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#1
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Metacam and my cat; overdose
Hi All, especially Phil who has been wonderful to me and others in the
past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. 3 weeks ago I brought my 11 year old female kitty in for a full panel and a general check-up. One of the prime motivating forces was that the night before while stroking her I found a small marble-size lump by her right foreleg. Fortunately, it was not attached to bone and muscle and was moveable. A fine needle aspirate showed very little and it was decided to excise the lump at the same time that she had a dental cleaning (2 weeks from then). Then starts the whole debacle. The geriatric panel showed her serum glucose at 16.8 mmol/L. This could well have been stress hyperglycemia after the wait at the vet and the very rough way she was handled by the vet tech. The vet then suggested a urinalysis would be conclusive but I had doubts as if this was stress hypergylcemia to do a urinalysis the next day would perhaps be pointless due to the glucose being dumped into the urine 24 hours afterwards. I suggested a fructosamine test and this came back normal. I wondered then why it was I who had to suggest this. Her Bun and Creatinine then were 25.21 and 1.56 respectively. Surgery was set for 2 weeks then for excision of the lump and the teeth cleaning. I suppose I was remiss in not asking what drugs they would be using, including NSAIDs. Ironically, a friend of mine had contacted me some 6 months earlier and had told me that her vet had prescribed Metacam for her cat's condition. I then proceeded to warn her about the dangers of this drug. Well the surgery went fine but I was told that the vet tech got some files mixed up and she was given the Metacam dosage for another animal. She allegedly was given 0.4 mg/kg (she is 6.2 kgs) when she was supposed to have received 0.2 mg. I really have no idea what dosage she was actually given but this is what I was told. I do know that Boehringer, the manufacturer of the drug have advised a 0.3 mg/kg one shot dosage post or pre-surgery. I have read loads of peer-review studies on Metacam and was frightened. The error was supposedly discovered immediately and the cat was put on iv fluids for 24 hours. Bun and Creatinine were then drawn 24 hours later and they were low due to the IV fluids. Bun was 13.17 (due to fluids) and creatinine was 1.22. A week later, yesterday, bun and creatinine were tested and Bun was a bit lower than it was 3 weeks ago at 22.41 but creatinine had gone up a lot from the 1.56 to 1.92. Normal range for the lab is 0.57 to 2.0 I am devastated - Forget about the lump, the biopsy of which I might get today or early next week. The vet when I phoned up last night said when I asked him how were the results he said "She's fine!". To me that is not fine and after I got the figures from him he said we should do another test in 2 weeks. I really do not know what else to say. Any advice would be most appreciated. Hey, I have some good news regarding my other kitty which I meant to post in the last few months. Here is my original post 4 years ago on this: http://groups.google.com/group/alt.m...hread/thread/a 73ce1d8ca4c0d98? hl=en&q=idiopathic+hypercalcemia+peter+group:rec.p ets.cats. *#da6aba922427264c or using tinyurl: http://tinyurl.com/6qe6rx 4 years ago I made a post to both rec.pets.cats.health+behav and alt.med.veterinary about my cats idiopathic hypercalcemia. I tested every which way and had ultrasounds and even exploratory surgery as there was a a possibility of a parathyroid problem (which I hoped for). I consulted twice with the Cornell Feline Health Center, had numerous visits to the Critical Care Group in Vancouver (a specialized hospital) and read every single peer reviewed journal on this. Nobody had a solution. So once a year he was on prednisolone, I gave him IV fluids to increase the volume and fed him Hill's X/D which is really low in Calcium and he liked. Then earlier this year while browsing I picked up anecdotal information that Lactulose might create hypercalcemia. I knew from reading studies that when lactulose is ingested with a meal it does increase calcium absorption but that is why I gave lactulose at least 30 minutes before a meal. But hypercalcemia? I was not sure. This kitty I had adopted after he dragged himself to my door with a broken pelvis some 10 years ago (he was a stray whom I fed whenever he came by). From the beginning he was on lactulose - 5 ccs twice a day. Anyhow, I read about Miralax aka Peg 3350 and substituted that for lactulose and a month later I did a test. After about 40 elevated serum calcium and ionised calcium tests this one came back normal and he was a reborn kitty. So that is the good news this year. Unfortunately, the bad news is all above with my girl. Peter |
#2
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Metacam and my cat; overdose
I remember you peter MY aka was different than Have you talked to another
vet yet "Peter Georgeu" wrote in message . .. Hi All, especially Phil who has been wonderful to me and others in the past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. 3 weeks ago I brought my 11 year old female kitty in for a full panel and a general check-up. One of the prime motivating forces was that the night before while stroking her I found a small marble-size lump by her right foreleg. Fortunately, it was not attached to bone and muscle and was moveable. A fine needle aspirate showed very little and it was decided to excise the lump at the same time that she had a dental cleaning (2 weeks from then). Then starts the whole debacle. The geriatric panel showed her serum glucose at 16.8 mmol/L. This could well have been stress hyperglycemia after the wait at the vet and the very rough way she was handled by the vet tech. The vet then suggested a urinalysis would be conclusive but I had doubts as if this was stress hypergylcemia to do a urinalysis the next day would perhaps be pointless due to the glucose being dumped into the urine 24 hours afterwards. I suggested a fructosamine test and this came back normal. I wondered then why it was I who had to suggest this. Her Bun and Creatinine then were 25.21 and 1.56 respectively. Surgery was set for 2 weeks then for excision of the lump and the teeth cleaning. I suppose I was remiss in not asking what drugs they would be using, including NSAIDs. Ironically, a friend of mine had contacted me some 6 months earlier and had told me that her vet had prescribed Metacam for her cat's condition. I then proceeded to warn her about the dangers of this drug. Well the surgery went fine but I was told that the vet tech got some files mixed up and she was given the Metacam dosage for another animal. She allegedly was given 0.4 mg/kg (she is 6.2 kgs) when she was supposed to have received 0.2 mg. I really have no idea what dosage she was actually given but this is what I was told. I do know that Boehringer, the manufacturer of the drug have advised a 0.3 mg/kg one shot dosage post or pre-surgery. I have read loads of peer-review studies on Metacam and was frightened. The error was supposedly discovered immediately and the cat was put on iv fluids for 24 hours. Bun and Creatinine were then drawn 24 hours later and they were low due to the IV fluids. Bun was 13.17 (due to fluids) and creatinine was 1.22. A week later, yesterday, bun and creatinine were tested and Bun was a bit lower than it was 3 weeks ago at 22.41 but creatinine had gone up a lot from the 1.56 to 1.92. Normal range for the lab is 0.57 to 2.0 I am devastated - Forget about the lump, the biopsy of which I might get today or early next week. The vet when I phoned up last night said when I asked him how were the results he said "She's fine!". To me that is not fine and after I got the figures from him he said we should do another test in 2 weeks. I really do not know what else to say. Any advice would be most appreciated. Hey, I have some good news regarding my other kitty which I meant to post in the last few months. Here is my original post 4 years ago on this: http://groups.google.com/group/alt.m...hread/thread/a 73ce1d8ca4c0d98? hl=en&q=idiopathic+hypercalcemia+peter+group:rec.p ets.cats. *#da6aba922427264c or using tinyurl: http://tinyurl.com/6qe6rx 4 years ago I made a post to both rec.pets.cats.health+behav and alt.med.veterinary about my cats idiopathic hypercalcemia. I tested every which way and had ultrasounds and even exploratory surgery as there was a a possibility of a parathyroid problem (which I hoped for). I consulted twice with the Cornell Feline Health Center, had numerous visits to the Critical Care Group in Vancouver (a specialized hospital) and read every single peer reviewed journal on this. Nobody had a solution. So once a year he was on prednisolone, I gave him IV fluids to increase the volume and fed him Hill's X/D which is really low in Calcium and he liked. Then earlier this year while browsing I picked up anecdotal information that Lactulose might create hypercalcemia. I knew from reading studies that when lactulose is ingested with a meal it does increase calcium absorption but that is why I gave lactulose at least 30 minutes before a meal. But hypercalcemia? I was not sure. This kitty I had adopted after he dragged himself to my door with a broken pelvis some 10 years ago (he was a stray whom I fed whenever he came by). From the beginning he was on lactulose - 5 ccs twice a day. Anyhow, I read about Miralax aka Peg 3350 and substituted that for lactulose and a month later I did a test. After about 40 elevated serum calcium and ionised calcium tests this one came back normal and he was a reborn kitty. So that is the good news this year. Unfortunately, the bad news is all above with my girl. Peter |
#3
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Metacam and my cat; overdose
Hello Matthew,
Thanks very much for the reply. I have been communicating with my two vets in Vancouver from the beginning and they have been extremely quick to respond. However, to this bad news, they seem to have stopped in their tracks - or they are just very busy. I am advised that even though this is the kidney and not the liver, this potential insult to her can come right and in all probability her creatinine will still stay within the normal range and may well come down a fair bit. I am normally pretty good at researching but I am so exhausted by all of this and don't want to think and just feel like cuddling up with a bottle of wine with my 2 kitties around me. Peter In article m, wrote... I remember you peter MY aka was different than Have you talked to another vet yet "Peter Georgeu" wrote in message . .. Hi All, especially Phil who has been wonderful to me and others in the past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. snip |
#4
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Metacam and my cat; overdose
Peter hopefully Phil will see this very soon. As for your vets keep trying
"Peter Georgeu" wrote in message ... Hello Matthew, Thanks very much for the reply. I have been communicating with my two vets in Vancouver from the beginning and they have been extremely quick to respond. However, to this bad news, they seem to have stopped in their tracks - or they are just very busy. I am advised that even though this is the kidney and not the liver, this potential insult to her can come right and in all probability her creatinine will still stay within the normal range and may well come down a fair bit. I am normally pretty good at researching but I am so exhausted by all of this and don't want to think and just feel like cuddling up with a bottle of wine with my 2 kitties around me. Peter In article m, wrote... I remember you peter MY aka was different than Have you talked to another vet yet "Peter Georgeu" wrote in message . .. Hi All, especially Phil who has been wonderful to me and others in the past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. snip |
#5
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Metacam and my cat; overdose
Our clinic will not use metacam on cats, just dogs.
Sub/q fluids at this point. Comments? "Peter Georgeu" wrote in message . .. Hi All, especially Phil who has been wonderful to me and others in the past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. 3 weeks ago I brought my 11 year old female kitty in for a full panel and a general check-up. One of the prime motivating forces was that the night before while stroking her I found a small marble-size lump by her right foreleg. Fortunately, it was not attached to bone and muscle and was moveable. A fine needle aspirate showed very little and it was decided to excise the lump at the same time that she had a dental cleaning (2 weeks from then). Then starts the whole debacle. The geriatric panel showed her serum glucose at 16.8 mmol/L. This could well have been stress hyperglycemia after the wait at the vet and the very rough way she was handled by the vet tech. The vet then suggested a urinalysis would be conclusive but I had doubts as if this was stress hypergylcemia to do a urinalysis the next day would perhaps be pointless due to the glucose being dumped into the urine 24 hours afterwards. I suggested a fructosamine test and this came back normal. I wondered then why it was I who had to suggest this. Her Bun and Creatinine then were 25.21 and 1.56 respectively. Surgery was set for 2 weeks then for excision of the lump and the teeth cleaning. I suppose I was remiss in not asking what drugs they would be using, including NSAIDs. Ironically, a friend of mine had contacted me some 6 months earlier and had told me that her vet had prescribed Metacam for her cat's condition. I then proceeded to warn her about the dangers of this drug. Well the surgery went fine but I was told that the vet tech got some files mixed up and she was given the Metacam dosage for another animal. She allegedly was given 0.4 mg/kg (she is 6.2 kgs) when she was supposed to have received 0.2 mg. I really have no idea what dosage she was actually given but this is what I was told. I do know that Boehringer, the manufacturer of the drug have advised a 0.3 mg/kg one shot dosage post or pre-surgery. I have read loads of peer-review studies on Metacam and was frightened. The error was supposedly discovered immediately and the cat was put on iv fluids for 24 hours. Bun and Creatinine were then drawn 24 hours later and they were low due to the IV fluids. Bun was 13.17 (due to fluids) and creatinine was 1.22. A week later, yesterday, bun and creatinine were tested and Bun was a bit lower than it was 3 weeks ago at 22.41 but creatinine had gone up a lot from the 1.56 to 1.92. Normal range for the lab is 0.57 to 2.0 I am devastated - Forget about the lump, the biopsy of which I might get today or early next week. The vet when I phoned up last night said when I asked him how were the results he said "She's fine!". To me that is not fine and after I got the figures from him he said we should do another test in 2 weeks. I really do not know what else to say. Any advice would be most appreciated. Hey, I have some good news regarding my other kitty which I meant to post in the last few months. Here is my original post 4 years ago on this: http://groups.google.com/group/alt.m...hread/thread/a 73ce1d8ca4c0d98? hl=en&q=idiopathic+hypercalcemia+peter+group:rec.p ets.cats. *#da6aba922427264c or using tinyurl: http://tinyurl.com/6qe6rx 4 years ago I made a post to both rec.pets.cats.health+behav and alt.med.veterinary about my cats idiopathic hypercalcemia. I tested every which way and had ultrasounds and even exploratory surgery as there was a a possibility of a parathyroid problem (which I hoped for). I consulted twice with the Cornell Feline Health Center, had numerous visits to the Critical Care Group in Vancouver (a specialized hospital) and read every single peer reviewed journal on this. Nobody had a solution. So once a year he was on prednisolone, I gave him IV fluids to increase the volume and fed him Hill's X/D which is really low in Calcium and he liked. Then earlier this year while browsing I picked up anecdotal information that Lactulose might create hypercalcemia. I knew from reading studies that when lactulose is ingested with a meal it does increase calcium absorption but that is why I gave lactulose at least 30 minutes before a meal. But hypercalcemia? I was not sure. This kitty I had adopted after he dragged himself to my door with a broken pelvis some 10 years ago (he was a stray whom I fed whenever he came by). From the beginning he was on lactulose - 5 ccs twice a day. Anyhow, I read about Miralax aka Peg 3350 and substituted that for lactulose and a month later I did a test. After about 40 elevated serum calcium and ionised calcium tests this one came back normal and he was a reborn kitty. So that is the good news this year. Unfortunately, the bad news is all above with my girl. Peter |
#6
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Metacam and my cat; overdose
Nothing earth-shatteringly new in this post but yet another cautionary
tale. The vet when I phoned up last night said when I asked him how were the results he said "She's fine!". To me that is not fine and after I got the figures from him he said we should do another test in 2 weeks. I really do not know what else to say. Any advice would be most appreciated. It sounds like you're staying on top of this, and that's what we have to do concerning matters of health. You're the one in charge. Carol Wilson, Cat Artist http://www.cafepress.com/carolwilsoncats http://CarolWilsonCatArt.imagekind.com |
#8
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Metacam and my cat; overdose
Here is a follow-up to my original post. I do not know if I am going
insane but here goes. Today - I am still with the same vet for the moment until I can find another one whom I trust - I took my girl in for another Bun and Creatinine test as well as urine Specific Gravity which was not done last week. The figures came back this in. Urine was 1.035 which is right on the edge of normal although it was not the first of the day which is normally the most concentrated.. The Bun was a bit lower than before but I don't think it is that important compared to Creatinine - Bun was 20.16 mg/dl so on the lower end of normal. Creatinine was essentially the same as last week -a very slight slight bit lower at 1.91 mg/dl, with the lab maximum being 2.00 mg/dl. Here comes the kicker. I paid in full for her surgery etc etc when I picked her up after I heard about the metacam overdose. I never balked at this at all. I *assumed* that the bun and creatinine testing a week ago was for the account of the vet (he admits that they screwed up) and I assume it was. However the testing today which I wanted due to the high normal creatinine apparently was not supposed to be on the vet's account but my account and also the urine specific gravity. I was floored. I said is there any charge for removing sutures and I was told no. I then said to the secretary that I assumed there was no charge for the bun and creatine and urinalysis and she said she did not know. The office manager said the same. One vet, not the owner said "this is not my practice so I cannot say but it would not seem right". The owner ummed and ahhed and said "the cat is normal but nothing will satisfy you....". He very reluctantly agreed to cancel today's bill for bun etc. He reiterated again that he is fully responsible for the overdose but this drug has shown in his practice to have very few problems. Am I going nuts?? And here is another ringer. My boy has to have a couple of stitches removed around his tail next Monday. Should I say screw it with this vet practice (although the vet who gave him the stitches is really nice and I like him) and just take him somewhere else for that? It is a minor thing and will take 1 minute but I really have not found a decent vet yet to continue. Peter In article , wrote... Hi All, especially Phil who has been wonderful to me and others in the past. Nothing earth-shatteringly new in this post but yet another cautionary tale. I moved to Montreal from Vancouver last year, having had wonderful veterinary care from my 2 vets there and the Critical Care Group for some 16 years. 3 weeks ago I brought my 11 year old female kitty in for a full panel and a general check-up. One of the prime motivating forces was that the night before while stroking her I found a small marble-size lump by her right foreleg. Fortunately, it was not attached to bone and muscle and was moveable. A fine needle aspirate showed very little and it was decided to excise the lump at the same time that she had a dental cleaning (2 weeks from then). Then starts the whole debacle. The geriatric panel showed her serum glucose at 16.8 mmol/L. This could well have been stress hyperglycemia after the wait at the vet and the very rough way she was handled by the vet tech. The vet then suggested a urinalysis would be conclusive but I had doubts as if this was stress hypergylcemia to do a urinalysis the next day would perhaps be pointless due to the glucose being dumped into the urine 24 hours afterwards. I suggested a fructosamine test and this came back normal. I wondered then why it was I who had to suggest this. Her Bun and Creatinine then were 25.21 and 1.56 respectively. Surgery was set for 2 weeks then for excision of the lump and the teeth cleaning. I suppose I was remiss in not asking what drugs they would be using, including NSAIDs. Ironically, a friend of mine had contacted me some 6 months earlier and had told me that her vet had prescribed Metacam for her cat's condition. I then proceeded to warn her about the dangers of this drug. Well the surgery went fine but I was told that the vet tech got some files mixed up and she was given the Metacam dosage for another animal. She allegedly was given 0.4 mg/kg (she is 6.2 kgs) when she was supposed to have received 0.2 mg. I really have no idea what dosage she was actually given but this is what I was told. I do know that Boehringer, the manufacturer of the drug have advised a 0.3 mg/kg one shot dosage post or pre-surgery. I have read loads of peer-review studies on Metacam and was frightened. The error was supposedly discovered immediately and the cat was put on iv fluids for 24 hours. Bun and Creatinine were then drawn 24 hours later and they were low due to the IV fluids. Bun was 13.17 (due to fluids) and creatinine was 1.22. A week later, yesterday, bun and creatinine were tested and Bun was a bit lower than it was 3 weeks ago at 22.41 but creatinine had gone up a lot from the 1.56 to 1.92. Normal range for the lab is 0.57 to 2.0 I am devastated - Forget about the lump, the biopsy of which I might get today or early next week. The vet when I phoned up last night said when I asked him how were the results he said "She's fine!". To me that is not fine and after I got the figures from him he said we should do another test in 2 weeks. I really do not know what else to say. Any advice would be most appreciated. Hey, I have some good news regarding my other kitty which I meant to post in the last few months. Here is my original post 4 years ago on this: http://groups.google.com/group/alt.m...hread/thread/a 73ce1d8ca4c0d98? hl=en&q=idiopathic+hypercalcemia+peter+group:rec.p ets.cats. *#da6aba922427264c or using tinyurl: http://tinyurl.com/6qe6rx 4 years ago I made a post to both rec.pets.cats.health+behav and alt.med.veterinary about my cats idiopathic hypercalcemia. I tested every which way and had ultrasounds and even exploratory surgery as there was a a possibility of a parathyroid problem (which I hoped for). I consulted twice with the Cornell Feline Health Center, had numerous visits to the Critical Care Group in Vancouver (a specialized hospital) and read every single peer reviewed journal on this. Nobody had a solution. So once a year he was on prednisolone, I gave him IV fluids to increase the volume and fed him Hill's X/D which is really low in Calcium and he liked. Then earlier this year while browsing I picked up anecdotal information that Lactulose might create hypercalcemia. I knew from reading studies that when lactulose is ingested with a meal it does increase calcium absorption but that is why I gave lactulose at least 30 minutes before a meal. But hypercalcemia? I was not sure. This kitty I had adopted after he dragged himself to my door with a broken pelvis some 10 years ago (he was a stray whom I fed whenever he came by). From the beginning he was on lactulose - 5 ccs twice a day. Anyhow, I read about Miralax aka Peg 3350 and substituted that for lactulose and a month later I did a test. After about 40 elevated serum calcium and ionised calcium tests this one came back normal and he was a reborn kitty. So that is the good news this year. Unfortunately, the bad news is all above with my girl. |
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