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Dr. Barbara
Dr. Barbara, Cat Veterinarian
Category: Cat
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Experience:  Over 30 years experience in veterinary medicine and surgery.
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, My 7 year old female cat (we think) has pancreatitis and

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Hi, My 7 year old female cat (we think) has pancreatitis and we have been back and forth to our Vets almost daily since mid January since she started refusing to eat. We were asked to give her a dietary Sensitivity control food which she would not eat. We tried the sachets mixed with boiled chicken which she licked and just ate little bits of chicken but wasted the rest. At first it was thought she had teeth problems with gingivitis and was treated for that. She was frequently vomiting bile so she was given an anti-nausea injections. Then it was thought she had a mild facial pain syndrome and given pain killers but over time she has lost weight from 3.6kg down to 2.8kg so they took bloods for analysis on 3 occasions and a scan which showed inflammation of the pancreas and intestines and we were advised if we could not get her to eat she would need hospitalisation referral for intubation feeding and fluids followed by endoscopy and laparoscopy biopsy samples to get a more accurate prognosis. However when told it would cost some £5000+ for such treatment as pensioners (without pet insurance) we cannot afford. She has to different forms of antibiotics, 3 daily doses of Vetergesic 0.2ml, and daily visits to surgery for anti-nausea injections. To give her any chance we needed to get her eating and found if I mixed high quality mince steak (<5% fat) with equal portion of chicken boiled til the water almost dries like a juice she enjoys it very much and has been putting weight back on and has increased to 3.1kg. The blood heamatology results showed high platelets (658) High Eosinophils (32%) low T Protein (48 g/l) Low albumin (24 g/l) high CK (693 u/[email protected]) High Lipase (32 u/[email protected]) Low B12 (163 pmol/l) High folate (45.1 nmol/l) all indicating pancreatitis with bacterial overgrowth and exocrine pancreatic insufficiency. She has now had a B12 injection. Needs to have a second worming tablet (1/2). She mentioned if she cannot keep up to weight gain my cat may have to have a steroid course and that she may develop type 1 diabetes and need 2 insulin injections each day for life! The vet asked how she was enjoying the Sensitivity Control food and when I told her that I was giving her ground mince beef steak at less than 5% fat I was told no under no circumstances can she have beef. It is against her dietary control. I am confused as to why and as to how to get my cat to gain weight if she will not touch the control food? Have I no option but to hospitalise my cat and remortgage my house? So far we have spent £1200 for treatment.
Your opinion would be gratefully appreciated. Regards Keith
Dr. Barbara :

Hi Keith, Welcome to JustAnswer. I'm a licensed veterinarian and I'll be happy to help. I am so sorry to hear about all you have been through with Bella. There are some differences with way your vet is treating pancreatitis than how I would usually treat it, so maybe I'll start there. First of all, pancreatitis is rarely an infectious problem in cats, so the antibiotics are probably not necessary and they could be suppressing her appetite, so I would recommend that you and your vet consider stopping those.

Dr. Barbara :

Pancreatitis doesn't seem to be caused by fatty foods as in dogs, so I think that the beef would be a fine temporary diet. . .it's not complete, but temporarily it seems fine to me. It is all important that cats eat, and if this is working for her, then this is fine in my opinion.

Dr. Barbara :

I think that your vet is also suspecting IBD (Inflammatory Bowel Disease) since the ultrasound showed a thickened (inflamed) intestine which would be the intestinal wall. For this, it is recommended that cats be put on hypoallergenic diets, prednisolone, and metronidazole. Vit. B 12 injections weekly are also recommended, and Bella was low in B 12 and did receive one injection so far. I'd keep these up weekly.

Dr. Barbara :

The Vetergesic is a very good pain reliever for pancreatitis so I'd definitely continue that.

Dr. Barbara :

In rereading your post, I see that your vet has diagnosed bacterial overgrowth from Bella's lab results. I see that she has high eosinophils with low albumin. This would support an allergic IBD, but I don't really see anything pointing to bacterial overgrowth and the need for antibiotics. However, I can't say either that there is not bacterial overgrowth, and she does seem to be responding positively to the antibiotics you are giving. . .she is eating, just not the special veterinary diet.

Dr. Barbara :

Your vet is probably giving Cerenia injections for vomiting. Cerenia does make a tablet, and the smallest would be 16 mg. The dose is 1mg / kg once daily. For Bella, I'd give her a little less than 1/4 of a tablet wrapping the remaining portion in aluminum foil to prevent exposure and deterioration of the tablet.

Dr. Barbara :

I'm going to switch this to the Q&A mode, as this allows us all the time we need to address Bella's case without more charges to you.

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Customer: replied 2 years ago.

Dear Dr Barbara

Thank you so much for your valued opinion. I feel relieved that I can continue with the minced beef steak which is very low in fats <5% mixed with equal portion of chicken. I will gradually add small percentages of the special dietary meats until she refuses. I was worried I was poisoning Bella. I will ask about the hypoallergenic foods. We have just realised one of the tablets we are giving Bella (in quarters 2 x per day) which I thought was a antibiotic is metronidazole 200mg. I will check what prednisolone is and ask about that. Again thank you so much.

Hi Keith,
So your vet is definitely thinking possible IBD, and the hypoallergenic diet would be great. . .if she'll eat it. One of my favorites is ZD which is a hydrolyzed protein hypoallergenic diet. When the protein is hydrolyzed it becomes non-allergenic, so don't be concerned by the proteins listed. Most cats like this, and it does come in canned and dry.
Another suggestion would be to give Bella a probiotic. I've always like FortiFlora, but was just at a conference where Dr. Dawn Boothe, a boarded veterinary internist and clinical pharmacologist spoke. She finds that Proviable does a better job of supplying the probiotics because it contains more. Your vet may also like to know this. . .I hadn't heard of it before.
It would be ideal to do further diagnostics, but totally understand if this is not financially feasible. Often we can arrive at a diagnosis by trying treatments. Then if an animal is clinically better, we can adjust the treatments accordingly. Sounds to me like Bella is getting better!!!!
If Bella doesn't continue to eat well, then a round of prednisolone would definitely be indicated and should not cause diabetes when used for a short while. Again, tho', it does sound like she is getting better without the prednisolone.
In general, the more nursing care you do at home, the less expensive Bella's treatment will be for you. For example, owners can be shown how to use and care for feeding tubes in their cats at home. Once again, however, it does seem that Bella is on the road to recovery and you won't need to do this. Hopefully, I'm understanding you correctly!