Why I think Scottie died

I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

As you may recall, Scottie was hospitalized for a week with a fever of
unknown origin, lethargy, and inappetance. He was on IV and oral
antibiotics but his fever did not respond. After a few days, the vet
wanted to put him on baytril. I had read about the possibility of
baytril causing blindness in cats and expressed my concerns so the vet,
instead, put him on oral doxycycline.

Now, after the fact, I have read that oral doxycycline can be a caustic
agent in cats which can lead to esophagitis and that, in turn, can lead
to a stricture (narrowing). I have several cites to this effect. It
should either be administered in liquid form or followed by a water
chaser. I was there once when he received his oral meds. No chaser
was given and it was not in liquid form.

When we took him home, still with a fever, a week later, I was given
oral doxycycline to give him. Almost immediately upon getting home,
however, he began his regurgitating so I never gave him any. A couple
of days later we began the steroid treatments which really didn't help
much either. He began exhibiting his odd difficulty in swallowing and
regurgitating, symptoms he never had prior to his hospitalization. I
initially thought he might have gotten a throat/esophagus irritation
from the feeding tube he had in while hospitalized but that was before
I read about the doxycycline.

Now, admittedly, he had something before he was hospitalized because of
the fever and the fever never responded to antibiotics. That can be an
indication of cancer but I first noticed him gulping a little while he
was hospitalized. It got progressively worse upon his discharge. I
told the vet to not bother sending the sample he took out to the
pathologist so I will never know for sure if it was cancer. I feel
awful about this. These vets have been in practice for 30 years, they
have a good reputation, they are very kind, and I hate the thought that
their negligence might have contributed to his condition and ultimate
death and also that it was me who did not want him on baytril, thereby
causing him to be on doxycycline. Yet they did apparently give him
doxycycline without a chaser so he could very well have developed
esophagitis from this. How could they not know this could happen? I
never heard this about doxy before but I'm not a vet. It seems a
little coincidental that he was given this drug and then developed a
condition that can be caused by it.

Nothing can bring Scottie back. I don't know whether to bring it up to
them. I consider that these guys were instrumental in Abbey's recovery
9-10 months ago. But should they not have known this? I also have a
huge vet bill now and no cat. Maybe he would have fully recovered if I
had never taken him there and/or if I had let him be on baytril all
along. I feel that I set a chain of events in motion that caused
Scottie to die and to experience some suffering prior to his death. I
know it's normal to start second-guessing after something like this but
there are veterinary references to this all over the internet when you
look for them.

Candace

(crossposted to vet board)

"Candace" wrote in message
oups.com...
I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

[...]

Candace, it all makes sense from the point of view of someone
who knows nothing at all about veterinary medicine--but honestly,
do you have this little faith in your vet?

I am not saying that you may not be right. But please, make an
appointment and go in and talk with him. I would not do it on the
phone, I would do it face to face. I think you could tell better from
his reaction what really went on. You could bring the material from
the web that you found. I know it seems odd to make an appointment
and just go and talk, but I really would. I don't know if you are right
or wrong, but I do think a phone call is not the way to go.

If what you suspect is right, then this vet has got to be set straight
before he hurts another cat. If it is wrong, you need to know.

Hang in there, kid.

"cybercat" wrote in message
...

"Candace" wrote in message
oups.com...
I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

[...]

Candace, it all makes sense from the point of view of someone
who knows nothing at all about veterinary medicine--but honestly,
do you have this little faith in your vet?

I am not saying that you may not be right. But please, make an
appointment and go in and talk with him. I would not do it on the
phone, I would do it face to face. I think you could tell better from
his reaction what really went on. You could bring the material from
the web that you found. I know it seems odd to make an appointment
and just go and talk, but I really would. I don't know if you are right
or wrong, but I do think a phone call is not the way to go.

If what you suspect is right, then this vet has got to be set straight
before he hurts another cat. If it is wrong, you need to know.

Hang in there, kid.



I agree. You need to get more information to set your mind at rest. If the
medication was given incorrectly, your vet needs to know about his so that
someone else doesn't suffer the same consequences. And if there is a
reasonable explanation (such as a different formulation), then you need to
give your vet the opportunity to clear the air. Above all, please don't
beat yourself up over this. I know that's much easier advice to give than
to follow through, but you loved Scottie and did everything you could for
him. Even with love and the best of care, sometimes it just isn't enough.
But the important thing is that you did your very best.

MaryL

Candace wrote:
I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

that's got to add to your hurt even more...

If you don't mind me saying it...you appear to be very grounded...just
an observation.

don't pay them anything, tellem it's the least they can do for what
they have done
if they take you to court, then counter sue..as well as...
seek punitive damages...
im sorry...i don't mean to talk insensitive...

Candace wrote:
I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

snip

I think you have a case for veterinary malpractice. I would gather
together your evidence and write him a letter. Ask him to respond to
your concerns and make it very clear you think he was negligent. You
can't bring Scottie back, but you can possibly recover part of your vet
bill (or have it cleared). If you do not get resolution, file a
complaint with the state licensing board.

I have never used doxycyline in felines and had no idea this was a
problem. Thanks for posting this - you may have saved another cat by
doing so.

-L.

Candace,

I am so sorry to hear about this complication. This sucks.

Please talk to the vet about it. If this really was the problem, you
could be saving the next cat that the vet treats.

This was in no way your fault. This is the vet's responsibility and
something they are trained to catch no matter what conversation happened
before using that drug.

Rhonda

Candace wrote:


Now, after the fact, I have read that oral doxycycline can be a caustic
agent in cats which can lead to esophagitis and that, in turn, can lead
to a stricture (narrowing). I have several cites to this effect.

Systemrecovery wrote:

If you don't mind me saying it...you appear to be very grounded...

Hope you have a nice day...just wanted to clarify my thoughts...
i just mean you seem very strong...

Candace, I'm sorry too to hear about this. I completely agree with the
others about it not being your fault. The vet should have known that
this could be a complication from the medication. Pet owners should
not be expected to know this information. We depend upon the
veterinarian to be well-educated about any possible side effects when
they prescribe a medication.

Hugs,
Lauren

On 1 Mar 2006 19:34:52 -0800, "Candace" wrote:

I don't think Scottie's esophageal stricture was caused by cancer.
This is what I think happened and how I inadvertently had a hand in
sealing my poor cat's fate.

As you may recall, Scottie was hospitalized for a week with a fever of
unknown origin, lethargy, and inappetance. He was on IV and oral
antibiotics but his fever did not respond. After a few days, the vet
wanted to put him on baytril. I had read about the possibility of
baytril causing blindness in cats and expressed my concerns so the vet,
instead, put him on oral doxycycline.

Now, after the fact, I have read that oral doxycycline can be a caustic
agent in cats which can lead to esophagitis and that, in turn, can lead
to a stricture (narrowing). I have several cites to this effect. It
should either be administered in liquid form or followed by a water
chaser. I was there once when he received his oral meds. No chaser
was given and it was not in liquid form.

When we took him home, still with a fever, a week later, I was given
oral doxycycline to give him. Almost immediately upon getting home,
however, he began his regurgitating so I never gave him any. A couple
of days later we began the steroid treatments which really didn't help
much either. He began exhibiting his odd difficulty in swallowing and
regurgitating, symptoms he never had prior to his hospitalization. I
initially thought he might have gotten a throat/esophagus irritation
from the feeding tube he had in while hospitalized but that was before
I read about the doxycycline.

Now, admittedly, he had something before he was hospitalized because of
the fever and the fever never responded to antibiotics. That can be an
indication of cancer but I first noticed him gulping a little while he
was hospitalized. It got progressively worse upon his discharge. I
told the vet to not bother sending the sample he took out to the
pathologist so I will never know for sure if it was cancer. I feel
awful about this. These vets have been in practice for 30 years, they
have a good reputation, they are very kind, and I hate the thought that
their negligence might have contributed to his condition and ultimate
death and also that it was me who did not want him on baytril, thereby
causing him to be on doxycycline. Yet they did apparently give him
doxycycline without a chaser so he could very well have developed
esophagitis from this. How could they not know this could happen? I
never heard this about doxy before but I'm not a vet. It seems a
little coincidental that he was given this drug and then developed a
condition that can be caused by it.

Nothing can bring Scottie back. I don't know whether to bring it up to
them. I consider that these guys were instrumental in Abbey's recovery
9-10 months ago. But should they not have known this? I also have a
huge vet bill now and no cat. Maybe he would have fully recovered if I
had never taken him there and/or if I had let him be on baytril all
along. I feel that I set a chain of events in motion that caused
Scottie to die and to experience some suffering prior to his death. I
know it's normal to start second-guessing after something like this but
there are veterinary references to this all over the internet when you
look for them.

Candace

(crossposted to vet board)

{{{{Candace}}}}

All I can say is I am so sorry. Please try not to blame yourself.
You aren't a vet, and there is just no way we can know every possible
outcome of medications, tests, or whatever when we are not the
experts. You did the best you could, and trusted a vet who sounds
like they may have missed something important in terms of how to give
the medication properly.

My condolences are with you.

Ginger-lyn

Home Pages:
http://www.moonsummer.com
http://www.angelfire.com/folk/glsummer (homepage & cats)
http://freepages.genealogy.rootsweb....mmer/index.htm (genealogy)
http://www.movieanimals.bravehost.com/ (The Violence Against
Animals in Movies Website)

"Phil P." wrote in message
news:AQwNf.35902$pE4.9867@trnddc04...

There's not much you can do about now other than never go back to that vet
again. Vets are only human and make mistakes- but this was an easily
preventable death and he has no excuse whatsoever. Its not your fault.

On second thought, there's a lot you can do about it.
Doxycycline-associated esophageal stricture in cats has been reported in
veterinary medical journals since 1980- 26 years. I think your vet agreed
to euthanize Scottie because he wanted to destroy the evidence of his
negligence and malpractice. That's probably why he failed to mention
balloon dilation to resolve Scottie's esophageal stricture.

Even though you can't prove your vet caused Scottie's esophageal stricture
you can prove he failed to instruct you in the proper administration of the
medication. If I were you I'd consult a lawyer. I think your case is strong
enough for a lawyer to take the case on a contigent basis. If you don't
want to sue him for the money- do it to avenge Scottie and donate the
proceeds from the suit to an animal shelter, and also so other cats won't
suffer from his negligence.

The below journal citations should be of interest to your lawyer.

J Feline Med Surg. 2005 Feb;7(1):33-41.

Oesophageal strictures in cats associated with doxycycline therapy.

German AJ, Cannon MJ, Dye C, Booth MJ, Pearson GR, Reay CA, Gruffydd-Jones
TJ.

Department of Clinical Veterinary Science, University of Bristol, Langford
House, Bristol BS40 5DU, UK.

Four cases of oesophageal stricture subsequent to doxycycline administration
are
reported. All cases were young to middle age (median age 3 years; range 1-7
years), and either domestic shorthair or domestic longhair breed. In all
cases
the predominant clinical sign was regurgitation, which developed at variable
times after doxycycline administration. In all cases the reason for
doxycycline
use was treatment or prophylaxis of suspected infections (Mycoplasma
haemofelis,
Chlamydophila felis or Bordetella bronchiseptica), and the duration of
therapy
was variable. In one case the stricture was definitively diagnosed at post
mortem examination, in the three other cases, definitive diagnosis was by
endoscopy. Balloon dilation was successful in the three cases that were
treated.
This is the largest case series, to date, of oesophageal disease in cats
associated with doxycycline administration. Caution should be exercised when
administering oral medication to cats, especially doxycycline, and should be
accompanied either by a water or food swallow.


J Small Anim Pract. 2002 May;43(5):221-3.

Oesophageal stricture in a cat due to oral administration of tetracyclines.

McGrotty YL, Knottenbelt CM.

Department of Small Animal Clinical Studies, University of Glasgow
Veterinary
School, Bearsden.

A three-year-old, male neutered domestic shorthair cat was presented with
dysphagia and regurgitation following treatment with oral doxycycline and
oxytetracycline for Haemobartonella felis infection. Fluoroscopy confirmed
the
presence of multiple strictures along the entire length of the oesophagus.
Balloon dilatation was performed successfully on two occasions and the
symptoms
resolved. To the authors' knowledge, this is the first report of oesophageal
strictures associated with oral administration of tetracyclines in a cat in
the
UK.


Laryngoscope. 1983 Feb;93(2):184-7.

Tetracycline induced esophageal ulcers. a clinical and experimental study.

Carlborg B, Densert O, Lindqvist C.

Medication with oral drugs has not been considered as a cause of esophageal
lesions in the general literature of esophageal disease. This study
demonstrates
40 patients with complaints of sudden onset of intense retrosternal pains
and
odynophagia during treatment with oral tetracyclines. All patients had
distinct
circumferential ulcers in the esophagus. Medical history, barium swallows,
esophagoscopy, biopsies and esophageal manometry revealed no other apparent
etiology but a local corrosive effect of the tetracyclines. Experimental
tests
on the esophagus of the cat verified a severe local corrosive effect of the
tetracyclines. Another tetracycline, lymecycline, not reported previously to
induce esophageal lesions in man, was significantly less ulcerogenic than
doxycycline and oxytetracycline. Drug induced esophageal ulcerations are
likely
to be more numerous than previously suspected. The experimental model used
appears to be sound for investigating ulcerogenic potentials of orally
administered drugs.


J Vet Intern Med. 2001 Sep-Oct;15(5):467-70.

Evaluation of esophageal transit of tablets and capsules in 30 cats.

Westfall DS, Twedt DC, Steyn PF, Oberhauser EB, VanCleave JW.

Department of Clinical Sciences, College of Veterinary Medicine and
Biomedical
Sciences, Colorado State University, Fort Collins 80523, USA.

We have reported tablet-induced focal esophagitis and esophageal stricture
formation in cats. The proposed mechanism is thought to be abnormal
esophageal
tablet retention resulting in focal esophagitis with subsequent stricture
formation. The objective of this study was to evaluate the passage of
tablets
and capsules when given alone (dry swallow) and when followed by a water
bolus
(wet swallow) to determine if this could, in part, explain the esophageal
stricture formation we have observed in cats. Fluoroscopy was used to
evaluate
tablet or capsule passage after administration. The percentage of dry tablet
swallows that successfully passed into the stomach was 0.0% at 30 and 60
seconds, 6.7% at 90 seconds, 13.3% at 120 seconds, 26.7% at 180 and 240
seconds,
and 36.7% at 300 seconds. Wet tablet swallows successfully passed 90.0% of
the
time at 30 seconds, 93.3% of the time at 60 seconds, and 100.0% of the time
thereafter. The percentage of dry capsule swallows that successfully passed
was
16.7% at each time interval. Wet capsule swallows successfully passed 96.7%
of
the time at 30 seconds and 100% of the time thereafter. For each time
interval,
wet swallows achieved significantly greater percentage passage into the
stomach
when compared to dry swallows (P .05). This study shows that tablets or
capsules given by dry swallow have prolonged retention in the esophagus
compared
to those given by wet swallow. On the basis of this study, we recommend the
routine administration of a water bolus to cats receiving tablets or
capsules PO
to facilitate esophageal clearance. This practice may help prevent
medication-associated esophagitis or stricture formation.


Eur Surg Res. 1980;12(4):270-82.

Esophageal lesions caused by orally administered drugs. An experimental
study in
the cat.

Carlborg B, Densert O.

This article presents an experimental method using cats for investigation of
the
local ulcerogenic properties of oral drugs in the esophagus. 15 drugs in
current
clinical use were tested. The drugs were placed in esophagus and the animals
were sacrificed after 5--8 h, 4--7 or 21 days. The esophagus was cut open,
photographed macroscopically and sectioned for light microscopy. Several
drugs,
e.g. doxycycline, alprenolol, propranolol, ferrosuccinate, ferrosulfate, and
emepronium bromide showed marked ulcerogenic properties, whereas
indomethacin
and betamethasone did not cause any lesions in the cat esophagus. The
results
seem to be in accordance with the local effect these same drugs exert on the
human esophageal mucosa. In order to predict and prevent drug-induced
esophageal
lesions in man we suggest that oral drugs should be tested concerning their
local ulcerogenic properties in the esophagus.