Low potassium in Hyperthryoid, CKD, possible IBD or possible SCL

[Mac and Cats]

Chelsea only took chlorambucil and pred. You are giving more medications and so there is more of a question of timing, both for the use of the meds and for the comfort of you and your cat who may not be thrilled about having to do all of this. I see that chlorambucil is every other day in your case.

With Chelsea, we tried for the morning but it was not an exact science as she remained somewhat semi feral so it was always a little bit of an issue to put her in a purrito. It usually meant sneaking up on her with the towel if she seemed relaxed or sleepy.

The only thing I would want to know is whether or not one medication should not be given at the same time as another one and your vet could answer that very quickly and tell you how far to space them out if necessary.

Thank you! I am extremely lucky in that my guy is honestly one of the easiest cats I have ever had to medicate. He has been taking pills twice a day with me since the day I brought him home 3 years ago. I don't even have to hold him! I just open his mouth, pop it in and then give him his after pill treat. I did send a message to our vet to see if they had an opinion one way or the other, but haven't heard back yet. . She did tell me that it isn't a problem to give those medications with Chlorambucil before. I guess I was wondering if maybe it's better to give it to him in the morning so I can keep an eye on him to see if he has any reactions? But I wasn't sure what other people do. I tried to google it, but didn't find anything.

 

[fionasmom]

If your concern is to watch for reactions, then the morning would be a good time. Chelsea did fine, but I have been told that reactions start fairly quickly in the administration of it if they are going to start at all.

 

[Mac and Cats]

If your concern is to watch for reactions, then the morning would be a good time. Chelsea did fine, but I have been told that reactions start fairly quickly in the administration of it if they are going to start at all.

Thank you, that's helpful. What dosage was Chelsea on and how often did she take it?

 

[fionasmom]

Two mg every other day.

 

[silent meowlook]

Hi. I can tell you what I would do, but of course discuss with your vet.

Ideally, the Thyroid medications are given every 12 hours. For example, let’s say 6a and 6p.
If it is a Prednisolone day, I give it at 6p along with her 2nd dose of thyroid medication. On the days I am going to give the Chlorambucil, I give the morning thyroid meds as usual at 6a. Then at 3 or 4 pm, I give the Cerenia. I wait until 6p and give the pm thyroid meds and the Chlorambucil, after the Cerenia has had a chance to kick in.

The Prednisolone is better to be given in the PM and it is always best to space out twice a day meds to every 12 hours. When giving meds every other day, I like to give them every 48 hours.

Hope this makes sense. But, of course with medication questions or any questions regarding your cat’s health, it is best to ask your veterinarian.

I also keep a whiteboard schedule on the fridge that lists all the meds and the days of the week, with empty boxes that I check off when I have given a medication. I also leave a space for any notes I may have.

 

[Mac and Cats]

Hi. I can tell you what I would do, but of course discuss with your vet.

Ideally, the Thyroid medications are given every 12 hours. For example, let’s say 6a and 6p.
If it is a Prednisolone day, I give it at 6p along with her 2nd dose of thyroid medication. On the days I am going to give the Chlorambucil, I give the morning thyroid meds as usual at 6a. Then at 3 or 4 pm, I give the Cerenia. I wait until 6p and give the pm thyroid meds and the Chlorambucil, after the Cerenia has had a chance to kick in.

The Prednisolone is better to be given in the PM and it is always best to space out twice a day meds to every 12 hours. When giving meds every other day, I like to give them every 48 hours.

Hope this makes sense. But, of course with medication questions or any questions regarding your cat’s health, it is best to ask your veterinarian.

I also keep a whiteboard schedule on the fridge that lists all the meds and the days of the week, with empty boxes that I check off when I have given a medication. I also leave a space for any notes I may have.

Thank you! He only takes methimazole in the morning and the bulk of his pills in the evening. Our vet said to keep him on 5mg daily of pred for now even with the Chlorambucil every other day. I did get a message back from them and it said "The good news is that they all work together and can be given at the same time. The only thought I had was to consider splitting up so he's not getting so many all at once (thinking preventing nausea, etc). Since he's a good boy for taking meds I think you can do what makes the most sense for your schedule." So, based on that, I think it makes the most sense to give it to him in the morning. I work from home and am also a homebody, so at least I can keep an eye on him. I appreciate the feedback! This is new territory for me, so any feedback from anyone with more experience is super appreciated! Thank you!

 

[fionasmom]

I also keep a whiteboard schedule on the fridge that lists all the meds and the days of the week, with empty boxes that I check off when I have given a medication. I also leave a space for any notes I may have.

I do this for all pets who have any complicated medication schedule or for whom I need to keep an anecdotal record. It is amazingly helpful if you have to keep track of a lot or suddenly recall everything that happened over the last two weeks and recount it to the vet.

 

[Mac and Cats]

I do this for all pets who have any complicated medication schedule or for whom I need to keep an anecdotal record. It is amazingly helpful if you have to keep track of a lot or suddenly recall everything that happened over the last two weeks and recount it to the vet.

Thanks to you both for the tips. I bought some little stickers to mark the days on the calendar when he gets his Chlorambucil so I can keep track of what days he gets it. I've also started a journal on my phone/computer to take notes about how he is feeling/eating/behaving during this process in case I need to recount it later. I gave him his first dose this morning and he seems to be acting normal and has eaten about a can and a half of food (3oz). Hopefully, I will be able to say the same for him tomorrow.

 

[Mac and Cats]

Just wanted to give an update on my sweet Orange. He's on day 7 and dose 4 of Chlorambucil. I'm keeping a journal on my phone so I can keep track of what we did and how he was feeling daily. The first few days he was still eating, but not a ton. Maybe had 2-ish small cans of food throughout the day.

He ate a boat load on Monday when I gave him Mirtazapine. Historically, Mirtazapine never really worked with him prior to him taking steroids. Now, I guess it works. I have not given it to him since Monday as I don't love giving it to him and sometimes I'm worried about him eating TOO much! What a roller coaster. Yesterday he ate probably 4-5 cans of fancy feast throughout the day and even asked my husband for food this morning, which he does not ever do. He ate about half that can and 95% of a FF that I gave him when I got up, plus about 25% of a 5oz Purina EN. I reduced his pred to 2.5mg yesterday evening as that is our goal and he was doing really well. He is alert today and has even cleaned his face and ears, which he normally does very little grooming. I relocated my computer to our bed so I could observe how he is doing. He is now laying next to me instead of his bed on the floor.

The first 3 doses, he seemed to not feel super great and I have been giving him cerenia daily. Sometimes 6mg and sometimes 12mg. He's around 13 pounds at this point, which is up from 9 around a year ago (his lowest was 7.5). He had one bout of diarrhea and got it all over him on Monday. I gave him a half bath and started him on Proviable DC probiotic, which I will continue daily. He has been coming up on the bed late at night/early morning to snuggle with me on my pillow, which he has not done for a very long time. So, overall, he seems to be doing pretty well.

I will be seeing our vet tomorrow with our other cat and will ask them if I can purchase a can of the hydrolyzed prescription food, but I do not have very high hopes that he will eat it. I will also see if they have the RC rabbit or duck (I don't think they make the venison any more?). If they don't have it, I guess I'll get a prescriptoin and waste $100 on ordering it from Chewy since I'm not counting on him wanting to eat it.

Anyway, that's it for now.

 

[silent meowlook]

When I give the Chlorambucil, I give the Cerenia about 2 to 3 hours before. It seems to help avoid any nausea.

 

[Mac and Cats]

When I give the Chlorambucil, I give the Cerenia about 2 to 3 hours before. It seems to help avoid any nausea.

Thanks for the tip. I did read that somewhere and planned to try it if it seemed like it was needed. The main issue is that I'm not always home 2-3 hours after giving him his morning pills as I sometimes. have to leave for a work appointment. So, I kind of wanted to see how it goes. The vet said that any side effects may lessen with time, so I'm hoping that will be the case. He did seem fine yesterday and eager to eat every time I checked on him. I'm happy with how he is eating today also. So, maybe it's not necessary with him for now? I'm hoping I won't have to give Cerenia daily or at least if I do, I'm hoping I can give him 1/4th of a tab instead of a half. Honestly, it is so expensive if I have to give him a half tab a day! I asked the vet about the generic that came out and she said "It's not really that much cheaper." Although, I found it online and it is actually $5.50 cheaper than I am paying now, which adds up.

 

[Mac and Cats]

Update on my Sweet Orange. He seems to be doing ok. I switched to Budesonide from Pred about 2 weeks ago. He does not seem quite as enthusiastic about food as he was on Pred. He is still eating, but he's a bit pickier. I've been using Mirtazapine (oral) about once a week. I truly hate to use it because he's a tiny monster. Following me around and restless begging for food but I have to give him the right food, which changes every time. So, I have to open like 8-10 cans. He is normally not a talker, but he is very much a talker on Mirtazipine. He still seems to be maintaining his weight. The doctor said to stick it out for a month and monitor is weight. Make an appointment in a month and if he has lost/isn't eating make an appointment sooner and switch back. He is mostly acting normal, and came to sleep next to me last night all night. So, at least there is that. We are just taking it day by day. So far, he's doing ok. I'm hoping for the best but expecting the worst with him and Molly and not sure how much longer we have left with either of them. Could be a few months. Could be a few years. I've been through this 3 times (with various health issues) in the last few years and 5 times in my entire life. Trying to just take it day by day and week by week and trying to be thankful for the days I get.

 

[fionasmom]

Thank you for letting us know! I hope that you continue to see improvement.