Pancreatitis?

RE: Pancreatitis?

Thomas Johnson — Fri, 29 Jul 2016 17:08:53 GMT

[quote user="Anthony Todd"]

[quote user="David Mills"]Shot of depo wouldn't go amiss in the short term whilst you trial diets etc.[/quote]

and

some evidence for out there for oral B12 in dogs

Crikey ,what goes around comes around, it's the Roberts/Norris "B12 and Betsolan" tango all these years later.

[/quote]

I think the debate here is whether oral supplementation of B12 is appropriate, or if it needs to be injected. My understanding is that traditionally it was throught that there was little value in oral B12 as if it was low the mechanism to absorb it was probably not working properly, but there now seems to be evidence that oral supplementation does work.

RE: Pancreatitis?

Anthony Todd — Fri, 29 Jul 2016 14:19:02 GMT

[quote user="David Mills"]Shot of depo wouldn't go amiss in the short term whilst you trial diets etc.[/quote]

and

some evidence for out there for oral B12 in dogs

Crikey ,what goes around comes around, it's the Roberts/Norris "B12 and Betsolan" tango all these years later.

Come on, not another one star, but you've gotta laugh...

RE: Pancreatitis?

Martin Atkinson — Fri, 29 Jul 2016 14:03:48 GMT

[quote user="Jenny Boyd"]Apparently kaminox has B12 in but I don't know how much.[/quote]1mcg/ml. The minimum recommended dose for cats is 125mcg/wk which equates to 17.85mcg/day = a lot of Kaminox! Although cats can tolerate high potassium doses I think that would cause a bit of an issue.

RE: Pancreatitis?

Jenny Harris — Fri, 29 Jul 2016 13:44:53 GMT

some evidence for out there for oral B12 in dogs, none for cats at the moment see recent paper-

Oral Cobalamin Supplementation in Dogs with Chronic Enteropathies and Hypocobalaminemia. L Toresson, JM Steiner, JS Suchodolski and T Spillmann. Journal of Veterinary Internal Medicine 2016:30:101-107.

so may be worth a try with oral if o can't manage the weekly visits for a month. Apparently kaminox has B12 in but I don't know how much.

RE: Pancreatitis?

Martin Atkinson — Fri, 29 Jul 2016 09:17:07 GMT

[quote user="David Mills"] Post-mortem "signs" are a surrogate outcome at best, 50% (of how many?) does not fit with clinical experience.[/quote]I can't remember where I saw the article but it was not a small number 50-60 perhaps. But the whole point is that it doesn't fit with our clinical experience because we are missing them or they are not being presented as its the 'cat has been off colour for a day or two then gets better just as they've decided to take it to the vet' scenario. I reckon if we sought we would find.

RE: Pancreatitis?

David Mills — Thu, 28 Jul 2016 22:46:28 GMT

Shot of depo wouldn't go amiss in the short term whilst you trial diets etc.

Pancreatitis in cats - jury out as to primary or secondary, I suspect the latter. Post-mortem "signs" are a surrogate outcome at best, 50% (of how many?) does not fit with clinical experience.

RE: Pancreatitis?

Ashlea — Thu, 28 Jul 2016 22:33:12 GMT

Thank you both, I had wondered whether pancreatitis could be occurring together with proximal small intestine inflammation but having only used the fPL test before I wanted to make sure before talking to the owner. Judging by the first consult she'll ask for every last bit of information she can wring out of me, so I don't want to make more work for myself than necessary! This is the first time I've used this particular lipase test too and had never heard of it before.

For vitamin B12 supplementation I've always used injectable, is there an oral supplement? The owner is disabled and regular injections are going to be very difficult to organise.

RE: Pancreatitis?

Jenny Harris — Thu, 28 Jul 2016 20:45:42 GMT

If money is an issue then I think B12 supplementation and changing diet to i/d, or poss z/d or d/d reasonable and likely to give good results. As I think spending money on things like ultrasound etc unlikely to change what you do at this stage with a cat that is otherwise well and in good body condition.

RE: Pancreatitis?

Martin Atkinson — Thu, 28 Jul 2016 19:22:22 GMT

I confess that I've not heard of DGGR lipase until now but have just quickly looked up some research which suggested it was a reliable and cost effective alternative to fPL. I understand that fPL is unreliable especially the SNAP test. Bear in mind that increase in pancreatic lipase may be caused by gut stasis (don't know how this would affect DGGR) and pancreatitis is often part of triaditis in cats so concurrent IBD is very likely and probably the presenting condition.

I also believe that pancreatitis is very under-diagnosed in cats with one report showing evidence of chronic pancreatitis in PM examination in something like 50% of cats which were investigated for other reasons which suggests a high rate of undiagnosed bouts of acute on chronic disease in this species and we see the tip of the iceberg. It would be wise to do some further investigation for lymphoma but the treatment for chronic pancreatitis is going to be largely dietary management anyway so in the absence of a specific diagnosis that's the way I'd head.