Expert: Jessica - 1/14/2010

Question
QUESTION: My 2 and 1/2 year old male cat has been on flourexitine for 3 weeks. I was given the prescription as a liquid. Which he absolutely hates. I don't blame him. It makes an oily ickey coating in the mouth. (Yes, I put a bit on my tongue-it's people medicine.) Started with 8ml. Went down to 5ml on day 11. That was the next step according to my vet. If I stop tomorrow will the cat suffer any side effects? It doesn't seem like he has taking this that long.
Thank you for your help.
PS Yes, I should ask my vet but I would like another opinion before I ask.
PPS At the cost of this stuff I am not going to continue using it anyway. I just want to stop the daily torment I am putting my cat thru by forcing this stuff donw his throat. No, there is no way he will take it with food or treats or anything. I just wrestle the syringe into his mouth.

ANSWER: Hi Karen.  It's unfortunate that your vet hadn't offered to prescribe your kitty a transdermal gel.  The fluoxetine is mixed into a cream, and you massage a tiny amount of this into his skin once a day, usually on the tip of the ear.  The medication soaks through the skin into the blood stream, and the kitty thinks he's getting a nice ear rub.  Any compounding pharmacy can do it, if you have a small pharmacy around, or it can be ordered online.

However, if price is the bottom line, then a transdermal gel still won't help you.  Although he has only been on it three weeks, he should ideally be weaned off of it.  Although stopping abruptly won't cause a life-threatening condition, like it can with certain other medications, it can cause him to feel poorly for several days.  He may experience dizziness or mental confusion.  Your vet can recommend the best plan to wean him off, but loosely, the plans are something like going down to a half-dose every day for 3-5 days and then the same dose every other day for a week, and then stopping, when the cat has only been on it short-term.

There are less expensive medications than can help with many of the same conditions that Prozac does, including amitriptyline and buspirone.  If you still want to work toward trying to control whichever condition he was suffering, you may want to ask your vet about these in a transdermal gel.  Once you have the dosage, you can call around and ask what the cost would be.

Best luck!

Jessica



---------- FOLLOW-UP ----------

QUESTION: Jessica, Same cat. The prozac was meant to modify behavior-ie: pees on the couch. And this time it's not a UTI. I added another cat to the household early in June. The new cat was a year old then. And despite the fact that I keep hearing 'if there's no blood-they're just playing!' It doesn't look or sound like play to me. The big cat chases the little one a lot. This is a large apartment and I have noticed there are no weight issues with these two I would reaaly like it to stop. I'm pretty sure the peeing is a territorial thing at this point. Plus, the big cat has never been very affectionate or 'cuddley'. So I have an 'attitude adjustment' plan for this cat. Here's my plan:have him boarded for a couple-three days. My idea is that that he will so grateful to be returned home after tasting how bad life could be that he will become a calmer and more agreeable cat. What do you think? Do you have any other suggestions?
Thank you for your time,
Karyn Owen

ANSWER: Hello again.  I have never heard the theory that if there’s no blood, they’re just playing, but I can say for sure this is inaccurate.  In fact, many cats defend themselves well enough and the fur protects them substantially enough that there is no bleeding with real fights.  So I agree with you that if it sounds like they’re fighting, and one is always chasing the other, they are fighting and not playing.  I also agree that the inappropriate urination is likely territorial/stress-induced.

Unfortunately, sending a cat to a boarding facility is likely to worsen inappropriate bathroom behavior, because this is the way these cats respond to stress.  Many people who bring their well-behaved cats to boarding facilities will return to find them with behavioral issues, at least for a while, because of the upset they experienced in their routine.  So I think sending him to a boarding facility for a few days would probably do more harm than good.

Because he doesn’t realize he’s doing anything wrong when urinating outside the box, this isn’t a behavior that typically changes until the situation that’s causing the behavior is modified.  To do that, you can try re-introducing him to the new cat over a much longer period, and addressing his obvious anxiety issues.

To re-introduce the cats, keep them separated at all times for a couple of weeks.  Keep one in an isolated room half the time, then swap their areas.  This cooling off period hopefully will help relieve some of the big cat’s urination issues.  Then begin allowing short visits, for about 15 minutes, a few times a day.  Always separate the cats if any threatening noises or moves are made.  It can take up to a couple of months to properly introduce some reluctant cats.

I would recommend using a product called Feliway to help reduce the inappropriate urination.  I use the plug-in diffusers at all times in my own home.  You can learn more about how it works at www.feliway.com and buy the products through many websites or at pet stores.

You could also try some flower essences if you like.  I like a line called Spirit Essences (www.spiritessences.com) because they were formulated by a holistic vet and an animal behaviorist.  There are a number of essences that may be helpful for the big kitty, including Safe Space for Cats, Bully Remedy and Peacemaker.  The smaller one could also benefit from Self-Esteem.

Finally, you could consider a medication once again.  I know he did poorly with the oral medication, and that cost was also a consideration with Prozac.  As I mentioned, most antidepressants can be compounded into a transdermal gel.  Medications like Elavil and Buspar tend to be less expensive than Prozac, so it might be worth it to check into how much these would be as a transdermal gel, which would be applied to the ear tip.  Sometimes medications are really necessary to solve these types of behavioral issues.  My experience has been that Elavil also helps to bring out the affection in many cats.

Best of luck!

Jessica




---------- FOLLOW-UP ----------

QUESTION: Jessica, A couple more things. I was thinking of feliway anyway. I've tried a couple different 'pet calm' essences with no result. Although my sister didn't have any luck with feliway in similiar circumstances. I know a couple people whose cats never really got along after 10 years. But stop being so aggressive after the first year or two. I hope I don't have to wait that long. Or lose a cat. Anyway, I live in Seattle where a high percentage of us take vitamin d to combat the lack of sun in winter. Would that make any difference in the cat? Although he was about the same in the summer. Would it make a difference if I let him outside? Although I hate that idea because of fleas and raccoons. But he has slipped out a couple times and come back after an hour or so so I don't think I would lose him. But I hadn't seen less fighting as a result of those excursions. And, finally, the whole 're-introduction' things just isn't feasible in our household.
Thank you for all your time,
Karyn Owen

Answer
I hadn't felt the Feliway really worked, either, until I stopped using it!  The spats started up again within a week.  It doesn't work for everyone, but I think it's worth a try.  

As for the Vitamin D, it's a good idea to talk to your vet about this.  Cats can suffer Seasonal Affective Disorder, although it's less common than in people.  While Vitamin D is helpful to elevate mood in people, this is not proven in cats.  Cat food generally contains all the Vitamin D a cat needs, but some cats can still stand supplementation.  However, an too much Vitamin D over time can cause dangerous toxicity, so it's always wise to have a consultation with a vet before beginning any vitamin regimen with your cat.

I do find that allowing cats outdoors can give them the extra space they need when they don't get along with other animals.  However, it's much too dangerous to allow them outside unsupervised.  I have solved this problem by building cat enclosures attached to my house, which the cats have access to by a cat door.  There are commercial enclosures available, or you can build them yourself if you own property.  If you don't own property but live in a house, consider a temporary product like the KittyWalk (www.kittywalk.com).  If you live in an apartment situation, I could only advocate bringing the kitty outside on a harness.  It takes them a while to get used to it, but I've trained many to walk on a leash.  Of course, a flea preventative such as Frontline or Advantage will still be necessary in these situations, but he'll be safe from predators, and he won't be able to run away, which unhappy cats can be inclined to do.

Unfortunately, there are a few cats who will never get along.  I can say it's very rare.  About 99% of cats will get along with others when given enough space, cat furniture, time to acclimate and attention.  But there is always that 1% that won't share their home with other cats.