? Pancreatitis & Ondansetron

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babyg

babyg

Member Since 2019
Those of you with kitties with pancreatitis, do you always keep a stash of meds/fluids for it and give as needed as soon as you see any possible signs? I'm not 100% sure that's what's going on right now, but it makes sense and matches her symptoms that that is what it is again. She's hiding, lethargic, and doesn't have much of an appetite. The Ondansetron is for 4 mg and says take 1 tablet by mouth every 8 to 12 hours. I don't like giving unnecessary meds but am thinking it good to catch this before it gets too out of hand, and of course now vets are closed. :(
 
I’d start with every 12 hours and you can up to 8 if needed. I also started Bobo on 1/2 a tablet and upped him to 1 once that stopped working. Is she acting nauseated? Like smelling of licking the food and not wanting to eat?
 
She's turning her nose up at most things she would normally eat. Her appetite is not the same at all. Acting sluggish, hiding. She threw up a couple small frothy liquid piles this morning. Recently had issues with her pooping too...she hadn't gone in a couple days and finally went.
 
I was just massaging her stomach and she doesn't act sensitive like it hurts her. She started this decreasing appetite thing around when I started a food change. I did the change gradually but maybe there's something in it that just doesn't agree with her and set her off. I can never figure out cats.
 
I used to keep anti-nausea meds and sub Q fluids for Sheba for when she got a pancreatic flare. She was taking tramadol for arthritic pain so I had that covered but having some pain meds on hand is a good idea too.
In cats, the usual dose of ondansetron is 0.11 mg per pound (0.22 mg/kg) every 8 to 12 hours.
If you think she is nauseated. and it does sound as if she is, I would give her the ondansetron routinely for a few days.
 
If i remember right, it doesn't affect the BG and I can give it any time in relation to her shot, correct? Boy that'll be fun. She's not good at pilling at all.
 
babyg said:
If i remember right, it doesn't affect the BG and I can give it any time in relation to her shot, correct? Boy that'll be fun. She's not good at pilling at all.
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Yes you can give the ondansetron at any time, as long as there has been 8 hours minimum since the last dose.
I would give it 30 minutes before feeding to give it a chance to take effect.
Let us know how you get on with it.:)
 
I think I just answered my own question. I found my notebook from 2022 and looks like I gave her the pill about a half hour before shot (probably because of the struggle to do it). So looks like it doesn't matter or affect that.
 
Update: so she was doing much better, great appetite and everything, was able to up her insulin dose, she wasn't hiding, etc. When I told the vet i had been giving her the Ondansetron over the weekend and that had seemed to help, she told me to stop. Now the cat is starting to act up again. I'm going to call the vet in the morning because I don't understand why she'd tell me to stop giving it to her when it was helping and I think we stopped too prematurely before "sealing" in her recovery. Any ideas? What on earth is the harm. I think I'm going to give her a dose in the morning regardless just because it takes time to hear back and I have to do something in the meanwhile... think vets don't take the not-eating-well-thing seriously enough. It makes no sense to prescribe something for as needed and then say oh but dont use it when it's clearly needed.o_O
 
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Sorry, and one other thing I've noticed but didn't think to mention is that her pupils seem wider than normal lately. Doesn't that usually mean something negative like they're in pain, don't feel good, or are scared, etc.
Tonight she's eaten for me dry mixed with temptations... pure bites... fancy feast savory selects or whatever they're called... and just ate a bit of a salmon filet. So mostly treats and not actual "food food." Refusing her wet food, even her fave seafood ones, though she never sticks with a flavor consistently. The fortiflora isn't as enticing this time around, probably because she gets it every day for maintenance, so it's not as exciting anymore.
 
Wow her glucose is low (for her) this morning, probably because she didn't eat while i was sleeping. :banghead: so there goes giving her the dose I wanted. :facepalm: when I got up I saw her go by her dish and take literally 1 bite of a kibble and that was it. I'd take her in to the vet but what will they do? They did nothing last time. I'm calling anyway and will see what they say. She was seemingly on the mend and being herself until we stopped the anti nausea med. I wonder how many days she'd have to be on it to be sure she is ready without it.
 
Another update: ER vet recommends not giving the med yet until I can check again with the primary vet. I personally don't see the harm, especially when it's helped her, but maybe there's something I don't know so will hold off this morning. Last time she also had gabapentin and mirtazapine, so thinking should look into getting those refilled? Do you guys do any kind of "maintenance " dose or meds with your pancreatic kitties even when they're normal again? Or do you just stay really on the watch for the slightest symptom and jump in then? Want to avoid a bad flare up again in the future.
 
My Minnie was on ondansetron twice a day for over 2 years for her IBD. Not just when she had a bad flare up. I needed her to eat for the insulin so that was her maintainance plan. Even Cerenia can be given every day now. I don’t see the harm and neither did her regular vet and specialty IM vet. I wouldn’t trust what your vet is saying and I’d push back and advocate for what you know is working for her
 
The apetite stimulant won’t help much if she’s nauseated and that’s where the ondansetron comes in. Minnie’s dose was 4mg x2 a day. Bobo is on it too now for his IBD. The only 2 meds for nausea and vomiting are ondansetron and Cerenia and she should be on one at least if not both. If the cat is nauseated, it won’t eat period. I think your vet is crazy. Sorry to be blunt but that’s really bad advice you’ve received from him and the er!
 
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Thanks so much! Yes, it makes zero sense why she said to cease the anti nausea meds.o_O I got ahold of the teaching hospital vet (I soooooo wish we lived closer because I would exclusively take her there; they are awesome) and he said to resume the ondansetron and that it's as needed and there's nothing wrong giving it as long as we give per the label instructions. He advised to administer for about a week straight. I happily gave her a pill now. :joyful: I just want her eating again and feeling better.
 
Got her to eat about 3/4ths can Fancy Feast salmon. Overnight she didn't eat at all on her own, though. How do you know when they're ready to get their normal dose, when you can trust them to eat enough, for anyone with pancreatic kitties? Is it when they eat most or all their food without your urging them at all? Or even if you urge them, as long as they eat "enough?" Her regular vet should be in today so hoping to talk to her later and update her on things thus far.
 
I wanted to make appointment tomorrow to see vet, even if its just me, I'll pay for visit...and ask questions so I can make sure everything is right, but she doesn't want to spend the time because they're busy and short on vets there and can I come tuesday or wednesday instead... and it's like no, i need answers now. They didnt call me yesterday. Just want to cry. Good vet hospital is over an hour away.
 
Thanks, I still am not sure how to tell when she'd be ready, but primary vet finally called me and said regardless if eating or not, to give her normal dose but if at any point she gets low, give half the dose next time and then the next cycle after try giving a little less than her normal dose. That was her 2 cents on it. I hope my girl ate while I was gone...
 
She didn't eat while I was gone but she just ate for me now and seems in good spirits. Glad I can now hibernate with her and keep pushing food. Vet had said to follow up on Monday with how she's doing. So I think I at least have some sort of structure or guidance now about her dose in relation to her eating or not. Seems like the idea is to not focus so much on the actual eating (or lack thereof) but on the numbers themselves and adjust based on those. Basically sort of ignore the food in relation to it. That's what I was concerned about, so I think I'm ok now. Just wish it were easier to get ahold of a vet when you need one. Cats always pull stuff on weekends or outside business hours or on the vet's day off. :facepalm:
 
This article is a good one: A Primer On Pancreatitis

I hope she continues to eat for you. I do agree with the vet that she needs her insulin. Other useful articles from our Health Links forum:
Are you testing regularly for ketones?

How much does Baby G weigh? Ondansetron is dose by weight, and if necessary, can be given 4 times per day. Reference for dosing is here: (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease
See table 9, ondansetron is given 0.5-1.0 mg per kg of cat, every 6 to 8 hours.
 
Thank you; I will be sure to check out those articles!
I checked her this morning and negative for ketones.
Since the definition of her "full dose" has changed a lot lately due to the diet change, pancreatitis attack, and just trying to get her numbers better in general, we settled on the 2.5 as being her full dose, so back to that tonight.
She's a big girl, close to 18 lbs.:cat:
 
Thinking of asking for mirtazapine. Not seeing much improvement yet
I dont see her doing the meatloaf position so dont think shes in pain. But maybe an appetite stimulant is next..?
 
Quick update. I have a vet appointment Monday morning in case she doesn't get better over the weekend and just because even though we're pretty sure it's pancreatitis again, what if it isn't? So I figure by then if it's not better we might need to stop assuming it's pancreatitis and investigate more. I just asked the vet now (they close in an hour) if the Mirtazapine I have leftover from last year (bottle says expires June 2022) is still good and if she can have it, and they said they checked their bottle (I guess the big bottle they get the pills from to give us) and she said it expires June 2025, so ok to give to her. Instructions say give half tablet every 72 hours. I got her to eat some more of a broth/stew packet. She was refusing her DM dry unless I mixed Temptations in, so out of desperation and curiosity I offered her the Dr Elsey's dry again. I think that's what started this whole mess, tbh, but she chowed down. I hope it doesn't make her worse and bind her up again; just want her to eat anything. Since she just ate some food I'm going to see what she does in about an hour or so, and if I don't see her going again for a bite of anything, I'm giving the Mirtaz.
 
If you get mirtazapine again, I would get Miritaz. It's a cream you rub in their ears. It's absorbed more slowly, less likely to be side effects. And can be given daily, as can the pill form. I'm glad she ate something.
 
Quick question. Last year's flare up she was on Ondansetron for 4 days. This morning, after being on it for 5 straight days, I skipped the pill to see how she would do. She still ate great. She does chill under the couch though, which makes me suspicious, but then I don't know if she's hiding or if that's just her new fave spot. Anyway, I'm hoping I gave the meds long enough since she's eating and pooping good, but if those of you more experienced with this kind of thing think I'm quitting too soon, feel free to let me know! I don't want to "over-medicate" but I don't want us going backwards either.:)
 
I think I'm just going to go ahead and give her a pill tonight anyway. I'm scared of her declining again even though she ate good today. I don't trust cats at all :arghh:
 
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