Cerenia as an anti inflammatory long term

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Rachel & Gus

Member Since 2010
Has anyone used cerenia as an anti inflammatory long term for their cat?

I have read not to use it more than 5 days, but my new vet said they use it for arthritis in cats that have GI problems because it doesn't cause stomach upset which my kitty is prone to.
 
Hi Rachel-
I know some time has passed since you posted this. Sorry you did not get a response. Hopefully you asked elsewhere and got the answer. Just in case, I thought I would let you know that NO, Cerenia is not for pain. Cerenia is used for uncontrollable vomiting. And you are correct, it should not be used more than 5 days at a time.

Here is information about Cerenia:
http://www.veterinarypartner.com/Content.plx?A=2798
It is not FDA approved for cats, so you may be hard pressed to find a lot of info online for use in cats.
It is commonly used among board members, who can attest to how effective it is. My Latte received great benefit from it.

What type of pain is your kitty having? THere are options. Unless it was a quality of life issue, I would avoid NSAIDS. Even then, you would want to think seriously about other options.
 
Thank you Carolyn. I actually did find some research showing it is an anti inflammatory and pain reliever. My vet said we are going to have to find the right dose for Gus. Right now he has turned into a monster and tearing the kitchen apart because he wants to eat all the time. The vet wanted him on it for 4 days straight and then every other day and then possibly two days a week, but I'm going to email her because he has been opening the kitchen cabinets and now I'm going to have to tie them shut when I'm at work.
 
are you sure you are not talking about metacam? That is how metacam would be dosed!

Please click on the link in my signature. If it is metacam, it is important you are fully informed.
 
also... if it IS cerenia, could you link any of the information you found about it being an anti inflammatory? It would be good information to tuck away as reference.

Thank you!
 
I don't know about being an anti-inflammatory, but I did run across an er dvm here that is willing to use it for more than five days in a row. He cited an internist that told him it could be used that way. My regular dvm disagrees, and so we never used it for more than five days to give the liver a break. I didn't find it to be very effective for my kitty anyway.
 
This is one article - written by a vet mostly about dogs because Cerenia hasn't been studied in cats and is used off label:

http://thelearningvet.wordpress.com/201 ... t-cerenia/

I cannot access the article she references in her article because it is for vets only, but she talks about using this drug in her practice and her results. I had to laugh when I saw it called the "Anti Obesity drug" since all Gus wants to do is eat. Last night I was so upset when I got home from work. He jumped on the kitchen counter and got into the cabinets and got Carma's dry food (I know, dry food is bad and I'm trying to get her off of it, but she also eats wet food). Anyway - Gus's BG was 171 when I left that morning and it was 293 when I got home after he helped himself to the food in the cabinets!!! I had to spend the evening "kitty proofing" the cabinets.

I really have no idea what the Cerenia is doing to him as he has only had Cerenia shots before when he was really sick. He is just crazy with hunger and won't stop jumping on the kitchen counters. He used to be like this when he was younger, but it's been so long ago that its hard to see him suddenly acting like that again and not worry. At the same time, he doesn't seem to be in pain because he holds his head up now and sleeps a lot less. Before this he had his head down all the time and the vet immediately said he is in pain from something when she saw him.

Before I started giving Gus the Cerenia the vet had prescribed Buprenex and after a couple days on that, he started jumping on the kitchen counters, but wasn't as ravenous. This tells me that something is causing him pain because Buprenex is only a pain reliever.

I get concerned about the liver and kidneys too, but the vet said they have been using cerenia for years without ill effect on any of the cats.

If anyone wants the info on the vet clinic I'm going to then just PM me. If you want your vet to prescribe cerenia then maybe they could talk with this practice and get more info.

I think you have to be careful about using Cerenia with other drugs like non steroid anti inflammatories and phenobarbital.

I'm not using metacam. My cats were given this a long time ago (years), but I don't think they use it at any of the practices I go to now.
 
Hi Rachel,
Do you have a copy of the VIN article mentioned in the link you provided? All I see is the title and one has to log in to see the info.

The article has only the summary of the Round Table:

A summary of the Rounds is as follows:

Cerenia (maropitant) is a tachykinin antagonist which acts by inhibiting the binding of substance P.
Cerenia is labeled only for treatment of nausea and vomiting, but can potentially be used extra-label for pain, inflammation, GI disturbances, allergies and immune diseases, bladder inflammation, CNS and spinal cord injury, and mast cell diseases.
Treatment schedules should be 5 days on, 2 days off or every other day as continuous dosing depletes substance P which leads to tremors.

I do know that B12 shots have helped my Shadoe immensely with her inflammation of her pancreas, shown to be a problem with u/s, Xrays, fPLI. I am figuring the problem is better because of no more pancreatitis issues.
 
I cannot access that article. I think you have to be a vet. I wonder if you could ask your vet to access and print it out for you.

I did Vitamin B12 shots last year after Gus was out of the hospital. I've debated doing them again. Even with the Vitamin B12 though, he wasn't jumping like he is now. Also - the Vitamin B12 isn't going to fix the arthritis in his back legs which is why the vet prescribed the cerenia (pain and anti inflammatory). It does so many things that she thought it would be a good drug for a cat with IBD issues as well.

Also- when Gus was tested, his Vitamin B12 was fine, but I'm not sure if some cats test ok, but still need the extra dose.

He still has eye and face twitches that look like mini seizures and I'm trying to figure that out. There are so many things going on that I'm overwhelmed - especially when the vet said the face twitches could be a slow growing brain tumor. I found a video on youtube that looks exactly what Gus does and the woman said it was because her cat is allergic to grains. I am probably going to write a separate post here to see if anyone has any insights to that problem. I feel like I'm trying to manage a lot of things and it's really difficult to solve them all at once.
 
If you are looking for something for the arthritis, there are other things to give.

For pain, gabapentin is quite good.
For inflammation of the pancreas/CP, the B12 shots helped immensely and have many other good benefits. The shots can be continued long term with no problems.
For arthritis, I would suggest to add it in your subject - what about Adequan?
 
I just started this and I need to see if it is going to work for Gus or not. So far he is feeling good - just really hungry. I am going to have to figure out the correct dose if we decide to go with this.
 
When Blackie was so sick at the end, my vet started him on Cerenia. He told me that in studies of CRF cats that were given Cerenia daily, they lived months longer than cats that did not get the Cerenia. My vet said that Dr. Twedt at CSU has been using it as palliative care. Dr. Twedt is putting out an article on this, but its not out yet. I think this is the abstract though: http://winnfelinehealth.blogspot.com/20 ... in-in.html According to this new research, it can be used for pain.

I think you could also look into Gabapentin. Blackie took that for arthritis pain for several years and never had any bad side effects. I don't think it upsets the stomach either.

Good luck!
 
My vet's office said they have used cerenia for a little over a year in a few of their patients - a quarter tablet every other day. However, they are cautious because no long term studies have been done with cats and cerenia. All the studies are with dogs.

The cerenia seemed to help at first, but Gus doesn't seem to feel great. I'm trying to figure out what's going to help him the most - burprenex, cerenia or both (which we are doing now). It's really hard to figure out what's going on with him because there are so many things wrong. I just want his quality of life to be enjoyable.
 
The cerenia ended up not working for Gus because it made him feel bad. He was hiding under the bed and I could tell it was having a negative effect on him. He is extremely sensitive to medications. I also found the buprenex was increasing his focal seizures so he is off that now too! He is a "less is more" kind of cat when it comes to medications.

I'm looking into acupuncture right now as I've read a lot of positive posts here and elsewhere. I figure I could at least give it a try because my vet is also certified in acupuncture. It seems to help a lot of cats with arthritis. I will update on how things are going.
 
Rachel & Gus said:
Has anyone used cerenia as an anti inflammatory long term for their cat?

I have read not to use it more than 5 days, but my new vet said they use it for arthritis in cats that have GI problems because it doesn't cause stomach upset which my kitty is prone to.
Click to expand...
I am joining this discussion really late but I am in need of information on long term use of Cerenia. My cat vomits if she does not take it every day. She has chronic pancreatitis although extensive biopsies have not been able to determine the cause. She is on prednisolone 10mg daily and Cerenia. She has taken the Cerenia every day now for 2 months except for the 3 days I withheld it but she vomited on those days. As far as pain relief for arthritis, the absolute crown in the jewel for this is Cartrophen/Cartrofen. It is available in the USA and your vet can get it in. It works by actually building cartilage, I used it on my Great Dane and it worked absolute miracles.
 
Gwen F said:
I am in need of information on long term use of Cerenia
Click to expand...
What info do you need? I found a paper on the pharmacodynamics, etc. if you want that. Basically, it accumulates in the dog/cat's system instead of getting "washed out" each day, which is why you're only supposed to use it 5 days in a row. My vet has prescribed it for 7 days in a row in the past though. If you want to try something different, there's ondansetron (generic Zofran). Also, have you seen if famotidine helps?
 
The internal medicine vet I went to said I could use Cerenia for more than 5 days in a row, but my cat was in a critical care situation. Maybe if she wasn't, he would have given me a time limit. Ondansetron also worked really well for my cat's nausea.
 
SpecklesandMe said:
What info do you need? I found a paper on the pharmacodynamics, etc. if you want that. Basically, it accumulates in the dog/cat's system instead of getting "washed out" each day, which is why you're only supposed to use it 5 days in a row. My vet has prescribed it for 7 days in a row in the past though. If you want to try something different, there's ondansetron (generic Zofran). Also, have you seen if famotidine helps?
Click to expand...
I did try Ondansetron, it did not help her, plus here in Australia, it is almost $50 per wafer which lasts 4 days. That is almost $70 US at the current rate of exchange. Not sure if Famotidine is even available but will check it out. Ok just checked Famotidine, don't think it is relevant to my cat's condition, but will discuss with the vet today. It also says limit to 5 days use so may not be the solution anyway.
 
My Vet started Wess on a trial of Cerenia, 2 tablets of cereneia green cut in half, 4 days on and 2 days off. This is day #5 of the trial.
This treatment was discussed in Dr Margie Scherk's paper on Feline Upper Respiratory Infection. She is Canadian trained Vet that has in later years started speaking at most of the Veterinary Association Meetings. There is a pretty strong collaboration between several vets from the US and Canada promoting further education and research on the topic of Feline Upper Respiratory Infections.
 
To all those insisting this is a mistake, it ain't, often drugs serve multiple purpose and have uses beyond what they were originally developed for. To my knowledge this paper as presented by Dr Scherk has been updated and currently is published in this years Ontario Veterinary Associations listing of keynote speakers.
 
I spoke to my vet Friday regarding using Cerenia for more than 5 days for my cat and he said only studies on dogs contra-indicate prolonged usage (five on 2 off for five weeks) and that no studies have been done on cats using it each day or long term. I withheld it once last week and on Saturday just gone by and both times, the next day she vomited. I am going to give her Ondansetron two days, possibly 3 days however and the other days on Cerenia. I am sincerely hoping that they can get to the bottom of why her pancreas is still inflamed after a year on prednisolone. She has no signs of cancer which is good news. A suggestion of 20mg of pred a day plus an anti-inflamatory used in chemotherapy cases has been suggested. A double whammy of different types of steroids in an attempt to ease her pancreas. I really hope this works if I decide to go ahead. She can't go on like she is now, she is not in pain but sleeps 23 hours a day and has absolutey no energy. Her liver and heart are also healthy, no signs of diabetes either. It is a mystery as to the cause of her pancreatic problems.
 
Have you used budesonide? Its often used in IBD as it doesn't have quite as much impact on the blood glucose.

And when you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

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BJM said:
Have you used budesonide? Its often used in IBD as it doesn't have quite as much impact on the blood glucose.

And when you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name | cat's name | date of Dx (diagnosis) | insulin | meter
general location (city and state/province)
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
Click to expand...
 
here's the paper I mentioned before in case it's helpful somehow: http://www.ncbi.nlm.nih.gov/pubmed/18471143
and some of the results are summarized here along with other maro info: http://veterinarymedicine.dvm360.co...netics-and-pharmacology?id=&pageID=1&sk=&date=
reading back through the thread, though, I'm wondering if you're main interest was discussing why it could be that your cat's been nauseous for so long? if so, I would suggest starting a new thread with this question to get more eyes on it. there are a lot ppl on here with a lot of pancreatitis experience who might have some thoughts.
 
An untested but interesting non-specific therapy for upper respiratory disease in cats is
maropitant therapy. Maropitant (Cerenia) inhibits tissue binding of substance P by antagonizing
tachykinin receptors. Tachykinins are released from degranulating mast cells during tissue
injury associated with allergy or inflammation. This group of substances includes bradykinin,
histamine, prostaglandins, serotonin, leukotrienes, tumor necrosis factor (TNF-alpha), and
various interleukins. Substance P is one of the primary neurotransmitters of inflammation; it acts
on the tachykinin NK-1 receptor sites. Blocking substance P at NK-1 receptors reduces
neurogenic transmission and could potentially reduce inflammation, pain, exudation and
edema, neuropathic pain and associated allergic reactions. While labeled for nausea and
vomiting (especially that induced by motion), maropitant may be beneficial for many
inflammatory and allergic conditions.
The dose is 1-2mg/kg PO, SQ or IV q24h Monday-Friday, i.e., five days on, two days off. This is
necessary as continuous dosing results in a depletion of substance P, which results in tremours.
Refrigeration may help reduce the stinging associated with giving SQ injections as may IV use
or administration with SQ fluids. It is contraindicated in patients with liver disease.
It is critical to pay attention to nutrition in quality, balance and quantity. In addition to the
frequently used antihistamine, anti-serotonin drug cyproheptadine (1 mg PO q12h), mirtazapine
at 2-3 mg/cat PO q72h is may work well as an appetite stimulant for cats.
Prognosis
It is important that clients understand that a cat with chronic rhinitis/rhinosinusitis will never be
cured. With on-going management, the patient’s quality of life can be improved with a reduction
in sneezing and nasal discharge.

From page 183 2015 OVMA Conference proceedings
Dr Margie Scherk DVM,DABVP (Feline)
 
Bonzo said:
An untested but interesting non-specific therapy for upper respiratory disease in cats is
maropitant therapy. Maropitant (Cerenia) inhibits tissue binding of substance P by antagonizing
tachykinin receptors. Tachykinins are released from degranulating mast cells during tissue
injury associated with allergy or inflammation. This group of substances includes bradykinin,
histamine, prostaglandins, serotonin, leukotrienes, tumor necrosis factor (TNF-alpha), and
various interleukins. Substance P is one of the primary neurotransmitters of inflammation; it acts
on the tachykinin NK-1 receptor sites. Blocking substance P at NK-1 receptors reduces
neurogenic transmission and could potentially reduce inflammation, pain, exudation and
edema, neuropathic pain and associated allergic reactions. While labeled for nausea and
vomiting (especially that induced by motion), maropitant may be beneficial for many
inflammatory and allergic conditions.
The dose is 1-2mg/kg PO, SQ or IV q24h Monday-Friday, i.e., five days on, two days off. This is
necessary as continuous dosing results in a depletion of substance P, which results in tremours.
Refrigeration may help reduce the stinging associated with giving SQ injections as may IV use
or administration with SQ fluids. It is contraindicated in patients with liver disease.
It is critical to pay attention to nutrition in quality, balance and quantity. In addition to the
frequently used antihistamine, anti-serotonin drug cyproheptadine (1 mg PO q12h), mirtazapine
at 2-3 mg/cat PO q72h is may work well as an appetite stimulant for cats.
Prognosis
It is important that clients understand that a cat with chronic rhinitis/rhinosinusitis will never be
cured. With on-going management, the patient’s quality of life can be improved with a reduction
in sneezing and nasal discharge.

From page 183 2015 OVMA Conference proceedings
Dr Margie Scherk DVM,DABVP (Feline)
Click to expand...
I had another vet visit last night, she is now on 20mg pred a day, along with a chemotherapy drug every second day. Evidently her pancreas is not the problem now, more so IBD and stomach issues. I have ordered Onadesteron so I can take her off the Cerenia and may do a 3-4 routine. I am waiting for blood test results from last night to measure how she is coping. She sleeps 23 hours a day which is a concern. I assume the medications are playing a big part in that although the vet seems to think it is the actual disease. She is also on weekly VitK injections. I would sincerely like to have her on slippery elm, aloe vera and Curcuvet rather than these toxic drugs and hopefully will be able to get her there soon. Thanks for the reports.
 
B12 injections are supposed to help with nausea and energy for IBD cats. You could ask your vet about administering the shots at home once a week. I gave my cat slippery elm even though she was also on meds. I just made sure to give it to her an hour or so before or after meds so it didn't interfere with absorption of the meds.

You could try use budesonide instead of prednisone. It's another anti-inflammatory but it only targets the gut so it has fewer side effects than prednisone. My cat did well on budesonide.
 
Yes, she is already on B12, I give them to her. I used to be a vet nurse a while back. I mentioned Budesonide to my vet last night, he did not comment other than to say Prednisolone is the drug she needs as it is the #1 anti inflammatory, hitting the disease at the top and working its way down. She isn't on Prednisone, rather Prednisolone which is the active metabolite of Prednisone. I believe they are both used for different types on inflammation. The liver breaks down Prednisone into Prednisolone so if the liver isn't well, Prednisolone is the preferred drug. I welcome all comments because I love my cat beyond words and she looks to me for support, she is my shadow when I am at home. My mother takes care of her whilst I am at work.
 
You could also try digestive enzymes. I used Animal Essentials Plant Enzymes and Probiotics. I got it from Amazon. I don't know if it's available to you but there might be something similar.

The theory is that they help kitty digest the food so they use more of the nutrients in the food. Start small, and work up to the recommended daily dose on the bottle (best if divided into however many meals you feed and added to the food at each meal time). You will know if kitty is tolerating it if there is no vomiting, no mucous in the stool, or anything else that indicates it’s upsetting kitty’s system. If she tolerates and does well on those -- and you should know inside of two weeks -- you should see smaller stool, slightly harder, but not constipated. Less volume of stool means she’s using more of the nutrients in her food.
 
It sounds like you're giving her everything she should be getting. :) I know that doesn't help how worried you are about her. There's a Facebook group called IBDKitties and they might be able to come up with some ideas for why she's sleeping so much.
 
Thank you
granadilla said:
It sounds like you're giving her everything she should be getting. :) I know that doesn't help how worried you are about her. There's a Facebook group called IBDKitties and they might be able to come up with some ideas for why she's sleeping so much.
Click to expand...
Thank you, will do so.
 
Hi All. I'm new on this post and just thought I'd let you know about my cat Tom, who had his first attack of pancreatitis two and half years ago at around 12 years of age. Since my vet didn't know what was wrong with him, she opened him up and saw that his pancreas was swollen and inflamed-- she said it was the largest pancreas she had ever seen in a cat. She said the average lifespan in these cases is one year. Since that day Tom has been on cerenia, prednisone, and vitamins, with occasional breaks but never more than two weeks or so. He has had occasional pancreatic attacks, he's having one right now as a matter of fact, but has pulled through each time (and he's feeling better today). As I said, it's two and a half years now since he was first diagnosed, so for long term use and speaking only anecdotally, there has been absolutely no problem with cerenia. In fact, it's been a genuine life saver for the boy.

Side note: his brother Jack has had diabetes and has needed insulin injections in the past, but recently recovered and is doing great with no special food or shots. Like people and unlike dogs, cats can sometimes recover from diabetes spontaneously.

Good luck to all, we do the best we can for our little beasts, don't we?
 
Gwen F said:
I am joining this discussion really late but I am in need of information on long term use of Cerenia. My cat vomits if she does not take it every day. She has chronic pancreatitis although extensive biopsies have not been able to determine the cause. She is on prednisolone 10mg daily and Cerenia. She has taken the Cerenia every day now for 2 months except for the 3 days I withheld it but she vomited on those days. As far as pain relief for arthritis, the absolute crown in the jewel for this is Cartrophen/Cartrofen. It is available in the USA and your vet can get it in. It works by actually building cartilage, I used it on my Great Dane and it worked absolute miracles.
Click to expand...
What was the dose size you were giving of the cerenia? My kitty is taking it and I was wondering about long term use. Thanks
 
Lymphoma/Diabetic said:
What was the dose size you were giving of the cerenia? My kitty is taking it and I was wondering about long term use. Thanks
Click to expand...
A lot of kitties get it long term for IBD. I think the standard dose is 5 days on, 2 off, of 1/4 tablet once a day. Double check with your vet about taking it 5 days on/ 2 off because if your kitty can't tolerate NOT having it on those 2 days the vet may have other suggestions.
 
Some vets says OK to give daily, Note that Cerinia comes in 16, 24, 60 and 160 mg tables so just saying 1/4 tablet is not sufficient
 
Here is the most extensive information about Cerenia from the CRF website it also contains quite a number of links concerning the drug. http://www.felinecrf.org/nausea_vomiting_stomach_acid.htm#maropitant

I used it extensively for Squeaker, more than 5 days, yes it is safe to use for more than 5 days, and he did not suffer any negative consequences for it. There were periods when he received it daily (8 mg rather than the standard 4 mg) for up to 2 weeks.
 
granadilla said:
A lot of kitties get it long term for IBD. I think the standard dose is 5 days on, 2 off, of 1/4 tablet once a day. Double check with your vet about taking it 5 days on/ 2 off because if your kitty can't tolerate NOT having it on those 2 days the vet may have other suggestions.
Click to expand...
Is that from a 16 mg tab? They have different sizes.....so a 1/4 of the 16 mg?
 
Anitafrnhamer said:
Here is the most extensive information about Cerenia from the CRF website it also contains quite a number of links concerning the drug. http://www.felinecrf.org/nausea_vomiting_stomach_acid.htm#maropitant

I used it extensively for Squeaker, more than 5 days, yes it is safe to use for more than 5 days, and he did not suffer any negative consequences for it. There were periods when he received it daily (8 mg rather than the standard 4 mg) for up to 2 weeks.
Click to expand...
How much does your kitty weigh? Why did they up the dose?
 
Squeaker weighed 10.5 lbs. He was rx'd 8 mg to stop the vomiting caused by the pancreatitis. He also experienced explosive diarrhea. He was also in Stage 4 renal failure and we couldn't risk excessive dehydration.
 
Thank you for your input. She is close in weight. I took her in yesterday for fluids. She is feeling better today and ate a little wet food this morning.
 
I give Rico cerenia injectable about 2-3x a week-
he is 17 in CRF
I give it after I give fluids and keep it refrigerated as it stings....(no stinging when I give in fluid bubble) I have wondered if it is ok long term but at 17 I want him comfortable. I gave it once without fluids first and he was NOT happy!!:confused: He is 11.5 pounds and gets .5-.6 cc
 
Anitafrnhamer said:
Squeaker weighed 10.5 lbs. He was rx'd 8 mg to stop the vomiting caused by the pancreatitis. He also experienced explosive diarrhea. He was also in Stage 4 renal failure and we couldn't risk excessive dehydration.
Click to expand...

My Lucy is doing better the last two days. The pancreatitis was so hard on her. My vet has her on 8 mg a day and had me continue because she
vomited the one day I took her off. I finally have her insulin leveled out. How long did you have Squeaker on the 8 mg a day....did you have any
breaks? This site has been soooooo helpful and I want to thank you all. Lucy has been over a year now after her diagnosis of GI Lymphoma...
so happy to have the extra time.
 
Squeaker was on 8 mg daily consistently for about 16 days at one point with no breaks.
What I did do as his condition improved was to give 4 mg in the morning and 4 mg in the evening to try to "even out" the effectiveness. Rather than one dose in the morning I thought it more reasonable to try to prevent the nausea throughout the night rather than letting him be very nauseated and vomiting then giving 8 mg. Does that make sense?
 
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