9/6 Naomi AMPS 88, +6 107 PMPS 121, +4 93, +6,5 111, +11 130

Yanna

Yanna

Member Since 2020
https://www.felinediabetes.com/FDMB...-78-pmps-126-4-82-6-5-97.234649/#post-2627993

Hi!

I didn't make it to vet today. I'm having difficulty keeping up with everything.

Spoonfed today although there were few times she went to her bowl and had 2-3 bites on her own. Had 1 pouch chunks in gravy so far. I added some water and ALH.

I read your suggestions about dosing. 2,5 units AM & PM.

In the mornings I will syringe feed her before going to work. But for the next 8 hours her stomach will be empty. How much insulin is safe to give?
I would be worried even with 1u

No one will be around to check on her
 
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I tend to agree that at this point 2.5 doesn’t make sense with Naomi in blue and green on 1 unit. See what happens on 1 unit today and tonight. It would be best if you can give her something each cycle though. If you can get enough food in before work think about even a token dose in the morning. You can’t take her to the vet every day. Would you please add the meds she’s currently on to your signature? I’ve been reading so many condos I forget plus others will see and can give input. Do you know if your pharmacies sell cyproheptadine? It’s my favorite appetite stimulant, a human antihistamine. What about Zyrtec? It tends to stimulate the appetite as well. My vet said it’s fine to give 1/4 a Zyrtec twice a day. Just a sliver of a 4 mg cyproheptadine he prescribed got Max eating. I gave a Tiffany 2 mg of it. I’m so sorry Naomi is causing you so much stress and hope she turns a corner soon, for both of you.
 
tiffmaxee said:
I tend to agree that at this point 2.5 doesn’t make sense with Naomi in blue and green on 1 unit. See what happens on 1 unit today and tonight. It would be best if you can give her something each cycle though. If you can get enough food in before work think about even a token dose in the morning. You can’t take her to the vet every day. Would you please add the meds she’s currently on to your signature? I’ve been reading so many condos I forget plus others will see and can give input. Do you know if your pharmacies sell cyproheptadine? It’s my favorite appetite stimulant, a human antihistamine. What about Zyrtec? It tends to stimulate the appetite as well. My vet said it’s fine to give 1/4 a Zyrtec twice a day. Just a sliver of a 4 mg cyproheptadine he prescribed got Max eating. I gave a Tiffany 2 mg of it. I’m so sorry Naomi is causing you so much stress and hope she turns a corner soon, for both of you.
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I asked my vet yesterday about cyproheptadine. Not available here.
I think Zyrtec is sold in pharmacies, is it like Primperan for stomach?

I'll give her 1 unit for PM tonight.

9/7 AM: token dose 0.25 units is it OK?
 
Zyrtec is another antihistamine sold over the counter here.The side effect in cats is it increases the appetite in many. I gave it to Mocha for a couple of days because her allergies and scratching were causing her ears to bleed and I had to drag her away from eating her sister’s food. Let me see if I can find an equivalent med available in Greece.
 
tiffmaxee said:
Zyrtec is another antihistamine sold over the counter here.The side effect in cats is it increases the appetite in many. I gave it to Mocha for a couple of days because her allergies and scratching were causing her ears to bleed and I had to drag her away from eating her sister’s food. Let me see if I can find an equivalent med available in Greece.
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We have Zyrtec here.
 
It’s worth a try. Regular strength. Try 1/4 or 1/3 and see. You can get it fast. Also look on drugs.com for hydrochloride and it might give you alternatives. I just googled and it looks like cyproheptadine can be bought on line but I don’t know reputable on line sources there. I just saw it can increase appetites in humans too. Never knew that. One can sure learn a lot on the internet.
 
tiffmaxee said:
It’s worth a try. Regular strength. Try 1/4 or 1/3 and see. You can get it fast. Also look on drugs.com for hydrochloride and it might give you alternatives. I just googled and it looks like cyproheptadine can be bought on line but I don’t know reputable on line sources there. I just saw it can increase appetites in humans too. Never knew that. One can sure learn a lot on the internet.
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Could it raise bg?

Is it safe for kidneys? Leaflet says do not take Zyrtec if you have renal failure
 
It will not raise bg. I gave it to Tiffany with CKD. Ask your vet before giving it. I found with Max I only needed a tiny amount once or twice and then nausea meds alone worked. He needed a larger amount of ondansetron and then almost never needed the stimulant. For the longest time I was giving cyproheptadine and ondansetron twice daily. Once I figured out how much ondansetron was needed I rarely needed the stimulant.
 
tiffmaxee said:
It will not raise bg. I gave it to Tiffany with CKD. Ask your vet before giving it. I found with Max I only needed a tiny amount once or twice and then nausea meds alone worked. He needed a larger amount of ondansetron and then almost never needed the stimulant. For the longest time I was giving cyproheptadine and ondansetron twice daily. Once I figured out how much ondansetron was needed I rarely needed the stimulant.
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What dose Ondansetron worked for Max?
 
If you can get to bed at a better time at night you can give her ondansetron a half hour before you shoot and then maybe feel comfortable shooting before work.
 
See what she does tonight and in the morning. Then if still green or blue token dose of .25. She’s getting a lot less overall even though it was just once a day. Now that she’s getting 2 times see how she responds. What are you thinking about tonight?
 
It’s what I would do. The protocol isn’t working for you or a Yanna right now. If you get sick you can’t take care of her. What do you think about switching to SLGS for now? We would need to see if even that will work right now.
 
tiffmaxee said:
It’s what I would do. The protocol isn’t working for you or a Yanna right now. If you get sick you can’t take care of her. What do you think about switching to SLGS for now? We would need to see if even that will work right now.
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OK. I'll switch to SLGS.
But again I would have to either skip or reduce the dose if her bg is low
 
Yanna said:
OK. I'll switch to SLGS.
But again I would have to either skip or reduce the dose if her bg is low
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Yes. But she would earn reductions if she drops under 90 so will get less insulin and perhaps will get to a point where you can safely shoot every cycle. You can switch back if it doesn’t work. If she can only safely get insulin at night, well, safety first. ECID.
 
tiffmaxee said:
Let me see if I can find an equivalent med available in Greece.
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Maybe check whether the cypro is available in human pharmacies under brand name Periactin (4mg tablets)? Don't know whether you'd need an Rx or if it might be available OTC.

It's definitely got approval in the EU as a whole, else I wouldn't be able to get it here under drug cascade rules.


Mogs
.
 
tiffmaxee said:
Yes. But she would earn reductions if she drops under 90 so will get less insulin and perhaps will get to a point where you can safely shoot every cycle. You can switch back if it doesn’t work. If she can only safely get insulin at night, well, safety first. ECID.
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OK. When should I start and what dose? This Tuesday & Wednesday I am off work and also every weekend
 
tiffmaxee said:
He needed 2-3 mg. You have been giving 2 twice a day. What about trying 2 three times? It takes 30-45 minutes to kick in.
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It can take a wee bit longer when starting treatment, and also depends on the cat. For example, there have been times when my civvie, Lúnasa, wouldn't eat for love nor money because of nausea. Give a one-off 2mg dose of ondansetron and 90 minutes later it's like a switch is flicked and she'll be able to eat again. You could set your watch by it.

I've found that once daily treatment has started it doesn't take quite that long for a dose to kick in.


Mogs
.
 
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Critter Mom said:
It can take a wee bit longer when starting treatment, and also depends on the cat. For example, there have been times when my civvie, Lúnasa, wouldn't eat for love nor money because of nausea. Give a one-off 2mg dose of ondansetron and 90 minutes, it's like a switch is flicked and she'll be able to eat again. You could set your watch by it.

I've found that once treatment has started it doesn't take quite that long to start working.


Mogs
.
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Are we talking cyproheptadine or ondansetron? She’s been giving ondansetron
 
Critter Mom said:
Maybe check whether the cypro is available in human pharmacies under brand name Periactin (4mg tablets)? Don't know whether you'd need an Rx or if it might be available OTC.

It's definitely got approval in the EU as a whole, else I wouldn't be able to get it here under drug cascade rules.


Mogs
.
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Just checked. There seems to appear in the bibliography in Greek both Periactin and cyproheptadine. I'll have to ask in a pharmacy
 
Critter Mom said:
It can take a wee bit longer when starting treatment, and also depends on the cat. For example, there have been times when my civvie, Lúnasa, wouldn't eat for love nor money because of nausea. Give a one-off 2mg dose of ondansetron and 90 minutes later it's like a switch is flicked and she'll be able to eat again. You could set your watch by it.

I've found that once daily treatment has started it doesn't take quite that long for a dose to kick in.


Mogs
.
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She was on Zofran for four days, 2mg twice a day, and didn't work. Then I stopped for two days. Should I start the treatment again?
 
Good. We can see what happens. I was going to come back and downgrade but I got a phone call. When 2.5 was suggested you were doing TR but a reduction was earned. Hoping you will get to sleep, she will eat, and she will be at a number you can shoot in the morning. How many hours away is it?
 
tiffmaxee said:
She’s been getting [ondansetron]. She only recently stopped because her vet said to and gave Valium.
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I like your suggestion about revisiting the dose size and frequency of administration for Naomi, Elise. If Yanna checks with her vet about restarting the Zofran and giving it more frequently it's worth a try. I think Plumb's Veterinary Handbook says you can give as much as 4mg BID (10lb / 4.5kg cat).

As an example, I could give Saoirse ondansetron 1mg BID and I might as well be giving her water. Switched the dose to 2mg BID and it worked a treat. If she had a pancreatitis flare up, I'd give her 1-2mg every 8 hours and then step the dose down to the maitenance amount when the flare subsided.

I've never given diazepam as an appy stimulant so I don't know whether or not there might be any interaction between it and ondansetron. With the potential hepatic side effects you mention, Elise, I think I would prefer to use an alternative if one could be found that works for the kitty.

Per one of your comments above, Elise, I too found that once I got control of the nausea I'd only occasionally need the appy stimulant if the appetite needed a bit of a nudge.

I've found that if you can do something to get a kitty to start eating in the first instance and then slide in the anti-nausea and appy stimulants immediately following it builds up momentum to restore regular eating habits, and then hopefully get to a point where a maintenance dose of anti-nausea meds can keep the kitty motoring along thereafter.

The other fly in the ointment here is phosphorus control. If that could be improved it might help with the nausea and inappetence problems.


Mogs
.
 
tiffmaxee said:
Good. We can see what happens. I was going to come back and downgrade but I got a phone call. When 2.5 was suggested you were doing TR but a reduction was earned. Hoping you will get to sleep, she will eat, and she will be at a number you can shoot in the morning. How many hours away is it?
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8,5 hours
 
No interaction between ondansetron and diazepam. Her vet told her to stop because it wasn’t working. Her vet also said Naomi isn’t nauseous because she ate a few bites. ;) Yes to all you wrote Mogs. We have talked about phosphorus too.


Yanna said:
8,5 hours
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I can be around at amps. If you can get to sleep soon enough and get up to test at +11 and give ondansetron we will have more info and can see if she will eat at amps.
 
Critter Mom said:
I like your suggestion about revisiting the dose size and frequency of administration for Naomi, Elise. If Yanna checks with her vet about restarting the Zofran and giving it more frequently it's worth a try. I think Plumb's Veterinary Handbook says you can give as much as 4mg BID (10lb / 4.5kg cat).

As an example, I could give Saoirse ondansetron 1mg BID and I might as well be giving her water. Switched the dose to 2mg BID and it worked a treat. If she had a pancreatitis flare up, I'd give her 1-2mg every 8 hours and then step the dose down to the maitenance amount when the flare subsided.

I've never given diazepam as an appy stimulant so I don't know whether or not there might be any interaction between it and ondansetron. With the potential hepatic side effects you mention, Elise, I think I would prefer to use an alternative if one could be found that works for the kitty.

Per one of your comments above, Elise, I too found that once I got control of the nausea I'd only occasionally need the appy stimulant if the appetite needed a bit of a nudge.

I've found that if you can do something to get a kitty to start eating in the first instance and then slide in the anti-nausea and appy stimulants immediately following it builds up momentum to restore regular eating habits, and then hopefully get to a point where a maintenance dose of anti-nausea meds can keep the kitty motoring along thereafter.

The other fly in the ointment here is phosphorus control. If that could be improved it might help with the nausea and inappetence problems.


Mogs
.
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My vet doesn't believe in cat nausea. I was asking for a Zofran prescription and finally I got one 2 months after her flare.

When I told her yesterday that Zofran didn't work for Naomi she replied that she knew it wouldn't.

Vet can't explain why she is not eating.
 
A question about the binder..

Can it be given with Zofran, zobaline, d-mannose, cornsilk

I mix the binder with her food. But Naomi doesn't finish all of her food at once. I spoonfeed her often .
When I give a drug or supplement the binder may not have been absorbed.
Is that OK?
 
Critter Mom said:
Perhaps print off a copy of this to discuss with your vet:

IDEXX Pancreatitis Guidelines

Although the document specifically addresses pancreatitis, it has a section on all of the treatments used for treating nausea in cats. (IDEXX are world authority on all things feline pancreatitis.)

Here's another very helpful resource (with lots of studies referenced):

Nausea, Vomiting and Inappetence - Symptoms and Treatments


Mogs
.
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She told me once "who told u about nausea? I understand vomiting but no nausea". And she asked me to send her the source I had read. So attached tanyas site all that part about nausea.
I never got a reply back
 
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