2/11 Ruby PMPS 92/+2 77/+4 80

Katherine&Ruby

Katherine&Ruby

Very Active Member
Yesterday the bad appetite continued. Ruby has been a pretty good member of the clean bowl club for a while now but the past few days are worrying me. She smells the food, licks her lips, and walks away. I'm even feeding her a higher carb food now that I know she usually goes nuts for. I know she is hungry as she eats up any dry treats I put in front of her. She's getting fluids today so perhaps that will help.

Could it be a question of acidic stomach? Should I ask my vet about Pepcid?

Will be out mid-morning until early afternoon. Hope Ruby stays good while I am gone.

Healing thoughts to all of the sick kitties. Have a delightful day, everyone! :bighug::bighug:
 
Nice AMPS for Ruby :D Hope she surfs safely while you are out :cat:

And, sorry to hear Ruby's not having the best appetite. What makes you think her stomach is acidic? The only time I've used Pepcid was when Benji was throwing up clear liquid - this was many, many years ago and the Pepcid did seem to help. ibdkitties has a short article on antacids in case you haven't seen it - it is focused on long term use but I found it informative nonethless- https://www.ibdkitties.net/pepcid-and-other-antacids/
 
JaxBenji said:
Nice AMPS for Ruby :D Hope she surfs safely while you are out :cat:

And, sorry to hear Ruby's not having the best appetite. What makes you think her stomach is acidic? The only time I've used Pepcid was when Benji was throwing up clear liquid - this was many, many years ago and the Pepcid did seem to help. ibdkitties has a short article on antacids in case you haven't seen it - it is focused on long term use but I found it informative nonethless- https://www.ibdkitties.net/pepcid-and-other-antacids/
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She isn't vomiting but I'm wondering if it's a symptom of her CKD. She goes through phases of this and I intend the Pepcid to be short term. Here's a bit from a cat vet site:
The kidneys are indirectly responsible for controlling levels of stomach acid. Cats with chronic kidney disease are more likely to have elevated acid levels making them more prone to vomiting. A daily dose of a 1/4 of a 10 mg tablet of Pepcid AC (or generic, famotidine) can control this. Some cats feel nauseous without vomiting, which causes a decrease in appetite. This medication can then trigger a return to normal appetite. We can order it in a transdermal gel (applied to the ear) if giving an oral medication is too difficult.
 
PerfumedCatMom said:
She isn't vomiting but I'm wondering if it's a symptom of her CKD. She goes through phases of this and I intend the Pepcid to be short term. Here's a bit from a cat vet site:
The kidneys are indirectly responsible for controlling levels of stomach acid. Cats with chronic kidney disease are more likely to have elevated acid levels making them more prone to vomiting. A daily dose of a 1/4 of a 10 mg tablet of Pepcid AC (or generic, famotidine) can control this. Some cats feel nauseous without vomiting, which causes a decrease in appetite. This medication can then trigger a return to normal appetite. We can order it in a transdermal gel (applied to the ear) if giving an oral medication is too difficult.
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Good luck with whatever you decide! Benji was on double that but that was per his vet instructions (again many moons ago so I have zero recollection other than being alarmed with the clear throw up and taking him in to get checked out).
 
JaxBenji said:
Good luck with whatever you decide!
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The IBD site clearly warns against using antacids, so I'm torn. It also says it can affect blood sugar levels among many other things. Sigh. Hoping others with experience here with it can chime in. Thanks as always, Susanne.
 
The new thoughts on Pepcid are that’s it’s rarely needed and not effective. For nausea cerenia or ondansetron work best. I hope the inappetence is short term.
 
tiffmaxee said:
The new thoughts on Pepcid are that’s it’s rarely needed and not effective. For nausea cerenia or ondansetron work best. I hope the inappetence is short term.
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Thanks, Elise. She's gone through bouts of inappetence before and came out of it, but that was when Ruby's BGs were all over the place. Placed a call to the vet and waiting to hear back. What is the difference between cerenia and ondansetron?
 
I hope Ruby starts eating better for you soon. I don't now if pumpkin can help if it is stomach acid, but it does help with other stomach issues. Maybe it's worth a try. Sending prayers. :bighug:
 
PerfumedCatMom said:
Yesterday the bad appetite continued. Ruby has been a pretty good member of the clean bowl club for a while now but the past few days are worrying me. She smells the food, licks her lips, and walks away. I'm even feeding her a higher carb food now that I know she usually goes nuts for. I know she is hungry as she eats up any dry treats I put in front of her. She's getting fluids today so perhaps that will help.

Could it be a question of acidic stomach? Should I ask my vet about Pepcid?

Will be out mid-morning until early afternoon. Hope Ruby stays good while I am gone.

Healing thoughts to all of the sick kitties. Have a delightful day, everyone! :bighug::bighug:
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Katherine, have you had her on Cerenia for nausea? That could help out. Cerenia and Ondansetron are similar - Ondansetron more rarely given if liver issues are involved. You can start with the Cerenia and add in Ondansetron if needed. Cerenia dose is 4mg (1/2 of an 8 mg tablet) for most cats. If Ruby ends up needing more support or is a larger girl that dose can increase. I'm not sure the Pepcid would do the trick in my experience with it.
 
Margaret (and Pearl) said:
Katherine, have you had her on Cerenia for nausea? That could help out. Cerenia and Ondansetron are similar - Ondansetron more rarely given if liver issues are involved. You can start with the Cerenia and add in Ondansetron if needed. Cerenia dose is 4mg (1/2 of an 8 mg tablet) for most cats. If Ruby ends up needing more support or is a larger girl that dose can increase. I'm not sure the Pepcid would do the trick in my experience with it.
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Thanks, Margaret. Ruby was on Cerenia when she had her DKA episode in the hospital and we used it for several weeks after that as needed. She tolerated it well. Her vet doesn't usually call me back until the end of the day and then I would not be able to get the prescription until tomorrow so I was wondering if I should give Pepcid in the meantime, but I'll hold off.
 
PerfumedCatMom said:
Thanks, Margaret. Ruby was on Cerenia when she had her DKA episode in the hospital and we used it for several weeks after that as needed. She tolerated it well. Her vet doesn't usually call me back until the end of the day and then I would not be able to get the prescription until tomorrow so I was wondering if I should give Pepcid in the meantime, but I'll hold off.
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Maybe the vet can even give you a few boxes at a time this time. I make sure I keep a small stock on hand, so I have some in my cupboard always for when needed to start up again. For us it is a chronic cycle of needing the Cerenia for time periods, then not.
 
Actually Max had chronic pancreatitis and did very well on ondansetron. It works better for nausea for many and cerenia works better for vomiting but ECID.
 
+7 = 84. A flat day for Ruby.

She's been nibbling a bit at her wet food, but eating it very slowly and only about half her usual portion each time. I have tried many other foods, even giving her some Wellness and Sheba, and she sniffs, licks her lips, and walks away every time. I pulled out some of her sister's Dr. Elsey's, put a teaspoonful in a bowl and she hoovered it up. Does anyone have experience with their cat becoming averse to wet food? Or is the desire for dry food a symptom of nausea?
 
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For Max, when he first got pancreatitis before he was diagnosed, I was told maybe he was nauseous when he became very picky. I didn’t think he was because he would eat dry food. Boy was I wrong.
 
PerfumedCatMom said:
What is the difference between cerenia and ondansetron?
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The two target different nausea receptors, sometimes one will work where the other won't. Or they can be used together. Cerenia is given once a day and is the option to give if there is vomiting. Ondansetron is given 3-4 times a day.

Cerenia and ondansetron dosing are given on page 232 of this article on managing CKD kitties. (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease Dosing is based on weight of cat. For oral Cerenia it's 2 mg/kg once a day and for ondansetron it's 0.5-1.0 mg/kg of weight, 3-4 times a day. Many vets underdose these drugs. The 4 mg suggested above would only work for a 2 kg cat (4.4 lbs).

Have you investigated slippery elm bark? Here's is Tanya's page on it.
 
Wendy&Neko said:
Have you investigated slippery elm bark? Here's is Tanya's page on it.
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Although I love the idea of SEB and it seems many CGs have success with it, I tried to administer it to Ruby a while ago for constipation and she would not go near it as was her reaction to pumpkin.

The vet tech is coming in a few hours to administer subQ to Ruby. I will see if it has a positive effect on her appetite tonight. If not, I am going to ask the vet for ondansetron though I am leery of popping a pill in Ruby 3-4 times a day as she doesn't enjoy the experience. My vet has prescribed 8 mg of Cerenia to Ruby in the past as she's a big girl weighing close to 12 lbs.
 
Ondansetron is small, I just give half a tablet for my smaller civvie. It goes down easily inside a bit of pill pocket. You could start with 2 times a day and see how she does with it.
 
Ruby does like the pill pockets. I break them up into little balls and use them as bribes/treats sometimes. :rolleyes: Thanks everyone for the advice! :bighug:
 
Sending many vines to Ruby to feel well enough to re-join the clean plate club.:bighug: I hope the fluids do the trick. I had ondansetron and cerenia for Butters and they were magic.
 
PMPS = 92. Despite the no eating drama, Ruby's BG has remained remarkably flat today. I'm happy for that.

The fluid man came this evening and gave Ruby her 100 mls. He also kindly brought the meds from the vets office for me. I now have Cerenia and Mirtazapine in hand and a script for Ondansetron because they don't carry that at the clinic. Will place an order from Thriving Pets tonight. Ruby did take a few bites of canned food as I gave the shot a few minutes ago. Hopefully the meds will kick in and she will be on her way to eating again. I have so many open cans and pouches of food in the fridge for her to get through now.

This cat causes me so much worry, but she is my heart so I have to try my best. Am so grateful to everyone for chiming in here today. I'd be a mess without you. :bighug:
 
Glad you got some meds and hope Ruby continues to eat :bighug:

you may know this - but just in case - you can take your script for ondansetron to your human pharmacy to fill.

Also, I've frozen food that my cats of banished :) Ice cube trays are great for this project :) once frozen, I pop them out of the ice cube tray and store in a ziplock bag; maybe after some time, Ruby will like those foods again and you can defrost whatever you need the night before in the fridge.

Hope you and Ruby have a wonderful night!
 
JaxBenji said:
Ruby will like those foods again and you can defrost whatever you need the night before in the fridge.
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What a great idea! You are so practical. :) She is so hungry right now though after her meds and the fluids that I don't think I will have to keep any of it in the fridge for long. She is literally sitting on top of me waiting for her next feeding at +2.
 
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