Been over 24 hours and gabapenten isn’t wearing off

[Draco]

He sat though his second session and complained the entire time. I think he’s too weak to fight me on this. I got 20g and 22g needles from the vet and using 20g seems to be easier. I also warmed the fluids foo

honestly, I’m still not feeling optimistic. He isn’t eating his dinner. He picked today, unless my other cat ate the food. I don’t know

 

[FeebysOwner]

Are you currently giving Monet an appetite stimulant and an anti-nausea? I think you need to try those and see if they help. Mirataz is a transdermal appetite stimulant to rub into Monet's ear; most vets carry it, and it can also be ordered through Chewy too.

Anti-nausea meds most commonly used with CKD cats are Cerenia or ondansetron, sometimes both. Which works better, really depends on the cat. But, if you are having trouble getting oral meds into him, ask the vet about a Cerenia injection which can be given subcutaneously. I know it can sting a bit when given directly into the skin, but I wouldn't think that would be so much the case if given during a sub-Q session - a question for your vet. I was starting to dialog with my vet about giving the injection through Feeby's sub-Q line, but things changed for her, and our conversation was put on the 'back-burner'. So, if I were you, I'd ask if that is an option for you. It can never hurt to ask.

 

[Draco]

Are you currently giving Monet an appetite stimulant and an anti-nausea? I think you need to try those and see if they help. Mirataz is a transdermal appetite stimulant to rub into Monet's ear; most vets carry it, and it can also be ordered through Chewy too.

Anti-nausea meds most commonly used with CKD cats are Cerenia or ondansetron, sometimes both. Which works better, really depends on the cat. But, if you are having trouble getting oral meds into him, ask the vet about a Cerenia injection which can be given subcutaneously. I know it can sting a bit when given directly into the skin, but I wouldn't think that would be so much the case if given during a sub-Q session - a question for your vet. I was starting to dialog with my vet about giving the injection through Feeby's sub-Q line, but things changed for her, and our conversation was put on the 'back-burner'. So, if I were you, I'd ask if that is an option for you. It can never hurt to ask.

yes to both. I actually have him the anti nausea about 2 hours ago. I think he ate it. It’s so small I’m not exactly sure. The stimulant I gave him this morning on the ear. I asked the receptionist to leave a message for the doctor about alternative anti nausea meds- liquid or even the shot. I’d hate to give the shots to Monet but if it gets him eating I will have to do it

hopefully she will call me back tomorrow with options

 

[iPappy]

I've found with giving pills that giving an empty piece of the pill pocket or treat first, then maybe another, then the one with the pill in it, then another, etc. can help, but that's if his appetite improves. It seems like they can be suspicious of those pills and if they get into a rhythm of eating those treats, the one with the pill will just go down while they go to get the next one.
I certainly hope he makes a turn and is feeling better. When Sarah wasn't eating, it seemed like a full bowl of food was overwhelming for her. She did eat some plain baby food, but I placed just a tiny little drop at a time on the floor. (For some reason she didn't want to eat off of a plate or bowl.) A little 1/2 teaspoon at a time seemed to not overwhelm her and she would eat some for me that way. Might be worth a try.

 

[Draco]

I can try offering the treats without the pill inside. He's just so unmotivated by anything right now, even his favorite freeze-dried treats. I also put smaller amounts of food on a paper plate and spread it around. Offered the raw and wet cat food for options (so far he's only eating the raw)

He only had two bites of breakfast. I managed to get another anti-nausea meds in him. At least I hope he didn't spit it out where I can't find it. I gave him another appetite stimulant on his ear too and left food out for him, hope my other cat doesn't find it and eat it before he does.

Anyone know if cats feel pain when they're at this point? I'm trying to understand why he's hiding away instead of being his usual self. Is he hurting? He's loafed up much of the time. I'm debating on giving him a small tiny dosage of gabapentin if he's in pain, but I don't want to give it to him on an empty stomach either.

Also, what's the typical amount of food they generally eat at this stage? Maybe if I have a better frame of the standard meals I won't be fretting as much.

 

[AbbysMom]

Abby is in stage 3, although she goes for blood and urine this morning and we may hear otherwise. She’s down to 6.5 pounds. My goal every day is two small cans but she’s all over the map. We’ve had a lot of one can or one and a quarter can days lately. She ate two and a half though yesterday. i would have given her cerenia yesterday but after your experience I held off since she got gabapentin this morning.

The past few days she’s been refusing her antihistamine, which is normally wrapped in a soft irresistables treat. I’ve had to add Fortiflora and a sprinkling of freeze dried salmon to the bowl.

 

[epona]

Even my stage 4 CKD boy who is food motivated and has always been a pig doesn't eat as much as he used to, he'll tuck in voraciously when I put a bowl of food down for him but he won't get all the way through it like he used to.

He's down to just over 3kg, which for a cat that once used to be very muscular and over 5kg in his prime, I find difficult - he's very underweight, visibly so.

I understand the worry about trying to get food into them. Even if Jakey isn't so bad and is still eating a bit, I've experienced inappetence with previous cats, and it's just on your mind constantly thinking about how much have they eaten, how can I get them to eat a bit more.

 

[Draco]

Abby is in stage 3, although she goes for blood and urine this morning and we may hear otherwise. She’s down to 6.5 pounds. My goal every day is two small cans but she’s all over the map. We’ve had a lot of one can or one and a quarter can days lately. She ate two and a half though yesterday. i would have given her cerenia yesterday but after your experience I held off since she got gabapentin this morning.

The past few days she’s been refusing her antihistamine, which is normally wrapped in a soft irresistables treat. I’ve had to add Fortiflora and a sprinkling of freeze dried salmon to the bowl.

Even my stage 4 CKD boy who is food motivated and has always been a pig doesn't eat as much as he used to, he'll tuck in voraciously when I put a bowl of food down for him but he won't get all the way through it like he used to.

He's down to just over 3kg, which for a cat that once used to be very muscular and over 5kg in his prime, I find difficult - he's very underweight, visibly so.

I understand the worry about trying to get food into them. Even if Jakey isn't so bad and is still eating a bit, I've experienced inappetence with previous cats, and it's just on your mind constantly thinking about how much have they eaten, how can I get them to eat a bit more.

Seems like thus far cats with CKD just don't eat much. Still worrisome. He still refused the fortiflora, I tried a bit more last night.

AbbysMom , I get it, the gabapentin has become scary. I don't know what to do with his vet appointment since he becomes feral and stressed out. The vet advised me to call the day before to discuss the gabapentin. I'm worried about that given his last reaction.

epona Monet's been the same. He'd eat anything I put before him without hesitation. Its hard to watch a cat with a once voracious appetite not eat much at all. If you find something Jakey loves, let me know and I'll do the same to try out.

 

[FeebysOwner]

Feeby's last tests placed her in Stage 3 CKD, but that was months before her death. She also had other ailments (hyperthyroidism, high BP, arthritis, lymphoma), so I have no idea the impact of those on her overall eating/behavior.

She was lucky to eat around 2oz of a 3oz can of cat food. But, most of the time, she gladly ate baby food meat - sometimes as much as two 2.5oz jars in a 24 hour period. So, the brux of her calories came from the baby food meat, and I was able to keep her around 200 calories per day because of that. I added a supplement to them to make them nutritionally complete. She was still steadily losing weight. She probably ate about 300 calories per day in 2022, and then maybe 250 per day in 2023. So, her intake was dropping as time passed.

She started out heavy before any diagnoses, and was still weighing around 13 pounds in mid 2023. Her weight at the time of her death was just under 9 1/2 pounds. So, she lost a little under 4 pounds in the last year of her life.

She was also becoming increasingly weak. In the last 6 months of her life, she had pretty much stopped moving about a lot. In her last 3 months, we were carrying her around quite a bit. She always let us know when she wanted to be moved.

The one thing I was told was that CKD is not generally considered painful, but I think a cat can feel unwell enough to make them appear as if they are in pain.

I did give Feeby buprenorphine, just in case. Whether or not it helped any, I truly can't say. I only gave her 1 dose a day (standard is twice a day), and never really saw that it made much difference one way or the other.

 

[silent meowlook]

Hi. It will be easiest to give the fluids higher up on the cat. It isn’t as sensitive if you give in the scruff. I also point the needle away from the head. It’s just what works best for me.

 

[Draco]

Feeby's last tests placed her in Stage 3 CKD, but that was months before her death. She also had other ailments (hyperthyroidism, high BP, arthritis, lymphoma), so I have no idea the impact of those on her overall eating/behavior.

She was lucky to eat around 2oz of a 3oz can of cat food. But, most of the time, she gladly ate baby food meat - sometimes as much as two 2.5oz jars in a 24 hour period. So, the brux of her calories came from the baby food meat, and I was able to keep her around 200 calories per day because of that. I added a supplement to them to make them nutritionally complete. She was still steadily losing weight. She probably ate about 300 calories per day in 2022, and then maybe 250 per day in 2023. So, her intake was dropping as time passed.

She started out heavy before any diagnoses, and was still weighing around 13 pounds in mid 2023. Her weight at the time of her death was just under 9 1/2 pounds. So, she lost a little under 4 pounds in the last year of her life.

She was also becoming increasingly weak. In the last 6 months of her life, she had pretty much stopped moving about a lot. In her last 3 months, we were carrying her around quite a bit. She always let us know when she wanted to be moved.

The one thing I was told was that CKD is not generally considered painful, but I think a cat can feel unwell enough to make them appear as if they are in pain.

I did give Feeby buprenorphine, just in case. Whether or not it helped any, I truly can't say. I only gave her 1 dose a day (standard is twice a day), and never really saw that it made much difference one way or the other.

I tried all meat baby food and he has zero interest in it. Im going to try different flavors and hopefully there's something he likes.
thank you for your experiences, it does help to lower my expectations a bit. Im so used to him eating everything in sight. Monet was never a big cat, he was always hovered around 9-10 lbs, stocked with muscles. he's 8.5 now. He doesn't have much fat at all shored up.

Feeby was one lucky cat to have you, and you were lucky to have her too <3

Hi. It will be easiest to give the fluids higher up on the cat. It isn’t as sensitive if you give in the scruff. I also point the needle away from the head. It’s just what works best for me.

I felt I was too low in that pic last night. It should've been higher. Thank you for confirming that for me! Maybe he won't complain so much tonight.

 

[AbbysMom]

Has the vet suggesting trying the high calorie prescription wet recovery food? Many cats will gobble it up. Abby is allergic to chicken so it’s not an option for us but I was advised to try to get her to eat more kitten food for the higher calories.

 

[Draco]

Has the vet suggesting trying the high calorie prescription wet recovery food? Many cats will gobble it up. Abby is allergic to chicken so it’s not an option for us but I was advised to try to get her to eat more kitten food for the higher calories.

I asked her about food and she said whatever he's willing to eat- not helpful. (which has been mostly chicken gizzards. I know, not nutritionally complete. better than nothing). I ordered Weruva low-phosphate food to try, which should becoming in tomorrow

 

[Caspers Human]

I felt I was too low in that pic last night. It should've been higher.

I think you did it all right, at least by the looks of that picture. Don't forget that every cat is different and every cat has different levels of tolerance for things. You might find one cat that totally doesn't care about being stuck in a certain place but, if you do the exact, same thing in another cat, it would go crazy.

I think that @ S silent meowlook gave good advice but don't think that you did something wrong because your cat doesn't react the same way as another cat. I think that it would be wise to take the advice but don't think that you did it "wrong." I just think you did it in a way that your cat doesn't tolerate as well.

Keep trying slightly different ways and making adjustments until you find the method your cat tolerates best.

You probably did it better than I would have!

 

[Draco]

thank you Caspers Human for the kind words, I appreciate it.

the vet called me to check in on Monet. I told her he isn't eating much and been isolating himself. She doesn't seem very optimistic and neither do I. trying not to cry at work.

 

[Caspers Human]

You have the right to feel sad. Anybody would. (IMO, "should.")

Your cat is fifteen years old. You have taken good care of him. By what I've seen, here, VERY good care!

Yes, it's not a very happy time to know that your cat is getting old and it's sad to think that he is getting ready to cross the bridge but this is the natural way of life. Don't second guess yourself. You have taken good care of your cat and I know that you will continue taking good care of him until the time comes.

I haven't got a doubt in my mind that any cat in the world would be lucky to have you as their human, taking care of them!

 

[Draco]

You have the right to feel sad. Anybody would. (IMO, "should.")

Your cat is fifteen years old. You have taken good care of him. By what I've seen, here, VERY good care!

Yes, it's not a very happy time to know that your cat is getting old and it's sad to think that he is getting ready to cross the bridge but this is the natural way of life. Don't second guess yourself. You have taken good care of your cat and I know that you will continue taking good care of him until the time comes.

I haven't got a doubt in my mind that any cat in the world would be lucky to have you as their human, taking care of them!

OK I just cried. Thank you for those kind words <3 It means a lot. I know I am doing everything I can for him, and there's nothing more I can do. i will just keep trying, and hope he turns around. Hope for the best and prepare for the worse.

 

[silent meowlook]

Hi.
I am not posting saying that you are doing anything wrong. If my posts come off that way, i apologize. It is not my intent. My concerns and any advice I give is only with the intent to improve your cat’s well being and make caring for him easier for you.

I am not a veterinarian and do not have any veterinary board license. All advice I give is just based off of my own personal experiences working in various veterinary hospitals and having critically ill cats myself. Please do not take this as medical advice and before adding or changing any medications always check with your veterinarian first.

Gabapentin would not be my first choice for pain control because it is hard for the kidneys to eliminate and it is not a pain medication. It is an anti seizure medication for humans that they have found to have some neuropathic pain relief in cats and sedative effects. I would ask for something like buprenorphine and give 1/4 the prescribed dose to see if it helps.

The hiding is a sign of pain. The loaf position can also be. If you look at the face, any expression that looks like they are angry by human standards is usually pain. Flattened ears, tight looking whiskers all would signify pain. There is a feline grimace scale you can look at with primitive cat drawings that may or may not help.

A cat in pain will not want to eat. A nauseous cat won’t want to eat. Giving Cerenia on a daily basis can help getting the nausea under control. It is in tablet form, but you usually give 1/4 of a tablet so the size is small. It should be given 2 hours prior to other medications. That is to help prevent nausea from the other medications. After the two hours you can try offering food. Cerenia is also made in injectable form. It does sting but can be given subcutaneous. I wouldn’t recommend though due to the cost and the amount it hurts when given.

Pulling works best when you can put the pills into an empty gel capsule. I buy the size 0 from the local health food store. It is still bigger than I want, so I cut it to the size I need and place the pills in it. This helps because if it doesn’t go down all the way they don’t taste it. Often times these meds taste horrible. Liquid Gabapentin even compounded is one of the worst there is. I know this because I have tasted every liquid medication I have ever had to give a cat.

With an anorexic cat, I don’t like to have food be involved in the giving of medication. I don’t want any possible association between the food and medication to be considered by the cat. Often times cats come up with associations between things and bad experiences. I also do not like to force feed or syringe feed a cat. You can’t syringe a cat enough food to make a difference and you run the risk of aspiration as well as damaging the bond you have with your cat. It also causes a bad association to the food for the cat.

Appetite stimulants work, but I only like Mirtazipine or Midazolam in a micro dose. Both work. The Mirtazipine comes in a transdermal so it can be rubbed onto the cat’s ear. It takes longer to work that way.

I have used crushed temptation treats sprinkled on food to get cats to eat, and I have done regular temptation treats only if they won’t eat anything else. It is important that they eat first and worry about what they are eating later.

If the potassium is low and it often is in CKD cats, it is important to supplement it. I use the RenalK gel. It helps. But you need to know what the potassium level is to know if it should be supplemented. It should have been tested in your most recent blood work.

Phosphorus being high can make them not want to eat. Sadly most cats do not like the taste of the phosphate binders. So once again, more important that they eat. I personally found Epakitan to be the best tolerated but it is expensive and might not be worth it. It is best to give the daily dose of phosphate binder divided into each meal so the phosphorus in every meal is being binded.

Giving anything additional isn’t usually advised because you are already doing so much and spending so much, it just doesn’t make sense to do anything that isn’t necessary.

One thing that is hard for people is the guilt they feel doing all these unwanted treatments. You have to let that go if you are going to help your cat. Just do it and don’t think about the emotional part of it. Your emotions in your cat’s treatments don’t help him.
Don’t try to track him down after to apologize. You can’t apologize to a cat. When a treatment is done they want to run and hide. Let him. It just makes things worse and prolongs the entire incident in the cats eyes.

Regarding fluids, it is best to give two smaller doses a day than one larger dose. You can always give more but you can’t take away. To much fluids can cause congestive heart failure. My own cat who has a grade 3 heart murmur gets 50cc twice a day even though she was prescribed 100cc once a day.

20 gage needle is better tolerated than an 18 gage needle. A 22 gage needle just isn’t possible without spending what will seem like years giving fluids. A20 gage, giving 50cc takes about a minute for me to do. After a minute the cat will get restless. Always make sure the fluids from the previous time have been absorbed before you give more.

Vitamin B 12 can be given in one of the fluid line ports ( rubber stopper) so you don’t have to do an additional needle stick.

Blood pressure should be checked, but if it wasn’t, I don’t know that I would make a special trip just for that. You do want to keep the stress as low as you can.


I hope some of this helps.

 

[iPappy]

Hoping for the best and preparing for the worst is really all we can do sometimes. In the past few months, Sarah has gone off food almost completely a few times, but has rallied. It's very worrisome when that happens.
I had a very close relative (human variety) who was in kidney failure. She never said it was painful, but she did say often that she was just tired.
The way I see it is that we can only do what we can do, and what we do is what we know. You're doing everything known possible thing to help him, and with any luck that will help pull him out of this funk. Hugs to you both!

 

[chelseasweets]

Hi, I have used this site for quite a while but just finally registered to comment. First, sending all the love to you and your baby I really hope he improves and can stay with you longer.
I was motivated to add on a few of my experiences and tack on to other's comments.
Have you heard of Zylkene? If not, you can read up on it and decide, but I give this to my boy for his hyperesthesia syndrome and it does wonders to calm his nerves. It could be a helpful replacement to gabapentin if that is too strong for him, or even add to a lower dose of gabapentin. Our previous vet hadn't even heard of Zylkene when I told her that's what I give him, but his current vet (whom we love) really liked that it worked and we didn't have to use gabapentin, since Zylkene is a natural supplement and less side effects. Just a thought!
Also, with my cats recent episode of refusing food (big scare because he is usually savage for food) for the appetite stimulant (mentioned in a comment above) the urgent care vet forgot to tell me to alternate ears and to also wipe the previous dosed ear with a warm towel - it caused irritation for him so I called to ask about it.. They also sold me a few Royal Canin Recovery canned food since it is high nutrient, and it is apparently very tasty because he finally ate that. If they haven't suggested that, you could ask and try it.
As for getting him to take icky medicine, he is very difficult. Pills = impossible. But when I did have to get by with pills before I could have them compounded&flavored, I would powder crush them and use bone broth to mix and mask, something like Churu works too or powdered freeze dried treats mixed into it with warm water or broth aaaand sometimes I had to alternate each day with those since he would pick up on it.
I know these things my cat went through aren't related to what your boy is going through directly, but since similar things were mentioned I wanted to offer any helpful tidbits I could. Wish you both all the best!