? 3/2 Pudge are Ondansetron and Milk Thistle ok close to one another?.. whoops :/ AMPS

[kitten68]

2/28/26 Prev Thread Pudgles

..

I can tell he feels better.. but idk where things are rn. Last few days have been nice after months of struggle.. Nausea meds been very consistent.

He’s just worsening tho im afraid.. because we dont have a good binder (helps phosphorus, etc..)
So combinations we could do for binders are: Niacinimide + capsule ALOH? Catney One/Epakitin + Niacinmide? Capsule ALOH alone? Is this maybe right? @Suzanne & Darcy @tiffmaxee @Wendy&Neko (Kidney group advised the middle option..)

I’d prefer a pill to powdering his food because im already putting/adding so many things to his food.. Doctors also didnt get back on what i could combine….. this has just been one gigantic irritation.

I’m generally atm not sure how my nugget is doing.. Thinking to get some current blood done (last was 2 weeks ago i think..). He’s urinating quite a lot lately.. that’s worrying. I’m doing all the things now but still need to do the B complex, try binder capsules, and think should up his fluids to 100.. was worried about his heart/him getting averse to it, but think we can now.. he doesnt like it but tolerates it frm me.. so might as well..

The fluids AND binders help stop things worsening.. tried adding to food. Didnt want.. need to do capsules. Just juggling so much.. feel like its getting by us.. but trying our best. (I also have to find help w the house here.. The idea was they would not be coming until much later (theyre painting the outside.. some repairs needed prior but oh well.. tried looking, got blew off haha, asked around, but no luck.. then all this happened and frankly this has my attention rn..).. Its always something..)

I don’t know whats going to happen.. or when.. trying to just do day to day.
Idk..

I been so tired (did some yard work to prep for the painting..) i reduced his dose a little for overnight.. got some rest.. but hes up and down and so me w him.. (tests, water, food, help w his potty..)

Any thoughts appreciated..

 

[Staci & Ivy]

If Pudge needs the binders in a pill and you’re giving it at same time as meals, wouldn’t that be ok if he won’t tolerate it in his food?

So glad the nausea meds are helping him feel better
(Suzanne, Wendy and Elise will know better)

As for looking for contractors, can you look on Nextdoor (the app). I’ve found many contractors that way that have been surprisingly good. Other people have posted suggestions for who they like.
I found my current electrician that way and he’s the best we’ve ever had!

 

[Suzanne & Darcy]

I personally would not leave Aluminum Hydroxide out of the equation. It’s binding capacity is just greater than the others. I would try Aluminum Hydroxide binder in capsules with food, the Epakitin in the food if he will eat it, and the Niacinamide as well (which obviously needs to be in a capsule.)

I would get bloodwork done, and then two weeks after starting this, I would get it done again.) If you don’t monitor it like this, you won’t know if everything you are doing is working or if you need to make changes (including a different binder altogether, because there are others.)

Finally, my heart really goes out to you. I feel sad for you because I can tell that it’s really getting you down. I just feel it from your messages. Try to focus on the positive things you have already accomplished for Pudge, like the fluids and controlling nausea. Those are “Wins.” But do take action on the other things so that you can soon add those to your column of “Wins” for Pudge.

 

[Tim & Pookey]

Agreed with Suzanne, I've been following along silently and seen you make so much progress managing everything. Great job!

 

[Staci & Ivy]

I personally would not leave Aluminum Hydroxide out of the equation. I t’s binding capacity is just greater than the others. I would try Aluminum Hydroxide binder in capsules with food, the Epakitin in the food if he will eat it, and the Niacinamide as well (which obviously needs to be in a capsule.)

I would get bloodwork done, and then two weeks after starting this, I would get it done again.) If you don’t monitor it like this, you won’t know if everything you are doing is working or if you need to make changes (including a different binder altogether, because there are others.)

Finally, my heart really goes out to you. I feel sad for you because I can tell that it’s really getting you down. I just feel it from your messages. Try to focus on the positive things you have already accomplished for Pudge, like the fluids and controlling nausea. Those are “Wins.” But do take action on the other things so that you can soon add those to your column of “Wins” for Pudge.

I agree completely! We understand how daunting all of this is and Pudge has so many wins because of you!

These are such good suggestions, thank you Suzanne for your help with Pudge

 

[tiffmaxee]

I 100% agree with Suzanne. If you can put some AH in a smaller capsule when you give snacks it would help possibly as it needs to bind with food whenever possible. I have been in your shoes and feel your pain. You are going above and beyond for Pudge. I know the frustration. I hope you can take some time for yourself as you need to stay healthy too. I wish we had the hug emoji right now.

 

[kitten68]

::UPDATE::

…… i thank everyone so much. will get back better when can later today.

we got blood done at the vet. will see where he is..

got the Niacinimide! and will capsule some ALOH today.. he was 12.02 lbs last week.. yesterday he was 11.9…. Im concerned as all *…. Sigh. He used to be 15.. the only thing i know to do is get his appetite (binders, keep on top of nausea), anemia (B vitamins), and hydration (ok to still increase to 100 mL now hes down to 11.9?.. assume so.. as its 10 mL per pind or so..) better???

ok to give binders at the same time even?

for the ALOH capsules, going to sprinkle what can in interim and then start him on 1/8 tsp thru capsules if able then increase to 1/4 tsp??? (Suzanne wont let me tag.. but hopefully you read this. )

also start the Niacinimide? Or wait a day or two see how he does w the capsules?

this has been really hard on us.. and im just disappointed. but still giving it a try..

 

[kitten68]

his numbers tho been ok.. nice.. ive been so tired tho i missed his +3 and +5 last night..

 

[Staci & Ivy]

::UPDATE::

…… i thank everyone so much. will get back better when can later today.

we got blood done at the vet. will see where he is..

got the Niacinimide! and will capsule some ALOH today.. he was 12.02 lbs last week.. yesterday he was 11.9…. Im concerned as all *…. Sigh. He used to be 15.. the only thing i know to do is get his appetite (binders, keep on top of nausea), anemia (B vitamins), and hydration (ok to still increase to 100 mL now hes down to 11.9?.. assume so.. as its 10 mL per pind or so..) better???

ok to give binders at the same time even?

for the ALOH capsules, going to sprinkle what can in interim and then start him on 1/8 tsp thru capsules if able then increase to 1/4 tsp??? (Suzanne wont let me tag.. but hopefully you read this. )

also start the Niacinimide? Or wait a day or two see how he does w the capsules?

this has been really hard on us.. and im just disappointed. but still giving it a try..

You’re doing great
I’ll try to tag Suzanne for you
@Suzanne & Darcy

 

[Suzanne & Darcy]

his numbers tho been ok.. nice.. ive been so tired tho i missed his +3 and +5 last night..

Lovely greens on March 1, but I don’t see March 2 (yesterday.)

 

[Suzanne & Darcy]

hydration (ok to still increase to 100 mL now hes down to 11.9?.. assume so.. as its 10 mL per pind or so..) better???

Yes. You have that right. He’s still okay to get 100 mL of sub-q fluids.

 

[Suzanne & Darcy]

ok to give binders at the same time even?

Same time as what? You can give the Niacinamide at any time of day. First thing in the morning or whenever you like. AlOH has to be given with food as you already know.

 

[Suzanne & Darcy]

also start the Niacinimide? Or wait a day or two see how he does w the capsules?

This is up to you. If you want to wait a couple days that’s probably fine.

 

[kitten68]

You’re doing great
I’ll try to tag Suzanne for you
@Suzanne & Darcy

ty!!!! woof….. made some ALOH capsules today..
not bad at all haha.. tho theyre slippery.

 

[kitten68]

Lovely greens on March 1, but I don’t see March 2 (yesterday.)

will be updating his SS..!!!! w everything i sorta lagged on it..

 

[kitten68]

This is up to you. If you want to wait a couple days that’s probably fine.

think best.. his tummy

Same time as what? You can give the Niacinamide at any time of day. First thing in the morning or whenever you like. AlOH has to be given with food as you already know.

right! was just thinking tho if i could pill pocket them and give together for breakfast/dinner w the ALOH capsules i plan on now adding (made a bunch today! starting w 1/8 tsp.. was told to go slow because its constipating.. ..).. idk

Yes. You have that right. He’s still okay to get 100 mL of sub-q fluids.

tysm….. ok. im going to start, been inching towards it. Get some Terumo 19s also, see how goes. Also makes fluids less of a pain.. no need for measure .75 mL etc..

 

[kitten68]

oopsie question..

Gave Ondansetron dose and was half asleep and just gave him some of his Milk Thistle in the snack after because he needs his Thistle too for today.. this ok???? :/ (i never did get complete answers on what could go together/cant frm the vets.. .. They didnt say tho Ondansetron and the Thistle couldnt.. if they know anyway..)

@Suzanne & Darcy @tiffmaxee @Wendy&Neko @Staci & Ivy

 

[Staci & Ivy]

oopsie question..

Gave Ondansetron dose and was half asleep and just gave him some of his Milk Thistle in the snack after because he needs his Thistle too for today.. this ok???? :/ (i never did get complete answers on what could go together/cant frm the vets.. .. They didnt say tho Ondansetron and the Thistle couldnt.. if they know anyway..)

@Suzanne & Darcy @tiffmaxee @Wendy&Neko @Staci & Ivy

I don’t know the answer here. I hope you get an answer from someone who knows. I’ve never used Milk Thistle

 

[Wendy&Neko]

Not a vet so can't say for sure. Maybe ask your vet? You could look up ondansetron instructions and see what it says. The instructions in my ondansetron box only talks about other medications, not supplements, that may be a problem if given together.

 

[tiffmaxee]

I don’t know the answer either. Maybe try Good RX. I know they have an interaction checker

 

[kitten68]

@Staci & Ivy @Wendy&Neko @tiffmaxee

just occurred to me.. hes got his Ondansetron dose in his system more or less 24 hrs a day rn….. so really, hes been taking his Thistle w it this whole time.. .. right? haha.. womp. hopefully its fine.. did the google and it did say there werent any known much w them both.. shrug.

thanks for trying to answer and quick replies

 

[tiffmaxee]

I just did a search and while not a lot of info I read together it can help with nausea.

 

[kitten68]

I just did a search and while not a lot of info I read together it can help with nausea.

oooh that's great to hear.. hm! okie

 

[Suzanne & Darcy]

oopsie question..

Gave Ondansetron dose and was half asleep and just gave him some of his Milk Thistle in the snack after because he needs his Thistle too for today.. this ok???? :/ (i never did get complete answers on what could go together/cant frm the vets.. .. They didnt say tho Ondansetron and the Thistle couldnt.. if they know anyway..)

@Suzanne & Darcy @tiffmaxee @Wendy&Neko @Staci & Ivy

I don’t think that’s a problem at all. How is his eating?

 

[kitten68]

I don’t think that’s a problem at all. How is his eating?

oh Suzanne.. so many things mess w his eating.. hes eating ok i guess but its not enough. hes been losing like a pound every 1-2 weeks it seems lately. i think i need to give the stimulant more.. but idk. think the anemia is messing w his appetite too now and his PS numbers.. insulin too maybe…..

his pressure might be high-ish again.. but idk.

he was 12 lbs. last week.. now hes 11.9… was told negligible but i dont like it. he used to be 14-15..

we get a handle on something.. another comes to drag us.

i started his B complex.. idk what else to do but increase his frequency of Mirataz rn (was advised maybe to do that..) and try to get a handle on his anemia.. is this possible?

i need to get him on oral B12 too right?.. (so many capsules.. )

i was going to start making him some fresh turkey meat too, some nice thigh..

 

[Suzanne & Darcy]

Well, I don’t know what his HCT is today, but if it drops below 20 you will have to start ESA injections. It works really really well for anemia. I just had my cat at the vet this morning and her HCT is holding quite steady and I haven’t had to give her an injection of Darbepoetin since January 26. At first her injections were closer together but it’s lasting longer now and it’s been 5.5 weeks now and she’s about ready for another one to raise her HCT again.

You are doing your best!

 

[Suzanne & Darcy]

Oh, I would try increasing the Mirataz to daily (alternating ears) and see if it helps and if he tolerates it okay.

Didn’t they check BP this week at the vet? Didn’t you take him for bloodwork? Or is that someone else I am thinking of?

 

[Suzanne & Darcy]

His BG numbers have been very nice with lots of green. You deserve the credit for that! You are also keeping him under the kidney threshold with those numbers and that will mean less work for his kidneys.

 

[kitten68]

Well, I don’t know what his HCT is today, but if it drops below 20 you will have to start ESA injections. It works really really well for anemia. I just had my cat at the vet this morning and her HCT is holding quite steady and I haven’t had to give her an injection of Darbepoetin since January 26. At first her injections were closer together but it’s lasting longer now and it’s been 5.5 weeks now and she’s about ready for another one to raise her HCT again.

You are doing your best!

just got his labs up hes not down to 20 yet (dont think..) is that the only route? or only if it drops that low, or can we expect it to do that?

do the B vitamins help? i was gonna make him some turkey meat and have that be a staple for his diet.. see if helps.

Oh, I would try increasing the Mirataz to daily (alternating ears) and see if it helps and if he tolerates it okay.

Didn’t they check BP this week at the vet? Didn’t you take him for bloodwork? Or is that someone else I am thinking of?

ok think will do this.. least every other or something.. probably needs it more regularly..

His BG numbers have been very nice with lots of green. You deserve the credit for that! You are also keeping him under the kidney threshold with those numbers and that will mean less work for his kidneys.

tysm for saying……. ok..

 

[Suzanne & Darcy]

do the B vitamins help? i was gonna make him some turkey meat and have that be a staple for his diet.. see if helps.

Yes. The B-vitamins contain the precursors (like the ingredients or helpers) for red blood cell production — so without enough of them the body can’t produce healthy RBCs. b2, b3, b6, b9 and b12 are all important.

I would definitely encourage you to keep up the B-Complex and B-12 injections. In several of my own cats with either CKD or heart disease or IBD) I have been able to keep their anemia under control with those. The were still anemic although they never dropped below 20. Now in my kitty who we took to the vet this morning, her PCV (packet cell volume… similar to HCT) was do to 26. The vet wants me to wait until about Saturday to give her the Darbepoetin injection but I may not wait that long. In the last week, I have noticed a subtle change in her appetite and I think it could be related to the anemia. After all, 26 is definitely below the IDEXX reference range. So I probably will give it to her tomorrow.

 

[Suzanne & Darcy]

Hey! You got hos potassium up!! Well done. Keep upbthe Renal-K potassium powder! Good job!

 

[Suzanne & Darcy]

Phosphorus way too high though. I am surprised you aren’t seeing hind leg weakness. Get those binders into him.

 

[kitten68]

Yes. The B-vitamins contain the precursors (like the ingredients or helpers) for red blood cell production — so without enough of them the body can’t produce healthy RBCs. b2, b3, b6, b9 and b12 are all important.

I would definitely encourage you to keep up the B-Complex and B-12 injections. In several of my own cats with either CKD or heart disease or IBD) I have been able to keep their anemia under control with those. The were still anemic although they never dropped below 20. Now in my kitty who we took to the vet this morning, her PCV (packet cell volume… similar to HCT) was do to 26. The vet wants me to wait until about Saturday to give her the Darbepoetin injection but I may not wait that long. In the last week, I have noticed a subtle change in her appetite and I think it could be related to the anemia. After all, 26 is definitely below the IDEXX reference range. So I probably will give it to her tomorrow.

I see! we doing it over here.. the capsules been ok so far!!! slippery little suckers.. but i been doing my best to squish em around a pill pocket i make..

i was reading one of the anemi meds was bad for FD.. maybe it was the Varentin.. (?) glad your baby does well on that!! heard of something called Epogen.. but think it has side effects.. :/ seeing some of the anemia treatments do..

 

[kitten68]

Hey! You got hos potassium up!! Well done. Keep upbthe Renal-K potassium powder! Good job!

still borderline.. but better than it was! bought that Famotidine for nothing.. guess its there tho.. but it went up ..

Phosphorus way too high though. I am surprised you aren’t seeing hind leg weakness. Get those binders into him.

yeah.. been about the same.. ugh. But thats to be expected..

 

[Suzanne & Darcy]

No. My cat does not take Varenzin. That is an oral medication to help stimulate the production of red blood cells. It is not recommended for diabetic cats.

My cat gets Darbepoetin injections for her anemia. That is permitted to be used with diabetic cats with the normal monitoring. I hope you won’t need it. My choices other than starting the Darbepoetin injections would have been to let her die of anemia or have frequent blood transfusions which would be unsustainable. It’s a bit lf a pain with the monitoring of her HCT/PCV, but she feels great and has gained weight and I am happy with her eating 3 cans of the renal food every day.

 

[kitten68]

No. My cat does not take Varenzin. That is an oral medication to help stimulate the production of red blood cells. It is not recommended for diabetic cats.

My cat gets Darbepoetin injections for her anemia. That is permitted to be used with diabetic cats with the normal monitoring. I hope you won’t need it. My choices other than starting the Darbepoetin injections would have been to let her die of anemia or have frequent blood transfusions which would be unsustainable. It’s a bit lf a pain with the monitoring of her HCT/PCV, but she feels great and has gained weight and I am happy with her eating 3 cans of the renal food every day.

the blood transfusion thing i agree … thats impossible to do all the time. thats the one then! i was right.. ok.

im so happy shes put on weight and eating..

 

[Suzanne & Darcy]

the blood transfusion thing i agree … thats impossible to do all the time. thats the one then! i was right.. ok.

im so happy shes put on weight and eating..

It is a relief when they eat. I have a different cat who should be 10 lbs minimum (he used to be like 13) and he’s now below 6 lbs. He is very emaciated. It’s sad, but he hasn’t given up yet and neither have we. We certainly have not had any help from our vet. I think she gave up on him long ago since she doesn’t know anything else to do. His kidneys are okay at least. We’re on our own. Next week he is going to University of Georgia. Maybe they will help. Maybe not. We will see.

 

[kitten68]

It is a relief when they eat. I have a different cat who should be 10 lbs minimum (he used to be like 13) and he’s now below 6 lbs. He is very emaciated. It’s sad, but he hasn’t given up yet and neither have we. We certainly have not had any help from our vet. I think she gave up on him long ago since she doesn’t know anything else to do. His kidneys are okay at least. We’re on our own. Next week he is going to University of Georgia. Maybe they will help. Maybe not. We will see.

a gigantic relief.. i panic.

aw the sweet boy.. oi. i guess that is the way to go. have heard that.. they havent given up, we keep going too.. and his weight loss is a bit of a mystery? really happy his kidneys are cool.. i hope they help! we were referred to a university too.. im contemplating calling but not sure..

most vets.. are trash.