Metronidazole - allergy / bad reaction Please Help

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Rachel & Gus

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The vet prescribed Gus Metronidazole last weekend for vomiting and diarrhea. He looked all cumpled up and hid under the bed after two doses and stopped eating. I stopped giving it to him 6 hours later he started to look normal. He was also given predisonal (sp), pecid shots and cerinia (sp). I only gave the steroid once as well. He returned to normal for 5 days and this started up again on Friday despite pepcid twice a day - 5mg.

He has severe diarrhea (sometimes with bloody mucus) and vomiting. The vet said to try the Metronidazole again because she said this is the best antibiotic for GI issues. 4 hours after giving it to him he has lost his appetite and is crumpled up on the floor again.

The vet cannot think of another antibiotic that will work for him. Has anyone had this happen and what did you do? We believe he needs an antibiotic, but the side effects from this are terrible.

Thank you for your help.
 
Hi Rachael,

I'm so sorry to hear that Gus is going through all of this. Can you tell me a little bit more about what's been happening? Was all of this new last week (vomiting and diarrhea)? If it was new, did anything change in Gus's normal pattern (food, medications, medical conditions, any new chemicals around the house, etc)?

What exactly did the vet tell you he/she was "treating" with the chosen antibiotic.
Were any specific tests done (blood, urine, ultrasounds, x-rays, endoscopy) and if yes, do you have the results of more specifically, the abnormal results?
How has Gus's blood sugar been since this all began?
When you say mucous/blood diarrhea, would you say it looks "fatty" or more mucousy?
What color is the vomitus, is there any blood in it and when does it happen in relation to eating?
 
He seems a better than a while ago. He is up and eating. I think I am going to reduce the next dose tomorrow even further and if he looks bad again then call the vet.

Gus has pancreatitis and possible inflammatory bowel. He gets pepcid every day along with Lantus 2x a day.

The vet has been happy that his blood glucose hasn't gone above 315 considering all the problems and because I can't give him insulin on days when he vomits everything. I wouldn't doubt if it goes up more while on the steroid because the last time he was on a steroid it was in the 400s. He was on steroids once before because he had 7 teeth extracted and after surgery he stopped eating.

The bloody diarrhea didn't start until he had diarrhea for a few days. The vet thinks the straining caused it.

This has happened before, but we were always able to get it under control with pepcid and cerinia. Also for diarrhea we used propectalin, but now when I give that to him he vomits because his stomach is already upset.

I wish I could just get a new pancreas installed for him :( This one seems to have all kinds of problems.

I have done so much research to find a treatment for pancreatitis, but there doesn't seem to be anything that really fixes it. Everyone seems to recommend Pepcid which he is on as well as a low carb Fancy Feast and occasional Tiki Cat diet.
 
That's really good news. Thank you for clarifying what was going on. If he does have bloody mucous diarrhea, I'm on board with the thought that he had coexisting gastroinestinal disease and that's one that can cause quick dehydration and electrolyte imbalances.

You may consider Cobalamin injections:
Cobalamin (vitamin B12) is a water-soluble vitamin that is absorbed in the intestine. Reduction in blood cobalamin levels can be seen in cats with gastrointestinal disease such as inflammatory bowel disease. It is common for cats with pancreatitis to concurrently have gastrointestinal disease; therefore, measuring blood cobalamin levels in cats with pancreatitis is a really good idea. If a cobalamin deficiency is found, it should be supplemented by injection. Generic formulations of cobalamin are available and extremely cost effective.

There are a couple of other anti-emetics you may want to try. These two work on a different pathway, and who knows...may offer you better results: Dolasetron (Anzemet) and Ondansetron (Zofran). I've seen a lot of people on this board talking about Ondansetron.

Probiotics are another must add with these signs and symptoms and especially if you're giving antibiotics.

Has your vet talked at all about Pancreatic Enzymes....not a cure, but may help with digestion.

As info: Pancreatitis is usually a sterile process in cats and antibiotics are rarely indicated. Indications for their use include sepsis (may result from bacteria from the gastrointestinal tract), bacterial peritonitis, other infections (e.g., urinary tract infection). Although, there may not be grounds for using antibiotics, there may be a rationale for not using them since some antibiotics can cause nausea and vomiting in cats.

If there truly is another infection suspected, there are some other drugs to be tried (Clavamox, Sulfa drugs, etc)....but I'm afraid you'll find the side effects to be nausea and vomiting....which is exactly what you're trying to avoid. Fenbendazole is often used in place of Metrodinazole and is considered safer.

I hope he continues to feel better!!
 
Besides being a mild antibiotic, metronitazole has an anti-inflammatory effect on the GI tract and that is why is is frequently prescribed for GI issues.
 
Jessica & Boo Radley said:
That's really good news. Thank you for clarifying what was going on. If he does have bloody mucous diarrhea, I'm on board with the thought that he had coexisting gastroinestinal disease and that's one that can cause quick dehydration and electrolyte imbalances.

You may consider Cobalamin injections:
Cobalamin (vitamin B12) is a water-soluble vitamin that is absorbed in the intestine. Reduction in blood cobalamin levels can be seen in cats with gastrointestinal disease such as inflammatory bowel disease. It is common for cats with pancreatitis to concurrently have gastrointestinal disease; therefore, measuring blood cobalamin levels in cats with pancreatitis is a really good idea. If a cobalamin deficiency is found, it should be supplemented by injection. Generic formulations of cobalamin are available and extremely cost effective.

There are a couple of other anti-emetics you may want to try. These two work on a different pathway, and who knows...may offer you better results: Dolasetron (Anzemet) and Ondansetron (Zofran). I've seen a lot of people on this board talking about Ondansetron.

Probiotics are another must add with these signs and symptoms and especially if you're giving antibiotics.

Has your vet talked at all about Pancreatic Enzymes....not a cure, but may help with digestion.

If there truly is another infection suspected, there are some other drugs to be tried (Clavamox, Sulfa drugs, etc)....but I'm afraid you'll find the side effects to be nausea and vomiting....which is exactly what you're trying to avoid. Fenbendazole is often used in place of Metrodinazole and is considered safer.

As info: Pancreatitis is usually a sterile process in cats and antibiotics are rarely indicated. Indications for their use include sepsis (may result from bacteria from the gastrointestinal tract), bacterial peritonitis, other infections (e.g., urinary tract infection). Although, there may not be grounds for using antibiotics, there may be a rationale for not using them since some antibiotics can cause nausea and vomiting in cats.

I hope he continues to feel better!!
Click to expand...

Thank you for your informative reply. It is greatly appreciated!!!

I'm going to look up the Dolastron and Ondansetron because I have never heard of it.

I've read conflicting reports about pancreatic enzymes. Some say it makes their cats worse, some say better. This concerns me because I certainly don't want to make things worse.

He's had a blood panel done and has no deficiencies. I've spoken to my vet about B12, but she feels his numbers are very good - which is surprising considering his pancreatic issues. I will talk to her again about it. I've heard the shots are painful for cats - not sure if this is true. He's in pain now so I guess he will be in pain no matter what :( I just want him better and healthy.

I will also look at the other antibiotic you mentioned that is safer than what I'm using.

I'm going to go look up all the stuff you've given me and see what I can figure out. Thank you again for this information Jessica and Boo!
 
I've read conflicting reports about pancreatic enzymes. Some say it makes their cats worse, some say better. This concerns me because I certainly don't want to make things worse.
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You two are sure welcome! I'm going to do some research on what you said about the enzymes....they are a staple in humans with chronic pancreatic problems! I would love to find something that gave you peace in using and knowing they were safe and conversely...want to make sure I"m not recommending something that would do harm! :oops:
 
It looks like you ahve received a lot of good info already. As Larry mentioned, Metronidazole is often prescribed for IBD because it also has an anti inflammatory effect on the GI tract. While I am not familiar myself with using the antibiotic that Jessica has mentioned specifically for IBD, it does raise a good question - has the vet tested for parasites and Giardia?

Another medication that may help with diarrhea is Tylosin (Tylan), which you could discuss with the vet. It doesn't appear that the metronidazole is going to be an option.

Treatments for IBD do often include steroids. You could ask the vet about one called Budesonide, which may have less of a systemic effect, and less impact on BG, than prednisolone does. In a very serious case of IBD, a steroid like Prednisolone may be required. It is fairly common for an IBD cat to also suffer from pancreatitis, as the inflammation can travel from the intestines to the pancreas.

If you do give a B12 shot, you will be looking for Cyanocobalamin. I do give that to my IBD cats, and they have not reacted as if it is painful.

The Pepcid (Famotidine) is good for both IBD and pancreatitis, as is the Cerenia, and the Ondansetron that was mentioned by Jessica. My IBD/CP cat takes these as well. He also takes Ursodiol (Actigall).

A few other things which may be helpful would be sub Q fluids, and a medication for pain, as pancreatitis is a painful condition.
 
Thank you with the follow up info Linda. I think Gus's case is pretty severe which is why she chose that steroid.

I gave him the rest of the Cerenia. He has been mostly vomiting in the wee hours of the night so I'm just hoping everything stays down and that he is ok. I took his blood sugar and it is 470. I know it's not good, but he was exploding with diarrhea and vomit about 9 hours ago, plus he is being pumped full of drugs. His blood glucose always goes up with an attack of pancreatitis and then the steroids make it worse. He hasn't had diarrhea for 9 hours though and he ate so I was able to give him his Lantus at a slightly increased (from 2.25 units to 2.5 units) dose tonight.

I posted on here several weeks ago - but didn't get any replies - that I had given Gus Claritin and his BG dropped dramatically. We thought he had an allergy in his ears, but I figured out it wasn't an allergy. In human diabetics, Claritin can increase BG. I took him off of it after a few days when I realized he was scratching his ear because of the pricks where I do the testing. I do think there is something to all of this though. I don't know what and I don't know if I will figure it out. When I told one of the vets about the lower BG she was perplexed. The problem is, I could tell he didn't feel good on the Claritin - very tired - or else I would give it to him all the time to get those numbers.

Thanks again for the info. Pancreatitis and IBD are so difficult to deal with. Way worse than diabetes.
 
Rachel & Gus said:
Thanks again for the info. Pancreatitis and IBD are so difficult to deal with. Way worse than diabetes.
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Thyay are hard to deal with but it can be done once you start finding out what works. I have dealt with three IBD kitties that have passed, and I still have one who has IBD and lymphoma. He is on all of these drugs I mentioned, except he is on a stronger steroid, and also a chemo drug (Leukeran) which may also work on IBD.
 
HI Rachel

Have you considered working with an internist (internal medicine specialist)? You can look for one in your area at acvim.org . If you are in the greater NYC/NJ area I can give you the names of some I know. I'm just afraid that with the diabetes and all of this vomiting and diarrhea, your kitty is going to get into trouble (dehydration, DKA, hepatic lipidosis), and it seems like your vet is at a loss somewhat. Ideally, your cat could be hospitalized to wrestle down the BG and re-hydrate him and start from there.
 
Hi Jessica

I'm not sure quite what you mean about using pancreatic enzymes to help with digestion in this case ... I don't think there's any indication that the cat has an insufficiency -?

Generally regarding pancreazyme use in pancreatitis cats and dogs: Many veterinary internists feel that, since pancreatitis can basically involve auto-digestion of the pancreas, adding more enzymes into the mix doesn't work out well. (Some feel the opposite, that negative feedback may cut down on the pancreas's autoenzyme secretion, and those who do use enzymes do it for this reason.) Also, oral pancreazyme in cats can be difficult to administer. Mixing it with food can result in mild burns in the mouth or throat (cats chew their food, unlike dogs who tend to bolt it, and the enzymes can become active in the mouth) and if this occurs, the cat needs to switch to capsules and then must swallow a few gelcaps of pancreazyme with each meal and this is hard to do with some cats. For cats with EPI there isn't a choice, but when the benefit is theoretical, many vets won't bother.

Jessica & Boo Radley said:
Fenbendazole is often used in place of Metrodinazole and is considered safer.
Click to expand...

Can you explain this? When are they interchangeable as antibiotics?
 
Jess - thank you for elaborating on the enzymes. I couldn't remember what I had read, but just knew that it could have bad effects. Also - I don't think he is deficient in anything. I believe that I read pancreatitis can be autoimmunity (not in all cases though) - which I believe is what type 1 diabetes is, but I could be wrong.

I don't know if my vet is at a loss. She is a cat only vet and I think she tries to treat cat's individually once she gets to know them over time. We have already done sub Q fluids at the last visit. My vet believes bringing him all the time causes a lot of undo stress, plus he is drinking a lot. She said the high BG for a few days is worth it if it stops the vomiting and diarrhea. My vet is open to suggestions whenever I bring them to her, but she usually has an arsenal of information as to why or why we can't do whatever I suggest. We discussed Milk Thistle, but her thought is that is only good for the liver in all the studies she read and Gus's liver is fine. However she said if I really wanted to give it to him I could and it wouldn't hurt, however, I have opted not to since it did cause vomiting once when I tried it.
 
Hi Rachel

If you can get your kitty to an internist, he or she will speak to your regular vet and they'll work together, with most follow up being at your regular vet. I think it just sounds like a good time to get another pair of eyes on the case, and perhaps get a look at the belly with ultrasound.
 
I don't understand what the difference is with an internist and a regular vet?

There used to be another vet that worked at my vet's office but she left to start her own practice working only with cats. Both of these vets have been featured in magazines. They both attend conferences on a regular basis. Additionally - Gus saw a "fill-in" vet last weekend and this was the same treatment she recommended - antibiotics, cerenia, pepcid.

I will research some internists in my area, but I like that I go to a cat only vet who is up to date with cat treatment. So many vets are focused on dogs and their diabetes is completely different from cats.

Thank you again for all the feedback. 11 hours and counting and no vomiting or diarrhea. Fingers and paws crossed that it lasts.
 
Oh - just one other thing - my vet said we could do an ultrasound, but her opinion was it will not be conclusive on anything. She suspects from Gus's symptoms he has pancreatitis. We have only had two bad flare ups that couldn't be controlled with Pepcid. Also - the only sure way to know is a biopsy - which all of my vets have said they do not want to do because it involves surgery. There is some blood test the fill in vet suggested and I will discuss this with my regular vet as well.
 
Last post for the night I promise! I just wanted to add that I live in Chicago and if anyone has suggestions on a vet then I am open. I still feel my vet is very good, but as I said, I'm open to suggestions.
 
It sounds like Gus has both Pancreatitis and IBD, my civie Conor has both. Sometimes its hard to tell which symptoms are from which disease. Have you done the fPLI test to confirm pancreatitis? its more accurate for diagnosing when its run during a flare up.

Conor was helped a lot by antibiotics, for the IBD, and he was getting B12 shots subQ (have to order more).

Are you giving liquid flagyl/metronidazole? or a pill? Metro tastes AWFUL! its very bitter. And if its liquid, the taste can linger in the mouth just like something nasty tasting lingers in your mouth. So its possible his appetite is being affected by the taste of the meds. If its a pill, I would recommend putting it in a gelcap (but make sure you syringe water after to make sure it goes down)

Sending cyber hugs for Gus
 
Rachel & Gus said:
Oh - just one other thing - my vet said we could do an ultrasound, but her opinion was it will not be conclusive on anything. She suspects from Gus's symptoms he has pancreatitis. We have only had two bad flare ups that couldn't be controlled with Pepcid. Also - the only sure way to know is a biopsy - which all of my vets have said they do not want to do because it involves surgery. There is some blood test the fill in vet suggested and I will discuss this with my regular vet as well.
Click to expand...

The blood test that was mentioned may be the fPLI, mentioned in a post above, which is a test for pancreatitis. Severe diarrhea with blood and mucous is not a usual symptom of pancreatitis. It sounds very characteristic of IBD (as well as parasites, which should be ruled out). As I mentioned earlier, it is quite common for an IBD cat to suffer flareups of pancreatitis if the inflammation of the GI tract is not controlled.

Jess & Earl, who posted in your thread, is a very experienced vet tech who works in a vet hospital. I would say that she raises some very valid concerns and suggestions. An internal medicine vet compares to a regular vet, just like a human specialist would compare to a general practice physician. The IM vet may have more tools and insights into the problem. I think an ultrasound may shed some light on the situation, and would give you more info on whether the next step of biopsy should be discussed. One good reason to pursue this is that intestinal lymphoma may present in a very similar way to IBD. It is also very treatable if caught early.

Since you have started using steroids, they may affect the results of any biopsies which may be done (i.e. give you a false negative reading), so please make sure to discuss this any vet before going to that step. Biopsies are more informative if done with surgery to do full thickness biopsies, but biospies done via a colonoscopy can also be informative.

As Jess/Earl says, it sounds like right now you need to stabilize your kitty, and then look into your next options.
 
I'm not sure quite what you mean about using pancreatic enzymes to help with digestion in this case ... I don't think there's any indication that the cat has an insufficiency -?
Generally regarding pancreazyme use in pancreatitis cats and dogs: Many veterinary internists feel that, since pancreatitis can basically involve auto-digestion of the pancreas, adding more enzymes into the mix doesn't work out well. (Some feel the opposite, that negative feedback may cut down on the pancreas's autoenzyme secretion, and those who do use enzymes do it for this reason.) Also, oral pancreazyme in cats can be difficult to administer. Mixing it with food can result in mild burns in the mouth or throat (cats chew their food, unlike dogs who tend to bolt it, and the enzymes can become active in the mouth) and if this occurs, the cat needs to switch to capsules and then must swallow a few gelcaps of pancreazyme with each meal and this is hard to do with some cats. For cats with EPI there isn't a choice, but when the benefit is theoretical, many vets won't bother.
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Jess -

I think the big difference is that you're explaining Acute Pancreatic and I'm speaking of Chronic Pancreatitis. 2/3 of all pancreatitis in cats is chronic.

Acute causes a premature activation of excessive pancreatic enzymes that destroy ductal tissue and pancreatic cells, resulting in autodigestion and fibrosis of the pancreas. Acute pancreatitis can range from mild involvement evidenced by edema and inflammation to necrotizing hemorrhagic pancreatitis (NHP) NHP is diffusely bleeding pancreatic tissue with fibroisis and tissue death. Acute pancreatitis is generally caused by some sort of trauma, alcohol or drug toxicity, hyperlipidemia, hypercalcemia, tumors, cysts, and ulcers. It can be life threatening and cause multisystem organ failure. It presents differently than chronic; sudden severe abdominal pain, worse in the lying position, generalized jaundice, gray-blue discoloration of the abdomen and/or flanks, and often no bowel movement (paralytic ileus). Lab abnormalities are typical in acute pancreatitis. Amylase levels usually increase within 12-24 hours and remain elevated for days (often more than 3 times the normal limits). Lipase is generally elevated for weeks. Trypsin testing is probably the most accurate, but is not widely available for cats. Bilirubin and ALP are generally elevated (and sometimes ALT if an obstruction is to blame). WBC's can also be elevated in Acute. If Acute was the cause - the key is to rest the pancrease to reduce pancreatic enzyme secretion through the acute period - food and oral fluids are withheld, and IV isotonic fluids are administered to maintain hydration. Because of Rachael's description, the co-morbid IBD, the chronic nature of these symptoms, and the treatment thus far...there's no indication that this kitty is having an acute pancreatic attack.

Chronic is a progressive, destructive disease of the pancreas that has remissions and exacerbations. Relief of pain, prevention of recurrence of attacks, prevention of complications and nutritional support are the principle interventions. Pancreatic insufficiency in chronic pancreatitis causes the loss of exocrine function, leading to decreased pancreatic secretions and bicarbonate. Pancreatic enzyme secretion must be greatly reduced to produced fatty, mucousy stools resulting from malabsorption of fats. You can actually see the fat content and in severe chronic can be as must as 40g/day!
Fat malabsorption also contributes to weight loss and muscle wasting and protein malabsorption results in starvation, nausea and vomiting. The loss of pancreatic endocrine function in chronic pancreatitis is responsible for the development of diabetes. Clinical manifestations of chronic differ from those of an acute inflammation. However, abdominal pain is the major clinical manifestation. You could also see fatty, mucousy stools, weight loss, dark urine, polyuria, polyphagia, polydipsia. Lab findings are generally normal or just mildly elevated lipase or amylase levels. Glucose elevations are common.
For chronic pancreatitis, pancreatic enzymes are essential dietary supplements. They should be taken just before or with meals. Antacids should be taken before (they can lessen the enzyme), the powder should be mixed with a non protein based food or it becomes active on the food - which is what you may be speaking about in regards to becoming active in the mouth. For people, we do have them wipe their lips afterwards to prevent any sort of lingering irritation.

Rachael - you mentioned your Vet wasn't too hip on doing an ultrasound. It could be useful if the vet suspected any kind of abcess or psuedocyst, or maybe even to see the atrophy or fibrosis....but I suspect the IBD is the relationship cause - thus their input to not perform.
 
The metronidazole is liquid and they told me it was chicken flavored. Please don't laugh at me, but I tested it myself to make sure it wasn't terrible. My cat is more important than the grossness of me testing his medicine. I'm sure my taste buds are different than his, but I'm doing the best I can to help him. He also gets a treat and eats his food right after to get any taste out of his mouth.

I think the reason the Claritin reduced Gus's BG by more than 100 points is because Claritin reduces inflammation. I am sending emails to every vet/researcher in the country that I can find to see if they can shed any insight on this and if they think it would be a good idea to put him back on Claritin. Type 2 diabetes is also caused by inflammation in humans. I just need to get more information and talk to some experts in this area. It seems inflammation is the root cause of most of these problems in all mammals.
 
Rachel:

I'm in Chicago. I don't know what vet you're currently using. I work with Holly Pohl, DVM at Cat Hospital of Chicago. All of the vets there are good.

The only other exclusive cat practice that I'm aware of is City Cat. This is now a "chain" operation and most of the good vets that were there have left over the last couple of years since the practice was sold. I don't know how much they've re-built the practice.

If you want to send me a PM, I'm happy to answer any questions about the practice or the vets.
 
My cat has had Ibd for about 7 years and just developed pancreatitis so I know how miserable they can get during flare ups. Maybe the metronizadole is upsetting his stomach because of the liquid flavoring or some lingering bitterness that he can taste but you can't? I've only ever used the pill form and, as someone else mentioned, it is ridiculously bitter. I got some in my mouth once in a failed pilling attempt and it was BAD! It makes my cat foam at the mouth and hiss and act really surly. However, if you can get it into your cat, it really does seem to help them heal. Before abandoning it completely, maybe you could try asking your vet for it in a pill. The key is to get some gel caps as mentioned above and a pill popper gun thing. Cut in half, it fits nicely into a small size capsule, but just make sure you don't get any pill dust on the outside. You need to use a pill popper because the gel starts to dissolve if you make too many attempts on getting it in. After about 2-3 tries, it gets gooey and they can taste the pill.

I second the recc of Cat Hospital of Chicago. They are really good with cats and people and they are totally into using technology for diagnosis. They have an ultrasound specialist in once or twice a week. They are over on Irving Park near Western. Even though I am having difficulties with regulating my tricky high dose cat and I wish they were a little more aggressive with dose increases, they are still the best vets I have ever gone to.

Good luck!
Ellen & redd
 
Rachel & Gus said:
The vet prescribed Gus Metronidazole last weekend for vomiting and diarrhea. He looked all cumpled up and hid under the bed after two doses and stopped eating. I stopped giving it to him 6 hours later he started to look normal. He was also given predisonal (sp), pecid shots and cerinia (sp). I only gave the steroid once as well. He returned to normal for 5 days and this started up again on Friday despite pepcid twice a day - 5mg.

He has severe diarrhea (sometimes with bloody mucus) and vomiting. The vet said to try the Metronidazole again because she said this is the best antibiotic for GI issues. 4 hours after giving it to him he has lost his appetite and is crumpled up on the floor again.

The vet cannot think of another antibiotic that will work for him. Has anyone had this happen and what did you do? We believe he needs an antibiotic, but the side effects from this are terrible.

Thank you for your help.
Click to expand...

Your Gus' history sounds very similar to my Buff's. My vet also could not think of anything and basically said she couldn't do anything more (I pretty much made a pest of myself begging for help). I'll list some of Buff's history and what we've been through. Maybe it could help you decide about your next step for Gus.

Buffy was first given a Convenia injection after diagnosis of a very mild UTI. She had already had a couple bouts of pudding consistency diarrhea the week prior, but nothing greatly concerning.

Two days following the Convenia injection, she began having extreme watery diarrhea, 6 to 8 bouts/day - large quantity. She was given metronidazole and at first seemed to get better, then she became violently ill, developed a worse UTI and was placed on Clavamox. This made her worse still, with vomiting of bile - and anorexia. She had several times during the weeks when she seemed to be recovering, then she would slip back due to an antibiotic.

She's gone through just about every test that can be done without a specialist being involved. We don't know if this is pancreatitis as we don't have the result back yet. I don't know why they don't do that test first so they can begin treatment. Anyway, this has gone on for weeks and we've tried a lot of different meds listed below:

Convenia - I believe this turned a minor case of UTI and mild diarrhea into a major illness.

Famotidine - not sure if this helped due to severity of symptoms.

Metronidazole - seemed to work at first, then diarrhea became much worse. Told by 3 vets that most cats respond well within a couple days. She didn't.

Clavamox - severe reaction within 2 hours - vomiting large amounts of bile.

FortiFlora - Did not seem to affect diarrhea but I believe this is helping keep things semi-normal in her gut.

Cerenia - administered at emergency vet for vomiting - worked very well both times.

Zofran - prescribed by regular vet for vomiting - supposedly was compounded with chicken flavor in order to disguise bitterness, but seemed to make worse after just one dose (maybe because of bitter taste?). At any rate, the med prescribed for nausea made the vomiting worse.

Mirtazapine - prescribed by emergency vet for appetite stimulant - only for very occasional use [antidepressant] - worked well.

Lomotil - prescription sent to compounding pharmacy by her vet with tuna flavor added. She didn't care for it - although it didn't make anything worse or better.

Albon - sulfa drug for the diarrhea because she has reaction to other antibiotics - like Gus. Albon has a sweet taste but Buffy takes it without balking - and she keeps it down. Only problem is it dries her out and she drinks pretty often even with subq fluids.

Subq fluids. Started by emergency vet and I requested they be continued and we've been doing this for 2 weeks.

Plain yogurt was suggested by emergency vet as an alternative to FortiFlora. Her diet mostly consists of dried chicken and other bland foods and broth. We began B12 injections today.

She's eating small amounts on her own, although she's lost more than a pound and has developed hemorrhoids, poor thing. But I truly thank God that she's beginning to act like her old self again.
 
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