Erik update

[cellio]

When Erik lost interest in food a few weeks ago, the vet (not my regular one; the one I could see that day) put him on an anti-vomiting drug (Metaclopramide) as well as giving subcutaneous fluids. His appetite picked up after that, and in fact about a week ago he was eating more than he had been at any point since the surgery. Then on Sunday, almost a week after the drug ran out, he largely lost interest in food again, which continued Monday morning. (Not much vomiting, though.) He was already scheduled with my vet for a followup (she wanted this specific date), so at least his timing was good.

She could detect no obvious problems (including dehydration, though I watered him Sunday night after he ignored food). I asked whether it was possible that, even though he wasn't vomiting a lot, he was queasy, and the drug had helped with that. She seemed doubtful, and she explained that it's not an anti-nausea drug; it helps speed up the flow of digestion (without loss of nutrients), so its effect on vomiting is to hurry the stuff out of the system through regular channels in a race to the orrifices, or something. I asked if a stomach emptying faster than normal would lead to hunger; she's not sure, but that got us talking about appetite stimulants. She said that sometimes a shot of vitamin B can have that effect, so she gave him a shot and she'll order some Metaclopramide for me to use as needed.

When I got him home and offered him food he dove into it. I wouldn't expect a vitamin dose to work that quickly, so maybe he was getting over it on his own, but either way it's a good sign.

He's gained one ounce since the last visit. Bummer; I thought he'd picked up a quarter pound or so.

He'll also be starting a new round of antibiotics in a couple days. The vet, and the specialist she consulted, think the best way to keep the hepatitis in check is to just pulse antibiotics for a couple weeks at several-week intervals.

Comments

[ealdthryth.livejournal.com]

That sounds like progress. Maybe he's on the mend.

[spiritdancer]

Hmmm ... that comment on metoclopramide is interesting :-)

I just checked my drug handbook, and, as I thought, metoclopramide (Reglan) has two modes of action - the increased stomach emptying, and "In the CNS, metoclopramide apparently antagonizes dopamine at the receptor sites. This action can explain its sedative, central anti-emetic (blocks dopamine in the chemo-receptor trigger zone), extrapyramidal, and prolactin secretion stimulation effects." (that's quoted from Plumb's Veterinary Drug Handbook, if you'd like to point her towards a reference).

In other words, it does have anti-nausea effects. Explains why one of the major uses is for chemotherapy patients to prevent/treat vomiting from the chemo drugs. Probably a pretty good idea in Eric's case, as the hepatitis is likely causing some nausea, I'd suspect.

Vitamin B is a Good Thing in cats that aren't eating well (they lose it pretty fast when they aren't eating, and the first sign of B vitamin deficiency in a cat? loss of appetite *grin*). And being water soluble, it might indeed work that fast.

[cellio]

Thank you for the information! I will pass this on to her. It's possible that I misunderstood what she said, but I didn't see her consult any references for this question. (She did look up something about Ursodiol; the other vet had suggested suspending that, and my vet consulted what looked kind of like a PDR for animals and then said to go ahead and restart, as it has both curative and preventative effects -- or so I understood.)

And being water soluble, it might indeed work that fast.

Good point. She did say it was water-soluble, but I didn't make the connection.

[tsjafo.livejournal.com]

I'm glad he's doing better.

[jhayman.livejournal.com]

So glad Eric is doing better. There are those who have NO CLUE why you might worry about a cat. Then there's the rest of us, owned by cats and poud of it!

[figmo.livejournal.com]

An ounce is better than no weight gain. Tell him to keep up the good work, m'kay? Hugs to both of you and Dani too.

[indigodove.livejournal.com]

I hope he keeps doing better!

[estherchaya.livejournal.com]

I'm sorry you're having to go through this over and over, but it sounds like you are getting closer to a workable treatment plan for him, so yay!