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Cat Forum / Health and Behavior / June 2005Managing pancreatitis
I have a 15 year old kitty who has been dealing with chronic pancreatitus for almost one year now. We have had pretty good success by managing it through Prescription Diet (I/D) and daily prednisone ingestions. We do not why he started having this problem but for the most part he is healthy and most of his issues are age related and nothing too serious. I am looking for advice from any other cat owner who successfully has managed this. Is there anything that you have noticed that are triggers or seem to help more than others? He generally has bouts with it about every 6-8 weeks. We will be starting to do some pain management with him when he does go through the cycle and we have anti-vomiting injections that we can give him when things get out of hand. It can be frustrating in a way because it seems that this disease is faily common but there is nothing really specific to treat it. Any advice is appreciated. You say you are feeding i/d. Both the dry and canned i/d contain over 30% carbohydrates, which is way too much and can put stress on an already compromised pancreas that wasn't evolved to process a lot of carbs to begin with. Pouring what amounts to sugar into a cat just adds fuel to the fire. Also, pancreatitis is often secondary to inflammatory bowel disease, which is also exacerbated by grains (especially corn) in the diet. You can read more about grains in the cats diet here (and make sure to take a look at the last paragraph): http://www.felinefuture.com/nutrition/grains.php Cats are carnivores and should not be eating dry food filled with grains. Just as an illustration, diabetic cats (another health issue where the pancreas is compromised) that are fed a high quality, low carb canned cat food usually have dramatically reduced insulin needs, and in many cases cats go off of insulin completely once switched to a *species appropriate* diet (high protein, low or no carb). You should check out http://www.catnutrition.org for some excellent reading and also this article: http://catsincanada.com/articles/feeding.html If this were my cat I'd switch to a high quality canned food that contained NO grains and a *low* carb content. There are a few flavors of Wellness that fit the bill (Beef & Chicken, Turkey, Turkey & Salmon), and none of the flavors in this line of food contain grains. Nature's Variety is another food that has no grains. I have a cat that had a severe bout of pancreatitis years ago and was hospitalized for 11 days. I switched her to canned food and she has had no issues since (and is 15 years old now.) Obviously the food you're feeding now is *not* helping if he's been having chronic problems for a year, and at this point you have nothing to lose by trying something else. Take some time to read the links I've provided. Megan  Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray > You say you are feeding i/d. Both the dry and canned i/d contain over > 30% carbohydrates, which is way too much and can put stress on an > already compromised pancreas A high-carbohydrate diet puts *less* stress on the pancreas. Protein and fat are much more potent stimulants of pancreatic secretion than carbohydrates. http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00120.htm http://www.marvistavet.com/html/body_pancreatitis__feline_.html You have your organs mixed up. Its the feline *liver* that can't handle large carbohydrate loads. Phil wrote: >A high-carbohydrate diet puts *less* >stress on the pancreas. Protein and fat >are much more potent stimulants of >pancreatic secretion than carbohydrates. I saw nothing in either of the links you posted that said protein is an issue and haven't found anything on several other sites that says that either. However *fat* is consistently point to as the main factor. You yourself have said "Fats are more digestible and utilized better by cats than carbohydrates." So why recommend high carbs to cats that already aren't built to process them well and much less so than fat? It doesn't make sense, especially for an animal that has no dietary need for carbohydrates and thrives without them. From what I've read most of the info available on pancreatitis is WRT dogs (which can handle high carb diets) and very little is known about pancreatitis in cats. I think the dietary recommendation for high carb/low fat is mostly because that's what they use for dogs, and the reading I did suggests that as well. The following quotes are from an *internal medicine specialist* and contradict both the dietary recommendation for treating cats and also point to "low protein" being a factor in the development of pancreatitis. From: http://www.michvet.com/articles/internal_medicine/pancreatitis_092003.asp "The inciting cause of spontaneous pancreatitis is usually unknown. There is evidence that low-protein, high-fat diets may induce pancreatitis, and that pancreatitis is more severe in pets being fed high-fat diets." "The cause of pancreatitis in cats is poorly understood. Some cats may experience single episodes of pancreatitis, whereas other cats have continuing relapses. "The role of dietary therapy to control pancreatitis in cats is in doubt." Add to that the issue with pancreatiis often turning into diabetes, which is also often caused and certainly exacerbated by feeding a high carbohydrate diet. I certainly wouldn't want to put this cat at even more of a risk for developing diabetes along with everything else. It seems apparent from the OP's description that the cat probably has pancreatitis secondary to IBD. If the OP can get the IBD under control it seems likely that the pancreatitis will resolve. If this were my cat I would immediately start supplementing with pancreatic enzymes such as Viokase to help aid digestion and a good nutritional supplement like Nu-cat, put it on a *grain-free* homemade diet tweaked to contain lower fat levels (but not lower protein) and see what happens. Megan Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray Phil wrote: >>A high-carbohydrate diet puts *less* >>stress on the pancreas. Protein and fat >>are much more potent stimulants of >>pancreatic secretion than carbohydrates. >I saw nothing in either of the links you posted that said protein is an issue and haven't found anything on several other sites that says that >either. However *fat* is consistently point to as the main factor. You need to do more research- real research... try veterinary medical *texts*. >You yourself have said "Fats are more digestible and utilized better by >cats than carbohydrates." They are- for *normal* cats. Fat, and to a lesser extent, protein, stimulate pancreatic secretion- which is exactly what you *don't* want in a cat with pancreatitis. <snip> Phil wrote: >You need to do more research- real >research... try veterinary medical >*texts*. I have The Feline Patient for one, which is a veterinary medical text, and that as well says nothing about protein or carbs and recommends low *fat* for *acute* pancreatitis and no dietary therapy recommendations other than administration of pancreatic enzymes for cats with *chronic* pancreatitis, which is what this cat has. It also underlines the fact that most cats with the chronic condition also have IBD, etc. It stands to reason that, since this is common, that treating the IBD, etc. will help control the secondary issue. I also see you conveniently snipped the quotes from the article that backs me up: "There is evidence that low-protein, high-fat diets may induce pancreatitis, and that pancreatitis is more severe in pets being fed high-fat diets." "The role of dietary therapy to control pancreatitis in cats is in doubt." The practice quoted has *4* Diplomate ACVIM, board certified internal medicine specialists. They know what they're talking about. Megan Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray Phil wrote: >You need to do more research- real >research... try veterinary medical >*texts*. >I have The Feline Patient for one, which is a veterinary medical text, Its more of cheap, light manual than a veterinary medical text. >and that as well says nothing about protein or carbs Better buy a better one- The Feline Patient doesn't mention *anything* about diet- other than "When feeding is resumed, small, frequent meals should be offered", p 360. Try Consultations In Feline Internal Medicine Vol. 3 p97: "protein and fat augument pancreatic stimutation" >and recommends low *fat* for *acute* pancreatitis and no dietary therapy recommendations other than administration of pancreatic enzymes for cats with *chronic* >pancreatitis, which is what this cat has. Yeah, and what do plan to use to fulfill the cat's daily caloric requirement if you can't use fat? All protein???? LOL! >It also underlines the fact that most cats with the chronic condition also have IBD, etc. It stands to reason that, since this is common, that treating the IBD, etc. will >help control the secondary issue. >I also see you conveniently snipped the quotes from the article that >backs me up: Really? Seems like your reference backs *me* up and discounts you! LOL! "The preferred diet initially is a high carbohydrate low fat food. This type of diet is less likely to stimulate pancreatic enzyme secretion. " http://www.michvet.com/articles/internal_medicine/pancreatitis_092003.asp You might want to try reading that which you reference before you cite it! >"The role of dietary therapy to control pancreatitis in cats is in >doubt." ...but low-fat, carb-rich diets have been working splendidly for cats with pancreatitis for years. So, just for the records, you don't recommend low-fat, carb rich diets for cats with pancreatitis? Is that correct? Phil wrote: >You need to do more research- real >research... try veterinary medical >*texts*. >I have The Feline Patient for one, which is a veterinary medical text, and that as well says nothing about protein or carbs and recommends low >*fat* for *acute* pancreatitis and no dietary therapy recommendations I don't have time to cite every veterinary medical text in my library- so I'll just cite the top of the top shelf texts- Kirk's Current Veterinary Therapy (vol 13, p. 702- Feline Exocrine Pancreatic Disease)- which is the most highly respected veterinary medical text in print: "After this time, water is reintroduced slowly, followed by small amounts of a carbohydrate-rich, low-fat diet (e.g., Purina CNM OM-formula or Hill's feline w/d)." Authors:: David A. Williams, M.A., Vet. MR, Ph.D., M.R.C.V.S., Dipl. A.C.V.I.M. Professor and Head, Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, Texas Jorg M. Steiner, Dr. Med. Vet. Clinical Investigator, Gastrointestinal Laboratory, Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, Texas Phil wrote: >You need to do more research- real >research... try veterinary medical >*texts*. >I have The Feline Patient for one, which is a veterinary medical text, >and that as well says nothing about protein or carbs For the benefit of others, I wanted to explain how protein and fat stimulates pancreatic secretion, but I couldn't remember in which text I read it- I finally found it. Saunders Manual of Small Animal Practice 2nd. ed. p.886 "Food (especially fats and proteins) stimulates pancreatic secretion through cholecystokinin (CCK) release. Even fluids can stimulate pancreatic secretion through gastric distention and release of gastrin. When vomiting has ceased for ~24-48h, offer small amounts of water PO. If water is tolerated, then gradually reintroduce food, initially using a carbohydrate diet (e.g., rice, pasta) restricted in fat and protein to minimize pancreatic stimulation. Then gradually resume normal maintenance feeding of a balanced, moderately fat-restricted diet." Authors: Robert Sherding, D.V.M., Dipl. A.C.V.I.M., Professor of Small Animal Internal Medicine, Ohio State University; Susan Johnson, D.V.M., M.S., Dipl. A.C.V.I.M.; Stephen J. Birchard, D.V.M., M.S., Dipl. A.C.V.I.M. >Its the feline *liver* that can't handle >large carbohydrate loads. When an already compromised pancreas has to work even harder to produce insulin to manage the onslaught of carbs being poured into the body it *is* going to put more stress on it. C'mon Phil. You've seen what happens when you dramatically lower or eliminate carbs in a diabetic and the diabetes then resolves. This is not rocket science. Megan Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray > >Its the feline *liver* that can't handle > >large carbohydrate loads. > > When an already compromised pancreas has to work even harder to produce > insulin to manage the onslaught of carbs being poured into the body it > *is* going to put more stress on it. You *really* need to do more research. Low-fat, *carb-rich* diets have been the mainstay of pancreatitis treatment in cats for *years* precisely because carbs put *less* stress on the pancreas and minimize pancreatic secretions. > C'mon Phil. You've seen what happens when you dramatically lower or > eliminate carbs in a diabetic and the diabetes then resolves. This is > not rocket science. We're talking about *pancreatitis*. When the inflammation subsides, islet cell function returns. > > >Its the feline *liver* that can't handle > > >large carbohydrate loads. [quoted text clipped - 13 lines] > We're talking about *pancreatitis*. When the inflammation subsides, islet > cell function returns. It's pathetic that Megan will not concede when she is wrong even though it is clear that following her advice would be harmful to the cat in question. When your ego begins to get in the way of your alleged devotion to the welfare of cats it is time to take a long, hard look at yourself, Megan. > I have a 15 year old kitty who has been dealing with chronic > pancreatitus for almost one year now. We have had pretty good success [quoted text clipped - 10 lines] > this disease is faily common but there is nothing really specific to > treat it. Any advice is appreciated. r/d or w/d are much better choices for pancreatitis than i/d. I've had the best luck with r/d because it contains less fat. A pancreatitis diet should have a low-fat and high carbohydrate content because fat is a more potent stimulant of pancreatic secretion than carbs. r/d isn't very palatable, so, mixing in a little catnip and sprinkling a little over the food does wonders! About vomiting: You should speak to your vet about withholding food for about 12 hours to rest the pancreas. Then begin feeding by offing small amounts of water. If the water is tolerated, try offering a low-fat, high-carbohydrate food. You should also monitor his blood sugar. Cats with pancreatitis can develop diabetes because during the inflammatory process extensive islet destruction occurs. Best of luck, Phil >>I have a 15 year old kitty who has been dealing with chronic >>pancreatitus for almost one year now. We have had pretty good success [quoted text clipped - 10 lines] >>this disease is faily common but there is nothing really specific to >>treat it. Any advice is appreciated. My cat Jasper had one bout with pancreatitis and no flare ups since. I got advice from the good folks on this list and I am also very happy with my vet. Just FYI...the food Jasper is on now is Eukanuba Low Residue diet. It is a prescrption diet and costs about 1$ a can. Ask about that at your vet maybe? Jasper seems to gobble it up with no problem. Pam > >>I have a 15 year old kitty who has been dealing with chronic > >>pancreatitus for almost one year now. We have had pretty good success [quoted text clipped - 18 lines] > > Pam Euk Low Res is an excellent diet for managing pancreatitis, its a low-fat/high carbohydrate diet. Thanks for mentioning it. Phil Hi there, We had a cat who had pancreatitus. What a tough thing for them. Our cat always got super-high fevers during an attack and was hospitalized with IV's. We went to a specialist. The internist vet said many times IBD is at the root of the problem, sometimes bacterial infections can cause pancreatitus, or Bob's could have been because he had diabetes and the pancreas was just not working well in general. We did find he had a massive mouth infection -- he ended up having six teeth removed. That could have contributed, we will never know. He did have an attack or two after that. It started to seem to feel worse when he ate dry food. We fed him IVD, a novel protein food with few ingredients. Food allergies was one suspect. We switched eventually to Waltham's (Petsmart's veterinary brand) of novel protein. Bob liked duck. After six months of attacks, tooth surgery, etc., he was okay. He lived another year with no pancreatitus flare-ups -- and it was a great year! We eventually lost him to cancer. The internist said the best way to treat pancreatitus is to fast so that no food is being processed. She does this in dogs, but cats cannot be fasted, so we did the "which food is least harmful" dance. He was on some antibiotics during flare-ups. I forget the name but it was also supposed to help with inflammation. Otherwise, he was not on any medication. I would be a bit concerned about your cat on a steroid when there is a pancreas problem -- steroids are what triggered our cat's diabetes. His pancreas was probably just waiting for a trigger, but I personally would do lots of checking before I ever gave that to one of our cats again. I am not a vet, but maybe that's a topic to revisit with yours. Good luck! Rhonda > I have a 15 year old kitty who has been dealing with chronic > pancreatitus for almost one year now. We have had pretty good success [quoted text clipped - 10 lines] > this disease is faily common but there is nothing really specific to > treat it. Any advice is appreciated. Thanks for the information. I suspect that possibly at some point he had a mouth problem. George also had 6 teeth removed the year before he started having problems although there was never a trace of infection found. We have ruled out IBD, infections and diabetes. He goes to the vet every 3 months for progress visits so we can keep up to date with the prednisone and check his weight. I have had suspicions about food allergies but he is so finicky that playing with food was never a win/win. Dehydration is a huge concern and since the prednisone is an appetite stimulent he will eat even when he doesn't feel good. The last time he ended up in the ICU was because he stopped eating. I will look at some different food options, maybe the i/d isn't the best choice. It's just always difficult to get him to eat new things. Good luck to you! I know the food problem. Our pancreatitus cat would sometimes just stop eating and would not look at that particular food again. The internist vet explained that cats will develop food aversions. If they don't feel well -- they blame the food. Luckily, IVD had a few different flavors of novel protein that we could try when Bob gave up on one. Hope you and the vet are able to get him under control! Our vet also told us that once they have a bout of pancreatitus, it changes the lining of the pancreas -- making them more susceptible to another bout. I was VERY happy that Bob had a year of no flare-ups. We found the right food combination for him. Rhonda > Thanks for the information. I suspect that possibly at some point he > had a mouth problem. George also had 6 teeth removed the year before [quoted text clipped - 9 lines] > isn't the best choice. It's just always difficult to get him to eat > new things. > Thanks for the information. I suspect that possibly at some point he > had a mouth problem. George also had 6 teeth removed the year before [quoted text clipped - 9 lines] > isn't the best choice. It's just always difficult to get him to eat > new things. Its very important he keeps eating because pancreatitis can quickly lead to hepatic lipidosis. Many cats with pancreatitis also develop concurrent HL. In these cases, nutritional support to treat or prevent HL overrides NPO therapy for pancreatitis. If he stops eating, you should seriously consider alimentation via gastrostomy (PEG) tube or even a nasogastric tube. Sometimes just a few days of nasogastric tube-feeding is enough to jump start a cat's appetite. Dehydration can be avoided with simple SC fluid therapy which you can do at home very easily. The fluid, venosets and needles are very inexpensive. Your vet can show you how to administer fluids in about 15 minutes. There are also several people in this group that have a lot of experience in fluid therapy who would be happy to guide you along. As far as acclimating George to a new diet, you can help things along by smearing a dab of the new food on his nose (not near his nostrils)- the smell will satiate his olfactory system and licking it off will satiate his gustory system so the food will seem a little more familiar to him. You can also smear a little food on his belly and paws- this will also get him to eat it and make the food seem familiar. A little sprinkle of catnip on the food does wonders, too. Best of luck, Phil |
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