesia can have half a dose. Insulin does more in the body than combat carbs in food. Also, do test for ketones. The formula for DKA is not enough insulin + systemic inflammation/infection + inappetance/not enough food. If he'll eat dry or higher carb over nothing, go for it. Food is medicine.

 

[Helen + Noogi]

Three links from FDMB on feeding when cat's don't want to eat:

• Suggestions on How to Stimulate Kitty's Appetite
• Syringe/Assisted Feeding (Video and Tips)
• THE '~LIVER SHAKE~' FOR SICK CATS

It does sound like poor Noogi is in some pain and nauseous. I find ondansetron best for nausea, but Cerenia can help some too. They target different nausea receptors so can be given together. If you give an anti nausea med, you can also give Mirataz which is an appetite stimulant. Though it targets the same nausea receptor as ondansetron and will make it less effective.

Neko got p'titis as part of the package deal with her GI issues. The cat currently purring in my face wanting me to stop typing and make a lap also is a GI issue/pancreatitis cat. Pain/inflammation from pancreatitis can raise the BG. I would give insulin, at least a half dose. Cats undergoing anaesthesia can have half a dose. Insulin does more in the body than combat carbs in food. Also, do test for ketones. The formula for DKA is not enough insulin + systemic inflammation/infection + inappetance/not enough food. If he'll eat dry or higher carb over nothing, go for it. Food is medicine.

Thank you Wendy. It's nearly 3 hours after the time he should have had his pm shot. He has eaten only one churu and six crunchy treats (his absolute #1 fav). He won't eat more now. Should I try a reduced dose now, maybe 0.25 (instead of 0.75) as it's so late?
Edited to add: his BG has come down a bit. I am scared to shoot as its already so late and i got very little sleep last night.
I think maybe I will stick with my decision to skip but start giving insulin from the morning. I need to be well rested to deal with what is likely to be demanding next few days as I look after him.

Appreciate all the info and links, I'll go through them carefully.

 

[Wendy&Neko]

3 hours late is probably too late. Just try to get a ketones test if you can. Anything other than "normal" would change my answer.

 

[Brianna & Xander]

Aww, I'm sorry that missed your updates from last night that you and poor Noogi had such a rough night.

I'm so sorry that it turned out to be the dreaded P-word. Poor sweet Noogi. And poor you, you must be exhausted and worried sick yourself!

I hope you're able to help kick this quickly with the help of all the meds. Pancreatitis is so scary and it's awful that so many of our sugar babies have to suffer from that too, and like you said, out of nowhere.

Absolutely agreed that you need to be as well rested as you can be to take care of him in the coming days - take care of yourself and get as much rest as you're able to. And (if you're anything like me), don't forget to eat and hydrate while you're distracted worrying about him too!

I hope you're able to rest well tonight and that Noogi gets through the night as comfortably as he can. Hopefully by the morning with meds he'll be more interested in food an the dosage question will be less daunting.

Sending you both hugs and healing vines!

 

[Helen + Noogi]

3 hours late is probably too late. Just try to get a ketones test if you can. Anything other than "normal" would change my answer.

Not going to be able to do that tonight as I don't have the strips (feeling very bad about that). But it will be a priority for tomorrow.

 

[Staci & Ivy]

I'm sure he will. I'll definitely ask. What food did you give Ivy?

Just seeing this now. Sorry for the delay.
Also, @Max@tif+chai&mocha2 Elise is here too and she is very knowledgeable about the dreaded P.

I fed anything I had, her homemade diet, Fancy Feast,
I had the vet give me some Hills Urgent Care A/D wet food. She liked this a lot. Smelly and tasty. She lapped it up (but she’d had fluids and Mirtaz by then).
I only gave it for one day then she began to eat.
But I have 8 cans in the house now, just in case

 

[Helen + Noogi]

Aww, I'm sorry that missed your updates from last night that you and poor Noogi had such a rough night.

I'm so sorry that it turned out to be the dreaded P-word. Poor sweet Noogi. And poor you, you must be exhausted and worried sick yourself!

I hope you're able to help kick this quickly with the help of all the meds. Pancreatitis is so scary and it's awful that so many of our sugar babies have to suffer from that too, and like you said, out of nowhere.

Absolutely agreed that you need to be as well rested as you can be to take care of him in the coming days - take care of yourself and get as much rest as you're able to. And (if you're anything like me), don't forget to eat and hydrate while you're distracted worrying about him too!

I hope you're able to rest well tonight and that Noogi gets through the night as comfortably as he can. Hopefully by the morning with meds he'll be more interested in food an the dosage question will be less daunting.

Sending you both hugs and healing vines!

Thanks Brianna, really appreciate your kindness.
I need to go to bed now - just been hit by a wall of tiredness. I'm grateful that I don't have much on this weekend and can look after him.

 

[Helen + Noogi]

Just seeing this now. Sorry for the delay.
Also, @Max@tif+chai&mocha2 Elise is here too and she is very knowledgeable about the dreaded P.

I fed anything I had, her homemade diet, Fancy Feast,
I had the vet give me some Hills Urgent Care A/D wet food. She liked this a lot. Smelly and tasty. She lapped it up (but she’d had fluids and Mirtaz by then).
I only gave it for one day then she began to eat.
But I have 8 cans in the house now, just in case

I just got him to eat a teaspoon or two of food out my hand! One of those MC in jelly types. He's never eaten out my hand before. So glad I tried - thanks to that list of suggestions Wendy shared.

I just checked my fridge and I have seven open pouches/cans of different foods! He has a buffet at his feeding station -a row of little bowls with different offerings. Under normal circumstances this would be his idea of heaven
Just praying he gets hungry in the night, otherwise I'm throwing it all out tomorrow.

 

[Sienne & Gabby (GA)]

I didn't catch whether the vet gave you an appetite stimulant (e.g., mirtazapine). That may be something to discuss with the vet. However, the nausea needs to be better controlled. Like Wendy noted, it may take a combination of ondansetron and Cerenia.

You might want to try baby food. Either Gerber or Beechnut Stage 2 are fine as long as there are no veggies, especially onions or garlic. Baby food isn't nutritionally complete but it may be something Noogi will eat.

 

[Wendy&Neko]

Your mileage may vary on what you can find for baby food in South Africa. All the ones in Canada have veggies or onions/garlic so are a no-go. I did boil some chicken and blend it with the resulting broth into a purree that helped.

 

[Marje and Gracie]

I echo trying to get Mirtaz transdermal if you’ve got anti-nausea drugs. It also has some anti-nausea effect but maybe not as much as you might need.

I also second trying to get something like Prescription Diet a/d or Recovery. I’ve used those very successfully in the past as well as subq fluids. It can take time for pancreatitis to run its course and you’ll just need to support with subq fluids, anti-nausea and vomiting, pain relief, appetite stimulant, and whatever food you can bribe him with.

 

[Mary & Jude]

Helen, I'm not sure if you've given subqs before. Several here have and can offer help if you need it. It's really not difficult. Keeping you and Noogs in my thoughts.

 

[wade]

Hi Helen, you’re doing all the right things and the best thing to do is to try to convince him to eat if you can
If it is the P word, the best thing you can do is act quickly, which you are, and get him on pain, medication, fluids, if they think that would help, Cerenia and possibly Ondansetron for nausea. Buprenorphine is the med for pain you want.

Remember, the way they treat it is based on the symptoms and it seems like just assuming they have it and jumping on the treatment is the best way to get rid of it

Unfortunately, when Ivy had it in February, there was a delay in time and I didn’t really know what I was doing since it was the first time I encountered it. So it went on longer than it needed to.

At least you have an idea that it could be that, so in my opinion, assume that it is and treat as fast as possible to get rid of it.

I would be inclined to not even wait for the lab results to come back to start treating it (if your vet agrees) I don’t think there’s any real harm in treating right away.
Just my opinion from having gone through it and that’s how I intend to deal with it if it comes back again.

Wishing Noogi a quick recovery and sending prayers your way

forgive my ignorance--what is the p-word?

 

[wade]

i read further and figured it out--pancreatitis. keeping you and noogi in my prayers.

 

[Maddie & Kai]

Oh gosh, I'm so sorry about the p-titis. It sound like you are doing everything you can to help poor Noogie. I hope he is feeling a little better tomorrow after getting some meds.

I'll be honest, when I read the post about him resting in the hurt crouch position, I began to worry if it was his kidneys. AKD and p-titis can go hand in hand sometimes. So I was really relived to ready that his kidney levels came back normal after the blood test.

Me and Kai are sending you and Noogi all our prayers and healing energy