Treatment for nausea in cats
January 5, 2024 10:46 AM Subscribe
Our cat has early kidney disease and struggles with nausea which is affecting her appetite. What successful treatments did you use for your cat's nausea and how did you administer them?
She is difficult to pill, especially something like famotidine which is bitter and has to be administered without food. She eats on her own schedule, so administering something thirty minutes before food is tricky. If you've used famotidine or another pill, how did you do it?
She is difficult to pill, especially something like famotidine which is bitter and has to be administered without food. She eats on her own schedule, so administering something thirty minutes before food is tricky. If you've used famotidine or another pill, how did you do it?
Cerenia is a wonder drug against nausea in cats. Unfortunately it can't be given as an injection, my vet told me, because it feels like it burns, going in. If you can pill the cat at all, Cerenia is a great thing.
My first cat who had kidney failure, in the late 1980s, felt better when given an aluminum-containing antacid to bind phosphates, because the high phosphate levels of kidney failure gave her nausea. I think I mixed the powder with her food. Now they give cats a quarter of a famotidine (Pepsid) tablet for the same reason.
I learned to give metoclopramide shots to my cat who had nausea caused by intestinal cancer because he simply could not be pilled. Giving subcutaneous shots to a cat is super easy: you just pull up the skin between the shoulder blades, and inject into the space. The vet tech showed me how to do it.
posted by metonym at 11:02 AM on January 5 [2 favorites]
My first cat who had kidney failure, in the late 1980s, felt better when given an aluminum-containing antacid to bind phosphates, because the high phosphate levels of kidney failure gave her nausea. I think I mixed the powder with her food. Now they give cats a quarter of a famotidine (Pepsid) tablet for the same reason.
I learned to give metoclopramide shots to my cat who had nausea caused by intestinal cancer because he simply could not be pilled. Giving subcutaneous shots to a cat is super easy: you just pull up the skin between the shoulder blades, and inject into the space. The vet tech showed me how to do it.
posted by metonym at 11:02 AM on January 5 [2 favorites]
If you aren't already using gel caps and a pill popper to pill her, that may help. It made a huge difference for us. My cat has a great temperament but it still took me a long time to learn to pill her quickly and with the least trauma to both of us. Kevlar gardening gloves with finger holes helped me pill her without getting scratched up, while letting her grab my hand so she could still feel in control of herself.
Depending on her bloodwork numbers, and your vet's recommendation, subcutaneous fluids administration can also drive down creatine numbers and reduce nausea. (The syringe method with a butterfly needle made it much easier for us.)
My cat kidney disease facebook is full of people who recommend slippery elm bark, but I've never tried it.
posted by celare at 11:03 AM on January 5 [3 favorites]
Depending on her bloodwork numbers, and your vet's recommendation, subcutaneous fluids administration can also drive down creatine numbers and reduce nausea. (The syringe method with a butterfly needle made it much easier for us.)
My cat kidney disease facebook is full of people who recommend slippery elm bark, but I've never tried it.
posted by celare at 11:03 AM on January 5 [3 favorites]
I do not remember the name of the anti-nausea drug we gave my late cat, apologies, but it was available as a gel through a local compounding pharmacy and we were able to just rub it on the inside of her ears.
posted by We put our faith in Blast Hardcheese at 11:26 AM on January 5 [2 favorites]
posted by We put our faith in Blast Hardcheese at 11:26 AM on January 5 [2 favorites]
Mirtazapine (brand name Mirataz) in gel form was what our vet prescribed when our previous kitty's kidney disease progressed to the point where she stopped eating. You give it by rubbing the gel into the inside of the ears. It worked pretty well for a few months, and when it stopped working was one of the first signs that our kitty wasn't long for this world.
posted by firechicago at 11:33 AM on January 5 [6 favorites]
posted by firechicago at 11:33 AM on January 5 [6 favorites]
Cerenia (maropitant) and Zofran (ondansetron) can safely be used in cats. I've known some vets who argue that Zofran is far and away the superior choice in cats for controlling nausea and vomiting. Cerenia is given once daily, and Zofran can be given once to twice daily. You also don't have to time their administration with meals. You can buy empty gel caps to put these tablets in, and these can make administration easier. I'd also talk to your vet about what stage of chronic kidney disease (CKD) your cat is in, expectations for progression, and your plans for monitoring kidney values. It may be an appropriate time to start administration of subcutaneous fluids, which will help with hydration, nausea, and comfort. CKD sucks! Good luck to you and your kitty.
posted by OsoMeaty at 2:18 PM on January 5 [1 favorite]
posted by OsoMeaty at 2:18 PM on January 5 [1 favorite]
Cerenia (maropitant) can be compounded into a topical gel. You rub it on the inside of your cat's ear, and they just think they're getting a lovely ear rub.
We've used Cerenia ear paste at various time for both our cats (one has IBD and one gets car sick), and it's a wonder drug. The topical/transdermal version is pricier than the pills, but 100% worth it as the administration is so much easier on both cats and humans. No need to try to shove a pill down your cat's gullet every day. (If you don't have a local compounding pharmacy, Chewy sells it here.)
posted by emilyanemone at 5:27 PM on January 5
We've used Cerenia ear paste at various time for both our cats (one has IBD and one gets car sick), and it's a wonder drug. The topical/transdermal version is pricier than the pills, but 100% worth it as the administration is so much easier on both cats and humans. No need to try to shove a pill down your cat's gullet every day. (If you don't have a local compounding pharmacy, Chewy sells it here.)
posted by emilyanemone at 5:27 PM on January 5
We also used Cerenia for our cat. We crushed it up and sprinkled it on her wet food and it worked just fine.
posted by jb at 6:04 PM on January 5
posted by jb at 6:04 PM on January 5
I didn't know that they gave Zofran (ondansetron) to cats! That's funny - when I was pregnant, I had it for terrible morning sickness. My cat and I could have been on the same drug! (We use Cerenia for her instead.)
posted by jb at 6:14 PM on January 5
posted by jb at 6:14 PM on January 5
Mirtazapine (brand name Mirataz) in gel form was what our vet prescribed when our previous kitty's kidney disease progressed to the point where she stopped eating.
I had the same experience with my 17-year-old cat suffering from GI cancer. For those few months, it was such a blessing to feed a cat who wanted to eat.
posted by gladly at 7:13 PM on January 5
I had the same experience with my 17-year-old cat suffering from GI cancer. For those few months, it was such a blessing to feed a cat who wanted to eat.
posted by gladly at 7:13 PM on January 5
(Mirtazapine is an appetite stimulant (and anti-depressant, often used in senior humans who are both depressed and experiencing inappetite, I’m told by a doctor friend). It has also been quite helpful, in conjunction with cerenia, for my cat. But nausea can prevent a cat from eating even when they are hungry - treating my cat’s nausea separately from/in addition to the appetite issue has also been crucial in getting him to eat.)
The ear gel sounds great! My cat would take his cerenia in a pill pocket, but would periodically cronch down on it and get the cerenia taste, which appears to be horribly bitter and results in an unhappy, frothing cat. Putting it in a gel cap with his other meds has made pill time much easier. My cat has learned to eat the pill pocket around the gel cap while also swallowing the gel cap, amazingly and fortuitously. In either case, pill pockets are worth a try if a pill is your only option.
Every so often my cat goes through a period where he stops swallowing the gel cap inside the pill pocket, so I still have to pill him from time to time. The method that I’ve found most helpful was from the Helpful Vancouver Vet YouTube series - holding the cat’s whiskers back seems to be a key component. But learning the right amount of pressure to use when holding the cat’s head was stressful for both of us, not gonna lie. If it were a palliative care situation, I’d find another option. But if you and your vet expect your cat to live for a while yet provided the kidney disease can be well-managed, I do highly recommend developing the cat-pilling skill. The pill popper devices are also a helpful option that your cat may tolerate better than being pilled completely by hand! You get them from your vet.
posted by eviemath at 8:47 PM on January 5
The ear gel sounds great! My cat would take his cerenia in a pill pocket, but would periodically cronch down on it and get the cerenia taste, which appears to be horribly bitter and results in an unhappy, frothing cat. Putting it in a gel cap with his other meds has made pill time much easier. My cat has learned to eat the pill pocket around the gel cap while also swallowing the gel cap, amazingly and fortuitously. In either case, pill pockets are worth a try if a pill is your only option.
Every so often my cat goes through a period where he stops swallowing the gel cap inside the pill pocket, so I still have to pill him from time to time. The method that I’ve found most helpful was from the Helpful Vancouver Vet YouTube series - holding the cat’s whiskers back seems to be a key component. But learning the right amount of pressure to use when holding the cat’s head was stressful for both of us, not gonna lie. If it were a palliative care situation, I’d find another option. But if you and your vet expect your cat to live for a while yet provided the kidney disease can be well-managed, I do highly recommend developing the cat-pilling skill. The pill popper devices are also a helpful option that your cat may tolerate better than being pilled completely by hand! You get them from your vet.
posted by eviemath at 8:47 PM on January 5
The other cat, with the sensitive stomach but plenty of appetite, every so often needs a cerenia after a bout of puking has given her some self-induced nausea. But since inappetite is not her problem, we can put the cerenia just directly into a pill pocket, which she gobbles down without biting into.
posted by eviemath at 8:51 PM on January 5
posted by eviemath at 8:51 PM on January 5
Oh, also, I am unfamiliar with famotidine, but at least the pill form of cerenia that we’ve used is a once a day or every other day thing (standard dose is every other day; my cat gets a daily cerenia), and long-acting. So you don’t have to worry so much about timing before food.
posted by eviemath at 8:55 PM on January 5
posted by eviemath at 8:55 PM on January 5
We were able to hide the tiny Cerenia pill in a bit of cheese or fish, or even in her wet food.
posted by Ochre,Hugh at 12:01 PM on January 6
posted by Ochre,Hugh at 12:01 PM on January 6
I've got a kidney kitty too! She's a tiny thing, and when the nausea kicks up we use mirataz on her ears, but 1/2 a tab of ondansetron a day is usually enough to keep her eating. She also gets 100 ml of subcutaneous fluids every day, phosbind powder on her prescription kibbles, and extra potassium (her kidney disease is pretty advanced though, and she also has an SUB port). I use a kind of paste you can get on chewy that's bacon flavored to stick the ondansetron and potassium pill together, and then go in real quick from behind with the pill popper. This is part of a daily routine now and it's gotten a lot easier with practice. She DETESTS liquid medicine, and honestly just shoving the pill down her throat super fast is least traumatic for everyone involved.
Honestly, the thing that's helped the most, prolonged her life, and definitely improved quality of life is the daily fluids. She literally sits on my lap and purrs while we do them, and it takes about ten minutes total. You may wish to talk to your vet about having some on hand and practicing giving them, dealing with the needles, et cetera. If she's throwing up frequently, just having that little bit of extra electrolyte support can reduce nausea and get her to her food bowl more often.
posted by lriG rorriM at 3:51 PM on January 6
Honestly, the thing that's helped the most, prolonged her life, and definitely improved quality of life is the daily fluids. She literally sits on my lap and purrs while we do them, and it takes about ten minutes total. You may wish to talk to your vet about having some on hand and practicing giving them, dealing with the needles, et cetera. If she's throwing up frequently, just having that little bit of extra electrolyte support can reduce nausea and get her to her food bowl more often.
posted by lriG rorriM at 3:51 PM on January 6
My CKD cat also does not want me to give her anything she doesn't want. It's been really hard, especially since it took her literally years of living with me to allow me to give her scritches - she was possibly a little feral when I got her (who knows), and she's just extremely protective of her bodily autonomy. I struggle with feeling like I'm failing her by not getting her the treatment she needs, because I'm also so uncomfortable with/not good at violating her boundaries. It's made worse by her increased wariness of me - her trust was so hard-won, it hurts to erode it.
I think she's close to 18 now, so I try to remind myself that I've done a good job taking care of her for a long time, and that I'm doing my best. IDK if these are things you've struggled with, but if so, know that you're not alone!
She gets Mirataz, but the vet prescribed a massive dose that just seemed too big, given my cat's reaction. I give it once or twice a week in about half the dose prescribed, rather than every other day as prescribed, and it does make her eat more. But she also gets very vocal and kind of a hyper/aggro energy on it. Sometimes she attacks me in the night. Eviemath is right that Mirataz is for appetite stimulation and may not help if the nausea is too strong.
There's an extensive website and associated online forum where I've learned a lot about CKD in cats. It can be a little overwhelming, but it's worth checking out. I'm particularly envious of everyone who's able to give their cats subcutaneous fluids, as it does seem like the best treatment (and my vet prescribed it) but my cat absolutely will not have it. CKD leads to dehydration in cats, which is why it's so good if you can get them on wet foods, and why sub-q's help so much. Think about what it's like when you feel dehydrated, maybe hungover or something - just a yuck-bummer.
Good luck. You're doing your best.
posted by TimidFooting at 8:32 AM on January 7
I think she's close to 18 now, so I try to remind myself that I've done a good job taking care of her for a long time, and that I'm doing my best. IDK if these are things you've struggled with, but if so, know that you're not alone!
She gets Mirataz, but the vet prescribed a massive dose that just seemed too big, given my cat's reaction. I give it once or twice a week in about half the dose prescribed, rather than every other day as prescribed, and it does make her eat more. But she also gets very vocal and kind of a hyper/aggro energy on it. Sometimes she attacks me in the night. Eviemath is right that Mirataz is for appetite stimulation and may not help if the nausea is too strong.
There's an extensive website and associated online forum where I've learned a lot about CKD in cats. It can be a little overwhelming, but it's worth checking out. I'm particularly envious of everyone who's able to give their cats subcutaneous fluids, as it does seem like the best treatment (and my vet prescribed it) but my cat absolutely will not have it. CKD leads to dehydration in cats, which is why it's so good if you can get them on wet foods, and why sub-q's help so much. Think about what it's like when you feel dehydrated, maybe hungover or something - just a yuck-bummer.
Good luck. You're doing your best.
posted by TimidFooting at 8:32 AM on January 7
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Good luck to you and your kitty.
posted by XtineHutch at 11:02 AM on January 5 [1 favorite]