Been over 24 hours and gabapenten isn’t wearing off

[Draco]

I will come back to reply to S silent meowlook and chelseasweets - not ignoring you. Need to come back on my laptop to properly read all.

I just wanted to pop on and say whoever suggested rotisserie chicken- I tried that and he had 4 pieces and 2 whole chicken liver. It’s not a lot but he ate something. I hope he will pick on more.

 

[neely]

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.

This sums it up in a nutshell for me. We went through a similar CKD Stage 4 experience with Carleton only four months ago so this subject is close to my heart.

Not only are you doing everything you can for Monet but you're doing it out of love and no one could ask for anything more. Now I'm tearing up with you. All my best, thinking of you and will keep Monet in my prayers.

 

[Draco]

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.

Nope, your posts are good. I don't find it offensive or took anything as wrong. I'm still learning and wading through this so I am happy to have any advice and experiences to follow! Thank you for your time in posting, I appreciate it!

I'm going to combine my reply below. Just easier to not repeat myself.

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!

Thank you for sharing your experiences, it is helpful and I appreciate it!

He does loaf up, but his face doesn't look painful to me. At least nothing that doesn't look different from his normal handsome face. Just dirty fur since he hasn't been grooming himself.

I'm going to call the vet Friday to ask about gabapentin for the Saturday visit. He gets so stressed out at the vet, the reason why he took it last time. I'm not sure what to do here. Give a lower dosage? Risk him getting angry at the vet where they can't get blood? I have to talk to her about this and see. She also advised gabapentin for his Feline Hyperthesia to take some pain away. I haven't given it to him for that, not since the last weekend where it took him 3-4 days to come out of it. I'm writing down Zylkene to ask the vet about it on Saturday.

For the appetite stimulant, the vet told me today to do every other day, alternate ear. I was doing it daily. Hope reducing it will help. She did suggest the shot, but she encouraged me to continue with the pills. She explained why but I forget. She said as a last resort I can try the shots.

Someone suggested crushing the pills and putting it in a syringe of water to squirt into his mouth. That sounds like an option to try too.

I am surprisingly OK with giving him the SubQ Fluids. I thought I'd have such a hard time with it, but it's actually simple. I am grateful my other cat let me practice on her (as well as giving a shot with a regular needle) at the vet which gave me the confidence to take care of Monet. I didn't feel guilty (as long as Monet accepts it. He did tonight thankfully) because I know it's what he needs, I know it's his only option, there's no other choice. I only felt bad the first night when he hissed and growled at me. Last night a little anger. Tonight none. It makes me feel better that he isn't too upset with me, though he does go to his little corner and not want attention. I'm gradually accepting that.

I can ask the vet about splitting the fluids twice a day. I never thought about that. I will talk to her about that on Saturday. She gave me a variety of needles (OK, I had to pay for them), 18g, 20g and 22g. I used the 20g yesterday and today and he complained. I did 18 first night and there was no complaints- though it might be because he was weak.

He has an appt on Saturday, and I hope his levels gone down. I will ask to have his blood pressure checked too while we're there.

Again, thank you everyone for following this thread and supporting me. I am feeling overwhelmed by the love on this site that I am wondering why I didn't come more often. I appreciate every kind word and advice posted.

 

[FeebysOwner]

You do need to clean his ears after a couple of administrations of the appetite stimulant. A soft make up remover pad moistened with water works just fine. It helps to stop any residue build up from accumulating in his ears and blocking absorption of future doses. If every other day dosing doesn't work, give him 1/2 dose instead of a full dose. That is what I gave Feeby every other day. It really is an experiment to find out what is best for Monet.

The smaller the gauge number the larger the needle is (I know it is in reverse of what one would think). I personally think 18 gauge is a bit big. But, if any of the needles you are using are not thin walled, it will pay off for you to get those in lieu of the ones you are using. I think they enter the skin easier. There are folks who split the fluids into two separate administrations. I am not sure what the benefit is to doing that, and the downside is that it causes you to stick him twice a day instead of just once. How much is he getting daily? I gave Feeby 100ml daily and she rarely got a pocket of fluid that had to slowly absorb - but, as long as it absorbs with a short period of time there is no harm to them developing.

As I said before, the loafing may not be pain at all, but rather the general feeling of unwellness.

I can't speak to the gabapentin, so I'll defer that to others.

 

[Caspers Human]

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.

Make sure your kitty knows that you love him. That's what you can do.

The greatest gift in the world, be thee human or be thee feline, is to pass on to the next world knowing that somebody loves you.

I am not posting saying that you are doing anything wrong.

No, I wasn't implying any such thing. I was saying that Draco hadn't done anything wrong.

 

[chelseasweets]

She also advised gabapentin for his Feline Hyperthesia to take some pain away. I haven't given it to him for that, not since the last weekend where it took him 3-4 days to come out of it. I'm writing down Zylkene to ask the vet about it on Saturday.

Awh, so he does also suffer from Feline Hyperesthesia Syndrome ~ I try to raise awareness about this and recommend the Zylkene supplement since it was a life changer for Goku & because a lot of people think this behavior is just "zoomies" and never know it is a neurological disorder they are actually suffering from. But anyway, skim over all that it's just me babbling on.
** I do hope if you try Zylkene it helps your baby as much as it does mine, and more than that I hope he improves and you get good news at the next vet visit I will be checking back and keeping you two in my mind.

 

[Draco]

Make sure your kitty knows that you love him. That's what you can do.

The greatest gift in the world, be thee human or be thee feline, is to pass on to the next world knowing that somebody loves you.



No, I wasn't implying any such thing. I was saying that Draco hadn't done anything wrong.

I tell him that every day every time. I snuggle him when he'd let me. He isn't feeling up for affections lately. generally he's never an overly affectionate cat, but he's had his moments where he just wants his snuggles. Not anymore. Selfishly, for me, I kiss and snuggle him anyway and tell him I love him.

Awh, so he does also suffer from Feline Hyperesthesia Syndrome ~ I try to raise awareness about this and recommend the Zylkene supplement since it was a life changer for Goku & because a lot of people think this behavior is just "zoomies" and never know it is a neurological disorder they are actually suffering from. But anyway, skim over all that it's just me babbling on.
** I do hope if you try Zylkene it helps your baby as much as it does mine, and more than that I hope he improves and you get good news at the next vet visit I will be checking back and keeping you two in my mind.

He's been pulling at his tail and flicking it. He has a bald spot at the base of his tail The vet at first couldn't figure out why. She thought nerve damage but it never healed. The second vet, I suggested Hyperthesia since I read about it online and she agreed it could be that. Monet has had the zoomies, but it was hard to tell if it was because of the tail or just zoomies. All along I thought it was zoomies, it's so easy to confuse it.

--

He didn't eat his breakfast. Just one tiny bite of liver. I offered different options from tuna fish to Churo, to a different brand creamy treat, to the rotissire chicken.. nothing. I don't like how he's curled up facing the corner of the wall, avoiding everything around him.

I'm brokenhearted again, and I am feeling even less optimistic. I think I need to have a serious discussion with my vet and ask if she does home visits. I'm starting to look at the quality of his life, and he's not exploring his home anymore. If I pick him up to put him in his favorite spaces he'd immediately jump off and go back to the corner in isolation. the only time he gets up is for his water bowl and to the litter box. That's not fair to him, that's not a life. I want to see what the vet says and what I can do to make him comfortable as possible.

I may have to go into work late because I can't stop crying.

He has an appt on Saturday for a follow-up. I'm going to keep trying still. I'm not giving up on him. Not until I know.

 

[epona]

I tell him that every day every time. I snuggle him when he'd let me. He isn't feeling up for affections lately. generally he's never an overly affectionate cat, but he's had his moments where he just wants his snuggles. Not anymore. Selfishly, for me, I kiss and snuggle him anyway and tell him I love him.




He's been pulling at his tail and flicking it. He has a bald spot at the base of his tail The vet at first couldn't figure out why. She thought nerve damage but it never healed. The second vet, I suggested Hyperthesia since I read about it online and she agreed it could be that. Monet has had the zoomies, but it was hard to tell if it was because of the tail or just zoomies. All along I thought it was zoomies, it's so easy to confuse it.

--

He didn't eat his breakfast. Just one tiny bite of liver. I offered different options from tuna fish to Churo, to a different brand creamy treat, to the rotissire chicken.. nothing. I don't like how he's curled up facing the corner of the wall, avoiding everything around him.

I'm brokenhearted again, and I am feeling even less optimistic. I think I need to have a serious discussion with my vet and ask if she does home visits. I'm starting to look at the quality of his life, and he's not exploring his home anymore. If I pick him up to put him in his favorite spaces he'd immediately jump off and go back to the corner in isolation. the only time he gets up is for his water bowl and to the litter box. That's not fair to him, that's not a life. I want to see what the vet says and what I can do to make him comfortable as possible.

I may have to go into work late because I can't stop crying.

He has an appt on Saturday for a follow-up. I'm going to keep trying still. I'm not giving up on him. Not until I know.

Are you offering him cold food?
It might be more appealing if you warm it up a bit - just a bit though, to about cat body temperature, don't give him food he might burn his mouth on.

I know how difficult it is. Hugs and love to you and Monet. (Lovely name for a cat btw).

 

[Draco]

Are you offering him cold food?
It might be more appealing if you warm it up a bit - just a bit though, to about cat body temperature, don't give him food he might burn his mouth on.

I know how difficult it is. Hugs and love to you and Monet. (Lovely name for a cat btw).

I warm his food, yes. I run the raw food under warm water, and zap the rest in the microwave for a few seconds.

and thank you. I'm still trying.

 

[Draco]

I was thinking on my drive to work. I'd like your opinions please. I'm also going to discuss this with the vet tomorrow, and I have a feeling she'd agree with me because she kept telling me "got to think about the quality of his life". But I want to hear more.

He has an appt on Saturday. He gets stressed out at the vet to the point where I have to sedate him with Gabapentin for the vet to even remotely check him over. Given how poor his kidneys are now and how long it took for him to get out of it (3-4 days) and the fact he isn't eating, I am really hesitant to even give him a small dose for the vet. I am also hesitant on bringing him in without gabapentin where he'd get too stressed out. I am not sure if he's too weak to not even fight the vet without the sedation, I don't want to risk him going into feral mode and the vet can't do anything and make things worse.

Then I started thinking..

What if the numbers got worse? Then what? There's nothing more to try, right? No other treatments aside from a transplant and that isn't going to happen. I am doing what I can now with the fluids and trying to get him to eat. If I am paying $400 just for the vet to tell me it got worse, it would break me knowing there's nothing more I can do. I don't think knowing the numbers would offer a peace of mind.

But what if the numbers get better? Then I can continue to do what I am doing and keep hoping. Nothing will change treatment wise.

Essentially, there would be nothing different or new to try, right? I'd just be stressing him out by taking him in just for numbers with nothing more to do. I can at least see for myself if he gets better (or worse), I really don't need numbers to tell me that. The only reason why I'd take him other than bloodwork is for blood pressure, but seeing how he's acting now with zero improvement in nearly a week, I'm not sure if it matters anymore.

I am heavily debating on cancelling the appointment and continue to do what I am doing and take care of him, knowing the vet is only a phone call away if I need her.

What would you guys do in my situation?

 

[AbbysMom]

I don't think it's a crazy thought. After how yesterday was with Abby I am not sure I will ever give her gabapentin again. Are there any mobile vets in your area that could come and do bloodwork if you wanted it done?

 

[Draco]

I don't think it's a crazy thought. After how yesterday was with Abby I am not sure I will ever give her gabapentin again. Are there any mobile vets in your area that could come and do bloodwork if you wanted it done?

What happened with Abby? is she okay? Are you okay?

There are mobile vets. But still same question. What would the bloodwork tell me? It wouldn't really make a difference to treatments and such.

 

[AbbysMom]

Yeah, I get that. If you are OK without knowing numbers that I don't think it is crazy not to bring him.

I gave Abby half the dose of gabapentin three hours before the 9:40 appointment. When we went to the vet it didn't seem like it really took effect. Same when we got home. She was a little out of it but not much. It hit her later and it it was really bad. She was due for Sub-Q's today but we gave them last night to try to flush them out. That did seem to help a bit. She's a lot better this morning but still a little groggy. Vet is supposed to call some time today with results.

 

[Draco]

Ugh, yea I can see why you don't want to give it to her anymore. That is scary! Im glad she's doing better now. let her rest and give her kissies

 

[iPappy]

For me, when it comes to these things, it comes down to if the knowledge would help *me*. Would knowing if the numbers were worsening or improving help you, or help you make a decision at some point in the time?
For comparison, I had a feeding tube placed in a cat who had an aggressive cancer we were hoping to treat. He could not physically eat or swallow, but, he was hungry. I knew the prognosis was not good, but I wanted to give him more time and was absolutely unwilling to let him die while he was so hungry. I didn't have his numbers tested beforehand, simply because the feeding tube was our complete last resort. I kind of wish I had known if his liver and kidneys were working before I tried. He did survive the surgery but passed away 9 days later.
I also had a dog (who was part of my soul, I swear) that showed some very odd symptoms on his skin, nose, and foot pads. He was diagnosed with allergies and autoimmune disease, and the treatments stopped working so a biopsy was done. He had cutaneous T-cell lymphosarcoma, with a grave prognosis. No autoimmune disease present. In his case, I felt he didn't have autoimmune disease even before that biopsy as not all the "little" symptoms fit, and knowing exactly what was wrong helps me after his passing 2 years ago. If I hadn't known, I'd still be second guessing if we missed something.
I'd say +1 for the mobile vet, if you decide you'd like to get the numbers checked.

 

[Draco]

thank you for your experiences iPappy

I don't know if knowing the numbers will help me or not. Im more concerned with his comfort. I need to take my time and think about this. Hopefully my vet can give me some insight

 

[FeebysOwner]

I cannot really offer anything other than to agree with you about discussing all of this with your vet and letting the conversation sink in before you make any decisions.

I was in a different situation from you in that Feeby was still eating some and interacting with us, despite all of her other behaviors that clearly indicated her continued demise. I can't even tell you what I would have done if I had been in your shoes. Sadly, it is really something for you and you alone to decide.

 

[rubysmama]

I won't go into all the details of Ruby's decline once she was diagnosed with hyperthyroidism in Dec, and kidney disease in May, but she went from being "ok" to needing the ER vet in a matter of hours. So I will advise you, Draco , to know where a 24 hour vet is, so you can be prepared if you should need it.

In Ruby's case, she'd gotten fluids at the vet on the Tue, when I learned her kidney numbers were really bad. Thursday evening, before I'd even had a chance to discuss with her regular vet how we should proceed, she took a bad turn, and couldn't stand up on her own. At the ER vet they said she was dehydrated again, and could have kept her and given her fluids, but that it would just delay the inevitable, so I made the difficult decision to let her go.

She'd lost a huge amount of weight, and was wobbly on her hind legs. She'd had gabapentin on the Tuesday, and like your Monet, it took a long time to leave her system, if it ever did. Not sure if it contributed to her hasty decline, but part of me feels like it did, and I really don't know if I'll ever agree to give it to another cat or not.

I'm sorry you're going through all this. It's not easy when we love our babies with all our hearts and just want them to get better. Sending you hugs.

 

[Draco]

I do have emergency vets in the area, one that I took him to over the summer that took good care of him.

I'm sorry to hear about Ruby. It's hard when they decline like that. These decisions are never easy to make.

Right now Monet is getting his fluids daily, it's all I can do. I just feel like taking him to the vet just for bloodwork that won't make a difference in his health would be too much for him. Sure, maybe I want to know the numbers, but is it worth it for his discomfort?

 

[rubysmama]

Right now Monet is getting his fluids daily, it's all I can do.

That will certainly help, as I saw how quickly Ruby got dehydrated after fluids at the vet.