? Help! appetite stimulant

hi all,
Since Scout’s been home from the hospital, I’ve been giving him 1/4 tablet cyproheptadine half an hour before meals, but it’s not making much of a dent in his appetite. The rx states 1/4 - 1/2 tab 2x/day.

How long before a meal does he need the cyprohept., and do you think it’s ok to bump it up to 1/2 tablet?

He was a great eater before the FD and Pancreatitis came back. When he was hospitalized they gave him DM dry cuz it was the only thing he would eat after they removed his nasal feeding tube (besides a/d, and I know he can’t stay on that too long.)
Any insight or ideas would be very much appreciated..

 

Is he getting pain or and nausea meds?

 

I use Cypro for two of my cats. They each get 1/2 tablet 1 - 1 1/2 hr before meals. I started at 30 minutes prior, and worked my way back to the amount of time that worked best for my kitties.

 

Hi !!

He is on Cerenia and Bupe.
I upped his Cypro to 1/2 tablet & gave it 1/2 hour before breakfast this morning.
I offered him dry DM and wet RC selected protein venison - he ate 3/8 can of RC and around 10 DM kibbles. This is the most he’s eaten since getting out of the hospital!!! I am cautiously optimistic, but so happy that he seemed hungry this a.m. !!! Also happy that he’s preferring his (RC venison) wet food over the dry DM they had been giving him in hospital.
His pre-meal #’s are down also, 372 this a.m. and 417 last nite.
Thank you guys )
I am starting the Spreadsheet/Foodchart today.

 

Hi
Murphy has frequent appetite issues due to chronic pancreatitis. Cerenia was developed for vomiting (it is also anti-inflammatory) but for nausea, I give ondansetron- it's a human drug developed for patients nauseated from chemotherapy. It can work miraculously well. I always give ondansetron before I give cyproheptadine (would be awful to be nauseated yet ravenously hungry). I also find that when I had to give cyproheptadine several days in a row, it seems to be less effective. Another note that when Murphy does seem to be having a pancreatitis flare, he goes off wet food and will only eat a little dry. Be careful not to discontinue the pancreatitis meds too soon (I learned that lesson the hard way) So you and Scout are on the right track - fingers crossed he eats normally very soon

 

Carol & Murphy,
Yes I think I might have waited too long giving his Bupe this morning. It had been 12 hours since his last dose, and even tho he ate well he went and hid under the desk afterwards & was sitting in the loaf position.

I got a little too nervous about the whole thing and ended up getting only 1/2 the syringe into him. I’m upset with myself now-arrggghhhhh.

(At least his appetite is coming back)

 

Hi - do you mean you only got half the insulin syringe into him or the bupe syringe? Are you giving the bupe in the cheek pouch? As Murphy is recovering from pancreatitis, sometimes I can tell that it hurts him after he eats. It does take a while to recover- that is why is it important to keep giving all the meds until they fully recover
How is he doing now?

 

I only got 1/2 the bupe into the check pouch. Thankfully my daughter got all of the 2nd dose in successfully.
Besides Cerenia and cyproheptadine, did your dr. prescribe any other meds to support Murphy’s recovery? I’m seeing the dr. report and they had him on Pantaprazole, dr. says it’s like an antacid. Is Murphy taking an antacid?

 

No antacid, but besides cerenia, the 2nd most important medicine for him (IMHO) is ondansetron - I told you about it in my post above. it's a human drug highly effective for nausea, and I always give that before I give the cerenia. Many kitties with IBD/pancreatitis take it -
here is an article in the health stickies forum you should read primer on pancreatitis The website ibdkitties.net also has info - but if I were you, I would definitely ask about ondansetron

 

I will!! We’re seeing the vet Wednesday. I’ll ask her then. Thank you, you’re the best!

 

I meant to say that I always give ondansetron before I give the cyproheptadine (not cerenia)- sometimes when nausea goes away from the ondansetron, he doesn't need the cyproheptadine
Other issue that can develop during pancreatitis flare is dehydration, so subQ fluids are frequently given - have the vet check for that
good luck at the vet tomorrow

 

Hi! So Dr. said she is happy that Scout is making progress, although it’s slow and steady.
The “scant abdominal effusion” is gone, she said it was probably the result of all the inflammation in the pancreas and surrounding area.
She agreed w/eating only the canned RC venison or duck versus the dry DM from the hospital. She wants to track his numbers for 2 more weeks before increasing the Lantus.
I got him more pain meds, an rx for Ondansetron, (it seems none of the online vet pharmacies have the tablets in stock right now,) and enough cyproheptadine to hold me for a few weeks, so I’m very grateful right now.
Thank you Carol and thank you everyone.

 

Glad to hear this - I assume he is eating better? How is his blood sugar doing?

 

He’s eating much better, now begging loudly for food mid-afternoon and in the middle of the night. The vet says I can gradually reduce the cyproheptadine from 1/2 to 1/4 tablet per day. So his appetite has improved tremendously!

His blood sugar is in the 300’s and 400’s now, with a few low 500’s here and there. I am getting better at getting blood samples and giving shots, making sure he’s getting all his meds at the right time & in the right order.

She will increase insulin amount in 2 weeks because he had a couple of outliers where his numbers dropped 200 pts. in 6 hours. and she wants to be cautious about his pancreas. So going doorways cautiously.
He seems so much happier : ))

 

I would just stop the cyproheptadine if he is eating that well - it's an antihistamine and I am not aware of any withdrawal symptoms
Is he now on daily cerenia? Murphy gets 4 mg of cerenia a day, which I increase to 8 mg during a flare. Most cats with pancreatitis (esp chronic) are on daily cerenia

 

Yes, he’s getting 4 mg. of Cerenia a day. I use Allivet or Valley Vet, it’s lots more affordable that way and I can have a little stockpile

 

There aren’t any withdrawal symptoms from cyproheptadine. For Max , once his nausea was controlled an appy stim wasn’t needed. I’d stop but continue cerenia. One change at a time is my rule. Your cat was on a hefty dose. Max never got more than 1//4 and often a sliver worked. If stopping cyproheptadine works and a normal appy continues after several days you could try skipping a dose of cerenia and taper off it but if the appy isn’t normal start up again. If cyproheptadine is still needed you can always start up again. Some cats like my eventually don’t need nausea meds until pancreatitis returns if chronic. Tiger need it all the time. With pancreatitis ECID is the rule. It’s great that’s he’s feeling better. Good luck.

 

Thank you all so much.