cat won't take meds - feeding tube in place...

RE: cat won't take meds - feeding tube in place...

Luciano Nebiante PGCertSAS — Fri, 17 Feb 2017 10:49:26 GMT

[quote user="robloxley"] but reading this by Kit Sturgess he says he uses ciclosporin as adjunct of choice[/quote]

I have used in a limited number of cases and they seemed to be doing well. I expect the safety profile of Atopica to be better than Chlorambucil?

RE: cat won't take meds - feeding tube in place...

Rob Loxley — Wed, 15 Feb 2017 17:55:36 GMT

[quote user="Luciano Nebiante PGCertSAS"]Anyone using Atopica oral solution in these difficult IBD cases?[/quote]

I have tended to add in chlorambucil to steroid rather than ciclosporin (or others), but reading this by Kit Sturgess he says he uses ciclosporin as adjunct of choice, though the evidence for one over another is lacking

RE: cat won't take meds - feeding tube in place...

Luciano Nebiante PGCertSAS — Wed, 15 Feb 2017 17:24:56 GMT

Anyone using Atopica oral solution in these difficult IBD cases?

RE: cat won't take meds - feeding tube in place...

Kate Richardson — Wed, 15 Feb 2017 12:11:14 GMT

dose control would be the main issue with using depo-medrone- what do you do if say after a week it's not working as well as you anticipate? Give another dose of depo-medrone? Top up with dexamethasone? At least with daily dosing you can increase or decrease the dose as necessary and assess the response much better. I wouldn't rule out using it, but bear in mind the pitfalls

RE: cat won't take meds - feeding tube in place...

Aisling McGrath — Wed, 15 Feb 2017 11:59:01 GMT

Definitely would use DepoMedrone, but was thinking pred would be ideal first line, then 2nd choice with be dex in food, then depomed would come last, just because you can't control dose as well, and risks of heart disease, diabetes etc?

RE: cat won't take meds - feeding tube in place...

Michael Woodhouse — Tue, 14 Feb 2017 23:25:48 GMT

If the animal is on longer term steroids and difficult to manage then why not just use Depo-medrone. I know not as a first line, but its tolerated really well in cats and works (and is licensed).

RE: cat won't take meds - feeding tube in place...

Aisling McGrath — Tue, 14 Feb 2017 10:29:15 GMT

It was David Godfrey (dermatologist) who first mentioned it to me, and as mentioned prior, I've had huge success with it. We'll see how we get on with crushed preds in various things, but I think we'll give the dexadreson in food a go if we don't get success that way.

RE: cat won't take meds - feeding tube in place...

Stephanie Wellings — Tue, 14 Feb 2017 09:02:01 GMT

Don't have any evidence but I have used dexadreson orally and it works really well. It was originally prescribed by a dermatologist - I can't remember why it was preferred over crushed tablets, maybe longer duration? - and in the long term sometimes you can reduce the dose (0.2ml in a cat) to a couple of times a week.

RE: cat won't take meds - feeding tube in place...

Allison Gleadhill — Tue, 14 Feb 2017 08:08:39 GMT

Have you tried putting his crushed meds in 'soup' made by Sheba or Purina?

my own cat has had to have 6 months of oral liquid meds (for TB) that I couldnt physically give him & contemplated a tube but he's taken it all happily in this 'soup'

RE: cat won't take meds - feeding tube in place...

Emily Rainbow — Tue, 14 Feb 2017 07:54:18 GMT

What makes you use dexadreson in food rather than steroid tablets?

RE: cat won't take meds - feeding tube in place...

Aisling McGrath — Mon, 13 Feb 2017 17:32:43 GMT

The whole dexadreson mixed in food thing! Glad someone brought that up. We've done it for several skin cases and it has worked really well. I did mention it to the specialist today to see what she thought of it, and she hadn't heard about injectable dexamethasone being used in this way. Does anyone know is there any published evidence? I have strong anecdotal evidence from our practice clients, but just wondering if there have been any studies?

And what dosage are other people using? We were giving around 0.2ml every other day?

RE: cat won't take meds - feeding tube in place...

Rob Loxley — Sun, 12 Feb 2017 00:33:26 GMT

[quote user="Thomas Johnson"] after that do you think the owners would be able to inject that cat daily at home? If so you could switch it from prednisolone to dexamethasone[/quote]

Dexadreson injection mixed in food works pretty well...

RE: cat won't take meds - feeding tube in place...

Thomas Johnson — Sat, 11 Feb 2017 16:12:40 GMT

[quote user="Aisling McGrath"] And I'll chat to the specialist at some point next week to discuss case management further (because I'm worried that the cat will never take daily prednisolone, and can't leave O tube in forever, so may need to consider depomed?!)[/quote]

I would agree with everyone else about leaving the o-tube in for another 3 weeks, after that do you think the owners would be able to inject that cat daily at home? If so you could switch it from prednisolone to dexamethasone.

RE: cat won't take meds - feeding tube in place...

Joyce Whitehead — Sat, 11 Feb 2017 16:01:44 GMT

We had one cat on long term preds for an autoimmune problem that was very hard to tablet. We eventually got him to take human soluble prednisolone dissolved in about 2ml water and mixed with single cream. Obviously he had no milk gut issues but might be able to mix with something particularly tasty?

RE: cat won't take meds - feeding tube in place...

Aisling McGrath — Sat, 11 Feb 2017 15:35:55 GMT

Thank you everyone for your comments, the owner has a funeral to go to that day, so she's been given a special 8.30am appointment (first appointment is usually at 9am). I haven't had a lot of experience with O tubes, hence the query. I definitely think it makes sense to leave it in, I'll reassess the cat Monday, but given all your comments, I'm confident to leave it in, at least for a bit longer, is right decision. And I'll chat to the specialist at some point next week to discuss case management further (because I'm worried that the cat will never take daily prednisolone, and can't leave O tube in forever, so may need to consider depomed?!)

RE: cat won't take meds - feeding tube in place...

Lucy Fleming — Sat, 11 Feb 2017 14:52:07 GMT

I would also leave it in. Might be worth trying to see if he will take the preds crushed in food, if those are likely to be needed longer, but if it's well tolerated and no problems with the site probably less stress on the owners and cat to plan to do all the meds through the tube.

RE: cat won't take meds - feeding tube in place...

Jenny Harris — Sat, 11 Feb 2017 14:06:18 GMT

+1 for leave it in

RE: cat won't take meds - feeding tube in place...

Rob Loxley — Sat, 11 Feb 2017 12:55:04 GMT

I'd agree with discussing with the referral centre, but I'd see no reason to not leave the o-tube if only just to medicate for the next few weeks. During that time I'd also experiment with ways to get the meds in orally, if the cat will need longterm meds once the o-tube finally comes out.

RE: cat won't take meds - feeding tube in place...

Kate Richardson — Sat, 11 Feb 2017 12:53:57 GMT

Yes you could leave the o tube in if he is eating and comfortable with it

RE: cat won't take meds - feeding tube in place...

Gillian Mostyn — Sat, 11 Feb 2017 12:53:04 GMT

If it isn't causing any problem, I would have thought you're best to just leave the o tube in for the meds. We often leave them in for many months in our exotics patients.

RE: cat won't take meds - feeding tube in place...

Linda Filshie — Sat, 11 Feb 2017 12:16:09 GMT

Could you not just call the client, tell them you need to speak to the specialist before their appointment and offer them a later/next day visit?