Pookey nausea help

Tim & Pookey

Tim & Pookey

Member Since 2024
Administrator
Hi all,

Previous:
2/14 - Pookey pics

I'm always hesitant to post about poor eating because maybe it's just older, kidney cat things, etc, but I'm wondering if anyone has any other ideas.

It's been 3 days now struggling. He's still getting most of the calories in but I'm micromanaging and doing Pookey buffet every single feeding (like 12 a day), and I feel like I'm losing steam... This is our worst episode of this yet.

He comes over to the food and sniffs, sometimes takes a lick, then walks away. A little sleepier than normal.

Things I've tried:
  • Ondansetron yesterday day, this morning, and tonight, basically 12 hours apart, doesn't seem to be helping. 4mg each time.
  • Fortiflora works sometimes. Same for crumbled treats.
  • Water or no water added, doesn't seem to matter. Same for dish material.
  • Other Fancy Feast varieties, he'll eat a brand new flavor nicely for like one or two snacks, then nothing.
  • Other brands of food, same deal, he'll have them for one or two snacks then refuses.
Maybe I'll go to the store and get some other random flavors/brands tomorrow, and hope whatever this is passes before I run out of new things to offer. Now that I'm thinking about it, I wonder if I could try cooking him something. He was begging me for some of our burgers for dinner earlier...

Seems like a lot of this going on on the board recently :confused: hope all the cats get better soon!

Have a great week! - Tim
 
Sorry to hear Pookey’s appetite is poor. It’s always such a worry. Don’t have much in terms of advice, seems you’re doing everything to help. I think you can give Odansetron up to 3 times a day. Glad to hear his blood work is stable, that’s always great news.

Sending hugs 🤗 and hope he feels better soon. 🍃🍃🍃
 
Thanks, Kat. I’m so glad Trixie’s numbers came back down on their own, that must have been nerve wrecking!

The three times a day for Ondansetron, I’ve wondered how much that would help. Because the third dose wouldn’t line up with many feedings. Unless it’s more a maintenance thing to keep him feeling alright in the meantime.
 
Hasn't eaten really anything today. Now having mushy poop and threw up.

I did give an extra dose of Ondansetron this afternoon but didn't seem to help. Vet denied my request for Cerenia. I'm trying not to spiral, but I just don't have experience dealing with this.

@Staci & Ivy remind me, is this similar to what you went through with Ivy? Or if anyone has any guidance, would be much appreciated. I'm off to try cooking some chicken.
 
Tim & Pookey said:
Hasn't eaten really anything today. Now having mushy poop and threw up.

I did give an extra dose of Ondansetron this afternoon but didn't seem to help. Vet denied my request for Cerenia. I'm trying not to spiral, but I just don't have experience dealing with this.

@Staci & Ivy remind me, is this similar to what you went through with Ivy? Or if anyone has any guidance, would be much appreciated. I'm off to try cooking some chicken.
Click to expand...
Oh gosh so sorry I missed this post entirely Tim.
I’m always worried about pancreatitis. (Will find link to the primer)
Ivy had it last year in February 2025. Began with poops getting mushier and mushier.
Then she wouldn’t eat by day 2. She was meatlloafing in the corner, head facing a corner.
I gave her a Cerenia and she threw it up first dose.
Went to ER next day, Saturday, hadn’t peed so I was panicked.
They have injection of Cerenia.
Finally on Monday back to my vet, did labs, showed pancreatitis but we began treating anyway before diagnosis.
I keep Animal Essentials Colon Rescue on hand, it helps with loose poops.
Can also give S. Boulardii (I use Jarrow brand) and gave large doses. And gave large to get it to work.

I also got the rescue canned food which is high density and very palatable. (Keep cans in the house just in case)
Insane vet won’t give you Cerenia!
My vet feels it’s very helpful and has inflammation related properties (once a day)

Ondansetron 3-4 times a day seems to be common around here for very nauseated kitties. And Mirataz transdermal to stimulate appetite (make sure you wipe clean each ear daily and rotate ears and use a glove on finger).

Poor you and Pookey.
Let me go find links 🫂🫂🫂❤️‍🩹❤️‍🩹❤️‍🩹
 
@Staci & Ivy that's OK I can search, I don't want to be too much of a burden.

I've been assuming pancreatitis too. Their logic for no Cerenia was it could be dangerous to mask symptoms with more nausea suppressant. But I kind of thought the treatment for pancreatitis was basically nausea and appetite stimulant anyways. The vet is coming tomorrow afternoon, not sure what she'll be able to tell me that I can't tell her, but if it gets me the meds...

He did eat the boiled chicken just now. I'm hoping he will keep it down.
 
Tim & Pookey said:
@Staci & Ivy that's OK I can search, I don't want to be too much of a burden.

I've been assuming pancreatitis too. Their logic for no Cerenia was it could be dangerous to mask symptoms with more nausea suppressant. But I kind of thought the treatment for pancreatitis was basically nausea and appetite stimulant anyways. The vet is coming tomorrow afternoon, not sure what she'll be able to tell me that I can't tell her, but if it gets me the meds...

He did eat the boiled chicken just now. I'm hoping he will keep it down.
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Tim you are never ever a burden.
I’m so glad you’re asking. I feel awful I missed your post.
Please don’t sleep on this.
I would treat as though it’s pancreatitis since his symptoms sound really like it.
Instructions for using S. Boulardii:
How to Use S boulardii for diarrhea
 
Tim & Pookey said:
@Staci & Ivy that's OK I can search, I don't want to be too much of a burden.

I've been assuming pancreatitis too. Their logic for no Cerenia was it could be dangerous to mask symptoms with more nausea suppressant. But I kind of thought the treatment for pancreatitis was basically nausea and appetite stimulant anyways. The vet is coming tomorrow afternoon, not sure what she'll be able to tell me that I can't tell her, but if it gets me the meds...

He did eat the boiled chicken just now. I'm hoping he will keep it down.
Click to expand...
I’m glad he ate the chicken.

Do you have baby food in the house? (With no spices or onions or garlic).
That can be very good to eat if they won’t eat regular food temporarily.
I’d make sure he’s seen by the vet.

As soon as Ivy gets loose stools now I immediately give a dose of Cerenia and if needed Colon Rescue (and s. Boulardii).
It can get dangerous quickly, so you want to be prepared and ready to go.
Glad you have Ondansetron on hand.
Make sure you have a good supply so you aren’t without it in a crisis.
I now keep Mirataz, Cerenia, ondansetron here just in case (after having gone through all of that last year).
I’m too scared so I’m as prepared as I can be (my pharmacy cat cabinet is a bit crazy).
I’d rather have and not need it!
 
My first thought was cerenia as well, as it targets nausea in a different way than ondansetron.

Xander had always had a day or two of low eating, but when he kept that up for about a week and then started with a day below 50% of his target I brought him in when he was diagnosed with pancreatitis. The cerenia helped him get back to eating decent, but it wasn't until we brought him back in for fluids/mirataz that he started back to eating really well. Since then, he hasn't eaten extremely poorly enough or showed obvious signs of nausea, but I have been giving him a very tiny maintenance dose every few days. I was scared of masking symptoms but it seems to work really well for him with a minimal dose.

With Xander's pancreatitis, his only real symptom was the inappetence. He was even playing right up to the vet visit where they said he was very dehydrated.

I haven't used it before but as Staci mentioned the baby food is a good idea. I picked up the Beech nut brand that you can get from target or walmart. The meat flavors that list broth as an ingredient don't include onion/garlic/spices in the broth, as confirmed by the company from a post I had found here or somewhere else.
 
@Albert & Xander great idea about the baby food. Katie just got back with a couple flavors of the Beech nut. I've got some momentum with the chicken so maybe I'll keep the baby food in my back pocket...

How did they diagnose, do you remember? Vet is talking about an ultrasound but I thought I remember there being a couple ways.

So he was doing decent with just the Cerenia? I'm curious about the appetite stimulant. I guess as long as the nausea is under control maybe it's one of those things like might as well also do it just to get through it.

Vet said she will bring "lots of options" for tomorrow's visit. Hopefully that includes the stuff you mentioned.
 
Tim & Pookey said:
Thank you soooo much @Staci & Ivy, do you give her the Colon Rescue and s. Boulardii via pill?

He just had another tablespoon of the plain chicken. Ate it pretty enthusiastically.
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S. Boulardii is capsules you open up and mix in the food (tasteless)
Colon Rescue is a liquid with dropper, I gave 1 ml 2x daily.
(Amazon or Chewy, I’ve seen in some pet stores too).
 
Tim & Pookey said:
@Albert & Xander great idea about the baby food. Katie just got back with a couple flavors of the Beech nut. I've got some momentum with the chicken so maybe I'll keep the baby food in my back pocket...

How did they diagnose, do you remember? Vet is talking about an ultrasound but I thought I remember there being a couple ways.

So he was doing decent with just the Cerenia? I'm curious about the appetite stimulant. I guess as long as the nausea is under control maybe it's one of those things like might as well also do it just to get through it.

Vet said she will bring "lots of options" for tomorrow's visit. Hopefully that includes the stuff you mentioned.
Click to expand...
I’d make sure she had it with her ahead of time. Ask her to bring it all 🙏
 
Tim & Pookey said:
@Albert & Xander great idea about the baby food. Katie just got back with a couple flavors of the Beech nut. I've got some momentum with the chicken so maybe I'll keep the baby food in my back pocket...

How did they diagnose, do you remember? Vet is talking about an ultrasound but I thought I remember there being a couple ways.

So he was doing decent with just the Cerenia? I'm curious about the appetite stimulant. I guess as long as the nausea is under control maybe it's one of those things like might as well also do it just to get through it.

Vet said she will bring "lots of options" for tomorrow's visit. Hopefully that includes the stuff you mentioned.
Click to expand...
Blood test confirms it.
And yes fluids helped Ivy too, I forgot that!
(I now have fluids on hand and all needed stuff for that) 😬
 
It was the Spec FPL blood test
1772493231300.png


It was hard to tell what helped when, as his appetite kept coming back and then dropping off again. But I noticed a big improvement after the second vet visit with a lot of fluids, a shot of cerenia, and mirataz. I believe they gave him a full dose of mirataz at the vet and he was insatiable for a while.


He has been a difficult eater ever since the switch to wet food (and even to an extent with before with kibble) so with Xander its really hard to tell what is just a low appetite drive vs pancreatitis etc.
 
If he does start on cerenia, I found out the hard way that the tablets are bitter. I must have missed the back of his throat a bit, and he ran around the house foaming at the mouth :rolleyes:

I ordered some size 4 gel capsules that I can put the tablet in. They're also handy if you need to give several things at once: you can just put them in the one capsule.
 
Tim & Pookey said:
Hasn't eaten really anything today. Now having mushy poop and threw up.

I did give an extra dose of Ondansetron this afternoon but didn't seem to help. Vet denied my request for Cerenia. I'm trying not to spiral, but I just don't have experience dealing with this.

@Staci & Ivy remind me, is this similar to what you went through with Ivy? Or if anyone has any guidance, would be much appreciated. I'm off to try cooking some chicken.
Click to expand...
I had to take Panzer to a different vet because my vet wouldn't see him because he wasn't up to date on his rabies vaccine & I only do the purevax which they don't have.
The other vet thought he was in DKA wanted to hospitalize him & check for ketones. I told her he's got chronic pancreatitis & he's having a flare I know my cat. I told her I needed a senior panel & a urinalysis so she did it his bloodwork always comes back with a high amylase which indicates pancreatitis. The urinalysis came back that he had a UTI & no ketones which I already knew he wouldn't have any. They gave him a shot of cerenia & 2 cerenia pills & I had to mail a prescription to chewy for 2 miritazapine pills, which dosed out to be 8 doses. The antibiotic they gave him for the UTI was liquid which Panzer doesn't do well with & didn't finish because it gave him constant diarrhea,he was having a hard time peeing & he puked up blood! They refused to give me more Cerenia & a different antibiotic. They just kept saying to bring him back in or take him to the ER vet. I asked them if they knew how to treat a diabetic cat with chronic pancreatitis & they said she went to school for veterinary. I said I understand but they can't learn about everything. They still wouldn't budge on Cerenia or another antibiotic. I got him through it with Ondanstran that I had a lot on hand from previous flares & Miritaz. I found some expired Zeniquin in my cat medicine cabinet gave him those & D Mannose 3xs a day. As soon as he was back to being somewhat normal I took him to get his purevax rabies vaccine & got him into my vet. They did an exam on him & I had brought a clean catch of urine in. I told them all about the other vet visit. They gave me 2 boxes of Cerenia & authorized a prescription for Miritaz through chewy because it was $20 cheaper than buying it from them. His urine came back clean no bacteria no UTI.
It boggles my mind how a vet can deny Cerenia for a cat with pancreatitis or even suspected pancreatitis. Also no vets in the state I live in will give buprenorphine, I had to give him gabapentin which at 100mg & vet stress it causes him to be in & out of the litter box trying to poop & pee for 3-4hrs after having it.
I'm waiting for the more updated vet to be in on Wednesday so I can talk to her about getting some tramadol for Panzer to have on hand incase of another flare.
I hope your vet will give you everything you need tomorrow & pookey will start eating & feel better soon. It's so scary when are babies don't & won't eat. I think your definitely dealing with a pancreatitis flare. Feel better Pookey & give your daddy some relief too ❤️
 
@Chrispooky12 wow! I’m sorry you’ve had to deal with a situation like that. I’m frustrated for sure. Didn’t know that about amylase. Pookey’s has been high for like a year and was high again last week. I hope I can use this situation to help my vet understand that I’m not the average cat caregiver they see and to have a little more faith in me for next time. They do house calls and are great with him otherwise.

How often does Panzer have flares these days?
 

From the (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease dosing table for anti nausea medications ondansetron can be given 0.5–1.0 mg/kg q6–8h.

Amylase is a better indicator of pancreatitis in dogs than in cats. It can also be high for cats with CKD. You want the Spec fPL test that Albert posted above.

I've seen a number of cats here get p'titis shortly after vet visits and I think I might be seeing a bit of that myself at home right now. The Tiki Cat Silver Comfort packets are currently saving the day. That and regular ondansetron.
 
Things have been better so far today. He’s eating small portions of plain chicken and even some of his normal fancy feast. Following me around like he’s hungry. So that’s great.

I syringed ondansetron and gabapentin for the first time (separately). The ondansetron must taste terrible. Gaba was much easier.

Drinking a lot from the water bowl. I’m thinking that’s probably a good thing with the dehydrating events from yesterday.

Vet will be here in a few hours.
 
Tim & Pookey said:
Things have been better so far today. He’s eating small portions of plain chicken and even some of his normal fancy feast. Following me around like he’s hungry. So that’s great.

I syringed ondansetron and gabapentin for the first time (separately). The ondansetron must taste terrible. Gaba was much easier.

Drinking a lot from the water bowl. I’m thinking that’s probably a good thing with the dehydrating events from yesterday.

Vet will be here in a few hours.
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I’m glad he’s feeling a bit better.
Good job with the meds.
I always follow a pill or capsule with greatly syringed water to make sure it doesn’t get stuck in the throat.
I also coat pills/capsules In a little butter, helps it slide down (and maybe hide taste a bit of some nasty pills).

Good luck with the vet, please keep us posted! 💕🍀🥰😻🍃🍃🍃🍀🍀🍀
 
Staci & Ivy said:
I’m glad he’s feeling a bit better.
Good job with the meds.
I always follow a pill or capsule with greatly syringed water to make sure it doesn’t get stuck in the throat.
I also coat pills/capsules In a little butter, helps it slide down (and maybe hide taste a bit of some nasty pills).

Good luck with the vet, please keep us posted! 💕🍀🥰😻🍃🍃🍃🍀🍀🍀
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Great point! I didn't realize dry pilling wasn't good (especially with certain medicines) until I read that you should follow it with water.

I haven't seen anyone else with this experience with cerenia, but Xander threw up about 30 minutes later after 2 of the doses. I started to make sure to give it with a snack/water
 
Albert & Xander said:
Great point! I didn't realize dry pilling wasn't good (especially with certain medicines) until I read that you should follow it with water.

I haven't seen anyone else with this experience with cerenia, but Xander threw up about 30 minutes later after 2 of the doses. I started to make sure to give it with a snack/water
Click to expand...
I do it with all pills and luckily, Ivy rarely ever puked back a pill or foams up. 🍀🍀🍀
Even a liquid med that may taste bitter, just a bit of water to wash it down too. ❤️‍🩹
 
Tim & Pookey said:
@Chrispooky12 wow! I’m sorry you’ve had to deal with a situation like that. I’m frustrated for sure. Didn’t know that about amylase. Pookey’s has been high for like a year and was high again last week. I hope I can use this situation to help my vet understand that I’m not the average cat caregiver they see and to have a little more faith in me for next time. They do house calls and are great with him otherwise.

How often does Panzer have flares these days?
Click to expand...
He's had 2 for sure pancreatitis flares within a couple of years,not sure if what he had going on in November was pancreatitis or not because my other cat non diabetic was having the same symptoms 2 days before Panzer was I think it was a stomach bug.

He has struggled with constipation even before he was diabetic but we had a good medicine regime going for quite some time & he hadn't been constipated until after this last Pancreatitis flare & UTI. I gave him some psyllium husk for the first time @ PMPS tonight & he just pooped a good normal turd @almost +3 PMPS so hopefully it's going to help. I could see the pain in his face earlier before I left for work & he hid under the couch. I only have gabapentin for him & the last 2xs he had it he had trouble peeing & pooping for 3-4hrs after it wore off. I'm going to call my vet tomorrow because I believe Dr Chelsea will be there & she's more up to date on things & knows & respects that I talk with the FDMB before making any decisions. I'm going to see if she thinks tramadol might help with pain for him in general & for future pancreatitis flares.
 
Tim & Pookey said:
@Mary & Jude just the usual symptom management we see here with nausea and appetite meds.

They told me to continue nausea meds for 10-14 days which is interesting. There might have been a miscommunication in there because I don’t really see why. I’ll just treat as things happen.
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Thanks for the update. How’s Pookey feeling?
I hope he’s doing much better.
And now you will be prepared in the future (and hope you don’t actually need the meds) 🙏🥰😻💕
Anti jinx 💓
 
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