Saturday, August 04, 2007

A Cautionary Tale

Every year, for two weeks in summer and two weeks in fall, I house/pet sit for a friend of mine. She has three lovely kitties, Little Bear, Jasper and Autumn. This story is about Autumn.

Autumn has arthritis. Her vet prescribed Metacam, which has been used with success on dogs but is iffy with cats. The vet gives it to her own cat, though, so it seemed okay. While taking it, Autumn was like a new cat! She was more active and seemed happier.

I was kitty sitting a week ago when I noticed Autumn was drinking a lot of water. Cats have a low thirst drive, so this is very unusual. None of the cats was eating their canned food, but for Autumn to refuse canned food is unheard of. I called my friends and told them I thought something was wrong. They had me do the litmus test - offer Autumn tuna. She wasn't interested, so we knew for sure something was wrong. I made an appointment to take her to the vet the next day.

I don't know what I was expecting, I thought maybe diabetes, but I was shocked when the vet came back and told me Autumn was experiencing kidney failure. The vet said her values were really, really high. She said my friends would have to choose between extraordinary measures and "letting her go." I told her my friends would never just let her go without a fight and went outside to call them. I couldn't believe it. I was thinking, "What, let her go? Right now??"

Skip forward about an hour and I'm on my way to an animal emergency hospital. Up to this point, I hadn't cried, partly because there were kids in the vet's waiting room and I didn't want to upset them, but I was beyond freaked out. The receptionist at the emergency hospital asked me what Autumn was there for and when I needed to say "kidney failure" I couldn't get it out. I still couldn't believe it. Yesterday she was maybe a little under the weather and today she's at death's door?? That's the thing with predators, once they start acting sick, they're on the verge of dying. Autumn didn't act sick at all, just super thirsty (which I knew was not good) and not hungry.

I was at the hospital for quite a while. They took Autumn in and ran a bunch of tests. There were phone calls back and forth between me and my friends, who were on the other side of the country. It kinda sucked to be me that day, but I really would have hated to be them. To be so far away when one of your fur babies is so very sick has to be horrible.

Finally, the people at the hospital told me they were going to keep Autumn and try to get her values down by hydrating her. They weren't able to tell me much more, just that they had to wait to see if she would produce urine on her own. It was hard to leave her there, but she needed round the clock professional care.

Both vets had repeatedly talked about toxins. Did Autumn get into anti-freeze, did she eat any poisonous plants, was there any other toxin she might have gotten into? No, no, no. I mentally went over everything in the house and couldn't come up with anything toxic or even anything that hadn't been there for ages already. Neither vet could say what caused the problem. They said it might be just her age (she's 12), it might be that she ingested something toxic or it might be the Metacam. There was just no way to know for sure.

Being an information age Google freak, the first thing I did when I got back to the house was Google Metacam use in cats. Guess what? Apparently there is very little difference between a safe, effective dose of Metacam for cats and a toxic amount. This is what is known as a "narrow margin of safety." According to one report, of 320 cats on Metacam, there were 105 cases of
kidney failure. (Source) Metacam is not recommended for long-term use in cats and Autumn had been on it for six months.

Fast forward a few days to my birthday. Autumn is still in the hospital, but she's been able to produce urine and her values have come down significantly. My friends are coming home today. I get a call saying they'd gotten Autumn's values down as far as they could and that she can go home! I want to surprise my friends, so I go to pick her up. Turns out they already know, but they were happy I was there to get her as they'd just gotten home from the airport.

I spoke to the vet and she gave me instructions for several medications Autumn needed to take, including needing to by subcutaneously hydrated daily. I asked her again what she thought had caused the problem. She repeated that there was no way to know for sure, but said, "The most suspicious thing is the Metacam. We only prescribe that for a week, maybe ten days. She won't be taking that anymore."

I had a very happy reunion with Autumn and took her home for more happy reunion joy. She isn't fine, but she didn't die and she will likely be with us for a while yet. I wanted to share this story to let other cat people know that they should use caution with Metacam. Again, there is no way to know for sure if that is what caused Autumn's kidneys to fail, but my friends were not aware of the risks. I'd hate for anyone else to have to find out the hard way.

No comments: