Save Your Cat's Life with a Question

Yesterday I got a heartbreaking comment on a post I wrote two years ago about the dangers of giving your cat Metacam®. The cat guardian found my post after he had given Metacam to his 13 year old cat because she had hip dysplasia and he wanted her to be comfortable. He noticed his cat became constipated and called the Vet to ask if the Metacam was the culprit and they said it was unlikely. He backed off giving his cat the medication and she got better, but she was still having pain in her hips so he felt obliged to give her the Metacam again.

The constipation returned to the point of her crying and straining when she attempted to defecate. She began vomiting so her guardian took her to the Vet. They determined she was in renal failure (based on blood work). They offered treatment but gave the cat about nine months to live. The guardian, feeling like he wanted to do what was best for his cat, chose to have her humanely euthanized. After she died, he did some research online and found out he could have treated her and she probably would have lived much longer- and clearly, too, it was possible that the Metcam caused her renal failure!

He wrote me, broken hearted. His cat was gone. Here he was trying to do the best he could for her and felt he had failed her.

What went wrong?

This brings up a few points I'd like to share about how to work with your Vet during your cat's health crisis. Notice I didn't write; “How to listen to your Vet and do what they tell you and not ask questions.”

If you're NOT someone like me, who has a lot of cats and is always at the Vet or learning about cat health, then it's very easy to put the decisions into your Vet's hands and not take an active roll in your cat's health decisions. The second you do this almost guarantees that later on you'll have a lot of regret. If your cat isn't in an emergency situation, like she was injured in an accident or ate something poisonous, then use common sense. Take the time to find out what the Vet is talking about. Even if it means, as I have done in the past, sitting down with a report in one hand and looking up terms online so you can decipher an ultrasound report, then do it. Here are other things to ask:

• If your vet says to change your cat's diet to a “prescription diet” 
or give them an antibiotic ask him or her WHY are they making this recommendation?
What side effects or other issues can this medication cause? Is there something
you can do to help offset the side effects (like give probiotics at a timed interval
after giving an antibiotic). What's in this food that's so good for my cat? 
Is it species appropriate or full of grain that will sicken my cat further? 
• How will your cat benefit from this treatment or is the Vet simply 
not sure what is going on and wants to try something to see if it works? 
You'd be surprised at how often that happens.
• Is this medication specifically ok to use in cats or is 
this an “off label” use? 
• Would my cat benefit from seeing a homeopathic, holistic or 
eastern medicine Vet? What about acupuncture? If the cat had 
bad hips, she may have done well with that therapy, alone.

Box of Bob.jpg
©2007 Robin A.F. Olson. My cat, Bob was given Metacam after he'd fallen almost 17 feet off of our deck. Bob had an ALT of 700 (normal is around 100), yet he was prescribed this medication. Had I known about the issues surrounding Metacam I would NEVER have allowed my Vet to give it to him. I don't know if it caused him to have a hepatic cancer or not. I will never know. Bob passed away last September from a variety of complications. Today I have a “NO METACAM” warning on ALL MY CAT'S FILES.

Unknowingly, the cat guardian thought it was safe to use Meatcam on his cat because his Vet prescribed it…but Metacam is NOT DESIGNED FOR USE IN CATS. It's used “off-label” because there are no effective NSAIDs (Non-steroidal anti-inflammatory drugs) for cats that wouldn't also cause them more problems or kill them. I wrote about it in more detail in my original post on Metacam that you can read HERE Even back then I wrote: “If you read the insert it clearly says " Do not give in cats" and it has caused renal failure in a number of cats after just one dose.”

To make matters even MORE confusing, lately Metacam is being touted SAFE for cats who are undergoing orthopedic surgery or even a spay/neuter if injected one-time before surgery is done to prevent swelling. In fact, Bobette's surgeon gave her Metacam, which flipped me out because I didn't know it until he had already given it to her. He said it was safe if used along with an IV which would keep the kidneys flushed out. So I did some reading about it and see he was correct, but it's still comes with MANY WARNINGS: “Pets should be evaluated for pre-existing conditions and currently prescribed medications prior to treatment with METACAM. Anesthetic drugs may affect renal perfusion; approach concomitant use of anesthetics and NSAIDs cautiously. Use of parenteral fluids during surgery is recommended. Concurrent use of nephrotoxic medications should be carefully approached. Multiple injections or concurrent or follow up use with an NSAID (including METACAM) or corticosteroid should be avoided.”

metacam warning.jpg
This is from the Boehringer Ingelheim Vetmedica, Inc. Metacam data sheet. It states: “Death has been reported as an outcome of the adverse events listed above. Acute renal failure and death have been associated with use of meloxicam in cats.”

Should YOU have to know this information? Should you have to know about every single medication your Vet prescribes? Why can't you just leave it up to them? They're the ones who went to Vet school!

Guess again. There can be more than one way to treat a health issue. Surprisingly, diet alone can help with a number of factors. If you DON'T get involved with understanding what your cat is being prescribed, then you can find yourself in a very sad situation, as our friend was a few days ago. It's not his fault that he trusted his Vet, but there's a point at which you MUST take an ACTIVE ROLL in your cat's health. Partner with your Vet. Don't let them simply dictate to you. Yes, they have more experience and they went to college, but you can read and you can ask questions. What your Vet is telling you may be spot on, perfect, appropriate and safe-and I hope that's always the case, but for the sake of helping your cat live a long and lovely life, please…ASK QUESTIONS!…breathe!…give yourself some time to consider what is going on and take a step back if you have to. I never want to read another comment or get another email from someone who felt like they were backed into a corner and put their cat down far too soon.

Take a moment do some research, ask questions, ask your friends, see another Vet. There's a tremendous amount of information out there. Even simply going to a pharmaceutical company's web site and looking up the information they provide on their drugs may be all you have to do so save your cat's life.

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Comments

Thank you!!

About a month ago we took Shadow to the vet because he was limping and favouring one of his back legs. He didn't flinch or anything if you touched it, but he was limping. Of course, by the time we got him to the vet, he was fine.  The vet couldn't find anything and suggested that he may have pulled his muscle jumping or running. Shadow is a bit of a goofball and very active and this is what I though also, but my son wanted to see the vet. Anyway, the vet prescribed Metacam. We did not give it to him mostly because he wasn't limping anymore and the vet said to give it with food - just mix it in. Bella and Shadow eat together and eat out of each other's bowls. I couldn't figure out how to do this. At 17 pounds and 40" long  Shadow is hard to hold and give medicine to. After reading your post I went home and checked the label of the medicine. It actually says "Metacam for cats". I have not had a chance to read all the information yet, but when I do I will certainly ask the vet why he prescribed this medicine.

Excellent Post!!

I have the reputation of being paranoid, but then again I have reason.  Things can and do go wrong, so more information is never a bad thing.  Vets all too often dismiss known side effects because they have never seen them.  That doesn't mean they won't ever happen, so don't ever let a vet white wash them.  You need to know what to look for.

I've been to several different vets over the years and most of them dismiss anything you find on the internet as dribble.  I can understand, but there is also a lot of great information out there and it is a shame they stop listening when ever they hear the words "I saw it on the internet"

it is best to remember that vets are just people.  They have studied more and have more experience in certain areas but that doesn't mean they know everything and can't make mistakes.  If ever you feel uncomfortable remember that they work for you and if the relationship doesn't work there is nothing wrong with finding another vet who you do feel comfortable with and will deal with "high maintaince" clients and appreciate it when clients care.

Yes, ask questions!

Please do tell your vet if anything doesn't seem right with your cat after giving a prescribed medication, or even a supplement or SQ fluid. My CRF cat kept vomiting on the type of SQ fluid he was getting, so one of my vets suggested trying a different type. He still vomited occasionally, so she suggested yet a third, and he's done fine on it. A co-worker had the same issue with her cat--he just wasn't acting right after getting fluids, and when she changed the type it solved the problem. Now that type of fluid is going to be the standard one we dispense for cats getting SQ's. Get a second opinion if you bring up a concern and feel it's not being heard, and don't be afraid to ask questions!

off label drugs

I assume that by this term you mean drugs not scheduled for use in a given species?

Assuming that this is the case have i got a story. 

A few years ago my indoors only boy escaped while i was away for a weekend. He eventually came out of where he was maybe half an hour after i got home.. it was 30 minutes of panic for me.. seeing the flyscreen pushed out of the window was terrifying to see. And from his adventures it became apparent his underbody was covered with either a mite or  immature ticks.. his armpits were black. 

Now.. my boy Romeo has a possible blood condition that shows itself in slow clotting times.. so i am really really wary about his health. The vet wasn't sure what we could do to get rid of the parasites.. went and looked up a book.. and wanted to use Ivomectin.. ok.. he was only a new vet but still.. it doesn't foster confidence when they don't know.. although i was already wary of this vet following Romeo's first visit for his final kitten vaccimation. (The vet put the needle right through the skin on his neck). So i digress, this vet was trying to work out what would be a safe dose for a cat.. when i asked "was this safe" the reply was "it should be". I told him i was not happy taking that risk. i asked while i'm here should it be safe to give him his booster vaccination.. same reply "it should be". If a vet can't say a hard yes then i'm not interested.

I knew that Frontline spray was the only thing that could be used on cats against ticks and went with that. It worked and my  cat was fine.. as i knew he would be.. using something at  a dosage designed for cats.

Thank you...

I found a link to your post on Facebook and am so glad I came to read it.  It's a wonderful reminder to ask questions.  And lots of them.  I always think to do that for myself at the doctor, but it's easy to just take everything the Vet says, leave, and do it.  Not that their guidance is by any means bad, inaccurate or even harmful.  But I know my cat better than anyone else and that should count for something.

She nearly didn't make it while recovering from emergency surgery to remove a piece of ribbon she had eaten.  (I know...bad cat mom for even allowing this to happen.)  Although the surgery went fine, I was unable to get her to eat or drink afterwards.  It was becoming very serious at 2-3 days post-surgery.  I tried everything, but she was just so lethargic she barely moved.  I was giving her pain medication and noticed that each time I gave her a dose, she would quickly just fall over and go to sleep. It seemed to me the dosage was just too strong, knocking her out so much that she had no desire to get up and eat.  So I decided to cut the dosage way back, still monitoring for signs of pain.  She slowly perked up and began eating later that same day.  I hate to think of what could have happened had she not started to eat.

I don't blame the Vet...althouth as many times as we talked, the dosage never came up as a possible problem.  It just illustrates the importance of knowing your own pet and using a little common sense.  

Common sense also now includes NEVER leaving ribbon out. 

Thanks for posting this again

Thanks for posting this again - I have had a holiistic vet for 15 years and would never go back to a regular one. So many drugs are more harmful than good - we try to find a natural alternative to drugs for any treatment. 

Amen!!!

Robin,

I had never heard of Metacam before. Thank you for sharing this info! 

I wholeheartedly agree that we should be involved in the vet care for ALL our animals! Same as you would ask questions about your our health care or for that of your human children. 

About 15 years ago I had a young healthy male cat, Stymie, who was over weight but I had him since he was 8 weeks old and he had always been a little butterball with his fat belly dragging the ground. He had some gastrointestinal issues as a baby but feeding his a special diet I cooked myself cleared up those problems. He, however, remained a large fat cat. One day on a Friday I came home from work & he looked a bit listless & did not follow me into the kitchen demanding food. He did not eat all day on Saturday so I began to worry especially when I noticed that his belly was hard & solid. I was a college student & could really not afford an emergency vet visit. Sunday I came home from work & he black fur looked like someone had dusted him with yellow pollen & the whites of his eyes were yellow. I did not know what jaundiced was or I would have rushed him to the er vet right them! However he ate a little for me that night so I thought for sure it could wait until the morning.

First thing Monday morning I show up @ my vet office as they are unlocking the doors. They saw him right away & immediately said he was in liver failure & the only way to save him was to hospitalize him & give him meds via IV & possibly tube feed him. HOLY CRAP! The estimate was $500-700 per day. No way could I afford that no matter how much I loved my guy! I tearfully asked the vet if there was any other alternatives. He said no not really if you want your cat to live. A tech came back in with a pile of meds & a sheet of instructions & wished me good luck.

They gave him a steriod, two different kinds of anitbiotics, an appetite stimulant. He had to have medication 5 times a day. They also gave me a couple of cans of special prescription food full of calories and nutrients (which he had absolutely no interest in)

So my sister (bless her) arranged her schedule to be able to come over on her breaks during the day to give him his doses during the day time. After 5 days my giant had lost almost half his body weight & was still not eating on his own. If I mixed the wet food with water & put it in a syringe he would let me shove it down his throat but most of the time he vomited that back up. On day 6, I was completely dejected & trying to come to terms with the fact that I was going to have to euthanize my boy cuz I could not watch him continue to suffer. My brother was in the kitchen making himself a tuna sandwich & Stymie walked into the kitchen & was meowing at him! I told my broither to give he cat the tuna! I didn't give a damn what the vet said - if my cat would eat tuna - I was giving it to him! I immediately went to the store & bought tuna in oil cuz it is stinkier & the cats like it better. He just licked the juice off but he did it on his own! I was ecstatic and I gave him as much as he wanted! On day 7 I heard my cat screaming in my bedroom & ran in to see him in the cat box. He pooped out a poop that was rock solid about 8 or 9 inches long AND it contained a blue wal-mart bag. MY CATE ATE A PLASTIC BAG! OMG!!! I scooped it up into a plastc baggie & Mon morning I took it to the vet office & gave it to the vet & said - here is your liver failure! 

The vet did not do any blookwork on my cat, even though his belly was rock hard & solid, they never offered an xray or ultrasound. Had they done an xray or an ultrasound they would have seen the obstruction. I did not know enough to ask for it or even question the hard belly. The Vet did not offer an opinion on it after the physical exam so I assumed it was caused by his being jaundiced. My opinion, the vet never looked past the jaundice & just assumed cuz he was a big cat, he was in liver failure even though he had never had any issues like this ever before. 

Stymie went on to live until he was 17. I stopped using plastic bags. 

My lesson: Always ask questions even of you think it is something small or insignificant or even unrelated! I always think back & wonder if I had brought up the belly issue & had asked if it was related to the jaundice or if the hard belly could be causing the jaundice because his belly was hard two days before he became jaundcied. My ending was happy & my boy lived a long healthy life; but it very easily could have been bad. Had I not been dumb enough & to wait a week or had my brother not decided to have a tuna sandwich that afternoon, I could have lost my boy. 

jaundice & liver failure in cats

It does by your description sound like your cat did indeed have jaundice. Characterized by the yellowing of the eyes, mouth & in severe cases skin. 

In this case it would have been brought on by him injesting the plastic bag. When a cat goes off its food for whatever reason they draw fat supplies out of the body and this blocks the liver up. The reversal of this is to force feed your cat if needed.. and support the system until it rights itself..  it doesn't have a high success rate sadly. 

Sadly having a multi cat home i didn't notice that my male had  gone off his food.. i kept looking at him worrying he had lost condition but when i picked him up he seemed fine.. i took him to the vets when i observed him repeatedly throwing up white froth. The vet noticed the jaundice right away.. and then i noticed the tell tale sign of his weightloss.. how loose the collar was..  i got him through this with assist feeds... the jaundice disappeared.. then he started losing his balance, and loss of sensation in his tail.. a vet was concerned that with the liver functioning now it had flushed toxins in to his blood and he was suffering brain damage.. dose of steroids to support his system.. a nursing friend said it sounded like trans-ischaemic attacks.. a sign that parts of the brain had interrupted blood supply and can be a precursor of a stroke.

Exactly a week later i got up for work to find my boy fitting on the floor. I scooped him up and he immediately relaxed.. but i had just woken up.. i needed the bathroom so badly and the minute i moved he'd go stiff again :( I got him to the vets as soon as they opened and they did their best.. the vet was suspicious of a brain tumour.. but i knew what it was.. for me the uneven pupils were a give away.. the tracking of his pupils may have been an indicator of the location of the problem and the fact he was fitting.. they admitted him and tried controlling his seizures with valium but sadly around 2pm that day Freddie lost his battle. 

I was gutted.. he was only 6/7 years old.. slept in bed under the covers with me, shared my pillow. I can't stress vigillence enough with making sure that your cat is eating.. anything more than 2 days can cause problems.

WOW!!!!

OMG What an amazing story! Thank you for sharing that. What a SHOCK! That poor cat! And to think a simple thing like an x-ray would have made everything so much easier..that said..they would have told you they would have to do an expensive surgery that would have been impossible for you to pay for (at the time)..so in a twisted way it worked out for the best-though I HATE that you and your cat suffered so much. I wonder if you would had had to put him down knowing he had a foreign object in his abdomen?? My goodness...I'm glad he lived a long life after all that!!!! :::HUGS::::

Baytril antibiotic also dangerous to cats

I've known of two instances where Baytril given to elderly cats caused blindness and neurological disorders. It happened to my cat Eve, and also happened a couple of years later with my brother's cat. Both cats' conditions deteriorated very rapidly and they had to be euthanized once they couldn't see, walk, or eat and were in distress. It was heartbreaking.

Please do not let vets give this type of antibiotic to your cats, especially if they are older!!!

http://www.tufts.edu/vet/vet_common/pdf/petinfo/dvm/case_march2003.pdf

Metacam

I had a similar experience with Metacam, my 8 year old cat jumped off the counter and injured her knee; the vet prescribed Metacam and I researched it online because my cat has a very sensitive stomach and we've had numerous ups and downs with her in the past year with food allergies and pancreatitis. I called the vet with concern about the dangers of Metacam and my cat's kidneys/and or stomach and she said the dosage was so small that it would not be a problem for her. So I gave my cat the Metacam against my insticts that I shouldn't, and after three days she started vomiting and wouldn't eat, and eventually vomited some blood. I was furious. I took her off the medication right away and took her to the ER. It took weeks to get her stable and we've finally gotten her fully recovered from that, although we're still struggling with a sensitive tummy and solving the food allergies. I would always recommend following your instincts and ask for other options if a medication is controversial or you are worried about it. I should have listened to my instincts and I would have saved my cat discomfort and potentially fatal consequences. Thank God we caught it in time, but I will never forget this and will NEVER use Metacam again. 

Another great comment!!

KF-thank you for sharing this with us. It's true-you have to trust your gut even if it goes against your Vet. It does not mean you'll always be right, but you'll at least know you did what you felt was the best thing possible and not feel like you're second guessing yourself. I'm so glad you were watching your cat for problems and jumped when you saw side effects. I'm glad your cat wasn't one of the statistics!!! :-)

Thank you

I didn't know this about the medicine so I appreciate having this information very much.

It's important for people to realize that not all vets are alike and not all vets are good.  I took one cat in a chronic renal failure crisis to a vet and the treatment she received was lousy.  I learned later that she should have been hospitalized and stabilized, not given fluids subcutaneously and sent home again (however, she just missed being next door to a tornado that evening, so maybe that was a good thing--that night was the only night so far I took refuge in a bathroom during a wind storm).  Another vet practice seemed to oppose treating chronic conditions in cats and didn't seem very people-friendly to me.  It sold crappy needles for subcutaneous fluids and despite the fact that I pointed out there were sharper ones on the market the same price and it made a great deal of difference, they didn't change brands. 

Just as you have to be an active participant in your own health care, you have to be an active participant in your cat's care too.  Thank you very much for writing about it so well.

Thank you for this vital

Thank you for this vital post. The shelter kitties where I used to volunteer are routinely given metacam post-dental work. I had no idea it could cause renal failure, and will now be extra-vigilant should my cats ever need pain meds.

I also cannot thank you enough for encouraging readers to ask questions and do their research. I can add two quick stories to this, both since we rescued our newest girl.


1) Tortie girl was with us a week and a half when she started bleeding all over the floor. My husband and I rushed her to the emergency vet (because these things always happen to us at night). Her backside was already red from diarrhea, so I thought that all of a sudden something went very wrong. Vet tech took her for a quick check with doctor (hospital was busy that night) and then said that she was "having a kitty period" and in heat, and we should talk to the regular vet about it next day (when the spay surgery was scheduled), as some do not like to spay cats in heat. Well. I searched the internet half the night because I had never heard of female cats having periods, despite working in a shelter for years. Could find no evidence of this on vet websites either. Took Tortie girl to regular vet the next morning for spay surgery. Got a call that surgery went well; Tortie girl was actually pregnant so therefore not in heat, and it was her FOOT that had been bleeding from a cut. Yikes.

2) Tortie girl had diarrhea from too many "outdoor" meals as a stray. After several medications, husband took her back to vet, who recommended "prescription" diet. Our cats only eat food that is real meat, with ingredients we recognize on the label, and that is grain-free. First three ingredients listed on prescription food: soy protein (I read in an article by Dr. Becker that cats and dogs are allergic to soy), chicken by-products (not good quality, and not really meat), and corn gluten. Please explain to me how this food is supposed to HELP cats with iffy digestion??? I did not get a chance to speak to the vet myself, who is a very good vet, but next time I will ask why this food is prescription. Needless to say, we are back to the better quality food. I can't urge pet guardians enough to read the labels and know what you are feeding your furry loved ones!

Thia is why I go to a feline

Thia is why I go to a feline only practice that NEVER uses metacam under any circumstances. They don't even keep it in the clinic.

ask questions

I agree, asking questions is critical but sometimes you don't even know where to start. How do you know the right questions to ask? I guess that's where the research comes in. Both the cats I have had to euthanize in the last 5 years had "masses" in their livers and one went into surgery and pretty much bled out. My poor baby! only years later did my vet confirm, somewhat guiltily, that long term use of neomercazole had been known to cause liver cancer in cats! Gee, thanks.
My boy Fox was diagnosed as hyperthyroid when he was 5(!) he lived to 11 1/2. I blame the mobile phone tower that was less that 50 metres from our house, but the health authorities say it's safe, they wouldn't lie, right..? And then Niles was diagnosed with the same condition exactly 5 years after he came to live with me! Coincidence? I just don't know...

I took my cats to a new vet recently and I don't think I'll be seeing him again. Rude, dismissive, just do what I say, oh, I'm not sure what's going on but here, let's give him a two week slow release antibiotic injection. Overwhelm let him get away with it, too. I vaccinate homeopathically and the cats are on a raw food diet, I even use Fleaz and Shoot Tags as aopposed to conventional flea treatments but still something chemical or toxic can slip through, right?

Definitely do your research, stand your ground and use alternatives if you can find them. My cats respond well to homeopathics, chinese herbs and supplements. Vets have their place but just like people doctors, they should not get the final say, they are not God.  Eg. the herb salve, Cansema, a safe, non-toxic way to remove skin cancers from humans and animals THAT WORKS! but it only cost cents per treatment and where's the profit in that? Let's have it banned!

Sorry, got carried away. Your post is much appreciated, Robyn and i will defintiely make a point of banning metacam. thanks, Lita

THX

Extremely good advice.  In fact, it goes for our own medical doctors as well.  I've shared this post with all of the cat people on my email list. 

I'm with you!

I didn't mean to infer that you should NOT use off-label, but you should be AWARE of the impact it might make on your cat's health. Some off-label use is the only way anyone figures out if something works for another issue than it was designed for, so yes..off-label can lead to breakthroughs as well... Hope that helps clear things up a bit. Best, Robin :-)

This Can't Be More True

Hi Robin - Thanks so much for this post. It can't be stressed enough that you need to question your vet, and not only that, any concerned pet owner should do research about their pet's possible condition, look up not only the name of the problem but the symptoms, online. Check meds for interactions. Check dosages. Then ASK questions - as many as you need to ask feel you understand and have answers. And also, challenege your vet if you have doubts. Need ammo? Print out what you've found on the web, and bring it along. Be calm, be firm, be polite, but stand your ground! 

My cat, Bandersnatch, lived to 19.5, but he would have been dead four years earlier, and then three years earlier, and then two years earlier, had I just listened to my vet - who is a great vet, by the way, with loads of life and care experience. 

Here is just one example but it kind of covers it all: In 2009 Bander developed hyperthyroidism on top of his CRF. I suspected it because of his behavior (aggitated, a bit short-tempered, weight loss, restlessness), and the blood tests confirmed it. He was proscribed Methimazole, and I went home with a bottle and a syringe, and the instructions for the dose were on the bottle. The first time I gave it to him, I thought, wow, this is a BIG dose! I could barely get it all down him. So I got online and looked it up. Problem was, it looked right online- I'm bad at math, and I didn't fully understand it all (I still get confused between CCs, Mls, Mgs, etc.), so I thought, OK, must be right. My excuse was that I was feeling overhwemled - this was just one thing on top of many others. But I should have ASKED THE VET about it, because it seemed wrong. 

About a month passed, and Bander seemed fine - put on weight, calmer. Then one day he comes out of my bedroom and he's staggering, he's obviously in pain: his hind leg was horribly swollen, he was panting. I called the vet and they said I could bring him in - I was in a total panic. At the vet, they told me he was so anemic they were surprised he was still upright. He had edema in his leg from the anemia. And two of the vets said, "Well, he's a CRF cat - his kidneys have just given out, and it's time." But I said, "Wait - he's on Methimazole at this dose. It seems large. Is it too large?"

My doctor looked at the bottle and blanched: the dose on the bottle was 10 times the recommeded amount.

I asked them if that could account for it: 10 times the recommeded amount! But they both said No - no way. We've never heard of that happening with Methimazole. His kidneys are gone. 

I said, what does the blood work say about his BUN and stuff?  It hadn't changed much from when he was running around just fine. Worse, but not dire. The only major change was his red blood cell count. So I said, look, I'm taking him home for the moment - in the meantime, I want you to order blood for a transfusion. They objected. I insisted. Very firmly. I said - I'm willing to pay for this, and it won't hurt him, so I want the blood here ASAP. My vet (who is great, really) said OK. 

When my poor cat and I got home (with some Buprenorphine for his pain) I got online, and started looking - and it must have taken me three hours, but I found a medical paper online, for humans, that said that overdosing on Methimazole can cause anemia. Just one paper - but it was the smoking gun.

The blood came in the next morning. Bander had his transfusion, and the adema began to drain. I had, of course, stopped the Methimazole. Gradually, he got stronger. And by the end of the month, he was charging around again, and his blood count was fine. Eventually, he went back on the thyroid drug, at the right dose, and his hyperthyroidism was controlled for the remaining two years of his life.

So, kind of a long story, but I hope it illustrates your point:

Always ask questions, especially if you aren't familiar with the problem, or the treatment options.

Then THINK FOR A BIT. Do some research - do as much as you need to feel you have a grasp of what's up and what's out there. Print it out if need be. 

Go back to your vet - ask more questions. 

Then do what seems best - and even if it turns out wrong, you will feel you tried your hardest for your pet.

Thanks again Robin. I too hope you never get another anguished email about regret and the loss of a pet that could have been prevented. 

Awesome & Helpful!

Wow Jnxy, That was a great post! It's VERY VERY helpful to everyone else to read stories like yours because it points out how easily things can go wrong and how trusting your gut also plays an important role in making health decisions for your cat. You really have to take a breath on making a decision so you do have time to research..god knows there is a ton of info out there and there are disease/illness-specific web sites for folks who have cats in renal failure, diabetes, lymphoma and everything else you can think of. Tap those folks for their knowledge, too. They've already been in your shoes and often can offer helpful advice. Great job! Thank you for sharing with everyone!

Your Welcome, and thanks for the post

Thanks for this topic Robin, and for the chance to participate. My terrific vet just told me he's retiring in July, and there seriously isn't another decent vet in the area, so I'm going to be doing a lot more research and asking a lot more questions in the coming years!

I agree but...

I agree with your post wholeheartedly and have seen the benefits of taking a very active role in my cats care.  My only caution would be deciding against a treatment simply because a medication is "off-label".  I agree with everything you say about metacam and will never give it to my cats.  I asked one of my former vets about the whole "off-label" issue.  He said that many times more research dollars are spent testing drug efficacy on dogs as are spent on cats.  Hopefully this situation has improved but only time will tell. 


Until research for cats catches up with dogs,  there might be situations where other drugs that are "off-label" need to be discussed and not dismissed solely for this reason.  The discussion is the important thing.  My vets appreciate the fact that I take an active role and they take the time to explain things.  If someone finds their vet acts otherwise it's time for a new vet!!!


Robin thanks for writing this as I think this post will help readers and their cats tremendously!!!


 

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