Cerenia: how long to work, how long to take it for?

[spookzilla]

Hi all,

My Madeline (15 yo) hasn’t been eating well the last while and we’re still trying to pinpoint the cause. She’s been drinking and urinating a lot, but the vet says her recent blood work didn’t show signs of kidney issues. They did a urinalysis and there was a low level of protein in it (Which makes me think kidney issues). They are now doing a culture to see what exactly if anything is going on with the urine. In the meantime, we’re trying to get her eating. The vet keeps pushing Cerenia, but honestly I don’t think it’s helping. I don’t know if I’m giving it enough of a chance to work. Does it typically make them feel better within an hour or two, like people would if they took an aspirin or some pepto bismol? Or does it have to build up in their system before being effective? When I have Given Madeline 1/4 tablet (total 16 mg) if anything it makes her eat less so I don’t give her another one the next day. She does respond fairly well to Mirtazapine. She hasn’t vomited so maybe this isn’t even a nausea issue, although I understand that vomiting alone doesn’t indicate nausea. For the most part, her demeanour is normal, but cats are experts at hiding pain. I have asked the vet about giving Madeline sub q fluids but she doesn’t feel it’s necessary at this point.

We were at the vet yesterday and I was given a week long course of Gabapentin to see if it might be a pain issue. I haven’t tried it yet, I wanted to see if the Cerenia would help first. She got 1/4 Cerenia this morning and about an hour later hid under the couch for several hours (something she rarely does). Has anyone else had poor results with Cerenia?

If Madeline isn’t eating better by this evening I’m going to go back to Mirtazapine. What are people’s thoughts on Gabapentin? If the urinalysis doesn’t show the cause of her inappetence I’m not sure what we will do next. X-rays we’re suggested in case there’s something else going on

 

[FeebysOwner]

Some cats don't respond well to Cerenia, and it generally works better for vomiting. Ondansetron is more for nausea, so you might ask the vet about trying that instead. I would try the MIrtazapine and see what happens, as it can somewhat act as an anti-emetic too.

I gave Gabapentin to Feeby for potential arthritic pain, and it really didn't do much of anything (50mg twice a day), and she learned quickly how nasty it tastes - I tried 4 or 5 different compounded versions before I gave up. It is supposedly pretty fast acting, so it might warrant 2, probably 3, doses over 24 hours to help with pain.

Feeby has kidney disease and has never had an issue with protein in her urine, so not sure that is much of an indicator. You can also do the what I call the 'scruff' test to look for dehydration - gently pull up on the loose skin at the base of her head/neck and then let go. If it pops back into place quickly, no dehydration. If it goes back slowly, that would indicate a level of dehydration.

 

[LTS3]

I've always been told to give Cerenia about an hour before a meal so it has time to work.

 

[daftcat75]

In dogs, inappetence was a rare adverse event. Cerenia has not been approved for cats. It is given as off-label use. But I am not certain there has been adverse event studies with cats. I believe, from my experience with two cats and the reports I read here over and over again, that inappetence is a much more common adverse event/side effect of Cerenia in cats. Cerenia is also an anti-emetic. I am not certain how much of an anti-nausea effect it has. If Madeline isn't vomiting, I would ask about ondansetron instead of Cerenia. Ondansetron (brand name Zofran) seems to be much better at controlling nausea. Cerenia is fast acting. But again, it's anti-emetic, and probably not anti-nausea. If she hasn't responded well to it by now, it's probably not appropriate for her. I don't have any experience with kidney disease. But you may need a combination of appetite stimulants (mirtazapine or cyproheptadine) and anti-nausea (ondansetron and/or slippery elm syrup.)

 

[spookzilla]

Thank you all for your input. MAdeline definitely did not respond well to the Cerenia. After spending the morning hiding under the couch she spent the rest of the day hunched in her bed in apparent discomfort, and had no interest in food. I ending up giving her Mirtazapine around 6 pm. By 8:00 she was eating, out of bed and asking for attention. She ate overnight and this morning spent less time obsessing over the water bowl as she usually does, and even played with a toy.

This leads me to another question: will cats drink more due to nausea, regardless of the cause? I suspect there are some kidney issues going on, but if she’s nauseous from something else could that cause her to drink more? Madeline will often ask for food but turn her nose up at it and go to the water dish instead. My understanding is that Mirtazapine will also help with nausea. I agree Daftcat and Feebysowner that it might be a good idea to try ondansetron.

 

[BellaBlue82]

I agree with the above responses. It's sort of unfortunate because Cerenia is fast working, however I have seen it cause inappetence in my cats. I only use it if repeated vomiting is involved.

I have experienced Mirtaz does curb nausea, but helps extremely to assist with getting kitties to eat. Im not sure if drinking more water means they're nauseous, I've usually seen this only if there is an underlying issue such as UTI, kindey issues, or even diabetes. This is only from my personal experiences.

As FeebysOwner indicated, she may be in a tiny bit of pain. I noticed this in Nico, and a very very small amount of pain medicine made the WORLD of difference for him. I only give in short term, but it helped him overcome the pain enough to eat and begin healing.

Good luck, keep us posted on what the vet says!