I Couldn’t Live Without: Cerenia

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I’ve decided to start a new category, “What I Couldn’t Live Without,” and I’d like to post a product or useful device that makes my life as a small animal veterinarian easier on a daily basis. Today’s can’t-live-without item is Cerenia.

Cerenia, or maropitant, is a wonderful anti-emetic. It comes in two forms: oral tablets and injectable solution. I feel safe and confident using it in many of my vomiting cases. In fact, that’s one way I know something is seriously wrong–I gave them cerenia and they’re still vomiting. Of course, xrays/ultrasound are important for investigating causes of vomiting, but I don’t see any reason why a patient shouldn’t get a Cerenia injection if they’re feeling nauseated.

VIN (the Veterinary Information Network) had a Rounds discussion not so long ago on this very topic, entitled, “Cerenia: Is It The New Anti-Inflammatory, Anti-Allergy, Analgesic, Anti-Emetic, Anti-Obesity, And Antidepressant Wonder Drug?” (if you’re a VIN subscriber, you can access that link; if you’re not a VIN subscriber, then I ask you, “Why not???“).

A summary of the Rounds is as follows:

  • Cerenia (maropitant) is a tachykinin antagonist which acts by inhibiting the binding of substance P.
  • Cerenia is labeled only for treatment of nausea and vomiting, but can potentially be used extra-label for pain, inflammation, GI disturbances, allergies and immune diseases, bladder inflammation, CNS and spinal cord injury, and mast cell diseases.
  • Treatment schedules should be 5 days on, 2 days off or every other day as continuous dosing depletes substance P which leads to tremors.

With all these benefits, why wouldn’t it be one of my favorite drugs? The VIN discussion includes a lot of other really useful and interesting information (way more than I ever thought I wanted to know about Cerenia but am now glad to know!), and I encourage you to read it over.

Cerenia is labeled for dogs, but it can be used in cats too. In fact, I gave it to two different cats in one day recently. It’s also touted as a useful aid for motion sickness in dogs. It doesn’t cause drowsiness, unlike Dramamine, which I’ve also suggested for dogs who get sick while riding in the car.

Practice Tip: Cerenia stings, but it stings less if cold–so wee keep the bottle in the refrigerator! We’ll also give it with SC fluids (when indicated) to help reduce the sting.

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51 Comments

Filed under What I Couldn't Live Without

51 responses to “I Couldn’t Live Without: Cerenia

  1. Cerenia is a good one – so much better on parvo pups and the like. If I had to pick one med I can’t remember how I practced without, though, it’d be Convenia. It’s made life SO much better for so many of my clients and my patients.

    • I agree, and I think Convenia is on my list of “couldn’t live without” also. Though it does cause me some concern with regards to the fight against antibiotic resistance and the reckless use with which some vets implement it.

  2. Something to think about with Cerenia in SQ fluids – there is question about the absorption. If you put it in a big bubble of SQ fluids, it absorbs much slower and irregularly. We used to do the same thing, but there have been several discussions about it on VIN lately – and we are now using it as a singular SQ injection.

    I agree it seems to sting less if refrigerated. I also think giving it far up in the neck, with a 20 or 18 guage needle helps too.

  3. So can you use this drug for what type of antihistamine? What histamine is it blocking?

  4. george

    cerenia works well IV, no sting, no delayed action

  5. I run a website for cats with IBD and other GI conditions. Do you think Cerenia might be another option for them? I have case studies on my site and many people count on these cases and other knowledge to bring to their vet when all else has failed.

    • It’s certainly something that can be discussed with the vet, but I don’t know that it’s something all kitties with IBD would benefit from. Thanks for the link to your site, keep up the good work!

      • Oh I understand. I’ve been doing this long enough and went through my own tragedy with nothing at all working for my kitty. I ended up losing her and that’s why I started the site. Believe me, I know all about things not working for every kitty. I have a link on my site, Living with IBD, those are all case studies of kitties with IBD. All on different methods of treatment and medications. I’m still glad to inform them of another option. If it works for even one kitty, I’ll be thrilled.

      • Ragan

        I see I’m commenting on kind of an old thread, but…I have an IBD cat with the worst case of this condition my vet has seen (a specialist I was referred to made the same comment). We will have maybe one good week, then a string of days with vomiting — not regurgitation but IBD-induced vomiting, hours after a meal. Cerenia is wonderful on those days as I am having a lot of trouble keeping my cat’s weight up (even with a feeding tube, prednisolone, metaclopramide, famotidine, metronidazole, and chlorambucil). For this cat, one injection usually lasts a couple of days and by then the IBD flare-up has subsided.

      • Ragan, is your cat getting B12 injections? If not, it should be. B12 is very important with these diseases as usually the kitty is very deficient. It helps with appetite, stools and absorption of nutrients which is why your kitty can’t keep the weight on. It’s probably suffering from malabsorption.

    • elaine

      My dog has IBD and vet gave him Cerenia. Sure helped while we were getting the IBD under control.

      Elaine

  6. Cindy Walter

    My 8 year old male cat was diagnosed with IBD last year and he has taken a daily dose of Cerenia ever since. I know for a fact he can’t live without it. Each time I have tried to wean him off the Cerenia (and other meds) he begins vomiting uncontrollably again and his organs began showing signs of stress. He takes a mere 1/4 tablet each morning and his blood tests have been normal. I love this medication!

    • Cindy could you email me at contact@ibdkitties.net? I would really love to hear how this has benefited your cat. I have a lot of people on my website that are looking for other options. Maybe I could just get a few more details from you, it might help.

    • Marianne

      Cindy, my vet has been reluctant to keep my cat on Cerenia long term, but like you every time I try to wean him off he gets nauseus.. He seems to respond well to 1/2 tablet every other day, but my vet would prefer 1/4 tablet every 3 days. did your vet have concerns about continual long term use? Marianne

  7. levotb

    Our 20-year old Ragdoll has lived with IBD and food allergies for more than half her life. We only recently started giving her Cerenia on days when she gets sick twice in the day and it knocks the vomiting out for 1.5 days, then we put her back on the twice-a-day Metronidozal. We hear Cerenia is a godsend for many dogs and cats and it seems to be for our cat. It still stings even though we refridgerate it and she jumps 10 feet in a reaction.

  8. Leslie

    So why does the cerenia injection sting so much? I was giving it to my terrier with CRF in the sub cu bubble and she didn’t react in any way. Tonight I gave it to her by itself, refrigerated, and she started screaming and then growling very loud. I have her vomiting under control since I started giving it to her in the bubble and am waiting for my vet to get the tablets in. I also have reglan but it didn’t stay down when she was vomiting.

  9. The injection stings because some medications just do. B12 injections don’t sting but B complex does. Zofran (anti-nausea med) stings in injection.

    I’m so glad to hear your Ragdoll’s IBD is managing well! I’d love to have a case study on my site that is using Cerenia if you’re ever interested.

    • Leslie

      Thank you Lisa for your information. I have my Yorkie on Reglan for now and she seems to be doing well. Once we got the vomiting under control with the Cerenia I started giving her the Reglan. I picked up Cerenia tablets to have on hand and also injectable. I will only give her the injectable if it is in the fluid bubble. Her reaction from the injection by itself was more than I had ever expected. Don’t think I will put her through that again.

      • Leslie and others check this out! Idea Exchange: Chill medication to eliminate sting
        Apr 1, 2010
        VETERINARY MEDICINE
        We use a fair amount of maropitant (Cerenia—Pfizer Animal Health) in our practice. While it is useful, it seems to sting the patient immediately after injecting it subcutaneously, especially the greater volumes required for large dogs. However, we have noticed that refrigerating the medicine seems to almost eliminate the discomfort. While I still warn owners that the injection might sting, they are almost always pleased to see that their pets aren’t bothered by the injection.
        Dr. John S. Parker
        Novi, Mich.

        http://veterinarymedicine.dvm360.com/vetmed/Medicine/Idea-Exchange-Chill-medication-to-eliminate-sting/ArticleStandard/Article/detail/665698.

        Have you tried doing that?
        Lisa

      • Leslie

        The injection I used was chilled and it didn’t seem to take any of the sting away. Wish it wasn’t so.

      • oh that stinks. I’m so sorry, I thought we found a way around it. I know that Zofran was chilled for my sister’s cat Midnight and helped but very minimally. Even putting it through the sub q fluids, it still stung, just not as bad.

      • Leslie

        Thanks for trying.

  10. Rodney

    I am a Technician at an ER hospital and my now 18 year old torti was diagnosed with IBD 4 years ago. I have tried all sorts of diet changes and pred nothing worked other than making her angry when I had to wrestle her to give her pred. She has been receiving 6mg every 3 days for 2 years and is a completely new cat. Blood work, rads and ultrasound couldn’t be better for an old cat. Wonderful drug.

  11. Dr. Val Heartsfield

    I have found that Cerenia stings whether it is chilled or not. I have discovered that giving the injection very slowly is much more comfortable. For a larger animal while giving a larger volume of the medication, the sting seems to come after a certain volume has entered the tissues, about 1 1/2 ml or so. I choose another site and finish giving the prescribed dosage.

  12. Angel

    My 10 and 1/2-year old cat had cryptococcus about 7 years ago, we put him on fluconazole for 5 years, and he is tested negative. But, for the last 2 years, he would vomit a clear foamy stomach acid-like fluid every now and then, it was a lot of it, at first I would give him Raglan and Pepcid SQ injections, that would help for a few days in between. A couple of days ago we went to see a new vet, and was introduced to Cerenia, he has not vomited since then, I’m keeping my fingers crossed.

  13. Marlene

    Just wanted to add something that I just recently learned when my dog with GI symptoms reacted to foods I didn’t think he would. Many canned dog and cat foods contain Carrageenan which can cause GI upset and inflammation. For more info you can check out the website of Cornucopia Institute and search there for Carrageenan

  14. Sydney

    My cat has not been diagnosed as yet (vet can’t find anything wrong in the blood). Also did a barium contrast w/xrays, no result. How is IBD diagnosed? What test or procedure do I need to ask for? I now have 16mg Cerenia tabs. I would like to get this cat comfortable while we try to sort this out. Should I cut the tabs into quarters? He weighs 12 pounds. Please help! We have been at this for 9 weeks now.

  15. Judy Winterhalter

    I have a 9-year old Ragdoll that has been plagued with cystitis for the last 8 years. My vet says it is “idiopathic cystitis”. In addition, for the last couple of years she’s had frequent bouts with throwing up.
    Sometimes 3-4 times in one day. We had just about run out of options. She has had sterile samples taken, an ultrasound, x-rays, and a full panel of blood work. As a last resort we put her on Cerenia and its like a miracle. The throw up and cystitis has stopped! I put her on 1/2 pill (16 mg) for 4 days and take her off for 2 days. If I go any longer without a pill she starts to throw up again.
    Is this safe for her? She has no adverse affects. Can she remain on the regime for her life?

    Judy

  16. suzanne oddo

    My cat has been in renal failure for seven years. We have been giving him sub Q fluids for all this time but he just could not get past the nausea. Down to 8# I was getting desperate. This drug cerenia has been a life saver. He is now eating again. Does anyone know where to buy injectible form for a reasonable price??

    • June

      Hi, Suzanne.
      What side-effects have you noticed since giving your cat cerenia? I’ve read the side effects and am worried about giving the pills to our kitty. Any feedback you can provide would be greatly appreciated. Thanks so much.

  17. Shadow

    My cat must be some kind of anomaly. She was recently diagnosed with pre-hyperthyroidism (so not even full blown hyperthyroidism) and is on meds for that and for an infection. It’s only been a few days, but I do see small overall improvements in her behavior. But she couldn’t keep any food down whatsoever, so she got a Cerenia shot and some pills for me to give her.

    Well she’s still vomiting. Even watered-down canned food (pate, not shredded meat). I thought maybe my poor girl – who is obviously hungry now – could finally eat again after several days of vomiting up whatever she tried to eat. No such luck. She’s been eating her kitty litter and that actually stays down longer than her actual food.

    Geez, cats that are sicker than mine can manage to eat on this medication, so I have no idea why my cat is the exception.

    • Janice Chadola

      Shadow- do you realize there is a cure for hyperthyroidism in cats. You would have to see I think from the total T4 blood test whether your kitty is hyperthyroid enough. It is a cure that involves one radioactive injection. I live near Vancouver, BC in Canada and it is offered here. One of my kitties appeared to be hyperthyroid or almost hyperthyroid and I was arranging to take him in for the treatment then oddly enough his thyroid test returned to normal. But the treatment must be offered in the US if that is where you are.

      Janice

  18. Janice Chadola

    I have a healthy cat who feel wonderful and has been checked out by my vet but she vomits constantly. Then my vet gave me Cerenia to try. It works wonderfully but he says it can only be used for 5 days. Are there any authoritative articles or studies showing its safety for continued long-term use. It is so wonderfull to not have my bed vomited on regularly! Janice

  19. concern about dosing, i know it goes by weight, but what about the sensitivity of cat??? i’m in fear of the side effects if not correct dosage.

    elizabeth

  20. Katie

    I was told today that there is an unpublished article coming out of Colorado that says Cerenia can be used long term. I’m not a vet and I don’t know the specifics. I trust the person that told me, so I look forward to getting more Cerenia for my IBD dog.

  21. it’s me again. no one ever states the dosage of tablet they gave to their cat or the cat’s weight???
    i asked this question before…..

  22. Cindy Maury

    Hello. I just found this site when I did a search for “Cerenia”, and I’m so glad I did! Last week; our five year old D.S.H.; who came to us as a stray a couple of years ago, started vomiting. Not huge amounts; but enough of course to concern us. We’ve found that whenever we do something in the house; some project or something; or in this case; when we changed the location of his food and water bowls, (As most of us know; cats HATE change!)–he will start throwing up. Sometimes it’s ‘pinkish'; like it has a little blood in it which someone told me (A former nurse); that it is probably stress-related enteritis. It would stop in a few days normally.
    This time; we didn’t notice any pink in the vomit; but it was just food or liquid.
    I give him furball ‘treats’ on a regular basis….I MUST brush him more often…and I had a feeling he might have a furball. But after a few days of not eating or drinking much and not using his box much; we took him to the vet. The vet said he was not dehydrated and evereything looked normal otherwise; so he gave him a shot of Cerenia and gave us some tablets to give him. He didn’t do any blood work or anyting like that; he just did the normal exam; listened to stomach; heart; lungs; looked at gums and teeth; palpated abdomen; bladder; etc. Anyway; after that shot which he got at around noon that day; and for most of the next day; he did not vomit at all. But I tried to give him his dose of Cerenia anyway; hiding it in a hairball treat…well; that didn’t go well at all. He was already VERY stressed since he was sick, more after seeing the vet; hiding and acting just not his self, and after giving him his dose; he must have chewed down on that tiny piece; and most of it came out of his mouth but he probably tasted some; because all of a sudden; he starting salivating profusely. It was bubbled up by his mouth and dripping all over. I called the vet and they said what I thought; that he tasted it and didn’t like it! They told me….in nicer words of course…that I would have to start coating the tiny piece of pill with butter or oil; forcing his mouth open; and sticking it down his throat far enough to make him swallow it. Right. This poor cat was ALREADY totally stressed out; WE are totally stressed out; and I’m going to FORCE a pill on him?
    I don’t think so. I didn’t see any reason to make this poor cat suffer any more than he already had; so we stopped giving him the meds.
    That night; he threw up; and there was in fact a big hairball in it; which I thank God for. I felt as though if I gave him the med. to stop vomiting; he may not have gotten rid of that furball.
    But now that I’ve read this site; and see that the med. may also help heal the G.I. tract AND the blader; among other things; I’m wondering what I should do?? I want to do what is best for him. He is eating and drinking more normally; but not like he did before; and he is stll not acting like his self totally yet. There is hardly anything in his litter box; either ‘thing'; and I sure don’t want his organs to start shutting down. But he IS better than he was; so I don’t know what to do. Does anyone have any suggestions? Maybe I could ask the vet if we could bring him in for another shot? That would be stressful too; but not NEARLY as stressful as it would be for me to hold his mouth open and shove a pill down his throat.
    Another thing we must consider to it cost. We; like most people; do not have lots of extra cash for office visits; exams, tests; procedures; shots; medicines; surgery’s, etc. So any suggestions anyone might have will be GREATLY appreciated. And I’m sorry this is SOOOOOOOOOOO long!

    • I’ve been most successful giving my cat meds with Greenie pill pockets. I also give him Gerber baby food – turkey or chicken when his stomach is upset. He seems to hold that down. When all else fails, I crush medication into his baby food.

      • Cindy

        Hi Elaine; and thank you so much for your reply; I truly appreciate it.
        I will have to look into getting some of the “Greenie” pill pockets. I have seen them before online; and I guess I’d better get some. Thank you too for the suggestion to put the pill into some baby food. I’m not sure if our kitty would go for that since he’s not interested in soft foods; but I can sure try if we need to. So far kitty has been fine in spite of us doing some renovation here; so I’ll keep praying he continues to do well.
        Thank you again for your time; take care. Sincerely; Cindy Maury

    • Brenda Howarth

      We have a poorly cat with Hyper Eosinophilic Syndrome. Through Prednisolone we have managed to get her blood eosinophils into the lower part of the normal range. This weekend she started to vomit ( a possible reaction to chicken) and our vet gave her an injection of Cerenia and we are following up with a 0.25 tablet (4mg) a day. We give all her tablets in a gel cap. They go down easily and there is no taste. You can order them cheaply on line and it makes giving her tablets so much easier. I hope this helps.

      • Cindy

        Hello Brenda; and thank you so much for your reply; it does help and I appreciate you taking the time to get back to me. Our kitty is doing well now; in spite of us doing some renovating here; which is literally a miracle since he gets so upset normally with anything work we do here. Thank God He has answered our prayers for our kitty!
        Thank you once again; take care. Sincerely; Cindy Maury

  23. Cindy Maury

    It appears this thread might be closed; since I see no comments to my question, or any other comments. I found some help elsewhere though; but I thank you for having this site for the good information I’ve found.
    In case the person who I got help from for the question(s) I had looks at this site again (I know she’s been on here before); I want to thank you ‘publicly’ for making the time to help me with the questions and concerns I have for my cat; I truly appreciate you helping me; when I know you are such a busy person. It means so much to me to know I’m ‘heard’ and ministered to; thank you so very much.

    • jchadola

      Tried to reply but I could not seem to send it so I hope it doesn’t go through twice. My vet would not prescribe Cerenia for long term use for my kitty who had been vomiting continuously for 2 or so years. My vet thinks she has motility problems. Also, it costs $7 a tablet which I cannot afford. I could not get it from the US as I had to get it prescribed by a US vet and/or I needed a US address to have it delivered to. Besides it was still too expensive for me to afford. As I recall it was about $3 or $4 a tablet. My vet first put my cat on cisapride but I found out it had been taken off the Canadian market for human use because it could cause fatal heart problems but is still available for veterinary use. Even if it has not been found to cause fatal heart problems in cats, I did not want to take the chance it could harm my cat. So she is on metaclopramide 1-1/2 of a 5 mg tablet twice a day. She now only vomits infrequently. I did have it compounded at a pharmacy in a liquid chicken-flavoured concentrated form but she vomited shortly after giving it to her so I have stated with the tablets. The liquid form has to be refrigerated and only lasts for about 30 days. My kitty is not impressed with being given medication twice a day. I had to resort to using a “pill popper” you can get from some vets which is plastic with a rubber tip you fit the pill into then insert it far enough down her throat that she cannot spit it out. She is still not too happy but at least I have my fingers and she seldom throws up.

      Janice

      • Cindy

        Hi Janice; thank you so much for all the info. you shared. I’m so sorry to hear about your kitty. But I’m glad that she is doing better. I may have to ask our vet if we can get one of those ‘pill poppers’ you mentioned; that might help a bit if kitty starts vomiting again. He hasn’t vomited since Janurary or February; so that’s great.
        I don’t blame you for not wanting to give your kitty that one medication; I wouldn’t chance it either. But if you’re having success with the other med.; that’s good.
        We tried; I think; mixing the tablet in soft food; but our kitty knew what we were up to and wouldn’t go for it; so if he has problems again; I’ll have to either try buying and using empty capsules to put the tablet in and/or get a ‘pill popper’ from the vet…..I know what you mean about ‘having your fingers’ using the popper! Take care; and pat your kitty for me!
        Thanks again; sincerely, Cindy Maury

      • greetings!
        just curious, what is the the time limit for using cerenia concerning cat???

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