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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 18250
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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Treating kitty for feline fatty liver disease... still is

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Treating kitty for feline fatty liver disease... still is throwing up a bit after we feed him. Trying to decide if we should add back in the cerenia in addition to his ondansetron. Last weekEND he didn't throw up just being on ondansetron, but then did during the week -- perhaps the effects of cerenia had worn off, so he went back to throwing up? I know we just administer that once a day for 5 days and then off for a bit (I can't recall timing). I think the cerenia caused excessive (I mean excessive) drooling - and that is one reason I was happy he was off it. It may have also caused diarreah - so hoping he still makes it to his little box! Would you give the cerenia with or without food? We are supposed to give 1/4 of the 16 mg pill. Cat was almost 13 pounds when checked out of hospital - very bony still. Not sure of his ideal weight.

Hello again,

If Tempo is still vomiting, we'd want him back on both to manage this for him. That way we can make sure he is as nausea free as possible; since its better to have him better covered then risk vomiting, appetite loss and more fat being put into circulation and ultimately ending up in his liver. As well, I do suspect the reason its making him drool is because you are having to split the tablets. Therefore, consider putting this in an empty gel cap (OTC at most pharmacies) to avoid that for him. And if he does have diarrhea on the Cerenia (usually it doesn't cause that), you can try adding some fiber (ie canned pumpkin) to his meals or even using a few millilitres of OTC Kaolin/Kaopectate (avoid Pepto Bismol, Loperamide, or any with salicylic acid/aspirin since those aren't kitty friendly) to counter that for him too.

Kind regards,

Dr. B.

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Customer: replied 5 days ago.
We crush the meds (pepcid and ondansetron) and were going to do the same for cerenia. Looking at the hospital bill, it looks like he had an injection and then he also had tablets. He was still throwing up there too -- and also drooling. They would cut back on his food because they assumed the drooling meant he couldn't handle the food. But when I came home and realized the Cerenia may be causing the issue, I stopped it, and the drooling stopped. Also no throwing up for a couple of days (except for a couple of times immediately after the ondansetron, before food). Are you saying put the 1/4 pill of Cerenia into an empty gel cap and then drop the pill into his mouth with one of those pill feeder things?

Hello again,

Yes, I would try it in a gel capsule and then given directly with a "pilling gun" since some tablets just irritate the stomach/throat/mouth when not enteric coated. Though if he had issues with the injectable as well, you could speak to his vet about swapping the Cerenia for Metoclopramide. That too is a good anti-nausea medication but comes as a liquid (or injectable) which may be a better option all around for keeping his nausea stable here.

Best wishes,

Dr. B.

Customer: replied 5 days ago.
Okay, great. I think I'll try giving it to him through his tube with pumpkin and a few mil of water and if he still drools excessively will try the gel cap. And hopefully the throwing up will be under control too - but I think the hospital still had some issues too. Looking online, and considering he is about 13 pounds now (lacking muscle at this point - bony - should be heavier), and quite sedentary, would you shoot for about 20 cals per pound? I know this is such a grey area.

Hello again,

That sounds like a good plan and if we still see drooling then Metoclopramide would be an alternative to consider. Anyway, in regards ***** ***** daily calorie goals, 20 cal/lb is only meeting his resting energy rate baseline for this weight and won't get weight back on him. Ideally, if we want more weight back on, we need to use 2-3 x resting energy rate. So, if we were feeding for the 13lbs, that's 494-742 kcal per day to start getting more weight onto him. We can then wean up as he gains as needed.

Best wishes,

Dr. B.

Dr. B. and 2 other Cat Veterinary Specialists are ready to help you
Customer: replied 5 days ago.
Oh wow - that's a lot. Well, I hope we can keep the food down because we are only at around 200 calories I'm guessing - give or take. He doesn't do a lot right now so - doesn't expend a lot of energy.
It is quite a bit since the rate we have him on now literally is the minimum for basic life function
So do take it slow but hopefully if we can't his nausea a bit more settled we can get more in so he has more energy to start doing things as normal.
Kind regards,
Dr. B