7/27 Max AMPS 275

Max & Lori

Max & Lori

Member Since 2021
Max got a Lev increase this am. Then we had a vomit fest, not sure if it was barf and scarf or if it is because I was trying to get by with just the Ondansetron twice daily for him. He was getting Cerenia once daily in addition, but I stopped that because I read on Tanya’s CKD that Cerenia shouldn’t be given with amlodipine (I’m assuming that meant at the same time). So since his amlodipine is now twice a day, I was worried about giving the two meds too close together. I’ve read that it can affect electrolytes such as potassium and he is already borderline low on potassium. I ended up giving the Cerenia at amps +1, after I was able to get more food into him. I gave the amlodipine morning dose at amps +4.5. His regular vet is out of town and the other vets evidently didn’t see that it is a problem to give the two meds. I guess I’m posting to see if anyone else knows anything. I know it’s a long shot but just curious.
Previous https://felinediabetes.com/FDMB/threads/7-25-max-amps-218-pmps-276.279895/#post-3090764
 
Okay well, I guess I will try and keep the two meds on a schedule of administering 2-3 hours apart. He obviously needs to stay on the Cerenia as well as the Ondansetron and he has to take the BP meds 12 hours apart. He was getting the BP meds in the morning and the cerenia at night so that was at least 12 hrs apart, but now with throwing in the night time dose of BP meds, maybe I will just do the cerenia at bedtime. I hope he will be okay. Thanks anyway.
 
Hi Lori. I'm sorry, I am only aware of the same thing about Maropitant and Amlodipine being used together -- the mention on Tanya's site. So he's on Amlodipine twice a day now?
 
Suzanne & Darcy said:
Hi Lori. I'm sorry, I am only aware of the same thing about Maropitant and Amlodipine being used together -- the mention on Tanya's site. So he's on Amlodipine twice a day now?
Click to expand...

Hi Suzanne, yes he was on amlodipine 1.25 mg and enalapril 2.5 mg in the mornings. Now they added another amlodipine 1.25 mg in the evenings. I called the vet and asked again earlier today, but she said it was fine to take with cerenia. I told the vet about all that I’ve read and she just said they prescribed those two meds together a lot of times. I don’t think he’s going to be able to go without the cerenia though. He can’t use slippery elm because he’s allergic to that, so I guess the only thing I can do is try and space it out between doses.
 
Hi Lori, I was trying to catch up a little bit on Max. Good to see you are using Visbiome. It's worth the $$. My IBD cat has (FINALLY) been able to go to every other day pred instead of daily pred since starting (well after two jars.. so 80 days, I tried it) the Visbiome. I've been using the Visbiome Vet.

As for meat sources, check this one out Raw Feeding Miami sells high quality meat. https://www.rawfeedingmiami.com/
 
He had a trace of proteinuria at his last labs just a few weeks ago. He’s been diagnosed with early CKD also.
 
Max & Lori said:
Hi Suzanne, yes he was on amlodipine 1.25 mg and enalapril 2.5 mg in the mornings. Now they added another amlodipine 1.25 mg in the evenings. I called the vet and asked again earlier today, but she said it was fine to take with cerenia. I told the vet about all that I’ve read and she just said they prescribed those two meds together a lot of times. I don’t think he’s going to be able to go without the cerenia though. He can’t use slippery elm because he’s allergic to that, so I guess the only thing I can do is try and space it out between doses.
Click to expand...
I guess that's what I would do. I've asked my vets this question before as well and had the same answer. I have given both to my cats before, but I've never had the every 12 hour Amlodipine before. I think your plan is a good one.
 
Suzanne & Darcy said:
I guess that's what I would do. I've asked my vets this question before as well and had the same answer. I have given both to my cats before, but I've never had the every 12 hour Amlodipine before. I think your plan is a good one.
Click to expand...

Thanks Suzanne. Have you tried that raw feeding place you mentioned? I couldn’t remember if you raw fed or not.
 
I would not give him sub-q fluids at this point either. His creatinine isn’t high enough. It’s not that bad. From Tamya’s website:

Sub-Qs are normally used when the cat can no longer drink enough to remain hydrated, which in practice tends to be once creatinine levels are consistently over 3.5-4.0 mg/dl (USA) or 300 -350 µmol/l (international). This equates to high Stage 3 of the IRIS staging system. They may also be needed on a temporary basis for cats who develop problems with vomiting or diarrhoea, which increase body fluid losses, or for cats with pancreatitis.
 
@Suzanne & Darcy I agree with you. I do have to periodically give him small amounts of subQ fluids though because of pancreatitis, but it’s only when needed and small amounts at the time. I worry about his heart. It’s difficult because it seems like when he needs one thing to treat a certain diagnosis, it’s contraindicated with something else. Thanks for the info on where to buy meat. I’m going to probably order something to try for him. I’m calling them tomorrow to ask about the shipping since it’s so hot here right now.
 
Max & Lori said:
@Suzanne & Darcy I agree with you. I do have to periodically give him small amounts of subQ fluids though because of pancreatitis, but it’s only when needed and small amounts at the time. I worry about his heart. It’s difficult because it seems like when he needs one thing to treat a certain diagnosis, it’s contraindicated with something else. Thanks for the info on where to buy meat. I’m going to probably order something to try for him. I’m calling them tomorrow to ask about the shipping since it’s so hot here right now.
Click to expand...
You are right to be cautious. I had a cat with a pleural effusion due to fluids given when her heart was weak. It’s all so hard to balance. You are right.
 
Lori I am sending my strongest healing and calming vibes for you and Max, sorry to read he wasn't feeling great when you posted this condo. It is super tricky to be balancing a lot of meds, I would be terrified. :nailbiting::nailbiting::nailbiting: Have you ever signed up for the Tanya's Website forum for cats with CKD? There is a support group(or there used to be when my Tiger was still with me) You might try posting questions there when it concerns such specific meds for BP and other meds that Max is taking? I hope otherwise you are doing okay, not cooking in summer heat!
 
Thanks @Tiger(GA) and Ruth. I’ve studied Tanya’s CKD site quite a bit. I haven’t joined the support group but I think I will. It is a lot but Max is still a happy kitty and has his good days too. Sometimes I feel like everyone has given up on Max except me. Yes he has a lot going on and he will most likely never go off of insulin or any of these other meds. He won’t be one of these cats who make it to remission, but it doesn’t even matter to me anymore. Max is the best kitty I’ve ever had and I am thankful for every day I have him. I heard a vet not long ago say that he is a “medical miracle.” He may be, but I’m doing my part to give him as many good days as we can get. Thanks for your suggestions Ruth!:bighug:
 
Max & Lori said:
Max is still a happy kitty and has his good days too.
Click to expand...
Love that part!

Those of us here haven't given up on Max either. :bighug::bighug: He's got a fantastic caregiver and it sounds like he still has lots of good days. My goal for Neko was as good a QOL as I could help her have. He's just "complicated". I found my IM vet was really good at balancing her multiple conditions.
 
Thank you Wendy, and same here, quality of life is what matters most. I’ve gotten compliments from both the IM vet and his regular vet about the care he gets, but I also get comments about how much is involved in taking care of him. I usually just tell them we manage to get it done and still have time to play (on the days he feels good). :)
 
I certainly will never give up on Max! You’re wonderful Lori. I have been a member of Tanya’s support group for many years now. It’s very good if you need specific answers, but it is a VERY busy group and can be a bit overwhelming.
 
OBYW, Lori, I did put out an APB the other day with your question about Amlodipine and Cerenia being used together (on the Tanya CKD support group) because we both had already read what the site says, but I wanted to ask for some real experience. Here is one of the responses I received from a person who had asked her vet about this same issue:

“the Cerenia and Amlodipine, we use moderate attention when using the meds together. Cerenia can make more amlodipine available in the body. Theodora's blood pressure has routinely been checked and is not low. Therefore, we are not concerned with Cerenia causing any issues with the amlodipine. The "risk' of Cerenia and amlodipine is more theoretical based on human enzymes and drugs interactions. We typically watch for our feline patients but don't typically see that effect in those patients.”

The other reply that I had (from a person I trust) was that she recommended, in the situation of Amlodipine being given every 12 hours, to give the Amlodipine at breakfast and dinner and to give the Cerenia at lunchtime. This is what you are already doing so I think you are on the right track (although what are the alternatives, right?)
 
Thanks for checking on that Suzanne! Good to know. I was just curious because it didn’t really explain the rationale on the website. So far he seems to be fine with it, but I’m giving the two meds several hours apart like we said. He is going back Wednesday for another blood pressure check. I’ll let you know how it goes.:)
 
You must log in or register to reply here.
Back
Top