Sam will not take medicine

janet k

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So Sam has a UTI. He had been taking Clavamox mixed with food beautifully. His culture came back positive for strep though, which is resistant to EVERYTHING. The doctor prescribed trimethoprim sulfa. I mixed the pill into his food and it immediately caused projectile vomiting. Thus began the almost two week long trial and error to get this pill down him. Here is what we have tried so far.

- Pilling with pill gun (by every single staff member at the vets, all with more experience than me)= caused vomiting

- Pill dipped in butter then pilled= vomiting

- Pill in pill pocket then pilled= couldn't get it down

- Pill crushed and mixed in stronger smelling food= didnt' touch it

We then had it made into a liquid through compounding it at a pharmacy

- Liquid mixed in food= didn't touch it

- liquid squirted into mouth= vomiting

We then went back to the pharmacy and had it compounded with double the amount of flavoring

- liquid mixed in food= won't touch it

- liquid squirted in mouth= vomiting

This med is not available in a sub Q, IV or IM form- that was my first question because that would solve all my  problems.
 

cocheezie

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According to this website (http://www.petplace.com/drug-library/trimethoprim-sulfamethoxazole-tribrissen/page1.aspx), there is an injection form of the drug used for horses. If the vet/pharmacy could figure out the dosage - however, a kitten-sized dosage may be too small to actually measure.

Other thoughts: Does giving the med on an empty stomach work better? Is there a substitute drug that can be used? Ask the vet is there is an antiemetic drug that can be given first to calm the stomach.
 
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janet k

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I've tried giving it on an empty stomach and he still vomits... just the pill/ liquid and stomach juices. I saw an injection form too, but I don't think they could get a kitty size dosage. The only other med that his infection is not resistant to is an antineoplastic drug that is not safe for humans to handle so that is not really an option my vet wants to try.
 
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janet k

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We havent tried that yet. My vet is consulting a vet teaching hospital today (csu) to see if they have any ideas
 

conikat

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I'd really recommend they contact the one in ( I think) North Carolina. Could be Virginia too. Anyway they are always on the cutting edge with everything.
Your poor baby, this just sounds like a major nightmare to me! I went through something similar with my cat Jessie. He had Toxoplasmosis ( very bad news). Most cats don't ( or didn't at the time--survive). Worse, I had to give him injections every day and wasn't very good at it. I pray you find a solution very soon.
Connie
 
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janet k

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Conikat, I WISH I could give shots at least he would keep those down. We live in Colorado, so they are consulting colorado state, which is a very good hospital. I am very worried about his uti spreading to other organs. .. can cats become septic??
 

peaches123

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It sounds like your kitty won't be fooled by adding the UTI medicine to food or on an empty stomach..  IMO, my Peaches kept throwing up for no apparent reason.  My vet treated her for gastroenteritis and gave her a shot of an acid reducer, some thing like Nexium, Pepcid, etc.  Perhaps your kitty's tummy is so upset from these powerful antibiotics she may need something to settle her tummy down, and the get the UTI medicine in her - just IMO.
 

white shadow

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Janet, I don't have much time to offer, so I'll drop a few tidbits for now.

You might benefit from some of the info on an UK site of a foundation dedicated exclusively to dealing with resistant infections: http://www.thebellamossfoundation.com/

Second, I'm wondering about/concerned because of the repeated vomiting....I first wonder if, perhaps, he is allergic to sulfa drugs. Allergies to these are common, and vomiting is one of the most common side effects.....lots of info on that through Google. What follows from that possibility is the question of whether/not you would even consider the risk of injecting that particular drug......

Plumb's Veterinary Drug Handbook, 7th edition, pp 948-951, suggests huge cautions if this (trimethoprim sulfadiazine) is to be used in cats.....there are also comments about the potential for its promoting crystallization in highly concentrated urine - here's one quote for you:
 Sulfonamides (or their metabolites) can precipitate in the urine, particularly when given at high dosages for prolonged periods. Acidic urine or highly concentrated urine may also contribute to increased risk of crystalluria, hematuria, and renal tubule obstructtion.
Feline urine is naturally (by nature) highly concentrated (in the absence of renal disease).

And, FWIW, this drug combo is not FDA-approved for cats, so we're talking an off-label useage.

Plumb's is very popular/prominent as a go-to pharmacological reference....you might want to ask to view it at the Vets/discuss all this with them.

I'd also want to know that they consulted with both an infectious disease and a renal specialist at Colorado state....individual specialists tend to 'silo' their info processing - putting myself in your shoes,  I'd want to ensure that info from each is weighed/considered.
 

hexiesfriend

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I can only comment on the pilling. It sounds like he hates the taste of the pill rather than having a stomach reaction. I've had this pill battle for years with my cats and have had this reaction a number of times with mine. The only thing that has worked for me is folding the pill in a soft whiskers lickin's treat chicken or salmon not the chicken and cheese flavor. You can then shape it with you fingers into a paramid and give your cat that with several other normal ones in the bag as a grouping of treats on the floor. Put the pill one in the middle of the grouping. I would guess that the pill is very bitter and compounded or broken up probably more bitter. This maybe why your cat has rejected your attempts with the treats before becuase he can taste it. If it is bitter be careful not to touch the outside of the cat treat with the finger that touched the pill. Your cat will taste the bitterness and either try to eat the treat and gag or never touch it. It's a juggling act but you can mush the pill into the treat with one finger and fold with the other. I've just been there and know how it is with the antibiotics they are very bitter. If you can't get the full dose of antibiotic in them it's hard to get them well. If he is truly getting an upset stomach from the antibiotic your vet can prescribe something for his stomach so it can accept the antibiotic. Famotidine is a common stomach medication. This one is not bitter and you can hide it easily in a cat treat.
 
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