13y MN DSH, stress case, frequent yelling/yowling after starting steroids. Can't stop the steroids, though. Need stress management advice via meds!
Hey all!
Signalment: 13y MN DSH, approx 9.8lbs (ideal weight 10-10.5lbs), indoor only
Current meds: Budesonide 1mg SID, Elura 0.45mL SID
No S/C/V/D. Energy levels normal for a cat his age, appetite is lower but consistent. Urinating normally, drinking normally.
Current diet: Purina Pro Plan Urinary Tract Health Turkey & Giblets canned. Eats about 70-80% of his ideal calories per day. His appetite is a work in progress (see: Elura)
I've got a 13 year old former cuddle bug who has gone through a pretty rough patch with his bowels. Possibly GI lymphoma, possibly IBD. Either way, pretty horrendous diarrhea and weight loss until we figured out steroids were the only thing to solidify those poops and keep that weight on. We are finally happy with the quality of his stools after a solid year of trial and error (mostly error) and are not looking for advice for managing that.
What I would like some insight on is related to an unwanted side effect of these steroids.
My boy won't stop yelling! He has always been extremely talkative, to the point where he and I could have "conversations", he trilled constantly, and he would "ask" for things he wanted. He's always been this way, and it's one of his fun quirks... until now.
Since starting the steroids, he has been yelling (not meowing, not howling, but yelling) repeatedly for hours on end and seemingly wanting nothing. We have fed him, we have pet him, we have tried playing with him, we have both moved into the same room as him, we have multiple Feliway plugins, we have accompanied him as he's eating. His litter box is spotless, his water is cleaned and filled up, his food bowls are regularly cleaned. We have tried everything we can think of!
While he was on prednisolone, he was yelling starting in the middle of the night, around 2-3am until 6am when we would wake up. We switched him to Budesonide, and the 3am yelling has subsided, but it has transferred to the day time with seemingly no solution. I legitimately have NO CLUE what he wants. Nothing seems to placate him, and it kills me because he went from being this sweet, sleepy cuddly boy to this screaming machine who never wants to be held.
Some notes: We have tried gabapentin, and it has paradoxical effects on him. It makes him more restless and agitated. Historically, he has always been a little jumpy and afraid of just about everything. He can't see very well, possibly farsided, so he often approaches familiar objects around the apartment as if he's never seen them before and they might pounce at him.
I've done just about every diagnostic test there is to do. CBC/Chem/UA, thyroid (TSH/T4/T3), fructosamine, GI panel for B12, etc, blood pressure-- everything but the $800 ultrasound. Clinically, he is completely fine (aside from the poopy problems and very early S1 CKD), but his previous GI symptoms are managed. Mentally, he has become this cat I no longer recognize and don't know how to help.
I've considered the possibility of cognitive decline. We live in a very small space and are unable to leave lights on or close doors. We also are unable to switch his food or add in oil-based supplements as I know MCT oils are thought of to help with cognitive decline. Our nightly routine is very regimented. My wife and I are people of routine, so everything is the same day to day.
I've tried Purina Calming Care to no effect. He doesn't like it and it gave him bad diarrhea. We tried Cerenia, we've tried Mirtazapine transdermal. We've done diet trials with dozens of diets (no, not the full, ideal 3 month trials, but long enough under strict supervision). At this point, I think his general anxiety has reached a point where it needs medical intervention, which is where your insight comes in.
So... Trazodone? Prozac? Amitryptalline? CBD? All of the above in a pill pocket with a jello shot? (I jest)
Any insight is appreciated. I miss my little guy and hate to see him so uncomfortable and restless.