Dr.Magnifico: I hope this message finds you and your family well. I actually have a …

I hope this message finds you and your family well.
I actually have a concern not about one of my pets but one of my daughter’s cat. Frisky (my grandboy cat of 12 years).
2 weeks ago my daughter noticed he had an odor of urine. She had tried a new litter and thought it was due to the muddy consistency. She bathed him with no luck and decided to take him to a vet in her area. Frisky is a very cool easy going gentle cat . Unfortunately, when he went to the vet, my daughter said he turned into the cat from hell. They were unable to treat him but managed to give him his rabies. He was prescribed 100mg gabapentin to be taken that night and then one more an hour before his visit the next day. She described him as acting stoned starting with the first capsule. He was fine at the vets office but sadly has been diagnosed with kidney disease. The following 3 levels are off the chart: IDEXX SDMA 63, CREATININE 8.6, BUN 165. The following levels are slightly elevated: Phosphorus 9.9, Anion Gap 27, Total Protein 9.4, MCH 17.6, Monocytes .646.
Frisky was put on a special renal diet with phosphorus powder added (to bind the phosphorus). He is supposed to go back to the vets on Monday to have his kidneys flushed in hopes of flushing toxins I guess.
My concern is that he has trouble processing the gabapentin due to his kidneys.
You know how much I value your opinion and I truly love Frisky. If one of my cats presented all these issues, would you recommend the same treatment? I am also extremely concerned considering what I have read about the toxicity of gabapentin with kidney disease. I am very surprised by his behavior at the vets but obviously he needs something in order to calm him down. Would you recommend an alternative to gabapentin? I believe they gave her a liquid for Monday’s visit opposed to the pill that was used for the previous visit. Have you seen the use of special food and the flushing of kidneys to help improve some of these numbers and allow him some time with a good quality of life? I hope I have provided as much information that you may need.
As always, I appreciate your insight very much.

Thank you
Sandy Brown

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Krista Magnifico
1 year ago

Hello! I’m sorry to hear about your daughters cat. As crazy as it sounds I have numerous patients like this. Ie perfectly wonderful at home and complete terrors at the clinic. My own cat is one of them. I can’t prescribe anything to a cat I haven’t seen. Nor can anyone else. But I do think it’s important this cat be followed up on and if that means gabapentin is used then so be it. You can and should ask about at home Sq fluids or even maybe an in clinic iv fluids hospital stay. It’s important to distinguish acute… Read more »