Diabetes and CKD-What to use when Pepcid doesn't work?

[Robyn and Penny]

Hi everybody! My Penny is in kidney failure...she was end-stage when she was originally diagnosed but after three weeks of home sub q fluids daily and an emergency dental, her numbers went dramatically down to Stage 3. She's due for blood work again the first week of May. Overall she's doing well, besides having trouble with stomach acid. She's eating her normal amount, has only lost a couple of ounces since her diagnosis (today she weighed in at 15lb 3oz - She's a Maine Coon), but she IS a social eater, so she doesn't eat from 11pm to around 7:30am the next morning unless I get up at 2 am to check her blood glucose on nights she's running lower than usual. She's been getting 1/4 Pepcid AC every evening at 8pm and was doing okay till the past two mornings when I was woken up to her vomiting foam. I know her late civvie sis, Weeny, didn't do well with Pepcid when she had an aggressive mast cell cancer.

My question is...has anybody used omeprazole or ranitidine over the longterm? Someone on the FB CKD age suggested slippery elm bark, but it has carbs. What has been YOUR experience? I'm really looking for some laymen's experience on the long term use of omeprazole

On March 9, her BUN was down to 66 from 138 at diagnosis (Feb 19th) and her creatinine was 3.2, down from 11.0. Her phos was down to 5.2 from 12.8 on diagnosis. She is on Epakitin with Fussie Cat and Weruva low carb wet foods and Young Again Zero Mature and binder is only given with wet food. She gets 150ml lactated ringers daily. Her SS is in my signature.

Thanks in advance! I have to finish work but will be back on later tonight or the morning! For tonight I"m just gonna give her Pepcid later, maybe 10-11pm when I do her before bed test.

 

[Anitafrnhamer]

I switched Squeaker to ranitidine as the disease progressed and I also used slippery elm as it doesn't have a high carb value. You might want to check out this link: http://felinecrf.org/nausea_vomiting_stomach_acid.htm#vomit_white_foam

 

[jayla-n-Drevon]

SEB works really good for my 2 boys--especially for my CKD boy who had a reaction to pepcid and can no longer take it as his heart races ....
we use onadestron and cerenia for nausea as well... (injectable and oral depending on his mood)

 

[Critter Mom]

Second the recommendation for ondansetron but it won't help the stomach acid issue, Robyn. The best suggestion I can give is to set an alarm during the night so that you can get some food into Penny. It doesn't have to be a big meal, just something to give the stomach acid a bit of food to work on for a few hours until her brekkie is due.


Mogs
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[Robyn and Penny]

SEB works really good for my 2 boys--especially for my CKD boy who had a reaction to pepcid and can no longer take it as his heart races ....
we use onadestron and cerenia for nausea as well... (injectable and oral depending on his mood)

Penny has been hyper on Pepcid, yowling a lot. She's almost acting like she's on mirtazipine and I just saw in another thread that somebody else was using slippery elm bark. It may have been you lol. I stuck a capsule under her nose today to get an idea if she would it at and she turned her head away and acted offended, so I guess I have to get gelatin capsules or syringe it. How much do I give and how do you give it?

 

[Robyn and Penny]

Second the recommendation for ondansetron but it won't help the stomach acid issue, Robyn. The best suggestion I can give is to set an alarm during the night so that you can get some food into Penny. It doesn't have to be a big meal, just something to give the stomach acid a bit of food to work on for a few hours until her brekkie is due.


Mogs
.

Thanks...I just started that last night. I should be testing her BG overnight anyway. Especially tonight since she had a low PMPS

 

[MsBliss]

Hi everybody! My Penny is in kidney failure...she was end-stage when she was originally diagnosed but after three weeks of home sub q fluids daily and an emergency dental, her numbers went dramatically down to Stage 3. She's due for blood work again the first week of May. Overall she's doing well, besides having trouble with stomach acid. She's eating her normal amount, has only lost a couple of ounces since her diagnosis (today she weighed in at 15lb 3oz - She's a Maine Coon), but she IS a social eater, so she doesn't eat from 11pm to around 7:30am the next morning unless I get up at 2 am to check her blood glucose on nights she's running lower than usual. She's been getting 1/4 Pepcid AC every evening at 8pm and was doing okay till the past two mornings when I was woken up to her vomiting foam. I know her late civvie sis, Weeny, didn't do well with Pepcid when she had an aggressive mast cell cancer.

My question is...has anybody used omeprazole or ranitidine over the longterm? Someone on the FB CKD age suggested slippery elm bark, but it has carbs. What has been YOUR experience? I'm really looking for some laymen's experience on the long term use of omeprazole

On March 9, her BUN was down to 66 from 138 at diagnosis (Feb 19th) and her creatinine was 3.2, down from 11.0. Her phos was down to 5.2 from 12.8 on diagnosis. She is on Epakitin with Fussie Cat and Weruva low carb wet foods and Young Again Zero Mature and binder is only given with wet food. She gets 150ml lactated ringers daily. Her SS is in my signature.

Thanks in advance! I have to finish work but will be back on later tonight or the morning! For tonight I"m just gonna give her Pepcid later, maybe 10-11pm when I do her before bed test.

It is possible that the vomiting and stomach upset, the tummy symptoms are related to a low grade pancreatitis. I couldn't figure out why my CKD/diabetic kitty was vomiting every morning despite pepcid or ranitidine before bed. Not that stomach acid wasn't a problem, but the pancreas inflammation made him very uncomfortable. It is theorized that some diabetic cats become diabetic due to a low grade pancreas inflammation that remains under the radar. We're trying Cerenia, fluids, pepcid, and I'm going to try Young Again for a trial period. Also, some vets recommend Buprenex to manage the discomfort, if it is severe. My experience with Buprenex was double edged, but I was glad it was available short term.

 

[MsBliss]

SEB works really good for my 2 boys--especially for my CKD boy who had a reaction to pepcid and can no longer take it as his heart races ....
we use onadestron and cerenia for nausea as well... (injectable and oral depending on his mood)

It looks like you are dealing with arthritis in your kitty. Did your kitty develop dystrophic calcification of the medial collateral ligaments? Or is it just arthritis alone? I was doing the Adequan IM, but my new vet said to do it subq. Then when we took her to a internal med specialist, they lowered the dose to once a month, and back to IM. Also, I am wondering how to get injectable onadestron, cerenia, for the days when they won't take oral meds for nausea. Is it very expensive or hard to fill the prescription?

 

[jayla-n-Drevon]

It looks like you are dealing with arthritis in your kitty. Did your kitty develop dystrophic calcification of the medial collateral ligaments? Or is it just arthritis alone? I was doing the Adequan IM, but my new vet said to do it subq. Then when we took her to a internal med specialist, they lowered the dose to once a month, and back to IM. Also, I am wondering how to get injectable onadestron, cerenia, for the days when they won't take oral meds for nausea. Is it very expensive or hard to fill the prescription?

I have not done extensive testing as far as ligaments /arthritis etc.... He is a bit of a challenge at the vet
My vet said IM adequan is better but not by a significant enough amount to put Rico thru the stress --he could care less about SQ-
I would do 1x a month but because of his age and issues I am trying to stay ahead of it

The onadestron is expensive injectable.... I have been a tech for my vet so I get it at a reasonable price but still it was a 20ml bottle (dose is 1 ml) =20 shots
I am pretty sure it would be sold for 40 ish$
The cerenia injectable is 150$ for the bottle I get (I have seen it online too) Rico gets .6cc --it is also 20ml=about 36 shots?
Rico is 10-11 pounds.
I got both from my vet but I am sure KV vet supply has it if your vet will give a script.
You probably know this but cerenia burns so I keep in the refrigerator and freeze the needle and give only when I have just given fluids to lessen the sting. It still works great.