How long can Cerenia injection decrease appetite?

[lisa_michelle]

Bitsy threw up clear liquid twice Friday morning (Nov 8th) but then went to her food bowl (low carb canned) 15 minutes later and ate a good bit so I didn't panic. When she's really feeling nauseated/unwell from Pancreatitis,she won't go near her food bowl so this was a good sign. I noticed though that throughout the day she was being fussier with her food and not eating as much so I gave her Mirtazapine 2mg. Peeing normal, normal bowel movements (not diarrhea but formed). For the first time the Mirtazapine didn't seem to have as much of an affect on her appetite as it always has in the past. She's still getting used to eating only low carb canned food and sadly in Canada, there seem to be very few options (and Dr Lisa's Food/Carb chart doesn't help all that much because most of the foods on there we don't have in Canada).

I always put out a little bowl of canned at around midnight for her, and her history is that when I wake up in the morning, the food bowl is empty....but on Sat morning (Nov 9), it looked like she hadn't touched her food at all which stressed me out. When I made up a new food bowl she wasn't interested at all and then threw up twice, clear liquid. So this time I gave her an injection of Cerenia. She last had Cerenia on Oct 13 at the Vet when she'd been throwing up that day and wasn't interested in food. The last time she'd I'd given her a shot of Cerenia was in May.

Now I don't remember her having any side effects from Cerenia, I don't recall it ever making her wanting to sleep more or impacting her appetite at all..........but yesterday after the shot and throughout the day (gave it to her at 11:15 am), she was not her usual active self, wanting to sleep more. Not really wanting to eat very much at all despite trying as many kinds of canned food as possible. Even mixed some of the higher carb (her past favorite) in there with the low carb and she would have a few bites but that's it. I have read that in some cats, although not common, it can have a side effect of making them tired and lowering their appetite. I have read in the past on different cat forums that some cats can maybe take a couple of days for their appetite to improve? Does anyone have a cat here that loses their appetite following Cerenia and if so, for how long?

This morning I gave her another 2mg of Mirtazapine because she ate very little through the night (48 hours since her last Mirtazapine). Normally within an hour she's got a voracious appetite from the Mirt. but not so much today at all. So I'm wondering if it's just the lingering effects of the Cerenia? Could that be the case?

2 hours after she had her Mirtazapine today, she was sleeping soundly then like often, she woke up from a dead sleep and headed directly to her food bowls...seemed very interested in eating but got up the bowls, sniffed them a bit then walked away. I now have 5 different types of canned food out for her. Usually Mirtazapine makes her get up to nibble from her bowl almost hourly. SHe's not lip licking at all, no signs of nausea. A couple of different types of canned I've given her, she is very very interested in them for several bites (like her usual self) then that's it, after 4-5 bites that's it, end of story.....whereas normally she'd eat much much more.

I don't want her to end up getting dehydrated and worried that maybe she is a slight bit due to not eating well the past 2 days so I gave her 75 cc of SC fluids. I know that dehydration can impact appetite.

I'm trying to tell myself that her appetite is still low, despite the Mirtazapine, because of the Cerenia 24 hours ago.

Her BG Nov 8 was 6.9 and 6.8. Yesterday was 7.0, 6.4 and 7.5. This morning her BG was 6.8. As you may recall, the Vet does not believe she's diabetic and is happy with her BG's so all I have been doing for her is giving her a low carb diet (fancy feast pate, friskies pate).

I am very stressed. I don't see her drinking water more than usual.

I've told myself to give today for the ?effects of the Cerenia (???) on her appetite go away, and for the SC fluids to be absorbed and perk her up. I'm trying not to overreact. I just don't know why she's had Cerenia before and it's never impacted her appetite before...so is that what's really going on here? I want to give her until tomorrow before taking her to the Vet in the event her appetite improves and by tomorrow this is not longer an issue and doesn't need to go to the Vet.

So again, I guess, for anyone whose cat has has Cerenia and it negatively impacts their appetite (even though I know it's rare), how many days after getting it do you find it takes for their appetite to return to normal?

Can anyone please share their thoughts/experiences? I live with a pretty significant anxiety disorder myself and I lost 3 of my older kitties within the past year (cross over the bridge), Bitsy is my last sweet cat.....and I'm on disability so money is always very tight.....so when she's not herself, it makes me very very anxious because I worry for her and love her so much (she's 17) but also because Vet clinics where I live are super expensive so I try to manage things as much as I can because every time I go in there it's at least $400. Thanks.

 

[Wendy&Neko]

I have a few comments on what you've posted.

I found that actually quite a few of the low carb foods listed on Dr. Lisa's list are available in Canada. Some vendors have new lines or products added to what is on that list, but also available here (BC). You do have to go to independent stores, or something like Pet-Valu/Bosleys, not always available in the big chains. But even Petsmart carries Weruva, Natures Variety and TikiCat. Have you also seen:

• CANADIAN Food Chart

Are you using Mirtazapine pills or the transdermal cream Mirataz? I find the latter is better, more gentler, less side effects. The effects of Cerenia only last 24 hours. You do want to give an appetite stimulant after giving an antinausea, and the Cerenia might have worn off by the time you gave the Mirtazapine. You don't want to give an appy stim to a nauseous cat.

I like ondansetron better than Cerenia for nausea. You have to get a prescription from your vet, and fill it at a human pharmacy. Going up to food bowls, sniffing then walking away, is a classic nausea symptom.

How much Cerenia did you give her? And how much does she weigh?

 

[lisa_michelle]

I have a few comments on what you've posted.

I found that actually quite a few of the low carb foods listed on Dr. Lisa's list are available in Canada. Some vendors have new lines or products added to what is on that list, but also available here (BC). You do have to go to independent stores, or something like Pet-Valu/Bosleys, not always available in the big chains. But even Petsmart carries Weruva, Natures Variety and TikiCat. Have you also seen:

• CANADIAN Food Chart

Are you using Mirtazapine pills or the transdermal cream Mirataz? I find the latter is better, more gentler, less side effects. The effects of Cerenia only last 24 hours. You do want to give an appetite stimulant after giving an antinausea, and the Cerenia might have worn off by the time you gave the Mirtazapine. You don't want to give an appy stim to a nauseous cat.

I like ondansetron better than Cerenia for nausea. You have to get a prescription from your vet, and fill it at a human pharmacy. Going up to food bowls, sniffing then walking away, is a classic nausea symptom.

How much Cerenia did you give her? And how much does she weigh?

Thanks for the Canadian Food Chart, didn't know about it. She has always preferred canned food that's chunky or fillets in a gravy, her favorite is Fancy Feast Florentine or Primavera in Sauce (Salmon, Tuna) but these are too high in carbs. I was shocked that she has really never had any interested in Fancy Feast Pate which is usually one that even sick cats will eat. Since starting the low carb, she'd been doing well on the Friskies Salmon or Oceanfish Pate but now has no interest in them. 2 days ago she was liking the Fancy Feast Primavera Pate Salmon and Chicken flavors but today, not a chance. I've tried the low carb Weruva varieties and she's not crazy about them, up until the past 2 days those had sort of been hit and miss so I'd sometimes mix a little of those with the Friskies. One day she liked some of the Tikicat low carb but the next day not so much. She never liked Nature's Variety even years ago. I've tried some of the Beyond low carb pate....3 different flavors and she's not crazy about them.

She's always gotten the Mirtazapine 2mg pill (I just wrap a bit of Pill Pocket around it and pill her that way, she's very hard to pill, even when I wrap her with a towel to keep her from pawing at my fingers. She's gotten Mirtazapine 2mg tabs off and on for a year now and they've always worked so well until these past 2-3 days. Usually an hour after she get it she's eating like a pig.

As for the Cerenia, she's 11 lbs and her dose is 4.7mg (0.47 cc) injection.

I've been reading up on Ondansetron as an alternative.....though I did read that in some cats it can cause very low blood pressure and heart arrhythmias (she has a heart murmur so not sure if that would pose any risk). I would only give it via s/c injection as if I have to get it from a human pharmacy (with Vet Rx), as long as I could get the injectable....because it's pointless to ever try giving an anti-nausea med in pill form to a nauseated/vomiting cat, they'll never keep it down...which is why I pushed to be able to give the Cerenia via s/c injection.

She didn't eat very well at all yesterday and in total today maybe had 1/2-3/4 of a can the size of a fancy feast can. I've tried so many different foods today, even some of the higher carb canned with gravy/sauce. She'll seem very interested and will eat several bites but then she's done and when I put the bowl back under her face she turns away. I have bowls of food all over the house and move them around depending on where she's sleeping so she has something when she wakes up. If she eats this poorly tomorrow, then I'm going to have to consider syringe feeding her at least a bit or else we're at risk her liver could be impacted. The problem with syringe feeding is, from my past experience with elderly cats who ended up needing this (it was usually my cats with later stage CRF), is that once you start syringe feeding they no longer want to eat on their own and syringe feeding is very stressful for them. She's hard enough to pill. For her weight of 11 lbs, I've read she needs between 25-30 calories per pound a day...so at least 275 calories. The problem with a lot of these low carb foods is that they have to eat a lot more in a day to get enough calories. In the past I'd normally syringe feed a cat AD or something with higher calories...but if I do that with her that will not be good for her blood glucose levels.

I'm very very stressed about all of this. Usually when she gets nauseated/vomiting from Pancreatitis, her poops are very very soft and greyish/tan clay colored........which goes along w/ Pancreatitis.....but her poops are totally normal and perfect, formed, brown.

The reason I didn't give her Mirtazapine yesterday after the shot of Cerenia was because I'd given her Mirtazapine the day before and from what I've read, it's not advisable to give older cats (she's 17) Mirtazapine daily.....best to wait 48 hours in between doses.

I don't think she's nauseated because she'll gladly eat treats......Temptations....and that's usually a good "test" of whether her throwing up is just due to a furball she's trying to bring up, or actual nausea. And when I mix up a new bowl of food for her today, she seems quite interested in it for several bites......but then suddenly that's it. I feel if she was nauseated, she'd not take any bites?

 

[Wendy&Neko]

I've been reading up on Ondansetron as an alternative.....though I did read that in some cats it can cause very low blood pressure and heart arrhythmias (she has a heart murmur so not sure if that would pose any risk). I would only give it via s/c injection as if I have to get it from a human pharmacy (with Vet Rx), as long as I could get the injectable....because it's pointless to ever try giving an anti-nausea med in pill form to a nauseated/vomiting cat, they'll never keep it down...which is why I pushed to be able to give the Cerenia via s/c injection.

Neko had much worse heart conditions (HCM and CHF) and was still fine with ondanestron. She did not have lowered blood pressure either. She was also nauseous and vomiting due to the heart conditions, CKD, and concurrent small cell lymphoma. I gave her the ondansetron via mouth, and she kept it down. I gave her Cerenia first so she wouldn't vomit. Once her medical conditions were treated, vomiting went way down. And once her nausea was treated, I didn't have to give an appetite stimulant. You can get injectable ondansetron too. Some people do find it easier to give. But it is harder to find in Canada.

Neko was around 14 lbs, and she was fine with 220 calories per day. A lot depends on a cat's metabolism and activity level too, our older pets don't need as much.

I used to syringe feed a bit of Royal Canin Recovery in her last year, and that would "prime the pump" to get her eating on her own. Getting a little food in their tummy settles it. Recovery is low carb. A/D is medium carb. What is really high carb is those temptation treats. All meat freeze dried treats are a better option. Many kitties goes nuts for freeze dried chicken, and crumbling some on their food can entice them to eat.

• Suggestions on How to Stimulate Kitty's Appetite

I don't think she's nauseated because she'll gladly eat treats......Temptations....and that's usually a good "test" of whether her throwing up is just due to a furball she's trying to bring up, or actual nausea. And when I mix up a new bowl of food for her today, she seems quite interested in it for several bites......but then suddenly that's it. I feel if she was nauseated, she'd not take any bites?

This sounds very familiar. Ondansetron can help.

 

[lisa_michelle]

Neko had much worse heart conditions (HCM and CHF) and was still fine with ondanestron. She did not have lowered blood pressure either. She was also nauseous and vomiting due to the heart conditions, CKD, and concurrent small cell lymphoma. I gave her the ondansetron via mouth, and she kept it down. I gave her Cerenia first so she wouldn't vomit. Once her medical conditions were treated, vomiting went way down. And once her nausea was treated, I didn't have to give an appetite stimulant. You can get injectable ondansetron too. Some people do find it easier to give. But it is harder to find in Canada.

Neko was around 14 lbs, and she was fine with 220 calories per day. A lot depends on a cat's metabolism and activity level too, our older pets don't need as much.

I used to syringe feed a bit of Royal Canin Recovery in her last year, and that would "prime the pump" to get her eating on her own. Getting a little food in their tummy settles it. Recovery is low carb. A/D is medium carb. What is really high carb is those temptation treats. All meat freeze dried treats are a better option. Many kitties goes nuts for freeze dried chicken, and crumbling some on their food can entice them to eat.

• Suggestions on How to Stimulate Kitty's Appetite

This sounds very familiar. Ondansetron can help.

Thank you so much, Wendy, for responding. I went upstairs where she's been hanging out most of the day and she did some canned food so that's a good thing. I was sitting on the bed and I picked up the bag of treats, she heard the crinkle of the bag and was out of her cat bed on the floor and up on the bed in no time so that says to me she's not nauseated? I gave her 3 treats, then brought the food bowl up and it put it below her, she had a couple little bites and that was it. So so strange.

I did phone my own pharmacy to see if they can order injectable Ondanestron in the event that my Vet clinic doesn't have it and my pharmacy can order it in if that's what Vet prescribes (1 day to get it). You would think the Vet clinic would have the injectable too? Seems odd that they wouldn't as I'd think that most cats they need to give it to are not going to keep down a pill.

I did make a Vet appointment for tomorrow morning,unfortunately it won't be with my usual Vet as I can't get in to see him until Tues at 5pm and I can't wait that long.

I didn't know Temptations treats were high carb, good to know in general but for now given that she's barely eating I don't think a few treats will hurt.

I did find a Reddit thread about owners whose kitties got a shot of Cerenia at the Vet and several posted because their cat was quite sleepy and not wanting to eat for 2 days following the injection. https://www.reddit.com/r/CATHELP/comments/17auqmw/cerenia_causing_lethargy/ .....seems for these cats/owners, their cat was fine and back to eating like normal after 2 days...so maybe by tomorrow she'll be back to herself.....but it's just strange because she's had Cerenia maybe 6-7 times over the past year and I've never found her to be wanting to sleep all day and not wanting to eat...so not sure if it's related to the Cerenia or not. I think I'd be leary about giving it again in the future though.

I think tomorrow I will ask for a full senior panel and urinalysis. She last had that done end of March (plus frucstosamine level & T4), everything was good including kidneys (BUN, Creat, SDMA, Cystatin B) but of course due to her age that could have changed over time.

I will pick up a couple cans of Royal Canin Recovery and some feeding syringes.

I wonder if maybe Mirtazapine has just stopped working for her and I need to ask for Cyproheptadine instead, if they even still have it?

She definitely does seem brighter today compared to yesterday tho is preferring to spend more time away from me sleeping in her sleeping spots. I feel that when she's feeling her usual good self, she spends more time downstairs with me even if it's just curled up on the end of the sofa with me. I've even tried warming up her canned food a little in the microwave before giving it to her as that apparently makes it more smelly and appetizing to cats?

 

[Wendy&Neko]

A vet visit and blood work are a good idea, just to make sure. Have you ever had a GI blood panel done? Just wondering if her B12 or cobalamin has been tested?

 

[SmallestSparrow]

Fwiw both of my boys get sleepy with cerenia—unfortunately for me (and him) especially the diabetic one so I’m always worried he’s hypo if he gets cerenia. I have a topical gel (sadly quite pricey) of cerenia (applied inside the ear, like the mirtazapine ointment).

I hope your kitty is better soon

 

[lisa_michelle]

A vet visit and blood work are a good idea, just to make sure. Have you ever had a GI blood panel done? Just wondering if her B12 or cobalamin has been tested?

No, she's never had those 2 done. I actually did buy a bottle of Pure Encapsulations Vitamin B12 (Methylcobalamin 1000 mcg) a couple of weeks ago, suspecting that she was going to end up being diagnosed w/ Diabetes and did give her a capsule a day for a few days but then stopped because her BG went down a lot once stopping all dry food and only low carb diet, and Vet said her numbers (in the 6's and 7's) did not constitute diabetes. https://well.ca/products/pure-encap...UlrRpJmpQZb-UKQ-eW8iV2lGbl3icz0YaAkeSEALw_wcB

UPDATE: she was soooo much more bright and active this evening. She just came downstairs, went straight to her food bowl like she meant business and ate a good amount without any prompting at all. She then went back upstairs and is snuggling on my bed. I opened a new can of Friskies Salmon Pate and put half a can in a bowl and offered it to her, she ate a good little bit. I left the bowl sitting near her. Now I'm more convinced that it was the Cerenia. It's been nearly 18 hours since the shot I gave her yesterday, I feel like it's taken that long to get out of her system and now she's feeling better. I wonder if the reason that the Mirtazapine didn't work is because her lack of appetite from the Cerenia was stronger than the stimulant effect of the Mirtazapine. I've even read that in some cats, even though rare, Cerenia can cause nausea....which is kinda wacked considered what it's given for. The S/C fluids I gave her this morning might also be making her feel better if she was starting to get a little dehydrated. We'll see in the morning how much she's eaten through the night. I'll still keep the Vet appt because if nothing else, I need to ask for a Rx for Ondansetron as I won't give her the Cerenia ever again, won't take the chance.

 

[lisa_michelle]

No, she's never had those 2 done. I actually did buy a bottle of Pure Encapsulations Vitamin B12 (Methylcobalamin 1000 mcg) a couple of weeks ago, suspecting that she was going to end up being diagnosed w/ Diabetes and did give her a capsule a day for a few days but then stopped because her BG went down a lot once stopping all dry food and only low carb diet, and Vet said her numbers (in the 6's and 7's) did not constitute diabetes. https://well.ca/products/pure-encap...UlrRpJmpQZb-UKQ-eW8iV2lGbl3icz0YaAkeSEALw_wcB

UPDATE: she was soooo much more bright and active this evening. She just came downstairs, went straight to her food bowl like she meant business and ate a good amount without any prompting at all. She then went back upstairs and is snuggling on my bed. I opened a new can of Friskies Salmon Pate and put half a can in a bowl and offered it to her, she ate a good little bit. I left the bowl sitting near her. Now I'm more convinced that it was the Cerenia. It's been nearly 18 hours since the shot I gave her yesterday, I feel like it's taken that long to get out of her system and now she's feeling better. I wonder if the reason that the Mirtazapine didn't work is because her lack of appetite from the Cerenia was stronger than the stimulant effect of the Mirtazapine. I've even read that in some cats, even though rare, Cerenia can cause nausea....which is kinda wacked considered what it's given for. The S/C fluids I gave her this morning might also be making her feel better if she was starting to get a little dehydrated. We'll see in the morning how much she's eaten through the night. I'll still keep the Vet appt because if nothing else, I need to ask for a Rx for Ondansetron as I won't give her the Cerenia ever again, won't take the chance.

 

[lisa_michelle]

MORNING UPDATE: After my good/positive/hopeful update last evening about her coming downstairs and eating, I put a bowl of a half can of Friskies Oceanfish Pate up on the bed for her where she's slept all night. By 2am she had nearly eaten it all. Now this morning, back to not wanting to eat. She got up to pee, had a VERY large formed bowel movement in the box, then followed me downstairs......definitely seems bright.....but when I put a bowl of canned food down for her or up to below her face, she turns her head. No lip licking or anything like that. She did have a normal formed BM yesterday so surprised to see what a LARGE one she had this morning considering she's been barely eating anything x 2 days. I did collect a sample and will take it into the Vet, just in case for some reason they want to test it. Maybe her symptoms are IBD-related? Maybe the times she's had very soft/loose BM's it's not been Pancreatitis but IBD? I did take her into the Vet on Oct 13th because she'd throw up a few times that day, had a very soft unformed BM with some fresh blood on it and was noted to be wretching/throwing up clear liquid in the litterbox after she was seen to be straining in the box (did have Urinalysis which ruled out any UTI or crystals, etc). BG this morning 7.6 (136). Vet appt in 3 hours.