3/5 - Gen, AMPS 117, PMPS 101

Allie & Gen

Allie & Gen

Member Since 2025
Yesterday

Hey friends! I hope your Thursday is going swimmingly - and safe-surfingly for your kitties!

I'm in the office and. alas, worried sick. Gen barely ate anything last night, and he's not doing great today so far either from what I can see from the camera. I think he ate up the 1/4 can of rabbit (which is MC, so there's that), but hasn't had much of his "regular" food (which is most of what I gave him per diet transition guidelines).

I was able to give him his ondansetron 30 minutes before feeding, but I forgot the mirataz last night. I gave him some this morning, but I suspect it's not kicking in much. (Tonight I'm going back to full doses in the evening, which seemed to work well for awhile, and maybe will again?)

Haven't heard back from my vet again since I replied to her initial thoughts with a few questions (cerenia dosing, more info about her potential suggestion of oral buprenorphine, and about cyproheptadine). Not surprising; the office opens at 11 on Thursdays, and she almost always has a surgery first thing. I am thinking of speeding up the food transition a bit if Gen keeps showing more enthusiasm for the rabbit; I'm also thinking of calling the animal hospital and seeing if they can move up his internal med consultation, just to get as much feedback as possible and see if we can come to a conclusion on the biopsy.

My vet seems to think the appetite trouble is all pancreatitis-based. I was thinking of how a lot of the cats here seem to have flares with their pancreatitis, not a continuous symptomatic experience. Has anyone had the experience of pancreatitis symptoms requiring medication for a longer period, or even more intensive pain management? (This may seem obvious, but is it likely that if he has either IBD or SCL, those are affecting/worsening the pancreatitis?)
 
With Indy the IBD (when not under control) definitely affects his appetite. He becomes super nauseous and does not want to eat at all. With pancreatitis though, the flare ups can last a different amount of time. Gen also still has the dental stuff going on, which could be affecting his appetite too, right?

I'm sorry that Gen is causing you so much stress right now. At least he is cute!! <3 <3 *huge hugs*
 
Jessica & Indy said:
With Indy the IBD (when not under control) definitely affects his appetite. He becomes super nauseous and does not want to eat at all. With pancreatitis though, the flare ups can last a different amount of time. Gen also still has the dental stuff going on, which could be affecting his appetite too, right?

I'm sorry that Gen is causing you so much stress right now. At least he is cute!! <3 <3 *huge hugs*
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I suppose any of it could be affecting his appetite, really. The dental stuff has never seemed to bother him all that much, but again ... cat. Very good at hiding pain and discomfort, even when you know them well! So it's awfully hard to be sure.

I love him so much, adorable pain in my ass that he is. Sigh. 🥺

There hasn't been an alarm in awhile ... it doesn't look like he's eaten more, but at least we're avoiding the citrus so far today. (I did give him 2/3 of his insulin dose this morning because I was worried; looks like that was the right call.)
 
I am sorry Gen is not eating well, Allie. It's so stressful!
I think you are correct, use the meds especially when they show signs of not eating. Seems some people give maintenance doses of cerenia and ondansetron and ad Miritaz when needed.
You're asking all the right questions.
Sending vines for better appetite! 🍀 🍀 🍀 🍀 🍃🍃🍃🍃
 
So glad you have the camera and Libre at your fingertips to monitor him... and that you opted for that slight trim off the dose this morning! Stressful to leave, especially when Gen isn't eating well :(

I wish I had some insights or advice on what could be going on, but like Staci said, you're asking all the right questions and in general the fact that you're asking and invested like this is great for Gen. I'm hopeful you'll find the right cocktail that works for all his things. Somehow it always has to be more than one thing, right? But Gen is so lucky to have you fighting for him and trying to figure him out.

Good luck going back to the full dose tonight 🤗
 
You asked:
This may seem obvious, but is it likely that if he has either IBD or SCL, those are affecting/worsening the pancreatitis?)

The answer is yes. It is quite common for pancreatitis to go along with IBD, scl, and fd. I am glad you are trying to get the appointment moved up. I know how worried you are. How I wish they could talk!
 
Thank you, friends. We made it through the AM cycle without limes, but I got home to find he had barely eaten anything at all. 😮‍💨 And the hospital internal med unit doesn't have any openings next week, though they've put me on a list in case something opens up. Otherwise, we'll have to wait for the 17th.

Per my vet's instructions, I've upped Gen's Cerenia dose to 16mg. She also said it was all right if I gave ondansetron at more frequent and uneven intervals (all I can manage). I gave him a half dose when I got home, and then a full dose just now. (Starting tomorrow he'll get the full dose in the late afternoon/early evening and then again at night, but all my pills were already made up into capsules and I just had one half-pill left to grab; I've reorganized my little capsule cocktails now to adjust for the dosing changes.

She also suggested I might want to start administering the oral version of mirataz, which might be more effective for him since it has higher bioavailability than the transdermal version. I'm considering it, but will stick to the transdermal for now while I wait to see how the other changes pan out.

I'm going to try to sleep now, though he's quite low and I'm worried that we'll have limes tonight and I'll wind up waking up a lot. My performance review kept being rescheduled, and now it's set for tomorrow morning, so I really could use a good night's rest!

Also, I got the fructosamine results back, but haven't had a chance to go over them; something else for tomorrow.

Goodnight!
 
The downside to oral mirtazapine is that it can hit hard and fast, more side effects. There's a reason the drug is called meowzapine. I do like your idea of one change at a time.

Pretty awesome set of numbers during the AM cycle today. Not liking that drop to +1 though.
 
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Wendy&Neko said:
The downside to oral mirtazapine is that it can hit hard and fast, more side effects. There's a reason the drug is called meowzapine. I do like your idea of one change at a time.

Pretty awesome set of numbers during the AM cycle today. Not liking that drop to +1 though.
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Honestly, right now something that would take effect fast sounds amazing, especially in contrast to what I'm dealing with right now ... a cat who sits and stares at his food but doesn't eat it unless I specifically give him a treat, and even then mostly just eats the treat. I feel so helpless and scared.

He ate a bit better overnight, but that was partly because I woke up in the wee hours, picked him up, and carried him to the food. It doesn't seem like he was going to keep getting up and eating more on his own after we went to bed.

I wish I could feel like those were awesome numbers, but they're the numbers of a cat who didn't really eat all day, and I feel like that doesn't count for much.

tiffmaxee said:
I had a cat on mirtazapine. She became very vocal and hyper. I would not use it again.
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I appreciate the warning, but at this point what you're describing doesn't feel like much of a deterrent by comparison.
 
I'll make a new post for today a bit later; I have my performance review in half an hour. For now, suffice to say that Gen's still not really eating, I gave him .5u when I left but I'm scared that even that might have been too much, and he's decided to nap outside the range of the Libre app-bearing phone so I don't have his current BG. I'm not sure when I've been this worried.
 
Did you ask your vet about cyproheptadine? It might work just as well with lesser side effects. I understand how you feel.
 
tiffmaxee said:
Did you ask your vet about cyproheptadine? It might work just as well with lesser side effects. I understand how you feel.
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I did. My vet essentially thinks mirataz is a much more effective medication generally and that we aren't at the point of concluding that it just isn't working, so she doesn't think it makes sense to pivot. She did say it's an option. I appreciate your recommendation, but as I'm not having the kinds of problems you did with mirataz, I'm not inclined to try and switch at this point either, though I'm keeping the option in reserve.
 
I did not have issues with Mirataz. It just did not work. My issues were with the pill, mirtazapine. It can cause seratonin syndrome. The antidote us cyproheptadine should it happen.i hope it works for you.
 
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