Upset and Need to Vent!

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Blamethecats and Hannah

Member Since 2014
Have had a lot of trouble getting Hannah to eat for the past week or so. Her vet prescribed Mirtazapine (1/4 tablet) to get her going... and it sure did! She ate very well all day. Did her blood work at 12:30 PM and she was at 218. Again at 2:10 PM and it was 233. Not great numbers, but for her, pretty much improved over what they usually are. Once more at 5:30 PM and... brace yourself...553. I about screamed!! Googled the drug and now see that it elevates blood sugar. Really!!?? Her vet prescribed this medication for a kitty with diabetes?? I am so upset, I hardly know what to do. Expect there is nothing I can do, except I really, really need to vent. I sure hope she will be okay. Her numbers haven't been that great anyway, and now THIS! Gasp! :evil:
 
I have used Mirtazapine for some of my diabetic cats and it did not have much effect on BG. Could the high BG be due to eating a lot of food?
 
Larry and Kitties, I sure hope you are right and that awful number is from eating more than usual. Am glad to know you have used it and it didn't seem to bother numbers, much. That is somewhat encouraging. Has anyone else on this Board used it with success and with not much effect on BG?

Sue, yes, I took it twice -- each ear. Using the Relion meter, got 553 in right ear, "Hi" in left. I am still shaking, I am so upset. Right now, she seems hungry, again, but can't have food until after her PMPS in about 45 minutes. She acts okay, for now, at least. We played a little bit this afternoon, and she enjoyed that until she lost interest, as she usually does.

She hasn't had a black number in quite some time and I thought perhaps we were past that, even though her numbers still leave a lot to be desired. nailbite_smile
 
Its important to remain calm about the glucose numbers. Your cat is more than a glucose test. Take a look at the 5 Ps below.

The 5 Ps
Purring - is the cat exhibiting customary signs of contentment or happiness?
Playing - will the cat play and interact with others?
Preening - is the cat maintaining its fur and cleanliness?
Peeing - occurs, and is a normal volume?
Poohing - fecal material is formed and passable?

Constipation may happen with a food change; adding a tablespoon or so of water may help, plus ensures the cat is hydrated properly.
 
Blamethecats and Hannah said:
Has anyone else on this Board used [mirtazapine] with success and with not much effect on BG?

Saoirse was initially prescribed mirtazapine, but I only gave her one dose of it. She became crazed with hunger and very aggressive. Also she had pupils like saucers a very short time after getting the drug. I got the drop of my life when I found out mirtazapine can induce serotonin syndrome (potentially life-threatening). I've also been prescribed mirtazapine in the past and my system didn't take too kindly to it either. I stopped taking after a couple of doses. It's a very strong, harsh drug.

I went back to the vet and now Saoirse takes cyproheptadine as an appetite stimulant. It's much gentler, and has a soothing effect on her. I have found it an invaluable aid in helping to keep Saoirse eating regularly. I think it helps with her digestive discomfort, too. According to the Wikipedia article, it is used in humans to treat cyclic vomiting syndrome. The article also indicates that it has local anaesthetic properties.

Cyproheptadine does not adversely affect Saoirse's BG in any way.
 
Critter Mom, your reply made me decide to throw the balance of her prescription into the garbage. Actually, I'd pretty much already come to that conclusion after seeing what the drug had done to her. Your info was very informative and scary, indeed. I sure hope the drug's duration is short for Hannah and that there are no lasting side effects... or worse. Right now, she wants to eat just about everything in sight and pretty much did so, today. I am glad she is eating, but that's one heck of a way to bring on an appetite. I will be watching her very closely (as I always do, anyway) and pray this turns out okay for her... and for me, too. After all, I'm the one that put that crap into her little system in the first place. She has had such a struggle with the diabetes, and now this setback, too. I feel so bad for her.
 
Thank you, one and all, for letting me vent while Hannah was doing scary things with her PM numbers. Just knowing there were folks who cared enough to comment helped a lot while I was panicking. Don't know if it was the overeating or the Mirtazapine that caused her numbers to skyrocket, but she seems to be back to her usual magenta numbers, this AM. Wish they were lower, but they are certainly improved over the 553 and 560. We won't go the Mirtazipine route, again. I don't trust the stuff, especially after reading Critter Mom's input! Have FortiFlora on the way and hope it will help entice her to eat. Has anyone here had experience with FortiFlora? Have read comments about it on this forum, but can't seem to locate them at the moment.
 
Carole, what do you think about increasing the dose? She still has lots of room to drop. Maybe one unit for the pinks+ and .8 for the yellows?
 
what do you think about increasing the dose? She still has lots of room to drop. Maybe one unit for the pinks+ and .8 for the yellows?

Sue, I think that is an excellent idea. Do you think I should wait a couple of days to let the Mirtazapine get out of her system? I understand it's good for 3 or 4 days. Her numbers are, once again, way too high this afternoon. It appears that this morning's shot didn't work at all. How can that be? I am certain it wasn't a fur shot. I hope she doesn't top yesterday's record. Or do you think I should go ahead and start with the new dosing, perhaps tomorrow, when I will be home all day, as I certainly need to monitor? Thank goodness, she acts pretty good, today. I am going to try to get through the rest of the day without a panic attack when I see her +9 number. grr_red It won't be easy, as you can probably tell.

Oops, the phone just rang and I found out I won't be home for part of the day, tomorrow. If I start the new dosing, guess it will have to be on Thursday.
 
Hi Carole,
You wondered about the FortiFlora. I had great results with getting Noodle to eat when he was so anorexic and ill just after he was diagnosed. I sprinkled just a tiny bit over his wet food, much like a human would do with maybe black pepper, and he just loved it and ate his food much more readily. I don't know what they put in that stuff but it sure worked magic. It was originally given for his IBD, to help the intestine, and that great side-benefit of increasing his interest in food was a welcome plus at a difficult time. Hope your sweetie feels better soon!

Christi
 
You wondered about the FortiFlora. I had great results with getting Noodle to eat when he was so anorexic and ill just after he was diagnosed.

Christi, I am so glad to hear this. :smile: I hope it arrives soon, as am anticipating that the Mirtazapine will get the heck out of her system in a couple more days. After that, I'm pretty sure her picky-eater attitude will return and we will go through another awful spell of trying to get her to eat. She is so thin and needs to put on a little weight. She seems to look forward to her food, then acts disappointed when I give it to her, eating only a couple of bites, then walking away. Have tried numerous flavors. Some she likes, then doesn't like them the next day. Maybe the FortiFlora will be just what she needs to quit being so fussy. Before the diabetes, she was a totally dry-food kitty and always ate quite well and held steady at about 9 pounds. Now she is 7.4 pounds and hasn't made any headway with her weight since this whole thing happened. Thanks for your well wishes.
 
Blamethecats and Hannah said:
She seems to look forward to her food, then acts disappointed when I give it to her, eating only a couple of bites, then walking away.

That's the piece of the puzzle I was looking for, Carole. Saoirse was just like that and nausea was the problem. Does Hannah lick her lips / pull faces after trying to eat her food?

If you're asking your vet for cyproheptadine it might be a good idea to ask about an anti-nausea medication as well. My vet initially gave Saoirse a Cerenia injection for nausea and then gave me metoclopramide for continuing home treatment. From watching my little Munchkin, I am of the opinion that the cyproheptadine helps with the nausea as well (presumably that's why it can be prescribed for human cyclic vomiting syndrome). Other members on the board have also recommended Cerenia tablets and ondansetron for nausea.

If nausea is the problem, then the right prescriptions could make a world of difference - for both of you. It might not be an overnight fix since you may find that some foods agree with Hannah better than others (that's where we are at the moment), but at least she would be getting the nutrition needed for weight gain and healing. Saoirse's coat was in bits a few weeks ago, but now there's new growth in spite of the difficulty in finding food that will agree with her. Indeed, it is starting to feel better than it has in years. Saoirse has also regained the weight she lost. (She gets vitamin B12 injections too. Has Hannah's B12/folate been checked?)

Saoirse sometimes takes Fortiflora. Other times it puts her off. I have found that it's best to use it sparingly. It definitely helped Saoirse with nutrient absorption but she won't take it consistently for me.
 
Re the dose, if you can be there an hour or so after the shot and near nadir to check, she should be okay. But if you are nervous, wait till you'll be home (or someone will)

You have gotten some great advice re meds for the nausea. Hope the vet will help.

Dr. Lisa says Fortiflora has the disgestive enzymes that are in dry food, which makes it as irrestible as dry food for some cats.
 
Larry and Kitties said:
Metoclopramide works poorly in cats. Cerenia tablets and ondansetron work well for cats and can even be used together.

I agree, Larry. I did ask the vet about the other meds. Cerenia is only available as an injection here, and he thinks ondansetron is possibly too strong. In my heart of hearts I think the cyproheptadine helps more with the nausea than the metoclopramide. I've tried dosing them at separate times and the metoclopramide doesn't seem to do as much to help her as the cyproheptadine. She seems much more comfortable when the latter is active in her system. :-|
 
cyproheptadine should have no effect on nausea but on the other hand Mirtazapine does have some anti-nausea properties. I never heard of ondansetron being too strong.
 
I used FortiFlora for Squeaker and it helped with his appetite most of the time. Periodically I would have to substitute grated parmesan (like you put on pasta) instead. One or the other did the trick but he did get to the point where he would lick it off the top of the food and not eat. I can't use it anymore as now the front runner of the health issues is his heart so sodium is the big issue.

Anita and Squeaker
 
but he did get to the point where he would lick it off the top of the food and not eat.

Yep, I can see Hannah doing that as well, Anita. That's just what she did when I tried the Parmesan cheese. Also, wish they didn't use so much salt in food products and supplements, including FortiFlora, but then I suppose it's part of what makes it a flavor enhancement. I hope to use it sparingly.

Good luck with your Squeaker and his heart issue. Hope he is doing well.
 
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