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Medications and Cats
Tylanol ingestion - toxicity
Clomipramine (Clomicalm Rx), psychogenic alopecia and itchy cat
Aspirin dosage
Misoprostol(Cytotec Rx) and other drugs used with piroxicam (Feldene Rx) to protect the stomach
Drontal (Rx) and Pregnant cats
Hairball Medicine - Laxatone
Acetaminophen (Tylenol) safety in cats
IBD and Prednisone
Hairloss and Amitriptyline
Megacolon treatment- cisapride (propulsid Rx) and ranitidine ( Xantac Rx)
Anything but a pill for my cat's medication.
Tapazole in PLO gel
Denosyl SD4-SAMe
Azithromycin (Zithromax Rx)
Tapazole
Treating pain in cats
Immunoregulin
Clavamox
Appetite stimulants
PeptoBismal
Tapazole and cats
Acepromazine and alternatives
Aspirin or Acetaminophen
Benedryl
Oviban
Prednisone and diabetes
Heartworm Prevention for Cats
Diazepam for spraying
Metronidazole - giving pill
Metronidazole and cancer
Medicating Traveling Cats
Rimadyl and Cats
Rimadyl for cats
Adaquan for Cats
Cerumite OK, Aspirin Not
Tagamet
also see Side Effects of Medication
also see Pain in Cats
also see Pilling a Cat
also see Insulin
| Medication for your animals is essential when treating them for some sort of health issue. Getting the proper pet medications is crucial and should be handled by a professional. Maintaining proper pet health is a tough job and someone has to do it, but you love your pet so it's definitely worth the time and energy. |
Question? Can a cat recover from ingesting a Tylenol gelatin capsule (extra strength 500ml)?
My cat is at the vet now - she is blind (detached retina's) and tests are being performed. We think it happened last Thursday night - on Friday her eyes were completely dilated
and she was blind and lethargic. We rushed her to the vet and she was immediately given "toxiban" (not sure of spelling). Do you have any recommendations?
Audrey
Answer: Audrey-
I can not find the reference, but somewhere I read or heard that one extra strength Tylenol capsule (500mg acetaminophen) would cause death in about 50% of cats if untreated. I do not know the success rate of treatment but these are the recommendations for therapy for acetaminophen toxicity. It is probably a little late for some of these therapies but others may still have a beneficial effect:
1) Induction of vomiting and treatment with activated charcoal. No effect can be expected from these treatments after the medication has been absorbed.
2) Administration of acetylcysteine (Mucomyst Rx), which helps spare the enzyme in the liver which processes acetaminophen. Since cats pretty much lack this enzyme any little bit helps. It may still be beneficial to give this medication.
3) Administration of ascorbic acid (Vitamin C). This helps to protect the hemoglobin in the red blood cells from being damaged by the acetaminophen and may still be helpful.
4) Methylene blue (a dye) can be used to try to prevent damage to the hemoglobin, as well.
5) Administration of sodium bicarbonate to cause the urine to be basic increases the excretion of breakdown products of acetaminophen. This may also still be helpful.
6) The use of S-adenosylmethionine (SAMe) may be helpful based on some recent studies (Webb et al 2003, Wallace et al 2002). This is used by giving a loading dose of 40mg/kg and then daily doses of 20mg/kg. The papers are available in abstract form on the PubMed web site. It may be helpful even late in the toxic process.
7) Any necessary supportive care, such as fluid administration, blood transfusions, correction of electrolyte imbalances, feeding by esophageal feeding tube or other care that helps the cat live until the effects of the acetaminophen wear off can be helpful.
If you are not sure that an acetaminophen capsule was ingested, the most common cause of sudden blindness in older cats is hypertension (high blood pressure) and treatment can sometimes allow reattachment of the retinas.
Good luck with this.
Mike Richards, DVM
5/27/2003
Clomipramine (Clomicalm Rx), psychogenic alopecia and itchy cat
Question: Hi Dr Mike,
could you tell me anything on the results of the use of Clomicalm in
cats ?
I have several customers who have been subscribed it to their cat for
aggressive behavior or excessive anxiety to other cats.
In some cases i wondered if they needed it, as I seriously
question the skills of that vet, but that is beside the question.
Currently I am taking care after a cat that has been licking himself
symmetrical bold since forever. His vet diagnosed him "nothing
wrong" by looking at him, and I encouraged the owners to
challenge a possible food-allergie as they fed him all kind of
supermarkt brands. The cat is imported from Indonesia to the
Netherlands, so it makes him a bit different from local cats.He has
been challenged various times on Hills Z/D and other non-allergic
diets, but allthough it made some improvements, he still licks
himself. Acoording to the owners he is stressed and i encouraged to
play with him every day for 20 minutes, which they faithfully do
wonder if this product could help him. Would it be a life-time
subscription or could he stop at some time and can they stop "could
turkey" or do you need to give them less by the day ?
thanks for your input.
lotje
Answer: Lotje-
I have not prescribed clomipramine (Clomicalm Rx) for a cat that I can
remember, so I have no personal experience with the results of using
this medication in cats.
I know that many vets are using clomipramine for cats, though. There
is
a published dosage of 1 to 5 mg/cat per day. The most commonly
recommended uses are inappropriate urinary behaviors (urine or stool
marking) and
psychogenic alopecias, or hairloss that is induced by
obsessive-compulsive grooming behavior on the part of the cat.
It is not possible to diagnose psychogenic alopecia by appearance
alone. It is necessary to rule out all possible causes of itching and
to
determine if the hair is being groomed out, which is usually possible
with
microscopic examination of the hair.
Cats who are itchy tend to lick or chew their hair off. Cats almost
always lick or chew in bilaterally symmetrical patterns which makes
the hair
loss look like it is hormonal or psychological. There are a number
of
diseases and disorders that can cause this sort of hair loss in cats.
The most
common ones are flea allergy, mange, ringworm, atopy ( pollen and
similar allergies), food allergies, hyperthyroidism and contact allergies.
A good plan for working through these possibilities is to do a ringworm
culture (should be done on all cats with these sort of symptoms),
starting a good quality flea treatment (Frontline Topspot tm, Advantage
tm,
Program tm and an adulticide like Capstar tm, or Revolution tm),
skin scraping
for mites, a food trial (single meat source the cat hasn't eaten previously
or new hydrolyzed diets), testing for hyperthyroidism if other signs
are
present, testing for allergies and considering skin biopsy if the
problem hasn't resolved and the other tests are all negative. After
the skin
biopsy it is reasonable to start thinking that the problem might be
psychological and to treat for this sort of problem. Clomipramine (Clomicalm
or
Anafranil Rx) would be a good choice at that point.
If you do try clomipramine it is best to use it for a month or two
after the problem seems totally resolved before trying to taper it
off and it
is best to cut the dosage down slowly over the course of a few weeks
to a
month or so. It is also a good idea to try to identify and eliminate
sources of stress.
When a serious attempt is made to diagnose an underlying skin disease
it is unusual not to find a cause for the problems before having to
resort to
treating for psychogenic alopecia.
I hope this helps some.
Mike Richards, DVM
1/25/2002
Question: I believe the aspirin dosage you reccommend for cats
is incorrect on
this page: http://www.vetinfo.com/catortho.html
You suggest 10mg/lb, but every other source I can find suggests
10mg/kg.
That makes the dosage you suggest more than twice the common
reccommendation. Here are some other resources:
http://oacm.uvm.edu/oacm/cat.htm
http://www.valleypetnews.com/venerable_vet_i.htm
Answer: Mark-
Thank you for being concerned enough to write to us about the dosage
for aspirin.
There are published studies indicating that aspirin is safe when dosed
from 10 to 25mg/kg every 48 to 72 hours and one study indicating no
problems
when it was dosed at 162mg/cat once a week. We use up to 10mg/lb
in
our practice, even though it is at the higher end of the dosage scale.
We
usually do not exceed 81mg per cat and I probably should indicate that
in our answers online, since this is often closer to 5mg/kg in large
cats.
Mike Richards, DVM
10/15/2001
Misoprostol (Cytotec Rx) and other drugs used with piroxicam (Feldene Rx) to protect stomach
Question: Dr Mike,
On your site you say: "Many vets use medications to protect the
stomach while administering this medication [piroxicam] but some do
not."
What medications could be used in a cat to protect the stomach, and
would
they interfere with the piroxicam's treatment of a gastrological cancer?
Karen
Parent of Cosmo the wonder cat
Answer: Karen-
The gastrointestinal protectant often recommended for use with piroxicam
(Feldene Rx) is misoprostol (Cytotec Rx), which is usually given at
dosages of 2 to 5 micrograms/kg of body weight every 8 hours for dogs
and every
12 hours for cats (not much support for this dosing scheme, for cats,
is
found in pharmacology texts, these is a dosage that has been included
in case
reports). This use has not really been validated by studies, at least
ones that I can find, but it seems to be frequently used by oncologists
who
seem happy with the results.
Alternatively, the over-the-counter medications cimetidine (Tagamet
tm,
5mg/kg twice a day), ranitidine (Zantac tm, 3.5mg/kg every 12 hours)
and famotidine (Pepcid AC tm, 0.5mg/kg once or twice a day) may also
be
useful.
Mike Richards, DVM
8/23/2001
Drontal (Rx) and pregnant cats
Question: Hi, our local vet thought that Drontal was OK to give to 2 pregnant cats.
Both cats are about 9-10 lbs and got only one pill dose for 7-8 lbs.
These
were feral cats and one is about 2/3 the way through pregancy and the
other
has about a week to go.
I looked up on the web and it says that Drontal causes problems and
should
not be given. Is there anything that I can do at this point?
Also cats seem
to be doing fine and kittens are still moving. What could we
see in the
kittens?
thanks, Cindy
Answer: Cindy-
I have checked several sources trying to figure out what might
be the basis for your question and have had to make a guess about that. Please let me know
if I
am wrong.
There are two similar products on the market. Once is Drontal (Rx),
which
is a mixture of pyrantel and praziquantel. This product is approved
for use
in cats. As far as I can tell from my research, this product is considered
to be safe to administer even during pregnancy. The second product
is
Drontal Plus (Rx), which is approved for use in dogs. This product
is a
combination of praziquantel, pyrantel and febantel. This product should
not
be given during pregnancy because febantel can cause birth defects
when
given at two to three times the recommended dose. Since this is a very
narrow safety margin, the product shouldn't be used during pregnancy.
My best guess is that there is confusion in the information about these
two
products. However, if I am wrong and you have found information
specifically relating to Drontal and problems with pregnancy, would
you
please send me the web address so I can see what the references used
were?
I am hoping your vet and I have the correct information and that you
will
not see any problems from the use of Drontal during the pregnancy.
Mike Richards, DVM
5/5/2001
Question: I subscribe to your newsletter and have a question
regarding my 2 long-haired
cats. I notice that they have hairballs more frequently
than my short-haired
cats and wonder how often I should give them hairball medicine.
I use
Laxitone. I try to remember to brush them frequently but
they still have the
hairballs.
Thanks, Jan
Answer: Jan-
Laxatone (tm) and other petrolatum containing laxatives have been used long term, even on a daily basis, in some cats for long periods of time. This does not seem to cause harmful effects based on the lack of reports of harm in the literature. There are several theoretical problems that might occur, though. It is possible that long term use of a petrolatum product could interfere with absorption of fat soluble vitamins and there have been reports of foreign body reactions to petrolatum products in the liver in horses, but I am not sure if this has been shown to occur in cats. With all of this in mind, it appears to be reasonably safe to use Laxatone and similar products pretty frequently. Despite this, we prefer to try to find the underlying cause for the hairball problem in our patients, when it is possible to do that. The two most common problems we find are skin disease leading to excessive hair ingestion and motility problems in the digestive system that make it hard for the intestines to get rid of the hair. If skin disease is not present, we often try the new foods made for hairball problems prior to doing a more complete workup for digestive tract problems because they do seem to help many cats who seem to have inflammatory bowel disease leading to vomiting, including vomiting of hair or hairballs. Your vet can help you determine whether skin disease or inflammatory bowel disease is likely based on the history and a physical examination.
Hope this helps some.
Mike Richards, DVM
4/3/2001
Acetaminophen (Tylenol™) toxicity cats
Question: Hi Dr Mike:
I have a question about Acetaminophen (Tylenol™). The
Receptionist at our local veterinarian told us never to give
our cats
a Tylenol™ and NOT to give them ASPIRIN unless the Doctor oks it. Is
that true? And what about Ibuprofen?
Answer: Acetaminophen is very toxic to cats and
this medication should simply never be used to treat a cat. Aspirin
has a
long half life in cats, at least 24 to 48 hours, so it will reach toxic
levels pretty quickly if it is given more frequently than once every
48
hours and the dosage is 10mg/lb so a baby aspirin (81mg) is a much
more
appropriate dosage for a cat than an adult aspirin. I have not seen
much
information on ibuprofen and cats but it is a good idea to avoid all
non-steroidal anti-inflammatory medications in cats, at least until
one of
them does prove to be safe in someone's clinical trials.
Mike Richards, DVM
3/10/2001
Dear Dr. Richards,
Thank you very much for your reply, I love your detailed answers!
I have another question now. My elder cat was diagnosed with IBD after exploratory operation in December, and he is now on Prednison (2 pills every other day). One week after surgery our vet also found Giardia in his stool, and the cat was on Novo-Nidazol (125g every day for 6 days - the weight of the cat is 14 lbs.). It seems to help him and he doesn't have diarrhea anymore, although his stool is not always perfectly formed.
My question is: for how long in your opinion should he stay on Prednisone? Our vet gave us about 400 pills - enough for the whole year. Is it really necessary? Can we lessen his dosage since he looks fine to me? And if yes, then when and how - 2 pills every third day? 1 pill every other day? I know we cannot just stop giving him the pills, but what is the scheme of gradual finishing this medication?
Thanks again for your help, I really appreciate it!
Have a great day,
Corinne
Answer: Corinne-
We usually try to keep cats who respond well to prednisone for IBD on
the medication for about six months. At that time, we try to wean them off of the medication. If
we have been using it daily, we go to every other day for 5 to 10 doses, then cut the dose in half
for 5 to 10 doses, then go to every third day at this reduced dosage for 5 to 10 doses and then stop the
medication, if the reduction in dosage has been effective. We chose six months as a compromise
between recommendations in the literature, because we have seen recommendations to use prednisone
for as short a time as 3 months prior to trying to wean patients off the medication and as long as
a year prior to making this attempt.
Your vet may have experiences that indicate the longer period is better
or may have strong feelings about the reliability of the information from one of the people who
recommends longer durations of treatment prior to attempting to wean a patient off of the prednisone.
We often try limited antigen diets (one protein source) prior to using corticosteroids, so we take
one dietary approach prior to their use. Lately, we have been going for short periods of time, usually
six to eight weeks, and starting different dietary changes such as adding essential fatty acids
to the diet or using diets that already have some fortification of these ingredients, such as the hair
ball formula diets. We seem to be having some luck with this approach, but definitely not total success.
We do have patients who we have to keep on prednisone or on intermittent injections of methylprednisolone acetate (DepoMedrol Rx) to control symptoms of IBD. We have had patients on these medications for several years in some instances without being able to successfully wean them off the medications. Many of these cats do develop secondary problems as a result of long term corticosteroid use, so we really prefer not to take this approach.
When the time comes to think about lowering the dosage of corticosteroids or weaning your cat off of them entirely, it is very important to get directions for doing this from your vet so that he knows what is going on if any problems occur during the dosage reduction period.
Mike Richards, DVM
1/26/2001
Question: Dear Dr. Mike,
I've written to you a couple of times regarding Lucy, my 4.5
year old, spayed cat. She has been losing hair slowly for about 6 months, and it keeps getting
worse. I brought her to my vet (again) and he did a complete blood testing which came back normal.
We ruled out mites, fleas, food allergies, and probably airborn allergies. I say probably because
the seasons have changed and there has been no change, or if anything, her bald spots have
become worse. My vet has come to the conclusion that her hair loss is probably due to stress
from playing with my other cat, as the hair shafts are broken. He is a 2 yr. old altered male,
very playful, but not aggressive, to the best of my knowledge. I've been reading behavior books and neither
of them put their ears flat or get puffy tails or use their claws. They bite each other,
but don't draw blood. My male is usually the aggressor, but they usually nap together and eat together, so
I've been assuming they like each other.
My vet has recommended 2.5 mg of amitriptylline each a.m.
She's usually O.K. taking pills, but I'm having ALOT of trouble getting her to take them. My
real concern is that she has lost interest in everything. All she does is sleep. And her "brother"
has been walking around the house meowing at her, I think to get her to get up and play.
I've only had her on medication for 5 days, but I'm really worried. Is the dosage correct? Is
there an alternative which may have less side
effects? I asked my vet and he told me to wait at least
10 days. If something else would cause less side effects I'd rather use it, or maybe just resign myself
to a bald cat......
Thanks so much for being such a wealth of information...I wish
I lived in VA!
Sandi
Answer: Sandi-
Amitriptyline in usually dosed at 5 to 10mg per cat, once or twice a
day. So 2.5mg once a day is actually a pretty low dose. We use this medication several times a
year for cats in our practice and have found that it is very hard to administer these pills, making us
think that the taste must be pretty bad. We have had some luck having a local compounding pharmacy
make gels out of the tablets with strong flavors like anchovy. Some of our clients also purchase
small empty gelatin capsules and put the pills in them so that cats don't get hit with the flavor right
away. We have had two or three clients whose cats reacted about like yours and all of them gave up
on the medication after a couple of weeks, which seemed perfectly reasonable to us. Many cats
have very little discernible effect but most get a little sleepy. We use this medication mostly for cats with
urinary tract problems and we recommend giving it at night before bed time. Most cats get a little
sleepy but it doesn't matter at that
time of night.
I am not sure how food allergy was ruled out. This is usually done by
feeding a diet that has a protein source the patient has never been exposed to, such as rabbit, venison
or using one of the new hydrolyzed diets (Hill's z/d (tm) is the only one I know of for cats).
The diet is fed for six to eight weeks and if there is improvement in the skin condition, then the most
likely diagnosis is food
allergies. If return to the normal diet induces problems and they clear
up with change in diet again, the pretty much confirms food allergy. If you have not tried a food
trial it might be worth doing that, although you would probably have to feed both cats the trial diet in
order to see if it works.
If there is not an adequate response to amitriptyline, or if the side
effects of amitriptyline are too
severe to tolerate, it might be worth doing a skin biopsy just to make
sure there isn't something like demodectic mange or a disorder that can be diagnosed by a pathologist.
You may find that buspirone (Buspar Rx) works as well as amitriptyline, if this is a problem in which Lucy is just nervous because of conflicts with your male cat. Some cats who seem to have hair loss from behavioral causes (psychogenic alopecia) will also respond to fluoxetine (Prozac Rx) or clomipramine (Clomicalm Rx) according to case reports I have seen but we have not tried these medications so I have no personal experience with this. Megestrol acetate (Ovaban Rx) works in many situations when other medications will not but it has very high potential for serious side effects, such as the induction of diabetes and mammary tumors. So it has to be looked at as a last resort and we use it very reluctantly.
I hope that things are improving some at this point. If so, there
is a good chance that you will
eventually be able to wean Lucy off the medications. We usually try
to do this about sixty days after there is obvious improvement and we take some time to taper the patient
off the medication to try to prevent quick relapses. Your vet may have a different approach based
on his experiences and it is best to follow his advice if that is the case.
Mike Richards, DVM
1/24/2001
Megacolon treatment - cisapride (Propulsid Rx) and ranitidine (Xantac Rx)
It is still possible to get cisapride (Propulsid Rx) from compounding pharmacies and many vets feel that it is helpful for megacolon problems. An alternative medication is ranitidine (Xantac Rx), which seems to have similar effects in some cats. The usual dosage of cisapride is 1.25 to 2.5mg given 15 to 30 minutes prior to eating and the dosage of ranitidine is 1 to 2mg/kg every 12 hours.
Mike Richards, DVM
1/15/2001
Anything but a pill for my cat's medication
Question: Hi Dr. Mike,
I've been surfing the net trying to find info about
trying a topical solution of prednisone instead of
oral for my cat who's kinda tired of being pilled!
Max is FIV+ and was treated with radiation for nasal
lymphoma in August of this year. Since I declined the
chemo and the cancer was advanced, my "pennence" is
having to medicate Max with prednisone for the rest of
his life (vs. the 6 months post radiation treatment I
was originally told).
Max is doing very well right now. In fact the best
he's been since he became very ill with the lymphoma.
There's still some slight (clear) nasal discharge
sometimes but otherwise he's eating very well and
playing a lot (something he hasn't done for quite a
while).
He seems to get recurrent sinus type infections (from
taking the prednisone?) so I wind up having to pill
him 4x a day. Not fun for either one of us. He's
relatively cooperative taking the two pred's a day but
when I have to add an antibiotic to the regime it's
darn near impossible.
I was told about a topical prednisone solution that's
rubbed on the inside of the ear and was wondering if
you could tell me about this. Would it be appropriate
for Max? Possibly in liu of the pill form during the
times I have to give him antibiotics?
Thanks for your time and help,
Becky
Answer: Becky-
Compounding pharmacists can mix medications with a plurionic lecithin
organogel (PLO cream) base, which is supposed to make many medications
absorbable into the blood stream after topical application. It has
to be
applied on a non-haired portion of the skin, making the inside of the
ear a
common recommendation. The PLO base doesn't work for all medications
and
dosing information has not been worked out for pets using PLO creams
for
any medications that I know of. However, I think it is still a reasonable
option for some situations. You may have to adjust dosage or evaluate
success based on clinical signs, though.
Flavored gels or liquids can be made from many medications, as well.
We
have used liquid prednisone formulations compounded by our local
compounding pharmacy and this seemed to work fine. Enrofloxacin (Baytril
Rx), a broad spectrum antibiotic, comes in flavored pill form now.
We
haven't tried this medication in a cat, though -- so I can't give you
a
personal assessment of how acceptable the pills are to cats.
Sometimes it is possible to nebulize antibiotics for sinus and nasal
passage problems.
If there is a compounding pharmacy (one that can make medications into
different forms) in your area, the pharmacist could probably tell you
how
successful they have been with topical prednisone. Your vet may know
of a
compounding pharmacy, if you are not aware of one.
Hope this helps.
Mike Richards, DVM
12/24/2000
Question: Dr Richards,
My cat is on Tapazole for hyperthyroidism and I give her 1/2
a pill in the morning and 1/4 in the evening. I requested information from a compounding pharmacy about tuna
wafers with Tapazole and he e-mailed back suggesting putting the Tapazole into a PLO gel which is then
rubbed behind the cat's ear. He said that excellent results have been achieved with this method without having to
worry about getting the cat to eat anything.
Have you heard of this method? It sound like a great idea if
it works, but I need to get more information before trying it. Perhaps you can shed some light on this method of
medicating.
Anne
Answer: Anne-
There are reports of good success mixing methimazole (Tapazole Rx) with
a pleurionic lecithin organogel (PLO cream) for use in cats that are hard to pill,
on the Veterinary Information Network message boards (a service for veterinarians, www.vin.com). It has to
be applied to a hairless area, so the inside of the ear or a hairless area in the inquinal or abdominal
areas would have to be used.
The gel would penetrate human skin, too, so it should be applied using
latex or vinyl gloves. The approximate dosage of medication should be the same as for oral administration
so the pharmacist would have to calculate that out for the gel mixture. Success of the
medication could be monitored by using T4 (total thyroxine levels) or by paying close attention to clinical
signs like heart rate, weight loss and appetite.
I guess I would want to reserve this approach for cats that were very hard to pill since I couldn't find any studies on dosing requirements or double-blind studies evaluating success of therapy with this approach.
Mike Richards, DVM
12/16/2000
Question: Dear Dr. Mike,
No-one, I mean no-one in Southern CA seems to know about the source
for
Denosyl SD4. I checked your link to the FDA's Green Book and could
not
find it either. Who makes the stuff? I would love to try it out on
Woofy
the Pomeranian with pancreatitis and liver disease, but my vet and
pharmacist are looking at me funny these days.
Sorry to bother you again. Best, Teal
Answer: Teal-
This is the address for the web site of the manufacturer:
http://www.nutramaxlabs.com/veterinary/products/denosyl_tech2.htm
I have to admit that we think it is perfectly acceptable to use any
brand
of SAMe --- it's just that Denosyl SD4 is the only one actually approved
for dogs and cats, so we feel an obligation to suggest it first.
Dr Mike
10/26/2000
Question: DEAR DOCTOR,
I AM WONDERING IF YOU HAVE EVER COME ACROSS AN ARTICLE ON ZITHROMAX
OR AZITHROMYCIN IN THE USE OF FELINE INFECTIONS? I HAVE COME ACROSS
ONE ABOUT TWO YEARS AGO AND HAVE SEARCHED FOR THE SAME WITH NO LUCK.
HOWEVER: I HAVE USED THIS DRUG ON MY CATS WITH RESPIRATORY PROBLEMS WITH
IMMENSE SUCCESS. THEY WERE PREVIOUSLY PERSCRIBED AMOXICILLIN AND
WHAT I FOUND IS THAT IT
RENDERED THE BACTERIA DORMANT BUT DID NOT SUCCEED IN KILLING
IT. IT CAME BACK AGAIN AFTER A FEW MONTHS. USING THE ZITHROMAX I HAVE FOUND
NO RETURN OF THE BACTERIA.
MY CAT BREEDS ARE BURMESE AND BURMILLA AND RESPIRATORY PROBLEMS ARE MORE PREVALENT IN THESE BREEDS.
IT IS ADMINISTERED ACCORDING TO WEIGHT EITHER IN PEDIATRIC SUSPENSION OR TABLETS ( 250 MG), CUT DOWN TO WEIGHT.
IF YOU COULD POSSIBLY SHED SOME LIGHT ON THIS ARTICLE I WOULD APPRECIATE THIS AS I SIAD IT DOES WORK AND HAS WORKED ON CATS THAT I KNOW THAT HAVE BAD VIRUSIS ANS PRACTICALLY NO OTHER OPTIONS BUT TO TRY THIS DRUG. THANK-YOU IN ADVANCE FOR READING MY LETTER.
YOURS TRULY
SHARON
Answer: Sharon-
I know of two articles on the use of azithromycin (Zithromax Rx) that have been published fairly recently. The references for these are:
"Antibacterial drug therapy. Focus on new drugs.", Veterinary Clinics of North America, Small Animal Practice, March 1998 by MG Papich.
and
"Pharmacokinetics, Oral Bioavailability And Tissue Distribution Of Azithromycin In Cats.", by Hunter, et al, in the Journal of Veterinary Pharmacology and Therapeutics, Feb. 1995
The first journal is pretty widely available and there is a good chance your vet has it but the second journal is pretty specialized and it would probably take a trip to a veterinary school library to find it, although the abstract is available from the PubMed site. (use "Hunter azithromycin cat" ) to find it.
Azithromycin is supposed to work better for chlamydiosis and mycoplasmal
infection than many
other antibiotics. These are both more common in multiple cat households
than single cat households. Azithromycin also works well against gram positive bacteria like staph
and strep. It is usually dosed at 5mg/kg from once a day to once every third day.
Azithromycin is a good antibiotic for upper respiratory infections in cats that do not respond to other antibiotics or that seem to be due to chlamydiosis or mycoplasma infections.
Mike Richards, DVM
10/31/2000
Question: Hi Dr. Richards,
I'm back. Your advice has been excellent. My cat has been back to the
vet since starting the Tapizole and we actually had to decrease the
doseage since it was working too well. She's due back in 3 more months
for follow-up blood work. She had not gained any weight but you said
that may take some time but, at least, she's not losing any more
weight. My question today has to do with one symptom that has not
changed very much and that is excessive drinking and urination. Could
that be a side effect of the Tapizole? When I had the initial blood
screening done, I was told her other levels were within normal limits
(sugar, kidney and the like) Maybe we cut the dose back too far. What
would be your guess? Thanks a million.
Kathy
Answer: Kathy-
There are strong associations between hyperthyroidism and diabetes
mellitus, so it is a good idea to monitor for diabetes when hyperthyroid
cats show signs of increased drinking and urinating. Sometimes diabetes
will occur even when cats seem to be well controlled by the treatment
for
hyperthyroidism.
Some cats with kidney disease appear to gain a protective benefit from
hyperthyroidism, in that its effects on blood pressure actually help
the
kidney in some ways. When cats who have subclinical kidney insufficiency
are treated for hyperthyroidism the kidney problems can actually get
worse,
leading to increased drinking and urinating. So it is also a good idea
to
monitor kidney function while using methimazole (Tapazole Rx) or after
surgical or radioactive iodine therapy for hyperthyroidism.
I am not aware of any direct effect that Tapazole might have on drinking
or
urinating, so I don't think the medication itself is likely to be the
culprit, although I couldn't absolutely rule that out.
If your vet ran a whole blood panel when the T4 levels were rechecked,
there may be no need for further testing. If he or she did not do this,
it
would probably be a good idea to consider blood work to try to
rule out
kidney problems and diabetes. A urine sample, or samples, might
also be
helpful in ruling out these problems.
Mike Richards, DVM
5/4/2000
Treating pain in cats - Adequan (Rx), glucosamine/chondroitin and prednisone
Q: Dear Dr. Richards,
Thirty days ago, I began a schedule of Prednisone (5mg) and
Glucosamine/Chondroitin Sulfate (250mg/200mg) for my arthritic cat.
I don't
like having her on Prednisone, so try to administer it only once every
3
days. I break a G/C capsule open and mix the powder into her cat food.
She
doesn't like it much, but most of the time I can get her to eat it.
You also
mentioned Adequan injections as being possibly helpful. My vet has
never
done this, but she ordered the Adequan and it's arrived, so we're ready
to
begin.
These are my questions:
* to begin the Adequan injections, do
I continue with the Prednisone
and G/C dosages at the same time?
* how much Adequan do we administer and
how often? Is it just used
initially, or ongoing?
* are you aware of any other form of
G/C to administer to my cat? I
would even prefer a pill that she can swallow, but those capsules are
much
too large.
* what side-effects should I be watching
for for the Prednisone? And
would you recommend that I ease her off of it to see if the G/C and
Adequan
are working by themselves?
As you know, it's difficult to monitor pain in a cat. Her arthritis
is in
her shoulder and elbow and she walks with a limp. My vet said her shoulder
joint is a little out-of-whack so there will always be a limp. So the
limping doesn't monitor the pain. However, every few days she will
lift her
paw off the ground and hold it up. I think that might be the pain signal,
so
that's what I'm watching for.
Thanks for your help. Nancy
A: Nancy-
There is no reason not to use Adequan (Rx), glucosamine/chondroitin
and
prednisone at the same time, if the combination seems to help more
than the
individual medications. In most cases, though, the object is to use
as
little prednisone as possible and so we try to wean cats off of it
during
treatment with Adequan, in the hopes that will be OK.
Adequan is dosed at the rate of 5mg/kg (approximately). There are all
sorts
of recommended dosing schemes. We usually give it weekly for 5 weeks
and
then try to lengthen out the interval to the longest time between
injections that keeps the cat or dog comfortable. Two to four weeks
seems
to be about the range that can be expected for Adequan to help. Different
vets have tried lots of different schedules. Adequan is pretty safe
to use,
so it is OK to experiment some with the intervals.
Glucosamine comes in a powdered formula. One brand name for this is
Arthroflex (TM). One of my clients loads the powder into gelatin capsules
and gives it that way. Some cats will eat the powder mixed with their
food
but cats that are sensitive to texture or the taste may not accept
food
with glucosamine products mixed into it. There are a lot of companies
making these products right now and it would not surprise me if there
are
companies making other formulations that might be easier to give (like
capsules or smaller tablets). I haven't really looked into this recently
but if I get a chance in the next few days I will.
Prednisone doesn't cause too many obvious side effects in cats but weight
gain from increased appetite and some fluid retention is pretty likely.
It
is necessary to try to control the weight gain by feeding less because
increased weight is bad for arthritic pets. The side effect that scares
me
is immunosuppression. If you find that you are seeing more upper
respiratory infections, more skin disease, or anything else that indicates
a decrease in immune function it would be a good idea to discuss this
with
your vet. At every three day intervals it is not too likely that this
will
be a problem for your cat but it is a good idea to stay vigilant for
signs
of problems.
Good luck with this. I expect to see more emphasis on finding medications
that are useful for pain and inflammation in cats over the next few
years,
so ask your vet every now and then if anything new is available. Cats
have
been frustrating due to their inability to process many anti-inflammatory
medications or odd reactions to others so there is some chance that
things
won't change much. Still, there is a good economic incentive for coming
up
with a good anti-inflammatory for cats so there is hope.
Mike Richards, DVM
5/5/99
Q: Dear Dr. MIke,
My cat was diagnosed with feline leukemia (despite her yearly
shots) about 10 days ago and is quickly going downhill. I live in a very rural area with the
closest vet being 40 miles away. Originally, the only treatment was the Clavamox
antibiotics, but I've been doing alot of Internet research and saw
hope in
the Immunoregulin. I asked my vet about this and she agreed to
give it a
try- so herein lies my question: She is not too familiar with
the use of
it and found some in the refrigerator (belonging to another vet in
the
practice) that is over a year old. She gave my cat her first
shot
yesterday (some vomiting side effects), but I just wanted to verify
what
the shelf life of this medication is? Thanks so much for your
help.
Sincerely, Lezle
A: Lezle-
The bottle of Immunoregulin should have an expiration date on it. From
a
practical standpoint, it seems reasonable to conclude that it would
be OK
to use it for a few months past the expiration date but from a legal
and
ethical standpoint your vet may not want to do that. If the label is
damaged and the expiration date unknown I think I'd wait for a new
bottle
of the mediation to arrive. It just seems safer to me.
Mike Richards, DVM
2/23/99
Q: I have an older cat that was having respatory
problems. I took him to the vet and I asked to do the felv test and it
was + . The vet put him on clavamox mixed with interferon which seemed
to help for the first week. The second week he started to vomit almost
every time he ate but his apetite only suffered slightly. I brought him
back to the vet and told her about the vomiting she said it could be alot
of things. She put him on the same clavamox mixture and some Aminophylline
for his lungs. After the vet visit his vomiting got much worse and started
dehydrating. I started giving him pedialyte which helped some . The info
I have read on the internet has said that some antibiotics will cause vomiting
is there any help for the vomiting? I know if his vomiting was under control
he would not get as dehydated. HE still wants to eat but he gets sick every
time.
Thanks so much Karla
A: Karla-
It has been our experience that Clavamox will occasionally cause vomiting. Please call your vet and let him or her know that you are concerned that the Clavamox itself is the cause of the vomiting. There are other antibiotics that may be useful.
Mike Richards, DVM
Q: I am looking for an appetite stimulant
for my felv+Tripod. She has lost
2 lbs and is refusing to eat.
Thanks
Kathy
A: Kathy-
The two appetite stimulants we use most commonly are diazepam (Valium
Rx)
in small dosages (1mg or less) and cyproheptadine (Periactin Rx), usually
2mg/cat once a day.
Hope this helps.
Mike Richards, DVM
Q: I read under Indigestion in Cats that PeptoBismal
may be given. Since it contains "asprin", I wonder if that
could be a problem. Thanks.
Linda
A: Linda-
You are correct that Pepto-Bismal contains salicylates which are related to aspirin. The salicylates are absorbed and if given in sufficient quantities would potentially cause problems in a cat. We have not seen problem with Pepto-Bismal in our practice, probably because it is difficult to give a cat enough of the liquid to cause problems. I did not consider the possibility of dosing this in caplet form since that was not an option when I first learned the dosage for this compound. I can see where that might cause problems.
Thank you for pointing this out.
We will correct the page to caution cat owners about this.
Mike Richards, DVM
Q: Hello Dr. Mike:
I have a fifteen year old female
house cat. She takes a medication called, Tapazole (C-methimazole)
for her heart? She started taking it because she was vomiting.
The doctor gave her blood work and said it was her thyroid, maybe? I wish
I remember exactly, but this was in June. I know I should ask these
questions to my vet, but I live in the very busy city of New York and often
feel rushed during my visits to the vet, even though my cat's doctor is
EXCELLENT.
Anyway, can you tell me what this drug does, are there any side effects, and does she have to take it for the rest of her life? Also, my kitty seems to be getting slower with her back legs. She still jumps on the bed, but she sits down often and wobbles, sometimes. She isn't sore to the touch, but just moves more slowly in the back area. Is there anything I can do?
And finally, how can I keep my cat alive for another fifteen years? She's my best friend. :) Thank you for any information you can give me. Or can you refer me to an on-line source to look up the medication or get other info. from veterinarians?
A: L-
Methimazole (Tapazole Rx) is the only pharmaceutical product that I
know of in the U.S. for the treatment of hyperthyroidism on a maintenance
basis. It interferes with the synthesis of thyroid hormones, which lowers
the amount produced by the over-active thyroid gland. It must be given
lifelong if the diagnosis of hyperthyroidism is accurate. It causes side effects in
approximately 20% of the cats it is administered to and serious side effects
requiring withdrawal of the medication in a small number but I am not sure
what percentage that might be. Serious side effects include bone marrow
suppression, liver damage or kidney damage. Loss of appetite from the medication
can occur and is a serious side effect if it goes on for more than two
or three days. I think that most veterinarians probably consider radioactive
iodine therapy (best) or surgical removal of the effected thyroid gland
to be preferable to long term treatment with methimazole but I also know
that is not universally true. It is generally a good idea to monitor the
blood count, liver and kidney chemistry values and T4 level while on this
medication, at least periodically. Most textbooks recommend checking these
levels every 2 or 3 weeks after initiating therapy until it is clear the
medication is working and not causing serious side effects and then monitoring
less often, perhaps every 3 to 12 months.
There is a very good site on radioactive iodine therapy at radiocat.com (there is a link to it from our link page). I am pretty sure that the Animal Medical Center in Manhattan does radioactive iodine therapy if you would consider that.
The weakness in her rear legs could be due to spinal problems, arthritis,
low potassium levels, diabetes or other conditions. Since this is new and
you need to talk to your vet about the methimazole again, anyway, it would
be a good idea to schedule an appointment and get this checked out. Bring
a list of questions written on a piece of paper and make sure that they
are answered before you leave -- or that your vet agrees to check into
the questions and call you back. This is reasonable for a client to ask
any vet, no
matter how busy they are. It is very important that veterinary clients
understand their pet's health needs and the veterinarian's instructions
since they are the link between the vet and the pet.
Keep working with your vet to maintain her health and you might get 15 more years. So far, our record for cat longevity is 27 years in our practice but we see many more 20 year-olds than we used to.
Mike Richards, DVM
Q: Hello! My cat was prescribed Acepromazine by a vet at Petsmart. I had a hard time getting them to give me specific info. (they barely have enough people working there to answer the phone) I had to bathe her and she has a great great fear of water and tries to bite me when I bathe her. They said to give 5-10 mg. She is 8.5 pounds. Do you have dosage/per pound info for this drug. She didn't appear to be affected by the 10 mg I gave her. (just to let you know, I have tried and tried to bathe her, and the groomers say that she was very difficult to bathe as well. I can bathe my other three cats, with no problem). When I am prescribed a drug by my Dr., I read the PDR. I like to know everything about what I'm taking. I even like to look at the chemical-molecule pics, even though I don't understand them. I like to read about the trials and incidence of side effects. So I was wondering if you knew of a website where I could read this kind of info, or could provide me with this kind of info, side-effects, that kind of stuff. Your response will be much-appreciated. Thanks!
A: Michelle- Acetylpromazine (Acepromazine Rx, PromAce Rx) has a wide dose range. The label dose is 0.25mg to 1 mg per pound of body weight. Many veterinarians, including me, feel that the label dose is often much higher than the necessary dosage. I tend to use 5 mg for pets weighing up to 25 lbs and then about 5mg per 25 lbs or so after that.
Acetylpromazine is pretty unreliable as a sedative for situations in which the animal is likely to be very frightened or very aggressive. Almost all pets can overcome the sedative effect to react to things they are frightened of or to bite the vet, groomer or even owner, if the circumstances are right. Despite this shortcoming, which is significant, acetylpromazine is pretty safe for the pet and it is available in an oral form. This makes it tempting to use in situations in which you describe because it works just often enough to make it worth a try. It is important that a pet owner understand in advance that this medication may not produce the desired effect and that the pet may react badly to whatever adverse stimulus it is being used for. As long as this is clear I feel comfortable dispensing acetylpromazine.
Since "Ace" didn't work for your cat, what are the alternatives? Diazepam (Valium Rx) will work in some cats to produce reasonable sedation when acetylpromazine will not. It is not any more reliable in our hands for this, though. Anesthetics may be necessary for some pets but these must be administered by the veterinarian and the necessary bathing, etc. done under the vet's care. If you are bathing due to fleas or ticks, consider using Frontline Topspot (Rx) or if fleas alone are the problem TopSpot or Advantage (Rx).
Putting a piece of window screen (in a frame) in the bottom of the tub so that your cat can sink her claws in it seems to help a lot in reducing bathing stress -- for some cats.
Mike Richards, DVM
DO NOT give any cat a non-steroidal anti-inflammatory medication
without consulting with your vet first. Acetaminophen is toxic to cats,
aspirin is extraordinarily easy to overdose in cats because the half-life
of aspirin in a cat is 72 hours (3 days!) and other non-steroidal medications
do not appear to have been studied much in cats, probably due to the problems
with these two common ones. For arthritis, we do sometimes use aspirin
but it must be used cautiously and it is important to know the patient's
medical condition well prior to its use.
Mike Richards, DVM
Photo of acetaminophen
toxicity in a cat.
Q: Dr. Mike, My cat has recently diagnosed with allergies. The treatment I tried was Children's benedryl liquid form. When ever I gave her the medicine she would start foaming profusely. The vet said she didn't like the taste. I can say that what ever she swallowed worked because she stopped licking. The vet recommended I try pill form. About a half an hour after I give it to her she throws up. I didn't get this reaction from the liquid. What I'm looking for is a cat flavored version of the benedryl, maybe liver flavored. I think that if I can find something she likes she'll be o.k. Is there something out there I can buy like this? Regards, S.
A: You can probably find a pharmacist in your area who still makes compounded medications (usually referred to as a compounding pharmacy or pharmacist). They can make many flavors of gels and liquids out of various medications.. Even though Benedryl is an over-the-counter medication it is possible you would need a prescription. I don't know the compounding laws well enough to know if changing the form of the medication would make a prescription necessary.
Mike Richards, DVM
Q: Hi Dr. Mike, We are having terrible problems with our neutered male cat. Sometimes he will use the litterbox and most of the times he doesn't. He now is defecating on the rug as well. Our vet put him on Ovaban, one a day for a week, then 1 a week. He's been on it for 5 days now but he is acting strang, he meows constantly for about 15 minutes non stop and will not let us alone when he does this. Is this a side affect, and what are the side affects of this drug? Any help would be apprciated. Thanks
A: I try not to use megestrol acetate (Ovaban Rx) in cats so I don't have a lot of experience with side effects, but I don't recall this as one. I have seen a vague reference to "personality changes" associated with this medication, so I guess this could fit in that category.
Wish I could be more helpful. There is some information on dealing with
litterpan
usage problems on our cat information page.
Mike Richards, DVM
Q: Have you seen any reports or studies that indicate an association between the use of predisone in dogs or cats and the onset of diabetes?
A: C- It is pretty widely accepted that prednisone
may predispose dogs and cats to diabetes. It is not as clear to me whether
this is enhancement of an existing tendency to develop the disease or if
it is an independent effect. They also can induce insulin resistance, leading
to hyperglycemia. In diabetic patients, corticosteroids can make insulin
regulation more difficult since they have this effect on blood sugar levels.
I think this is a relatively rare side effect but it is a consideration,
especially in a pet likely to already be predisposed to diabetes.
Mike Richards, DVM
Heartworm Preventative for Cats
Merck (tm) recently released a version of their Heartgard (Rx) heartworm preventive, containing ivermectin, for use in cats. The product is a chewable pill formulation which is available in two dosage sizes, one for cats weighing 5 lbs. or less and one for cats 5 to 15 lbs. of body weight. The medication is administered once a month, on the same day each month, for heartworm prevention. It may be used in cats already infected with heartworms to prevent introduction of new worms into the cat's cardiovascular system.
The manufacturer recommends testing cats prior to placing them on Heartgard (Rx), which follows the recommendations of the American Heartworm Society. While testing of cats for heartworm disease is not as accurate as testing dogs for heartworm disease, there are tests available from Idexx and Heska for cats.
This is a prescription medication. It will also control infection with
hookworms in cats. The package insert indicates it is safe for use in kittens
over six weeks of age and that it is safe to use during pregnancy. There
are no known conflicts with other medications at this time. It is packaged
in cartons of 6 tablets and should be used from the beginning of heartworm
(mosquito) season until one month after mosquitoes are gone. For some areas
of the country it will be necessary to use this medication on an all-year
basis.
Mike Richards, DVM
Q: Dear Dr. Mike, I just finished reading your web site and found it very informative. I have a couple of questions regarding medication my dog and cat are currently taking. Have you heard of a medication called Geri Zyme or Comfort. I'm giving it to my 2 1/2 yr old Golden who was diagnosed with severe hip dysplasiaa couple of years ago. It made a vast improvement in his mobility, even before he had his hip operation a year ago (the operation where they remove the head of his femor bone). I was curious if you had heard of this medication, and if so, could you give me some information on it. Also, we just introduced a kitten to our household, and our older cat began spraying. We have him on a low dosage of Diazapam (about 1 1/4 milligrams twice daily). We have taken him off it once since we got the kitten and he began spraying again. I suspect we may have to keep him on it for quite a long time (he's 17 yrs old). Do you know of any side effects keeping him on it for an extended time could cause? Thank you.
A: I am not familiar with GeriZyme or Comfort, so I can't help with that question.
Many times it is possible to slowly wean a cat off of diazepam (Valium
Rx) after administering it for 2 months or so after spraying is controlled.
Slowly cutting down the dose rather than stopping abruptly really seems
to help. I am not aware of any long term problems associated with the use
of diazepam in cats. It has been implicated in some cases of liver failure
in cats but these occurred during the first few days of use and appear
to more an individual sensitivity problem among some cats. If you have
to use this long term to control the spraying I think it will be OK to
do so.
Mike Richards, DVM
Q: Hi, it's me again. I've been to the vet and got another dose (2wks worth) of metronidazole. A stool sample was also sent away to be analyzed for an exact diagnosis. My question is: I am having a great deal of difficulty getting my cat to take her pills. We have an extremely difficult time dropping it into her mouth (even the vet had trouble), she spits it out if she can, then it disintegrates and never gets into her. We have tried crushing it up and putting it in margerine, tuna and wet food--no luck (i know it must taste bad ) Our final method, which still very difficult but more effective is disolving it in a small amount of water and squirting it into her mouth with a syringe. Any suggestions to make the two weeks of medication administration go by with out such a production (and believe me it is a production with her!)? Thanking you in advance
A: Metronidazole tastes really really bad. It is very difficult to administer to some cats due to this.
Three things that might help:
1) lightly crush the tablet into chunks and buy gelatin capsules from the pharmacist to pack the chunks into, then give the capsule to your cat. This keeps the taste down and may limit her reaction to the medication.
2) find a compounding pharmacist and see if mixing into a strong tasting gel formulation (like anchovy or something similar) can disguise the taste enough for your cat. We have had some successes and some failures with this approach. It is nice when it works.
3) use a pill gun. We have nice pill guns with soft rubber ends but I can't remember who makes them -- I'll try to remember to look it up and send you the name.
Fenbendazole (Panacur Rx) tastes better than metonidazole and it is still an option, if necessary.
Good luck with this!
Mike Richards, DVM
2) The second question is do you know what the clinical trials indicate as far as the association of cancer and the use of metronidazole. Thank you for your help.
A: I am not aware of any studies linking metronidazole
to cancer. It is known to be teratogenic (causes birth defects) when adminstered
to lab animals who are pregnant but I don't know if this occurs in dogs
and cats. I have no intention of giving it to a pregnant pet, though. It
can also cause neurologic signs in some pets even at the recommended dosages.
These go away when the medication is withdrawn (or at least they have in
the few cases we have seen).
Mike Richards, DVM
Q: Dear Dr. Mike, I'm an American living in Sao Paulo, Brazil, with two non-pure bred cats. I will travel with them to the US in July on United Airlines, which has indicated that they may travel with me and my fiance' in the cabin. From all that I have read about cats and tranquilizers, it seems to me that there are veterinarians who prescribe them and those who don't. My veterinarian here in Brazil does not, and also believes that a reverse reaction could occur, actually exciting the cats. He prefers to prescribe a homeopathic medication. My cats have been on one longish car trip (6 hours) and several shorter trips (they are now 7.5 mos. old) and do quite well. One is calm and doesn't cry and the other, it seems, cries only in the beginning. I think all will go well. Nonetheless, I would like to be prepared with a tranquilizer in the case that one (or both) becomes stressed, for their benefit, our benefit, and the benefit of the other passengers on board. What are your thoughts on tranquilizers? Which do you recommend? Which would be the easiest for ME to administer (preferably liqued drop form - if it exists), perhaps on board in the middle of the flight in the worst case scenario? Assuming the medication you may indicate exists here in Brazil, I'm sure I could get another vet. to prescribe it for me. Please also include recommendations about dosages. I would greatly appreciate any feedback you can give me. Thank you.
A: If your cats are traveling in the passenger compartment of the airplane (which seems like the situation based on your email) it may be OK to administer tranquilizers for the flight.
It is a very bad idea to give tranquilizers to a pet traveling in the baggage compartment. Recent data compiled by the FDA and the airlines strongly suggests that sedation is a major factor in most of the deaths of pets traveling by air. Apparently, the effect of tranquilizers is enhanced by the pressurization (or relative lack of pressurization --- most baggage compartment pressures are roughly equivalent to the pressure at 8000 ft. of elevation). Pets who may be properly dosed for use of tranquilizers at ground level may be overly sedated at altitude. The mechanism of death as it relates to sedation and air travel is not completely worked out but it is better to be cautious.
In the passenger cabin the situation is a little different, I think. Pressurization is probably better and there is therefore probably less risk associated with the use of the tranquilizers. Still, if you don't have to use them it would be best not to. The most commonly used tranquilizer for travel by U.S. vets is probably acetylpromazine (PromAce or Acepromazine). I would dispense it with careful directions for use if requested in this situation. I would recommend against using it despite that, unless absolutely necessary. I usually recommend trying it out once at home before using it while traveling. It can sometimes cause excitement instead of sedation. Plus, if it causes profound sedation you know to cut the dosage. That could be very important.
Hope all this helps.
Mike Richards, DVM
Q: What is a safe dosage of rimadyl for a cat (mgs/lb.)?
A: Michael- There are some vets who feel that carprofen
(Rimadyl Rx) should not be used in cats at all. We have used the same dosage
as for dogs (1mg/lb of body weight) and restricted use to five days or
less and so far have not experienced any problems. Cats may be more prone
to side effects such as gastrointestinal ulcers from this medication which
is the reason there are vets advising caution and further evaluation before
recommending use of Rimadyl in cats.
Mike Richards, DVM
Q: Our 17 year old cat, Mouser is extremely stiff in the hind quarters and cries sometimes when you pick him up as if he's in pain...our vet has run the usual tests on him and confirms that he has arthritis but is otherwise healthy. His kidney function is relatively good considering his age. Mouser used to be a huge cat but has lost a great deal of weight over the past 4 yrs. and hardly has any muscle on his old bones anymore. To pet him, you'd think we were starving him to death but his appetite is very good. A couple of weekends ago, we sensed Mouser was in some pain with his arthritis and the vet filling in on Saturday gave us a steroid shot to take home to give Mouser. She said it would probably perk him up and make him more comfortable but that there were other drugs out now that we could talk about with his regular vet that didn't have the side effects that the steroids did. Mouser did perk up for about a month and then seemed to regress again. Last week I talked to his regular vet and he advised us to start him on Adequan injections once a week for 3 weeks and then he would probably only have to have an injection once every month or two. He said this had been very successful in race horses and seemed to help cats as well. We gave Mouser his first injection which was only 0.15 and we haven't really seen any improvement in him this week. This was such a miniscule amount that we wonder if it did him any good. Does this drug have to build up over the next few weeks to do him any good? Is there anything you can tell us about this particular drug and what it will do to help our old kitty...at this point we just want to keep him comfortable but don't want to jeopardize his other health. Our vet seemed to think that giving him the steroids would help him to feel better but it had so many side effects such as kidney problems which old cats don't need any more of than they already have. We would appreciate it if you could give us any info you might have on this particular drug used in cats. Thanks
A: Adeqan has not been approved for us in dogs or cats, so there is not a lot of information from field trials or anything like that. I have seen recommendations for its use in cats, though. Adequan is made for horses and that is probably one of the reasons it doesn't take very much to meet a cat's needs. Adequan is a natural anti-inflammatory medication that does seem to be beneficial for control of arthritis, based mostly on anecdotal reports. The usual recommendation is to give it once a week for several treatments (between 3 and 6) and then to give it every 2 or 3 weeks as necessary. Based on our experience it appears to be beneficial about 60 or 70% of the time. There aren't very many choices of medication for cats with arthritis since they are sensitive to most non-steroidal anti-inflammatory medications, like acetaminophen and aspirin. Adequan is one of the few non-steroidal medications that may be helpful. It sounds like it would be a good idea to consider checking Mouser for hyperthyroidism (causes weight loss while the appetite remains good) and low potassium levels, which can cause muscular weakness and pain.
Mike Richards, DVM
Q: I got a bottle of Cerumite from the vet to try
to treat a cat that has adopted us. He is fairly wild, and I'm having problems
getting the drops in his ears. I believe he is running a fever, and was
wondering if it would be ok to try to put some aspirin in his food..I'm
not sure if this would be safe for a cat. Is there any way of sedating
him so I could clean his ears out? I would really appreciate any help you
could give me.
Do not give acetaminophen to cats!
A: Please DO NOT give your cat aspirin, acetaminophen (Tylenol Rx, etc.), ibuprofen (Advil Rx, etc.) or any other non-steroidal anti-inflammatory medication without the direct advice of your vet to do so.
Aspirin has a half-life in people of about 2 to 3 hours -- so it is given every 4 hours. Aspirin has a half-life in cats of about 72 hours -- so one dose lasts 3 days! It is extremely easy to overdose a cat on aspirin. Acetaminophen is even more toxic to cats and they may die with a single administration of extra-strength acetaminophen products.
When treating semi-wild or nearly wild cats for ear mites, I favor the use of ivermectin. It is not approved for cats but it requires only two treatments at intervals greater than 2 weeks to resolve most cases of ear mites.
I haven't had much luck sedating cats that didn't want their ears cleaned but there are very good short acting anesthetics -- which allow the ear to be cleaned and treated the first time.
If you just can't get the Cerumite in, you might want to ask your vet about treating your cat at the office. It is obviously more expensive than Cerumite but it might be the only way to resolve the problem.
Mike Richards, DVM
It is OK to give cats cimitedine (Tagamet Rx). The dose is 3 to 5mg per pound of body weight which is about 1/2 tablet per 10 pound cat.
Mike Richards, DVM
Last edited 03/16/07
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