5/15 Asia AMPS 345 Cerenia Info/Cerenia doesn’t work, read here

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Stacy & Asia, May 15, 2018.

  1. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    http://www.felinediabetes.com/FDMB/threads/5-13-asia-amps-171-aha-an-important-observation.195515/

    Asia is doing really well. There is one thing I gained from the vet visit fail on Saturday is that she needed and can have more pain meds than I was giving her. Currently she is getting 1.5mL bupe every 7 hours. I tried for every 8 and it was too long, every 6 was too close, so 7 it is. :rolleyes: We are about past post vet freak out numbers and hopefully that combined with no pain might bring her numbers back down a bit.

    She is not in pain and that makes me happy. She spent a good amount of time playing with her bird toy last night and even chub run chased it down the hall a bit. Have to run out for several appointments this morning so hopefully she behaves.

    PSA for the day on Cerenia:

    So I noticed a trend on here that some people weren’t having much luck with Cerenia and ondansetron was being suggested as working better/working differently/used in conjunction with Cerenia to provide nausea relief. No doubt some cats respond better to one than the other or perhaps even need both, but I found some interesting info on how Cerenia is dosed and wanted to make it available because Cerenia works for 24 hours and ondansetron needs to be given multiple times a day. Which only means if Cerenia can work for your cat, it last a lot longer and is probably less expensive for needing to be given less frequently.

    The first time Asia got Cerenia was at the vet’s office and it was an injection. It was a miracle for her, she wasn’t eating well and it was a game changer. I was sent home with a compounded liquid form. When the shot wore off and I gave the oral version, it did absolutely nothing. Asia stopped eating again. I wish I still had the bottle to see what the mg/mL was, but I threw it out long ago. I’ve been giving the sub-q injectable version ever since and we are both happier about that!

    I came across some (outdated) info that Cerenia (maropitant) should be dosed 1mg/kg period. That info is still out there and likely some vets still unknowingly prescribe 1mg/kg regardless of oral or sub-q delivery. Then I found some info on the Merck Veterinary Manual and Plumb’s (like the PDR for veterinary drugs) and they both say the oral dose (PO) is essentially double the sub-q (SC) one. Thought that could explain (for some cases) why Cerenia wasn’t working for some cats.

    From Plumb’s:

    From Merck Veterinary Manual:

    Even the Merck info seems to already be out of date as a cat dose had not yet been established and it doesn’t seem to be half the dose as is for dogs, but instead based on weight and growth stage/age. And Merck still lists 5 days as the maximum length of time for use. But they acknowledge the dosing is different depending on method of delivery.

    So if you think Cerenia just doesn’t work for your cat, check your prescription bottle for the pill form and if it isn’t 2mg/kg or very close to, it likely isn’t a therapeutic dose for your cat and maybe have a discussion with your vet about it too so you can make the next cat’s life easier.
     
  2. carfurby

    carfurby Well-Known Member

    Joined:
    Feb 19, 2012
    It's good to hear Asia was playing some last night and is not in pain. That is interesting on the Cerenia. Thanks for sharing. Sending prayers for Asia.
     
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  3. Judy and Boomer

    Judy and Boomer Well-Known Member

    Joined:
    May 23, 2014
    Always nice to hear about kitties playing! And at 21 years old that is awesome!
     
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  4. HWright

    HWright Well-Known Member

    Joined:
    Jun 19, 2016
    Wow re the cerenia and it explains a lot. Had same kinds of experiences with the differences in effect between the injectable and oral (pill). Thank you!
    Vines for Asia feeling better❤️
     
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  5. Tracey&Jones

    Tracey&Jones Well-Known Member

    Joined:
    Dec 12, 2016
    That is interesting on the Cerenia. Jones has been on a 1/4 tab forever and it does the job I need it to for the most part. Though he has been on it for almost a year and a half now. There are days I think he needs a bigger dose but he does well on it.

    So that would be 16mg tab = 4 mg which when he was at his lowest weight was 1mg/kg.


    Happy to hear that Asia is feeling good.
     
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  6. MyTitan

    MyTitan Well-Known Member

    Joined:
    Jul 20, 2017
    Glad Asia is feeling better. Thanks for the Cerenia info, good stuff.
     
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  7. Mandy & Rex

    Mandy & Rex Well-Known Member

    Joined:
    Mar 22, 2017
    Question: Are vets willing to prescribe Cerenia in injectible form as needed?
     
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  8. CassAndGordy

    CassAndGordy Well-Known Member

    Joined:
    Sep 23, 2016
    My vet offered the injectable one to me over the weekend and I almost took her up on it... but thought of giving my civvie a shot frightened me LOL. She did mention that the injectable stings a decent amount.
     
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  9. Doodles & Karen

    Doodles & Karen Well-Known Member

    Joined:
    Jun 2, 2015
    It does which is why I opted for Anzemet with Doodles back in the day. It's way more expensive and you hear little about using it. Other than that I have little to no experience with nausea meds in my cats.

    I'm glad Miss Asia is feeling good and playing with her toys! This is most important :bighug::bighug::bighug:
     
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  10. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    I don’t see why not, it depends on your vet. Before Asia had diabetes I was prescribed injectable B12 to give her, in pre-loaded syringes. I’m sure they could give you pre-loaded Cerenia for something acute. I bought a bottle since I was giving it daily for a long time. It is supposed to sting and does not need to be refrigerated but they told me to keep it in the fridge so it stings less.

    Oddly, it doesn’t seem to sting Asia at all, or if it does, she doesn’t react. It’s a lot more than Lantus, by comparison she would have about 50 units of Cerenia (no sting) compared to 1 unit of Lantus which stung her. Either she’s a weirdo or it depends on the cat if/what stings them. :rolleyes:
     
  11. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    ASIA JUMPED ON THE COUCH! :woot::)

    She hasn’t done that in many, many months! I thought she may never do it again since she got a little rounder than she used to be. :rolleyes: She has cat stairs too, so she just decided for whatever reason to jump up there instead. So happy for her! Adequan? Must be.
     
  12. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    This is SOOOOO cool! I have a bottle of Adequan for civvie Noah but have been hesitant to start it because of his other issues he's been having. I know it works great...it helped Trixie and Mario so much, but I've been so nervous about getting Noah going on it. Asia jumping on the couch, though, has got me motivated! Yay Asia!!!
    My vet was willing to prescribe injectable Cerenia because she knew I knew how to do SubQ shots - however, it is cost-prohibitive to use regularly. At least at my vet, the injectable is something like $49 or $59 per shot! I know others have gotten it cheaper than that, but it was still too expensive to use regularly. (I have to say, though, I never did ask about getting a whole bottle of Cerenia...)
     
  13. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    If this chubster can do it, Noah can too! :joyful:

    The 20mL Cerenia bottle for me is $157 usd...and that’s a NYC price which is often double of what it would be elsewhere. If they charge $50 a shot, it would be much more economical to get the whole bottle even if for acute/occasional use. My bottle expires in 7/20 so it will last a good long time. Onda was brand name Zofran, I had that when I had HG with my pregnancies, there was no generic at the time and I needed it 3 times a day, I want to say it was $30 a pill or something crazy like that. My insurance would only pay for 15 a month. It was a rough time financially for us because of that! :facepalm:
     
  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    The tablet version of ondansatron is more expensive than the injectable. However, the injection stings. When I gave Gizmo a shot, he ran and gave me the stink eye. Gabby didn't care but then again, she was used to shots.

     
  15. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    Wow....$30 a pill! I got some Zofran for Trix when she had her first big p-titis flare; it was $7 a pill and I thought that was bad! Worse than that, the vial of ondansetron was something like $19 - but it had to be ordered (and I did order it) whereas I could get the pills immediately.

    I'll keep in mind about ordering a bottle of Cerenia next time (which I hope never happens, of course!). However, does that expiration date mean before the seal is punctured, or after? Technically, Lantus has a 1 year expiration date, but that drops to 28 days once the seal is punctured.
     
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  16. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    I’m sure the package insert says whatever time after first puncture, but I asked the vet about it and they said they use it until it’s gone. It probably has a lot of preservatives and if it’s in the refrigerator, hopefully not so many baddies can get in there. At the price you have to pay per shot though, you would start saving money even if you only used it four times!
     
    Last edited: May 15, 2018
    Reason for edit: typo
  17. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    Good to know - thanks!
     
  18. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
  19. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    I have shared before on other condos but will post it again here. Best pricing I have found for Cerenia tablets is here

    https://www.kvsupply.com/item/cerenia-tablets-4-pack/496933/

    They will call your vet for authorization so if your vet will let you use online pharmacy they are very easy to deal with. I usually get minimum of 2 boxes of the 24mg (6mg per 1/4 pill). Cost per box $12.99. They do charge a minimal shipping fee ($5?). You place your order and when checking out there is a place to enter your vet info. After I place the order I send my vet an email with KV Supply info and order confirmation # and ask them to approve (as a heads up). Orders are received within a week of the vet approving.

    Thriving pets has Ondan. I have not ordered any from them. I was given a bunch from a member here but compared to some prices y'all have posted their pricing looks good.

    http://www.thrivingpets.com/index.php/ondansetron-zofran.html
     
  20. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

    Joined:
    Nov 25, 2017
    Playing catch up yet again.

    I am always in awe when I read our geriatric pusscats have had a bit of a play or a chase.
    Makes me smile.
     
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  21. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hey Stacey! I missed your condo yesterday and am glad to see that Asia is pain free and jumped up on the couch. :woot: Good information on your thread about pain meds. I think I will keep this in my file. :bighug:
     
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  22. Kathy and TiTi

    Kathy and TiTi Well-Known Member

    Joined:
    Feb 12, 2016
    Very pleased to hear how well Asia is doing. That pain med is the berries!
     
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