Dick Ballard wrote:

We went through a fatty liver/pancreatitis episode several years ago
with a then 13 year old cat. The vomiting clear or yellow fluid, not
eating, withdrawal, postures and behavior suggesting pain, all too
familiar. The vet even did an exploratory surgery. Internal organ
appearance suggestive of pancreatitis but nothing definitive.

Yeah. That's the problem I have with this. There appears to be no real
way to diagnose the problem except by "heuristic" analysis, i.e. making
a good guess after ruling out other possibilities.

After we got him back in shape with tube feeding and prednisone for
several weeks, he gradually recovered. He has been on prednisone, and
later prednisolone, ever since. He now gets 5 mg every other day.

Ok, here's where I am getting conflicting information. I have read
several news articles which reported success with using prednisone to
address a "probable" but inconclusively diagnosed pancreatitis.
However, my vet as well as several web sites and other articles strongly
discourage the use of prednisone in the event of pancreatitis. When I
mentioned the possibility of trying steroids to my vet, she declined
"because the cat may have pancreatitis".

Why do these conflicting opinions exist? Would I be crazy to suggest to
my vet that we try a small dose (5mg) to see how the cat responds? I'm
curious what sort of corticosteroid interaction would be required to
negatively impact a pancreatitis attack. Can the dosage be kept low, or
is it the mere presence of the steroid that causes problems?

About a year ago I tried tapering off the med and then dropping it.
But within a few weeks he started going down again. So we're resigned
to giving him a pill every other day for the rest of his life. We
still have no idea of the origin of this malady.

He is now 17 and leads a pretty normal life, although he is badly
spoiled and neurotic. That's partly his original personality, but also
can be blamed on the attention he necessarily got while he was so
sick.

Pnut is pretty neurotic to begin with. Your post gives me a great deal
of hope, but I hope some others chime in with their opinions before
tomorrow.

Thanks!