Pallina has been hospitalized: pancreatitis

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Antonio
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Pallina has been hospitalized: pancreatitis

Post by Antonio » Tue Jul 03, 2018 8:59 am

Hi all,
As I told you in a separate thread (which is not mine), Pallina has been hospitalized :(

I and my wife had been away for holiday the first three weeks of June.
Some days before leaving, Pallina had a visit with a University professor to try and understand her issues, mainly the chest fluids that are still there, not increasing and this is a good news, and her gastrointestinal troubles.
During that visit they did an ultrasound scan that revealed the usual amount of fluid in her chest, and a slightly different texture in the right lobe of her liver, but nothing that would worry the doctors. They also took some blood from her and the results were bad.

Cholesterol 423 [95-130]
GGT 10 [<5.1]
AST 100 [12-56]
ALT 289 [30-100]
ALP 305 [25-93]
Total Bilirubine 1.93 [<0.26]
Amylase 1551 [365-948]
Creatinine 2.5 [06-1.8]
BUN 79 [43-64]
SDMA 25 [0-14]
fPLI 37.1 [>5.4 = pancreatitis very likely]

Potassium 3.93 [4.0-4.5]
Sodium 160 [147-156]
Chlorine 124 [112-119]

All these numbers led the professor to the diagnose of a pancreatitis and cholangiohepatitis.
Pallina was put on some meds. Ursacol to try and lower her bilirubine, Metoclopramide (here sold with the name Plasil, but I know it has also the name Reglan elsewhere) to try to control her vomit, a few days of hypodermo fluids to hydrate her and ease her discomfort.
On my side I added some Vitamin B's supplement, the vet agreed it is good.
All the therapies started before we left for our holiday. The hypodermo fluids were discontinued two days before we left.
The Metaclopramide too was discontinued and replaced by Omeprazole in a gel to be given her once a day for three weeks.

During our absence two girls, veterinary students, came twice a day to lok after Pallina and they told me that she was fine, eating regularly and using the litter. She was also loving, active and playful. She would vomit every other day, though.
She didn't lose or gain any weight, she was 3.310 kg before and after holidays

On the night we came back home Pallina she was still fine and eating.
From the following day on, she started eating less. At first I thought she was so happy to see us home that she was forgetting eating, but after two days I thought something was wrong.
Pallina was sleepier than usual, not eating and drinking a lot.

On past Friday we had a pre-booked appointment with the same University professor for a follow-up of the visit of May. He saw nothing wrong, apart from some jaundice that was consistent with her hepatic condition. He took some more blood and the first results (still waiting for a complete report) are that some levels have worsened a little bit. She had also lost 200 grams, she was 3.110 kg.

GGT 11 [<5.1]
ALT 297 [30-100]
ALP 288 [25-93]
Amylase 1551 [365-948]
Creatinine 2.43 [06-1.8]
BUN 84 [43-64]
fPLI 39.5 [>5.4 = pancreatitis very likely]

Potassium 4.18 [4.0-4.5]
Sodium 159 [147-156]
Chlorine 119 [112-119]

Waiting for the rest...

During the last weekend Pallina was too quiet, and on Sunday she slept a lot, would move slowly and threw up twice!
At 8 pm she was in a terrible state, an hour later I was taking to the her regular vet at the 24h clinic. Of course her vet wasn't in, but everybody at the clinic knows her well.
She was alert and fine during the visit, but the vet didn't let her cheat him and she was hospitalized for a few days. While there she peed and her pee was as yellow as a ripe lemon, a consequence of her jaundice.

She was put on a drip right away. On the following morning, yesterday, Monday, her regular vet did an ultrasound scan and it was just like the one she had in May at the University. Only the pancreas area was a bit reactive. Pallina was put on antibiotic (enrofloxacin) too.

Yesterday after work I went there and Pallina was fine, eating and happy to see me. The vets told me she had been eating all day, but they are not going to release her at least until Wednesday.
When I left she was sad to see me leaving, this means she was fine, but I prefer she stays there, where any issue can be promptly taken care of.
I think they are going to run some blood test during these two days, I will keep you updated.

Thanks everybody for reading this long post!

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Re: Pallina has been hospitalized: pancreatitis

Post by Lilith » Tue Jul 03, 2018 10:02 am

All best wishes and you have done your best and she's getting the best care ...

Hugs to you and your wife and fusses to Pallina, no cat could have more love and care, and all paws and tails crossed here for her speedy recovery. Purrs x

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Re: Pallina has been hospitalized: pancreatitis

Post by alanc » Tue Jul 03, 2018 11:31 am

Hope she continues to improve. Quite agree with you that hospital is the best place for her at the moment, much better to have expert care immediately on call. As you know, I have recently been in this situation with Tilly and know only to well what you a re going through. Best wishes for a speedy recovery to Pallina.

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Re: Pallina has been hospitalized: pancreatitis

Post by booktigger » Tue Jul 03, 2018 12:29 pm

I'm so sorry that she is so poorly - I'm sure my vet told me that SDMA is only classed as early stage CKD till 26. I am surprised that they didn't think too much of the jaundice. Fingers crossed she improves

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Tue Jul 03, 2018 12:39 pm

booktigger wrote:I'm so sorry that she is so poorly - I'm sure my vet told me that SDMA is only classed as early stage CKD till 26. I am surprised that they didn't think too much of the jaundice. Fingers crossed she improves
Do you mean that they should have addressed the jaundice some way? Any tip on this?
They said that given that liver levels, jaundice was expected, but said nothing on how to fix it apart from keeping an eye on her physical condition, treatment and meds.

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Re: Pallina has been hospitalized: pancreatitis

Post by booktigger » Tue Jul 03, 2018 12:41 pm

I've never dealt with jaundice, but thought they would have done something rather than thought it was to be expected. Maybe they just hoped the meds would work

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Re: Pallina has been hospitalized: pancreatitis

Post by Janey » Tue Jul 03, 2018 1:48 pm

Poor Pallina, sending get well wishes to her and hoping she’s home and feeling much better soon. (Re Metoclopramide, I once had that and it made me feel terrible, I just didn’t know where to put myself, it was kind of like restless legs but all over my body, I think it’s a common side effect, hopefully she didn’t feel like that, but glad she’s off it anyway just in case).

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Re: Pallina has been hospitalized: pancreatitis

Post by vanilla » Tue Jul 03, 2018 5:36 pm

Sorry to hear this. Sending over lots of healing hugs to Pallina xx

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Re: Pallina has been hospitalized: pancreatitis

Post by fjm » Tue Jul 03, 2018 7:13 pm

So glad to hear Pallina is feeling better - she is very lucky to have such a caring and careful human!

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Wed Jul 04, 2018 5:47 am

Pallina's home! :D

Yesterday after work I drove straight to the clinic (10 miles / 16 km from me) and when I got there they told me were going to release her, she was fine enough to go home. Too fine, in their opinion, because she had bitten them all :lol: :lol: :lol:
They told she had eaten good, no other signs that she was needing more treatments.
I wasn't prepared to that, they had told me she was going home on Wednesday, today, so I hadn't her carrier with me (she had peed inside it, I have still to clean it) so the vets lent me one of theirs, I'll return it today to a different practice close to home where one of them works on Wednesdays.

They left me a prescription for all the meds she needs at home.
Practically they confirmed the current therapy, they added the Ranitidine for her stomach and a supplement for her liver, something similar to Denosyl. It's a pill that I had given her for weeks a few months ago, but then I stopped when I noticed that it made her puke.
I'm trying it again, if she throws it up again I know I have to avoid it.
They also gave her an antibiotic for ten days (marbofloxacin).

As soon as we got home, she started asking for food, but then you know, she hardly ate something :?

I'll keep a close eye on her. They gave me an appointment in 30 days to re-check all levels... I think it'll be a long month!

Thanks for all your positive thoughts, really appreciated!!! ;)
Last edited by Antonio on Wed Jul 04, 2018 7:13 am, edited 1 time in total.

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Wed Jul 04, 2018 5:51 am

Janey wrote:Poor Pallina, sending get well wishes to her and hoping she’s home and feeling much better soon. (Re Metoclopramide, I once had that and it made me feel terrible, I just didn’t know where to put myself, it was kind of like restless legs but all over my body, I think it’s a common side effect, hopefully she didn’t feel like that, but glad she’s off it anyway just in case).
Pallina has to take Metoclopramide for a month, twice daily. So far she hasn't shown any side effect to it, but it seems it isn't doing her any good.

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Re: Pallina has been hospitalized: pancreatitis

Post by Janey » Wed Jul 04, 2018 6:34 am

So glad she’s home again and I hope she continues to do well :)

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Re: Pallina has been hospitalized: pancreatitis

Post by booktigger » Wed Jul 04, 2018 6:40 am

Glad she is home, do hope she eats and seems well in herself. Hope she tolerates the liver supplement this time.

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Re: Pallina has been hospitalized: pancreatitis

Post by alanc » Wed Jul 04, 2018 7:33 am

Glad she is back home. Naughty girl for biting the vets, Tilly would tell her it is much more productive to be cute to them!

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Re: Pallina has been hospitalized: pancreatitis

Post by Lilith » Wed Jul 04, 2018 8:06 am

So glad you've got her back and hope the meds do the trick.

Yeah, Emily bites too - I couldn't believe such an angelic cat was capable! :o Now if it had been Molly ... :lol:

Fusses and best wishes for a good recovery, get well soon Pallina :)

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Wed Jul 04, 2018 3:23 pm

alanc wrote:Glad she is back home. Naughty girl for biting the vets, Tilly would tell her it is much more productive to be cute to them!
I, too, didn't recognize her.
Usually she bites me at home when I try to handle her too much.
At the vets' she's so scared that she turns into a toy cat, they can turn her as they wish and they doesn't say a word or move an inch.
They would always tell me "Oh, you have such a lovely and quiet cat!" :D

This time she decided to make things clear :lol:

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Wed Jul 11, 2018 7:22 am

On last Friday we had a scare! :shock:

Pallina had just gone out in the backyard, supervised by my wife while I was in the kitchen preparing the dinner for the ferals. I heard a cat scream, I thought it was a fight between the ferals, but a few seconds later my wife ran inside with Pallina in her arms, still screaming and panting.
We laid her down and she was panting with her mouth open and her eyes open wide, breathing rapidly!

I was shocked and terrified. My wife told me that Pallina got near to an ivy plant, not sure whether she chewed on it, but I'm rather sure she didn't. After getting near to this ivy, Pallina threw up some stomach juices, screamed and fell on a side, that's when my wife picked her up and brought her inside.
In an absolute state of panic we watched her panting for a few seconds, then she calmed down and after a couple of minutes she slowly tried to stand up, but then again she laid in a different spot of the floor, with a troubled breathing...

My first thought was she had an heart attack and she was going to die! :shock:
The second thought was she had eaten some ivy, but the reaction was too sudden to be a poisoning, in my opinion.
The third thought was that she had stood in the heat outside, but my wife told me she was sitting in the shade. I put some wet clothes on her head, just in case.
Some minutes later she was walking again, she was slow and seemed a bit confused. And she started wandering in the house like she was looking for something. Then she started to visit her litter tray, at least 6 times in 45 minutes, only producing a tiny amount of pee two times. So, to me, it was clearly a problem with peeing.

I took her to the 24h clinic, the clinic where she goes regularly and where they know her well. It was 10 pm.
There was another emergency at the clinic, and once the vet assessed that Pallina wasn't in a real emergency, she let us wait for 2 hours!
The vet visited Pallina at midnight, she found nothing, apart from some gas in her bowels, no stools, but she said she was going to hold Pallina for the night, just in case. Her bladder was nearly empty, so the urinary issue wasn't an issue.
On the following morning I called them and they told me that Pallina was fine and could have been released in the afternoon. I picked her up at 5 pm.

For the following two days she was slow and sleepy. She wasn't meowing or purring anymore!
Then, on Monday she perked up a little and today she seems a bit more quick and alert.
What is true is that this episode left her weaker, she seems she has no energy to do the things she would do until the day before this event.
She is meowing again, though less often than before. And she is pooping again. The last time she had pooped was on Friday morning and she did nothing until Monday night. I was a bit worried.

The vet upped the dosage of Ursacol from half a pill to 3/4 of a pill (25 mg to 37 mg) per day.
I added a supplement broth used to restore pets who have gone through heavy surgeries or long and heavy therapies or that show no more interest in food. It is produced by Virbac, the name is Nutribound.

We'll have a check-up visit the first week in August. I'll have all tests done: complete blood works with thyroid included, heart scan, abdomen scan and whatever comes to my mind or advised by the vets.
Right now Pallina is doing better, she is finding her balance again, I wouldn't ruin this recovery with another visit.

That was a scare! :shock:

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Re: Pallina has been hospitalized: pancreatitis

Post by Lilith » Wed Jul 11, 2018 6:04 pm

OMG Antonio, hope she never does that again!

Stay well now, little Pallina x

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Re: Pallina has been hospitalized: pancreatitis

Post by booktigger » Wed Jul 11, 2018 6:06 pm

Poor Pallina, glad she is ok

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Re: Pallina has been hospitalized: pancreatitis

Post by alanc » Wed Jul 11, 2018 7:34 pm

Good grief Antonio, what a fright. At least when Tilly had her bad turn, she was already at the vets. Paws crossed Pallina continues to recover.

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Wed Jul 11, 2018 9:19 pm

This late afternoon I decided to change the schedule, I booked a heart scan for tomorrow at 6:30 pm.
There are signs in Pallina, like the tiredness, some lethargy, lack of appetite, the fainting, the fluids in her chest, the slight heart murmur that some vets had detected (first time in Belgium at the visit prior to the I-131 shot) that might lead to a bad diagnosis.
I hope it's not the case, tomorrow I will know!
Fingers crossed!

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Re: Pallina has been hospitalized: pancreatitis

Post by Mayday21 » Wed Jul 11, 2018 11:03 pm

Hi Antonio poor Pallina, she’s certainly going through some heath issues. She’s so lucky to have you & your wife looking after her. Fingers & 10 front paws crossed as well as lots of fusses for Pallina. Vivian & the Famous Five from Oz.

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Fri Jul 13, 2018 2:50 pm

Oops, where's my post? I had updated this thread two hours ago, now it's gone! :evil:

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Fri Jul 13, 2018 4:10 pm

I'll try and re-write my gone post! :evil:

Yesterday Pallina had a visit with the ultrasound specialist to have her heart checked.
The scan said that Pallina's heart is working fine, and that is a good news, but leaves us with no idea on what caused the fainting on last Friday.

The vet said that the strain for the vomit that Pallina had a few seconds prior to her passing off might have reduced her heartbeat for a short time and also reduced her breathing, so she collapsed due to hypoxia.
This could also explain her wandering in the house, she felt confused and didn't know where she was, and this also had her visit the tray for a few times.

Another idea is that she could have neurological issues, but these would be harder to detect.
In the case a similar episode happens again they would like to put a Holter recorder on her to monitor her heartbeat during 24 hours and see if there's a random arrhythmia. I hope it won't be necessary.

The suggestion the vet gave me was to buy a stethoscope and get familiar with Pallina's heartbeat when she's fine and relaxed. In the event of something, I should listen to her heart and see if something in her heartbeat is different.

That's all :)

Hopefully this time my post gets through! :evil:

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Re: Pallina has been hospitalized: pancreatitis

Post by Lilith » Fri Jul 13, 2018 6:47 pm

Good luck Pallina - you couldn't have better care and hope it's a temporary glitch x

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Re: Pallina has been hospitalized: pancreatitis

Post by Mayday21 » Fri Jul 20, 2018 9:31 pm

Hi Antonio how’s Pallina...sorry I’ve not been on the site as been rather busy & time/days disappear. Vivian

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Re: Pallina has been hospitalized: pancreatitis

Post by Antonio » Tue Jul 31, 2018 10:06 am

Mayday21 wrote:Hi Antonio how’s Pallina...sorry I’ve not been on the site as been rather busy & time/days disappear. Vivian
Hi Vivian, hi everybody, sorry for the long silence, but things here have been hectic!

Pallina had been hospitalized again on July 19th and released on 21st. She was sick again at home, but this time too they just put her on IV and some meds and did not run any blood test, though I had explicitely asked for it!
She came home on Saturday 21st in the evening, but on Sunday 22nd she was terribly sick again, and I had to rush her to the University Hospital, where they did a complete blood panel as soon as she was admitted, they did an ultrasound scan of chest and abdomen and eventually they hospitalized her.
I was able to get news daily at 1 pm and had a visiting hour every day at 6 pm.

There were days when she was rather alert and bright, other days when she was less playful.

The blood works say that her liver is compromised, her liver enzymes are through the roof, her bilirubin is 5.8 (where 0.26 is the maximum).
So they sent her home on last Friday, July 27th, and told me to wait for the inevitable. But... they didn't give me a valid diagnosis.

I'm not giving up!

She still has some good days. Part of Saturday and Sunday she was as quick and playful as a kitten, she even meowed, something she hadn't been doing since July 6th, the day when she collapsed.

She isn't eating on her own anymore, I'm syringe feeding her 4-5 times a day wit Royal Canin Recovery.
She's taking her meds (antibiotic Marbofloxacin, anti-nausea Maropitant) and her supplements regularly.
Unfortunately it seems that the anti-nausea isn't working... she threw up twice this morning...

In 4 hours time I have an appointment with a new vet in a new clinic, a place that I've been recommended.
I'm not giving up, but I'm very tired and weak. I have lost much weight myself, I'm sleeping bad, can't focus on anything, I'm scared, desperate.
And my bank account has been totally drained!

I will let you know what they will tell me today.

Thanks!

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Re: Pallina has been hospitalized: pancreatitis

Post by fjm » Tue Jul 31, 2018 11:43 am

I am so sorry Antonio - I hope there is better news today, but whatever happens you will know that you have done everything possible for her, and given her the very best life she could have.

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Re: Pallina has been hospitalized: pancreatitis

Post by booktigger » Tue Jul 31, 2018 12:20 pm

I'm so sorry to hear she isn't any better, please keep us posted on what the new vet says

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Re: Pallina has been hospitalized: pancreatitis

Post by alanc » Tue Jul 31, 2018 7:17 pm

Very sorry to hear the news about Pallina. Tilly sends purrs and we hope you get better news soon.

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