Famotidine/Pepcid in Kidney kitties and Cerenia

Hi there,

Tonight we will be seeing the vet and I want to discuss options for treating my girls upset tummy from kidney disease.

Her levels are not high but she isn't concentrating her urine.

Most days I know her stomach hurts-we tested for Pancreatitis and it came back negative but I have a suspicion that there is something going on in the GI tract=we did xrays/ultrasound and all inconclusive.

She has constipation=I give miralax or canned pumpkin

I wanted to know where do you guys get compounded Pepcid and what flavors you have had success with.

I also want to try to get a vial of Cerenia prescribed so I can have this when the Pepcid isn't enough.

The hot weather despite AC still seems to bother her. I don't know if the heat is causing the stomach acid to be over what it is normally but I hope the vet will at least allow me to buy compounded Pepcid but the problem is-she is NOT pillable.

This cat will NOT allow you to tip her head back unless you are a groomer or vet. For me she claws and bites.

Last ngith I smashed up the Pepcid and mixed in a bit of babyfood=I know it tastes horrible. I followed with a water and wet food chaser but I know if we do this again she will fight me harder.

I want to instead get her meds as injectables. I don't see the point in stressing her out even more.

She is 17/18-age unknown. I have had her since 2001.

She also stopped eating her wet food a week or more ago=last Sunday vet gave injection of Cerenia and she was eating OK but still no wet food until a day later and now its been about 3-4 days she refuses wet food. She eats plenty of kibble.

So my question is-do any of you do injections for your cat or is this too far out to ask for?

I found several sites the sell Cerenia and its pricy but a vial at her dose will give me roughly 30 injections. I still have to search the shelf life.

I miss my old Vet in Durham-she used to send me home with prefilled needles of Cerenia and only charged me $35 for 5. This vet charges $27 for ONE injection!!!

Just wanted to know thoughts/ideas.

I think its the heat and her kidney disease but I do syringe her water. She is going to the bathroom just fine and spends her day outside sleeping on the deck=this is where she wants to be otherwise it is in the bedroom on the floor. I notice she isn't jumping up on the bed anymore-its really high up. Going to mention to vet.

Cerenia is usually an occasional thing and the Pepcid is given daily to help reduce the nausea caused by being backed up.  I found with my girl that she would only poop about every 2 days, even though she was eating normally for her.  At this stage of the game, any wet food is okay, and many renal kitty owners feed the original Fancy Feast because it's so important for them to keep eating.  You might want to ask the vet about using Miralax to help with the constipation.  You can also use Slippery Elm Bark.  Here's a great thread with info on using SEB.  http://www.thecatsite.com/t/270597/slippery-elm-bark-wet-food-managing-constipation

Also, talk with your vet about sub-q fluid treatments.  That will help with hydration and flushing her kidneys.  You can learn to do it at home and get supplies from the vet, though there are online sources that are much less expensive. 

She probably also is getting arthritic.  We gave our old girl Cosequin for arthritis.  Whatever you do, do not allow the vet to use Metacam for pain meds as that can contribute to kidney issues.

Hi Steph-yes she is already on Miralax-but the week I havent been able to get it in her-she does usually love fancy feast. but the heat really bothers her. We just don't like the AC too cold but looks like I will keep it cooler in here come Sat when the heatwave starts again.

they did sub fluids, cerenia, pepcid and Gabepentin for pain due to suspected pancreatitis. She took a short walk outside to chew grass=I only let her out for 5 minutes. then she layed down in her spot. I let her lay for a few minutes. sun is going down now so we are all back in the house. she sleeps in the window and gazes outside. She caught a mouse a month ago so she is definately still got zest for life.

she lost 16 ounces in 9 days. So they want to see how the next few days go. then next week ultrasound IF things don't resolve. We have a few more drugs to try but my vet thinks its pain from upset stomach since she has been so sensitive lately. I also wonder if its constipation causing gas. She looks ok but you can tell she has lost some muscle mass.

i just ordered some better quality dry kibble and we tried all the wet foods=if they made it in pate then she would eat it but for the longest time she prefered Fancy feast turkey and giblets. 

the vet ordered transdermal pepcid and gabepentin  and a vial of cerenia. If I need to start subfluids she will help me set up what I need for at home but she seems ok for fluids but today she did 100 ml because of the heart issue. She said normally she does 150 to 200 for vomiting type patients but she feels this will help. hopefully she will make another stinky poop. tomorrow morning i will syringe her the miralax. i have put enough meds in her for one night.

and xrays showed nothing significant. 

she said it could be lymphoma, cancer or the kidney disease progressing. If she doesnt improve in the next 2 days I will have them do another round of bloodwork. But normally the Cerenia works like a charm. The heat really affects ALL of us. Me included.

To help with the heat, you can put ice in a shallow dish like a 9X13 casserole dish and then place it in front of a fan.  That will help cool the air.  You can also take a balloon and fill it partially with water.  Place it in the freezer.  Once frozen, remove the balloon and place the solid ice form in a dish and place in front of the fan.

What I found with my kitty was that because she's not eliminating her poop, there's no where for waste to go in her intestines.  So, her tummy became upset, similar to indigestion.  Once she pooped or her tummy calmed down, she would eat small meals better. It was a constant battle with her to get her to eat.  She was also a carboholic and loved her crunchies, so it was a balance to keep her eating.

Oh, Foxxycat. I am so sorry to hear this. I will post more tomorrow. Fingers crossed

thats exactly what i think is going on. she gets the burps and just sniffs and meows pitifully. I know she is hungry.

i just stuck her kibble in her face and she ate quite a bit. i stopped after a minutes. I will do this again at midnight then 2 am then 5am. small meals seem to work better on my tummy so it probably works for her.

three nights ago i gave her babyfood=normally she has no prob eating the entire bottle. this time a few licks then turned head and growled at me.so that tells me its nausea. i am really amazed how well pepcid and cerenia work. they wanted to do pepcid a year ago. i have been fighting to get the pill in her for the past month. i should just smash it up and put it in butter. she licks butter. thats something i forgot about. she LOVES butter.

Floey nibbled some more last night. I woke at 3am and its now 7:30 and  I hope I can go home after work and get some sleep.

Floey also ate some tuna juice. She slept in her window seat all night. Sometimes she curled up.  I checked on her to make sure her breathing is ok. It's a tad higher than before but nothing alarming. She peed several times and this morning I gave her miralax-there was also some in her tuna. I got bowls of water all over but the vet said she probably won't drink water for a day as she got 100ml of ringers fluids last night.

((hugs)) Foxxycat...

I know Artie will not eat if he is full of poop.. So I give him a bit more of miralax. 

The pepcid I tried having compounded at a semi-local independent pharmacy. No matter what flavor I got, Artie was still hating it, spitting it out and such. I finally took a little taste of it myself...OMGosh!! disgusting.. no wonder he spit it out. I could not get the bitterness out of my mouth. 

I finally decided to go the gel cap route. 

Too bad Floey is such a bear about pilling. I think you are right to get the Cerenia injectable and the Pepcid derm. 

As you all ready know, fluids can really perk up a cat. Artie has had the Vet do that several times. It gave him more of an appetite, and he pooped also. Hoping it does the same for Floey.

The weather is gorgeous out there right now. Wishing Floey gets a break from the heat, at least to get her turned around. Yes, I would definitely keep the AC on for her. She has beautiful long fur. The heat must really get her suffering. I have been having a hard time breathing outside when it is so humid. It is my asthma, so I can imagine how she feels. 

When the heat returns, tomorrow, I would have the AC on for her. Jon can always go outside to warm up. That si what I do. I keep it on 24/7...I find my guy is not caring for the heat also. I discovered that yesterday--and he is short haired and a lot younger than Floey. 

I know you are doing all you can for her. It still hurts, no matter whether it is our first or hundredth cat. They are part of our family. They are our kids. We love them. You are so knowledgable and your Vet seems to be working with you..that is awesome. Very hard to find. 

((hugs)))

I'm sorry to hear this.  Sending prayers to your Floey.

A new canned food I tried for Sandra was Spot's Stew Wholesome Chicken.  It was a hit with her before she took a turn for the worse and stopped eating completely .  I also used to mix baby food with the canned food and she also like that too when she was doing ok.

Sending hugs to you and your girl  .

We had her fur shaved off in end of May beginning of June. It isn't as short as I usually have it as she gets cold in her old age.

At home she lays on her back when it gets too hot. I may have Jon help restrain her to buzz some more furr off since it has grown in. Its about an inch long.

thank you for the suggestion. she doesn't like any chunky type foods. I think this time I will stick with kitten chow type of foods. We need to get her muscle back but we have to be careful of overloading the kidneys with too much protein. I got an order from chewy coming in today. I think once we get her medicated on a regular basis then she will do better.

the funny part about the AC is she still sleeps in the hot rooms. So this time hopefully I can set up some beds for her in the livingroom. Ithink she doesn't like the loud tv and prefers fresh air but this time I rule the house with an iron fist.

we have had a decline in health-she keeps bugging me but I don't know why. I did 75 ml of fluids last night under advisement of vet=she only peed once. Is this normal?

The night she got 100ml tuesd night she peed 3 times and I thought that was good.

Thur they did 100 again=only peed once right after then again 10 hours later.

last night was Friday and then sat am at midnight I did the fluids again.

I did it because she has been drinking excess water out of the faucet more than I have seen her in a long time. even after doing fluids she still wanted to drink but not as much. I checked hydration-it was OK. some tenting over her hindend but not on neck. gums were sort of tacky but not as bad as tues night.

I also gave her a shot of Cerenia=the Pepcid didn't come in yet so I crushed some up this morning and put in tuna juice=she didn't like it but tolerated better than babyfood. I only got half of the 1/4 tab in her.

at 6 she nibbled a few times at dry. My boyfriend Jon thinks she may have sores on her mouth as it looks like she is having a hard time picking up food.

I had the vet look in her mouth 4 times since this started on July 10 and nothing noticeable=no bumps but we didn't look under her tongue.

Just wanted to give an update and notes to follow our journey however it lasts.

I had the dreaded end of life talk and he doenst think its her time. he said she still purrs and grooms herself. I said I don't want to wait for her to suffer and be yucky feeling. He said if you think its time then you do what youwant but I think you are jumping the gun.

So this is so hard=I see so many threads on here asking the same thing=when is it time? Maybe I am a coward and don't want to wait until a point of no return. I still feel confident I can keep her comfortable with the meds=the Pepcid seems to make the most difference. She looks out her window all day or pokes around outside.

Today I am working a half day to go home early and keep eye on her. I will look inside her mouth one more time but all I saw was a bit of discolor on her tongue from the liquid med paste I made up. her gums and tongue nice and pink. breathing good and deep. meows. purrs soooo loud!! 

I wish we knew what was going on. the vet suspects something is hiding in the intestines and suspects lymphoma or other inflammation type disorder. BUT the vomiting stopped since we started the meds.

My next step is a steroid IF she doesn't improve. For now we just do the best we can. She wont sleep with me. is very independent.

With Sandra they were hoping to do and ultrasound of her abdomen.  The vet decided to hold off since she would start having breathing difficulties when the'd put her on her back from her heart issue.  Maybe an ultrasound would help figure out what's causing your girl's tummy troubles?

Sending prayers and hugs to you and your baby  .

We ended up going back to the vet. Floey has a raging bladder infection. They did urine on July 10 but they didn't see blood only bacteria. They said it was bacteria that is in the bladder. So next time we have illness I will ask for urine analysis. We didn't culture it. I probably wouldn't be able to afford it anyway.

They gave her convenia due to hard to medicate and bupre injection. I gave her the transdermal pepcid at the hospital. It just came in the mail. They want me to give her gabepentin as well. I don't know if I should? Seems like a lot of meds. Shes been sleeping since 4pm. Its 8 now.

I'm going to leave her alone tonight. She's sleeping in the office. I found out that they don't like air conditioning. So I turned it down to 73. I'm hot but they don't seem to be.

I gave her 100ml fluids as requested by vet. She ended up peeing on the table so they used that suction thingy to pull it in right in the stream of urine.

They said it had blood n protein in it. So we did blood work because she has been so finicky about eating. Her kidney level is 1.5 which she said is perfect. I don't remember what the other one was. I think 26? Does this sound right? She said her total protein was lower than last time but we figured it is from not eating. Everything else looked normal.

Her electrolytes were within normal range. I noticed the sodium was on the high normal but she wasn't too concerned.

just...... 's...

Thank you! She's resting in her window bed. She peed a good amount this time. She hasn't eaten but her blood work didn't show liver issues. I think that tomorrow she will start to eat once she starts to feel better. The pain meds probably making her tired.

We had a dickens of a storm and the meds probably made her not hurt as much.

I still have to give her gaba but I figured that she has enough chemicals swimming around in her body right now.

@foxxycat  ---((hugs))...hopefully it will be a bit cooler today and Floey, along with pumpkin face, will feel better...

Floey still isn't eating as well as she usually does.

I asked the vet if they can give mirtazapine to her and do I have to pay the $76 exam fee? I still have an appointment Tuesday with the regular vet. I don't think that the transdermal gel is working as well.

Plus they never smelled her mouth. I think she has something like a cold ontop of this. Her mouth stinks just like pumps did when pumps was ill. Pumps sneezed last week and floeys eye leaks a bit. I tried to syringe some lysine but she wouldn't let me. I got some canned pumpkin into her and fluids. At least the fluids will keep her going but I don't know why she won't eat.


Her bloodwork was very good last night. I wonder if I didn't put the pepcid gel in her hair correctly. Hopefully this cold or whatever gets lost soon. She doesn't have a fever which pumps did when she was ill. I think floey is sick of vets and stressed out.

Trying to leave her alone. She munched this morning. But not sure if maybe she is eating a ton of grass? She was outside with me early this morning and munched away.

She looks better though. She doesn't have that pain gaze anymore.

Yesterday afternoon we took Floey to a vet for an ultrasound.

She's has many things going on.
Enflammed pancreatis, enlarge spleen, abnormal shape to liver, and the dooser. She has an orange shaped tumor wrapped around the right kidny And it probably hasn't functioned in awhile. Then the tumor spreads out like an orange with sections pulled apart in her small and large intestines. My girl is very ill. The not eating has been due to the tumor and other organ abnormalities.

They agreed to no more heroic efforts. Euthanasia will be done today. She got a shot of pred in her thigh to keep her comfortable. She's eating and drinking but its due to the drugs. We cried all night and still.

I won't let my girl suffer. Pray for us to do the right thing.