New member - complex health issues

Second post - just wanted to share all of my cat's health issues and I am open to any and all advice. He was diagnosed with hyperthyroidism and early stage kidney disease, approximately three years ago, then IBD, pancreatitis, constipation, and heart murmur about a year ago, and now diabetes. Given his complex health issues, I am trying to find the right food and meds for him. He was prescribed .5u Prozinc BID but I cant get him to eat much. He is also prescribed 5 mg felimazole/methimazole BID, renal gel 2 tsp BID (there's no way he's eating it now though), Mirtazapine every third day for now, and Cerenia 12 mg every third day. Was on lactulose 2 mg daily but discontinued due to all this other stuff. Was prescribed Hills z/d canned but he stopped eating it mostly and I want to switch to fancy feast due to the lower carbs.
My cat is so sick right now. I just feel terrible. I feel sad and want to take good care of him and help him feel better. He is approximately 14 yrs old and I hope he has some good years left of laying in the sun and giving good cuddles ♥️

 

Is he eating dryfood?
If so, throw it out.
All his organs needs fluids, specially his kidneys and bowls.
My nondiabetic was constipated from September 19 to January 20, the trick was canned food with extra water. Now he's getting slippery elm on his wet food just as a precaution.
Hope he's getting better soon

 

Are you home testing his Blood sugars? If not I would suggest buying a blood glucose monitor AND strips. It is VERY important t monitor blood glucose numbers before any food changes when Insulin is on board.
Hometesting Links and Tips

I also want to WELCOME YOU TO FDMB!

You've landed in a safe place. There are many kitties here with multiple issues. We welcome yours!
jeanne

 

Britt, I've left links with information on treatments that might help Eddy in this post on your opening thread.

The discussion over there talks about appy stimulants and anti-nausea meds, but with Eddy's history of pancreatitis I wonder whether he might be having a bit of a flare-up? Make sure the vets have tested for pancreatitis (Snap fPL or Spec fPL tests). If he is having a flare he will need pain meds (e.g. buprenorphine) to help him eat better.

You can't get Cerenia in tablet form in the UK for cats, only injections done by the vet, so I can't comment on dosage ... BUT ... if a cat's badly nauseated it benefits from quite intensive treatment. When treating Saoirse's pancreatitis I gave her 1-2mg ondansetron BID for maintenance, and 1-2mg up to every 8 hours during a flare-up (10lb / 4.5kg cat). At the very beginning of treatment, a Cerenia injection gets into the system faster than ondansetron given by mouth, but I found the latter to be superior in anti-nausea benefit thereafter. If required, both medications can be used in tandem since they target different systems in the body to control nausea.

According to Wikipedia, Cerenia (maropitant) has mild anti-inflammatory and analgaesic properties. According to dvm360.com, it has an elimination half-life of 7.75 hours in dogs. No info for half-life in cats but I would lay odds that it's measured in hours, not days, so dosing every 3 days is likely to be ineffective.

For appetite stimulation I prefer to use cyproheptadine. It's milder in effect than mirtazapine administered by mouth BUT it is much easier to manage appetite with it because it can be dosed up to 3 times a day. Mirtazapine's appy stimulant effect can peter out much sooner than the 3 days between doses. The dosage for cyproheptadine per my vets instructions is 0.5mg cyproheptadine q8-12hrs, but up to 1mg BID if needed. I found that giving the 0.5mg q8 worked best for Saoirse during a flare-up. (All dosages for 10lb / 4.5kg cat.) A small dose of cyproheptadine can be administered ad hoc if on a particular day if the appetite just needs a bit of a nudge. (Much easier to keep a cat eating rather than to get it going again if the appetite grinds completely to a halt.)

A course of B12 injections can give a general boost and also help with appetite. Saoirse also received buprenorphine for pain management during flare-ups.

If Eddy is constipated at the moment that is very likely to adversely affect his appetite and constipation needs to be addressed first otherwise none of the anti-nausea meds will work properly. A check-up by the vet is needed before starting any treatments to make sure there's no obstruction. If all is OK obstruction-wise, a couple of days' treatment with metoclopramide (Reglan)* may help restore normal gut motility. Thereafter, adding fibre to the die, water to food, and perhaps an osmotic treatment like Miralax can be used as preventative treatments. Lots more information here:

felineconstipation.org

On diet, I fed Saoirse small meals (wet, low carb food) every three hours in general, perhaps smaller meals every 2 hours at the height of a flare (timed feeders are a godsend). Mixing a couple of teaspoons of water to each meal can help greatly with maintaining good hydration.

At the most fundamental level, a cat has to eat. When dealing with IBD and pancreatitis, it can be a huge struggle to find things that are tolerable to our little ones' digestive systems. There might be a lot of trial and error to find a low carb food that Eddy can tolerate. If that's not possible, then the right diet has to take priority but the insulin treatment can be managed around that. I found managing Saoirse's pancreatitis much more difficult to manage than the insulin treatment: there were so very few foods I could find for her to eat comfortably. I hope things are much easier for your little fella. (((Eddy))) There is helpful information on IBD at the following site:

ibdkitties.net

My heart goes out to you when I think of you looking at how poorly Eddie is at the moment (been there). Keeping fingers, paws, and anything else I can think of that once you get the right treatments in place he'll feel - and look! - much better very soon. Cats can be extremely resilient creatures, and their powers of recovery nothing short of astounding at times.




Mogs
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