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Old April 5th, 2009, 03:19 PM
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tbcookie tbcookie is offline
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How quickly would I notice signs of Aspiration Pneumonia?

I'm not sure if this matter requires urgent attention, but I'm extremely worried.

I have been giving my cat, General, Metronidazole in liquid form since Tuesday. Anyway, yesterday, I'm quite sure General inhaled some of the medicine when he was struggling. He coughed a few times and gagged a little. Worried about this, I went online and found out that cats can be very susceptible to aspiration pneumonia and that improper administration of liquid medication is one of the most common cause of this. I have always given liquid medication to my cats by opening their mouths and by squirting the medicine toward the back to of throat. No one ever mentioned that I shouldn't be doing it this way. Even when the vet and I discussed General's medication this time around, I said "So I pop his mouth open, syringe to the back of the throat and squirt?" the vet told me yes.

I called my vet and the receptionist reassured me that this happens to everyone, even they who have been administering medications for ages. She said the amount potentially inhaled would be so small as to not be an issue and that it's just like us when we drink something that accidentally goes "down the wrong pipe."

Later in the day, General sneezed several times and I noticed he had watery eyes. Again, I called the vet and the receptionist told me that I had nothing to worry about unless General was showing signs of greenish mucus from the nose or laboured breathing.

I just didn't feel comfortable about this because these things seemed to coincide with General seeming to have inhaled some of his medicine. I also notice that General's demeanor seems different overall. He's just not his usual self. Not quite as social. And though he still purrs and will come up on my lap, he slaps his tail a fair bit more than he ever does and seems less interested in and even bothered by much petting, and often jumps down and goes off to sit by himself and spends more time this way -- sitting off by himself or sleeping.

I don't want the vet to feel like I'm hounding them, but the truth is that I'm terrified that by my administering the medication incorrectly, General may be at risk of developing a potentially life-threatening illness from what I can gather from the Merck Veterinary Manual and other online literature.

Help?
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Old April 5th, 2009, 05:22 PM
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Hi tbcookie, welcome to pets.ca.

Quote:
Originally Posted by tbcookie View Post
I have been giving my cat, General, Metronidazole in liquid form since Tuesday.
Why is he on metronidazole?

Quote:
Originally Posted by tbcookie View Post
Anyway, yesterday, I'm quite sure General inhaled some of the medicine when he was struggling. He coughed a few times and gagged a little.
It's possible he inhaled a bit, or it could also partly be a reaction to the terrible taste of Flagyl.

Quote:
Originally Posted by tbcookie View Post
I have always given liquid medication to my cats by opening their mouths and by squirting the medicine toward the back to of throat.
Here is a good video by Cornell University on the best way to administer liquid meds. As I'm sure you've now realized, you don't want to aim straight down the back of the throat, but rather at the pouch between the teeth and cheeks, or else across the tongue at an angle.

http://partnersah.vet.cornell.edu/pe...id_medications

Quote:
Originally Posted by tbcookie View Post
I just didn't feel comfortable about this because these things seemed to coincide with General seeming to have inhaled some of his medicine. I also notice that General's demeanor seems different overall. He's just not his usual self.
Is he eating and drinking okay? Sometimes antibiotics can make cats feel nauseous. It might be better tolerated if given with food, if you aren't already.

Quote:
Originally Posted by tbcookie View Post
I don't want the vet to feel like I'm hounding them, but the truth is that I'm terrified that by my administering the medication incorrectly, General may be at risk of developing a potentially life-threatening illness
I wouldn't worry about hounding the vet, they are supposed to be there to help you, the client. To ease your mind, maybe you can take him in and have the vet listen to his lungs with a stethoscope. Here is a list of some symptoms of aspiration pneumonia: http://www.petplace.com/cats/aspirat...ats/page1.aspx

Quote:
What to Watch For

Coughing
Respiratory distress, with rapid breathing and a high heart rate
Cyanosis (blue color to the mucus membranes)
Exercise intolerance, weakness
Nasal discharge
Fever
Depression
Loss of appetite
Good luck! I hope General is feeling better soon.
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Old April 5th, 2009, 05:34 PM
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Welcome, tbcookie! I agree with SCM--don't worry about hounding the vet. They should be there to help. (I hound ours unmercifully when there's something going on with our dogs that makes me uncomfortable. )

and for a quick recovery for General.
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Old April 6th, 2009, 12:37 AM
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Hi, sugarcatmom & hazelrunpack. Thanks very much for the welcome, and for your replies.

Quote:
Why is he on metronidazole?
General was having soft stools and some diarrhea for a few weeks, and I'd been noticing fairly frequent occurances of mucus, sometimes with a touch of blood, in his stools. The vet prescribed metronizadole for this.

Quote:
It's possible he inhaled a bit, or it could also partly be a reaction to the terrible taste of Flagyl.
Yes, I understand that medication is nasty, bitter stuff (poor guy). I anticipatd a short term reaction to it and each time was sure to follow up with his favourite treats to help get the nasty taste of of his mouth.

Quote:
Here is a good video by Cornell University on the best way to administer liquid meds. As I'm sure you've now realized, you don't want to aim straight down the back of the throat, but rather at the pouch between the teeth and cheeks, or else across the tongue at an angle.

http://partnersah.vet.cornell.edu/pe...id_medications
Thank you for that. Yes, I came across that video (or a similar one) after the fact and sure wish I'd seen it beforehand. Sigh... :sad:

Quote:
Is he eating and drinking okay? Sometimes antibiotics can make cats feel nauseous. It might be better tolerated if given with food, if you aren't already.
He is. He still gets excited about treats and wet food at dinnertime. (He doesn't seem overly interested in his crunchies, though he does snack on these during the night.) If he were really ill, I would expect him to lose interest, but so far, nope!

Quote:
I wouldn't worry about hounding the vet, they are supposed to be there to help you, the client. To ease your mind, maybe you can take him in and have the vet listen to his lungs with a stethoscope. Here is a list of some symptoms of aspiration pneumonia: http://www.petplace.com/cats/aspirat...ats/page1.aspx
Quote:
Welcome, tbcookie! I agree with SCM--don't worry about hounding the vet. They should be there to help. (I hound ours unmercifully when there's something going on with our dogs that makes me uncomfortable. )
Thanks, I appreciate that. I couldn't help but feel like that receptionist was thinking she had an obsessive, paranoid client on her hands. But here's the thing, she's the receptionist! (Nothing against receptionists, of course.) There isn't any medical training to support her advice, so is it any wonder my fears weren't allayed? Ah well... the vet is supposed to be contacting me tomorrow anyway to follow up on General's "poop issues" so I'll be sure to discuss all of this with her.

I have to admit, I didn't actually give General his dose of medicine this morning, as I was supposed to; and I think I'm skipping tomorrow too. (He was supposed to have a dose this morning and a final one tomorrow morning. He's been on the meds since Tuesday.) I just couldn't bring myself to do it, with him obviously not feeling too hot, and considering how poorly the last dose went. I hope the vet doesn't come down on me too hard for that. He's been on it for five days now, and definitely, his stools are looking much improved. Also, I may just be imagining it, but with no meds this morning, General seems in a bit better spirits this evening. Still not entirely himself, but not quite as withdrawn.

The good news is that other than General exhibiting maybe a touch of depression, there are no other signs or symptoms from that list! Will see what the vet has to say tomorrow.

Thanks again to you both for listening. I'll keep you posted.

PS -- General just jumped up for a snuggle and to let me know it's time for bed. All good signs...
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Old April 6th, 2009, 02:13 PM
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UPDATE -- So, the vet called this morning and I let her know my fears. She too didn't think there was cause to worry about aspiration pneumonia. She indicated that General would be experiencing very noticable breathing difficulties if that were the case. Phew!

She asked how things were looking in the litterbox, and I let her know there had been no further signs of diarrhea, blood, or mucus, and that the stools were all healthy sized with good consistency.

She was ok with me having skipped yesterday's dose of medicine, but said she'd like for General to have a couple more doses yet. She mentioned, more in passing really, the possibility of colitis. She dropped the dosage down from 1.5cc to 1cc to make administering the meds a little easier for both me and General, and wants me to check back with her on Thursday.

So, I got up the nerve to give General the meds today. (I felt so bad, thinking he would never going to forgive me for trying this again!) But it went well. I tucked the syringe in through the side of his mouth and gave little bits so he had time to swallow. He wasn't happy about it, but he got treats when we were done and was actually purring and letting me pet and cuddle with him within minutes. WOW! I really felt so much better, at least about giving him the medication.

He's napping in bed now and, though he's still not 100% his usual self, I feel my stress level has come down a little bit. It's always interesting to me to recognize how the responsibility of caring for our little loved ones can weigh so heavily upon the heart. Thanks again for listening, and for being the sort to understand the weight of that responsibilty.
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Old April 6th, 2009, 04:58 PM
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Quote:
Originally Posted by tbcookie View Post
General was having soft stools and some diarrhea for a few weeks, and I'd been noticing fairly frequent occurances of mucus, sometimes with a touch of blood, in his stools. The vet prescribed metronizadole for this.
Something else to consider when there are intestinal issues is the food. What does General eat? A grain-free, meat-based wet food, possibly even a novel protein source such as venison or duck, can be very helpful in minimizing the symptoms of IBD or colitis. In fact it's frequently the inappropriate plant ingredients in kibble that cause IBD in the first place. If you haven't seen these links yet, they have some good info on what an obligate carnivore should be eating for optimal health:
www.catinfo.org
www.catnutrition.org

In the meantime, if the soft mucusy stools return, you might want to pick up some slippery elm bark powder. It's easy to mix about 1/8th to 1/4 of a tsp in with some wet food a couple times a day (along with 2 tbsp of extra water). The SEB works by soothing the intestinal lining, and it also helps balance the moisture levels in the colon, which is good for both diarrhea and constipation. More on that here: http://www.littlebigcat.com/?action=...em=slipperyelm
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