The following are real life questions about Medication use for Cats that have been treated by Dr. Mike Richards, DVM.
Tylenol Ingestion - Toxicity
Clomipramine (Clomicalm Rx), Psychogenic Alopecia and Itchy Cat
Aspirin Dosage for Cats
Misoprostol (Cytotec Rx) and Other Drugs Used with Piroxicam (Feldene Rx)
Is Drontal (Rx) Safe for Pregnant Cats?
Hairball Medicine - Laxatone
Acetaminophen (Tylenol?) Toxicity in Cats
IBD and Prednisone
Hairloss and Amitriptyline
Megacolon Treatment - Cisapride (Propulsid Rx) and Ranitidine (Xantac Rx)
Topical Prednisone Solution?
Tapazole in PLO Gel
Denosyl SD4 - SAMe
Azithromycin (Zithromax Rx)
Treating Pain in Cats - Adequan (Rx), Glucosamine/Chondroitin and Prednisone
Appetite Stimulants for Cats
Pepto Bismal and Cats
Tapazole and Cats
Acepromazine and Alternatives
Aspirin or Acetaminophen
Benedryl and Allergic Cat
Prednisone and Diabetes
Heartworm Preventative for Cats
Diazepam for cat spraying
Pilling a cat - Metronidazole
Tylenol Ingestion - Toxicity
Can a cat recover from ingesting a Tylenol gelatin capsule (extra strength 500ml)? My cat is at the vet now - she is blind (detached retina's) and tests are being performed. We think it happened last Thursday night - on Friday her eyes were completely dilated and she was blind and lethargic. We rushed her to the vet and she was immediately given "toxiban" (not sure of spelling). Do you have any recommendations?
I can not find the reference, but somewhere I read or heard that one extra strength Tylenol capsule (500mg acetaminophen) would cause death in about 50% of cats if untreated. I do not know the success rate of treatment but these are the recommendations for therapy for acetaminophen toxicity. It is probably a little late for some of these therapies but others may still have a beneficial effect: 1) Induction of vomiting and treatment with activated charcoal. No effect can be expected from these treatments after the medication has been absorbed. 2) Administration of acetylcysteine (Mucomyst Rx), which helps spare the enzyme in the liver which processes acetaminophen. Since cats pretty much lack this enzyme any little bit helps. It may still be beneficial to give this medication. 3) Administration of ascorbic acid (Vitamin C). This helps to protect the hemoglobin in the red blood cells from being damaged by the acetaminophen and may still be helpful. 4) Methylene blue (a dye) can be used to try to prevent damage to the hemoglobin, as well. 5) Administration of sodium bicarbonate to cause the urine to be basic increases the excretion of breakdown products of acetaminophen. This may also still be helpful. 6) The use of S-adenosylmethionine (SAMe) may be helpful based on some recent studies (Webb et al 2003, Wallace et al 2002). This is used by giving a loading dose of 40mg/kg and then daily doses of 20mg/kg. The papers are available in abstract form on the PubMed web site. It may be helpful even late in the toxic process. 7) Any necessary supportive care, such as fluid administration, blood transfusions, correction of electrolyte imbalances, feeding by esophageal feeding tube or other care that helps the cat live until the effects of the acetaminophen wear off can be helpful. If you are not sure that an acetaminophen capsule was ingested, the most common cause of sudden blindness in older cats is hypertension (high blood pressure) and treatment can sometimes allow reattachment of the retinas.
Could you tell me anything on the results of the use of Clomicalm in cats ? I have several customers who have been subscribed it to their cat for aggressive behavior or excessive anxiety to other cats. In some cases i wondered if they needed it, as I seriously question the skills of that vet, but that is beside the question.
Currently I am taking care after a cat that has been licking himself symmetrical bold since forever. His vet diagnosed him "nothing wrong" by looking at him, and I encouraged the owners to challenge a possible food-allergie as they fed him all kind of supermarkt brands. The cat is imported from Indonesia to the Netherlands, so it makes him a bit different from local cats.He has been challenged various times on Hills Z/D and other non-allergic diets, but allthough it made some improvements, he still licks himself. Acoording to the owners he is stressed and i encouraged to play with him every day for 20 minutes, which they faithfully do. I wonder if this product could help him. Would it be a life-time subscription or could he stop at some time and can they stop "could turkey" or do you need to give them less by the day?
I have not prescribed clomipramine (Clomicalm Rx) for a cat that I can remember, so I have no personal experience with the results of using this medication in cats.
I know that many vets are using clomipramine for cats, though. There is a published dosage of 1 to 5 mg/cat per day. The most commonly recommended uses are inappropriate urinary behaviors (urine or stool marking) and psychogenic alopecias, or hairloss that is induced by obsessive-compulsive grooming behavior on the part of the cat.
It is not possible to diagnose psychogenic alopecia by appearance alone. It is necessary to rule out all possible causes of itching and to determine if the hair is being groomed out, which is usually possible with microscopic examination of the hair.
Cats who are itchy tend to lick or chew their hair off. Cats almost always lick or chew in bilaterally symmetrical patterns which makes the hair loss look like it is hormonal or psychological. There are a number of diseases and disorders that can cause this sort of hair loss in cats. The most common ones are flea allergy, mange, ringworm, atopy ( pollen and similar allergies), food allergies, hyperthyroidism and contact allergies.
A good plan for working through these possibilities is to do a ringworm culture (should be done on all cats with these sort of symptoms), starting a good quality flea treatment (Frontline Topspot tm, Advantage tm, Program tm and an adulticide like Capstar tm, or Revolution tm), skin scraping for mites, a food trial (single meat source the cat hasn't eaten previously or new hydrolyzed diets), testing for hyperthyroidism if other signs are present, testing for allergies and considering skin biopsy if the problem hasn't resolved and the other tests are all negative. After the skin biopsy it is reasonable to start thinking that the problem might be psychological and to treat for this sort of problem. Clomipramine (Clomicalm or Anafranil Rx) would be a good choice at that point.
If you do try clomipramine it is best to use it for a month or two after the problem seems totally resolved before trying to taper it off and it is best to cut the dosage down slowly over the course of a few weeks to a month or so. It is also a good idea to try to identify and eliminate sources of stress.
When a serious attempt is made to diagnose an underlying skin disease it is unusual not to find a cause for the problems before having to resort to treating for psychogenic alopecia.
I believe the aspirin dosage you reccommend for cats is incorrect on this page: http://www.vetinfo.com/catortho.html
You suggest 10mg/lb, but every other source I can find suggests 10mg/kg. That makes the dosage you suggest more than twice the common recommendation.
Thank you for being concerned enough to write to us about the dosage for aspirin.
There are published studies indicating that aspirin is safe when dosed from 10 to 25mg/kg every 48 to 72 hours and one study indicating no problems when it was dosed at 162mg/cat once a week. We use up to 10mg/lb in our practice, even though it is at the higher end of the dosage scale. We usually do not exceed 81mg per cat and I probably should indicate that in our answers online, since this is often closer to 5mg/kg in large cats.
On your site you say: "Many vets use medications to protect the stomach while administering this medication [piroxicam] but some do not." What medications could be used in a cat to protect the stomach, and would they interfere with the piroxicam's treatment of a gastrological cancer?
The gastrointestinal protectant often recommended for use with piroxicam (Feldene Rx) is misoprostol (Cytotec Rx), which is usually given at dosages of 2 to 5 micrograms/kg of body weight every 8 hours for dogs and every 12 hours for cats (not much support for this dosing scheme, for cats, is found in pharmacology texts, these is a dosage that has been included in case reports). This use has not really been validated by studies, at least ones that I can find, but it seems to be frequently used by oncologists who seem happy with the results.
Alternatively, the over-the-counter medications cimetidine (Tagamet tm, 5mg/kg twice a day), ranitidine (Zantac tm, 3.5mg/kg every 12 hours) and famotidine (Pepcid AC tm, 0.5mg/kg once or twice a day) may also be useful.
Hi, our local vet thought that Drontal was OK to give to 2 pregnant cats. Both cats are about 9-10 lbs and got only one pill dose for 7-8 lbs. These were feral cats and one is about 2/3 the way through pregnancy and the other has about a week to go. I looked up on the web and it says that Drontal causes problems and should not be given. Is there anything that I can do at this point? Also cats seem to be doing fine and kittens are still moving. What could we see in the kittens?
I have checked several sources trying to figure out what might be the basis for your question and have had to make a guess about that. Please let me know if I am wrong.
There are two similar products on the market. Once is Drontal (Rx), which is a mixture of pyrantel and praziquantel. This product is approved for use in cats. As far as I can tell from my research, this product is considered to be safe to administer even during pregnancy. The second product is Drontal Plus (Rx), which is approved for use in dogs. This product is a combination of praziquantel, pyrantel and febantel. This product should not be given during pregnancy because febantel can cause birth defects when given at two to three times the recommended dose. Since this is a very narrow safety margin, the product shouldn't be used during pregnancy.
My best guess is that there is confusion in the information about these two products. However, if I am wrong and you have found information specifically relating to Drontal and problems with pregnancy, would you please send me the web address so I can see what the references used were?
I am hoping your vet and I have the correct information and that you will not see any problems from the use of Drontal during the pregnancy.
Get additional information on Drontal Roundworm Treatment for Cats.
I subscribe to your newsletter and have a question regarding my 2 long-haired cats. I notice that they have hairballs more frequently than my short-haired cats and wonder how often I should give them hairball medicine. I use Laxitone. I try to remember to brush them frequently but they still have the hairballs.
Laxatone (tm) and other petrolatum containing laxatives have been used long term, even on a daily basis, in some cats for long periods of time. This does not seem to cause harmful effects based on the lack of reports of harm in the literature. There are several theoretical problems that might occur, though. It is possible that long term use of a petrolatum product could interfere with absorption of fat soluble vitamins and there have been reports of foreign body reactions to petrolatum products in the liver in horses, but I am not sure if this has been shown to occur in cats. With all of this in mind, it appears to be reasonably safe to use Laxatone and similar products pretty frequently. Despite this, we prefer to try to find the underlying cause for the hairball problem in our patients, when it is possible to do that. The two most common problems we find are skin disease leading to excessive hair ingestion and motility problems in the digestive system that make it hard for the intestines to get rid of the hair. If skin disease is not present, we often try the new foods made for hairball problems prior to doing a more complete workup for digestive tract problems because they do seem to help many cats who seem to have inflammatory bowel disease leading to vomiting, including vomiting of hair or hairballs. Your vet can help you determine whether skin disease or inflammatory bowel disease is likely based on the history and a physical examination.
Also see our page on Laxatone.
I have a question about Acetaminophen (Tylenol™). The Receptionist at our local veterinarian told us never to give our cats a Tylenol™ and NOT to give them ASPIRIN unless the Doctor oks it. Is that true? And what about Ibuprofen?
Acetaminophen is very toxic to cats and this medication should simply never be used to treat a cat. Aspirin has a long half life in cats, at least 24 to 48 hours, so it will reach toxic levels pretty quickly if it is given more frequently than once every 48 hours and the dosage is 10mg/lb so a baby aspirin (81mg) is a much more appropriate dosage for a cat than an adult aspirin. I have not seen much information on ibuprofen and cats but it is a good idea to avoid all non-steroidal anti-inflammatory medications in cats, at least until one of them does prove to be safe in someone's clinical trials.
My elder cat was diagnosed with IBD after exploratory operation in December, and he is now on Prednison (2 pills every other day). One week after surgery our vet also found Giardia in his stool, and the cat was on Novo-Nidazol (125g every day for 6 days - the weight of the cat is 14 lbs.). It seems to help him and he doesn't have diarrhea anymore, although his stool is not always perfectly formed.
My question is: for how long in your opinion should he stay on Prednisone? Our vet gave us about 400 pills - enough for the whole year. Is it really necessary? Can we lessen his dosage since he looks fine to me? And if yes, then when and how - 2 pills every third day? 1 pill every other day? I know we cannot just stop giving him the pills, but what is the scheme of gradual finishing this medication?
We usually try to keep cats who respond well to prednisone for IBD on the medication for about six months. At that time, we try to wean them off of the medication. If we have been using it daily, we go to every other day for 5 to 10 doses, then cut the dose in half for 5 to 10 doses, then go to every third day at this reduced dosage for 5 to 10 doses and then stop the medication, if the reduction in dosage has been effective. We chose six months as a compromise between recommendations in the literature, because we have seen recommendations to use prednisone for as short a time as 3 months prior to trying to wean patients off the medication and as long as a year prior to making this attempt. Your vet may have experiences that indicate the longer period is better or may have strong feelings about the reliability of the information from one of the people who recommends longer durations of treatment prior to attempting to wean a patient off of the prednisone. We often try limited antigen diets (one protein source) prior to using corticosteroids, so we take one dietary approach prior to their use. Lately, we have been going for short periods of time, usually six to eight weeks, and starting different dietary changes such as adding essential fatty acids to the diet or using diets that already have some fortification of these ingredients, such as the hair ball formula diets. We seem to be having some luck with this approach, but definitely not total success.
We do have patients who we have to keep on prednisone or on intermittent injections of methylprednisolone acetate (DepoMedrol Rx) to control symptoms of IBD. We have had patients on these medications for several years in some instances without being able to successfully wean them off the medications. Many of these cats do develop secondary problems as a result of long term corticosteroid use, so we really prefer not to take this approach.
When the time comes to think about lowering the dosage of corticosteroids or weaning your cat off of them entirely, it is very important to get directions for doing this from your vet so that he knows what is going on if any problems occur during the dosage reduction period.
I've written to you a couple of times regarding Lucy, my 4.5 year old, spayed cat. She has been losing hair slowly for about 6 months, and it keeps getting worse. I brought her to my vet (again) and he did a complete blood testing which came back normal. We ruled out mites, fleas, food allergies, and probably airborn allergies. I say probably because the seasons have changed and there has been no change, or if anything, her bald spots have become worse. My vet has come to the conclusion that her hair loss is probably due to stress from playing with my other cat, as the hair shafts are broken. He is a 2 yr. old altered male, very playful, but not aggressive, to the best of my knowledge. I've been reading behavior books and neither of them put their ears flat or get puffy tails or use their claws. They bite each other, but don't draw blood. My male is usually the aggressor, but they usually nap together and eat together, so I've been assuming they like each other. My vet has recommended 2.5 mg of amitriptylline each a.m. She's usually O.K. taking pills, but I'm having ALOT of trouble getting her to take them. My real concern is that she has lost interest in everything. All she does is sleep. And her "brother" has been walking around the house meowing at her, I think to get her to get up and play. I've only had her on medication for 5 days, but I'm really worried. Is the dosage correct? Is there an alternative which may have less side effects? I asked my vet and he told me to wait at least 10 days. If something else would cause less side effects I'd rather use it, or maybe just resign myself to a bald cat...... Thanks so much for being such a wealth of information...I wish I lived in VA! Sandi
Amitriptyline in usually dosed at 5 to 10mg per cat, once or twice a day. So 2.5mg once a day is actually a pretty low dose. We use this medication several times a year for cats in our practice and have found that it is very hard to administer these pills, making us think that the taste must be pretty bad. We have had some luck having a local compounding pharmacy make gels out of the tablets with strong flavors like anchovy. Some of our clients also purchase small empty gelatin capsules and put the pills in them so that cats don't get hit with the flavor right away. We have had two or three clients whose cats reacted about like yours and all of them gave up on the medication after a couple of weeks, which seemed perfectly reasonable to us. Many cats have very little discernible effect but most get a little sleepy. We use this medication mostly for cats with urinary tract problems and we recommend giving it at night before bed time. Most cats get a little sleepy but it doesn't matter at that time of night.
I am not sure how food allergy was ruled out. This is usually done by feeding a diet that has a protein source the patient has never been exposed to, such as rabbit, venison or using one of the new hydrolyzed diets (Hill's z/d (tm) is the only one I know of for cats). The diet is fed for six to eight weeks and if there is improvement in the skin condition, then the most likely diagnosis is food allergies. If return to the normal diet induces problems and they clear up with change in diet again, the pretty much confirms food allergy. If you have not tried a food trial it might be worth doing that, although you would probably have to feed both cats the trial diet in order to see if it works.
If there is not an adequate response to amitriptyline, or if the side effects of amitriptyline are too severe to tolerate, it might be worth doing a skin biopsy just to make sure there isn't something like demodectic mange or a disorder that can be diagnosed by a pathologist.
You may find that buspirone (Buspar Rx) works as well as amitriptyline, if this is a problem in which Lucy is just nervous because of conflicts with your male cat. Some cats who seem to have hair loss from behavioral causes (psychogenic alopecia) will also respond to fluoxetine (Prozac Rx) or clomipramine (Clomicalm Rx) according to case reports I have seen but we have not tried these medications so I have no personal experience with this. Megestrol acetate (Ovaban Rx) works in many situations when other medications will not but it has very high potential for serious side effects, such as the induction of diabetes and mammary tumors. So it has to be looked at as a last resort and we use it very reluctantly.
I hope that things are improving some at this point. If so, there is a good chance that you will eventually be able to wean Lucy off the medications. We usually try to do this about sixty days after there is obvious improvement and we take some time to taper the patient off the medication to try to prevent quick relapses. Your vet may have a different approach based on his experiences and it is best to follow his advice if that is the case.
Learn about the side effects of Amitriptyline in Cats.
It is still possible to get cisapride (Propulsid Rx) from compounding pharmacies and many vets feel that it is helpful for megacolon problems. An alternative medication is ranitidine (Xantac Rx), which seems to have similar effects in some cats. The usual dosage of cisapride is 1.25 to 2.5mg given 15 to 30 minutes prior to eating and the dosage of ranitidine is 1 to 2mg/kg every 12 hours.
I've been surfing the net trying to find info about trying a topical solution of prednisone instead of oral for my cat who's kinda tired of being pilled!
Max is FIV+ and was treated with radiation for nasal lymphoma in August of this year. Since I declined the chemo and the cancer was advanced, my "pennence" is having to medicate Max with prednisone for the rest of his life (vs. the 6 months post radiation treatment I was originally told).
Max is doing very well right now. In fact the best he's been since he became very ill with the lymphoma. There's still some slight (clear) nasal discharge sometimes but otherwise he's eating very well and playing a lot (something he hasn't done for quite a while).
He seems to get recurrent sinus type infections (from taking the prednisone?) so I wind up having to pill him 4x a day. Not fun for either one of us. He's relatively cooperative taking the two pred's a day but when I have to add an antibiotic to the regime it's darn near impossible.
I was told about a topical prednisone solution that's rubbed on the inside of the ear and was wondering if you could tell me about this. Would it be appropriate for Max? Possibly in liu of the pill form during the times I have to give him antibiotics?
Compounding pharmacists can mix medications with a plurionic lecithin organogel (PLO cream) base, which is supposed to make many medications absorbable into the blood stream after topical application. It has to be applied on a non-haired portion of the skin, making the inside of the ear a common recommendation. The PLO base doesn't work for all medications and dosing information has not been worked out for pets using PLO creams for any medications that I know of. However, I think it is still a reasonable option for some situations. You may have to adjust dosage or evaluate success based on clinical signs, though.
Flavored gels or liquids can be made from many medications, as well. We have used liquid prednisone formulations compounded by our local compounding pharmacy and this seemed to work fine. Enrofloxacin (Baytril Rx), a broad spectrum antibiotic, comes in flavored pill form now. We haven't tried this medication in a cat, though -- so I can't give you a personal assessment of how acceptable the pills are to cats.
Sometimes it is possible to nebulize antibiotics for sinus and nasal passage problems.
If there is a compounding pharmacy (one that can make medications into different forms) in your area, the pharmacist could probably tell you how successful they have been with topical prednisone. Your vet may know of a compounding pharmacy, if you are not aware of one.
My cat is on Tapazole for hyperthyroidism and I give her 1/2 a pill in the morning and 1/4 in the evening. I requested information from a compounding pharmacy about tuna wafers with Tapazole and he e-mailed back suggesting putting the Tapazole into a PLO gel which is then rubbed behind the cat's ear. He said that excellent results have been achieved with this method without having to worry about getting the cat to eat anything. Have you heard of this method? It sound like a great idea if it works, but I need to get more information before trying it. Perhaps you can shed some light on this method of medicating. Anne
There are reports of good success mixing methimazole (Tapazole Rx) with a pleurionic lecithin organogel (PLO cream) for use in cats that are hard to pill, on the Veterinary Information Network message boards (a service for veterinarians, www.vin.com). It has to be applied to a hairless area, so the inside of the ear or a hairless area in the inquinal or abdominal areas would have to be used. The gel would penetrate human skin, too, so it should be applied using latex or vinyl gloves. The approximate dosage of medication should be the same as for oral administration so the pharmacist would have to calculate that out for the gel mixture. Success of the medication could be monitored by using T4 (total thyroxine levels) or by paying close attention to clinical signs like heart rate, weight loss and appetite.
I guess I would want to reserve this approach for cats that were very hard to pill since I couldn't find any studies on dosing requirements or double-blind studies evaluating success of therapy with this approach.
For more information, see our overview of Treating Cats with Tapazole.
No-one, I mean no-one in Southern CA seems to know about the source for Denosyl SD4. I checked your link to the FDA's Green Book and could not find it either. Who makes the stuff? I would love to try it out on Woofy the Pomeranian with pancreatitis and liver disease, but my vet and pharmacist are looking at me funny these days.
I have to admit that we think it is perfectly acceptable to use any brand of SAMe --- it's just that Denosyl SD4 is the only one actually approved for dogs and cats, so we feel an obligation to suggest it first.
Dear doctor, i am wondering if you have ever come across an article on zithromax or azithromycin in the use of feline infections? I have come across one about two years ago and have searched for the same with no luck. However: i have used this drug on my cats with respiratory problems with immense success. They were previously perscribed amoxicillin and what i found is that it rendered the bacteria dormant but did not succeed in killing it. It came back again after a few months. Using the zithromax i have found no return of the bacteria.
My cat breeds are burmese and burmilla and respiratory problems are more prevalent in these breeds.
It is administered according to weight either in pediatric suspension or tablets ( 250 mg), cut down to weight.
If you could possibly shed some light on this article i would appreciate this as i siad it does work and has worked on cats that i know that have bad virusis ans practically no other options but to try this drug. Thank-you in advance for reading my letter.
I know of two articles on the use of azithromycin (Zithromax Rx) that have been published fairly recently. The references for these are:
"Antibacterial drug therapy. Focus on new drugs.", Veterinary Clinics of North America, Small Animal Practice, March 1998 by MG Papich.
"Pharmacokinetics, Oral Bioavailability And Tissue Distribution Of Azithromycin In Cats.", by Hunter, et al, in the Journal of Veterinary Pharmacology and Therapeutics, Feb. 1995
The first journal is pretty widely available and there is a good chance your vet has it but the second journal is pretty specialized and it would probably take a trip to a veterinary school library to find it, although the abstract is available from the PubMed site. (use "Hunter azithromycin cat" ) to find it.
Azithromycin is supposed to work better for chlamydiosis and mycoplasmal infection than many other antibiotics. These are both more common in multiple cat households than single cat households. Azithromycin also works well against gram positive bacteria like staph and strep. It is usually dosed at 5mg/kg from once a day to once every third day.
Azithromycin is a good antibiotic for upper respiratory infections in cats that do not respond to other antibiotics or that seem to be due to chlamydiosis or mycoplasma infections.
Also see Azithromycin for Cats.
My cat has been back to the vet since starting the Tapizole and we actually had to decrease the doseage since it was working too well. She's due back in 3 more months for follow-up blood work. She had not gained any weight but you said that may take some time but, at least, she's not losing any more weight. My question today has to do with one symptom that has not changed very much and that is excessive drinking and urination. Could that be a side effect of the Tapizole? When I had the initial blood screening done, I was told her other levels were within normal limits (sugar, kidney and the like) Maybe we cut the dose back too far. What would be your guess?
There are strong associations between hyperthyroidism and diabetes mellitus, so it is a good idea to monitor for diabetes when hyperthyroid cats show signs of increased drinking and urinating. Sometimes diabetes will occur even when cats seem to be well controlled by the treatment for hyperthyroidism.
Some cats with kidney disease appear to gain a protective benefit from hyperthyroidism, in that its effects on blood pressure actually help the kidney in some ways. When cats who have subclinical kidney insufficiency are treated for hyperthyroidism the kidney problems can actually get worse, leading to increased drinking and urinating. So it is also a good idea to monitor kidney function while using methimazole (Tapazole Rx) or after surgical or radioactive iodine therapy for hyperthyroidism.
I am not aware of any direct effect that Tapazole might have on drinking or urinating, so I don't think the medication itself is likely to be the culprit, although I couldn't absolutely rule that out.
If your vet ran a whole blood panel when the T4 levels were rechecked, there may be no need for further testing. If he or she did not do this, it would probably be a good idea to consider blood work to try to rule out kidney problems and diabetes. A urine sample, or samples, might also be helpful in ruling out these problems.
Thirty days ago, I began a schedule of Prednisone (5mg) and Glucosamine/Chondroitin Sulfate (250mg/200mg) for my arthritic cat. I don't like having her on Prednisone, so try to administer it only once every 3 days. I break a G/C capsule open and mix the powder into her cat food. She doesn't like it much, but most of the time I can get her to eat it. You also mentioned Adequan injections as being possibly helpful. My vet has never done this, but she ordered the Adequan and it's arrived, so we're ready to begin.
These are my questions: * to begin the Adequan injections, do I continue with the Prednisone and G/C dosages at the same time? * how much Adequan do we administer and how often? Is it just used initially, or ongoing? * are you aware of any other form of G/C to administer to my cat? I would even prefer a pill that she can swallow, but those capsules are much too large. * what side-effects should I be watching for for the Prednisone? And would you recommend that I ease her off of it to see if the G/C and Adequan are working by themselves?
As you know, it's difficult to monitor pain in a cat. Her arthritis is in her shoulder and elbow and she walks with a limp. My vet said her shoulder joint is a little out-of-whack so there will always be a limp. So the limping doesn't monitor the pain. However, every few days she will lift her paw off the ground and hold it up. I think that might be the pain signal, so that's what I'm watching for.
There is no reason not to use Adequan (Rx), glucosamine/chondroitin and prednisone at the same time, if the combination seems to help more than the individual medications. In most cases, though, the object is to use as little prednisone as possible and so we try to wean cats off of it during treatment with Adequan, in the hopes that will be OK.
Adequan is dosed at the rate of 5mg/kg (approximately). There are all sorts of recommended dosing schemes. We usually give it weekly for 5 weeks and then try to lengthen out the interval to the longest time between injections that keeps the cat or dog comfortable. Two to four weeks seems to be about the range that can be expected for Adequan to help. Different vets have tried lots of different schedules. Adequan is pretty safe to use, so it is OK to experiment some with the intervals.
Glucosamine comes in a powdered formula. One brand name for this is Arthroflex (TM). One of my clients loads the powder into gelatin capsules and gives it that way. Some cats will eat the powder mixed with their food but cats that are sensitive to texture or the taste may not accept food with glucosamine products mixed into it. There are a lot of companies making these products right now and it would not surprise me if there are companies making other formulations that might be easier to give (like capsules or smaller tablets). I haven't really looked into this recently but if I get a chance in the next few days I will.
Prednisone doesn't cause too many obvious side effects in cats but weight gain from increased appetite and some fluid retention is pretty likely. It is necessary to try to control the weight gain by feeding less because increased weight is bad for arthritic pets. The side effect that scares me is immunosuppression. If you find that you are seeing more upper respiratory infections, more skin disease, or anything else that indicates a decrease in immune function it would be a good idea to discuss this with your vet. At every three day intervals it is not too likely that this will be a problem for your cat but it is a good idea to stay vigilant for signs of problems.
Good luck with this. I expect to see more emphasis on finding medications that are useful for pain and inflammation in cats over the next few years, so ask your vet every now and then if anything new is available. Cats have been frustrating due to their inability to process many anti-inflammatory medications or odd reactions to others so there is some chance that things won't change much. Still, there is a good economic incentive for coming up with a good anti-inflammatory for cats so there is hope.
My cat was diagnosed with feline leukemia (despite her yearly shots) about 10 days ago and is quickly going downhill. I live in a very rural area with the closest vet being 40 miles away. Originally, the only treatment was the Clavamox antibiotics, but I've been doing alot of Internet research and saw hope in the Immunoregulin. I asked my vet about this and she agreed to give it a try- so herein lies my question: She is not too familiar with the use of it and found some in the refrigerator (belonging to another vet in the practice) that is over a year old. She gave my cat her first shot yesterday (some vomiting side effects), but I just wanted to verify what the shelf life of this medication is?
The bottle of Immunoregulin should have an expiration date on it. From a practical standpoint, it seems reasonable to conclude that it would be OK to use it for a few months past the expiration date but from a legal and ethical standpoint your vet may not want to do that. If the label is damaged and the expiration date unknown I think I'd wait for a new bottle of the mediation to arrive. It just seems safer to me.
I have an older cat that was having respatory problems. I took him to the vet and I asked to do the felv test and it was + . The vet put him on clavamox mixed with interferon which seemed to help for the first week. The second week he started to vomit almost every time he ate but his apetite only suffered slightly. I brought him back to the vet and told her about the vomiting she said it could be alot of things. She put him on the same clavamox mixture and some Aminophylline for his lungs. After the vet visit his vomiting got much worse and started dehydrating. I started giving him pedialyte which helped some . The info I have read on the internet has said that some antibiotics will cause vomiting is there any help for the vomiting? I know if his vomiting was under control he would not get as dehydated. HE still wants to eat but he gets sick every time.
It has been our experience that Clavamox will occasionally cause vomiting. Please call your vet and let him or her know that you are concerned that the Clavamox itself is the cause of the vomiting. There are other antibiotics that may be useful.
Learn about the Side Effects of Clavamox.
I am looking for an appetite stimulant for my felv+Tripod. She has lost 2 lbs and is refusing to eat.
The two appetite stimulants we use most commonly are diazepam (Valium Rx) in small dosages (1mg or less) and cyproheptadine (Periactin Rx), usually 2mg/cat once a day.
I read under Indigestion in Cats that PeptoBismal may be given. Since it contains "asprin", I wonder if that could be a problem.
You are correct that Pepto-Bismal contains salicylates which are related to aspirin. The salicylates are absorbed and if given in sufficient quantities would potentially cause problems in a cat. We have not seen problem with Pepto-Bismal in our practice, probably because it is difficult to give a cat enough of the liquid to cause problems. I did not consider the possibility of dosing this in caplet form since that was not an option when I first learned the dosage for this compound. I can see where that might cause problems.
Thank you for pointing this out.
I have a fifteen year old female house cat. She takes a medication called, Tapazole (C-methimazole) for her heart? She started taking it because she was vomiting. The doctor gave her blood work and said it was her thyroid, maybe? I wish I remember exactly, but this was in June. I know I should ask these questions to my vet, but I live in the very busy city of New York and often feel rushed during my visits to the vet, even though my cat's doctor is EXCELLENT.
Anyway, can you tell me what this drug does, are there any side effects, and does she have to take it for the rest of her life? Also, my kitty seems to be getting slower with her back legs. She still jumps on the bed, but she sits down often and wobbles, sometimes. She isn't sore to the touch, but just moves more slowly in the back area. Is there anything I can do?
And finally, how can I keep my cat alive for another fifteen years? She's my best friend. :) Thank you for any information you can give me. Or can you refer me to an on-line source to look up the medication or get other info. from veterinarians?
Methimazole (Tapazole Rx) is the only pharmaceutical product that I know of in the U.S. for the treatment of hyperthyroidism on a maintenance basis. It interferes with the synthesis of thyroid hormones, which lowers the amount produced by the over-active thyroid gland. It must be given lifelong if the diagnosis of hyperthyroidism is accurate. It causes side effects in approximately 20% of the cats it is administered to and serious side effects requiring withdrawal of the medication in a small number but I am not sure what percentage that might be. Serious side effects include bone marrow suppression, liver damage or kidney damage. Loss of appetite from the medication can occur and is a serious side effect if it goes on for more than two or three days. I think that most veterinarians probably consider radioactive iodine therapy (best) or surgical removal of the effected thyroid gland to be preferable to long term treatment with methimazole but I also know that is not universally true. It is generally a good idea to monitor the blood count, liver and kidney chemistry values and T4 level while on this medication, at least periodically. Most textbooks recommend checking these levels every 2 or 3 weeks after initiating therapy until it is clear the medication is working and not causing serious side effects and then monitoring less often, perhaps every 3 to 12 months.
There is a very good site on radioactive iodine therapy at radiocat.com (there is a link to it from our link page). I am pretty sure that the Animal Medical Center in Manhattan does radioactive iodine therapy if you would consider that.
The weakness in her rear legs could be due to spinal problems, arthritis, low potassium levels, diabetes or other conditions. Since this is new and you need to talk to your vet about the methimazole again, anyway, it would be a good idea to schedule an appointment and get this checked out. Bring a list of questions written on a piece of paper and make sure that they are answered before you leave -- or that your vet agrees to check into the questions and call you back. This is reasonable for a client to ask any vet, no matter how busy they are. It is very important that veterinary clients understand their pet's health needs and the veterinarian's instructions since they are the link between the vet and the pet.
Keep working with your vet to maintain her health and you might get 15 more years. So far, our record for cat longevity is 27 years in our practice but we see many more 20 year-olds than we used to.
My cat was prescribed Acepromazine by a vet at Petsmart. I had a hard time getting them to give me specific info. (they barely have enough people working there to answer the phone) I had to bathe her and she has a great great fear of water and tries to bite me when I bathe her. They said to give 5-10 mg. She is 8.5 pounds. Do you have dosage/per pound info for this drug. She didn't appear to be affected by the 10 mg I gave her. (just to let you know, I have tried and tried to bathe her, and the groomers say that she was very difficult to bathe as well. I can bathe my other three cats, with no problem). When I am prescribed a drug by my Dr., I read the PDR. I like to know everything about what I'm taking. I even like to look at the chemical-molecule pics, even though I don't understand them. I like to read about the trials and incidence of side effects. So I was wondering if you knew of a website where I could read this kind of info, or could provide me with this kind of info, side-effects, that kind of stuff. Your response will be much-appreciated. Thanks!
Acetylpromazine (Acepromazine Rx, PromAce Rx) has a wide dose range. The label dose is 0.25mg to 1 mg per pound of body weight. Many veterinarians, including me, feel that the label dose is often much higher than the necessary dosage. I tend to use 5 mg for pets weighing up to 25 lbs and then about 5mg per 25 lbs or so after that.
Acetylpromazine is pretty unreliable as a sedative for situations in which the animal is likely to be very frightened or very aggressive. Almost all pets can overcome the sedative effect to react to things they are frightened of or to bite the vet, groomer or even owner, if the circumstances are right. Despite this shortcoming, which is significant, acetylpromazine is pretty safe for the pet and it is available in an oral form. This makes it tempting to use in situations in which you describe because it works just often enough to make it worth a try. It is important that a pet owner understand in advance that this medication may not produce the desired effect and that the pet may react badly to whatever adverse stimulus it is being used for. As long as this is clear I feel comfortable dispensing acetylpromazine.
Since "Ace" didn't work for your cat, what are the alternatives? Diazepam (Valium Rx) will work in some cats to produce reasonable sedation when acetylpromazine will not. It is not any more reliable in our hands for this, though. Anesthetics may be necessary for some pets but these must be administered by the veterinarian and the necessary bathing, etc. done under the vet's care. If you are bathing due to fleas or ticks, consider using Frontline Topspot (Rx) or if fleas alone are the problem TopSpot or Advantage (Rx).
Putting a piece of window screen (in a frame) in the bottom of the tub so that your cat can sink her claws in it seems to help a lot in reducing bathing stress -- for some cats.
DO NOT give any cat a non-steroidal anti-inflammatory medication without consulting with your vet first. Acetaminophen is toxic to cats, aspirin is extraordinarily easy to overdose in cats because the half-life of aspirin in a cat is 72 hours (3 days!) and other non-steroidal medications do not appear to have been studied much in cats, probably due to the problems with these two common ones. For arthritis, we do sometimes use aspirin but it must be used cautiously and it is important to know the patient's medical condition well prior to its use.
Photo of acetaminophen toxicity in a cat.
My cat has recently diagnosed with allergies. The treatment I tried was Children's benedryl liquid form. When ever I gave her the medicine she would start foaming profusely. The vet said she didn't like the taste. I can say that what ever she swallowed worked because she stopped licking. The vet recommended I try pill form. About a half an hour after I give it to her she throws up. I didn't get this reaction from the liquid. What I'm looking for is a cat flavored version of the benedryl, maybe liver flavored. I think that if I can find something she likes she'll be o.k. Is there something out there I can buy like this? Regards, S.
You can probably find a pharmacist in your area who still makes compounded medications (usually referred to as a compounding pharmacy or pharmacist). They can make many flavors of gels and liquids out of various medications.. Even though Benedryl is an over-the-counter medication it is possible you would need a prescription. I don't know the compounding laws well enough to know if changing the form of the medication would make a prescription necessary.
We are having terrible problems with our neutered male cat. Sometimes he will use the litterbox and most of the times he doesn't. He now is defecating on the rug as well. Our vet put him on Ovaban, one a day for a week, then 1 a week. He's been on it for 5 days now but he is acting strang, he meows constantly for about 15 minutes non stop and will not let us alone when he does this. Is this a side affect, and what are the side affects of this drug? Any help would be apprciated.
I try not to use megestrol acetate (Ovaban Rx) in cats so I don't have a lot of experience with side effects, but I don't recall this as one. I have seen a vague reference to "personality changes" associated with this medication, so I guess this could fit in that category.
Wish I could be more helpful. There is some information on dealing with litterpan usage problems on our cat information page.
Have you seen any reports or studies that indicate an association between the use of predisone in dogs or cats and the onset of diabetes?
It is pretty widely accepted that prednisone may predispose dogs and cats to diabetes. It is not as clear to me whether this is enhancement of an existing tendency to develop the disease or if it is an independent effect. They also can induce insulin resistance, leading to hyperglycemia. In diabetic patients, corticosteroids can make insulin regulation more difficult since they have this effect on blood sugar levels. I think this is a relatively rare side effect but it is a consideration, especially in a pet likely to already be predisposed to diabetes. Mike Richards, DVM
Merck (tm) recently released a version of their Heartgard (Rx) heartworm preventive, containing ivermectin, for use in cats. The product is a chewable pill formulation which is available in two dosage sizes, one for cats weighing 5 lbs. or less and one for cats 5 to 15 lbs. of body weight. The medication is administered once a month, on the same day each month, for heartworm prevention. It may be used in cats already infected with heartworms to prevent introduction of new worms into the cat's cardiovascular system.
The manufacturer recommends testing cats prior to placing them on Heartgard (Rx), which follows the recommendations of the American Heartworm Society. While testing of cats for heartworm disease is not as accurate as testing dogs for heartworm disease, there are tests available from Idexx and Heska for cats.
This is a prescription medication. It will also control infection with hookworms in cats. The package insert indicates it is safe for use in kittens over six weeks of age and that it is safe to use during pregnancy. There are no known conflicts with other medications at this time. It is packaged in cartons of 6 tablets and should be used from the beginning of heartworm (mosquito) season until one month after mosquitoes are gone. For some areas of the country it will be necessary to use this medication on an all-year basis.
I just finished reading your web site and found it very informative. I have a couple of questions regarding medication my dog and cat are currently taking. Have you heard of a medication called Geri Zyme or Comfort. I'm giving it to my 2 1/2 yr old Golden who was diagnosed with severe hip dysplasiaa couple of years ago. It made a vast improvement in his mobility, even before he had his hip operation a year ago (the operation where they remove the head of his femor bone). I was curious if you had heard of this medication, and if so, could you give me some information on it. Also, we just introduced a kitten to our household, and our older cat began spraying. We have him on a low dosage of Diazapam (about 1 1/4 milligrams twice daily). We have taken him off it once since we got the kitten and he began spraying again. I suspect we may have to keep him on it for quite a long time (he's 17 yrs old). Do you know of any side effects keeping him on it for an extended time could cause?
I am not familiar with GeriZyme or Comfort, so I can't help with that question. Many times it is possible to slowly wean a cat off of diazepam (Valium Rx) after administering it for 2 months or so after spraying is controlled. Slowly cutting down the dose rather than stopping abruptly really seems to help. I am not aware of any long term problems associated with the use of diazepam in cats. It has been implicated in some cases of liver failure in cats but these occurred during the first few days of use and appear to more an individual sensitivity problem among some cats. If you have to use this long term to control the spraying I think it will be OK to do so. Mike Richards, DVM
I've been to the vet and got another dose (2wks worth) of metronidazole. A stool sample was also sent away to be analyzed for an exact diagnosis. My question is: I am having a great deal of difficulty getting my cat to take her pills. We have an extremely difficult time dropping it into her mouth (even the vet had trouble), she spits it out if she can, then it disintegrates and never gets into her. We have tried crushing it up and putting it in margerine, tuna and wet food--no luck (i know it must taste bad ) Our final method, which still very difficult but more effective is disolving it in a small amount of water and squirting it into her mouth with a syringe. Any suggestions to make the two weeks of medication administration go by with out such a production (and believe me it is a production with her!)?
Metronidazole tastes really really bad. It is very difficult to administer to some cats due to this.