Appetite stimulant for complex case?

RE: Appetite stimulant for complex case?

Busybee — Thu, 18 Apr 2019 18:19:59 GMT

Many thanks all! I saw the dog for booster yesterday and the owner reports since I spoke to him, she's been eating really well! So we're holding off additional meds at present. If needed, we're going to try mirtazepine or cyproheptadine (great shout Lucy!) but the owner is pragmatic about our options.

RE: Appetite stimulant for complex case?

Kate Richardson — Mon, 15 Apr 2019 19:49:33 GMT

Try maropitant for poss nausea and try analgesia if not already on any. If no better prob cognitive dysfunction. just make sure not trying to keep her alive at all costs I guess, sometimes it’s really hard to let these ones go but inappetance despite being fine otherwise always concerns me re quality of life

RE: Appetite stimulant for complex case?

Anthony Dennison — Mon, 15 Apr 2019 15:37:33 GMT

Sorry to muddy the waters further but is there any indication of the cause of the inappetance? There's raised ALKP, could it be worth testing specCPLi to see if there's a low grade grumbling pancreatitis from all the meds causing the inappetance?

Some abdominal imaging with ultrasound to look for subtle lesions may be a good idea too if not done already.

RE: Appetite stimulant for complex case?

Lucy Fleming — Mon, 15 Apr 2019 12:27:39 GMT

Cyproheptadine (Periactin)?

RE: Appetite stimulant for complex case?

Busybee — Mon, 15 Apr 2019 10:24:12 GMT

[quote user="Michael Woodhouse"]

Yea, steroids. I feel like this is a trick question with an obvious answer.

[/quote]

Haha, I wish! I should have said, she has previously been on prednisolone but it didn't really help her skin and she suffered with marked pupd and the owner is very against using them again. This was my first suggestion!!

RE: Appetite stimulant for complex case?

Thomas Johnson — Mon, 15 Apr 2019 09:54:44 GMT

[quote user="Michael Woodhouse"]

Yea, steroids. I feel like this is a trick question with an obvious answer.

[/quote]

That's what I was thinking, but make sure she's on something like Bravecto to stop the demodex coming back.

RE: Appetite stimulant for complex case?

Bob Russell — Mon, 15 Apr 2019 09:44:17 GMT

Perhaps consider replacing the Selgian (+-diazepam) with Mirtazapine. A good appetite stimulant and inducer of sleep!

RE: Appetite stimulant for complex case?

Anthony Todd — Mon, 15 Apr 2019 09:07:27 GMT

Perhaps add B12, as was standard BITD, but wonder if there is any evidence or agreement??

RE: Appetite stimulant for complex case?

Michael Woodhouse — Mon, 15 Apr 2019 01:30:14 GMT

Yea, steroids. I feel like this is a trick question with an obvious answer.