Fluoxetine Side Effects (Sorry to talk so much about Poop)

[GailMJ]

My almost 3 year old Persian, Jazzy, started urinating inappropriately last spring, and we tried every possible solution to correct the behavior before finally starting her on Fluoxetine on December 16th, 17 days ago. She seems to be trigggered by any kind of change in her environment, and we know that we have some house renovations coming up in the spring, so we wanted to have time for it to get into her system. At the same time we started fluoxetine we also started using Feliway diffusers. She definitely is aware that the difussers are there and seeme to be drawn to them but I have no way of knowing how much effect they have. We started her on 5mg tablet daily, and almost immediately we noticed that she was sleeping more and her appetite was decreased, both known side effects of the drug. Whether it is an additional side effect or a result of the decreased intake, her output has also drastically changed. Prior to Fluoxetine she weighed 9.4 lbs and was eating 1/2 cup of kibble per day (she won't eat wet food), and peeing three times a day and pooping daily, with little exception. Her urinary output has gone to once a day, usually at night, and she defecates every two to three days. We are giving her 1/3 cup of kibble each day and if we are lucky she eats about half of it. I have tried various wet foods and Boars Head deli turkey, which she loves, to supplement. She licks the gravy out of the wet food, and does eat the turkey, but not like she did pre-medicated. She acts like she is hungry, but then she just doesn't eat as much. This past Tuesday, December 28th, I took her to the vet as she had not had a bowel movement since Christmas Eve, and the vet gave her an enema and told me to give her Laxatone for three days and then once or twice a week, and to cut her dosage to 2.5mg per day. She went another 3 days without defecating and then had what I would consider a normal bowel movement yesterday. Today she has eaten very little. In total she was on the 5mg does for 12 days, then I skipped the day she had the enema, and started her on the 2.5mg dose, and she has had 4 doses. I have been giving it to her at night rather than the morning, so she hasn't had her dose today. As of last Wednesday she had lost a pound. I haven't weighed her since then.

That is the long background. Now, for my questions. I know that it takes at least 4 to 6 weeks for the meds to be completely effective. She actually has not urinated inappropriately in over 3 weeks, when it was happening about every two weeks, so that part is working. But the side effects are very disturbing. For those of you who have seen these side effects and have cut the dosage, how long did it take for the appetite to return, and if you did have to discontinue the medication, how long after weaning your cat off the medicine did it take to return to normal. I haven't tried going to every other day yet and would not do that without vet approval, but has anyone tried that and is it effective? Jazzy does seem more engaged with us now that we have cut the dosage, but not to the point that she was before. Lastly, does it make any difference if you medicate in the morning or at night? Thanks in advance for your patience and input.

 

[suzeanna]

My cat Susan had aggression issues (starting last October) and once we started her on fluoxetine, we saw results pretty much immediately. Like in your case, there was also diminished hunger, peeing, and activity. Things picked up back to near normal within a month probably. Her medication formulation is liquid at 10 MG/ML strength, and she was prescribed 0.2 ml (at night mixed into her evening meal). I've gradually tapered it to 0.1 ml at night. Her behavior is still fine. I like medicating at night because if she's sleepy after taking it then that'll be better for me during the night so I can sleep better, too. The liquid medication has been nice because it's easier to precisely change the amount administered and it's easy to mix into her food. If your cat likes gravy, might she be interested in a pate with a little bit of warm water added to it and all smushed up into a stew, perhaps with crushed kibble on top? If you can get more hydration and nutrients into her then it'll help with producing more pee and poop. I also posted in another thread recently that the Nulo puree treats help give my cat an assist if I see that she's had drier or smaller poops for a couple days -- I just feed her one to help things along. Also she pees more often now (3-4 times a day) -- either because she's adjusted or the lowered dosage. I'm not sure if it's applicable to your situation, but sometimes in order to get her to pee I'd bribe her and feed her a couple treats/kibbles in the bedroom so she'd be like "I'm here already, might as well" and use her litter box. She hangs out in the living room mostly so I had to motivate her to go to the room where her box is.

 

[GailMJ]

On the advice of my former cat sitter who is now an awesome vet and still a great friend, I ordered Churu treats to stimulate her appetite and give her more liquid in her diet. They appear to be similar to the Nulo Puree treats. They arrived today and I gave her one and she lapped it up (yea!). Hopefully it will stimulate her appetite and other bodily functions! I wish she would eat wet food. It would make life so much easier, but she just is not interested so mixing liquid meds with food is out. Her food and her litterbox are in the same room, a guest bedroom. She does like for us to go in there with her and pet her when she eats, so I think that does help with her thinking that while she is here she may as well go. It looks like I have at least until the middle if not the end of January to see how all of this shakes out. In the meantime, after a failed attempt to hide her 1/4 pill in frozen butter and her decision that she no longer likes yogurt as a chaser, I ordered a piller and some gelatin capsules. Oy vey!