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Ladybug surgery

I can tell she’s nauseous but I feel like they aren’t listening to me about it. They are scared it will worsen her gi tract motility if they give her ondansteron. She is on cerenia for nausea and I feel like it’s not helping that much because she’s still gagging sometimes. Maybe I should keep giving her the omeprazole they said I could stop? I’m worried I’ve already given her a food aversion. I’m so frustrated with all these vets I feel like they all suck all 4 vets that are supposed to be great vets. :( ugh now im so worried I’ve done permanent damage to my baby and she will never wanna eat :( and im scared to give them the meds they wanna give her
 
They also STILL won’t let me know if her urine culture came back it’s been over a week that’s ridiculous to me it’s taken this long
 
Ugh I’m sorry to freak out I’m just super stressed and constantly worried I’m doing the wrong thing and I just want my baby to feel better and not hate me :(
 
they said reglan is also an anti nausea med. elura they had to order through chewy and I get reglan tomorrow. I really think she was withdrawing off gaba so even though they said no need to taper that’s what im doing. Oh and I see flea dirt on her and she’s scratching so I have to somehow get more flea meds and cerenia because im almost out of that too because I keep wasting pills. She spits out everything. I think I have to put the pill popper farther back. I know liquids have to be in the cheek pouch but that makes her spit it out and it’s so so hard for me to keep her mouth shut with one hand. Im so worried she’s not getting full doses of her liquid meds. Idk im trying my best and I feel like it’s not good enough sometimes.
 
ladybug991 said:
That’s what they said to me today. I am not sure if liquid is better than pills at this point I feel like she holds pills in her mouth for up to minutes at a time and angrily keeps them in her cheek pouch. Liquid she just immediately tries to spit it out. I think she’s getting madder at me and hiding more after pills and that might have caused some of the shaking I feel so bad. Going to get some capsules in the next couple days maybe the compounding pharmacy I use for myself and for her chicken flavored blood thinners 😅 ahhh she just needs to eat more and poop and I hate stressing her out with all these meds. I really feel like cold Turkey gaba was giving her twitches even though they deny it. It’s been reported in dogs and humans but not studied in cats. She’s already sensitive to it and also hates it cause it’s so bitter.
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My Rosa used to do that with pills. Which she would then freakin' hide under the couch or somewhere like that where she knew I wouldn't see them for a few days. 🤣 You can only do the best you can do. As long as she gets most doses, sometimes that's all we can achieve. Cats are super smart - don't drive yourself crazy trying for perfect when you're working with a cute furball that's also inclined naturally towards being a little sneaky when they want to outsmart us.

Wendy&Neko said:
I've always been told it's best to control nausea first, before giving an appetite stimulant. I found with Neko, that if I controlled her nausea, I usually did not need an appetite stimulant. No one wants to be made hungry if nauseous, it can cause food aversion.
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The weird thing that I always find with this is that a lot of vets don't seem to see it that way. They think that stimulating the appetite is enough. Honestly, I find that kind of mean - the worst feeling in the world is having one of those bugs that makes you nauseous but you're still in some weird way hungry. I'm not sure why anyone thinks it's OK to make a cat feel like that every day.

Wendy&Neko said:
Elura can raise blood sugar values for several hours, as it works by causing extra growth hormone to be output. It is specifically contraindicated for cats with acromegaly. I'm saying this, for any lurkers in this forum.
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I've not found it all that successful either. I think some cats do respond to it, at least for a while, but for a lot of them it just doesn't do anything all that useful. And, as you say, it raises glucose levels too. I much prefer mirtazapine overall. I'm not saying not to try it - it may work well for Ladybug, but do bear in mind that it doesn't work for all cats.
 
ladybug991 said:
they said reglan is also an anti nausea med. elura they had to order through chewy and I get reglan tomorrow. I really think she was withdrawing off gaba so even though they said no need to taper that’s what im doing. Oh and I see flea dirt on her and she’s scratching so I have to somehow get more flea meds and cerenia because im almost out of that too because I keep wasting pills. She spits out everything. I think I have to put the pill popper farther back. I know liquids have to be in the cheek pouch but that makes her spit it out and it’s so so hard for me to keep her mouth shut with one hand. Im so worried she’s not getting full doses of her liquid meds. Idk im trying my best and I feel like it’s not good enough sometimes.
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Reglan can help a bit with nausea...if the nausea is genuinely related to low GI motility. It's absolutely not a general anti-nausea med. And not as powerful as Cerenia or ondansetron for relieving nausea.

I would do what you need to for getting her off the gaba. I've not really seen an issue with stopping it without a taper for any of my cats, but ECID and if she's struggling with no taper, I would 100% reduce the dose gradually until she's off it instead.

The good thing with liquid meds is that there's absolutely no way she's spitting out the whole dose. So she'll be getting a decent amount of it despite her best efforts. I actually find pills easier overall with most cats, but again you do whatever's easiest and works best for you. There's no right or wrong choice between pills and liquid - just whatever you can make work the best out of the two.
 
Reglan is free for me she’s also on mirtazapine transdermal you think switching to pill or liquid would help? My capsules get here tomorrow. Also with the twitching she’s having vets don’t want me to give her flea meds except collar because she has sensitive skin and they worry it’s seizures I think it might be stress or gabapentin or gabapentin withdrawal. She’s super sensitive to gaba and I think I need to titration her no matter what they say. Rn she’s on the steroid, I filled elura liquid and reglan liquid flavored with chicken I’m not sure I’m gonna give her the elura or not. I’m keeping up with mirtazapine. Hopefully the capsules help me get the cerenia in her and I can put steroid pill in there too. Idk if I can put omeprazole tablet inside it or not. I think capsules are easier than liquids honestly if I have a pill shooter at least. May jus suffer through liquid though because these are expensive. I just wanna make sure she gets full dose and now I need to figure out whether to get her follow up blood work done at a first vet appointment or stick with the old place I did the former but I think maybe I just should switch now. They are concerned about her twitching as am I her electrolytes blood sugar and blood pressure were normal so ER is lesss concerned I do notice them at certain times also potential feline hypermesia or fleas could be contributing. This vet says they are interested in IM and I know people who love them maybe I should just switch and see if they can do paperwork at initial appointment. I don’t want my vet to hate me but I think I need to leave. Ladybug pooped today everyone! I think I just need to calm down and celebrate little wins I think my stress is affecting her and I feel bad
 
I’m so sorry you’re both going through this. It can be so stressful. Please take a deep breath and remember to take care of you too. :bighug:

As for the twitching, I do wonder if it could be related to the fleas, especially if her skin is super sensitive. Might be worth asking the vet again about whether any of the flea meds would be safe to use. You might also want to treat the environment to try to eliminate the fleas that will hatch out or that are already lurking and will jump back on her.
 
They are worried about her seizures so recommended a flea collar but I think that wouldn’t work for her sensitive skin. I think a pill with low likelihood of seizure as a side effect (if that exists) is my best option but IM vet is out this week and old vet bloodwork appointment is Monday but maybe ill change that to new vet appointment Friday or Thursday? Idk they wanted recheck blood work from beginning of next week. I have a vet in mind
 
You could try switching to oral mirtazapine. It is one of the ones that absorbs fairly well transdermally, but any transdermal med can irritate the ears too. I would consider that a reason to switch to a different formulation.

Just thinking out loud here - when you say she has sensitive skin and reducing the gabapentin made her twitch, that 100% sounds like feline hyperesthesia syndrome. That absolutely makes their skin sensitive and twitchy and gabapentin is how you treat it! Fleas will contribute because just them moving around on her skin could be enough to trigger the twitchiness for her. While it is potentially a form of seizure disorder (some research supports that but not all), most flea meds should still be safe. I would try something like Revolution Plus. I would avoid Bravecto, Nexguard for cats etc - that newer class of med can sometimes contribute to seizures in animals that are prone to them. But older active ingredients (Revolution, Advantage 2 etc) shouldn't affect her.

I can't think of any reason you couldn't put the omeprazole in a capsule too - it pretty regularly comes as a capsule from pharmacies, so I don't think you're going to stop it working by putting it into one at home.
 
ladybug991 said:
They are worried about her seizures so recommended a flea collar but I think that wouldn’t work for her sensitive skin. I think a pill with low likelihood of seizure as a side effect (if that exists) is my best option but IM vet is out this week and old vet bloodwork appointment is Monday but maybe ill change that to new vet appointment Friday or Thursday? Idk they wanted recheck blood work from beginning of next week. I have a vet in mind
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I have to be honest. I loathe flea collars with a passion. My preference when there's concern for a potential reaction would be a spot-on treatment. If she seems to be reacting, you can wash it off. Can't do that with a monthly pill.
 
ok this helps I’m thinking of switching to mirtazapine pill (her ear is irritated a little ) using the chicken liquid reglan and blood thinners to mask taste of gaba and put steroids, mirtazapine, cerenia, potentially blood thinner in pill form in a capsule and the omeprazole is already a capsule so idk if capsule on capsule will fit but I’ll try. They are easier as they don’t dissolve. I hate flea collars too and will try revolution now these New Orleans fleas are ridiculous. I might also try chicken mirtazapine 😅 also I’m gonna change my vet for her next appt I think and I need to transfer a plethora of records to them so you need prescriptions for revolution?
 
FWIW, my IBD kitty had ileus for a while, and she did fine with ondansetron.

I much prefer the Mirataz transdermal. That format also reduces the mirtazapine side effects. I alternate ears and clean well in between. I also find it doesn't need to be given every day.
 
You can always empty the original omeprazole capsule into the empty capsules you plan to use. IIRC, omeprazole in capsules is actually usually more like little beads than powder, so transferring shouldn't be all that difficult.

Revolution is still prescription only. When they first introduced the Plus version, there was some talk of making the original one OTC, but it never happened. Possibly because Europe is now trying to control the amount of insecticides that are used on pets because some of them can be damaging to the fish population if they make it into the water table.
 
Maybe I haven’t been cleaning well enough and applying too much but it doesn’t seem to be returning her appetite comepletely I’m hoping now that’s she’s off antibiotics that on gi drugs she will feel better
 
Wendy&Neko said:
Is she on probiotics now? That makes a huge difference with some types of antibiotic side effects. Speaking both for my cat and myself.
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This! Probiotics make so much difference. It's incredibly common for cats to have gut dysbiosis after antibiotics and it can take ages to resolve without probiotics on board.
 
Thinking about calling the new vet now because the vets I have been dealing with are making me want to scream lately. And just like starting over. Do I need a prescription for probiotics? The antibiotics were prescribed unnecessarily I feel they thought she had a uti and she didn’t…..
 
ladybug991 said:
Thinking about calling the new vet now because the vets I have been dealing with are making me want to scream lately. And just like starting over. Do I need a prescription for probiotics? The antibiotics were prescribed unnecessarily I feel they thought she had a uti and she didn’t…..
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No prescription needed for probiotics unless you particularly feel a need to go with Proviable Forte. Roxi's IM always recommended Visbiome which is a little more expensive than most, but absolutely does work.
 
Ok so she’s still exhibiting weird behavior one day she ate super well and the rest of the days this week back to only a few bites a few times during the day but today seems a little better than yesterday? I’ve been trying the GI drug and I think it seems to be helping. but she’s still shaking her head and ears and twitching. and theres some hair loss on her ears. She also seems agitated in the mornings. I think the mirtazapine is helping her eat more but it also makes these weird symptoms worse? Or maybe it’s the gaba? Idk if these side effects and symptoms are from the mirtazapine?

And I got capsules but they are too small but I can put the steroid and cerenia in one. My only issue is giving multiple pills in a row feels dangerous and I hate having to do more than two sessions a day of pills. I just got the elura and I’m scared to give that because she had low BP during surgery. Ugh it’s so hard I don’t know why the shaking is going on or what it’s from exactly they checked her blood sugar electrolytes and blood pressure and it was fine. I’m gonna try to find bigger capsules somewhere where I won’t have to order and wait days again but idk if that will be possible. Also need ear wipes and probiotics. Idk if any of this will be in pet stores so I might just do another order of stuff. I realized I have this calming powder also with probiotics in it she used to eat on her wet food and I sprinkled some of that back on today.

I have an appointment next week with a new vet but also have one with the hospital IM endocrinologist person the same day for a blood work recheck and to talk about that’s going on. So I guess I will cancel the new vet appointment and just make one later or a few months out? Unfortunately these are both drop off appointments so idk if I would be able to talk to the vet in person about all my concerns when I pick her up or over the phone?

I’m most stressed about giving the elura I’m thinking about putting it in a capsule and putting gaba in a capsule and just giving like 30 min between pills. That way she doesn’t have to deal with bitter liquid. But I only have size 4 capsules. I’m also very stressed about this shaking I feel like it could be either stress or a medication side effect and I dont want it to continue but can’t get it to stop and don’t wanna stop the meds that are helping her eat.

I’m just so worried about her because she’s still not close to being back to normal :(
 
ladybug991 said:
Ok so she’s still exhibiting weird behavior one day she ate super well and the rest of the days this week back to only a few bites a few times during the day but today seems a little better than yesterday? I’ve been trying the GI drug and I think it seems to be helping. but she’s still shaking her head and ears and twitching. and theres some hair loss on her ears. She also seems agitated in the mornings. I think the mirtazapine is helping her eat more but it also makes these weird symptoms worse? Or maybe it’s the gaba? Idk if these side effects and symptoms are from the mirtazapine?
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It could be the mirtazapine. It's not common unless you combine it with something like bup, but it can cause serotonin syndrome, which can present with generalized agitation.

ladybug991 said:
And I got capsules but they are too small but I can put the steroid and cerenia in one. My only issue is giving multiple pills in a row feels dangerous and I hate having to do more than two sessions a day of pills.
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I literally taught my Rosa to understand numbers that way. She was on 5 different meds twice a day at one point, and I didn't use gelcaps for her. I would count down each med, and when I said "one" she would get all excited because she knew treats were coming after that. It's definitely not dangerous, although it can be uncomfortable for you to feel as though you're forcing her for long enough to take more than one pill.

ladybug991 said:
Also need ear wipes and probiotics. Idk if any of this will be in pet stores so I might just do another order of stuff. I realized I have this calming powder also with probiotics in it she used to eat on her wet food and I sprinkled some of that back on today.
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I usually buy from Amazon to be honest. Although I'm sure most pet stores will have the ear wipes, they may not have a good quality probiotic.

ladybug991 said:
I have an appointment next week with a new vet but also have one with the hospital IM endocrinologist person the same day for a blood work recheck and to talk about that’s going on. So I guess I will cancel the new vet appointment and just make one later or a few months out? Unfortunately these are both drop off appointments so idk if I would be able to talk to the vet in person about all my concerns when I pick her up or over the phone?
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Agree. I'd keep the IM appointment and schedule the new vet appointment later if you still feel you need a regular vet appointment right now.
If not, maybe give her a few days/couple of weeks to decompress from the IM appointment and then make an appointment for a new patient exam just so you're not having to go over the basics if you need a vet more urgently later on.

ladybug991 said:
I’m most stressed about giving the elura I’m thinking about putting it in a capsule and putting gaba in a capsule and just giving like 30 min between pills. That way she doesn’t have to deal with bitter liquid. But I only have size 4 capsules. I’m also very stressed about this shaking I feel like it could be either stress or a medication side effect and I dont want it to continue but can’t get it to stop and don’t wanna stop the meds that are helping her eat.
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Personally, I would not put a liquid in a gelcap. That's going to get really messy, really fast. And if the liquid makes it through the gelcap while it's still in her mouth (likely at some point), it may put her off the whole idea of gelcaps and make pilling her other meds more difficult too.
 
manxcat419 said:
It could be the mirtazapine. It's not common unless you combine it with something like bup, but it can cause serotonin syndrome, which can present with generalized agitation.


I literally taught my Rosa to understand numbers that way. She was on 5 different meds twice a day at one point, and I didn't use gelcaps for her. I would count down each med, and when I said "one" she would get all excited because she knew treats were coming after that. It's definitely not dangerous, although it can be uncomfortable for you to feel as though you're forcing her for long enough to take more than one pill.


I usually buy from Amazon to be honest. Although I'm sure most pet stores will have the ear wipes, they may not have a good quality probiotic.


Agree. I'd keep the IM appointment and schedule the new vet appointment later if you still feel you need a regular vet appointment right now.
If not, maybe give her a few days/couple of weeks to decompress from the IM appointment and then make an appointment for a new patient exam just so you're not having to go over the basics if you need a vet more urgently later on.


Personally, I would not put a liquid in a gelcap. That's going to get really messy, really fast. And if the liquid makes it through the gelcap while it's still in her mouth (likely at some point), it may put her off the whole idea of gelcaps and make pilling her other meds more difficult too.
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Ugh now im scared she has serotonin syndrome, she has had really big pupils as well. It’s hard to know what her normal behavior even is since the tumor was affecting her appetite and behavior for a year now. I don’t know if I should stop the mirtazapine and just try the elura? Im scared to stop it and I’m also scared to keep giving it. Im worried I’ve been poisoning her but the vets said she’s ok?

I haven’t mentioned to them about the mirtszapine potential side effects other than the ear issues I did call them but idk when I’ll hear back.

Idk what to do about meds. The elura tastes awful too im guessing worse than the gaba.

I just want a solid plan for her meds and im so worried im gonna hurt her with them somehow and I can’t figure out what’s going on.
 
manxcat419 said:
It could be the mirtazapine. It's not common unless you combine it with something like bup, but it can cause serotonin syndrome, which can present with generalized agitation.


I literally taught my Rosa to understand numbers that way. She was on 5 different meds twice a day at one point, and I didn't use gelcaps for her. I would count down each med, and when I said "one" she would get all excited because she knew treats were coming after that. It's definitely not dangerous, although it can be uncomfortable for you to feel as though you're forcing her for long enough to take more than one pill.


I usually buy from Amazon to be honest. Although I'm sure most pet stores will have the ear wipes, they may not have a good quality probiotic.


Agree. I'd keep the IM appointment and schedule the new vet appointment later if you still feel you need a regular vet appointment right now.
If not, maybe give her a few days/couple of weeks to decompress from the IM appointment and then make an appointment for a new patient exam just so you're not having to go over the basics if you need a vet more urgently later on.


Personally, I would not put a liquid in a gelcap. That's going to get really messy, really fast. And if the liquid makes it through the gelcap while it's still in her mouth (likely at some point), it may put her off the whole idea of gelcaps and make pilling her other meds more difficult too.
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Honestly I’m more concerned about her not full swallowing a pill and then getting stuck in her throat. She won’t even eat anything including treats for an 30 min to an hour after pills and runs away from me and shakes. Sometimes she comes around to me sooner but yeah she doesn’t want any treats after the pills she just wants me to leave her alone :(

I guess I will go by the pet store today and see what they have. Is there another probiotic that’s good? I’m probably not gonna get the other probiotics for a while because of the cold shipping.
 
I wish they could give me ondansetron but they said it could slow down her GI system. But I really don’t think the cerenia is helping her nausea. I see online ondansetron can also interact with mirtazapine…. I don’t know what to do. Although I did come home to a decent amount of her food eaten. But I still don’t like whatever is happening with her muscle twitching and weird behavior that I’m not sure is from gaba or mirtaz or stress or what at this point. :( I just want my baby to feel better this is breaking my heart
 
I think I’m gonna go ahead and pay the $100 to order through the website and get visbiome. Unless anyone has anything else that they recommend
 
Fortiflora can entice some cats to eat so it can be helpful in that way, but unfortunately it’s not a great probiotic. Visbiome seems to be one of the best.

Did you ever treat for fleas? Fleas can cause twitching too and even fur loss if they trigger overgrooming or excessive scratching (I saw one cat who was nearly bald from fleas, sadly). Not saying that’s what’s happening but it would be nice to rule that out as the culprit. Revolution seems to be a pretty safe option. Remember to treat the environment as well.

I don’t know what to tell you about an anti-nausea med. Ondansetron seems to be the go-to these days. We used to use famotidine (brand name Pepcid AC) with good results. It’s fallen out of favor a bit over the years but it’s still my first choice. If you’re desperate, you can always consider it. Dose is 2.5mg (1/4 of a 10mg pill). Just make sure you get Pepcid AC and NOT Pepcid Complete.
 
JL and Chip said:
Fortiflora can entice some cats to eat so it can be helpful in that way, but unfortunately it’s not a great probiotic. Visbiome seems to be one of the best.

Did you ever treat for fleas? Fleas can cause twitching too and even fur loss if they trigger overgrooming or excessive scratching (I saw one cat who was nearly bald from fleas, sadly). Not saying that’s what’s happening but it would be nice to rule that out as the culprit. Revolution seems to be a pretty safe option. Remember to treat the environment as well.

I don’t know what to tell you about an anti-nausea med. Ondansetron seems to be the go-to these days. We used to use famotidine (brand name Pepcid AC) with good results. It’s fallen out of favor a bit over the years but it’s still my first choice. If you’re desperate, you can always consider it. Dose is 2.5mg (1/4 of a 10mg pill). Just make sure you get Pepcid AC and NOT Pepcid Complete.
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My revolution is on the way I am probably going to order probiotics and see what the vet says when I talk to them tomorrow hopefully.

Scared to try the Elura because she had low BP during her surgery and it can cause low BP. Also unsure about the amount of mirtazapine I could be giving her. But I will see what the vet says.
 
I don’t blame you about the Elura, especially since it doesn’t work for all cats. It didn’t work well for my crew, but every cat is different.
 
Your question on serotonin syndrome reminded me that people here used to use cyproheptadine as an appetite stimulant. It's also used to offset mirtazapine and get rid of serotonin syndrome. Maybe another option to discuss with your vet?

You can use human probiotics, something like RenewLife is one brand I've seen people use. In Canada, I used a Natural Factors product my vet had recommended for Neko, before Visbiome came out. Just check out your local vitamin store. Dosing towards the bottom of this page: Probiotics – IBDKitties
 
Ditto what Wendy said about cyproheptadine. I still often use that instead of mirtazapine as an appetite stimulant. Definitely worth considering if worried about seratonin syndrome.
 
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