Appetite Stimulants?

[bsmith]

I know that a number of you have used appetite stimulants and one time or another. I'd be insterested in hearing which ones worked for you, side effects issues, and any other information you might have on the subject. I'm currently giving Edwin 500 mcg of B12 MethylCobalamin per day, but I think I need to do something more.

Edwin went OTJ about a week ago after successfully transitioning to Young Again Zero Carb Mature food, which was started about three weeks ago. He did have some issues with a hard belly during the transition. He also stopped eating the small amount of Friskies special diet canned food (low carb/no fish) during this time, but he was eating plenty of dried food so I wasn't too worried. For the canned food, I tried forti flora, warming the food, sprinkling crushed freeze dried chicken treats on top, and ground oregano. No go.

Last week he decided to stop eating the YA out of his bowls. I had been trying to get him to eat more, as he needs to put on some weight, so I had put a variety of bowls around the house, raised the bowl heights, garnished with treats and catnip, etc. By hand feeding, and putting small piles of food around the house, I was able to get him to eat enough food every day. Then he decided to stop eating any YA.

I went through all the lists of possible medical issues for not eating and was able to rule them out. I then went through the canned food lists again to find a low carb/low phosphorus/no fish food he might eat. I ended up with the Fancy Feast delights with cheese since he really likes canned food with cheese. They're not the best phosphorus wise, but they're okay. I was definitely able to rule out inappetence and nausea as he scarfed one of those cans right down.

I called YA and they suggested grinding up the dried food and mixing it into the canned food. This worked the first night. I took up all the other bowls of YA and left out only one bowl with exactly one cup of food in it so I could more accurately see how much he was eating, but he has yet to touch a single piece in that bowl.

The next night, Thursday night, I tried mixing a larger amount of YA in with the canned food. He wouldn't touch it, even after I mixed in more canned food. I did get him to eat a handful of roasted chicken breast and then, on his own, he ate a small pile of YA food and dried chicken treats that were on his cat steps. I did notice his belly was hard again that evening.

Today (well, Friday) I backed off on the amount of ground YA mixed into his canned food and I put it out earlier in the day, but he wouldn't touch it. His belly is still hard. After massaging his belly, I did get him to eat some roasted chicken thigh. Later, I gave him some unadulterated canned food which he ate (he probably heard me muttering about the fact that I have syringes and that's what was going to happen if he didn't eat something). I'll be putting out some more regular canned food before bed.

Edwin's coat is looking better than it has in a year, but he is still not eating enough and is thin. He seems active and happy and his last BG test looked good at 92 (sorry I haven't updated his spreadsheet with numbers and notes). He is pooping a small amount every other day (or perhaps more as he has been outside). Today's poop was a bit broken apart and tracked into the hallway and seemed to have a little bit of dried grass in it. The person at YA said that as long as he was pooping every day, or every other day, he should be fine.

The YA rep also said he may be supplementing his diet with outdoor prey, but I don't think this is true. He was an indoor cat for most of his life and everything he's ever brought back for me has never had a single mark on it. The only thing I've ever seen him eat is moths. Though today he came home with mud on his mouth. Strange, is he eating worms or grubs? At least they're low carb.

I'd be happy for any suggestions you might have about appetite stimulants, diet, or clues as to what is causing his hard stomach.

 

[Larry and Kitties]

For phosphorus control yo can use a phosphorus binder is yo can find higher phosphorus food that he will eat.
For an appetime stimulant there are two: mirtazapine and cyproheptadine
- mirtazapine is usually give as 1/8 to 1/4 of 15 mg tab every three days. Some cats become spacy with mirtazapine. Also there can be other problems ( serotonin toxicity ) with mirtazapine and the antidote is cyproheptadine
- cyproheptadine is given twice daily at 1/4 or less of a 4 mg tab. Again some cats become spacy.

 

[Blamethecats and Hannah]

I tried forti flora, warming the food, sprinkling crushed freeze dried chicken treats on top, and ground oregano. No go.

Yep, we've tried all of the above, too, and then some more. FortiFlora has helped so many kitties... but not Hannah. She hates the stuff. Warming the food... nope, not Hannah. Sprinkling crushed freeze-dried chicken or beef on food... negatory, again. Ground oregano or catnip on food... she gave me a funny look. Raising the bowl... worked one time, not the next. Changing brands... hated them. Mirtazapine... turned her into a hyper-active zombie with a ravenous appetite, until it wore off in about 3 days... plus I worried about serotonin syndrome being a possibility.

Thanks to suggestions by @Critter Mom, we started Hannah on Cyproheptadine (1/4 of a 4 mg tab, twice a day) several months ago. That has helped quite a bit, even though Hannah hates taking the stuff... it's very bitter and she's determined to chew it when I pop it into her mouth. I then quickly follow with some wet food, as she has learned that helps to get the taste out of her mouth and send the pill on its way "down the pipe." When we first started the Cypro, it made her lethargic and turned her into a bit of a space cadet. But those symptoms have diminished as her body acclimated to the drug. Every now and again, she ditches the Cypro and I find it in various places around the house. And some days/weeks, for whatever reason, it doesn't seem to work at all and her appetite fails. But all in all, the Cypro has been a tremendous help. My little girl has managed to gain a little over 2 lbs. since last fall.

I don't know what the long-term effects of Cypro might be, as I don't think this drug has been formally tested and approved for use in cats. All I know is that, right now, it seems to be the only hope Hannah has for having any kind of appetite at all. Best wishes with getting Edwin to like food, again. Wouldn't it be great if kitties could be like dogs and eat anything and everything we put on their plates?!

 

[Karen & Rudy]

Rudy is currently on cypro and he hasn't had too many side effects- a little groggy- but I'll take it over not eating.
He is also on an anti nausea (Zofran), which I think helped even more- since he finally started eating again after that, subq fluids and a b12 shot.
I hope Edwin gets back to eating soon. It's so scary! hugs!!!

 

[Critter Mom]

Edwin went OTJ about a week ago after successfully transitioning to Young Again Zero Carb Mature food, which was started about three weeks ago. He did have some issues with a hard belly during the transition.

Just did a quick web search and came across this on a Yahoo Answers thread:

I had some foster kittens who had that problem. X-rays showed that they weren't digesting the dry food I was feeding them, it was just sitting in there and fermenting. You could try gradually switching him over to canned food, which is much healthier than dry is anyway.

(Emphasis mine.)

Source: https://uk.answers.yahoo.com/question/index?qid=20110115170541AAgTsLM

There may, of course, be another reason why Edwin's tum is getting hard but I given the changeover to the dry diet, maybe look at the vegetable content? It's certainly a place to start.

Re appetite stimulants, mirtazapine may work for longer (and according to one of our vets may have anti-nausea properties) but the risk of serontonin syndrome is very real. Mirtazapine is a tetracyclic antidepressant that affects both serotonin and noradreanaline function. I've been prescribed it myself and it really is a very harsh, 'dirty' drug. I've been thrown umpty-'leven psych meds in the course of the medical profession's attempts to medicate away my PTSD and of all of them, mirtazapine was the worst. My whole nervous system went haywire on it after only a few doses, after which I stopped taking it. The one - tiny - dose of it that I gave Saoirse (before knowing the side effect profile) had her go from her normally quiet, pacific self to a borderline psychotic, aggressive thing with pupils like saucers and she became absolutely crazed with hunger. I got the drop of my life when I did an internet search for some of her symptoms and discovered the drug could cause serotonin syndrome. I would have to be very desperate indeed to ever give it to Saoirse again, and then I would only be prepared to give it to her provided I had cyproheptadine to hand and detailed instructions from the vet about exactly how to use it as a mirtazapine antidote.

By comparison, cyproheptadine had a midly sedating but gentle action in Saoirse. Again, only a tiny dose once - or occasionally twice - a day was enough to keep her eating well. She did need anti-nausea meds at the same time (ondansetron generic) but over time I was able to stop giving the cypro and I now give the anti-nausea med ad hoc.

If it is the case that the new food is blocking or constipating Edwin, it could be making him nauseated. If marked nausea is present, no amount of 'appetiser' techniques will work. If his stools are dry and crumbly that might point to constipation/dehydration. How is Edwin's kidney function BTW. Also how do the protein and phosphorus contents of the different foods compare?

 

[bsmith]

For phosphorus control yo can use a phosphorus binder is yo can find higher phosphorus food that he will eat.

I've had phosphorus binders suggested to me before on this board. The fact many of them are aluminum based makes me uncomfortable. Do you have any experience with them?

Yep, we've tried all of the above, too, and then some more. FortiFlora has helped so many kitties... but not Hannah. She hates the stuff. Warming the food... nope, not Hannah. Sprinkling crushed freeze-dried chicken or beef on food... negatory, again. Ground oregano or catnip on food... she gave me a funny look. Raising the bowl... worked one time, not the next. Changing brands... hated them. Mirtazapine... turned her into a hyper-active zombie with a ravenous appetite, until it wore off in about 3 days... plus I worried about serotonin syndrome being a possibility.

Wouldn't it be great if kitties could be like dogs and eat anything and everything we put on their plates?!

It's always nice to hear that at least I'm not alone in the dance of the non-eating kitty. (Maybe if I put out the good china he'll eat from that. Grandma always said coffee tasted better in those good china cups.) Edwin won't go for the forti flora at all either. I was hoping it would be the magic bullet that it seems to be for so many cats here, but, alas, no. Also, I seem to remember a time when Edwin was more dog like and would eat just about anything I put down. Of course, at that time he had a little extra weight to work with so if he didn't eat really well for a bit it wasn't such a big deal.

There may, of course, be another reason why Edwin's tum is getting hard but I given the changeover to the dry diet, maybe look at the vegetable content? It's certainly a place to start.

Re appetite stimulants, mirtazapine may work for longer (and according to one of our vets may have anti-nausea properties) but the risk of serontonin syndrome is very real. Mirtazapine is a tetracyclic antidepressant that affects both serotonin and noradreanaline function. I've been prescribed it myself and it really is a very harsh, 'dirty' drug. I've been thrown umpty-'leven psych meds in the course of the medical profession's attempts to medicate away my PTSD and of all of them, mirtazapine was the worst. My whole nervous system went haywire on it after only a few doses, after which I stopped taking it. The one - tiny - dose of it that I gave Saoirse (before knowing the side effect profile) had her go from her normally quiet, pacific self to a borderline psychotic, aggressive thing with pupils like saucers and she became absolutely crazed with hunger. I got the drop of my life when I did an internet search for some of her symptoms and discovered the drug could cause serotonin syndrome. I would have to be very desperate indeed to ever give it to Saoirse again, and then I would only be prepared to give it to her provided I had cyproheptadine to hand and detailed instructions from the vet about exactly how to use it as a mirtazapine antidote.

By comparison, cyproheptadine had a midly sedating but gentle action in Saoirse. Again, only a tiny dose once - or occasionally twice - a day was enough to keep her eating well. She did need anti-nausea meds at the same time (ondansetron generic) but over time I was able to stop giving the cypro and I now give the anti-nausea med ad hoc.

If it is the case that the new food is blocking or constipating Edwin, it could be making him nauseated. If marked nausea is present, no amount of 'appetiser' techniques will work. If his stools are dry and crumbly that might point to constipation/dehydration. How is Edwin's kidney function BTW. Also how do the protein and phosphorus contents of the different foods compare?

Edwin has always been on a dry diet and the YA food doesn't have anything in the way of vegetable content. Also, after being on the YA food for a few weeks his stomach stopped being hard and it seemed that he had adjusted. The YA has the same amount of phosphorus as the Hill's k/d he was eating before, but much more protien. His kidney numbers have been holding steady in the stage two CKD range for a few years.

Constipation may very well be the issue given the crumbly stool of yesterday. I just double checked for dehydration. His skin is maybe a little bit slow in snapping back today, but there isn't a really large difference. His water consumption seems normal too. Perhaps I'll try to sneak a little miralax into him, though I've never used that on him before and I'm unsure how he'll react. The stomach massage I've been doing on him is supposed to be good for constipation and gas. I do notice that after massaging him that way he is more likely to eat something and his belly does soften up too.

About the mirtazapine, I have also taken it myself for chronic nausea and pain issues. A bizarre med for sure, but, given that I have bizarre reactions to medications, I seemed to do okay on it (it didn't help a lot, but there were no dramatic side effects). @Blamethecats and Hannah, that three days of eating was right on the mark. Because of the nausea, I hadn't ate large amounts of food at one sitting for years, but the first three days on mirtazapine I was a bottomless pit of hunger. It was like the switch that tells you when you're full had totally been disconnected. I can see how many people gain 50-60 lbs in just a few months on it and how it can be very effective in helping cats put on weight.

Given the strangeness of mirtazapine, and that Edwin is already on tramadol (if I remember correctly there's a drug interaction there), I think I'll give cyproheptadine a try. That's if it turns out that he's not just constipated and the miralax doesn't help to fix him up. Plus, cyproheptadine is an antihistamine too and we've both been terribly stuffy from the beginning of spring. Edwin was snoring really loudly last night. (Hmmm... maybe that's part of the eating problem too. If he's really stuffy he may not be able to smell very well. Something else to think about.)

 

[Critter Mom]

Edwin was snoring really loudly last night. (Hmmm... maybe that's part of the eating problem too. If he's really stuffy he may not be able to smell very well. Something else to think about.)

Good point. Try nuking some of his kibble in the microwave for a few seconds.

BTW, mirtazapine had the same effect on my appetite.

 

[Chica & Carol]

Yep, we've tried all of the above, too, and then some more. FortiFlora has helped so many kitties... but not Hannah. She hates the stuff. Warming the food... nope, not Hannah. Sprinkling crushed freeze-dried chicken or beef on food... negatory, again. Ground oregano or catnip on food... she gave me a funny look. Raising the bowl... worked one time, not the next. Changing brands... hated them. Mirtazapine... turned her into a hyper-active zombie with a ravenous appetite, until it wore off in about 3 days... plus I worried about serotonin syndrome being a possibility.

Thanks to suggestions by @Critter Mom, we started Hannah on Cyproheptadine (1/4 of a 4 mg tab, twice a day) several months ago. That has helped quite a bit, even though Hannah hates taking the stuff... it's very bitter and she's determined to chew it when I pop it into her mouth. I then quickly follow with some wet food, as she has learned that helps to get the taste out of her mouth and send the pill on its way "down the pipe." When we first started the Cypro, it made her lethargic and turned her into a bit of a space cadet. But those symptoms have diminished as her body acclimated to the drug. Every now and again, she ditches the Cypro and I find it in various places around the house. And some days/weeks, for whatever reason, it doesn't seem to work at all and her appetite fails. But all in all, the Cypro has been a tremendous help. My little girl has managed to gain a little over 2 lbs. since last fall.

I don't know what the long-term effects of Cypro might be, as I don't think this drug has been formally tested and approved for use in cats. All I know is that, right now, it seems to be the only hope Hannah has for having any kind of appetite at all. Best wishes with getting Edwin to like food, again. Wouldn't it be great if kitties could be like dogs and eat anything and everything we put on their plates?!

Have you tried crushing it and putting it in water and using one of those syringes that you can use to administer fluids through the mouth that way she doesnt taste it?

 

[bsmith]

Have you tried crushing it and putting it in water and using one of those syringes that you can use to administer fluids through the mouth that way she doesnt taste it?

Are you referring to crushing the cyproheptadine? That's the way I'll have to go if I start giving it to Edwin. Although, even if you crush and mix the pill with just water in a syringe, the cat will still taste the bitterness of the pill and greatly dislike it. It's sometimes best if you can just get the cat to swallow the pill either in a pill pouch or covered with butter. Edwin has decided that he's no longer taking pills though, so I have to crush his tramadol and mix it with plain yogurt to help cover the flavor. I've also found that adding B12 (MethylCobalamin) to the mix and refridgerating the whole thing overnight helps with the bad tasting pills.

 

[Chris & China (GA)]

Have you ever tried Pill Pockets?

The dog Duck & Pea variety are low carb. You can break them into smaller pieces and "wrap" them around the pill

 

[bsmith]

Have you ever tried Pill Pockets?

The dog Duck & Pea variety are low carb. You can break them into smaller pieces and "wrap" them around the pill

Pill pockets for Edwin? I personally end up with it either totally untouched or a missing pill pocket and licked clean pill. And that was in the past when he trusted me more. At this point, Edwin suspects everything I give him even if I assure him repeatedly that it's just a treat, no trick, I promise. Dude, seriously, not everything I give you is some sort of evil plot (you know, the evil plot where I try to give you medications to help you). I think Edwin and I are going to need to have a little discussion about are trust issues. Honestly, I'm only trying to slip stuff into his food like half of the time. Okay, okay, 3/4 of the time. I don't understand why he's so suspicious and untrusting.

 

[BJM]

Sometimes, you can use a bit of processed cheese to wrap a pill.

When you dissolve it into water, suck up a bit of mushy cat food not normally fed to help mask the pill's taste. The reason for using a food not normally fed is that doing this may provoke food aversion.

 

[bsmith]

When you dissolve it into water, suck up a bit of mushy cat food not normally fed to help mask the pill's taste. The reason for using a food not normally fed is that doing this may provoke food aversion.

The idea to use a food not normally fed is an excellent idea. There's already plenty of food aversion going on in this house. Do you think it would be reasonable to use a medium carb food in this case since you will only be feeding a very small amount with the syringe? The whole low carb/low phosphorus/no fish thing makes it so there are very few food choices. I don't really have anything novel that fits all those requirements.

 

[Critter Mom]

The whole low carb/low phosphorus/no fish thing makes it so there are very fewer fewer food choices.

Oh boy, do I know how hard that is...

 

[BJM]

If it makes the medicine go down better, use whatever you want. Getting food in and medical conditions stabilized trumps low carb, even if it means raising the insulin dose.

 

[Critter Mom]

Thank you so much for posting the above, BJ. I really needed to hear someone say that right now. ((BJ))

 

[Elizabeth and Bertie]

I read a tip that has really helped us (can't remember whether it was here or on the CRF forum); but I'd tried pill pockets, cheese, that paste in a tub that smells like bacon (can't remember what it's called!), and a few other things, and my foster kitty would still spit the pill out.
The tip was to crush the pill, mix it with a little fish oil, and then add that to the food. I tried doing that with krill oil and my foster kitty has eaten every pill since then (touch wood/anti-jinx). Of course, it wouldn't work if the kitty hates fishy tastes...

 

[bsmith]

Of course, it wouldn't work if the kitty hates fishy tastes...

Edwin's issue is that fish causes his BG to spike. I'm not sure if it's all fish or if good quality fish oil would cause this issue too. The Young Again food does contain fish oil (even though the rep originally told me it contained no fish), but I never saw any BG spikes from it so I assume whatever they're using is okay with his system. The BG spiking from fish is an odd and somewhat rare issue.

 

[Critter Mom]

That's interesting. Tuna spike's Saoirse's BG. Do you know why it happens and why it's rare?

 

[bsmith]

That's interesting. Tuna spike's Saoirse's BG. Do you know why it happens and why it's rare?

I have no idea why it happens or why it's so rare. I'm not even sure if it's all fish for Edwin or just certain fish. I was feeding him canned Ocean Whitefish when I saw that big BG spike and cut him off fish (his BG was better after that). I also saw a big spike when I tried to switch him to one of the Hill's Science Diets that contained fish oil. Young Again also has fish oil, but Edwin's BG seems okay with the particular fish oil they use.

Ocean Whitefish is a pretty low quality fish to start with and then who even knows what's in the "cat food" grade whitefish. Some websites claim that human grade fish is fine for cats, but not "cat food" fish. I can't find the particular reference I'm looking for (I have a good one somewhere), but this website discusses some issue about cats consuming fish. Be advised though that some of the information on that site seems poorly referenced and overblown.

However, I wonder if the BG spiking comes from a fish allergy that was previously undetected (though looking back Edwin did always get stinky when he ate that whitefish version of food). The histamine reaction could cause inflammation, which could then cause the BG spiking. I could also be completely wrong about this entire thing and just be making stuff up, but it sounds vaguely plausible .

 

[Critter Mom]

Thanks for the additional info. Saoirse has a marked intolerance to salmon oil. It nauseates her. I only discovered it when I switched her over to wet food. It's so unfortunate because some of the better foods available in Europe contain salmon oil (e.g. Granatapet) and I can't give them to her.

 

[bsmith]

An update on Edwin for the past few days:

I'm seeing a bit of an uptick in food intake. Saturday night we had guests over for dinner and Edwin actually came upstairs during dinner. Edwin isn't a guest sort of cat, but he wanted some of that tasty chicken. Ate a little under a 1/4 cup of chicken breast in addition to 1/2 can of FF beef and cheese earlier in the day. He also ate the 1/2 can of FF chicken and cheese, spiked with 1/8 tsp of miralax, overnight.

Sunday he's eaten 1/2 can FF beef and cheese, a little ham, 1/2 can FF chicken and cheese (miralax and 1/2 tsp of ground YA). I'll put out more canned/YA mix before bed. Looking better Edwin. I'm not even having to do any fancy garnishing. His belly feels a bit softer too.

Off to put out more food and maybe do a little poopsmithing to see if there's anything to find.

 

[Elizabeth and Bertie]

I'm seeing a bit of an uptick in food intake.

Am so glad to hear that Edwin's eating a bit better.

...and maybe do a little poopsmithing to see if there's anything to find.

BTW, I'd really like to thank you for your sense of humour.
This forum can sometimes be a sad, frustrating and challenging place, but I've lost count of the times that your posts have brought a smile to my face or made me chuckle. And I'm sure I'm not the only one who feels that way. Your sense of humour is a real gift to this forum.

Eliz

 

[Critter Mom]

... poopsmithing ...

Luvvit!

 

[bsmith]

BTW, I'd really like to thank you for your sense of humour.
This forum can sometimes be a sad, frustrating and challenging place, but I've lost count of the times that your posts have brought a smile to my face or made me chuckle. And I'm sure I'm not the only one who feels that way. Your sense of humour is a real gift to this forum.

Eliz

Thank you, that's a really nice thing to hear. I'm always glad if I can get a smile or a laugh out of someone, even if the situation is somewhat of a challenge. It's a family trait to try to see the humorous and positive side to even bad situations. (You've probably seen my grandpa's picture. That sums up a lot of my family's outlook.) You can choose to laugh or cry at what life throws your way and I try to keep laughing (you can laugh and cry at the same time too, but that sometimes looks a bit nutty and is usually reserved for funerals).

About poopsmithing, if you're a Smith you have to decide what kind of "smith" you're going to be, at least as a hobby. My dad likes gunsmithing, and I was thinking of silversmithing or keysmithing. The past few years have made it abundantly clear that, alas, poopsmithing is to be my advocation. The "Poopsmith" is also reference to a character on the Homestar Runner internet cartoon from the early 2000s, where I first learned of that smithing option. As a Smith, it's always good to keep an eye on all the different types of smithing that are available out there.

 

[Critter Mom]

 

[bsmith]

As a poopsmith it is my duty to share with you this website I just found today: http://www.felineconstipation.org/index.html

I haven't seen that site before, but it seems informative and well designed.

Posting that Edwin was eating better seemed to jinx me a bit. There was less eating again yesterday. Let's see if posting this makes him eat more again. Now I'm going to go have a cup of tea to see what the tea leaves at the bottom of the cup have to say. Wait, do I have to drink the tea or does Edwin need to drink it? Maybe I'll just cast some chicken bones instead .

 

[Chica & Carol]

Are you referring to crushing the cyproheptadine? That's the way I'll have to go if I start giving it to Edwin. Although, even if you crush and mix the pill with just water in a syringe, the cat will still taste the bitterness of the pill and greatly dislike it. It's sometimes best if you can just get the cat to swallow the pill either in a pill pouch or covered with butter. Edwin has decided that he's no longer taking pills though, so I have to crush his tramadol and mix it with plain yogurt to help cover the flavor. I've also found that adding B12 (MethylCobalamin) to the mix and refridgerating the whole thing overnight helps with the bad tasting pills.

You can get B12 in a liquid and use a syringe and needle to give to your cat. Since I have to give my cat insulin I can easily give this to my cat. You might try mixing the pill with chicken broth instead of water or some other liquid the cat might like but the bottom line is that the animal gets the stuff. We as Adults have to endure distasteful things for our own good. Just remember that you are doing this for the welfare of the animal and not trying to make them suffer. Commend yourself for caring and doing this.

 

[bsmith]

You can get B12 in a liquid and use a syringe and needle to give to your cat. Since I have to give my cat insulin I can easily give this to my cat. You might try mixing the pill with chicken broth instead of water or some other liquid the cat might like but the bottom line is that the animal gets the stuff. We as Adults have to endure distasteful things for our own good. Just remember that you are doing this for the welfare of the animal and not trying to make them suffer. Commend yourself for caring and doing this.

Thanks @Chica & Carol. I use plain yogurt to mix Edwin's pills into as it's tangy taste seems to cover at least part of the taste of the meds. @BJM also mentioned trying a canned food that is not in your regular rotation as a medium to mix your meds into (thin with water as needed), which sounds like a very good idea too. With chicken broth, I'd make sure that it wasn't one that is too high in sodium. For cats that can have fish (not Edwin ), sometimes people use tuna juice to mix with meds or to make other foods more interesting.

As far as B12, I use powdered MethylCobalamin from a capsule. Edwin actually likes the taste of it and has been more willing to take his tramadol since I've started adding it to the mix. (Edwin actually liking something I'm giving him, a novel idea indeed). About the injectable form of B12, I actually just had a conversation with my vet about that today.

The injectable form of B12 is cyanocobalamin instead of the more desirable MethylCobalamin form of B12. Injectable cyanocobalamin generally contains aluminum, which is not such a big issue unless your cat already has CRF like Edwin. (This is all covered on Tanya's CRF kitty page here. I'm not sure if you've been to that site before. There's lots of good information there even for cats not in CRF.) Oral B12 MethylCobalamin is just as effective as the injectable cyanocobalamin form (see this study) and a better choice for CRF cats.

Back to mixing meds in a syringe, if tramadol, or another pain med, was injectable that would be great as Edwin would prefer a shot any day over anything mixed in a syringe. (You could mix magical pixie dust and powdered bat wings, he loves bats, into the syringe with the meds and he'd still hate it.) Getting the appropriate medications into your cat is definitely the most important thing. Edwin and I have had many a discussion about how I know he doesn't like it, but we have to do it to help him feel better. Making the time, when you administer syringe medication, calm and peaceful with lots of praise and treats afterwards definitely helps too. And maybe a verse or two of "Soft Kitty," as he really does like that song and it seems to calm him down.

 

[bsmith]

Update: At the vet for tests today to make sure we're not missing something that's making Edwin not want to eat much. A small, hard, broken bit of stool in the litterbox last night. Not much urine output either and a bit dehydrated by looking at the skin snap back action last night. This morning he seemed better hydrated and I checked his skin and gums too, as did the vet, and things seemed back to normal. The vet, while feeling his colon today, said that there is some stool in there, but it feels soft, normal, and a reasonable, though small, amount. I wonder if the stool he pushed out last night was just a hard bit that was blocking the way for the normal stool to makes its way out. That happens sometimes. Not that I'd know about something like that .

After coming home (we have to go back for the fasting tests tomorrow, whoops) Edwin proceed to lick every plate clean. Excellent. As usual, the cure for your cat not eating is to take him to the vet for tests concerning that. ("Ohhh, you wanted me to eat more? I thought you meant 'eat the floor' and then I was confused since you don't like it when I scratch and chew at the carpeting." I need to get Edwin's hearing checked or something.) Lab tests will look at kidney levels, Spec fPL, B12, and folate levels.

Since Edwin was seeming a bit dehydrated last night I started mixing some extra water in with his canned food. I'm starting to wonder if a teaspoon of water mixed with the canned food was all we needed to get him eating more. That would definitely be cheaper than running all these tests. Though, I am interested to see where his kidney levels are at after the whole diabetes and changing foods thing. Also, he's lost much less weight than I thought, which is very good news.

 

[Chris & China (GA)]

"Ohhh, you wanted me to eat more? I thought you meant 'eat the floor' and then I was confused since you don't like it when I scratch and chew at the carpeting."

HAHAHAHAHAHAHA

Sounds like pretty good news!! Sending positive vines for the test results!!

 

[BJM]

There are 2 ways to check for dehydration listed in my signature link Secondary Monitoring Tools, in case you don't already know them.The easiest one is the scruff test. The more sensitive one is the gum test.

 

[bsmith]

There are 2 ways to check for dehydration listed in my signature link Secondary Monitoring Tools, in case you don't already know them.The easiest one is the scruff test. The more sensitive one is the gum test.

I actually did use the gum test too after I did the scruff test, but I forgot to include it in my post. I had remembered something about it in your Secondary Monitoring Tools, so I went looking for your signature to get the link and double check how to do that. Thanks for including that in there. I do have a question though. Edwin has always been quick to foam at the mouth and when he's really happy he drools all over me. Since he is prone to these things, do you think this could effect the gum test since he's extra saliva-y to start with?

 

[bsmith]

Update as I'm back from the vet:

The good news:

• When we weighed Edwin at the vet yesterday he had lost way less weight than I thought. He was at 8.1 lbs down from 8.6 lbs a few months before. A healthy weight on him is 9.5-10 lbs. That makes me feel much better. It's still a lot of weight to lose, but it's not as dramatic as I thought it was. (I thought he was in the 7-7.5 lbs range. That kitchen scale lied, but, then again, it's not designed for weighing cats.)
• The stool in the litterbox last night was of regular size and consistency. I think the hard bit from the day before may have been blocking things up a bit. I'm planning to stick to the 1/8 tsp of miralax per day for now.
• I had to fast (food and water) Edwin for 10 hours last night. When my previous CKD kitty was getting ready to go she stopped eating and drinking. Edwin is definitely not planning on leaving any time soon. He was f***ing obnoxious all night long. If I did manage to sleep through his meowing, he would come lay on my neck or right next to my head and then meow really loudly demanding food and water. He's definitely still feeling peppy.
• Spec fPL test came back negative for pancreatitis!
• Since kidney problems are suspected we tested his blood pressure. Everything looks good there.
• Took samples for B12 and folate tests today. Edwin was making so much noise in the back room (he's usually very quiet and well behaved) that I actually opened the door to see what was going on. The vet referred to him as "hangry" (you know, the combination of hungry and angry). I certainly agree on that after last night.

The bad news:

• Edwin's kidney levels are definitely elevated from just a few months ago, though he's still stage 2 CKD. I suspect at least some of this is from the higher phosphorus canned food that I have been giving him to get him to eat anything. Since he was so hungry after being fasted, I switched him back to the Friskies Special Diet with groud YA mixed in (I am very tricky). He seems to like and eat that just fine when he's really hungry. Hopefully he'll keep eating it as it's a way better choice for his kidneys.

So, the plan is to start Edwin on 100 ml subq's every other day. Does anyone have any suggestions on places to buy subq supplies? The vet's markup is usually pretty high on supplies.

I'll also be starting Edwin on 5 mg of Pepcid every day and Cyproheptadine (not sure of the dosage as I haven't picked it up yet). What we'll do about B12 dosage and folate will be decided after we get those tests back.

It's good to have a better idea of what is going on so we can plan and treat accordingly. Hopefully, I'll be able to get his kidney numbers looking better again and get him eating better too.