10/04 Dolly AMBG 260 end thread

Our Dolly Girl (GA)

Our Dolly Girl (GA)

Member Since 2019
https://felinediabetes.com/FDMB/thr...4-1-2-hours-ago-nauseous.236332/#post-2649830
In California. Will be taking Dolly to vet this morning but need to know if I should give Insulin, she ate a few bites (this am) since yesterday afternoon. Insulin 12 1/2 hours ago. I gave her Zyrtec-D and just lost a post that said one kind of Zyrtec is dangerous for them. Is it this one? Do I need to call poison control? She is alert but barely slept all night.
 
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Our Dolly Girl said:
I gave her Zyrtec-D
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Call your vet now.

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=5419140
There is a formulation of cetirizine called Zyrtec-D that combines cetirizine with pseudoephedrine, a decongestant. This product (as well as similarly formulated generics) are not appropriate for animal use as the pseudoephedrine has toxicity potential.

https://www.petcoach.co/canigive/cat/zyrtec/
NEVER use Zyrtec-D due to the potential for serious side effects!

https://www.aspcapro.org/resource/shelter-health-poison-control/pseudoephedrine-toxicity-pets
Being a sympathomimetic, pseudoephedrine causes stimulation to the nervous system and cardiovascular systems. Common signs include restlessness, agitation, hyperactivity, tremors, tachycardia, hypertension, hyperthermia, panting and mydriasis. DIC and rhabdomyolysis are uncommon but serious sequelae of clinical signs.

Onset of signs will depend on the formation of the pseudoephedrine. Liquids and immediate release tablet/capsules (15, 30 and 60 mg) can be very rapid with signs starting as soon as 15 to 30 minutes after ingestion. The extended release formations signs may take 3 to 6 hours or longer for signs to develop. With the extended release formulations the progression of signs may be more subtle – so it may take the owner even longer to realize there is something wrong with the pet.

Treating Pseudoephedrine Ingestion
Treating pseudoephedrine toxicity is similar to treating amphetamine toxicosis. CNS stimulation is commonly controlled with acepromazine or chlorpromazine. Valium is generally avoided for agitation and hyperactivity as it may potentially worsen the stimulation.

Cyproheptadine as a serotonin antagonist may be considered. A muscle relaxant such as methocarbamol may be used for tremors. Propranolol or another appropriate beta blocker may be considered for controlling tachycardia. Hypertension is often controlled through the use of acepromazine for CNS stimulation control; however, if that is insufficient, other vasodilators such as nitroprusside may be considered.

Stronger sedatives such as barbiturates, propofol or gas anesthesia may be considered if acepromazine is not enough. Alpha 2 adrenergic agonists such as medetomindine and dexmedetomindine should be avoided as they, as well as pseudoephedrine, cause peripheral vasoconstriction and have the potential to worsen the hypertension.
 
I have used only Zyrtec allergy and 1/4 a pill per my vet’s ok. What you gave is not the correct one.
 
Our Dolly Girl said:
I gave her Zyrtec-D and just lost a post that said one kind of Zyrtec is dangerous for them. Is it this one? Do I need to call poison control? She is alert but barely slept all night.
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From: Plumb's Veterinary Drug Handbook 6th ed (2008)
Overdoses of cetirizine products that also contain pseudoephedrine (Zyrtec-D 12 Hour®) may be serious. It is advised to contact an animal poison control center in this event.
 
She is having a full work up. I was told 5mg for her weight- 13#. All my fault. I gave the pharmacy the right card. I was clear about that. Didn’t check, no sleep, too much stress. I Made a serious mistake and I know it. Vet said she was doing okay so far. Spending the day there.
 
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Red & Rover (GA) said:
It's not your fault if the pharmacy gave you the wrong product. Glad you took Dolly in. Better safe than sorry. :bighug:
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Pharmacist had to enter my driver’s license 4 times. She was all stressed out. I should have checked. My fault for not not checking. Her vet was against Zyrtec but I was getting desperate to get her to eat. Help her to smell food. Forum said it was okay to sometimes not listen to your vet and Use Zyrtec. I could have killed Dolly. I did stay up with her all night just watching her. Trying to get her to eat. Thank you and sorry for talking so much.
 
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Critter Mom said:
Thinking of you, Adrienne, and sending prayers and healing vibes for Dolly.

(((Adrienne and Dolly)))


We're here for you, Adrienne. Talk as much as you want and need.

:bighug::bighug::bighug:


Mogs
.
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Thanks Mogs for always being here for me. It looks like Dolly has pancreatitis, ultrasound tomorrow. Diagnosed with a snap test, not definitive. The only thing positive about the Zyrtec nightmare is that we are finally finding out why Dolly hasn’t been eating and has been just off. I was getting nowhere with her vet. Left her there the other day and she did chest X-rays. Did not help me with the eating problems, never suggested checking for pancreatitis. Thank you again for always supporting me. I’m scared and sad. :bighug::bighug::bighug:
 
tiffmaxee said:
Hoping to hear from you soon. :bighug::bighug::bighug:
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Thank you so much for being here for me again..... It looks like Dolly has pancreatitis. Will know after we get ultrasound results. Test tomorrow. It was a scary night, I had no idea what was wrong. Dolly stayed in the same room with me but under the table. We were both up all night, she never slept, ate or drank water. I love her so much and it makes me so sad she’s probably been in pain. I knew she was nauseous all night. Thank you again for being there. :bighug::bighug::bighug:
 
I have years of experience with pancreatitis. Is she still at the vet’s? Ask for an RX for ondansetron for nausea. It’s a human drug. Look on Good RX to see where you can get the best price. Get 30 pills minimum. Have them give a cerenia shot if they haven’t already. It stings so you don’t want to give it. They might send you home with cerenia pills which are fine but get the RX too. Make sure you get at least a week)s supply of cerenia. For pain buprenorphine is best. More later. :bighug:
 
Hi Adrienne,

I know how very, very much you love Dolly and I know that sad, scared feeling only too well. (((Adrienne)))

I'm very sorry about the circumstances that brought it about but it's good that you're getting the right help for Dolly now. I'm sorry that your main vet didn't help you both sooner but hopefully things will greatly improve going forward. All going well, Dolly will get the right treatments in place and she'll start feeling and eating better. I found the following paper very helpful for my Saoirse, and I hope it will help you too:

IDEXX Pancreatitis Treatment Guidelines

I'll keep an eye out for updates from you. Sending more prayers and healing vibes for your little one, and some :bighug::bighug::bighug: for you.

(((Adrienne and Dolly Girl)))


Mogs
.
 
tiffmaxee said:
I have years of experience with pancreatitis. Is she still at the vet’s? Ask for an RX for ondansetron for nausea. It’s a human drug. Look on Good RX to see where you can get the best price. Get 30 pills minimum. Have them give a cerenia shot if they haven’t already. It stings so you don’t want to give it. They might send you home with cerenia pills which are fine but get the RX too. Make sure you get at least a week)s supply of cerenia. For pain buprenorphine is best. More later. :bighug:
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Thanks so much. I take Zoltan myself. She will be there for several more hours. Take both Cerenia and ondansetron? She Is a nightmare to pill. Is the snap test a sure indicator of pancreatitis? So upset my vet didn’t look at her symptoms and test for pancreatitis. I kept taking her in For the eating problem and thinking it was the chronic sinusitis. :mad:
:bighug::bighug:
 
tiffmaxee said:
I have years of experience with pancreatitis. Is she still at the vet’s? Ask for an RX for ondansetron for nausea. It’s a human drug. Look on Good RX to see where you can get the best price. Get 30 pills minimum. Have them give a cerenia shot if they haven’t already. It stings so you don’t want to give it. They might send you home with cerenia pills which are fine but get the RX too. Make sure you get at least a week)s supply of cerenia. For pain buprenorphine is best. More later. :bighug:
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I second the above.

Also, I suggest asking the vet about a course of vitamin B12 injections. They can give a real boost, and they can help the appetite too.

All the treatments suggested above are mentioned in the IDEXX document linked above. It's a very useful document to have handy for discussions with your vet.

(((Adrienne and Dolly Girl)))


Mogs
.
 
Critter Mom said:
I second the above.

Also, I suggest asking the vet about a course of vitamin B12 injections. They can give a real boost, and they can help the appetite too.

All the treatments suggested above are mentioned in the IDEXX document linked above. It's a very useful document to have handy for discussions with your vet.

(((Adrienne and Dolly Girl)))


Mogs
.
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Just a quick mention this is not her vet, not there sundays. Dolly has been going to her all cat vet for 7 years. Unfortunately her veterinarian passed away 2 years ago. Care has changed with COVID. Also, I have been up for over 30 hours and having a hard time taking in all this information. Thank you, writing everything down. So scared and so tired. I emailed myself the document you sent me.
 
The info we're posting will all be there for you on the morrow, Adrienne, ready for you to sift through it in your own time. :)

I know it's nigh on impossible to get any rest during such a scary time, but if there's any way you can manage to get even a few hours of sleep while the vets are looking after Dolly that little bit of rest will stand to you when she comes home. (Bit like the 'putting your own oxygen mask on first' principle.)

Forgot to mention above that an appetite stimulant is also indicated for pancreatitis treatment (see the doc!). I used cyproheptadine for Saoirse. It's milder in action than mirtazapine but you can give it up to 3 times a day.

Our Dolly Girl said:
[Dolly] is a nightmare to pill.
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Maybe this video might give you some ideas - the demonstration of technique is very good (fast forward to 4mins 45secs):




Can't recall whether the above video mentions it, but remember to give a little 'chaser' of food or water after the med to make sure it goes down the little red lane properly.

(((Adrienne and Dolly Girl)))


Mogs
.
 
An alternative for ondansetron is that you can get it in injectable format, sometimes easier for cats that don't want to eat. Thankfully the pill is tasteless (unlike Cerenia that is bitter), so I've had pretty good luck tucking it in a pill pocket.

Marje also wrote a Primer on Pancreatitis.

I second Mogs, try to get a nap in while you can. Your body will thank you later. :bighug:
 
Critter Mom said:
The info we're posting will all be there for you on the morrow, Adrienne, ready for you to sift through it in your own time. :)

I know it's nigh on impossible to get any rest during such a scary time, but if there's any way you can manage to get even a few hours of sleep while the vets are looking after Dolly that little bit of rest will stand to you when she comes home. (Bit like the 'putting your own oxygen mask on first' principle.)

Forgot to mention above that an appetite stimulant is also indicated for pancreatitis treatment (see the doc!). I used cyproheptadine for Saoirse. It's milder in action than mirtazapine but you can give it up to 3 times a day.


Maybe this video might give you some ideas - the demonstration of technique is very good (fast forward to 4mins 45secs):




Can't recall whether the above video mentions it, but remember to give a little 'chaser' of food or water after the med to make sure it goes down the little red lane properly.

(((Adrienne and Dolly Girl)))


Mogs
.
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I just tried the cyproheptadine for both the congestion and stimulant, my vet didn’t want to give it to me but finally did, but the Mirtazapine seemed have stopped working, probably being sick is why nothing seemed to work.
 
Our Dolly Girl said:
I just tried the cyproheptadine for both the congestion and stimulant, my vet didn’t want to give it to me but finally did, but the Mirtazapine seemed have stopped working, probably being sick is why nothing seemed to work.
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I am going to try again to rest. I’ve been up nearly all night with her several times this week. Injectable Zophran would be great. I know how nasty Cerenia is. I taste all of her meds first. Pill pocket rolled in FortiFlora was working great until yesterday. Tried Cerenia liquid, nasty. Thank you.
 
Our Dolly Girl said:
I just tried the cyproheptadine for both the congestion and stimulant, my vet didn’t want to give it to me but finally did, but the Mirtazapine seemed have stopped working, probably being sick is why nothing seemed to work.
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Assuming it is pancreatitis, if the vets prescribe anti-nausea and pain relief (bupe) then the appetite stimulant should hopefully work better.

Our Dolly Girl said:
I taste all of her meds first.
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Our Dolly Girl said:
I’ve been up nearly all night with her several times this week.
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You are a great kitty mama. Dolly is blessed that you are her Person, Adrienne. :) I'm very glad to hear you're going to try to get a little rest. It'll be good for both of you.

:bighug::bighug::bighug::bighug:


Mogs
.
 
Critter Mom said:
Assuming it is pancreatitis, if the vets prescribe anti-nausea and pain relief (bupe) then the appetite stimulant should hopefully work better.



You are a great kitty mama. Dolly is blessed that you are her Person, Adrienne. :) I'm very glad to hear you're going to try to get a little rest. It'll be good for both of you.

:bighug::bighug::bighug::bighug:


Mogs
.
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I can’t sleep. So worried about her not eating and what to do about insulin. This is an ongoing problem this last week especially. I don’t know what decision to make. She has missed several shots, her first hypo last week. I know it could have been worse. I just don’t know. Hopefully meds will help and she will eat, maybe I’m being negative. We have been isolated for two years next month. Due to my husbands illnesses and poor immune system we don’t even see family. He also went 100% deaf in a moment two years ago November. We lived with communicating with white boards for a year. He now has a Cochlear implant for one ear. With COVID now it’s even scarier. I know it has affected us in so many ways. Even doctors appts are still virtual. He has a procedure coming up and the constant is leaving Dolly alone if she’s having BG issues. Sorry for bringing up other issues but want you to understand why I may sound crazy at times. :bighug::bighug::bighug: Doctor said half dose of insulin if she doesn’t eat. 1.25units ??? .5u or .75u?? Really sorry for bothering you.
 
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Hi Adrienne,

I'm so sorry I didn't see this in time last night. :(

How are yourself and Dolly doing? Any news from the vets?

:bighug:


Mogs
.
 
Critter Mom said:
Hi Adrienne,

I'm so sorry I didn't see this in time last night. :(

How are yourself and Dolly doing? Any news from the vets?

:bighug:


Mogs
.
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I am withholding food , waiting for answer from her vet. Not answering, yesterday’s vet. Don’t know what to do. I am awake but exhausted, had to stay up most of the night again. I am 75, don’t know how I am still standing. Should I wait a day and hope Dolly gets some nutrition? Only food was during hypo middle of the night. Thanks again for being there for me. I am scared for Dolly.
 
Our Dolly Girl said:
I am withholding food , waiting for answer from her vet. Not answering, yesterday’s vet. Don’t know what to do. I am awake but exhausted, had to stay up most of the night again. I am 75, don’t know how I am still standing. Should I wait a day and hope Dolly gets some nutrition? Only food was during hypo middle of the night. Thanks again for being there for me. I am scared for Dolly.
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Vet would not give me Cerenia or odansetron. Said she wanted to wait???
 
Oh, Adrienne... :(

:bighug::bighug::bighug:

I had hoped you might have got some little bit of a nap but I can completely understand why that couldn't be. I've done the same.

I'd suggest ringing the vet, Adrienne. You need answers. With all of the difficulties that go with trying to get help for our little ones during covid times - and Dolly and yourself need the vet to help - maybe it's not a bad thing to be a bit of a 'squeaky wheel'. What do you think?


Mogs
.
 
Critter Mom said:
Oh, Adrienne... :(

:bighug::bighug::bighug:

I had hoped you might have got some little bit of a nap but I can completely understand why that couldn't be. I've done the same.

I'd suggest ringing the vet, Adrienne. You need answers. With all of the difficulties that go with trying to get help for our little ones during covid times - and Dolly and yourself need the vet to help - maybe it's not a bad thing to be a bit of a 'squeaky wheel'. What do you think?


Mogs
.
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I have left detailed message with her vet and also sent email. The vet for the ultrasound is not answering. Sent them an email. I need to know if I should feed her and postpone the ultrasound. She is at 244 BG right now.
 
Our Dolly Girl said:
I have left detailed message with her vet and also sent email. The vet for the ultrasound is not answering. Sent them an email. I need to know if I should feed her and postpone the ultrasound. She is at 244 BG right now.
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The Zyrtec issue is out of her system. I want to wait a day because Dolly won’t get food all day again. Fasting now and they won’t feed her at the ultrasound vet. Supposed to drop her off in 1 12 hours.
 
Called the vet to cancel ultrasound, not answering still. Called her vet again, scheduled an ultrasound with them for tomorrow. Fed Dolly, ate about 5 bites. Waiting to hear from her vet. Going to be a long day.
 
I'm very glad to hear that Dolly is clear of the Zyrtec. :)

Our Dolly Girl said:
The vet for the ultrasound is not answering.
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:banghead:

I'm so sorry that they're being so unresponsive and causing you such unnecessary distress. :(

Our Dolly Girl said:
Called the vet to cancel ultrasound, not answering still. Called her vet again, scheduled an ultrasound with them for tomorrow. Fed Dolly, ate about 5 bites. Waiting to hear from her vet. Going to be a long day.
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Given that you got no response from them and that they weren't going to feed her while she was with them I think rescheduling was likely the best thing you could do in the circumstances, Adrienne.

The best thing I can think of to suggest to you right now so you don't end up in a similar situation is to post a thread here at FDMB today to ask for advice on what to do about insulin tonight and tomorrow morning in preparation for tomorrow's scheduled visit to the vets for the ultrasound, and also seek input from the vet who'll be doing the scan. That way, you'll be able to choose the best course of action to ensure Dolly gets her scan and you won't have any worries about her blood glucose levels.

Will keep you both in my thoughts and prayers.

(((Adrienne and Dolly Girl)))


Mogs
.
 
Critter Mom said:
I'm very glad to hear that Dolly is clear of the Zyrtec. :)


:banghead:

I'm so sorry that they're being so unresponsive and causing you such unnecessary distress. :(


Given that you got no response from them and that they weren't going to feed her while she was with them I think rescheduling was likely the best thing you could do in the circumstances, Adrienne.

The best thing I can think of to suggest to you right now so you don't end up in a similar situation is to post a thread here at FDMB today to ask for advice on what to do about insulin tonight and tomorrow morning in preparation for tomorrow's scheduled visit to the vets for the ultrasound, and also seek input from the vet who'll be doing the scan. That way, you'll be able to choose the best course of action to ensure Dolly gets her scan and you won't have any worries about her blood glucose levels.

Will keep you both in my thoughts and prayers.

(((Adrienne and Dolly Girl)))


Mogs
.
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Thank you Mogs. Will do, no answer still from yesterday’s vet, crazy, they don’t answer the phone. Waiting to hear back from her vet. :bighug::bighug:
 
Hi again, Adrienne.

Our Dolly Girl said:
Had a shot of both [ondansetron and cerenia] late afternoon afternoon yesterday
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I've been thinking about the anti-nausea side of things for you, and I wanted to share something I've learned from experience.

* It can take a bit of trial and error to find the right dose of ondansetron.

* Even once you get the right dose, it can take 24-48 hours before it will reach full effect.

*You may still need to use an appetite stimulant - at least at first - to help Dolly eat.

* Adequate pain relief (bupe) makes a big difference to the success of anti-nausea and appy stimulant treatment.


I've found the key things with ondansetron are:

1. Give the initial dose a chance to start working (c. 48 hours).

2. If it doesn't have much effect on the initial dose, don't give up on it too soon. Workwith your vet to adjust the dose amount/frequency of administration.

3. It's important to maintain anti-nausea support for quite some time after a kitty starts eating well again. If required, it should be considered as a daily 'maintenance medication'.

Here's a very helpful section covering this (from Tanya's Site):

http://www.felinecrf.org/appetite_loss_nausea_vomiting.htm#ondansetron_amount

In particular, note the dosing guidelines cited at the above link from Plumb's Veterinary Handbook: they're much more closely aligned with the 'real world' needs of a cat with pancreatitis who is having difficulty eating.

Will be keeping you both in my thoughts and prayers.

(((Adrienne and Dolly Girl)))

:bighug::bighug:


Mogs
.
 
I already have a new thread for today. Wasn’t sure what to say. Going to try to rest. Just took a zophran myself. Don’t have RX for the ondansetron for Dolly. Thank you for all the info. I will come back to it. Thank you for everything. :bighug::bighug::bighug:
 
I saw your new thread and the questions you asked are just fine. :)

I posted the ondansetron info on this thread so all the info will be in one place for you when you need it.

I know you don't have an Rx for ondansetron yet, Adrienne, but I'd suggest asking your vet about it. It's very much worth considering.

Saying a little prayer you'll manage to get a little bit of rest.

(((Adrienne and Dolly Girl)))

:bighug::bighug:


Mogs
.
 
Critter Mom said:
I saw your new thread and the questions you asked are just fine. :)

I posted the ondansetron info on this thread so all the info will be in one place for you when you need it.

I know you don't have an Rx for ondansetron yet, Adrienne, but I'd suggest asking your vet about it. It's very much worth considering.

Saying a little prayer you'll manage to get a little bit of rest.

(((Adrienne and Dolly Girl)))

:bighug::bighug:


Mogs
.
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Thanks Mogs for being proactive for me. I literately can’t think today. I am so grateful for all the info, care and support. I wish I trusted vets but I am having trouble. Everyone has cut back on staff but are busier than ever. I can hear the stress in the doctors voices, this is not reassuring. :bighug::bighug::bighug::bighug::bighug:
 
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