Looking for something to replace Cerenia for acid reflex

My cat Peaches has episodes of constipation, vomiting and nausea. Vet is leaning towards IBD and has been treating her as if she did have IBD. She gets a vitamin B injection every month and miralax twice a day in her canned food. Peaches had a very bad week last week and was vomiting every morning before being fed breakfast. Today I went to pick up some medication that will help for acid on her stomach. I will not be able to afford this long term. I am only going to be giving it to her every other day but we only get 4 pills for $16.00.

Is there anything else a cat can take for this problem that might not cost so much?

Hi there, poor baby!

Cats with IBD can have flare ups.  1/4 of a 10mg pepcid once a day is fairly standard, but you should at least speak with your vet on the phone before starting a new medication.  Every cat is different and you should never start a human medication even when suggested here without speaking to your vet first.

Keep us updated ok.

Thanks but my vet is against anything but what they give me. It even took me a couple years to get her to consider Peaches might have IBD.

Snugglecat said:

 
Thanks but my vet is against anything but what they give me. It even took me a couple years to get her to consider Peaches might have IBD.

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Good vets aren't opposed to appropriate medications, almost every drug a vet has is a human medication in a different form or dosage.  But they won't make any money from Pepcid.  My cat has IBD and pepcid is one of the things my vet put him on.  So given your vet's reluctance to offer a medicine that "they don't sell", and that it took 2 years for them to even consider IBD, I would have to suggest you consider getting a different vet. 

I agree with StephenQ that Pepcid is a pretty standard med for cats with acid reflux issues. A good vet should consider the needs of the patient first and foremost.

Snugglecat said:

 
Thanks but my vet is against anything but what they give me. It even took me a couple years to get her to consider Peaches might have IBD.

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I understand why vets don't want owners self-diagnosing or self-medicating, but this sounds extreme.  I'd get a second opinion and hopefully some help for your kitty.

peaches08 said:

 
I understand why vets don't want owners self-diagnosing or self-medicating, but this sounds extreme.  I'd get a second opinion and hopefully some help for your kitty.

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This isn't about self medicating, its about getting her Vet to offer a medication that will work, and just because her Vet doesn't stock Pepcid doesn't mean it isn't an appropriate medication. 

StephenQ said:

 
This isn't about self medicating, its about getting her Vet to offer a medication that will work, and just because her Vet doesn't stock Pepcid doesn't mean it isn't an appropriate medication. 

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Looking for medications other than what is prescribed is technically self-medicating.  In this case (and many others), I completely agree with the OP for doing so.  I wasn't condemning her at all.

Thanks. I think my vet is very old school or doesn't really think the human grade stuff works for pets. My vet doesn't even believe or know that I give Peaches miralax for her constipation issues. Peaches was given lactulose but it makes her very sick. I stopped that and heard of a lot of people that give their cats miralax and it works great for her. Asked my vet about giving miralax even through I had been giving it to Peaches for over a year and the vet said no....it is not meant for cats and will do them harm.

I don't have a car and have to get rides, this vet is close so I am stuck with this place.

Okay I just gave Peaches part of the Cerenia pill in her wet food and she does not look well. She looks like she feels sick to her stomach. I think I just wasted $16.00. Anyone have experience with this medication?

peaches08 said:

 
Looking for medications other than what is prescribed is technically self-medicating.  In this case (and many others), I completely agree with the OP for doing so.  I wasn't condemning her at all.

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We may be splitting hairs.  Discussing an OTC medication with one's vet isn't self medicating so long as you don't administer the medication without their approval.  My issue is with her vet refusing to discuss this and basically invalidating a medication that vets around the country (USA) consider a valid medication for an upset stomach.  I took great care in telling her not to use this medication without her vet's approval.

@Snugglecat I have only given cerenia as an injection and it worked well.

I've dealt with one of those before.  It stinks and my heart goes out to you.

Before throwing more meds at the kitty, what is kitty eating?  Is kitty picky?  Let's start with basics and move forward.

As far as Cerenia, I've used it once on my ver sick CRF kitty before she died. It helped a little at first, but not as much as Pepcid did and frankly, my kitty was on her way out so I can't give a fair opinion on it.  But if I were in your shoes and my cat couldn't keep food down, I'd consider Pepcid.

Also, are hairballs a possibility?  It's hairball season here in GA.

Hi Snugglecat, so sorry to hear about Peaches!

My cat Tim has had problems with nausea, vomiting, and constipation. I think we have mostly gotten the vomiting under control, as he hasn't vomited in over two months. This is something of a record for him. What brought about this was a change in diet. You've written previously that Peaches is very fussy about food, so this might not be a realistic solution. I also don't let Tim gobble all his food at one time - his morning and evening meals are each spread over 60-90 minutes. Tim also had a couple of serious episodes of constipation and I am working with a holistic veterinarian to get him off cisapride and manage it via diet. This is a long process that is going mostly well.

Up until about two weeks ago, however, Tim was still having nausea and acid reflux. Sometimes so bad that it caused his lower lip to swell on two separate occasions. Other times so awful, I can only imagine, that he would suddenly jump up from a relaxed pose and vigorously shake his head. The holistic veterinarian prescribed a short course of Pepcid AC, which is not expensive and gave him almost immediate relief. I tend to agree with the others that you might want to consider another opinion for Peaches.

I did one other thing for Tim to help with his nausea and I'm not sure if this helped or the Pepcid AC. However, he's not had a Pepcid dose since April 3, and no signs of nausea, so I'm not sure. I made a very intense bone broth and started mixing that with Tim's food. To make the broth, I bought a turkey drumstick at Whole Foods and simmered it in my slow cooker for about 48 hours. That stuff was like gel at room temperature. Tim has not been diagnosed with IBD or IBS, but I knew something was wrong inside, and I felt the bone broth would help. And the holistic veterinarian was supportive of this. I would only caution you, as Peaches is prone to constipation, to not overdo bone broth. Bone broth is very rich in many minerals, including calcium. Too much calcium is excreted and can cause harder stools. I realized this was happening in time to stop the broth with Tim, but had to treat my female cat for mild constipation (there was nothing wrong with her, she just liked the taste of the broth). Moving forward, I will give this broth to Tim only once a week or so as maintenance. The female won't be getting it, unless I see signs of nausea.

Good luck!

StephenQ said:

 
We may be splitting hairs.  Discussing an OTC medication with one's vet isn't self medicating so long as you don't administer the medication without their approval.  My issue is with her vet refusing to discuss this and basically invalidating a medication that vets around the country (USA) consider a valid medication for an upset stomach.  I took great care in telling her not to use this medication without her vet's approval.

@Snugglecat I have only given cerenia as an injection and it worked well.

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Not once have I condemned the owner nor you.  I'm not sure what this is even about.

I would ask for a full blood work up.  These are classic symptoms of kidney problems.  Be sure they check her BUN and Creatinine and do a urine culture.  I would also suggest a second opinion on all this.

peaches08 said:

 
I've dealt with one of those before.  It stinks and my heart goes out to you.

Before throwing more meds at the kitty, what is kitty eating?  Is kitty picky?  Let's start with basics and move forward.

As far as Cerenia, I've used it once on my ver sick CRF kitty before she died. It helped a little at first, but not as much as Pepcid did and frankly, my kitty was on her way out so I can't give a fair opinion on it.  But if I were in your shoes and my cat couldn't keep food down, I'd consider Pepcid.

Also, are hairballs a possibility?  It's hairball season here in GA.

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Peaches is very picky about food. She will only eat Wellness canned turkey and even then it takes all morning to eat her breakfast. Every once in a  while I give her Wild Calling turkey but her stomach rumbles and makes lots of noises when I feed this to her. She also gets a 1/8 cup of her Royal Canin Fiber response dry food. She started that dry food in December and has been doing very well on it.

Like I said we have been dealing with episodes on and off since 2010 and have seen several different vets. None of them would even discuss or bring up IBD/IBS, I am the one who brought it up and asked if we could treat her as if she did have it. We have never treated her for the nausea that she gets with these episodes until I took her in the other day and asked if we could try something for it. She has had blood work done.

I had not heard of this medication before but was willing to try it. I only gave her half of the pill in her food just in case she wouldn't eat it and was going to give the other half later last night. Peaches didn't look well and slept most of the time so I didn't give her the other half. This morning she was not really interested in her canned food and just picked at it. She has a hard time taking medications as they all seem to make her sick so not sure I will try this again or not.

Thanks again for your help.

I think this is definitely IBD/IBS since it started in 2010 and has continued since.  My kitty has IBD and is also prone to constipation.  I give him Miralax daily during shedding season.  Being very picky about food often goes with IBD.  They eat something that makes them feel bad and they shy away from it the next time.  Eventually they become very picky.  What works is very individual to the kitty.  I tried Pepcid with Patches and it didn't help but it has helped many kitties.  Since it's worse in the morning it does sound like an issue with too much acid.  I haven't tried Cerenia but I know people have used it.

My kitty is on a maintenance dose of a steroid and has been for a little over 3 years.  Some people have had very good luck with probiotics.  I don't know if you have seen this website http://ibdkitties.net/.  It has a lot of good info in it.  If you go to LDG's post in this thread http://www.thecatsite.com/t/274582/long-term-ibd-meds  there is a lot of good info about a natural approach to controlling IBD.

Just providing some objective information...

Cerenia and Pepcid work differently.

Cerenia contains one active ingredient, maropitant citrate, which helps block vomiting signals in the brain to help prevent vomiting and nausea (source). It is not an acid reducer.

This article gives a more detailed explanation of how Cerenia works by blocking signals to the emetic center in the brain: http://www.vetstreet.com/pfizer/effective-treatment-of-vomiting-in-dogs

Pepcid AC contains the active ingredient, famotidine, which is known as an H2 histamine blocker. It works by blocking a specific kind of histamine receptor. Histamine is a chemical released by that body that has several effects. In the stomach, it causes more acid to be produced. By blocking histamine in the stomach, Pepcid AC reduces the amount of acid produced (source).

My Sebastian has chronic pancreatitis and gets a maintenance dose of both Cerenia and Pepcid AC for each of their distinct purposes. Both were prescribed by our vet.

Pepcid can be very helpful for kitties who have nausea and vomiting associated with excess stomach acid and/or acid reflux. However, Pepcid alone may be not be helpful if vomiting and nausea are originating from another cause, such as with Sebastian's case (pancreatitis).

GoHolistic said:

 
Just providing some objective information...

Cerenia and Pepcid work differently.

Cerenia contains one active ingredient, maropitant citrate, which helps block vomiting signals in the brain to help prevent vomiting and nausea (source). It is not an acid reducer.

This article gives a more detailed explanation of how Cerenia works by blocking signals to the emetic center in the brain: http://www.vetstreet.com/pfizer/effective-treatment-of-vomiting-in-dogs

Pepcid AC contains the active ingredient, famotidine, which is known as an H2 histamine blocker. It works by blocking a specific kind of histamine receptor. Histamine is a chemical released by that body that has several effects. In the stomach, it causes more acid to be produced. By blocking histamine in the stomach, Pepcid AC reduces the amount of acid produced (source).

My Sebastian has chronic pancreatitis and gets a maintenance dose of both Cerenia and Pepcid AC for each of their distinct purposes. Both were prescribed by our vet.

Pepcid can be very helpful for kitties who have nausea and vomiting associated with excess stomach acid and/or acid reflux. However, Pepcid alone may be not be helpful if vomiting and nausea are originating from another cause, such as with Sebastian's case (pancreatitis).

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Thank you for explaining all that to me. I was not really told anything about Cerenia, it was just given to me and they thought this might help with the vomiting in the early morning hours that she was doing for a week. Usually when she has this problem she is constipated at the same time but that was not the case this time. Peaches was vomiting bile every morning for a week so I took her in to see the vet. I had to just drop her off at the vet because they had no appointments available and the vet would look at her between appointments. When I picked Peaches up I didn't even get to talk with the vet. They just told me she was not constipated and everything looked good.

I was the one who brought up about the nausea and she was not wanting to eat her canned food. She would act so hungry and get excited when I was fixing the food but when I sit it down for her to eat she would sniff it and walk away. When she is feeling good she has no problem eating. I have been having trouble getting her to eat this week so I gave her some Friskies mixed grill to try and get her to eat something and she ate it no problem. It's hard to find a food she will eat because the ones she really wants has fish in it and she is allergic to fish even fish oils in canned food. She does not like chicken, duck or any flavor but turkey and for a few years now the only food I am able to get her to eat is the Wellness Turkey but right now she won't even eat that.

I only gave her half of the Cerenia pill on Wednesday, she only gets it every other day. I will try again and give the other half today. She did not look well after taking that pill though. You could see it in her eyes and the way she was laying down. I do believe her problem is excess stomach acid.

Cerenia just addresses a symptom to help a kitty feel better, but it does not address the underlying cause for nausea and vomiting.

Other than symptoms, what else has the vet used to come to the conclusion of IBD? Has blood work been done? How about an x-ray or ultrasound? Ultrasounds seem to be the most helpful when it comes to looking for inflammation and thickened intestinal walls.

What has really helped my Caesar significantly with his vomiting was raising his food bowl. I used to use a stack of about three to four 5.5 oz. cans of cat food and set a small bowl on top of that, until my dad (a woodworker) ended up making me a custom bowl stand.   I did have to raise it slowly using one can at a time for awhile because it seems weird to them at first.

From what I've read, your kitty is on Vitamin B injections and Cerenia, correct? With IBD, if this is the diagnosis, I think a little more needs to be done. IBD is an inflammatory condition and the key is to get the inflammation under control. The link @Denice provided above is a good one. Some people opt to try holistic remedies first and experiment with diet. In severe cases, some have chosen the traditional route with steroids. Many do both.

Anyway, in the case of excess stomach acid, Pepcid AC and/or Slippery Elm Bark seem to be the most used.

I do think there are some cats that are fussy eaters, but a part me believes that a really picky eater is not normal. Sebastian went through this phase for a few months prior to his first pancreatitis attack. I attributed it to being picky or being bored with his food rotation. This was not the case. He was telling me something is wrong. And something ended up being very wrong. 

My cat Chanel has inflamitory bowel disease (IBD) she gets b12 injections once a week for 4 weeks at the moment she's also on prednicare 1mg and famotidine 5 mg both once a day one of these is steroids which will get reduced through time my problem was sickness in the morning it was wearing me down but now it's hardly at all sometimes 3 days after her jag she's a bit off but other than that it been great I was also told to change her diet to a hypoallergenic but at the moment she's on instinctive wet pouches by royal canin she's is gobbling it up I'm just using this all up just now then I'll look into something more hypoallergenic I only buy thrive treats and give her a handful of Arden grange sensitive if she's has the munchies its ocean white fish and potato. I had my cat on chicken and rice and chicken chicken chicken till it was coming out her ears so the vet said change to something else get her off chicken and she's fine so I'd read the labels and take her if whatever protein she's getting and change that to fish or lamb or whatever