20 July, Minerva, AMPS 389, still having serious eating issues

Joy W

Member Since 2021
Hey folk

What a rollercoaster of a week. Minerva was sent home from the vet on Thursday evening, and she seemed to be doing really well. But it is like 2 steps forward, 1.5 steps back. She ate well Thursday night, ate ok Friday morning, stopped eating Friday night. Vet finally conceded and gave him at home cerenia Saturday afternoon and then she started eating again Saturday evening, but over the course of Sunday stopped again, until about 10.30 when she suddenly ate a bunch of raw kangaroo meat.

I ended up rushing home from my work trip early as I was so worried about both her and Garth (who was incredibly stressed about it all, as was I), so got home late Sunday night, just after she decided to eat the kangaroo.

I spent Monday and Tuesday at home with her. Monday I gave her mirtazapine mid morning and got a bunch of new foods to try, and she actually did pretty well over the course of Monday - still fussy but I could find some things she liked, and she voluntarily went to her bowls and ate food at least 2 or 3 times! But then yesterday, she ate very little. I did finally manage to give her some gabapentin yesterday for the first time in a couple of days; they gave it to us in a powder form to go on her food which would be great if she didn't instantly reject whatever food it was on. Butter was the trick to finally get her to consume it. But then afterwards she was much more subdued and barely ate for the whole day, so not sure if that was the sedating effect or if it was coincidence.

It is nearly midday here and so far she has only had a few mouthfuls of cat milk today and that is about it. I am at our shop as Garth has medical appointments this morning, and then when he gets to the shop I will go home and give her mirtazapine, gabapentin, and see if I can tempt her to eat.

I have tried ALL the things: different foods, different flavours, tinned, raw, warmed up, mushed into paste, pet milk, etc. She ate Recovery in the vet so got some of that - she won't touch it. (I haven't tried baby food as can't find any suitable). She will eat something and then later not even look at it. We had a good run with those gooey squeezy tubes, then I tried to use one to dose her with gabapentin, and she rejected that and hasn't eaten any since.

She is showing a desire to eat: for example last night she woke us at 1am, 1.30am, and 6.30 am loudly demanding food, ran into the kitchen, yelled at us, tail quivering - and then rejected like 5 options in a row. I finally got 1/3 of a tin of fancy feast into her at 1.30 am by offering it to her off my fingers, which she liked. Then when it fell onto the floor she pounced on it and starting eating before I could pick it up, so I spent 5 minutes spooning it off the plate she wouldn't even acknowledge and dropping it on the floor in front of her, before she abruptly decided she was done. At least then I got to sleep until 6.30. I tried the floor trick then and she wouldn't have a bar of it, but she decided she was excited by pet milk and started drinking it like she was starving - and then again abruptly stopped after a few mouthfuls. That was enough to go back to bed for 20 minutes until my alarm went off.

About her sugars: yes they are high, and yes it bothers me. She got down to 2.8/50 at the vet so she earned a decrease from 1.5 to 1.25, but the vet wanted us to drop it even further, to 0.5 if under 20 and 1 if over 20. I was a bit uneasy with that but we rolled with it for a couple of days before I switched to 1.0 for all doses but she has only had one pre-shot under 20 since then anyway. Her readings will be high for a few reasons including that we aren't pulling up her food in the 2 hours before - at this point I don't want to deny her food in the unlikely event she actually wants to eat some - and she is always hungry about an hour before; and also we are focusing on what she will eat and I imagine some of it is a bit higher in carb although we are trying as much as possible to stick to LC options.

Aside from the food she is mostly happy, purring, she even played with Garth on Monday night, she comes for cuddles and is back to sleeping on the bed and most of her behaviours are mostly normal, she just won't eat.

I could scream, and have already cried multiple times. I am sure more experienced people here would be handling this fine but I just don't know what to do.

@tiffmaxee I finally asked and yes the pancreatitis test they did was SNAP; it was negative but they decided to treat as positive for pancreatitis

https://felinediabetes.com/FDMB/threads/13-july-minerva-update-from-vet-mixed-news.265743/
 
She’s needs daily cerenia as she’s clearly nauseous. It only lasts for 24 hours. Wanting to eat but walking away or only drinking the liquid are signs of nausea. The SNAPP as I think I mentioned just gives a positive/ negative result so if in the gray area will show negative. When Max first started with pancreatitis his only symptom was inappetence. It was the only consistent symptom with all bouts. I used ondansetron and he was on it for a few months along with cyproheptadine as an appetite stimulant until I realized his dose wasn’t high enough. Once on the right dose I rarely used cyproheptadine. :bighug:
Her bg is too high. She needs an increase badly. Can you syringe feed if needed? Sometimes eating gets them back to eating once nausea is under control.
 
Sorry, I meant to say she has been on daily cerenia since the vet gave us some to take home on Saturday, but still getting the mixed results. We only got 8 doses, today will be dose 5 when she gets it in 4 hours, and I'm not sure they will give us more, they seem really really really reluctant to give cerenia for at home oral treatment.

I think odansetron might be available over the counter for humans so if someone can help me figure out a dose I'll do that if they won't give us more, which is scary.

The mirtazapine is meant to be every 48 hours but G didn't do Saturday's dose as we didn't have cerenia at that point and he didn't want to just make her hungrier if she couldn't eat, and then he was unsure on Sunday and the vet was closed. So we checked on Monday and they said to keep it up, so she got a dose Monday and today.

Gabapentin was meant to be every 12 hours but we worried about how stoned she seemed when she got home from the vet, and also its a powder to go with food and she keeps rejecting it. But I've worked out she will lick butter with it in, so shes had 2 doses at 24 hours apart, shes currently grooming her second dose off her whiskers haha. Should we go to 12 hourly?

We have syringes for feeding and the syringe compatible recovery mousse, so it can go there if needed.

Yes I'm thinking it's time to go up in insulin to 1.25 again, I'll do that tonight. Does it matter so much that we're not withholding for 2 hours given how patchy her food is anyway? The vet was way cautious due to her low: he wanted no shot under 15, 0.5 between 15 and 20, and 1 over 20. We did that for the first couple of days then decided to do 1 regardless of her preshot, but have only had high preshots since.

I'm meant to be leaving tomorrow for my final work trip of the season, Garth is stressing about pilling her while I'm away and I don't think he would manage syringe feeding her. If I have to skip the trip I can but it's for my own business, my mum is my business partner, and she would be doing it alone and I feel so bad about that. I need to be in 2 places at once.
 
We need an RX here for ondansetron. If you can get it I can give you dosing according to the vets here. Old thinking was you couldn’t give cerenia long term but that’s not true. Ondansetron is dosed 2-4 times a day though.

How long will you be away? If cerenia us actually helping maybe she has a food aversion to food she has eaten when nauseous. Have you tried a different flavor or brand of food. Not much help though if leaving tomorrow. Cerenia comes as an injectable but it stings. I tried it with two cats and just couldn’t give it. So sorry about the timing and test he’s still not feeling well.
 
Hmm I might be wrong on the odansetron then, mixing it up with something else. I'll look into it.

I'm meant to be away from Thursday night to Monday morning but could make it Sunday morning possibly. He will pill her if he has to, he's just really anxious about it and it would be 4 doses of cerenia and 2 of mirtazapine (or 3 and 1 if I'm home Sunday). He's convinced he can't do it, despite doing it twice while I was away last weekend, his anxiety is of course worrying me!

I've tried so many flavors and brands: Fancy Feast, Ziwi, Feline Naturals, Whiskas, raw kangaroo, raw goat, Dine squeeze tubes; some with and without fortiflora, some warmed and not. The whiskas and squeeze tubes were brand new to her diet, she happily ate like 6 squeeze tubes on Monday and a couple yesterday but hasn't touched them since I put gabapentin in one. She had 2/3 of a whiskas pouch Monday, in 2 goes, voluntarily, then wouldn't touch it yesterday, but she is right now eating some Whiskas again, not sure if it will be more than 2 bites, but it's better than total rejection we had yesterday!
 
Holy moly she just ate most of the Whiskas pouch! It's the most food she's had in one go since yesterday morning! (It's 2.30 pm)
 
Ugh, she is really putting you through the wringer. You have lots of sympathy from me with the fussiness. I've been there in tears with a buffet of food strewn across the floor.

I hope you can get the ondansetron, that has been successful for me - I have a really hard time with pilling. Someone suggested here the soluble ondansetron (I've heard them called mini-melts too) - the ones I get have a sort of strawberry flavour. I don't think she really likes them but they don't make her drool like the cerenia and the benefit of them being soluble is that once I get it in her mouth, I just have to be sure and hold her mouth shut long enough for them to dissolve so she can't spit them out.

Good luck to your entire team :)
 
Thank you @Liz & Minnie yes the buffet and tears is an exact experience I've had this week. At least she is, if not exactly happy, not entirely miserable either: she's grooming and purring and smooching and snuggling and telling us off for everything we do wrong (which is a lot, we are getting a lot of 1-star reviews from her lately!).

Thanks for the advice on the ondansetron, I will enquire!

@tiffmaxee our vet can do transdermal mirtazapine but it's 15 days to get it! ‍:banghead: So I guess capsules it is!
 
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