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Peter Georgeu
December 12th 08, 03:17 PM
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.med.veterinary/browse_thread/thread/a
73ce1d8ca4c0d98?
hl=en&q=idiopathic+hypercalcemia+peter+group:rec.pets.ca ts.
*#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

Matthew[_3_]
December 12th 08, 04:43 PM
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.med.veterinary/browse_thread/thread/a
> 73ce1d8ca4c0d98?
> hl=en&q=idiopathic+hypercalcemia+peter+group:rec.pets.ca ts.
> *#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

Peter Georgeu[_2_]
December 13th 08, 01:09 AM
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 >,
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>

Matthew[_3_]
December 13th 08, 01:15 AM
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 >,
> 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>

W****n S***********g
December 13th 08, 06:15 AM
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.med.veterinary/browse_thread/thread/a
> 73ce1d8ca4c0d98?
> hl=en&q=idiopathic+hypercalcemia+peter+group:rec.pets.ca ts.
> *#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

cwcatartist
December 14th 08, 12:47 AM
> 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

Peter Georgeu[_2_]
December 14th 08, 04:47 PM
Thanks for the reply.

I have thought about it and I do have line sets, needles and bags left
over from my boy's idiopathic hypercalcemia (I used the fluids to
increase the volume and lessen the impact of high serum calcium).
Unfortunately, the bags I have are NaCl as Lactated Ringers increased
the calcium load and I fancy NaCl will irritate her (my boy is a toughie
and had no problem with it).

As I mentioned right after the metacam overdose A(1/3 higher than
Boehringer's recommended dosage) was administered the cat was put on IV
fluids for 24 hours and a test was taken. Her bun was below normal due
to overhydration (not liver damage as this was tested as well) and
creatinine was at the lower end of the range at 1.22.

It was felt then that whatever insult had occurred had passed and she
came home with retesting in a week. That was done and the creatinine was
at the high end of normal.

Do you believe sub-q fluids now - lactated ringers say at 150 ccs daily
- can help assist in potentially reversing the insult? Clinically she
looks and behaves fine and eats well. How long would you give the sub-q
fluids for? a couple of weeks?

Peter


In article >,
wrote...
> 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.med.veterinary/browse_thread/thread/a
> > 73ce1d8ca4c0d98?
> > hl=en&q=idiopathic+hypercalcemia+peter+group:rec.pets.ca ts.
> > *#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

Peter Georgeu[_2_]
December 18th 08, 03:10 AM
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.med.veterinary/browse_thread/thread/a
> 73ce1d8ca4c0d98?
> hl=en&q=idiopathic+hypercalcemia+peter+group:rec.pets.ca ts.
> *#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.
>