12/27 Herman update, we are home!

Amy & Herman

Amy & Herman

Member Since 2022
https://www.felinediabetes.com/FDMB/threads/12-26-herman-update-still-in-er-but-improving.284975/

I visited Herman at the ER this morning. I can tell he’s been quite a handful for them…. so hard to see your baby looking like that. I do believe he was very happy to see me though and after spending 45 minutes with him just giving him his scratches he calmed down a fair bit and then ate like a champ for me!

I’m going back in a couple hours to pick him up, they needed some time to get him off the IV etc. and put his med list together. It was hard to get a straight answer but my understanding is they’ve skipped at least a dose or two of insulin because his numbers have been running between 5.6 and 6.8 and he wasn’t consistently eating. At this point, I told them to leave it for me and I will plan to give him his dose later this afternoon once he’s settled at home. From what I can tell, they aren’t giving him his ear pokes in the Sweet Spot because he’s got horrible bruises in areas of his ears that I’ve never even attempted to draw blood from. My poor little dude. Also of concern is that I feel like his third eyelid was slightly covering his eye, and his eyes seemed red. I imagine he hasn’t been getting tons of sleep. It is quite stressful being there, so I will be keeping a close eye on that.

When I asked for ondansetron They weren’t sure what I meant and I mentioned it was anti nausea med said they could send him home with Cerenia… Do I push for the ondansetron or perhaps ask my regular vet? She said she would also be giving me some gabapentin for pain. Does that make sense?
 
Amy & Herman said:
https://www.felinediabetes.com/FDMB/threads/12-26-herman-update-still-in-er-but-improving.284975/

I visited Herman at the ER this morning. I can tell he’s been quite a handful for them…. so hard to see your baby looking like that. I do believe he was very happy to see me though and after spending 45 minutes with him just giving him his scratches he calmed down a fair bit and then ate like a champ for me!

I’m going back in a couple hours to pick him up, they needed some time to get him off the IV etc. and put his med list together. It was hard to get a straight answer but my understanding is they’ve skipped at least a dose or two of insulin because his numbers have been running between 5.6 and 6.8 and he wasn’t consistently eating. At this point, I told them to leave it for me and I will plan to give him his dose later this afternoon once he’s settled at home. From what I can tell, they aren’t giving him his ear pokes in the Sweet Spot because he’s got horrible bruises in areas of his ears that I’ve never even attempted to draw blood from. My poor little dude. Also of concern is that I feel like his third eyelid was slightly covering his eye, and his eyes seemed red. I imagine he hasn’t been getting tons of sleep. It is quite stressful being there, so I will be keeping a close eye on that.

When I asked for ondansetron They weren’t sure what I meant and I mentioned it was anti nausea med said they could send him home with Cerenia… Do I push for the ondansetron or perhaps ask my regular vet? She said she would also be giving me some gabapentin for pain. Does that make sense?
Click to expand...
The eyelid issue can be from pain meds. I'm not sure which he is on. They warned me that this could happen to my guy when they gave him buprenex.

Yes, please push for ondansetron. Cerenia did nothing for my extremely nauseated guy. His vet didn't want to give it to me and after a week or so when she did finally write the script, it wasn't even a strong enough dose. I had to give him the proper dose because he was being underdosed. Ondansetron is generic for Zofran. If they don't have it, ask for a script and fill it through a pharmacy. GoodRx has good deals for this. I'm not sure if you are in the US or not though.

When my guy was at the vet, they didn't even check his bg, they blindly shot him. Even though it is an ER setting, I just don't think there is enough knowledge and experience for our cats when it comes to these situations. I'm sorry about Herman's ear.

Wonderful that you were able to be with him for a good amount of time and he responded well to food with you.

Excited for you to get your boy home.
 
Just reading through your posts. I'm sorry Herman's having a tough time. I'm sure he was happy to see you this morning. So hard to see your baby not doing well. I've only had to leave one of our kitties at the hospital overnight once, and that was frightening. Hope you do get to bring Herman home today. Sending pawsitive thoughts and big hugs.
:bighug::bighug::bighug:
 
Basic's Mom said:
The eyelid issue can be from pain meds. I'm not sure which he is on. They warned me that this could happen to my guy when they gave him buprenex.

Yes, please push for ondansetron. Cerenia did nothing for my extremely nauseated guy. His vet didn't want to give it to me and after a week or so when she did finally write the script, it wasn't even a strong enough dose. I had to give him the proper dose because he was being underdosed. Ondansetron is generic for Zofran. If they don't have it, ask for a script and fill it through a pharmacy. GoodRx has good deals for this. I'm not sure if you are in the US or not though.

When my guy was at the vet, they didn't even check his bg, they blindly shot him. Even though it is an ER setting, I just don't think there is enough knowledge and experience for our cats when it comes to these situations. I'm sorry about Herman's ear.

Wonderful that you were able to be with him for a good amount of time and he responded well to food with you.

Excited for you to get your boy home.
Click to expand...
Thanks for the info. I’ll mention zofran to see if that rings a bell to them. I’m in Canada. I’m heading out shortly to get my boy. I’m going to be early but I can’t help it.
 
I believe @Wendy&Neko mentioned that the medicine is very expensive in Canada. I believe she also suggested calling around for pricing if you can.

Cerenia is really used to prevent puking, not to help with nausea. I'm only telling you this because my cat wasn't puking. His vet said he didn't need the ondansetron because he wasn't puking. The group quickly informed that just because he isn't puking doesn't mean he isn't extremely nauseated. Once I got the ondansetron in his system, at the correct dose, and giving it every 6 hours, he really responded well.

I don't blame you for getting to the ER early, because SAME. Hahaha.
 
Oh Amy I’m so glad to hear you’re picking Herman up and he ate well for you today!! I’m praying g got you both. I know he will be so happy to be home with you.
Much love to you both :bighug::bighug::bighug:
 
Last edited:
So happy Herman ate for you! That's great news.

Ondansetron is the generic drug name, Zofran a brand name which you don't want to pay for in Canada. Been a while, but the quote was over $10 a pill. :arghh: Generic was better, but still pricey. It does depend on the cat, but I find ondansetron better a controlling nausea. The downside is you have to give it more often. Ondansetron and Cerenia target different nausea receptors. You can actually can use both. So if they don't get you a ondansetron prescription right away, grab the Cerenia and contact your regular vet for the ondansetron script.

I would vote for buprenorphine for pain over gabapentin. Again a bit ECID, but gaba didn't do a lot for Neko when we trialled it but buprenorphine did. Some vets fuss over giving it out because it's a regulated controlled substance. Problem is that pancreatitis is very painful and there are very few pain meds that cats can take safely so options are limited.
 
We are home! He instantly went to his dish for a snack. :p

He hasn’t had insulin since yesterday at 9am (.75 unit) and his numbers were below what they were comfortable shooting and I just tested him and he’s 83. Thinking to hold off…..?

After much discussion I got the prescription for ondansetron, my husband has to go get from pharmacy. Herman was sent home with clavamox, metronidazole (confused by this one…need to Google more, input appreciated), mirtazipine and gababentin.​
 
I'm going to let the experts weigh in on all of this.

I do want to tell you to make sure to clean the ear daily (which ever one you apply the app stim to). My cat got what was almost like a chemical burn from it. While it may not be a common side effect, had I known it could happen, I would've been cleaning his ear daily. The build up wasn't visible to the naked eye either. Not telling you this to scare you, just advising you to what happen with my boy. If your cat pulls away as you try to apply it, don't assume he's being jerky. Look at his ear to make sure it isn't red, inflammed, or irritated in any way.

So glad you are home and he is eating. THAT IS HUGE. He will feel much better at home.
 
Basic's Mom said:
I do want to tell you to make sure to clean the ear daily (which ever one you apply the app stim to).
Click to expand...
The appetite stimulant I got is in pill form…unless I am mistaken, when I go back to the kitchen I’ll check…!

reading about metronidazole and I’m not comfortable with it…. Herman is prone to constipation, not diarrhoea. I will skip it and call my regular vet tomorrow.

Other than that and the Clavamox I understand most of his meds meds are to be administered as needed… ie if he’s not eating showing signs of nausea or pain. so I’ll need to judge that.
 
Goodness. Maybe I should've asked first which form you have.

My cat was given metro and clavamox at the same time too. Wrecked his system. Had to have his behind shaved. Heed the advice about probiotics I've seen others tell you about. My guy had a e tube so I had to give him kaopectate in his tube. Once it was removed, he was giving a few different supplements to help.

Keep in mind, he has been given pain and anti nausea intra while he's been in the hospital. Don't get behind on either. You want to stay ahead of both.
 
Last edited:
Basic's Mom said:
Goodness. Maybe I should've asked first which form you have.

My cat was given metro and clavamox at the same time too. Wrecked his system. Had to have his behind shaved. Heed the advice about probiotics I've seen others tell you about. My guy had a e tube so I had to give him kaopectate in his tube. Once it was removed, he was giving a few different supplements to help.

Keep in mind, he has been given pain and anti nausea intra while he's been in the hospital. Don't get behind on either. You want to stay ahead of both.
Click to expand...
Thanks for all this! I’m on it. :D
 
If you got mirtazapine pills, what dose? I've seen that go wrong. You want smaller dose more often. Miritaz (transdermal ear cream) is better from a reduced side effects point of view. But if he's eating, you can hold off on the appy stimulant.

Good call on holding off the metronidazole. Good to review with your own vet. IMHO, it tends to be given more often than it should. By the way, it is the most bitter of meds.
 
Vets love mirtazapine as an appetite stimulant but I’ve seen too many cats react badly to it, so I’m with Wendy re: caution with dosing and only if needed. The reactions I’ve seen are very distressed, yowly cats who seem disoriented and stressed, sometimes pacing about, and sometimes it lasts for hours. It can be very dramatic. Given Herman’s already sensitive nature, just wanted you to be forewarned.

I’m glad Herman is home. I’m sure you both are too. :) Now Herman, let’s keep eating and getting better!

edited to add: in the old days we used cyproheptadine as an appetite stimulant. I still ask for it if needed. It always seemed to work but with fewer side effects than mirtz. Anyway, something to keep in the back of your mind.
 
Wendy&Neko said:
If you got mirtazapine pills, what dose? I've seen that go wrong. You want smaller dose more often. Miritaz (transdermal ear cream) is better from a reduced side effects point of view. But if he's eating, you can hold off on the appy stimulant.

Good call on holding off the metronidazole. Good to review with your own vet. IMHO, it tends to be given more often than it should. By the way, it is the most bitter of meds.
Click to expand...
Thanks for this…. and I see @JL and Chip agrees on the mirtazapine (the dose is 1mg every 24 hours if needed). So far he is eating so I will talk to my vet about the ear cream if we need to boost his appetite.
Will plan to test him at 4am and shoot and give insulin if he’s still eating well and his number doesn’t make me too nervous.
 
You must log in or register to reply here.
Back
Top