Twas the night before Christmas
And all through the house
Sadie was meowing like a banshee due to a medication called Mirtazapine (Remeron).
Here’s what happened at the vet on Tuesday:
- Sadie had an ultrasound, which was unremarkable.
- Sadie’s bloodwork showed normal white and red blood cell counts.
- Sadie’s kidney values were elevated: BUN 50 (normal is 10 – 30) and creatinine 4.9 (normal is 0.3 – 2.1).
- Sadie’s blood sugar, even in the midst of all the vet stress, was 129 (normal 70 – 150).
- Sadie was given subcutaneous fluids.
- The vet gave Sadie a dose of Mirtazapine (Remeron) to stimulate appetite.
- The vet sent Sadie home with two prescriptions: Baytril (a broad-spectrum antibiotic) and Cerenia (for nausea).
Sadie’s kidneys aren’t feeling good. The vet opined she either has (1) CKD/CRD (chronic kidney/renal disease) or (2) pyelonephritis (kidney infection). Because the ultrasound showed normal kidneys, the vet said if she does have CKD, it has not caused significant damage to either kidney. Also, if she has pyelonephritis, it likely has not caused much permanent damage, for the same reason. The vet put Sadie on an antibiotic, Baytril, while we await the results of the urine culture and the urinalysis. At that point, we may switch (or stop) antibiotics. If she does have pyelonephritis, she’ll need to be on antibiotics for at least four weeks. Which means I will have to get a better system down for pilling Queen Sadie.
When Sadie got home from the vet Tuesday evening, she seemed to be feeling better. She was less lethargic and went straight to the food saucer and began eating more heartily than she has in days. The vet instructed me to feed her whatever she’ll eat at this point, so I gave her her favorite tuna. Once she’s gotten her appetite back and her diagnosis is certain, we’ll adjust her diet. I’m also to make sure she’s drinking plenty of water, which she is.
Yesterday, Wednesday morning, she walked to the fresh tuna I put out, took a sniff, and walked away. I tried Greenies treats. I tried Temptations treats. Nothing. I went to the store and bought three different kinds of Gerber’s stage 2 baby food (chicken, turkey, and ham), three kinds of Fancy Feast (I hear cats love the stuff), and a freshly roasted chicken. Sadie ate about a teaspoon of the ham baby food. I then gave her a plate with two more kinds of baby food and three kinds of Fancy Feast. She was interested in none of them. I brought out the big guns: freshly roasted chicken, and a few bits of skin. Sadie took one sniff and walked away.
I tried to feed her off and on until early afternoon, at which point she’d taken a few more licks of baby food, a bite of chicken, and a handful of Greenies. She’d eaten enough to take her antibiotic, which I managed to get her to take in two parts. (The pill is huge.)
Pilling has gotten more difficult each time. This morning, in an attempt to dislodge the pill and my finger from her mouth, she bit me. She drew blood. My, what nice teeth you have. I tried to hide the pill in pill pockets. She wouldn’t eat them. I tried again to put it in her mouth. She kept pretending she’d swallowed and would then spit it out. I tried nose-blowing and throat-stroking. Nothing worked. At one point, I did this and held her for five minutes. She appeared to have swallowed so I put her down. She spit the final 1/3 of the pill (or what hadn’t disintegrated in her mouth after five minutes) out. Yes, Sadie held the pill in her mouth during five minutes of petting and promptly spit it out when I set her down. We’re going to have four to eight weeks of this? Oy.
Because Sadie’s appetite had faded again yesterday and the vet was going to be closed from Thursday until Monday, she called in a prescription for the same appetite stimulant she’d given her in her office on Tuesday: Mirtazapine, which goes by the trade name Remeron, a human antidepressant that is well-known to stimulate the appetite in humans. (For this reason, it is an antidepressant I will never take.) Mirtazapine is also a popular appetite stimulant in CKD cats.
Sadie is to have 1/8 of a 15 mg pill every other day. (Trying to split a tiny pill into 8 somewhat uniform pieces was challenging.) Since she’d had a dose on Tuesday, I waited until this morning to give her another dose. Remember, the first time she had it, the vet gave it to her when I was not present. So this was my first time giving her this particular drug. It was a tiny little sliver and so I managed to get it down without too much trouble. But within two minutes she began drooling profusely. It could almost have been described as foaming at the mouth. I freaked out and hopped on the google. Apparently this is not uncommon and passes quickly. And it did. The next thing I noticed, Sadie started taking more of an interest in Sophie (something she hasn’t done since she’s not been feeling well), looking like she was ready to chase her down and tackle her. I redirected her, and the next thing I knew, I could hear her downstairs rifling around the food saucers, clink clink clink. I hurried downstairs, and sure enough, Sadie was chowing down on the uneaten tuna from earlier in the morning. When she finished, she ate Sally’s leftovers. When she finished that, she meowed for more, so I gave her some roast chicken. When she finished that, she ate some Greenies.
After Sadie finished with her feast, she jumped up on the back of the sofa and lay down. But then she began meowing repeatedly. Based on my research, I knew this might happen. The appetite stimulant is referred to as Meowzapine in cat circles. She’s also very clingy on the drug. She wants to be held and cuddled closely, burrowing into my neck. She’s getting no objections from me. Right now she’s back to lying on the back of the sofa, staring out the window, watching the birds.
So, the appetite stimulant is a success, although a little weird. Sadie is eating, drinking, peeing, and pooping just fine. The anti-nausea medication is working, as she’s keeping everything down. My biggest challenge has been to get her to take the Baytril (antibiotic) without taking off my finger. Next time, I’ll try to get the hang of the pill-popper contraption I bought from the vet. If only she was one of those cats who can be tricked by a Greenies pill pocket.
In the midst of all this, it’s Christmas Eve. With the 75-degree weather here in Central Texas and my focus on the cat, I can hardly tell it tis the season. Because I don’t want to leave Sadie overnight, I’ve scrapped my plan to go to Houston today. I’ll go tomorrow morning just for the day, and be back in time tomorrow evening to give Sadie her medication and some Christmas cuddles. Perhaps we’ll have a Christmas miracle, and she’ll take it without a fuss.
Wishing a Merry and Happy Christmas to all my friends in the Blogosphere!