Is Anyone Treating Their Youngish Cat With Both Cerenia And Prednisolone?

plkboise

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My sweet Maine Coon mix, Eleanor, has been diagnosed with IBD. She is almost 8 now and her symptoms started when she was 6. We got some relief from a hydrolyzed protein food. She has dry stool (no diarrhea), but vomits uncontrollably without treatment even with the HA food.

She has been on Cerenia for about a year with good results until about 8 weeks ago when the Cerenia seemed unable to control her vomiting any longer. The vet had me withhold her Cerenia and we added prednisolone. She's taking 4 mg twice a day for two weeks, then is to drop to 4 mg once a day, and then we were planning to evaluate. I should also say that we compound her medications because getting the Cerenia tablets reliably into her was too hard.

So - for two weeks with the twice-daily dose of pred and no Cerenia she did not vomit at all. Her behavior was altered, and she was a little withdrawn and anxious, but no vomiting and the behavior changes were, I think, mild (unless you are her doting mother, that would be me). Except she ate and drank a lot, which was good - she'd been losing weight.
Yesterday we went to the once-a-day of prednisolone, and last night she vomited. She also seemed to be in some pain, which I think the Cerenia and the pred help with.

Has anyone been down this path before me? The goal is to get her to every other day doses of the prednisolone, but as others have said the symptoms of the IBD are much worse than the risk of side effects of the pred OR the Cerenia. Should I reintroduce the Cerenia? Stick to the twice a day pred dosing? Any thoughts appreciated. I'll also consult with my vet, of course, on Friday, but using Cerenia long term is a new journey for most vets. Thanks for any thoughts!
 

PushPurrCatPaws

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I'm so sorry your kitty is going through this! :alright:

I wanted to ask you if you have ever scheduled an ultrasound for Eleanor? How was she initially diagnosed for IBD?


... So - for two weeks with the twice-daily dose of pred and no Cerenia she did not vomit at all. Her behavior was altered, and she was a little withdrawn and anxious, but no vomiting and the behavior changes were, I think, mild (unless you are her doting mother, that would be me). Except she ate and drank a lot, which was good - she'd been losing weight.
Yesterday we went to the once-a-day of prednisolone, and last night she vomited. She also seemed to be in some pain, which I think the Cerenia and the pred help with. ...
Her initial signs of withdrawn anxiousness could be from the sudden withdrawal from using Cerenia for a year, then stopping it. A body gets used to drugs like these, so I would probably verify that with your vet (if those symptoms she was showing 2 weeks ago were withdrawal symptoms from Cerenia). It's great she was eating well on the twice-a-day Pred dose, but only your vet would likely know if she would suddenly vomit on the day of switching to once-a-day Pred -- or the vomiting was just "building up" due to other health factors the last two weeks. I guess that's why I'd recommend an ultrasound. I didn't really have a cat with IBD per se (my last cat had pancreatitis, which is similar), so maybe other members here can chime in with their IBD experiences.

I'm glad you'll be checking with the vet on Friday!
Good luck to you and Eleanor!

(Is she the declawed kitty you got a few years ago? How is she doing otherwise?)

Lots of hugs :hugs:
 
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plkboise

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Yes, she is the declawed kitty! She is the sweetest. Thank you for remembering!

We diagnosed via an ultrasound/biopsies to rule out leukemia.

I am so sorry, I didn't make it clear that we stepped down on the Cerenia over the first 6 days. But yes, given the calming properties of the Cerenia, it must have seemed really abrupt. I thought that was pretty normal behavior under the circumstances.

My plan at the moment is to give her a second dose of prednisolone today, then see what the vet has to say. Her prednisolone dose is 4 mg per dose, so she is getting 8 mg a day when we're doing 2-a-day. Either I'll need to add back Cerenia, stick to the two-a-day dose a while longer or maybe try upping her single dose of pred? My preference would be a little more prednisolone and less-frequent-than-we-had-been-dosing Cerenia. Also - kind of sweet/sad--she loves the taste of the compounded pred (artificial chicken). I think the HA food must taste like cardboard.
 

PushPurrCatPaws

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:hugs: Yeah, the vet's input is what you need! Do the two of you have some baseline blood panels for the time before she went on Cerenia? Maybe getting some blood work done again could help pinpoint the vomiting. I personally think that when a cat is on meds longterm it might be good to keep checking how they are doing with blood work and urinalysis. I have a cat on some steroids and I just have her blood panels done every 6-8 months so we can catch any inability to process the medicine well or other health issues.


... I think the HA food must taste like cardboard.
Some kitties like the actual cardboard boxes to chew on! lol!
 
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plkboise

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Yep, we've been doing panels and she's due for another one in two weeks when we check in. Thanks for the advice!
 

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If you haven't already found these, these web site have good info on treating IBD:

IBDKitties – Helping Save Lives…One Paw at a Time
Raw Feeding for IBD Cats

One of my cats has IBD. We used Cerenia in the beginning but it wasn't for very long. Cerenia should be given half an hour before meals. If you didn't know that, give it a try. Have you tried Pill Pockets for the Cerenia? I used a bacon flavored pill dough to get Cerenia and other pills into my cat.

The hydrolyzed food might not be necessary. Most are chicken based which may trigger flare ups in some sensitive IBD cats. I feed my cat what he's always been eating, Nature's Variety frozen raw but now only in rabbit as chicken gives him a flare up. You can give a novel protein limited ingredient food a try.
 

1 bruce 1

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An acquaintance of ours has a cat recently diagnosed with IBD and she's doing really well on a Merrick canned food, LID. They're tapering her pred down a bit.
Has the vet done a liver check on her, to make sure her levels and enzymes are good? I'm not super familiar with cerenia but we've used it very short term, never long term.
 

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Adding that some IBD cats have low B12 levels which can cause weight loss. The vet can check B12 levels and if they are low, prescribe B12 injections.

It make take awhile to taper off the pred to every other day and there may be setbacks. My cat started at 4 mg twice a day for 2 months. Then the vet changed it to 4 mg once a day. A month later it was changed to half a pred (2 mg) once a day for another month. Then it was half a pred once a day every other day. We tried stopping it a month later and my cat was fine for a few days before he started coughing. That was determined to be asthma and we're guessing he had the asthma for awhile and the pred just helped control it. We restarted the pred at 4 mg twice a day for a week. Then it was 4 mg once a day for another week. Then it was 4 mg once a day every other day for 2 weeks. Then half a pred once a day every other day for nearly 2 months. Then we tried stopping it again :crossfingers: Fortunately this time around, both the asthma and IBD were controlled without the pred:yess:
 

1 bruce 1

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Adding that some IBD cats have low B12 levels which can cause weight loss. The vet can check B12 levels and if they are low, prescribe B12 injections.

It make take awhile to taper off the pred to every other day and there may be setbacks. My cat started at 4 mg twice a day for 2 months. Then the vet changed it to 4 mg once a day. A month later it was changed to half a pred (2 mg) once a day for another month. Then it was half a pred once a day every other day. We tried stopping it a month later and my cat was fine for a few days before he started coughing. That was determined to be asthma and we're guessing he had the asthma for awhile and the pred just helped control it. We restarted the pred at 4 mg twice a day for a week. Then it was 4 mg once a day for another week. Then it was 4 mg once a day every other day for 2 weeks. Then half a pred once a day every other day for nearly 2 months. Then we tried stopping it again :crossfingers: Fortunately this time around, both the asthma and IBD were controlled without the pred:yess:
Sounds similar to us!
Once upon a time our asthmatic/IBD cat was on (liquid) 1 ML twice a day, and he's now taking .3 or .4 ML once a day.
For a time he was on 1/2 ML twice a week.
I wish he could go without but anytime we skip a day to see if we can do every other day he has an attack and it's upsetting to all of us. :(
We've done some alternative things to keep his inflammation low and these do seem to help.
:crossfingers: for your cat keeping the problem controlled, LTS3 LTS3 , the combination of these problems is annoying and frustrating, and I'm so glad he's doing so well!
 
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plkboise

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If you haven't already found these, these web site have good info on treating IBD:

IBDKitties – Helping Save Lives…One Paw at a Time
Raw Feeding for IBD Cats

One of my cats has IBD. We used Cerenia in the beginning but it wasn't for very long. Cerenia should be given half an hour before meals. If you didn't know that, give it a try. Have you tried Pill Pockets for the Cerenia? I used a bacon flavored pill dough to get Cerenia and other pills into my cat.

The hydrolyzed food might not be necessary. Most are chicken based which may trigger flare ups in some sensitive IBD cats. I feed my cat what he's always been eating, Nature's Variety frozen raw but now only in rabbit as chicken gives him a flare up. You can give a novel protein limited ingredient food a try.
Thanks for the links. Yes, I started with those and considered the raw feeding, too. We went through about 5 months (and about $450) trying different foods before she went on the Cerenia as a maintenance med. She still threw up in those early days taking Cerenia, but less with Cerenia. That was also when we switched to the compounded liquid Cerenia - she was not great about being pilled and we wondered if the stress of it was contributing to her nausea and vomiting. She also doesn't like very many foods and won't eat anything that isn't kibble. No wet foods.

We tried single protein/novel protein options in prescription foods and a brief attempt at raw, but since she dislikes wet foods I had a hard time getting her to try it. And, honestly, it is hard with my lifestyle to feed her a raw diet. Her current HA food is chicken based. Her favorite flavor was an HA Salmon food I found, but it did not agree with her at all.

Thanks for caring enough to share some ideas!
 
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plkboise

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An acquaintance of ours has a cat recently diagnosed with IBD and she's doing really well on a Merrick canned food, LID. They're tapering her pred down a bit.
Has the vet done a liver check on her, to make sure her levels and enzymes are good? I'm not super familiar with cerenia but we've used it very short term, never long term.
Cerenia has become a relatively common medication for treating IBD in cats. In addition to the anti-nausea/vomiting effect, it also has some pain relief properties. The small'ish compounding pharmacy I use (which is mostly a people pharmacy) has more than 100 cat patients with active prescriptions.

She has had a liver check and the B12 test recently (both were good) and is getting more blood work in a few weeks. I don't think Eleanor will eat the LID food because it is wet, but I'll check it out!
 

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Cerenia has become a relatively common medication for treating IBD in cats. In addition to the anti-nausea/vomiting effect, it also has some pain relief properties. The small'ish compounding pharmacy I use (which is mostly a people pharmacy) has more than 100 cat patients with active prescriptions.

She has had a liver check and the B12 test recently (both were good) and is getting more blood work in a few weeks. I don't think Eleanor will eat the LID food because it is wet, but I'll check it out!
Good to know that she's been treated so well!!!
Some of these LID come in a dry form, if worse comes to worst it might be an option.
Your kitty is a lucky little soul.
 
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plkboise

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Good to know that she's been treated so well!!!
Some of these LID come in a dry form, if worse comes to worst it might be an option.
Your kitty is a lucky little soul.
Thank you very much.

I'd venture to guess most of the kitties owned by people on this site are lucky little souls, right? I wish I could make Ms. Eleanor healthy again. It's been tough to accept that she has this illness when she's so young.
 

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I’m curious on this topic of cerenia as well. My kitty was puking bile with pink in it almost daily. I already feed her a raw diet in addition to canned. I have an apt with the specialist for an ultrasound but it’s not till mid December. We are using cerenia 1/2 tablet every other day and she’s doing fantastic. Happiest I have seen her! I’d love to just skip the ultra sound and continue with the cerenia. The vet did an X-ray and saw a shadow in her stomach and suspected it was a big hairball but wanted the ultra sound to confirm. She also is a diabetic in remission for almost a year so no insulin and I monitor her blood glocuse 1x per week so we’re cautious with any steroids which could trigger the need for insulin again.
 
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plkboise

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I’m curious on this topic of cerenia as well. My kitty was puking bile with pink in it almost daily. I already feed her a raw diet in addition to canned. I have an apt with the specialist for an ultrasound but it’s not till mid December. We are using cerenia 1/2 tablet every other day and she’s doing fantastic. Happiest I have seen her! I’d love to just skip the ultra sound and continue with the cerenia. The vet did an X-ray and saw a shadow in her stomach and suspected it was a big hairball but wanted the ultra sound to confirm. She also is a diabetic in remission for almost a year so no insulin and I monitor her blood glocuse 1x per week so we’re cautious with any steroids which could trigger the need for insulin again.
Personally, I wanted the ultrasound (and possibly an endoscopy) to rule out lymphoma and to gauge the amount of thickening in her stomach and intestines. What we did instead was two ultrasounds (different vet clinics/radiologists/2 months apart) and needle biopsies of two enlarged lymph nodes. She has only moderate thickening of her stomach and no signs of cancer, just inflammation. Do you know the strength of the tablets? That was the other reason I went to compounded Cerenia - the ability to really dial in her dosage. Eleanor is 9 pounds and we tried to keep her at about 4 mg (much easier to do with the suspension than with tablets) per dose. The guidance is about 1 mg per kg of body weight for cats. Every other day should be okay for your kitty according to what I've been told and have read. If she needs a daily dose, then you would need to take a break from the med after 5 consecutive days. So a 5 days on, 2 days off type of thing.
 

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I have the cerenia for dogs it says 16 mg but I cut the tablet in half and give every other day
If this is what your vet instructed ignore me, but always be cautious when using anything formulated for dogs on cats, even if it's the same name brand medications!:wave3:
I was told once (not by a vet) that using a large breed dog dose of K-9 Advantix, split up, would be fine on cats and save money. :help::eek: BAD news!
 
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plkboise

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I have the cerenia for dogs it says 16 mg but I cut the tablet in half and give every other day
All of the Cerenia packages show "for dogs" even though it is approved for cats for occasional use. There are 12 mg, 16 mg and 24 mg tablets available. The maintenance use that you are considering and I am following are off-label.

If your vet says it is okay, you are probably fine with the 8 mg, but from what I've been told 8 mg would be appropriate for a cat that weighs about 17 or 18 pounds.

Also, to 1Bruce1's point about dogs and cats and medication--the dosage guidance for cats is about half what it is for dogs - dogs take 2 mg per kg of body weight. One of our vets mistakenly prescribed the Cerenia at that dosage for Eleanor. The pharmacist caught the fact that the dosage had doubled, and it got straightened out.

Good luck with your kitty!
 

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Yes of course vet gave this to me.
If this is what your vet instructed ignore me, but always be cautious when using anything formulated for dogs on cats, even if it's the same name brand medications!:wave3:
I was told once (not by a vet) that using a large breed dog dose of K-9 Advantix, split up, would be fine on cats and save money. :help::eek: BAD news!
 
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