Help vet apt this a.m.

Topaz diabetic for abou t8 years. On Humulin N now after stopped production of Humulin U and is on very low dosage as her numbers are never that high. There is a profile on her as we were on the old board and here also. Here is the question. Topaz had been getting increasingly stiff in her hind quarters. It looked like arthritis. She was put on Metacam but threw up each time she was given it so i stopped. Then the vet put her on Arthrimax which is basically Glucosamine and chondroitin but there has been no improvement. Now for the past two days she is not walking, when she does she limps. Does anyone know of a medicine I can ask the vet for as his only solution is Metacam.

 

Metacam now has a 'black box' warning on it stating that it is not to be used in cats so most of my colleagues will not use it anymore due to liability issues.

Other suggestions....Adequan injections....gabapentin....buprinorphine as needed for breakthrough pain....acupuncture.

 

Try Cosequin. It helped Witn with her arthritis. It is non-prescription and you can get it several places including PetSmart.

 

Were x-rays done to confirm arthritis? I ask because acupuncture is contraindicated in bone cancer, so you want to rule that out before beginning acupuncture.

For Meowzi's arthritis, we use fish oil, SAM-e (we use denamarin, but denosyl is fine) and dasuquin, in addition to the Adequan injections and acupuncture that Dr Lisa mentions above.

 

Thank you all for getting back to me. We went to the vet and she is there waiting for Xrays. In the search engine I found Adequan but he says he only uses it on dogs. I also mentioned Dasuquin and the buprinorphine but he is concerned with how rapidly she stopped moving and so we have to wait for the results of the Xray. Thank you all for this wonderful site as it gave me something to offer the vet. I'll keep you all updated but send Topaz good wishes please as it does not look good.

 

Sending prayers and good wishes for your Topaz.
jeanne

 

O.K. x rays showed no arthritis which I would have bet the house on was the difficutly. He did a full blood work - does not know what is going on except maybe neurological. He gave me hie Banfield Journal (vet journal) which says the only meds for arthritis in cats is Meloxicam, Carprofen and Adequan but states their usage in cats is likely to be problematic in cats and their use should be cautious.
I would still like any feedback you guys could give me. Oh he did start her on Adequan.

 

That is outdated.

Didn't your vet tell you about the black box warning about using Metacam in cats? It sounds like he didn't if he showed you that outdated article......

 

Were good spinal films taken?

I have not re-read your initial email but I would suggest a second opinion from a radiologist or someone else who is good at looking at backs....ie.....a good ortho doc.

Just looked at this:

"Topaz had been getting increasingly stiff in her hind quarters"

So my comments above...remain a strong suggestion.

 

Lisa thank you for your feedback. The mag. is a new one just sent to him and I was also surprised at the vet's and magazine's statements about Metacam. My vet is still using it for cats. I was given it, read what you all wrote and stopped after the second dose.

Her Xrays are being sent out as well as the blood work and will be discussed with the other vet partner. Again, this site is wonderful. Will keep you up to date.

 

Sorry Topaz is having problems walking. Is the limping with both back legs? I keep wondering if her x-rays will show if she could possibly have a herniated disc or something. Something that could possibly be fixed with chiropractic. I do hope you get a definitive diagnosis soon so you will know how to treat it. Will be looking for the update.

 

I'm sending well wishes and feel better soon vines to Topaz, and hugs and hang in there vines to you.

 

Maybe if you take some info to the vet about metacam and the warning, it will be clear.

For me, I have had my vet office list what meds that they are never allowed to give to my cats and this is one of them.
All I did was google "Metacam Boehringer Ingelheim warning" and below is just a bit of what I found.
There's even a site http://www.metacamkills.com

Some info:
FDA has required Boehringer-Ingleheim to add a “Black Box” warning to the boxes of Metacam, an anti inflammatory medication. It reads: “Warning. Repeated use of Metacam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See contraindications, warnings and precautions for detailed information.” The FDA has asked for this warning due to reports of side effects associated with the product.

And here's just one article on the warning:

METACAM® (meloxicam) Now Includes Warning for Cats on Label
Friday October 29, 2010
The FDA announced yesterday that the drug's manufacturer, Boehringer Ingelheim Vetmedica, Inc. (B.I.V.I.), changed the label to include:

WARNING

Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information.

This announcement comes after many cases and comments about Metacam usage and cats.

From the release:
"FDA asked B.I.V.I. to add the boxed warning based on FDA's review of reported adverse drug events for METACAM®. FDA identified many cases of kidney failure and death in cats associated with repeated use of METACAM®."

METACAM® Solution for Injection was approved for one-time use in cats in 2004. It was to be used once before surgery to control postoperative pain and inflammation post-operatively. This is what the approval was for, but this drug was also used in other circumstance, with repeated doses. This is called "off-label" usage, and it is OK for veterinarians to prescribe drugs in this manner, for some cases, and with veterinary supervision.

Additional info from the release:

"FDA is aware that some veterinarians prescribe or use METACAM® in an extra-label manner. Under certain circumstances, veterinarians are allowed to use a drug in an extra-label manner. The new boxed warning on the METACAM® labels helps inform veterinarians of the serious risks associated with extra-label use of meloxicam in cats." View full FDA release

If you cat (or dog) is taking Metacam and showing any signs of illness - not eating, increases in thirst or urination, vomiting, losing weight, etc., please contact your veterinarian as soon as possible.

FDA Metacam Black Box Warning October 27, 2010

 

Even though I am in the anti-metacam camp, to be fair, there have been a significant number of cats that have really benefitted from this drug. These are cats whose quality of life was being severely compromised by arthritis and were not responding to other treatments. So...there is a subset of cats who may benefit from the use of this drug at a low dosage.

There is a lot more to the metacam story...but my hands don't want to type anymore. :sad:

 

Topaz got an injectionof Adequan with more to come, the second Tues. However, she is just the same. She does not move, sleeps all day and when I roust her she growls, walks stiffly to the next sleeping spot and goes into such a deep sleep she does not move - not even when spoken to. Her Xrays and blood work are all normal, no arthritis. Please- anyone have any more ideas?? Could she be having a bad reaction to adequan on top of it all??