8/20/19 Willow- Advice desperately needed Please..Sweetened AB

Yesterday

Hi everyone,

More info in yesterday's post.

I don't know what to do. Last night I decided to retry Aventiclav for her uti, since she used to be good on clavamox, then had diarrhea after a week of clavaseptin, and tried Aventiclav once but had a horrible night (spreadsheet May 24) and not sure if it was the AB or all the gravy causing her vomit/nausea then, so switched to baytril since then, but obviously not working.

Vet prescribed Apo amoxi liquid yesterday, but I got home and saw sucrose in ingredients, and Willow is well regulated. So thought I'd retry Aventiclav last night, but after 2 vomits (loose hairballs, but I don't think it's coincidence) and lethargy/ inappetence , having to syringe her +1 meal this am. She's just looking a bit livelier now.

Amoxil 100mg tabs (vet prescribed first, before liquid) are too big.

Got Urine via cysto but not enough for C/S....She pees before vet every time, and peed during cysto.

Do I just give amoxi liquid and increase lantus dose? Can you get amoxil compounded in diabetic safe chew tabs or ??

Any thoughts? Didn't give any ab yet today.

Thanks so much, with love, nikki

 

Hi Nikki... someone will come around (hopefully soon) with wisdom. Everything is going to be ok

 

If I were you (& Im not ) I would cap ADVISE DESPARTLY

 

Thanks, I might yet...Right now we're struggling to keep her numbers up. Sigh.
With love, nikki

 

What about plain amox suspension. They do make that. How about Orbax liquid, it's doses once a day and has always worked for me but I never used it for UTI. And there is clindamycin suspension. Remind your vet Willow is diabetic and can not have sugar in meds. To get it compounded would probably take another week.

 

No advice but

 

Thanks, I didn't know you could get plain.
I think she forgets she's diabetic because her numbers are so good lol.
With love, nikki

 

Need those so much now lol thanks. Her numbers tanked and trtlying to keep them up. Will update SS later today.
With love Nikki

 

Nikki, I'll join Tracey and send you hugs

I just received some new compounded Gabapentin, and the pharmacy cannot tell if there are any sugars/carbs in it. She was first gagging and drooling on the liquid (chicken), so I ordered these chews. I can't tell if they make a difference yet, but will be watching her BGs.
Bless Willow and you . . . she is in very good control with the diabetes. That is a big thing in her favor.

 

A couple of thoughts....

Can the tablets that are too big be cut? Some tablets can be cut up and some can't. If they can, you can buy blank capsules and put the pill in the capsule -- you may need more than one capsule. (That way if the pills are bitter, you're kitty won't start drooling or better yet, foaming. Are you able to pill Willow without a problem?

Did you get the amoxicillin liquid with sucrose from the vet or a compounding pharmacy? If it's from the vet, the vet should know that your cat is diabetic and never should have prescribed it. (Not reading the ingredients is not an excuse.) You should be able to get the liquid version from a compounding pharmacy and they should be able to formulate it so it's safe for a diabetic cat. I have called compounding pharmacies to make sure they are aware that my cat was diabetic (and I would be very vocal if they used a sugar solution base).

Would it be feasible to leave Willow at the vet long enough for them to get a cystocentesis and have enough urine for a C & S? Would the vet be willing to make a house call and do the cysto at your home?

You may need to consider giving Willow a probiotic if diarrhea from the antibiotic is an issue. S. boulardi is great for managing diarrhea. You need to give it at a time separated by a couple of hours from the medication.

@Tina Marie and Jan - A compounding pharmacy absolutely should be able to tell you what the ingredients are in a medication. They are making the medication and therefore should know what they are adding. If they can't tell you, find another compounding pharmacy or ask to speak with a pharmacist. The person answering the phone is likely a clerical staff person vs a pharmacist. If the pharmacist can't tell you what's in a medication they've compounded, that's more than a little bit terrifying. If it were me, I'd find another compounding pharmacy. Be aware that many "chew" type of preparations contain corn syrup -- it's when makes them chewy.

 

not sure this is still valid, but I happened to find the amoxicillin bottle of powder to be reconstituted, brand name is Augmentin, mfg is Beecham Labs of Bristol TN

am I a hoarder? is this old? bottle says 4/90 ....

ingredients say amoxicillin and clavulanic acid

 

@Tina Marie and Jan and @nslade001
I have used Diamondback/Wedgewood compounding pharmacy exclusively.
*If I ask clerical staff person a question... which I wouldn’t ask, knowing their policy... the phone answering person always can’t/won’t answer-refers to pharmacist and always asks if I’d like to speak to one

 

Augmentin is different than amox. Augmentin has amox in it and usually harder on the cats and humans too. They can and probably have diarrhea, vomiting and stomach cramps.

 

I called back and got a much better person who led me to the pharmacist! The chewables I have, do have a small amount of cornstarch, which makes them tasty. That wasn't surprising after Sienne's description. I'm not too worried right now, since the +4 today was fairly normal and last night's PMPS was good. With the surprising rise after PMPS, the only change was that new chewable though.

 

I've spoken to Wedgwood pharmacist a few times. Their gourmed tabs so not have sugar or sweetener in them. She gets 2 of her meds in that form, gab being one of them. When my vet calls in a new rx, I then call Wedgwood and remind them Ollie is diabetic and absolutely no sugars are to be used. Pharmacist said the gourmeds are the thing for her. Their gummies and mini tabs have sugar or sweetener. I'm thinking of getting her benazepril in it if they can do her dose.

 

Sending lots of vines for Willow! I hope you find an A/B that will help her and not raise her levels! She's looking good!

 

I thought I was getting the Gourmed tabs, because that's what I asked for, and talked to my vet about. Calling my vet again

 

Ravan had a terrible UTI a while back (blood in his urine) he took Amoxicillin tablets /62.5 mg 2 X a day for a week. It cleared up the UTI.( these tablets are tiny. I'd squirt a bit of water in his mouth then drop the tab on the back of his tongue & squirt some more water. Ravan rarely gets any pills but this worked OK)
I now give him , " pure D-Mannose Powder " a few times a week to prevent a recurrence of another UTI. So far it's working!

 

Thank you
Willow is on Gaba tablets, 25 mg, I just crush them to powder and mix in her food and she doesn't notice. I don't know if you've tried that already...
With love, nikki

 

Hi Sienne, thanks for your comments.

I can pill her, but I try to keep it to a minimum because I think it hurts her to have my finger pressing where her resorbed incisors are on her lower jaw, when I open her mouth.

Got it from her vet. I'd just asked them to check on compounded cisapride, and they said the compounding pharmacy can't do that without sweetener, and flavor is even more sweetener. Don't know about amoxil.

Can't leave her because she needs feeding and medicating too often, and she doesn't just eat. 14 meals a day. I don't know about her coming, but she's off tomorrow and we leave Friday, and Thursday is sort of hectic.

Will probably try in Prescott when we move.

She's on probiotic; her issue now is more vomiting than diarrhea.

Rough morning today, she dropped low again and couldn't get her up easy, so lots of pokes. 3rd morning in a row. I reduced again, but may end up increasing.

I didn't give Ab today, hopefully there will be a new RX for us to start tomorrow.

Thanks again, with love, nikki

 

Thanks Kristina. I'm in Canada, though. With love, Nikki

 

Gosh, I knew that . I didn’t mean to refer you to diamondback... I don’t think I was- giving an example of a compounding company’s policy/ procedures.
Sorry

 

Thank you all so much!
Willow had a rough morning after that rough day and night, but is much better now, eating on her own and moving some. No antibiotics given today. Possible bouncing now, +2 was 5.9 after 5.3 pumps, or else a failed reduction. At least she's not low!
With love, nikki

 

Nikki,
I upset myself this morning over this sugar in meds situation. As it turns out, in my case, the little bit of cornstarch did not prevent a decent day of BG numbers.
I did leave a message for the vet to change to a no-sugar option, but right now, the med is helping and the bit of carbs is not hurting her overall D control.
Blessings for Willow

 

Thanks, Jan. Tina's SS looks great!
With love, Nikki

 

Not true on the cisapride. Ollie gets it in the gourmed chewable from Wedgwood. Natural chicken flavor
https://www.wedgewoodpetrx.com/items/cisapride-gourmeds-chewable-tablets.html

gabapentin comes the same way.

vet has to specify gourmeds and tell them your cat is diabetic. Then call pharmacy yourself to verify its gourmeds and no sugars.

 

You could try a pill "shooter." You don't need to put pressure on the jaw. You put the thing between the space in their teeth. I also don't press on my kitty's jaw. I grab the scruff and tilt his head back. His mouth opens automatically.

 

Thanks @Olive & Paula . But is gourmeds just a Wedgewood pharmacy product? Because I'm in Canada. My vet works with summit, but I'm checking for other companies.
With love, Nikki

 

Thanks. Is the pill shooter any more likely to drop the pill down her trachea than using my hand to pill?

Willow has a very tight scruff (she's difficult to restrain because of it) and she gets *really* upset when she is scruffed, so that's a last resort...We try to go the nice-as-possible route for her. But it's definitely good to know her mouth will open automatically that way, maybe I'll work on that with her (clicker training) to see if we can make it nicer...

Thanks! With love, nikki

 

Oh probably is a wedgewood product. There must be someone in Canada who makes sugar free meds. Are you close to the border and can use a U.S. address to ship to than pick up?

Can a pharmacist maybe tell you if you go in and talk to them, they might know a compounding place.

 

This is the pill shooter I used. There are a couple of different styles on Amazon. The advantage is that you're less likely to get bitten!!

FWIW, I got meds compounded at RoadRunner. When I asked about making sure that Gabby's meds were sugar free, there wasn't a problem.

 

Good luck with pilling Willow! I use a pill shooter too! Have always found it safer ( for my fingers) and easier. Hope she gets over her UTI soon!