1/14/18 |Darwin - ER vet this morning, hanging in there.

Condo

I went ahead and took Darwin in to the ER vet this morning. He was still acting fairly normal, but still not interested in any food at all. I felt a bit like a crazy person, but just didn't want to wait until tomorrow and really got a bad feeling about giving him even one steroid injection.

The vet was wonderful, and the ER practice (not the closest to me, but I don't love that one) is Feline Friendly certified, which certainly makes me feel more at ease! We went ahead and took some more x-rays of his chest (and abdomen for good measure), and his pneumonia is slightly worse. He is not coughing or congested, but seemed to have a bit more respiratory effort. He has had a history of possible ashtma (much improved with his weight loss), but the ER vet and radiologist cannot rule out that that may be why he has additional changes on x-ray, and some harsher lung sounds.

She recommended we start him on a second antibiotic (Clavamox), and Mirtazapine for an appy stimulant. I went ahead and let them give his first dose of Mirtazapine (a tablet), and apparently he was just fine for it Go figure! On that note; I am now wondering if he might be easier to pill rather than administer liquid?! I've never tried it, but he HATES liquid! The vet also did a bit of research and couldn't find anything linking Clavamox (which may be sugary) to cats coming out of remission/having higher BG....can anyone weigh in on that?!

Oh, and P.S. - As I type this my girlfriend comes round the corner freaking out because Darwin just walked in the kitchen and started eating.....WHAT? CATS!!

 

Many are fans of mirt but I’m not. What dose did they give? It can cause seratonin syndrome that can be life threatening. Did they mention that or what to look out for? Someone on this list, @Deanna & Billie just went through this so you might want to read her condos. If you give mirt I’d make sure to have cyproheptadine (which counteracts mirt) on hand. The ER should have it but it’s a human drug you can buy with an RX. The vets that gave her mirt said it wasn’t the cause but I gave her a few articles to read and they gave her cyproheptadine. BTW cyproheptadine is an appy stimulant that can be dosed twice a day and shouldn’t cause any type of medical emergency.

Hope the infection gets knocked out.

 

Oh! I'm am so so so so glad he's eating! I hope you figure out the pilling situation (Asia is 21 and it's still a no fly zone for her, so I understand where you are coming from). I will forever be paranoid of steroid injections, but I know sometimes they are a necessary evil.

I have no idea about Clavamox, what would make it sugary? It's a compounded liquid? If so, I think you can request it made up without.

Just him eating is such a good sign, I hope he continues to improve!

 

Saw your title about the er visit and got worried. So glad to read that he started eating on his own. Sorry I don’t know anything about the meds. Sending continue to feel better vines for Darwin.

 

Peace of mind is well worth the price sometimes. Hopefully the appy just needed a jump start.

On pilling- if I can get the pill dropped to the back of the throat I have good success but if I miss the drop it isn't pretty. If the drop is good then close the mouth, dribble a bit of water in the side of the mouth and blow (puff) a breath towards his nose to make him swallow. Then give a treat to help the pill get all the way down.

 

I have used both Mirtz short term and Cypro long term.

The mirtz will get them eating for sure. The thing I found with Jones as he would howl on it. It would make him very jittery. It is an antidepressant drug that just happens to make animals eat.

Steroids do have a bad rap but there is a place and purpose and if the benefits outweigh the risks, you can always dose around them. I do! Though for pneumonia I would say antibiotics for sure and maybe some bone broth. You can make your own by boiling chicken necks etc from the store. Some good benefits in bone broth.

For the asthma - I guess with the lungs being full of fluid it would be hard to use an inhaler and the use of limited prednisolone (3 days twice a day, 2 days 1 a day, 1/2 tab for 2 days) is used to contain a flair until the inhalers kick in. That is what they did for my civvie and it worked out ok with no FD developing.

Wishing Darwin continued healing vines and a good appy.

 

Congratulations on taking Darwin back home from the ER, having him so much better.
I am one of those who have had great success with mirtazapine, and never saw any one of my cats suffer any side effects other than increased appetite and renewed interest in life. I speak with 12 years of experience using mirt', to help 5 different cats. Don't know for sure, but from my experience it seems that the serious side effects are rare. Mind you I used it in the smallest doses possible.

 

Thanks for the concern, but I am aware of the potential risk of side effects with Mirt. We discussed it as well, and she dosed on the low end 1.8mg (1/4 of a 7.5mg tab) every other day, but she is hopeful that one dose will be enough if we just get him eating. Obviously, I am concerned about the potential for side effects, but the risk of hepatic lipidosis is also just as concerning and just as life threatening (I have seen many more cats perish from that than have reactions to Mirt). I realize it's not helpful to say it's a rare occurrence to someone who's kitty has had a reaction to it, but I will just have to hope one low-end dose won't cause him any problems, and hopefully he won't need anymore. I can easily get my hands on Cypro should it be needed.

 

Thanks!! I actually thought I had ready on here about the sugar content of Clavamox, but I can't find anything now so I wonder if I am just remembering wrong. There's nothing on the package about it, and I can't find anything online. While I know it wouldn't be fun to pill him, I am sure I could - I CAN get liquid into him, but he gets so upset and foams at the mouth after (as if he's been poisoned) - wondering if pills would, at least, avoid that...so stoked that he came home and ate though!!! Thanks!!

 

SO true - thanks! I actually pill my civvie every day, but he's very good for it. Darwin is very resistant to anything with his mouth, but he may be a bit better for pilling rather than liquid. Guess I'll see how he does, but also, he has no teeth so no risk of getting nabbed on accident

 

Thank you!! Ooh, I have never tried him with bone broth - I make it for my dog all the time. I could at least mix some into food once his appy is better.

Ther vet is hopeful that he won't need steroids at all, but we'll see. If so, she thinks inhaled would be better than oral - less risk of coming out of remission. He has had possible asthma for a while, but since his weight loss and Herpes are under control; his asthma seems much better as well. He VERY rarely coughs, and it tends to be more seasonal - hence us being unsure if it was truly asthma or allergy-based.

Thanks! Hoping this is the case for Darwin as well. He is currently a purr machine, and has taken to loving everything and everyone in his path, so he seems to be a happy camper!

 

Asia is the same with liquid, she's so offended and skulks off under the couch, leaving long trails of foamy drool behind her shooting "you did this to me!" glances my way. I never know if any of the liquid actually gets to where it needs to go. Pilling would probably be easier, as long as you can do it.

Keep eating, Darwin!

 

I found some old posts re: Clavamox and sugar, I think you're safe with the pill, it's the liquid that can have sugar in it.

 

Did you? I was trying to find them again - I have liquid at home, but haven't given yet. I can easily go down to my clinic and get tablets though. We carry the same dose in tabs.

 

I'm glad Darwin is eating for you. I hope the meds help him continue to get better. Sending prayers.

I've had cats foam at the mouth after taking liquid medicine. I always thought it was because it tasted bad.

 

Glad you took Darwin in today and have a plan. I would also believe the liquid form of Clavimox has sugar in it. I will try to find evidence to support that and send a link.

 

Post #10, there were other threads, but this was specific to pill vs liquid, Marje knows her stuff:

http://www.felinediabetes.com/FDMB/...-96-6-92-pmps-109-3-5-98.156666/#post-1659403

 

It's funny because I found a few posts saying liquid Clavamox did affect BG, and some saying it doesn't. Might just try the tablets to avoid a problem. I feel he already runs the risk of FD due to the infection itself - I'd rather not take any chances unless I have to. Especially as ONE of the reasons we did the full mouth extractions was to avoid backtracking into FD again

 

That seems like a logical plan! I'm guessing some of the liquids can have sugar, it doesn't mean they all do. And even if they do, the sugar content might be so small it wouldn't matter anyway, but I'm with you, why take the risk if you can just get the tablets.

 

Did I miss it, but do they know why Darwin developed pneumonia?

 

I hear you.
I'd get the probably get the pills and make sure they don't get stuck in the esophagus!

 

There's no way to know for sure, unfortunately, but given that he had a dental procedure on the 2nd - it's likely related. It appears to be aspiration pneumonia based on x-ray, and there is always a risk, albeit small, of that occurring after a dental procedure. He also did have one episode of vomiting last Tuesday, and it's possible he just aspirated at that time? Hard to say for sure, but I sure feel helpless about the whole situation.

Right?! Let's not add insult to injury

 

I know it's hard. Darwin had to have the dental surgery no question about it. Uncle did as well and one of his stitches opened up and he got an infection so we had to get past that as well!
Hang in there. Sending tons of healing vines

 

We make our decisions based upon the best knowledge we have at the time then fate takes over. Was just wondering if it was a bug he picked up or likely some complication that occurred. Hopefully they can knock this out quickly.

 

I can't give George liquid AB's without him turning into a ball of froth, he get's it all down his chest, he hates it, so much froth comes out I doubt whether he gets a workable amount of AB in him. I have found pilling much easier, as Lizzie says as long as you get the drop right it's over and done with in an instant.

I'm glad to here that he's eating.

Paws crossed he continues to improve.

 

Tasha! So glad he's eating!! Vines for fast healing.

 

So glad that he is feeling better

 

I'm glad he's eating. Any of the appetite stimulants work pretty quickly. FWIW, Gabby was fine with either mirtz or cypro.

I think the compounding pharmacies have gotten better about not using a sugar solution when they compound into a liquid. I think many of them have started using artificial sweetener. Personally, I find the artificial stuff pretty awful so who knows what our cats think about it.

 

Obviously fatty liver is serious. I just thought it worth mentioning that it’s good to have cyproheptadine on hand if using mirtazapine and that it also is an effective appy stimulant for many. One of mine had mirt and it just made her very vocal. Cyproheptadine worked better. ECID.

 

No, I totally appreciate that. I’m sure most people aren’t knowledgeable about adverse reactions and such things. He seems to be doing fine on it so far, and has had a few snacks today - yay!! I’m inclined to ask my vet tomorrow for an rx for Cypro - why not? If he stops eating again I may as well give it a try. I’m always one to err on the side of caution since vet techs seem to have bad luck with our own kitties

 

All of our cats have hated liquid Clavamox. It was impossible to get it even near Rusty. Good luck!

I'm glad that Darwin's vet appt. went well and hope for his speedy recovery.

 

Well, the pilling actually wasn't as bad as it could have been - I do think he hated me following it with a bit of water than the pill itself. It was markedly easier than giving the liquid Orbax - he just hates it. It kills me to do it - makes me feel like such a monster, but he still came back over a minute later for his brushing. Such a trooper!

He's not super interested in dinner (I did offer food before medicating him), but hoping he'll want a little snack later. I just feel better that he ate something. He's eaten a whole can of FF today - not great, but a far cry from no food yesterday.

 

I'm so glad Darwin is eating. Sending more appy vines.

Mirtz made Minka hyper - meowing and running around, not knowing what she was looking for. Cypro didn't cause any side effects. Mirtz didn't affect Harvey that way. I just prefered Cypro because you can give it more often.

Cinco was the only one of my cats that did well with liquids, and once he became diabetic I tried to avoid them at all cost. I once tried to give Sasha some liquid Benadryl and she not only foamed at the mouth but she shook her head and I had pink foam all over the walls of the bathroom. That's when we switched to pills.

I had more success using a pill shooter with my cats, but I know some people prefer to do it by hand. ECID is definitely true.

 

Tuna water (low sodium) tastes better than water.

Glad Darwin is eating.

 

Thanks! I am thinking the same with the Cypro - he initially had a better appy, but isn't so interested tonight. I'm still not so worried as he ate enough today to make me a bit more comfortable.

I have liked using pill shooters with some cats - we are sort of required to at work when pilling so we don't get nipped by someone else's kitty (for ours and their sake). Our civvie, Ben, is on oral Pred, and takes his 1/2 pill like an absolute champ. He also gets oral Bupe and Gaba, and is one of the easiest kitties I've ever medicated.
Darwin isn't so easy, but I will say giving a pill is quite a bit easier when they have no teeth

Thanks! That's a good idea! Darwin doesn't love fish-flavored food, but wonder if a little chicken water would do the trick too!

 

Read the ingredients before you use either of them! I found, to my dismay, that the tuna water I so carefully saved for my guys was flavored with garlic and onions!

 

I gave it to my cats for years before I joined FDMB and found out it was bad for them. I still torture myself that the CKD that took Harvey was caused by the plates I let him lick, or the tuna water I gave him, or the plants I had in the house that he was so interested in....

 

There is nothing quite like getting gummed by one's loving but toothless cat.
Hope Darwin keeps on slobbering his food for you & he comes right for you a.s.a.p

 

I did, too. No more!!!