Civie not eating - appy stim options?

My Civie, Abbey, often stops eating. She's always been this way - but usually after a couple of days of offering her a dozen or more options, :roll: she will find something that interests her again. Not this time...
I have been syringe feeding her several times a day for the last couple weeks. ... That, on top of taking care of Doodle and my daughter, (and everyone else) has left me so exhausted that I have resorted to offering her dry food. I now have 6 different brands of dry food in my house - one of which, she will eat.
She has early renal disease but her numbers and her activity level don't indicate that she is feeling poorly - she just won't eat.

For whatever reason, my vet has not been on board with appy stims in the past - but right now I feel the need to insist.
What are my options? She was unfamiliar with mirtz last time I asked. What else can I ask for?

 

Michelle,

Your vet can look-up Mirtazapine on the VIN. My vet had no experience with it but when I asked her for new rx (giving her the old one from the Texas A&M Vet hospital), she looked it up and now uses it for cats. Give your vet some info. http://www.marvistavet.com/html/body_mirtazapine.html
Also, I think I paid about 12 dollars at Walgreen's for 4 pills. The dose is 1/4 pill (they are tiny pills) every 3 days.
Layla got hungry within 3 hours of getting this pill.

Another option is Cyproheptadine (often referred to here as cypro). http://www.marvistavet.com/html/body_cy ... adine.html
With Layla, the dose was 1/2 pill BID. This works well too - the main drawback is pilling twice a day.

Lastly, we've also used Valium for appy stim. I don't remember the dose - maybe 1/4 or 1/2 pill - you need to check. This worked well for Layla too.


All three have worked for Layla when she needed help eating.

Present these three options to your vet, and let her research on VIN to see her comfort level, but really she should be open to give you an RX for any of the above. They are all reasonably priced. I happened to use Walgreen's.

I would try for the mirt first, because of less pilling and quick results.


Best,
Pam & Layla

 

Regarding using Valium, there has been reported problems with liver damage due to using the generic valium (diazepam).
http://www.veterinarypartner.com/Conten ... &A=540&S=1

 

michelle, has she had b/w done recently? could she have deteriorated enough to need fluids? (i forget if you give them yet). renal kitties also have excess stomach acid, does she respond to pepcid ac?

 

Pam, thank you for the education links! - and the list of options!
Larry, thank you for the precaution!
I really appreciate both!!!

And Choy-Foong, It's been a couple of months since bloodwork. She's always been sooo darn stable that I think I'm 1/2 convinced she's not really sick...
but I'm going to try to take her in this afternoon to make sure. (We have to do a walk-in - so fingers crossed that they can fit her in and we don't sit there for nothing)
She had been getting fluids but we stopped a while back on the vets recomendation and it didn't effect her values at all.

I've given her pepcid for the last couple of days - I don't know if it is helpful or not.
She hasn't been throwing up or licking her lips etc... but she wasn't before I gave it either.
And of course, she has been eating the dry food today - i don't like giving it to her, but maybe that's all she wants. ?? I don't know.

 

> My vet had no experience with mirtazapine but when I asked her for new rx,
> she looked it up and now uses it for cats. [...] The dose is 1/4 pill (they are
> tiny pills) every 3 days.

A potential drawback is that some cats become overstimulated with mirtazapine: restless, meowing incessantly, etc.


> Another option is Cyproheptadine. The dose was 1/2 pill BID. This works
> well too - the main drawback is pilling twice a day.

Yeah, this is a twice-a-day thing.

I will say that I dislike pilling cats to give them appetite stimulants; I had a cat once where that just made him even more stubborn about not-eating. Where possible, I like to do appetite stimulants transdermally: you quietly rub the ointment into their ear and half an hour later you can be a hero for feeding them, as opposed to them still sulking because you forced something into their mouth!!! Since I do prefer the transdermals, we use cyproheptadine: no trauma from a transdermal gel twice a day, and I didn't have to deal with the incessant meowing from the mirtazapine (once was enough, thank you very much!)

 

Pam

Pam, if you have a Costco close by, you can get 16 more mirtz pills (15 mg each) than you did for $12+.

Here are the px quotes I got from Costco:
5 pills: $9.32
10 pills: $10.41
15 pills: $11.59
20 pills: $12.77

 

Good luck at the Vet today Michelle.

Larry - we haven't used Valium on Layla in almost 6 years, so, I didn't realize there were potential issues.

Thanks for the Costco info Choy-Foong. That is good to know - I do get Layla's lev at Costco without a card - and no issues, so will use them in the future for any meds.

Jean, Layla isn't a talker in the first place, but we did not have the same reaction. The Mirt remains my first choice for my cat.

Best to all.

 

A strange fact is that some cats have a bad reaction to mirtazapine and the antidote is Cyproheptadine (an antihistamine).
http://www.veterinarypartner.com/Content.plx?P=A&A=2552

 

Hi Michelle

IIRC, your vet options are limited where you live, right? Has your kitty had a workup during one of these episodes? Bloodwork, abdominal ultrasound or at least abdominal x-rays? To state the obvious, it's just not normal. I'm concerned that your cat is not eating because she's crampy, or nauseous, or painful. She could even have a wicked pancreatitis -- it's a common cause of "superstitious" refusal of previously-loved foods.

As far as the diazepam goes, there is a published study of several cats who had an idiosyncratic reaction to oral diazepam and developed liver failure. I don't know where the brand-name vs. generic thing came from; I can't find any references to it and can't find anyone else who ever has. Anyway, many vets do use it for behavior modification or in certain cases of bladder spasm. Since there are other choices available, I'd go there first, but again I think it's very important to find out why your cat is refusing food.

 

to expand on Jess' thought of possible p-titis.
an fPLI test would be a good start to find out if that is the culprit.
A good idea when you take Abby in to get checked to have them throw that test in.

blood can be sent to texas a&m lab :
http://www.cvm.tamu.edu/gilab/research/ ... itis.shtml

Idexx also now offers a fPLI test
http://www.idexx.com/animalhealth/labor ... /index.jsp

(both sites also offer some info on p-titis)

My civie Wolfie's original symptoms of his CP was what you are describing-- occasional bouts of not eating.


I hope you get to the bottom of this so you can get some rest.

 

didn't see vet

Abbey didn't see the vet tonight. We sat for 2 hours -- we were the only ones left in the waiting room and a lady came rushing in with her cat... she had just ran over him :cry:
We decided not to stay any longer. (so sad...)

But she is again eating the dry food - a pretty good amount tonight. I'll try topping some wet with the dry tomorrow and see how that goes. At least she's eating. sigh...
And I'll make an actual appt. with the vet tomorrow.

Jess, she has had bloodwork and x-rays but no ultrasound. And she's been tested for pancreatitis with normal results - but I realize that doesn't totally mean she doesn't have it , if my timing was off.
And Yes, my vet options are a bit limited... but if she needs an ultrasound I'll get her wherever she needs to be to have one. Thank you for posting!
I always appreciate your input so much!

 

Thanks Cheryl, maybe I'll have them do the fPLI test again.
that's probably a good idea.
I'm a bit puzzled as to why she's eating the dry food when she has been so persistently refusing the insane variety of wet I've offered her - but honestly right now I'm just glad she's eating something.

I'll update later after we see a vet.
Thanks again everyone!

 

Michelle,

I still agree w/ the need for previously mentioned diagnostics.

but as a shot in the dark --- have them take a look see in her mouth too.
Has she had a dental? I know much can't be discerned by just a look but sometimes.....
My civie preferred dry over wet before he had some teeth extracted. It seems the temp of the wet food bothered him. I would warm it a bit... but as a grazer it would get cold too soon for him.
You'd think the crunching would of bothered him more.
now with the teeth out he eats his wet and still wants the dry, but doesn't have enough teeth left to chew it. my fail safe for low appy is gone. *sigh*

I hope your next trip to the vet is less sad and a short wait.

 

I don't know if my posting here will bump this post - but I'll give it a shot rather than start a new thread.

Abbey has been eating a bit more, but she is still really turned off wet food for the most part. I hate feeding her dry food... but that is what she will eat. So I'm feeding it to her.
She's also eating baby food which of course I know isn't complete, but i'm hoping it will at least compensate a bit for the higher carbs in the dry and it's lack of moisture.
Her labs came back looking fine - she's holding steady and her xrays didn't show anything abnormal.

She does need a dental, so maybe her problem lies there. I just don't know.
Thanks for sharing your story Cheryl - I would have never even have considered it could be a dental issue if she's preferring dry.

 

Mine is not a medical intervention, per se, but it might get her to eat if nothing else will. At the animal hospital where I work, we refer to FortiFlora (the probiotic) as "kitty crack." It is a GREAT appetite stimulant and has virtually no adverse side effects. Dr. Lisa has mentioned using it in the past as an appy stimulant. You might see about getting a few packets of the stuff from the vet. You can sprinkle as little as it takes to get her interest on the canned food. It always works for us!

 

Odie has IBD and pancreatitis, he's been on appetite stimulants at different times over the last year and a half.

Mirtazapine - made him ravenous, but then very spacey, agitated, dilated pupils, meowing constantly. I stopped giving it to him.

Cyproheptadine - not as ravenous, but it did convince him to eat, less side-effects

 

I have had recent sucess with b-12 methyl, my civvie has developed a much healthier appetite since taking one tablet a day.