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Old January 25th, 2012, 10:14 AM
Longblades Longblades is offline
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Cholangiohepatits, CRF AND Now Pancreatitis Too

Sadie has been treated for Cholangiohepatits for about 10 years now. She's 16 and in early CRF and is at the Vet's this very moment (two night stay) with suspected, most likely, Pancreatitis. There is a mass in her abdomen which shows on X-ray; for the moment they are not sure but are hoping it is simply gas. She was mildly constipated and was given an enema. She was also on fluids to rehydrate her as she could keep nothing down and vomitted right after drinking.

She was in two months ago with the same symptoms, lethargy, vomitting, not eating, not bathrooming and it seemed to be resoved by the enema which was sorely needed. Constipation this time though was very mild. And this time she definitely has pain in her abdomen.

Sadie has long hair, we brush her daily but she still has hairballs. She will not eat hairball remedy.

She will NOT willingly eat canned food. She prefers kibble. We try to restrict the morning kibble so she will eat at least some of the evening wet food which has the Ursodial and the every other day 2.5 mg of Prednisone in it. She has lost 1/2 pound since November and should not lose much more weight. She now weighs 8 lbs. Sadie is fed Hill's CD, wet and dry. We have tried to switch to other foods and she has held out for so long that we gave up. As you know, it is very dangerous for cats to not eat as they can develop fatty liver disease and Sadie already has a compromised liver.

I know we have some pretty knowledgable cat ailment people on board. I'm wondering if anyone can suggest a food that will be good for all three of Sadie's ailments. The Vet has suggested the renal Hill's formula but it would not address the liver issue. I tried to add kidney support additives in powder form to her usual food, no go, she can tell and won't eat it. She also will not eat any treats I could conceivably put meds. in. Not real salmon, tuna or anything we've tried, which incidentally the other two cats both love.

We can bring her home tonight. The Vet wants one more, making it the third, day to observe her but they say she is much, much better this morning. Any suggestions would be gratefully accepted and perhaps we can discuss ideas with the Vet.
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Old January 25th, 2012, 07:22 PM
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sugarcatmom sugarcatmom is offline
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We have tried to switch to other foods and she has held out for so long that we gave up.
How did you introduce the other foods? The key with cats is to do it veeeerrrrryyyy slowly, allowing them to become familiar with the smell of the new food. One way is to start with just the teensiest amount of the new food and mix it thoroughly in with the old food. I'm talking really small, like the size of a pea. After a few days of eating that, increase the amount to the size of 2 peas. And so on. You'll likely waste a great deal of food during the transition (unless you have a dog or another cat that'll happily eat the remnants).

Some other methods to help switch a cat to better foods is explained in these videos:
http://healthypets.mercola.com/sites...et-part-1.aspx
http://healthypets.mercola.com/sites...et-part-2.aspx

I successfully converted my die-hard kibble addict using the method in the second video, where I would feed him 2 meals of a very precise amount of dry food but leave out canned food for free-feeding. Super slowly (over the course of many months), I decreased the amount of dry I gave him at mealtime.

And in case you want some other ideas, more links!
http://www.littlebigcat.com/nutrition/switching-foods/
http://www.catinfo.org/#Transitionin...o_Canned_Food_

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I'm wondering if anyone can suggest a food that will be good for all three of Sadie's ailments.
Yup, low-carb good quality wet food .
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Old January 25th, 2012, 07:40 PM
Longblades Longblades is offline
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Thanks, I'm going to look at all of those. In order to keep things short I did not say that about 4 years ago we did manage to transition to a Wellness wet food, though she still preferred kibble. We also managed another brand of kibble though I don't remember what it was. It sent the bilirubin levels back up and we had a liver scare once again. At this point, as she is thriving on the CD, I would be happy if I could only get her to eat the wet. But I will read and watch.

She is home, happy, much better. We still aren't sure of the mass in the abdomen, hoping it is gas. We are going to give sub-q fluids twice a week to keep her hydrated. She will also get a stool softener once a day, that'll be fun, it is to be squirted into her mouth.
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Old January 25th, 2012, 10:44 PM
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about 4 years ago we did manage to transition to a Wellness wet food,
I wonder if a lower fat wet food would be better. I know Wellness is really quite high in fat (around +60% of calories, depending on flavour). Weruva and Merrick are much more reasonable in that department (30-40% fat calories).

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She is home, happy, much better.
Glad to hear it! Crossing my fingers that whatever that mysterious thing in her abdomen is turns out to be insignificant.

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She will also get a stool softener once a day, that'll be fun, it is to be squirted into her mouth.
Do you know what the stool softener is? Some are pretty harsh and rather traumatic to administer. I'd be inclined to try something like slippery elm bark or aloe vera juice first.
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Old January 26th, 2012, 09:30 AM
Longblades Longblades is offline
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I wonder if a lower fat wet food would be better. I know Wellness is really quite high in fat (around +60% of calories, depending on flavour). Weruva and Merrick are much more reasonable in that department (30-40% fat calories).



Glad to hear it! Crossing my fingers that whatever that mysterious thing in her abdomen is turns out to be insignificant.



Do you know what the stool softener is? Some are pretty harsh and rather traumatic to administer. I'd be inclined to try something like slippery elm bark or aloe vera juice first.
The stool softener is lactulose syrup. The biggest danger I could find by googling is dehydration from diarrhea if too much is given. Do you know of other dangers? I did read it is contraindicated for diabetic cats but Sadie is not diabetic. That's all I found.

It's hard when we go to the Vet for something we have not experienced before and did not anticipate. It's a hour round trip just for the drive and once there I don't have time to say, wait, I want to read up on that first. It's usually better to buy their stuff while I'm there, then look it up.
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Old January 26th, 2012, 01:29 PM
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The stool softener is lactulose syrup.
I think one of the biggest issues with Lactulose is trying to get it in the cat. They don't tend to be big fans of it and you and/or the cat will often end up wearing much of it. Miralax would be easier (supposedly tasteless - and not as sticky).

You also might want to add extra water to the canned food she's eating. Since Lactulose is an osmotic stool softener, it pulls moisture into the intestines from the rest of the body. If the constipation is caused by dehydration in the first place (and that's often the case in CRF situations), then Lactulose could make the dehydration worse whether there's diarrhea or not.

There's some good info at this link on constipation and various treatments for it: http://petdiabetes.wikia.com/wiki/Constipation
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Old January 26th, 2012, 03:55 PM
Longblades Longblades is offline
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Sadie had the first dose of Lactulose today. The first dose is always easy. I'd love to have her get her hydration from her food and her water, she does drink water, and get her off this stuff. Right now she is not yet 100% back to normal, only eating a small bit.

One trick I've never tried is to put her food in one of the other cats' spot. You know how they think the other one is getting something better, even if it is exactly the same thing. This will take some watching but because of the dog we do have gates on the kitchen and one on a room downstairs. We realized they came in handy for a dirty, wet dog as well as a puppy and never took them down.

I have tried to moisten both her canned food and her kibble previously. With home made chicken broth no less, with no salt in it, no fat, just good stuff. No go. The other critters love it of course.
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Old January 26th, 2012, 06:21 PM
Longblades Longblades is offline
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OK, just back to report, I've read all those articles. We don't free feed and we do exercise portion control. With three cats and a dog and Sadie needing her meds in what little of the canned we can get into her it is a must. Otherwise the wrong critter is getting the wrong food. And that has happened and it irks me immensely that the two cats and the dog who do not need any meds think Sadie's taste fine. Arrgghhh.

Thank you for all the ideas, I'm still researching.
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Old January 26th, 2012, 06:45 PM
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And that has happened and it irks me immensely that the two cats and the dog who do not need any meds think Sadie's taste fine. Arrgghhh.
Isn't that always the way?!?! My old guy gets various supplements in his food (including heart meds!), and of course the 3 youngsters are always trying to nom his meals out from under him.
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Old February 29th, 2012, 09:01 AM
Longblades Longblades is offline
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Thought I would update in case it gives anyone else hope and just because we are so happy. Sadie is doing very well. We have had a major breakthrough in the diet and got her to eat canned only. YAY!

A chance remark at the Vet's about her eating recovery food started it. I asked for a can to take home. She likes it and we were able to get her onto he regular canned by mixing smaller and smaller amounts of recovery in with her CD (urinary tract) stuff. Sadies' ailments are not really in her tummy. Some secondary troubles there, yes, but it derives from her liver and she was never sent home on a recovery diet before.

We have tried to cut out the stool softener but she still needs it as well. I have lessened the dose though. It's not all good, I'm pretty sure I notice some hearing loss now. Ageing is not fun, not as a participant nor as an observer.
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Old February 29th, 2012, 01:04 PM
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That's such good news, Longblades!! I'm glad she's doing so well!
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