introduction & my story / geriactric cat

hello. i'm new here.

i just had an experience i sent to some friends of mine and thought i
"share" it here.

any opinions, suggestions welcome.

- my concerns a differences in opinions of the vets
- otomax toxicity/side effects (renal, not eating, etc. and how it
might have affected the blood tests)

she's about 17. has had chronic ear allergies (they say) and i've done
occassional wekk long stints of otomax. she has had cortisone a couple
of times. (they don't see any other ear problems except for
irritation.)

stopped eating hard food maybe 2 months ago (or only eats very little
of it)
seems to have slowed down eating her wet food.
drinking / urinating ok
occassionally constipated, (but not very often) sometimes stools are
hard.
she's definitely a little skinnier, lost a little weight.
but otherwise seems ok


here's the email:

the last 2 days have been HELL.
2 nights ago the cat was having what appeared to be head tremors.
those calmed down later, but i had never seen her do that before
(except for the time she was accidentally poisoined by the hartz
moutain flea & tick drops 3 years ago.)

i went to work the next day, came home and she was having them again.
i called my regular vet at 6:15pm. they said they were open till 6:30 -
but - stopped taking
admissions at 6.
i said i live 10 mins from here, but they still wouldn't admit me.
so then i called animal medical ctr. in portsmouth.
they said if i could get there by 7:15pm they could see me.
by this time it was 6:30. i knew i could make it there in 45 mins.
so i left.

i drove 80-90 mph to get there.
made it in 35 mins. despite every construction vehicle, sunday driver
and red light i got stuck behind.
then had had to wait another 30 mins before the vet came in.
i explained the problems and the vet said she suspected
hyperthyroidism, (she said there was an abnormal heart beat), she had
lost over 1/4 pound since last week ( i had my "regular" vet fax her
records there before i left...), and she also suspected possible kidney
problems (because she was so skinny, lost muscle mass, was shaking
(she's always nervous at the vets..), etc. but without doing tests she
couldn not give me a definite statement, except to say that that's what
she suspected, so she gave her some saline and i took her home. (that
was $85 total including gas).

made an appointment today (with the regular vet) at 2:30.
got there, and they couldn't find her medical records and - - wouldn't
admit me until they did.
so i had to wait 30 mins until they called the OTHER vet in portsmouth
and to have them fax back a copy of the records back to the vet in
rochester.

i was getting pretty steamed at this point and quite ready to start
choking people.... seriously.
isn't my life hard enough, then having to be put through this after i
just got a "death sentence" from the other vet?
at this point i thought god MUST be testing me....
i've pretty much been sobbing uncontrollably since 7:30pm yesterday
thinking i had a finite amout of time with the cat, especially since
the vet in portsmouth told me that even with treatment i might get 6
months out of her. just knowing that every day i had her would be one
less day until her demise was enough to crush my spirit, not to mention
the thought of having to give her meds every day, more and more trips
to the vet, etc.

they finally got the COPY of the medical records that they LOST and
admitted me, and then i waited another 15 mins in the examination room.
the poor cat was shaking like a leaf (she's terrified of vets) and i
thought she was going to have a heart attack.

the vet finally came in and asked me how i was doing. i said "not
great", and explained everything.
she offered to waive the exam fee for this visit (not the test though)
so that was at least a little compensation.

they took her away to do the blood and urine tests. came back a few
minutes later and said that her urine was ok. nothing jumped out at
them, but because of the saline she got last night i should have her
tested in a week again because it might be somewhat of a false reading.
she said if i wanted to stay and wait for the blood test results it
would take 20-30 mins., so i put her in the carrier and waited outside
in the car.

i went back in 30 mins later and the vet came up to me smiling. why?
i was only slightly encouraged.
she said all the tests were in an "acceptable" range.
2 of them were "artificially high" (i forgot why she said - maybe
because of the saline?)
but said i should try to video tape her tremors the next time i see
them and to bring her back in a week for another kidney/urine test
because she may have the very beginnings of something going on there
even though nothing jumped out at them. (from what i understand bad
kidneys don't show up i cursory testing until they are 75% not
functioning..) but she's not showing signs of any other symptoms of
kidney problems (excessive drinking or urinating.)
over $200 and a world of aggravation, angst, fear, etc. later i'm
still a wreck and less than impressed with the vets and treatments i've
gotten.
for the time being the prognosis is better than negative (at least as
far as hyperthyroidism goes), but i till feel there is "something"
going on here with her.

she isn't eating as much (quit eating dry food), not drinking as much
(but not over eating or drinking either).

she's a little wobbly at times, a little skinnier.. (but weighed the
same at my "regular" vet the next day) and the head tremors are
something to keep an eye on.
(they told me to try to video tape her next time..)

any body want to comment on any of this?

thanks!

any body want to comment on any of this?

Did they do a T4 test to check her thyroid? When I had it done, it had to be
sent away for results.

What were her blood profile numbers? Did you get a copy? If not, get a copy.
As for kidney problems, they don't always show symptoms until the disease
progresses. Yes, you're correct, it doesn't show up in the blood test until
at least 70% of the kidneys are not functioning. But even though this is the
case, a cat may still not show many symptoms. Definitely find out what her
creatinine and BUN numbers were.

--
Message posted via http://www.catkb.com

I totally agree - this sounds exacly like Hyperthyroid and they have to
send the blood out for those results. Make sure you ask if that was
done. If not, get back in and have it done immediately.

My cat was having the head tremors also - about the same age as yours.
The vet never suggested thyroid until I found something about it on
line. I don't know why they don't regularly test for it in old cate.

Excessive drinking, eating and peeing are also signs. Also, seemed to
never be still. Always moving. Losing weight and cold. Mine lived to
be 20 1/4. You need to get yours on medication fast.

"rumble" wrote in message
oups.com...
hello. i'm new here.

i just had an experience i sent to some friends of mine and thought i
"share" it here.

any opinions, suggestions welcome.

- my concerns a differences in opinions of the vets
- otomax toxicity/side effects (renal, not eating, etc. and how it
might have affected the blood tests)

she's about 17.


WTF? Otomax contains gentamicin- which is an *aminoglycoside*- which are
infamous for their nephrotoxic and *irreversible* ototoxic effects in cats
and should not be used- *especially* in older cats. Cats are *very*
sensitive to the vestibular and neuroblocking effects of aminoglycosides.
Besides, cats *rarely* get infections that would respond to aminoglycosides.
The first-choice drugs for otitis media/interna are cephalosporins,
amoxicillin and clavulonic acid, and fluoroquinolones (e.g., Baytril Otic).
The choice of medication should be determined by culture and susceptibility
testing not guesses with ototoxic and nephrotoxic drugs. Also, if the cat
had chronic otis- the eardrum might be ruptured in which case ototoxic drugs
should *never* be used. If the cat coughs or gags when medication is put in
her ear the eardrum is definately ruptured

The cat doesn't want to eat because she probably has temporomandibular joint
(TMJ) pain from otitis media. If she has chronic ear infections, she
probably has otis media- which is a perpetuating factor for otis externa.
OTOH, otis media can result from otis externa through the eardrum. IOW, a
vicious cycle. Has the cat had any upper respiratory infections lately?
That's another route for otis media- up the auditory tube (the same route
medication takes if the cat gags or coughs- only in the opposite direction.

Please tell your friend never bring his cat back to that vet-- he's in the
dark ages if not a complete bozo.

Good luck,

Phil

Hi there,

I can't comment on all of the tests, etc., but I can tell you we had a
cat with head tremors and sometimes tremors through her whole body.
These started in her last few years (she lived to be 18.) They would
last for an hour or more, I forget now, but then they'd disappear.

Our regular vet could find nothing more wrong, other than the CRF she
had for years. She did not think that was the problem.

I talked to an internist vet when I took in another cat, to see if she
had any ideas or other tests to suggest. She asked if Mandy was Siamese.
She was! She said Siamese cats are wired a bit differently and sometimes
end up with tremors. Mandy showed no distress when these were happening,
she would sometimes either be purring or trying to sleep.

You might talk to an internist vet and see if it could be something
neurological like that -- possibly inherited like our Siamese.

Good luck,

Rhonda


rumble wrote:

she's a little wobbly at times, a little skinnier.. (but weighed the
same at my "regular" vet the next day) and the head tremors are
something to keep an eye on.
(they told me to try to video tape her next time..)

any body want to comment on any of this?

thanks!

wow.

lots of good info from everyone.

yes i have a copy of the blood test results. i had to wait 30 mins for
them.
they are a "large" animal hospital (not just 1 vet, but several exam
rooms) so i'm assuming
the $130 tests weren't just cursory.

one of the things that struck me odd was the 1st vet i saw that night
(not my "regular vet) said i should up the dosage on the otomax to 3-4
drops daily in each ear 2x a day for a week. i was looking at the
directions and these are the dosages they give to dogs, and my cat is
small.

she's already been on this stuff (1 drop 1x a day for a week, then off
for a few days).

when her ears bother her she normally scratches them to the point where
she has rubbed off some of the fur on the tip of the ear and on her
face just before the ear canal, but i see her scratching her throat too
a lot (no fleas or ticks) so i'm wondering if her thyroid is indeed
bothering her. both vets felt her throat and said there wasn't a tumor
there, and i'm hoping the blood tests would have revealed that, but at
this point i don't trust anyone because of the conflicting or different
opinions.

i'm supposed to go back in a week for more urine tests to double check.

is there a foolproof test to test her kidneys and for hyperthyroidism?

also, when i got her in to my "reg" vet she said she did not hear any
heart murmur.
so now i don't know what to believe.

p.s. the vet that "pre-diagnosed" thyroid problems told me last year
(when i brought her in because she was coughing in a funny way) took
xrays and said there may be a blockage in her intestines, and almost
had me convinced to cut her open that night, except she had calmed down
and i already had an appointment with original/preferred vet the next
morning, so i waited until i saw him.

it turned out to be a blade of grass stuck on her upper palate, and
these other guys almost had me convinced to cut her stomach open.
didn't they even look down her throat!!?

so, i don't trust everything anybody says.

i want more definitive tests, but not sure what to ask for.

unfortunately, my original vet (who was just a cat doctor) is no longer
practicing.

are there any vets on this list?

thanks again.

p.s. p.s. - yes i have a copy of the blood work. i can scan it and send
it to anyone that can tell me what it means.

thanks

rumble wrote:
wow.

lots of good info from everyone.

yes i have a copy of the blood test results. i had to wait 30 mins for
them.
they are a "large" animal hospital (not just 1 vet, but several exam
rooms) so i'm assuming
the $130 tests weren't just cursory.

one of the things that struck me odd was the 1st vet i saw that night
(not my "regular vet) said i should up the dosage on the otomax to 3-4
drops daily in each ear 2x a day for a week. i was looking at the
directions and these are the dosages they give to dogs, and my cat is
small.

she's already been on this stuff (1 drop 1x a day for a week, then off
for a few days).


Stop the Otomax NOW. Get your cat to another feline specialist NOW.
The tremors can be neurotoxicity, or possibly seisures. I suspect the
cat is hyperthyroid, but at this point that may be the least of his
problems.

-L.

"rumble" wrote in message
oups.com...
wow.

lots of good info from everyone.

yes i have a copy of the blood test results. i had to wait 30 mins for
them.
they are a "large" animal hospital (not just 1 vet, but several exam
rooms) so i'm assuming
the $130 tests weren't just cursory.

one of the things that struck me odd was the 1st vet i saw that night
(not my "regular vet) said i should up the dosage on the otomax to 3-4
drops daily in each ear 2x a day for a week. i was looking at the
directions and these are the dosages they give to dogs, and my cat is
small.

Otomax was designed for dogs and although it can be used in cats at low
doses, its still dangerous- cats are much more sensitive to the toxic
effects of aminoglycosides than dogs. The anitbiotic (gentamicin) in Otomax
is effective against Gram negative bacteria- which are common in dogs, but
most bacterial infections in cats' ears are secondary and caused by Gram
positive bacteria. Your vet doesn't even know if your cat has an ear
infection- and if she does have an infection, its almost certainly secondary
to an underlying problem.

When a drug doesn't seem to work, the cat should be re-evaluated instead of
increasing the dose of a risky drug. Culture and sensitivity testing are
also essential- and in many cases, more helpful than cytology.



she's already been on this stuff (1 drop 1x a day for a week, then off
for a few days).

when her ears bother her she normally scratches them to the point where
she has rubbed off some of the fur on the tip of the ear and on her
face just before the ear canal,

Scratching or rubbing the ear- even regular cleaning can exacerbate otis.



but i see her scratching her throat too
a lot (no fleas or ticks) so i'm wondering if her thyroid is indeed
bothering her. both vets felt her throat and said there wasn't a tumor
there, and i'm hoping the blood tests would have revealed that, but at
this point i don't trust anyone because of the conflicting or different
opinions.

i'm supposed to go back in a week for more urine tests to double check.


You've got to find another vet and get a second opinion about the Otomax as
soon as possible. I can't tell you to discontinue a medication because I'm
not a vet- but if she were my cat- I damn sure would- quick- if not sooner.



is there a foolproof test to test her kidneys and for hyperthyroidism?


Yes, but they're very expensive and involve nuclear medicine. A routine T4
or Free T4 by Equilibrium Dialysis are usually definitive for
hyperthyroidism. High BUN, creatinine and low urine specific gravity are
usually diagnostic for kidney disease. However, hyperthyroidism can mask
chronic real failure by increasing blood flow through the kidneys. In cats
with both diseases, CRF is usually revealed after they hyperthyroidism is
treated.


also, when i got her in to my "reg" vet she said she did not hear any
heart murmur.
so now i don't know what to believe.

Hyperthyroidism doesn't always produce a heart murmur/gallop but it will
increase the heart rate (tachycardia) and lead to myocardial hyperthrophy-
similar to hypertrophic cardiomyopathy- if not treated. Fortunately,
thyrotoxic myocardial hyperthrophy is reversible.



p.s. the vet that "pre-diagnosed" thyroid problems told me last year
(when i brought her in because she was coughing in a funny way) took
xrays and said there may be a blockage in her intestines, and almost
had me convinced to cut her open that night, except she had calmed down
and i already had an appointment with original/preferred vet the next
morning, so i waited until i saw him.

it turned out to be a blade of grass stuck on her upper palate, and
these other guys almost had me convinced to cut her stomach open.
didn't they even look down her throat!!?

so, i don't trust everything anybody says.

i want more definitive tests, but not sure what to ask for.

unfortunately, my original vet (who was just a cat doctor) is no longer
practicing.

are there any vets on this list?

thanks again.

p.s. p.s. - yes i have a copy of the blood work. i can scan it and send
it to anyone that can tell me what it means.


I'd like to see it. Do you have a urinalysis, too?


Good luck,

Phil

"-L." wrote in message
ups.com...

rumble wrote:
wow.

lots of good info from everyone.

yes i have a copy of the blood test results. i had to wait 30 mins for
them.
they are a "large" animal hospital (not just 1 vet, but several exam
rooms) so i'm assuming
the $130 tests weren't just cursory.

one of the things that struck me odd was the 1st vet i saw that night
(not my "regular vet) said i should up the dosage on the otomax to 3-4
drops daily in each ear 2x a day for a week. i was looking at the
directions and these are the dosages they give to dogs, and my cat is
small.

she's already been on this stuff (1 drop 1x a day for a week, then off
for a few days).


Stop the Otomax NOW.

Mind boggling isn't it? Instead of sensitivity testing because the drug
isn't working, the bozo increases the dose of a nephro/ototoxic drug in a
senior cat with a possible neuromuscular and/or vestibular disorder.


Get your cat to another feline specialist NOW.
The tremors can be neurotoxicity, or possibly seisures. I suspect the
cat is hyperthyroid, but at this point that may be the least of his
problems.

-L.

Phil P. wrote:
Mind boggling isn't it? Instead of sensitivity testing because the drug
isn't working, the bozo increases the dose of a nephro/ototoxic drug in a
senior cat with a possible neuromuscular and/or vestibular disorder.



Sometimes I read these posts and just want to bash my head into my
desk. Some days, I seriously can't read them.

-L.