Nursing Sadie

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.

Sadie is quite a Handy Cat when she is feeling up to par.
Sadie is quite a Handy Cat when she is feeling up to par.

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!

Ella xox

 

30 comments

  • Prayers for Sadie! I am glad the medication is working and hope for a permanent recovery. We’re having an interesting holiday, since ‘cousin Quark’, a sun conure is visiting … Mr. M is ignoring the bird and Ms. Purrseidon wants in that cage to play with all the pretty toys. So far, no one has drawn blood, but if it is drawn, I suspect Quark will be the biter (he has a well-deserved reputation)… he also breaks walnut shells….

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  • Lots of prayers for both you and Sadie. Mom says she’s glad she doesn’t have to give us pills ‘cuz we would probably be as sneaky as Sadie is! We all wish you a Merry Christmas and much better days ahead. Purrs and soft paw pats…..

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  • hope for good recovery! warm wishes to you and your lovelies! may you continue in health, wealth, joy and peace!

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  • Thank you so much for continuing to share this familiar, touching, funny, and suspenseful story. Here’s hoping the culture comes back negative and it’s the Baytril killing her appetite. If you end up with sub-Q fluids, at least they’re easier than pilling. When she is feeling better, perhaps she can build me a set of shelves.

    Liked by 1 person

  • I have one of those pill-popper devices. The trick is to get it far enough back in their mouth that it becomes impossible to spit out the pill. At that point, it just goes down.

    Easy enough in theory.

    My preferred method to give my late cats pills was to kneel on the floor, and then back the cat into my groin. At that point, I lean over, pull down the cat’s lower jaw with my left hand, and with the pill popper in my right hand, do the deed. There’s no means of escape, and when you get good at it, you can get it done surprisingly quickly.

    Good luck. And keep your fingers out of her mouth. Cats have a bacteria called pasturella which can case a nasty infection. If you get swelling in your finger, GO TO THE DOCTOR; don’t wait. I was once bitten by a cat, waited over night, and the next day I went to the ER. They put me on an antibiotic drip and then I had to take antibiotics for a couple of weeks thereafter. Cat bites are serious stuff, so don’t fool around.

    Merry Christmas and best of luck!

    Saludos,

    Kim G
    El Granada, Ca
    Where we are thankful we aren’t administering any pills. Now if we could only remember to take our own.

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    • P.S. If you grab her lower jaw where the teeth meet the gums, even if she bites, she doesn’t get you. That’s how my vet taught me.

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    • These are good tips, Kim. I’m never quite sure where to put my fingers on her jaw. Luckily, my finger is not swollen. Yesterday morning, I tried again with the Baytril. I thought I had it done, and when I let her go, once again, she spit it out. So I gave up and drove to Houston. When I got back last night, I wrapped her up in a towel like a burrito. Then I used the pill popper with the idea of getting the pill back a little farther and keeping my fingers intact. I also read that if you chase the pill with a couple of drops of water from an eye dropper, it will stimulate swallowing. After fumbling the pill popper a bit, I popped the pill in and followed up with a few drops of water. And then I waited. I petted her and talked softly to her while she was still wrapped up like a little kitty burrito. I stroked her throat. I blew on her nose. After five minutes or so, I let her go, fully expecting her to spit the pill out. She did not. I followed her around, searched the floor, shook the towel, shook my shirt. No pill. I’m fairly certain she swallowed it. A true Christmas miracle. Hopefully we can do a repeat tonight. I think there is a business opportunity here. Cat Piller: $25 per visit. You could be done in 5 minutes and earn $175 a week with just one cat client.

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      • You can do it. I like the “burrito method.” As for someone else doing it, it’d probably be tough for a stranger to do it the first time, and the second time the cat would probably be gone in a shot. Saludos!

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        • Probably so. Sadie is no dummy. The water chaser seems to be the key with her. I just gave her the appetite stimulant, and no foaming at the mouth this time. I worry it’s going to get harder as she starts feeling better, but we’ll just take it one pill at a time.

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  • Merry Christmas to you and Sadie! Hope she feels better soon! Love to you both. And to Sally, though I don’t seem to know her that well.

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  • Dashing to catch up. I have no luck at all to get cats to take pills – husband has to do it…somehow they understand they might as well take the darn thing or it gets ugly. Dogs, though, he can’t do…Molly is too sneaky and smugly hides the pill for long periods. I do dog pills…inside various food combinations…usually works with dogs, not the cat.
    Oh, picky RC Cat only eats Friskies turkey and giblets pate…several of her vet tests always come back out of whack…the vet really thought she, a tiny tiny abandoned kitten, was so abnormal she’d probably die – that was some 9+ years ago. He finally said some cats have weird metabolisms. And what ever she would eat and grow on was what she should eat.
    Your vet is right, feed her what she will eat. (Yogurt for good bacteria or tiny bit of vanilla ice cream is also OK)

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