Long term Cerenia use for chronic pancreatitis?

For those whose cat has had acute or chronic pancreatitis - how long was your cat on Cerenia? Is anyone’s cat taking it daily?

Frosty has been on 1/2 of the 24 mg pill for a month now. I tried cutting it into 1/4th 2 weeks ago in hopes of weaning him off it because he seemed better, but that’s when he suddenly stopped eating and became lethargic again, and we had to start all over again. He has been getting his 1/2 pill daily since.

I think I remember someone here posting whose cat also had chronic pancreatitis, and I believe that cat was on it every other day. I am afraid to decrease it, but I also don’t know if he should be on it forever?

I am going to hopefully speak to our IM vet later this week and I will ask her opinion as well, but wanted to see what input you guys may have on the topic.

Thanks!

 

Plenty of cats on the pancreatitis have needed cerenia or ondansetron indefinitely. Max had chronic pancreatitis for several years. I mostly used ondansetron but also used cerenia at times. We went months at a time initially with him getting sail nausea medication. Whenever he was back to normal I would try to wean him off slowly. With cerenia that would be trying every other day and see how it goes. Only change one thing at a time. Any increase in symptoms and resume daily. Hope this helps.

 

Thank you. I am so scared to try to wean him with how quickly we went backwards last time. He has lost so much weight and muscle over the past month - he is so bony now and now that he’s finally eating again I don’t want anything to disrupt that. He is still not himself and very weak, but at least he is eating. I don’t know if he will ever get back to the way he was or we are just buying time here. At least hearing that other cats have been on it for months at a time makes me think it is safe. Thanks again for sharing your experience!

 

Your welcome. There are cats that ne Er come off cerenia. When first used it was thought that was a problem but not any more. We used to have to take a couple days off, I think five days on two days off. Folks used ondansetron on the off days. Now they have learned there’s no reason for the off days. I wouldn’t even consider trying to wean unless he was 100% normal. I’m glad he’s eating.

Are you still using Entyce? If that’s still needed I definitely would not stop cerenia. When I got Max on the right dose of ondansetron he rarely needed an appy stimulant.

 

So I’ve cut entyce down to every other day. Last time I stopped entyse first for a few days and then cut the cerenia dose in half (from 1/2 pill to 1/4) and after the 4th dose of the 1/4 he stopped eating. He never came completely off of it. So I am so afraid to stop any of the medication.

However, he hates taking entyce since it’s a liquid, he was so upset when I gave it to him today that I’m thinking of stopping it and seeing how he does without it.

Will definitely continue the cerenia for now. Thanks again!!

 

Good plan.

 

Lots of kitties in the pancreatitis groups use cerenia daily. I've been able to use CBD with a little THC daily for my guy and most of the time that's enough now, so I just use cerenia on occasion. That decision is in large part just because my guy hates being pilled so much, and the CBD/THC comes in a liquid that easily goes in food/treats.

 

Phoebe has chronic pancreatitis and gets cerenia and zofran everyday. If we stop the cerenia she pukes. So for over a year now she has taken both. to you and that adorable Frosty.

 

Thanks guys. He’s not eating that well today again. I’m gonna restart the appetite stimulant every day but he’s in really bad shape.

Last night I noticed his back feet were very swollen. Especially the right back foot. I thought maybe it was from the bandaging around his waist that held the gauze over his skin tears so I removed it. There was no drainage on the gauze so i thought maybe the heart meds were helping him get rid of the excess fluid. But this morning his onesie was completely soaked on that side. I put an abd pad and taped it to inside the onesie to help absorb the fluid and keep him dry until I get home.

I spoke to our IM doc and she said there isn’t much more she can really think of doing, but she squeezed us in for Saturday. I feel like she’s the only vet I can really trust and if she says it’s time I will know that it’s true. She said that even though the abdominal US didn’t show it, Frosty could still have small cell lymphoma of the GI tract which could be the reason for his weight loss and wasting, but she also said that his pancreas looked “horrible”, so could just be that.

I might still opt for an in home euthanasia rather than doing it there if it’s time. She had a recommendation of a vet she knew who does it so maybe I’ll use him instead of laps of love. I’m not sure.

I feel like I need her opinion, and also having some objective data like repeating his renal labs and hemoglobin could be useful as well. Idk. I’m feeling pretty awful today. I do think that the cerenia helped prolong his life over the past month.

 

to you and Frosty.

 

Ana, I'm so sorry. Are you giving pain meds for the pancreatitis? I've found that keeping my guy's pain under control really really helps with the appetite issues. I use bupe when it's really bad, but I also use CBD with THC to help with both pain and appetite. And since I started giving the CBD daily several months ago, the flares have become much less severe.

Sending so much love to you an Frosty

 

I have no clue what to believe.. my vet said my cat's pancreatitis was to the point of nothing helping it - but the Cerenia for awhile, solving the constipation, getting on insulin, using metro to start the bowels then using Lactulose/Miralax.... Fena's doing GREAT.

I haven't needed ANYTHING since - but I have a great coupon for Pepcid just in case, but so far, she's GREAT. They didn't expect anything good for her, and I hate them for that. I can do that all on my own, I don't need their help - I always worry!

I have Miralax here, vet Lactulose, Pepcid just in case - she's great. You CAN do this. I'm looking to get CDB oil and some other stuff. My baby's approximately 14, her brother 13.. I'll do whatever I have to.

For Cerenia, NO - no lasting effects, or so my vet says - though after 6 weeks, she suggests 1-2 weeks no Cerenia, just to see, if the flare-ups haven't been properly mapped and apparently that's hard to do. But if continued, no problems - but she does say switching from 1mg per 24 hrs to 1/2 per 24 hours can be helpful.

Every 6 months full blood panel - plus stool and urine. If after 1.5 yrs she has recommendations for supplements.

I can get more info, let me now - my baby's been on Cernia too!

 

Djamila…..Saw your reference to pain meds and CBD with THC...what is that? Mishka now is likely looking at a pancreatitis dx. He has not been eating well at all. Still waiting on lab results and scheduling an ultrasounds. I'm so worried. Taking Cerenia daily. Doesn't seem to be helping. Not vomiting but only nibbling at food then not wanting to eat and changing food almost every day just to get him to eat a little. Makes it difficult to decide how much insulin to give. Tonight is the first night that he hasn't enjoyed at least a little combing and not purring. I wondering if he is in pain. Vet said "no" because no reaction on palpitation of the abdomen. But he's twitching his tail when I try to pet him, etc. Thanks.

 

Please insist that your vet give you pain meds. Cats are notorious for hiding pain, and even moreso when at the vet where they are so afraid already.

Your vet may benefit from this article: https://idexxcom-live-b02da1e51e754...pec-fpl-treatment-for-feline-pancreatitis.pdf
which clearly states, "Abdominal pain is frequently recognized in dogs with pancreatitis; however, it is rarely recognized in cats. Nonetheless, many cats will show clinical improvement if provided analgesic therapy. Because of this, many experts agree that pain management should be provided in all cats with acute pancreatitis."

CBD and THC are both derivatives of marijuana. CBD is legal in all 50 states and can be easily ordered online (Charlotte's Web brand has been widely used in cats). In human terms, CBD does not give any sort of "high" feeling, it is purely medicinal. THC is the part that makes humans feel high. CBD is being used fairly widely in the pancreatitis groups both to address symptoms and as an ongoing supplement. THC is toxic in dogs, and there is insufficient research in cats to be sure it's safe. It is also still illegal in many states. I have found that using a version with a very small amount of THC (50:1) has been more helpful for my guy regarding appetite and pain, than just using straight CBD. However, there is a risk involved as again, there is not the clinical research to be sure it's safe, only anecdotal evidence from those of us who have tried it. There are several people using higher proportions of THC and not finding any adverse effects on their cats, but I have been cautious in my use of it. Sam was sick enough that I decided experimental therapy was worth the risk, and for him, it seems to be of benefit. I also live in a state that has legalized marijuana, so it's easy to buy for him. I hope that helps. Pancreatitis is the absolute worst. I hope Mishka gets past this current flare quickly!

 

Yeah when I asked my vet about pain meds, she said no - that they were opiates, and would compound her constipation and offered me NO alternative, despite the flare. I've managed it so far on my own, and so far so good but still, CBD oil is something on my list to get ASAP once I can. I can usually tell with Fena, since she'll be off her food - not vomiting so much, that's primarily hairball related but off food.. and she's been starting to be a bit off again, so am worried.

Fingers crossed my car comes homes this coming week - called the mechanic and that's what they said, so... never been this long without a car and having stuff to do. Am making due.

No appetite, no purring.. yeah, something's up and twitching tail - does your baby get excited/hyper when you pet? If not, the tail MEANS something.

 

THANKS Djamila!!!! Will be getting him started on buprenorphine tonight. Hoping the vet is right about dosage. I'll probably go half of what the vet prescribed. Nervous. I hope he continues to eat!

 

Thanks Candy. No, Mishka, usually enjoys being combed -- lays on his back with front paws up kneading the air. It's so cute! Never hyper excited when combing, just so relaxed. So administered my first dose of bupe tonight. Only half of what the vet said, just to see what Mishka's reaction would be. Good lucky with your baby!

 

Thanks again Djamila. Mishka ate two 3-oz cans of FF today (which would have been his normal 12 hour intake). Tonight not eating as well. Although he seems to feel better when I got home. Purring, etc. But as soon as I put the food in front of him....turned away. Had to entice him with his freeze dried chicken, then gave Zofran and he ate. First dose of bupe. Afraid to give the entire .2ML vet prescribed, so just gave .1ML. Mishka has been so lethargic most days anyway. Afraid my administration of it may be a bit off though. Between cheek and gum? Not sure if I actually got between cheek and gum. But, it's all a learning process, isn't it? I will check into the CBD too. There is a vet in the practice that practices holistic medicine, so perhaps I should book a consult with her. Thanks so much for your advice.

 

So glad you got some bupe. And I agree with starting low on the dose since occasionally cats will get a little agitated from it. If the half dose was okay though, you're probably okay giving a bit more. Sleepy is alright. Resting helps the body heal.

I struggled the first few times with figuring out where exactly to put the dose of bupe too. Eventually I figured out how to gently pull down on the side of his mouth to get it into the little pocket. I do think that even the doses that were squirted in messily helped at least a little.

I've found that pancreatitis seems to wax and wane a little and when I've tried to use cerenia and bupe by guessing if he needed it, the flare has lasted longer than when I've just given both, regardless of how he "seems" for a few days. I think the consistency helps to get on top of the symptoms a little better, at least for my guy.

I'm glad to hear that you've been able to entice Mishka to eat, despite him not feeling well. Hang in there, and hugs to you! Hope the flare passes quickly and he's back to his usual self soon!

 

Sometimes cerenia needs to be helped with zofran or Ondansetron, it works differently on receptors. It's used more for nausea as cerenia is used more for vomitting. My girl has to take both.

 

Eating better today!!! Yay!!! Still worried about the bupe and then not eating if he is totally out of it! And then timing -- thankfully my boss hasn't mentioned that I show up late for work most days...LOL. Do you have any recommendations about steroids that will not mess with BG? Vet is recommending prednisone and then just deal with the results of higher BG? Thanks again!!!!

 

Candy -- thanks for the advice. Got PURRS tonight. And eating somewhat better . Mishka will be out of it pretty soon. Bupe tonight . I see you are from NE Ohio -- I'm in Cleveland. Are you anywhere near there?

 

I am definitely not an expert in this area. There is a pancreatitis group in yahoo groups, and a facebook page. The yahoo group is more academic and they have some interesting information about steroids and pancreatitis. Again with the disclaimer that I'm NOT an expert: I decided that the evidence of them helping was not strong enough to try them yet. Pancreatitis goes away on it's own (and then comes back again for our chronic kitties), so people who have used steroids and it goes away vs. people who don't use steroids and it still goes away -- the evidence of it working just wasn't strong enough for me. Now if Sam completely went off of his food and I wasn't able to get him to eat any other way...I might change my mind at that point. But since so far my little home pharmacy of anti-nausea, appetite stimulant, pain meds, CBD/THC, and all of the flavor enhancers and treats have kept him more or less eating and keeping it down, I'm continuing with managing the flares and avoiding the steroids. Again though, if he got really acute, I know I'd throw anything at it, including steroids, if it gave even a shred of hope of saving him.

 

Djamila -- just when I thought things were going better -- diarrhea this morning -- from the bupe? So stressed. Have to go out of town on Monday and don't want to hospitalize him because I know he won't eat.

 

Oh, Mishka.... Bupe is more likely to cause constipation. Anything else different? If you have any Slippery Elm Bark, that can help settle down pretty much anything stomach/intestinal. Do you have a pet sitter that takes care of him while you're gone?

 

Nothing different Djamila. I have a pet sitter who normally just comes 2x a day. But I'll be talking to her later and hoping she can up the visits and maybe stay longer. Hate to leave him alone and hate to hospitalize him. Afraid he will deteriorate and not eat. I have some slippery elm bark but never gave it to him. I'm not sure I have the right kind. So worried and stressed. Was going to skip the bupe this a.m. but not sure what to do...

 

Deep breaths. You're going to be okay. How is he eating today? Is he acting panc-y, or is he feeling better? If he's still not back to his normal self, I'd say give the bupe.

What kind of SEB do you have? If you look here: http://felinecrf.org/holistic_treatments.htm and scroll down a ways, you will find the section on SEB and what to check to see if you have one that is good.

 

Only nibbling at his food this morning. Thanks for the info on SEB.

 

@Djamila ... what is the recommended dosing on Zofran? I've read confusing info. Mishka prescribed 4mg 2x a day. But I halved that and gave him 2mg 2x a day to start. Today he is not eating so wondering if I should up the dose. Mishka weighs 13 lbs (at least a week ago he did).
Thanks

 

I haven't use that in a very long time, so I went to look it up and found this thread: http://www.felinediabetes.com/FDMB/threads/overdose-on-ondansetron.178211/

It sounds like there is a range of doses that are okay for cats, anywhere from 1mg/day to up to 4mg BID (for a larger cat), so I think halving it like you did is probably good to start (unless Mishka qualifies as "large") and then you can adjust to see how much he needs.

 

@Djamila -- will you send me a link to the CBD that you use? I see CBD for dogs on Charlotte's Web, but not for cats. What dosage did you start with? Are there any studies regarding CBD use in cats? Will be searching he pancreatitis support group and CRF group as well. Mishka not doing well. Eating a little today. But yesterday was bad. Got fluids at the vets and felt a little better. Upped his bupe last night and he spent the night staring at the dresser. I slept on the floor with him until he settled down. Sadly, I'm going to have to board him at the vet hospital for two nights. Hating that and wondering what he'll be like when I get back. Talked to the sitter and I could tell she was a little overwhelmed. Good news, no diarrhea today So CBD is the only thing you use for nausea? What appetite stimulants do you use? Thanks a million, as always.

 

You can give the full 4mg of ondansetron. I give my girl 4mg in am and 2mg in evening, she is 12lbs.

 

I'm so sorry he'll need to stay with the vet, but it sounds like the best decision. Sounds like you might have found his max dose on the bupe and maybe a little lower is better for him? Sam did that staring thing too when he got too much one time. It was unnerving to see him sit there for hours and hours and not fall asleep.

When the CBD/THC aren't enough, I use cerenia for nausea and have used cypro for appetite. I don't know that straight CBD does much for appetite, but have read from other people that it can help. Most people use the Charlotte's Web that is formulated for humans. https://www.cwhemp.com/all-charlottes-web-cannabinoid-hemp-cbd-supplements Some people get full strength and some get extra strength just depending on their cat. I live in Seattle where it's all legal, so I use something from a local company that doesn't sell on a website. As far as dose, mine is similar to the full stregnth of the CW and I started at two drops, 2-3 times/day. When Sam is bad i've gone as high as five drops, but at that point it makes him really sleepy so I usually stop at four drops unless he's really bad. Most often twice/day just because I'm at work so much. Otherwise I would probably give it three times/day.

It's also fairly common to read about people using it daily regardless of symptoms and they have found that the frequency of flares has decreased. I did that for awhile, but didn't noticed the same reduction...just one more area where ECID.

 

Thanks Djamila. Heart is breaking this morning knowing I have to leave him. But I'd be sick with worry anyway. Gave 4 mg Zofran this morning and eating a little better. Definitely going to try CBD. Yes, the Bupe staring at the wall all night was sad. But decreased it last night and I could hear him snoring from across the room...lol.

 

Sending love to you and Mishka today. I hope you can enjoy your trip and not worry too much. He's going to be in good hands.

 

Sorry for everyone whose kitty is going through this too. Glad this post is helping other kitties. ❤️

 

Anytime, and so glad to hear that Mishka is perking up!! Sent you a message about location but am near yes.

 

Thanks Djamila. Mishka survived the stay at the vet! Thank goodness. I was a nervous wreck. He's still basically the same -- not eating as much. Still on bupe, Zofran, and occasional Cerenia. Vet is once again recommending prednisone and we'll just work around the BG increase. I was actually supposed to give him his first dose tonight, but Mishka seemed to be eating better today and got kitty purrs tonight. I am so torn about the prednisone, fearful that BG will jump like crazy. I know you gave me your suggestions previously. Looked into CBD oil, but overwhelmed with that as well. There is a holistic vet about an hour from me that will discuss a source for Hemp Oil. Oh well, guess I don't have a question, just thought I'd update you. Do you know anyone that put their diabetic kitty on prednisone? How high did the BG go? Guess it depends on the kitty

 

One of my neighbors up the street, her boy Yuri was on prednisose and went up about 30-40 points, but added in plus stress. After about 1 week or so, he evened out better. So for them it wasn't tootoo bad, just a waiting period, basically - try to keep your baby calm, happy and low key as best you can.

Caution though, once he's into it - watch for possible aggression/irritability and lethargy along with some weight gain, depending on food.

 

Thanks Candy -- if pred only increases Mishka's BG by 30-40 points, I'd be happy. I've delayed starting him on it until the weekend so I'll be home to monitor. I know he feels bad, no kitty purrs, and grumpy. So far I've managed to keep him eating, but the Bupe doesn't seem to be giving him the relief that it did when I first started it. I feel so bad for him because now he is fighting the chronic sniffles and had him in the bathroom with shower for steam which he hates. He won't want me to come near him anymore!!!