Liquid Medicine - Atopica & Prednisone (for IMHA)

[colliecollie]

Hi there. I've been doing a lot of reading on the site lately because of my 1 year old, spayed female, Speck, who's been diagnosed with Primary IMHA (Immune Mediated Hemolytic Anemia). When Speck got sick on 10-21-14, her Hematocrit level was 9 and she had NO platelets. After a transfusion, a couple overnight hospitalizations, a ton of drugs, special food, and good old TLC, her Hematocrit level was 28 and platelets are within normal range on 11-6-14 (reference range 29-48) after 7 days of 25 mg of Atopica in the pill form every 24 hours. 

My poor kitty has been thru hell and back and we still have no idea why... She's negative on everything; FIV, FELV, FIP (although she's been exposed), and Heinz bodies. WBC's are normal (still we put her on doxy), liver enzymes, kidney counts... Her radiographs and ultrasounds came back clean. The only thing that's strange is she has a slightly small liver. Like abnormally small. Speck (and her full sister Spike, who I also own) was bottle fed at 4.5 weeks old after losing her mom. Not sure if that makes a difference. She's a small cat at 8.25 lbs full grown. 

ANYWAYS, Speck has been on Atopica for a little over two weeks now and it's such a PITA to give. The pills were a horrible experience for both of us. She fought tooth and  nail to not swallow those. Normally pills are ok, because they're small. Not this one! It was rather large and sticky. Ugh. 

Now we've been doing the liquid for 10 or so days (.25 ml every 24 hours) and it's slightly easier to give than the pills, but it smells and tastes horrific. I accidently got a taste and couldn't get it out of my mouth. The smell gags me now too. Currently, I bribe her with packaged salmon. She goes nuts over it. She gets a few bites, then I dose her, hold her mouth shut towards the ceiling, and after a few minutes I give her more salmon.

Speck also takes 5 mg of dissolved Prednisone, .80 ml of doxy, and 800 micro grams of folic acid (per vet instructions) both AM and PM. The Atopica is PM only. I give B12 shots twice a week. Oh and pepcid AM/PM to help prevent ulcers. 

So does anyone have advice to cover up the taste of the Atopica and the meds? Even though I'm holding her mouth shut, now she drools like crazy. I've tried mixing it with food and you can still smell the Atopica over it. 

I'm afraid the little stinker isn't getting her full dose since she drools so bad. 

Sorry for the novel. TIA everyone. 

 

[cards222002]

You posted on my tread for my anemic cat, our cat did not like the liquids wasn't sure if it was the atopica or the doxicyline but he would look almost rabid after taking them. We ended up stopping the atopica on our cat since we didn't see any improvement with it after two weeks. I am going to try and push to get him on the b12 at his next appointment. Reading what others have posted I am suprised he hasn't been put on it by the vet yet.

 

[adventureme]

Sorry you're having so trouble giving meds to your cat - I too have to do the same. I find the best way with pills is to tear off a small piece of deli meat (ham/turkey) and roll the pill in it and place it in the cat's mouth. You can't just put it near their mouth you have to actually place it in their mouth gently (not being aggressive). The deli meat will mask the smell of the pill. This is how I give my cat her meds every day without any issues. The only thing you have to watch for is that your cat does not fully get it in her mouth and it gets spat out. My cat sometimes tries to out smart me by pretending that she is eating the deli meat and then when I start walking away she spits it out or shakes her head and it gets spat out. I'm on to her though and I now watch to make sure she actually chews and swallows it. I gently push the deli meat right fully into her mouth which works great.

The best way I found to give meds in a liquid form is taking the syringe and filling it with the med and then adding a little bit of tuna or salmon juice from the liquid from her food into the syringe so when you squirt it in the back of their mouth, they taste the salmon/tuna juice first which makes it much easier because they smell this first. This is the only way I was able to give my cat her liquid meds. 

Hope this helps.

 

[colliecollie]

Thanks for the replies.

So far tuna juice and salmon juice are the only things that work! If I get her to eat some salmon or tuna before her meds, she doesn't spit up as much. 

I really wish there was a way to completely mask the flavors. Last night she took her Atopica well. It's real hit or miss.

 

[colliecollie]

You posted on my tread for my anemic cat, our cat did not like the liquids wasn't sure if it was the atopica or the doxicyline but he would look almost rabid after taking them. We ended up stopping the atopica on our cat since we didn't see any improvement with it after two weeks. I am going to try and push to get him on the b12 at his next appointment. Reading what others have posted I am suprised he hasn't been put on it by the vet yet.

I would start him on folic acid asap. Just dissolve the pills in a smidge of hot water or crush them. It's at least something to start and won't do any harm since it's water soluable. The baby blood cells need all they can get to grow. 

I can't remember if you said if you were giving him any b-complex? I'm considering ordering NutriVed B Complex Plus Iron Liquid for my girl. 

 

[cards222002]

Hes on a vitamin called hyvit looking at it really no b vitamin or folic acid. Do you just give your cat a tablet worth of it? Also just get it from a store or you get it from your vet.

 

[colliecollie]

I got it from the store. She's on a lot, per specialist recommendation. 800 micrograms, twice a day. 

Btw, her Hematocrit was up to 36 on 11-18-14. After this bottle of Predniose is finished, I'll bring her in again for another test and decide if we're going to cut down on the meds. 

 

[burkey]

My cat George is taking liquid Atopica for severe allergies. 

Based on advice given in another thread I came across here, we put the liquid into an empty size 3 (# 3) capsule. His dose is 7 units, and it just fits with no room to spare. I'm not sure what that would equate to in ml? The dropper/syringe with his medication is labeled per pound of cat, and he gets the 7 pound cat dose (he's almost 10 lbs, though).

We bought NOW brand size 3 capsules from a vendor on Amazon. They are intended for human use, and NOW is a well known brand. Our local vitamin/health shop only carried the larger sizes (the smaller the number, the larger the capsule is).

We coat the filled capsule with a tiny amount of coconut oil so it doesn't stick to his throat on the way down, and follow it with a piece of freeze dried shrimp as a chaser. The size 3 caps aren't tiny, but they aren't monstrous.  George is an average size cat, and if we keep his head tilted for a few extra seconds after pilling him, and stroke his throat downward a couple times, he has no issue swallowing them. 

Be careful not to get any of the Atopica on the exterior of the capsule when you fill it, the cat will know.

Also, Atopica is a very powerful medication. If you get any on your hands, wash them as soon as you can. It is a medication given to humans who have had organ transplants, I believe it is an anti-rejection drug.

 

[colliecollie]

Hey thanks for the reply! The trick would def be not getting any on the outside of the capsule. It's so damn sticky!

Anyways, I scrub my hands with dishsoap after giving it. Since she foams it up, I hold her jaw shut with a papertowl underneath to keep it off my hands. Sometimes it works, sometimes it doesn't. I don't think a small amount like that will hurt me though. I've accidently tasted it once and that was enough to make me extremely careful! Yuck yuck yuck.

Speck isn't so much into the salmon as she was before, so I've switched it up. Her current favorite treat is cheese. Well, basically anything I eat is her favorite treat. So as long as I take a bite first, she's ALL over it. I'm sure this phase will pass too. 

 

[sarah ann]

Have you tried pill pockets?

 

[jonm77]

please be careful of atopica and your pets. atopica caused jaundis and liver failure to my 5 year old cat olly because it lost weight too fast on this medication. this caused us to have to try surgery to add a feeding tube that would run out the back of my cat's head. my cat passed away this past monday morning (1/19) and did not survive the surgery. i am looking for others that this may have happened to and hopefully warning others who may have pets on this dangerous drug. i saw your question was semi recent and i am online trying to find answers and just wanted to share what has just happened to our family. 

 

[zoocat]

My Sammy cat has allergies and my vet wants him on Atopica....I fought it/and my vet after reading all the potential side effects. My vet pretty much gave me the condescending "doctor knows best" lecture and argued that it was very safe...much safer than the steroid shots. I gave him a couple of doses and stopped....tried many, many other things (homeopathic)...his sores weren't getting better so I broke down and agreed to try Atopica again...I won't give it to him daily though because he gets diarrhea bad, throws up, feels bad and then loses his appetite. I'm trying to find a balance where he keeps eating good, feels good and the sores don't get worse. I've been giving it about two or three times a week for a couple of months. However after hearing your experience, I'm probably going to stop again. I'm at a loss as to what is best for my boy, but I'm not sure I trust "doctor knows best" It really makes me angry.

 

[jonm77]

for us, both our cats Toby and Olly were over grooming their bellies. the one vet wasn't sure so and said it could me a multitude of things so wanted to start with $600 worth of tests on our cats. my wife and i sat there a little shocked so she brought in another vet who worked there for a second opinion. he came in and "knew exactly what it was" so he gave them phenobarb which is like valium for cats from what i read. he said it was most likely anxiety from a major change in our cats living situation. the only thing we could think of was another dog in our building who moved in relatively recently can get anxious when they leave and howl for a little bit. we can't hear it unless we are out front of our building... but we assumed maybe our cats could. 

anyway,.. the plan was then to try the phenobarb which is a small pill that was semi easy to give them. if that didnt work after a few weeks, then we would try something else.

we try for a bit but it doesn't seem to be working so i call and a 3rd vet(at the same clinic) says the same thing as vet 2. YES! i know what this is, and then prescribed the Atopica. says it'll clear it up in no time and said it is normal for appetite loss and vomiting to occur. giving it to them was just pure awful. i felt so bad that it was so oily that i would have their favorite treats ready to help get the taste out of their mouths. they would try to drool it out so i would have to hold them like babies with their heads back so they would swallow it down. very stressful on all of us but we did what we had to do. 

Olly, our 5 year old girl, actually stopped licking her belly after about 2 weeks of giving her the Atopica. I couldn't have been happier so i immediately took her off of the medication. i had only been giving them both a little less than half of the dose prescribed to their weight. once a day. i think about 4 days passed where she was off the medication. her appetite was very poor and she would still vomit at night, but i was told that was normal. i fed her canned tuna because she didn't seem interested in anything else. even her treats. i could tell from her vomiting that she was digesting more food and that she would vomit less so i thought she was getting better. i then noticed her gums were a slightly pale and maybe slightly yellow so we brought her in.

they told us she had jaundice from either hepatic lipidosis or something else about a fatty liver. i said it was from the atopica and the vet said it wasn't. i looked it up online when she left the room on drugs.com and it even says it on drugs.com for atopica that during the trials that it caused both jaundice and hepatic lipidosis. also in the caution section it said this: 

Cats should be tested and found negative for FeLV and FIV infections before treatment.

A complete clinical examination should be performed prior to treatment with ATOPICA for Cats.

when i mentioned th when she came back in the room, she didn't like that i just enlightened her about a medicine they were prescribing so she said "You guys turned down the blood tests when we suggested them." i'm only assuming she is referring to our original visit 6 months prior when we went with the advice of vet#2 who said no blood test was necessary and we'd try the phenobarb pill. i really had to bite my tongue and not explode on her because i just wanted Olly cared for & that was pretty much their way of having a sound reason why the medicine prescribed was done in the proper way. 

so they did the blood tests on Olly and said we had to put a feeding tube in that would come out the back of her neck and we would have to feed her a ton of calories/food to reverse the effects of the trouble to her liver. we had them do the surgery but she didn't make it through the aftercare. they said she was having trouble breathing when they tried to do her first feeding so they tried cpr and she didn't make it. the really strange part about that, is that when i went in to see her and say my painful goodbyes, they said that she still had her breathing tube in from the surgery. i'm not a doctor but i thought breathing tubes were the fail safe way of getting oxygen to the lungs when someone can't do it on their own.

i took Toby off of it immediately. he is our 2nd cat. the Atopica did seem to help out with his itching and over grooming but his appetite has changed so we are taking him today to get him fully checked out by a completely different vet clinic.

i wouldn't suggest any changes in medications without talking to the vet first. i'm just sharing my awful experience that i am going through so hopefully nobody else has to and to see if there are others out there that had anything like this happen to them. folks need to be made more aware of what to look for when giving their pets meds. i am absolutely heartbroken and in shock about how easily this could have been avoided. sorry for writing a novel. i hope you have success with your Sammy and wish you guys the best. just be careful with weight loss because because if it looses too much weight too quick, it is very bad for their liver. 

 

[siold]

[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <woNotOptimizeForBrowser/> </w:WordDocument></xml><![endif]Avaleen hates liquid medication.

I’m sorry for your cat’s health problems.

I give Tatertot a supplement called Thyroid Forte Syrup.

Tahya is on liquid Atopica.

I highly recommend pill pockets for pills.

Any cat that is on Atopica should have his or her liver checked twice a year.

My vet is also pushing to put Sabin on Atopica.

Pandy and Kells lick their bellies a lot, too.

 

[zoocat]

Jonm77, I am so sorry about what you went through with Olly. We should be able to trust these professionals to take better care of our pets....it seems like the way they seem to be "pushing" Atopica they must be getting a financial kickback or something. It just infuriates me. My vet never suggested any blood tests before prescribing the drug. And when I expressed my concerns about everything I read in the drug insert, she basically "poo-pooed" my concern....made me feel like a whaco nut case! Since I had seen the warning about severe weight loss, I have been very vigilant about weighing him and making sure his appetite stays good. I just don't trust my vet now.

 

[siold]

It breaks my heart to hear about any cat having health problems.

 

[njs21]

I have been reading this thread. My cat George is going through the same thing and I am feeling very lost about what to do. He had a blood transfusion this weekend and I am not sure it helped. He is on pred and just started atopica 2 days ago. They say atopica takes at least 5-7 days to begin working. Has anyone has success with this? I am worried about his well being in the meantime and I am sure if I take him to the vet they may recommend another transfusion. Do I have any reason to believe that if the first one didn't work a second one will? Any advice would be great. Thank you.

 

[njs21]

@colliecollie did atopica continue working for your kitty?

 

[colliecollie]

Hi Everyone! Sorry I haven't been back to update in a while. 

Here's her updated history.

Date	PCV %
02/17/15	36%
01/09/15	42%
11/18/14	36%
11/06/14	28%
10/21/14	9%

After her PCV tested to 36% on 11/18/14 (weight 9.8 lbs), we decided to give her 5 mg of Prednisone every other day. Speck still got .25ml of liquid Atopica daily. 

Then after her PCV tested to 42% on 1/09/15 (weight 10.5 lbs), we decided to give the .25ml of liquid Atopica every other day as well.

Currently, her PCV dropped down to 36% on 2/1715 (weight 11.6 lbs) doing the same routine above. 

The vet isn't worried (but I am). It's still well within normal range. Speck was super crazy active earlier that day and my vet was sure that the number was lower due to her activity level and hydration. Btw, all the times we've tested it's been around 7:00 PM. She isn't generally very active, but my husband was home playing with a laser pointer (Speck goes bonkers over it). The past we times we tested, she was home alone all day and I know that they basically sleep all day until I get home.

Speck has absolutely no side effects so far from Atopica BUT we're having Prednisone issues. She's gained quite a bit of weight and now we're slightly worried about diabetes.  We're going to start weaning her off it immediately. 

So, starting today 2/18/15, she will receive   2.5 mg Prednisone every other day  (FOR 2 WEEKS)  and her .25ml dose of Atopica every other day. 

After two weeks, if all seems well, we will drop her down to  2.5 mg Prednisone twice a week  (FOR 2 WEEKS). Then we will do another PCV. 

If the PCV's ok, Speck will get 2.5 mg Prednisone once a week  (FOR 2 WEEKS). After that's done, we will do another PCV. 

That's the plan of attack for now. She may need to be on a low dose of it for years, but first we need to wean her. 

Oh and I still give her 200 micrograms of Folic Acid once a week. I'm going to give her a B-12 Injection this week as well (haven't done that in a while).

@njs21  Please don't be afraid to start your cat on Atopica. Don't delay either! It saved Speck's life!! Truly. There was no response with Prednisone alone even after her transfusion but after a few days on Atopica, wow! Big response. There might have been a bigger response, but I wanted to run fluids under supervision since she wasn't eating well. 

Your cat absolutely must get high calories and be kept hydrated during this time. I blended up super high calorie wet food and syringe fed it. Along with the syringe fed food, I syringed her unflavored Pedialyte to keep her hydrated. Since she was kept in a large dog crate, I was also able to leave the Pedialyte out for her to drink. She really liked it and drank it often. Are you keeping your cat confined? I never left her loose during the day and never let her out of my sight at home. She was kept from playing, jumping, and going up the stairs. Basically lots of snuggles!

Speck also got tons of Nutri-Cal paste. I believe that the Nutri-Cal helped keep her alive. Also, absolutely start B-12 injections and Folic Acid as soon as possible. They stimulate appetite and RBC production within the bone marrow. We started those things right after Atopica. Btw, multiple transfusions are dangerous for cats. That should be a last ditch effort. Has your cat been cross matched with a fresh donor cat? If not, please make sure they test and match. 

I really hope your cat comes around @njs21!! Do you know if your cat been diagnosed as primary IMHA or secondary? How old is he and when did the issues present? 

 

[njs21]

@colliecollie thanks a lot for the advice. George is not doing well at all after his transfusion. He came back from the hospital Saturday night and steadily declined. I had him on Atopica since Saturday but it looks to me like he will need another transfusion to buy him more time to see if any of these meds take. The problem according to my vet is that he is not producing enough new red blood cells, indicating a problem with the bone marrow. The vets said that there is not much of anything we can do to to make his bone marrow make new red blood cells. The issue I am having is that he is not well right now--very lethargic, heavy breathing, looks like a very sick kitty. If the answer is a second transfusion, and the first one didn't help, I don't want to put him through that again especially if he has a bone marrow issue that cannot be fixed. These are very hard decisions He has been on prednisolone for awhile and it hasn't done much. They believe it is secondary IMHA.