Pepcid Suspension

I'm just wondering if anybody's tried this... My kitty has chronic kidney disease and throws up a lot, and I have trouble sometimes getting even small pieces of Pepcid tablet into her (must taste very bitter), so thinking of getting the suspension and just putting a drop or two in her food.. Anyone try this?  I'll also call my local vet and see if it's an option..

Pepcid Suspension

http://www.rxlist.com/pepcid-drug.htm

Thanks.   

Not sure about the suspension, if it would work as well if mixed in food?

Here are some tips that might help you though?  I've had a few CRF kitties over the past few years who had to have Pepcid.   For one cat, I got her used to eating Pill Pockets, she thought they were a treat.  Can find them at most pet food stores, a lot of vet clinics sell them too.   They're like a soft treat with a hollow spot in the middle that you can put a pill into then squish the end closed to it fully encapsulates the treat and many cats love them, will eat them and not even notice the pill inside.   They come in a couple of flavors.   My one cat went for this.....for a while.....lol......then she caught on.  So what I'd do for her was.....I'd just break off just enough of the Pill Pocket to totally cover around the outside of the Pepcid tablet (you're usually giving 1/4 of a 10mg tablet and in elderly cats/cats with major kidney disease it's been advise to give it every 48 hours).......then I'd pill her, followed by gently/slowly squirting a little water into her mouth with a 3-5 cc syringe (slowly, you don't want the water to go down their windpipe!)....just to ensure it goes all the way down the esophagus.   This worked well for her.

I had another cat I did something different with (as I didn't know about Pill Pockets at the time).....and that was to give any and all of her pills in Gelatin Capsules (gelcaps).   Most health food stores sell them, they're very cheap, like about $5 for 1000.  Come in various sizes.....you want to use the smallest size to hold the pill.   You just open up the gelcap, put the pill inside.......I'd always use a tiny bit of margarine or olive oil to lube up the outside of the gelcap, and pill the cat.....then again chase it with 3-5 cc's of water to ensure it went down (gelatin capsules can get a little sticky when they become moist so you chase with water to ensure it doesn't get stuck in esophagus).    I would order mine from www.iherb.com. 

Here are a couple of links about gelcaps as they pertain to CRF kitties.    I would often give multiple pills in ONE gelcap (as long as they weren't meds that could be given at the same time), made things so much easier!

http://www.zzcat.com/CRF/supplies/gelcaps.htm

http://www.felinecrf.org/medicating_your_cat.htm#gelcaps

Now, with any of my cats, whether CRF or otherwise, I would always use gelcaps.

Most cats are very smart when it comes to meds mixed into their food and will turn their nose up at the food.   You don't want to do anything that will deter your kitty from eating, or developing a negative association with their food...........so I'd personally try the above before trying suspension......and by the way, unless it's a specially compounded suspension that is done by a compounding pharmacy that's familiar with compounding up liquid pet meds and using appropriate pet flavorings (tuna, chicken, beef), most all human liquid meds taste AWFUL to animals.
 

Wow, I'd never heard of those Pill Pockets... what a great invention!  I've ordered some and hoping she goes for it.  If not, will try your other good ideas.  Thanks!  :-)

I also had a CRF cat who got wise to all my tricks of pilling him, so on those days when I absolutely could NOT get his Pepcid AC in him any other way, I used the compounded liquid famotidine, and mixed it on with just a teeny bit of wet food, just to make sure he would eat it, because sometimes there was no guarantee he would eat much at all.  I was able to get the famotidine in tuna flavor .  They could not guarantee that it would not still be bitter, but he usually would eat it, so was definitely better than just plain!. 

another trick that another TCS person taught me was to get the soft Whiska Lickin's treats (the salmon or chicken flavors work best), and squish them down, then wrap the pill in those.  THAT worked really well too.  (sometimes I would have to use 1 1/2 treats to completely surround the pill, but whatever.  And I would give him a couple of plain ones first, then give him theh "loaded" one, followed by a couple of plain ones again.  Worked me us most of the time)

That's good to know they can make these compounded things in tuna flavor!  Well, if need be, I'll have to go back to the former vet to have it made up.  The new vet (who I switched to because he's closer and Gwen hates car rides), pooh-poohed the idea of giving cats Pepcid, though he was the one who diagnosed her with CKD.  Never met such an idiot vet like this one. 

Thanks again.  :-) 

Diane and Gwen, who still plays a mean piano at age 18.  

www.LearnPianoWithElssa.com

My online vet thinks the Pepcid might not help that she has "azotemia or uremia".  Is there anything I can do for that?  Thanks.  Getting desperate as she's throwing everything up now.  

So, just to confirm, most people give their CRF cat a total of 5 mg of Pepcid a day?  Would it be of any help to give more than that if she's still throwing up? 

Well, when my CKD cat continued vomiting even with Pepcid twice a day (can't remember the dosage now, sorry), we added Metoclopramide to his regime. 1/8 tablet 3 times a day.  That seemed to help.

But as far as the CKD itself, are you doing Sub-q fluids?  That should help flush out the build up of toxins since the kidneys are working at capacity.  Our Vet explained that when the start throwing up more and more, it means the toxins are building up more and we need to increase the amount of Sub-Qs we're doing (from weekly to 2 or 3 times a week, etc.)  We noticed a huge change when we did that. 

Did you check out that site provided above:  http://www.felinecrf.org/treatments.htm.  It has oodles and oodles of great information on anything related to CKD

Gwen hadn't been throwing up on a regular basis until a few days ago, so my on-line vet said now's probably the time to start subq fluids.  Can one person do that or do you need someone else to help?  He said Metoclopromide (Reglan) isn't indicated unless my patient has delayed gastric emptying.  I don't know what that means. 

Thanks again. 

Yes, one person can do Sub-qs, many people on this site have done it all by themselves.  There are many YouTube videos on how to do them, and if you have a regular vet, they can also show you how.  You will need a prescription for the fluids, but can order everything on-line, including the fluids, or can buy the fluids at Costco, Walgreens, Walmart, whereever.  (Getting them at the Vet is probably the most expensive).

Doing Sub-qs will seem a little intimitating in the beginning, but you just need to remember that you are not hurting your kitty, you are helping them.  And once you get the hang of it, it's really very quick and easy.

We can help you with the best needles to use, tips on how best to do the fluids, etc, once you are ready. 

As far as what the Vet meant by "delayed gastric emptying", I have no idea what that means...sorry.  Do you not have access to a walk-in Vet?

The standard dose of Pepcid AC (must be the "AC" formulation......not any other formulation!) is 1/4 of a 10mg tab (generic Famotidine is fine, too......same thing) daily however in older cats there's been thoughts that cats with kidney disease, particularly senior cats, have reduced ability to eliminate this med from their bodies so safer to give it every 48 hours....but many do give it daily.

I did have an old CRF kitty who, like clockwork, would throw up about 4 hours after I gave it.   Took me a while to 'clue in' and make the connection.   

I have an older CRF kitty now (she's at least 17)....her kidney bloodwork in Aug 2011 was not good at all.   She's about my 4th cat with CRF.   I give her daily subQ fluids here at home, I also syringe feed her once a day some prescription canned food that's reduced protein (Medi-Cal reduced protein) and I mix some B Complex vitamins in it and some Omega 3 Oil for pets.   She does eat on her own but not enough each day to sustain her so I supplement by feeding one meal a day this way.    She is doing wonderfully!  I had originally started her on 1/4 tab of Pepcid AC back in the beginning as I'd sometimes hear her tummy gurgle, which is a sign of high stomach acid (so is frequent drinking of water, or 'hovering' over the water dish) but strangely I found that she would eat more when she wasn't getting the Pepcid (remember tho, every cat is different).   you might want to try NOT giving the Pepcid IF the throwing up coincided with you starting it.   And the vet is correct, Pepcid won't correct azotemia.......but with high urea (BUN) levels in a cat w/ CRF, comes an increase in stomach acid production........and the Pepcid helps to block some of that production.   Sometimes cats w/ CRF get so much acid in their stomachs that they'll also get reflux up their esophagus (like humans do, 'esophageal reflux') and the acid can then cause ulcers in the mouth.....making mouth sore and cat not wanting to eat.

With one cat who didn't like Pepcid, I would give her Slippery Elm Bark powder mixed with water in a syringe.  It helps to coat the GI tract.

Giving subQ fluids truly is easy once you get the hang of it.   there are excellent videos showing step by step.   You and your kitty will get used to no problem.   It's cheaper than taking cat into Vet for fluids.......and you can usually buy a case of the fluids and the tubing and needles from medical supply places for so much cheaper.   

I attribute my old girl Cleo's longevity to me giving her fluids every 1 to 2 days since Aug 2011.   The way her numbers were (BUN, Creat), I would really have not even expected her to live this long (her sister passed away of CRF a year prior).

I think that this website is by far one of THEE BEST for giving info on CRF in cats.....symptoms, common treatments, common meds and supplements, etc etc.   Very reader-friendly.   Have a good look through it and be sure to bookmark it as it will become your "bible" :-)

http://www.felinecrf.org/