Metronidazole problems

betsygee

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Two of the four older cats we inherited earlier this year have been taking metronidazole for IBD.  From what I can tell from the medical records we got, Jake (age 13) and Molly (age 10) have been on varying doses of this for the past three years or so.  Jake's on 0.9 ml a day, and is also on prednisolone every other day (I forget the dosage).  Molly's on daily doses of 0.6 ml. of metro. and 0.2 of budesonide.  

When we got the cats, I took them both to the vet for blood work and confirmation of their treatment, since our friend died before we could get information from her directly about Jake and Molly's conditions.  The vet did an exam, bloodwork, urine samples, called their previous vet and wrote up comprehensive reports.  His recommendation was that they continue indefinitely on the meds they're on.  I took them back after six months, got more tests and it was decided to keep them on that regimen.

Both cats seem to be doing well--I'm switching them over to a grain free diet and trying to get them on more wet than dry food.  Neither has diarrhea at this point.  Molly goes through bouts of vomiting--she'll have a bad day and then be okay for several days.

Molly goes through times of drooling out the metro.  Poor thing, I feel terrible trying to get her to take it and then watching her spit/drool it out.  I took the suggestion of somebody on this site and started giving it to her after meals and that helped for quite awhile but now she's doing it again.  The odd thing is that Jake, who used to take his metro with no problems, is now actually trying to get away from me when he sees me coming with the syringe and for the first time, he's drooled it out the past couple of days, too.  I get it compounded with tuna flavor, which is the same way they've been taking it all along.  

Does anyone have any experience with long term use of these meds for their cats?  Do they ever get off of it?  Do they go through times when they won't take the med? 

 If they're going to be on it indefinitely, I could use suggestions for getting them to swallow it, if anybody has any.

Thanks so much.

Oh yeah--I've also started adding omega 3s to their meals as well, as I read that might help with the intestinal inflammation.
 
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katluver4life

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I myself have no experience with IBD in cats, but we have quite a few members here who do. I'm not sure if you have been pointed to this site yet: http://ibdkitties.net/, but it is very informative on this condition and may give you some help/tips until someone here can respond to your questions.

I wonder if just pilling them might be better if your comfortable doing it.

I do want to add a BIG thank you for taking in your friends kitties! How good of you to do that and to be taking such great care and interest in improving their condition. Koodos to you!
Sending you mega
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denice

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My IBD kitty has been on a steroid for almost three years.  He started on pred and then there were supply problems and he was switched to dexamethasone.  He hasn't had any problems yet but diabetes is a concern with long term use.  He has only been on the metro when he has a flare, never anything long term.  That stuff is very bitter.  My vets office would cut up the pill and put it in a gel cap and that made it much easier.
 
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betsygee

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I myself have no experience with IBD in cats, but we have quite a few members here who do. I'm not sure if you have been pointed to this site yet: http://ibdkitties.net/, but it is very informative on this condition and may give you some help/tips until someone here can respond to your questions.

I wonder if just pilling them might be better if your comfortable doing it.

I do want to add a BIG thank you for taking in your friends kitties! How good of you to do that and to be taking such great care and interest in improving their condition. Koodos to you!
Sending you mega
and
's
We had pred pills for Jake and I even had the vet show me how to do it since I'd never pilled a cat.  Sometimes it worked and sometimes it didn't--the pill would end up a soggy mess after a few tries--and I was worried he wasn't getting the proper dosage.  The liquid is easier for me.  I did read last night somewhere that keeping the liquids cold helps with administration so I put their meds in the fridge and will try that this morning.  That might  be the problem--I used to keep their meds in the fridge but with this last batch, the pharmacy said it didn't need to be refrigerated so I had them out at room temperature--maybe the kitties don't like that.  We shall see...

I guess I need to talk to the vet about long term metro use.  We realized that our friend had been too ill to properly take care of the kitties the last few months of her life (she lived in a different city so we were taking her word by phone about how things were going).  I think they hadn't had the correct dosages of meds for some time.  So these past few months, it's been all about stabilizing them and getting them used to a new environment.  Now it's probably time to do some more research and try to figure out if this med. regimen is best for them long term.  I had seen the ibd website but honestly I was sort of overwhelmed at the time and didn't really check it out in depth--I'll take another look.

Thank you so much for the kind words--it's been kind of crazy, but we're all slowly adjusting.  
 

Thanks for the info, Denice.  I had read the metro is nasty stuff and thought the tuna flavor was helping....I hope chilling it will make a difference.
 
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blueyedgirl5946

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My cat takes 1/4 pill daily for thyroid. I give it to him in the pill pockets which you can buy at the store or the vet office.
 

denice

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I didn't even know they used it for thyroid problems.  I have heard of using Methimazole   but not metro.
 

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Ditto on the wonderfulness of adopting these kitties. Can't comment on the appropriateness of the meds, but if they are going to continue the meds, you might check out compounding the meds into something more palatable. I had a cat take Budesonide for several months and one takes Methimazole now, and both meds were compounded into liver chew treats via BCP Vet Pharmacy in Texas. One of my cats refuses to be pilled, the other will be pilled but hates pill pockets, both love these chews. They come in lots of flavors, I've stuck with the liver because they said it hid the taste of the meds the best. My vet calls in the prescription on a Monday, they are at my door by Thursday (I live in CA). I can't recommend them enough for a long term medication. Made everyone's life much easier!

They also do transdermal gel and liquids. I won't do the gel because my cats like to groom each other. Liquid tends to get tossed to the walls.

Anyway, it's a suggestion. Good luck!
 

finnlacey

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Metronidazole is usually used for diarrhea so I'm not really sure, why they're keeping them both on that medication. I would ask if there's any way you can take them off of it. Ask the vet first, don't just stop it. But I would definitely have that discussion. If you keep them on that med, the problem is if they need it in the future it may not work due to their systems being used to it. And it does have side effects. Btw, the website for IBD is mine so please feel free to ask anything. Are they on anything for nausea?
 

denice

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Metronidazole is usually used for diarrhea so I'm not really sure, why they're keeping them both on that medication. I would ask if there's any way you can take them off of it. Ask the vet first, don't just stop it. But I would definitely have that discussion. If you keep them on that med, the problem is if they need it in the future it may not work due to their systems being used to it. And it does have side effects. Btw, the website for IBD is mine so please feel free to ask anything. Are they on anything for nausea?
I didn't know that the IBD site was yours.  I have been meaning to write up Patches saga for that site.  Patches has done well since going on steroids but there was six years of vet hopping trying to find a vet that knew what was wrong with him.
 

finnlacey

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I'm sorry it took so long for Patches to get some relief. Unfortunately some vets are just not that experienced or well versed in IBD. Definitely contact me if you write it up. I'm glad Patches is doing better! 
 

jclark

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Metronidazole is an antibiotic and just bitter stuff. Couldn't wait to get my IBD cat off it ASAP. The only technique I can suggest for administering this product is to use a syringe and get the dose as far back in the mouth as possible. This will keep the drooling down. There's also an anti-nausea med (Corvenia?) they can give them. It'll last about 2-3 days.

Be sure to use a priobiotic once you've ended the course of Metronidazole. I'm surprised your cats have been on it for so long.

Prednisolone will probably be lifetime but hopefully at a very low dose. My vet explained IBD as a condition rather than a disease. You can never cure them, only manage it via diet and meds.

The Pred will help inhibit the auto-imune response (i.e. IBD) and it makes them want to eat as well. I read that giving it to cats at night gets better results.

I'd also look at B12 shots or pills. IBD cats have difficulty absorbing B12 via the GI tract. Personally I give my cat 1,000 mcg of B12/day by dissolving a tastless pill in a syringe with about 1 CC of water. It's a large dose but I know he's not getting full absorbtion. I think that and priobiotics are helping. He doesn't have as much weakness in his hind quarters and he's even running around a little and even jumping.
 
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betsygee

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I didn't know you could get B12 as pills.  Part of the medical supplies we got from our friend's house was B12 liquid with syringes for injections.  We've been giving it to them once a month--not fun, but hubby helps and we've got down a routine so it's not too bad.

Is it possible that if their nutrition wasn't good and/or stress levels were high it caused the diarrhea to be worse and cause  them to be on the metro longer? I know their 'mom' did the best she could but she was so ill, I know they got inconsistent care and unfortunately not very good quality food, either.  Maybe now with a stable environment and better food, we can try to at least reduce the dose of the metro?  

Interesting about giving pred. at night--I usually give it to Jake in the morning.

I can see I've got a lot to learn about this condition....  
      I will definitely be perusing the ibdkitties.net website and may be taking you up on the offer to ask questions, finnlacey!  Thank you all and if anybody has any other suggestions, I'm all ears.  
 

finnlacey

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For GI disorders in cats and especially IBD, pills will not make much of a difference whatsoever. there's a reason they recommend injections and not even the liquid will do much. it must be injection to bypass the stomach. 
 

sarah ann

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I would try taking them off of it and monitoring them. 

I personally cannot tolerate Metronidazole along with most antibiotics. It makes me vomit within 20 minutes of taking it.  If I don't throw it up, I get severe migraines from it. Metronidazole crosses the blood brain barrier and can cause neurotoxicity.

I see no benefit to long term use. By now you have just built up a very antibiotic resistant population of bacteria. Those bacteria can spread to other cats and even to you!

Even in severely immuno-compromised patients, antibiotics are not usually given for long term use. Usually you either rotate antibiotics, treat for one week and then take a month off, or determine the exact bacterial infection you are fighting and give specific antibiotics for that. 

Strange to give metronidazole for IBD. In general it can be very harsh on the GI tract.

As long as they are in good condition now (without any problems with weight), I would think that it would be safe to take them off of it and monitor them. If they get worse you can always put them back on it. 

This might be helpful.

http://www.vetcontact.com/en/art.php?a=572
 

blueyedgirl5946

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My cat takes 1/4 pill daily for thyroid. I give it to him in the pill pockets which you can buy at the store or the vet office.
I was wrong what I posted here. This is not the same medicine my cat takes for thyroid. It is Methimazole. Not the same medicine.
 
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betsygee

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Thanks again for all the thoughts and suggestions.  I'm definitely going to talk to the vet about getting them off of the metro.  In the meantime, I'm going to add organic pumpkin to their food and maybe try tapering down the dose of the metro.

JClark, you mentioned getting them on probiotics if they get off the metro.  Is this to help prevent diarrhea after the long antibiotic use--sort of like humans eating yogurt for a week or two after taking anbitiocs? 

By the way, I think it did help putting the metro in the fridge--neither of them drooled it out yesterday.
 

denice

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Some people keep their cats on probiotics to keep the balance of good bacteria right.  Using them after antibiotics does help restore the good bacteria.
 

jclark

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Thanks again for all the thoughts and suggestions.  I'm definitely going to talk to the vet about getting them off of the metro.  In the meantime, I'm going to add organic pumpkin to their food and maybe try tapering down the dose of the metro.





JClark, you mentioned getting them on probiotics if they get off the metro.  Is this to help prevent diarrhea after the long antibiotic use--sort of like humans eating yogurt for a week or two after taking anbitiocs? 





By the way, I think it did help putting the metro in the fridge--neither of them drooled it out yesterday.
Denise hit the nail on the head. My vet said that the antiobiotic your cats are on wipes out the bacteria in the GI tract. I had good results with it.

Metro should be refridgerated IIRC. Atleast that's what my Vet told me.
 
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