I posted on this issue 11/9/09 on the old board and will probably post on it periodically since I see the abuse of this antibiotic more and more frequently. Here is the link to that thread: http://www.felinediabetes.com/phorum5/r ... 168,page=1 This is the first post: Convenia....aka....."the two week antibiotic"....which is being used far too often without considering if its administration is appropriate or not. It is becoming the 'easy fix' for people who don't want to give antibiotics to their cat twice daily. (1/10/10 comment: Convenia does have its uses. For instance, for feral cats that will cannot be medicated any other way...BUT....you also have to weigh out the issue of a feral cat having an adverse reaction out in the wild....with no medical help available to him/her. Given this issue, you better makes sure that the rewards outweigh the risks. Also, for house cats that cannot be medicated any other way although I find that most cats will eat crushed clavamox in food or a whole pill in a Pill Pocket.) One of my favorite consulting patients became extremely ill post Convenia administration. Can it be absolutely proven that Convenia caused the severe anemia in this patient? No - but the evidence is very compelling. The good news is that we are on Day 17 and the patient is still alive. The bad news is that the vet bill is now $5,000 and we are not done yet. When I did a search on VIN, I found a post that discussed severe hemolytic anemia in two cats. Both cats died - 1 within 7 days of Convenia, the other one on Day 10. Both had normal HCTs prior to the Convenia administration. This drug is known to wreak havoc on the bone marrow and, according to one source on VIN, anemia was seen in the patients post convenia in trials that were done outside of the US but no anemia in the patients involved in the US trials. Please keep in mind that when you inject such a LONG ACTING drug into a body.....if that drug exerts a toxic effect on the body, you are in deep trouble because you can't retrieve the drug. When a drug has a long half-life, you better be sure that it is a safe drug to be giving and that you have a very compelling reason to give it. Please note that this patient was given Convenia for an off-label reason - ie - a dental. This is not an appropriate use for Convenia since there are much better choices for oral bacteria. Convenia is labled for skin infections. Plus, this patient just had a *routine* dental - no extractions - no significant gingivitis. The patient did not even need antibiotics which makes this case even more heartbreaking. It is interesting to read posts on the VIN dental boards that have the specialists speaking out about the abuse of antibiotics in dental patients. They frequently comment about the overuse of ABs in this area. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Patient: 9 year old neutered male. Healthy...goes in for pre-dental blood panel and CBC on 10/21/09. All is well - HCT = 41%. Timeline: 1) healthy - normal full blood panel and CBC the day before a routine dental (Day 1 = dental day 10/22/09) 2) no gingivitis, no extractions - ie - no reason for post-dental antibiotics 3) my client picks up her cat and is asked to give clavamox…..why?....we don't know since there was no indication that abs were needed 4) client says patient is hard to orally medicate so they give a shot of Convenia 5) note that Convenia is NOT labeled for use for dental issues - it is labeled for skin issues - the spectrum of this drug is not targeted toward oral bacteria Day 3 - 48 hours post dental/convenia - listless, ate half of normal amount Day 4 -72 hours post dental/convenia – ate a little bit then vomited it up….later that day, vomited blood-tinged fluid Day 5 - 96 hours post – HCT (the measure of the percentage of red blood cells in the serum) had gone from 41% pre-dental to 31% client called me for a consultation on Day 7 and I did a search on VIN and found a post from last Feb that outlined the cases of 2 cats – separate practices – that had died within 10 days post Convenia – with severe anemia Day 8 - patient was taken to a 24 hours critical care facility where his HCT was measured at 33%. Day 9 – HCT down to 26% Day 10 – HCT at 28% Day 11 – IN HOUSE test showed 34% - most likely an error Day 12 – HCT down to 22% Day 13 – HCT down to 20% Day 14 – HCTs were 18, 21, 24, 22 – Bone marrow results showed Panhyperplasia with relative erythroid hypoplasia meaning that RBCs were not being produced normally. The patient was discharged on Day 14. Day 16 - He is eating well but is a bit weak and tired. Today is HCT is 27%. Day 17 (11/7/09) - HCT = 25% For the past 25 years as a practicing veterinarian, I don't think that I have ever stuck a needle into a patient or given them a pill without stopping and thinking about it. Does the patient really need this drug? Is it the right drug for the situation? The correct dosage? etc..etc.... It has been frustrating to watch Convenia being reached for - in many instances - because it is *convenient*....NOT because it is actually the right thing to do for the patient. The drug does have its legitimate uses but I also see quite a bit of abuse involving this drug. This patient did not even need antibiotics and, even if he did, Convenia was not appropriate for use with oral issues. Now the client has a bill that is over $5,000 and is hoping that her cat lives and has not had his life shortened.