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Re: [FH] Chloe - Need Medication/Symptom Advice

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  • Karen Plasket
    Hi Suzanne, Oral potassium supplements can cause nausea and stomach irritation, so I think that may be your problem. What was her potassium level at? Also, I
    Message 1 of 3 , Nov 18, 2012
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      Hi Suzanne,

      Oral potassium supplements can cause nausea and stomach irritation, so I think that may be your problem. What was her potassium level at?
      Also, I would give the Cyproheptadine in the am (better schedule for getting her to eat throughout the day). I would also give the Pepcid in the am, since it's job is to block the secretion of stomach acid. That way, both medications will work optimally during the day, when Chloe should be eating the most. Then you can monitor how much she eats during the day, and decide in the evening whether to give the potassium supplement (and, of course, check with your vet tomorrow...since I don't remember seeing what her potassium value was, I'm concerned if she is very low and not receiving her supplement).

      Karen Plasket, DVM

      -----Original Message-----
      From: zan200 <zan200@...>
      To: feline-heart <feline-heart@yahoogroups.com>
      Sent: Sun, Nov 18, 2012 11:16 am
      Subject: [FH] Chloe - Need Medication/Symptom Advice





      Hi All,

      I need help setting up Chloe's medication schedule. I'm not sure how much time needs to elapse between meds - the vet said not to worry about interactions, but do you wait 1 hour, 2 hours, etc. before giving another medication? Also, Chloe is really not eating (despite the cypro for appetite), but her postassium supplement needs to be given after meals to prevent stomach upset (I don't want to add nausea, vomiting, diarrhea to my list of problems). I don't know what to do - skip the potassium for now?

      Chloe has not looked "herself" this weekend - not eating, staying in the back room, etc. I'm not sure if she needs more Lasix (she perked up a bit after last night's Lasix dose - her respiration rate is still about 24, but I thought her breaths seemed a bit more pronounced), or if the potassium gel upset her stomach, or she's gearing up for something major...I'll call the vet Monday and see what she says, but any advice would be greatly, greatly appreciated.

      Medications -

      Renal K Gel 1/2 tsp. 1X, or Renal Kare Tabs 2X, daily

      (Renal Tabs are way too big for Chloe - It was suggested by Chloe's vet tech that I crush the pills and put them into the gel caps I use for Chloe's other medications - 1 pill fills 3 capsules - 6 caps a day! I can't see it...)I haven't tried the pills, but I did give Chloe 1/4+ gel yesterday morning - she didn't seem to want to eat after that.)

      Cyproheptadine - 1/4 tab 6:00PM (I'm thinking of bumping it up to the AM in hopes of getting Chloe to eat).

      Lasix - 1/2 tab 9:00PM

      Pepcid - 5 mg 11:30PM

      Laxatone - as much as possible for constipation problems (I give it as a "treat" after meds - since the heart issues/new meds started, Chloe has been extremely constipated)

      I'm supposed to start Chloe on the 5 mgs of aspirin tomorrow, but with the not eating problems, etc. I will call the vet before I start anything else...

      So sorry for the lengthy note...again, I'd so appreciate any advice...
      Suzanne and Chloe









      [Non-text portions of this message have been removed]
    • zan200
      Hi Dr. Karen, Thanks so much for your response. I don t think Chloe s potassium level was seriously low - I ll ask the vet for an exact reading when I call
      Message 2 of 3 , Nov 18, 2012
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        Hi Dr. Karen,

        Thanks so much for your response. I don't think Chloe's potassium level was seriously low - I'll ask the vet for an exact reading when I call tomorrow, but I do think she mentioned it was slightly down after the 1 week on the 2X per day Lasix. I hope it's not dangerous to skip the potassium today.

        Chloe looked a bit miserable after yesterday's AM dose of the Renal K gel, so I'm thinking (hoping) it's an upset stomach issue. No vomiting, etc., but just the no-eating, and acting unhappy. Chloe did eat a little earlier this afternoon - maybe her stomach calmed down after I stopped the potassium?

        I'll switch the "cypro" to the AM - Chloe's been on a very small dose of "cypro" for years and it always worked like a charm, but ever since the HCM diagnosis it doesn't seem to do much at all. She only gets 1/8 - 1/4 tab because a larger dose makes her extremely "spacy".

        I don't know why, but the vet always insisted the Pepcid be given at night - I've questioned this decision over the years as Chloe used to have a daily bout of vomiting attributed to the pancreatitis - the Pepcid never seemed to help, but the vet said to keep giving it anyway. The strange thing is, ever since the HCM - the vomiting completely stopped...

        Chloe is supposed to start on her 5 mgs of aspirin tomorrow, but I'll check with the vet first - if she's not eating and all the meds upset her stomach, what do you do?

        Is there a transdermal form of potassium available, thus bypassing the stomach entirely? Chloe did take a transdermal antibiotic years ago and had a bad reaction - swollen ear where the medication was administered - but maybe that was from the medication itself. I'd be willing to give it another try if possible.

        Chloe's respiration rate is still in the 20-28 range, but I worry about the 1X versus 2X dose of Lasix - is a smaller dose 2X per day better than 1 big dose?

        I hope I can sort all this out before Chloe's vet goes on her Thanksgiving vacation, Wednesday.

        Thanks again for all your advice and help,
        Suzanne and Chloe





        --- In feline-heart@yahoogroups.com, Karen Plasket <slammerfold@...> wrote:
        >
        >
        > Hi Suzanne,
        >
        > Oral potassium supplements can cause nausea and stomach irritation, so I think that may be your problem. What was her potassium level at?
        > Also, I would give the Cyproheptadine in the am (better schedule for getting her to eat throughout the day). I would also give the Pepcid in the am, since it's job is to block the secretion of stomach acid. That way, both medications will work optimally during the day, when Chloe should be eating the most. Then you can monitor how much she eats during the day, and decide in the evening whether to give the potassium supplement (and, of course, check with your vet tomorrow...since I don't remember seeing what her potassium value was, I'm concerned if she is very low and not receiving her supplement).
        >
        > Karen Plasket, DVM
        >
        > -----Original Message-----
        > From: zan200 <zan200@...>
        > To: feline-heart <feline-heart@yahoogroups.com>
        > Sent: Sun, Nov 18, 2012 11:16 am
        > Subject: [FH] Chloe - Need Medication/Symptom Advice
        >
        >
        >
        >
        >
        > Hi All,
        >
        > I need help setting up Chloe's medication schedule. I'm not sure how much time needs to elapse between meds - the vet said not to worry about interactions, but do you wait 1 hour, 2 hours, etc. before giving another medication? Also, Chloe is really not eating (despite the cypro for appetite), but her postassium supplement needs to be given after meals to prevent stomach upset (I don't want to add nausea, vomiting, diarrhea to my list of problems). I don't know what to do - skip the potassium for now?
        >
        > Chloe has not looked "herself" this weekend - not eating, staying in the back room, etc. I'm not sure if she needs more Lasix (she perked up a bit after last night's Lasix dose - her respiration rate is still about 24, but I thought her breaths seemed a bit more pronounced), or if the potassium gel upset her stomach, or she's gearing up for something major...I'll call the vet Monday and see what she says, but any advice would be greatly, greatly appreciated.
        >
        > Medications -
        >
        > Renal K Gel 1/2 tsp. 1X, or Renal Kare Tabs 2X, daily
        >
        > (Renal Tabs are way too big for Chloe - It was suggested by Chloe's vet tech that I crush the pills and put them into the gel caps I use for Chloe's other medications - 1 pill fills 3 capsules - 6 caps a day! I can't see it...)I haven't tried the pills, but I did give Chloe 1/4+ gel yesterday morning - she didn't seem to want to eat after that.)
        >
        > Cyproheptadine - 1/4 tab 6:00PM (I'm thinking of bumping it up to the AM in hopes of getting Chloe to eat).
        >
        > Lasix - 1/2 tab 9:00PM
        >
        > Pepcid - 5 mg 11:30PM
        >
        > Laxatone - as much as possible for constipation problems (I give it as a "treat" after meds - since the heart issues/new meds started, Chloe has been extremely constipated)
        >
        > I'm supposed to start Chloe on the 5 mgs of aspirin tomorrow, but with the not eating problems, etc. I will call the vet before I start anything else...
        >
        > So sorry for the lengthy note...again, I'd so appreciate any advice...
        > Suzanne and Chloe
        >
        >
        >
        >
        >
        >
        >
        >
        >
        > [Non-text portions of this message have been removed]
        >
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