Image from https:\/\/veteriankey.com\/pancreas-4\/<\/figcaption><\/figure><\/div>\n\n\n\nOnce we understood what was going on and that Herc did not have any other underlying issues that we need to deal with (like cancer or IBD) we got some more of the I\/D food and started the healing process again, anxious awaiting the coveted 90-days where we could breath easier.<\/p>\n\n\n\n
Managing Chronic Pancreatitis – 2019 + 2020<\/h2>\n\n\n\n
While Herc hadn’t had a full on flare-up of acute pancreatitis since April of 2016, there were many instances where we would notice softer stools or vomiting without a hairball. In those cases we would either use Fortiflora for a few days and monitor, or give Hercules a Cerenia and monitor. We always had a supply on hand in the event that Herc would have a flare-up.<\/p>\n\n\n\n
During the few instances where we would be away for more than 24 hours and need someone to come by and feed the cats, we had a list of all the “What to look for” signs in Hercules, instructions on meds, vet numbers and emergency contacts in the event Herc got sick. Thankfully he didn’t have any acute flareups after his ultrasound.<\/p>\n\n\n\n
Feline Pancreatitis Attack #4 – December 2021<\/h2>\n\n\n\n
Hercules turned 13 in 2021 and he was my ‘old boy’. As his birthday rolled around, I would find myself saddened by the thought of wondering what Herc’s final years would be like. Would he end up diabetic due to his weight? Would he be immobile from arthritis? Would he just loaf somewhere all day and we would need to carry him everywhere as proper peasants would – uh, I mean pet owners? Herc was my baby and the thought of being without him was simply too much to bear. In all my anxieties; however, I never thought that pancreatitis is what would be Herc’s final chapter. <\/p>\n\n\n\n
Up until this point, I did a reasonable amount of research about feline pancreatitis but noticed that there was very little out there on the internet. I found some basic resources to understand the disease in it’s acute phase but I never took the time to understand how<\/em> pancreatitis can set the stage to take a life.<\/p>\n\n\n\nThe story is more detailed here; but the summary is this:<\/p>\n\n\n\n
Hercules vomited on Monday afternoon, we anticipated another flare of up acute pancreatitis and gave him antinausea meds and I\/D food. We made a vet appointment for the next day for a checkup. He ate breakfast the next day without vomiting so that was a great sign! The checkup was unremarkable and we were given more meds and told that we caught it early and to keep doing what we were doing. That night, things changed quickly.<\/p>\n\n\n\n
Hercules regressed and no longer wanted to eat – not even Temptations or Churu. He threw up after the administration of medication and a significant<\/em> amount of liquid (for size reference, the puddle on the floor was larger than a dinner plate) that was not only yellow in colour but incredibly foul smelling. As the sun was about to rise and the vet clinic about to open, I noticed some open mouth breathing and while I know that’s not a good sign I also recall having seen it in the week or so prior for very short amounts of time. I had actually wondered is Herc was becoming asthmatic as I would see him do that after moving. It was only a few breaths and went away – same as that night. We ended up at the vet office as the first patient to arrive. Being COVID times, I then drove home and anxiously awaited a call from the vet with news.<\/p>\n\n\n\nI don’t recall how many times the vet phones – it was 2 or 3 and with each phone call things were looking more dire. One of the first call came in with a description of Herc’s vitals. He was breathing rapidly (tachypnea) and now had a fever. The doctor recommended and an x-ray and bloodwork and if that wasn’t conclusive then to consider an ultrasound. (Thankfully the ultrasound tech was going to be in that day – a true stroke of luck). We gave the ok for all of that. <\/p>\n\n\n\n
The bloodwork wasn’t promising – lymphocytes, eosinophils and PCT were low. His creatinine was high and his lipase was through the roof. The bloodwork, with combined with the presentation of a fever, could indicate an infection or severe immune response and the high lipase and creatinine were indicative of pancreatitis and the creatinine could indicate some kidney issues, shock or dehydration.<\/p>\n\n\n\n
The focus: Find out why he’s having an immune response or where the source of an infection may be. <\/p>\n\n\n\n
Was an infection triggering the pancreatitis? If so – we wouldn’t be able to address the pancreatitis unless we fixed the infection. Was the pancreatitis causing<\/em> an infection? We needed to learn more.<\/p>\n\n\n\nThe x-ray results came in. The x-rays hosed aerophagia, which is air in the stomach, as well as a significant amount of liquid in his stomach. There was also some increased desnsities with busy looking interstitial patterns in his lungs near his heart and in the middle lobe of the right lung. Despite these densities, no edema or effusion was present (water between the layers of the lungs or around\/on\/in the lungs). <\/p>\n\n\n\n
We needed to keep looking so the ultrasound was performed. His pancreas was difficult to visualize and delineate. There wasn’t a “clear edge” to the pancreas the way there would normally be. This can indicate that the organ is breaking down. The pancreas also showed several substantial nodules. There were other areas of inflammation within his abdomen but his pancreas was in rough shape – the ultrasound was indicative of exceptionally advanced pancreatitis.<\/p>\n\n\n\n
The decision we faced<\/p>\n\n\n\n
Once all the information was presented, this is what we knew:<\/p>\n\n\n\n
- Hercules had pancreatitis<\/li>
- There was an infection present – likely sepsis<\/li>
- There was air and fluid accumulating in his stomach<\/li>
- There were areas of concern in his lungs<\/li>
- He was dehydrated and nauseous<\/li>
- He likely was in absolutely tremendous pain<\/li><\/ul>\n\n\n\n
While we knew that these issues were present, we didn’t know the why<\/em>. Why did he have gas and liquid in his stomach? Was that somehow caused by pancreatitis? What about the issue with his lungs? There’s no way that<\/em> could have been pancreatitis, could it? That sounded outrageous.<\/p>\n\n\n\nWe were left with a few possibilities to consider:<\/p>\n\n\n\n
- Everything was due to the pancreatitis – if we could fix the pancreatitis then we may<\/em> be able to fix the damage the attack had done to the other organs
- There’s no guarantee it’s even from<\/em> pancreatitis<\/li>
- There’s no guarantee or even any indication of how “fixable” the situation is<\/li>
- Even if he made it through in the short term, the likelihood of severe damage to his pancreas would be substantial (which would be diabetes + pancreatic enzyme insufficiency – so more meds for the rest of his life)<\/li>
- There’s no guarantee that another flare it wouldn’t happen in a few days or weeks<\/li><\/ul><\/li>
- Everything was due to something else, other than pancreatitis – but that the pancreatitis flared up because<\/em> of this other problem – possibly cancer
- If Herc had IBD which became lymphoma or if he had a form of quick and aggressive adenocarcinoma, it’s possible that the inflammation from that induced<\/em> pancreatitis<\/li>
- It’s also possible that the issues with his stomach and lungs were a result of metastasis <\/li>
- There was no guarantee that this was cancer, though – just a working theory<\/li>
- Even if we tried to treat the pancreatitis and made it through this, we would then have to treat the cancer<\/li>
- Cancer that is that far advanced<\/em> upon clinic presentation would not have a positive outcome or one that would provide us any significant amount of time together<\/li><\/ol><\/li><\/ol>\n\n\n\n
Given those two horrible scenarios, we discussed what “treating it” would look like – and regardless of the underlying issue being pancreatitis, cancer or another issue that wasn’t discussed, Hercules would need an esophigastric feeding tube (a tube that goes into the side of his neck and into the stomach) as a means of draining the fluid that is accumulating and feeding him. Without getting calories in, Hercules was facing hepatic lipidosis which is almost always fatal. After the feeding tube, Hercules would require significant IV fluids, anti-inflammatory medication and pain medication. He would need to be monitored ideally in an ICU setting or be transferred back and forth from the emerge clinic to the main vet each night as the emerge clinic provides overnight care.<\/p>\n\n\n\n
This would have been a minimum of $10,000 just for care in the days ahead – this wouldn’t include the follow up care necessary including additional ultrasounds in the coming weeks. I didn’t have that kind of money, but if there was any reasonable chance of survival and a good quality of life post-survival, I would have found a way to get the money. The reality of the situation was, however, that the prognosis was grim. <\/p>\n\n\n\n
I didn’t want to say the words. If I said the words out loud then it would make it so much more real.<\/p>\n\n\n\n
But I had to say the words.<\/p>\n\n\n\n
“We need to let him go to the bridge.”<\/p>\n\n\n\n
And with that, we made a final trip out to the vets office to be with Hercules one last time. I held him in my lap, his body just flopping over me, his eyes staring off into the distance. With Hercules’ arch nemesis (Rebecca) next to me, I consented to the procedure and gave Herc a selfless gift. I let him go to the bridge.<\/p>\n\n\n\n
Unanswered questions<\/h2>\n\n\n\n
Hercules was gone now and the grief in the room was palpable. Myself, my husband and Rebecca were feeling the shock of having gone through such a whirlwind of events. In just over 12 hours, Hercules went from “he’s doing fine – we’re managing like we always have” to crossing the rainbow bridge.<\/p>\n\n\n\n
I had so many questions. I needed to find answers to them.<\/p>\n","protected":false},"excerpt":{"rendered":"
Hercule’s Pancreatitis Story This page will share, in detail, what we went through with Hercule’s pancreatitis over the years. The story does not have a traditionally happy ending – Hercules did end up crossing the rainbow bridge – but in sharing his story and what we have learned, we hope to provide others with resources…<\/p>\n","protected":false},"author":1,"featured_media":120,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"spay_email":""},"categories":[19,17],"tags":[],"yoast_head":"\n
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