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MusicMagEditor

Registered:
Posts: 76
 #1 
As you all know, my wonderful nearly 17 year old killy Wizard has recently been digonosed with Renal Failure.  He's at home with me and I'm giving him his fluids under his skin as perscribed.

Today, he eeded more needles and another bag of fluids so I went to my vet and got it along with he special diet food.  Along with that, because of his constipation, they prescribed and sold me Cyproheptadine tablets.  I'm to give a 1/2 tablet every 12 hrs to get him to eat more.  The tablets came all cut in half.

I gave him one about 1 1/2 or 2 hrs ago and he did start eating.  But, in the last 1/2 hr he as be unsteady about himself, almost fell over a couple times, looks nervious about climbing and wants to just lay down a lot.

I called my vet and she siad drowseyness and dizzyness can be side effects.

I look up the drug online and it say they could be side effect, but the way I read it, I took it to be NOT GOOD side effects.

I called the drug company and, tho the girl was very nice, she was just a young girl in a phone center readin the same information as me.  She said It CAN be a side effect.  However, the drug company's website also said Use Caution In Prescribing Cyproheptadine to cats with Liver diease and so forth....

I'm assuming my vet remembered my cat has renal (liver) failure???  Is this something I should worry about?  He IS far more interested in eating though.  That is a good thing, but he does seem very dizzy, nervous about walking or climbing and looses his footing (he hasn't fall, he quickly catches himself).

Has your cat had these symptoms on this drug to help their appitite?

Bob Donovan
Wizard's Dad

WooWooWoo

Registered:
Posts: 5,100
 #2 
Bob,
 
Human doctors prescribe Cyproheptadine (Periactin) sometimes for anorexic patients to stimulate appetite, and my vet uses it with animals for the same purpose.   Yes, your vet is aware Wizzy is in renal failure, but is probably realizing he/she has to find a way to stimulate Wizzy's appetite.  And, yes, there are some side effects....but, if Wizzy doesn't eat, well, that is probably far more serious that any side effect.  Remember, CALL YOUR VET WITH YOUR CONCERNS.   He/she can advise you better than anyone on this board can, because he/she is treating and assessing Wizzy.
 
The following info is from a clinical veterinary site I respect a lot.   It will at least explain more about Periactin (brand name).
 
 
BRAND NAME: PERIACTIN

AVAILABLE IN
4 mg TABLETS

BACKGROUND

Cyproheptadine is an antihistamine in many ways similar to other antihistamines with which we are more familiar. Histamine, a biochemical mediator of inflammation, works by binding to special histamine receptors. The histamine receptors we usually want to inactivate in combating allergic reactions are called “H1” receptors and this is the type inactivated by cyproheptadine. (There  are H2 receptors but those are responsible for acid secretion in the stomach).

Cyproheptadine also has some other properties of interest. It also antagonizes serotonin, a neurotransmitter, in the brain. This leads to an increase in appetite and often is the reason this medication is used, rather than for its antihistamine effects.

Excess secretion of Adrenocorticotropic Hormone (ACTH), the hormone that stimulates the adrenal gland to produce cortisone, is associated with increased serotonin levels in the brain. Cyproheptadine has been used in the treatment of Cushing’s Disease, where there is excess cortisone production but not with reliable success.

HOW THIS MEDICATION IS USED

Cyproheptadine has several uses:

  • Appetite stimulation
     
  • Treatment of Feline Asthma
     
  • Symptomatic relief of itching, particularly in cats.

SIDE EFFECTS

Drowsiness is a common side effect.  Occasionally a cat will have a what is called a “paradoxic” reaction and become excited.

As with other antihistamines, “anticholinergic effects” occur at higher doses or overdose.  These effects include:

  • Urine retention
     
  • Increased pressure in the eye (only of concern in patients predisposed to glaucoma)
     
  • Dry mouth
     
  • Increased heart rate
     
  • Elevated body temperature

INTERACTIONS WITH OTHER DRUGS

Sedation side effects are magnified when this medication is used with other sedatives.

CONCERNS AND CAUTIONS

Cyproheptadine is best avoided in patients with glaucoma, recovering from urinary blockage, and heart failure patients.
 

Good luck, Bob.

Hugs,
Melissa
WooWooWoo

Registered:
Posts: 5,100
 #3 
You mentioned that your vet said to give Wizzy Periactin 1/2 tab every 12 hours, but said you gave him one and 1/2 tab, which is an overdose.  Maybe this was just a typo on your part, but if not, please, please listen to your vet, just as Loudpurring recommended.   Periactin was not prescribed for constipation, just to stimulate appetite.

In fact, you should only be communicating with your vet regarding these issues since none of us are vets here.   Loudpurring is a vet tech, I believe, and has good common sense and she has recommended you always call your vet with questions.  I know you are very anxious about all this, but your vet needs to know all your concerns.  Drug companies will give you their "party line" to cover themselves; your vet is acting in best interest of Wizzy.

We can support you through this emotionally, but your vet KNOWS Wizzy best.

Melissa 
MusicMagEditor

Registered:
Posts: 76
 #4 
UPDATE ON WIZARD:

As far as the Cyproheptadine 1/2 tablet goes, he has been really lathargic since.  Somewhat unsure of himself when he walks, wants to lay down a lot, very low on energy and almost fell over a couple time walking but caught himself.  He can still climb up over my printer and monitor and get into the window and so forth.  But really slow and cautious.

I call med my vet twice...  First they said a little dizzy can be a side affect.  When I called them back a while later and explained he's really unsure of himself walking, wants to just lay down very quiet and has no energy, they said they hadn't heard of side effects like that and to take him off the pills and see if it changes.  So, if I'm supposed to give 1/2 tablet every 12 hrs, that mean Wizzy will be like this for 12+ hours before I find out if it's something more serious and I'm loosing him?  It's been 4 to 4 1/2 hrs since I gave him the pill and he's still like this.

The medication did work in the fact that he did eat all day...  Sucked down 80-85% of a full size can of cat food.  So, that part worked.

Also, as for the Lax'Aire, a hairball remidy they gave me for his constipation, I guess that is working.  He pooped a little diariea and a but of solid poop mixed in!  That is a good thing...  Don't like the diariea part, but he's been holding it for a while.

But, the larthatgic part, dizzy look, unsure footing, almost falling stuff along with wanting to SLOWLY move and laydown all started within an hr of Cyproheptadine.

I'm keeping my fingers crossed that taking him off this will will make him start feeling better.   I'm so worried as I don't know if he's dieing right now or if its from the medication.  He REALLY loves being with me now; always has, but reall with me like glue since this.If I sit, he has to be in my lap instantly.  If I lay down, he has to be on m chest instantly.  If I leave the room and come back, he makes his way toward me right away, slowly, but comes right to me and starts trying to be with in.

I'm worrying.

Bob
Wizard's Dad
bdpringle

Registered:
Posts: 190
 #5 
"I'm assuming my vet remembered my cat has renal (liver) failure???"

I just wanted to point out that renal failure is not liver failure. Renal failure is kidney failure.  Some people may confused by the statement I copied from your post.

I would make sure your vet is well aware of your concerns just as Melissa and Loudpurring have suggested.

We put Emma on a new treatment regimen for her chronic ear infections, including a really strong anti-histamine and anti-fungal medication.  It said ti could cause drowsiness and lethargy.  The first couple days really knocked her out, and after that it didn't seem to effect her at all.  She is has been on her medicines for several weeks now, and is doing good.

Perhaps the side effects will wain as the treatment progresses. 

Daun

P.S.  Wizard is so cute!  I like the picture of him checking *his* email. 


WooWooWoo

Registered:
Posts: 5,100
 #6 
Did you talk to your vet or a vet tech or a secretary at the vet's when you asked about the side effects?  Because drowsiness is a COMMON side effect of Periactin.   It is an antihistamine, as is Benadryl (which makes people very drowsy).   So, I am very surprised someone (hopefully not the vet) told you they had never heard of this side effect.  Look at the info I sent you.  It is the most common side effect.  Period. 

I find it amusing that someone would tell you it would make your cat dizzy, because the only way you can tell if a cat or human is actually "dizzy" is to ASK them.  You can't really visualize dizziness, per se, but you can see "drowsiness" and "lethargy" which you described perfectly with Wizzy. 

Over time he may become tolerant of this side effect and you may just see a good improvement in his appetite.  But, again, listen to your vet.

M.
paws4me75

Registered:
Posts: 18
 #7 
During Macey's initial vet visits, our vet also prescribed him cyproheptadine to stimulate his appetite.  It did nothing at all to get Macey to eat more.  It was only when he was started on his steroids did his appetite return.  Macey fortunately did not have side effects from the cypro.....Best of luck and you and wizzy are in my prayers.

Lisa
Loudpurring

Registered:
Posts: 774
 #8 
Sorry going through my own private hell today can only answer for a second.
Hepatic=Liver
Renal = Kidney

Cyproheptadine is used as an appetite stimulant. If you are noticing adverse effects from it you need to discontinue giving it. Wizards body may be so run down as to not be able to clear the drug. We have used it in Renal (kidney) Failure cats before but each cat is an individual.

You have to judge the pet not what is written sometimes. meaning if wizard was better before the drug do not continue it. But, he must eat, so i would do frequent small feedings. Did you get a syringe from your vet to help him eat. Did you get the 20 gage needles instead of the 18 gage ones?
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