10/30 Bear Man Tapazole overdose

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Linda and Bear Man

Linda and Bear Man

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I found out today, by way of the most casual conversation with the receptionist at my vet, which appears to have initiated a conversation behind the scenes there, that I have been overdosing Bear with twice the dose of Tapazole that he is supposed to be getting. On my last refill on Dec 18, they doubled the concentration of the gel to make it more convenient for me to apply, but never mentioned it to me, and I didn't notice it in the fine print on the package label. I don't know exactly when I started applying the gel from the new box, but he has been getting 10 mg rather than 5 mg BID for at least 10 days. I had been trying so hard to stabilize his T4, and now we have to cut back to his real dose, and not recheck T4 for another 4 weeks. The vet is "not concerned", but this has really upset me. I am trying so hard to hold him together, only to find out that I have probably been doing damage to him. I should have caught that dose change on the label. I am so angry, and just losing it here, and worried about what sort of harm I have done.

History:
Oct 15 Start Tapazole 2.5 mg UID
Oct 29 Increase Tapazole to 2.5 mg BID
Dec 10 Increase Tapazole to 5 mg BID
Dec 18 (approx) Accidental overdose of 10 mg BID
Dec 30 resume 5 mg BID
 
OMG, Linda, I'm so sorry to hear this. They should have told you about the change. Hopefully there isn't any long term effects from this. Keeping Bear and You in my thoughts and prayers.
 
Yikes! (((Linda))) You did have so much going on, please don't beat yourself up. Maybe Cassandra can give an idea of if there is any long-term consequence - I'm crossing my fingers there aren't. Has any b/w been done since 12/18?
 
Don't blame yourself ((Linda)) ((big hugs))

the thought of the unknown can be pretty scary - let's see what the advisors say, ok?
 
OK Bear, let's hope you start to feel tons better now that the mixup has been discovered.
I sure hope there is no long-term effects with the large dose.
I agree that they should have mentioned the change to you.
 
I don't blame you for being pissed.

I just went to read up on what the symptoms of an overdose would be. What I did come across, though, is that Tapezole has a drug interaction with omeprazole which I believe you also give Bear. http://www.drsfostersmith.com/Rx_Info_S ... mazole.pdf

Had you ever thought about a consultation with a veterinary pharmacist/pharmacologist? I've called the vet school near me for info on medications and they are routinely extremely helpful.
 
The vet's office should have made absolutely certain that you knew what dose you were being given. Imagine if a human pharmacist did that!

You'll get Bear Man back on track, I know. At least now you have an answer. (((hugs)))
 
oh christ! i'd be pissed too. but not at yourself. someone should have said something to you about the change. i don't care if we are supposed to read the labels or not, they should have told you too. personally, if his current condition is tied to the od at all, whoever made the change and didn't tell you needs to be responsible for some of the care he gets now. grrrrrrrrrrrrrrrrrrrrrr
 
I'm so sorry Linda, I would be upset too. I'm not sure but I think the gel isn't as strong or effective as the pills, seriously I don't know. Just thinking that if that's the case then maybe this didn't do any harm. I saw Bears video of him looking for litter box, omg I was so happy when he got to it. He's so sweet, ya know we all love the Bear Man and his mama . Who btw is a very great mama Bean . I think they should have told you and that this is not your fault at all.

Really don't be so hard on yourself, they should have told you.
Hugs, Sandy
 
((((Linda))))

The overdose would cause side effects of hypothyroidism - common ones are heat seeking/lowered body temp, lethargy, inappetance, skin changes (dry skin, hair loss), weight gain, weakness, constipation, and myxedema (rarely unless the OD is prolonged, and this was not).

Just keep an eye on him like you normally do. If he did experience any severe symptoms, you could always have the vet supplement levothyroxine for a short time in order to normalize his T4 until the effects of the Tapazole wore off. Luckily you are using the transdermal, and it does take longer to show effect than the oral, so there is a very good chance this will be a non-issue.

You may want to have your vet do a consult with one of the endocrinologists at Michigan State University or Cornell if something like that was necessary. Their endocrinology departments are the best in the US. I don't know what vet schools to refer you to in Canada.

This is NOT your fault. They should have let you know the dose change was done. Please do not blame yourself.
 
Cassandra and Sasha said:
((((Linda))))
You may want to have your vet do a consult with one of the endocrinologists at Michigan State University or Cornell if something like that was necessary. Their endocrinology departments are the best in the US. I don't know what vet schools to refer you to in Canada.

This is NOT your fault. They should have let you know the dose change was done. Please do not blame yourself.
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Maybe contact the Vet university in Guelph?
 
Thanks, Cassandra. He has been losing a ton of hair, but I was brushing that off as a resurgence of his Cushingoid symptoms. Lethargy, inappetance, and weakness are normal for him. I can only pray for constipation. I am wondering about anemia - we were going so slowly with the Tapazole because he was slightly anemic when he started it. The vet, who had her office call me with this news, did not say to bring him in for any tests.
 
(((Linda - Bear))). They should have advised of the difference in the medication. You do a wonderful job with Bear. Do not blame yourself. Can they prescribe anything to offset the overdose? Snowflakes, vines your way.
 
Linda and Bear Man said:
Thanks, Cassandra. He has been losing a ton of hair, but I was brushing that off as a resurgence of his Cushingoid symptoms. Lethargy, inappetance, and weakness are normal for him. I can only pray for constipation. I am wondering about anemia - we were going so slowly with the Tapazole because he was slightly anemic when he started it. The vet, who had her office call me with this news, did not say to bring him in for any tests.
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Because Bear has been on the Tap for awhile, the chances of him developing the blood problems from it have lessened a bit. That may be why they are not quite as worried about it. Usually the major blood, liver, and marrow issues crop up in the first few months. I'm not saying that couldn't happen, of course, but he has been broken in to the Tap a bit, so to speak.

The way Tapazole works, especially the transdermal, it may take a week or two before you start seeing other symptoms of the OD. If it would give you peace of mind (and I know it would me), I would have a CBC and Chem panel run in a week or so just to err on the side of caution. I wouldn't bother having the thyroid tested then, because that will change back and forth with the dose changes. A blood pressure check wouldn't be a bad idea either, and that would cover most all bases.

I know how difficult it can be to differentiate between symptoms of certain diseases and side effects of medications. The hair loss may be a Cushing's response, but could also be from the additional Tap. It will subside if it was a Tap effect, once his T4 stabilizes.

You caught this early. Let me reiterate again that this was NOT your fault. If the pharmacies that provide Sasha's meds had changed the dosage of her pills without letting me know I would be in the same boat. It is their duty to inform you of the change, or the vet to tell you when the dosing was switched. You have a right to be upset. Being vocal about it (sweetly, of course :)), may help for this to not happen to someone else in the future.

I've said this before, but let me remind you - You are one of the BEST mommabeans I know. Any kitty in the world would be lucky as all get out to have a mom like you. So don't you ever forget that.
 
Awwww (((((((((((linda)))))))))))))

Cassandra offers some great thoughts about the issue. Please do at some point follow through with the vet/pharmacy to make sure this NEVER happens to anyone else - EVER! It's so difficult when we give someone we should trust, all of it and then something like this happens. I went through similar stuff with the metacam and Latte. But its not YOU and it was not ME. It is the responsibility of the one dispensing the medication to inform you of changes and/or side effects.

Please be gentle with yourself, and give bear man a great big hug, kiss, or skritch (whichever he prefers ;) )
 
Linda and Bear Man said:
Thanks, Cassandra. He has been losing a ton of hair, but I was brushing that off as a resurgence of his Cushingoid symptoms. Lethargy, inappetance, and weakness are normal for him. I can only pray for constipation. I am wondering about anemia - we were going so slowly with the Tapazole because he was slightly anemic when he started it. The vet, who had her office call me with this news, did not say to bring him in for any tests.
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((Linda)). I am glad that you caught it at all and that it can be fixed. I would *sweetly* ask your vet to call one of the veterinary schools Cassandra suggested to ask them about the long term effects, and also, about the medication interaction someone else posted about?? As for the dosing, it would be like if someone decided to double the calories in a serving of french fries and didn't tell me. I would eat the same portions, but be gaining weight even faster!! How was I supposed to know? Grrr.

I hope the circling stops soon.... and that other thing that Jojo posted about on Facebook with the eyes. Are those side effects of OD on Tap?

((Linda))
 
Oh, wow, so glad this was caught. I think they should offer to do the blood work to make sure everything's ok, and do it free of charge. You're more than a regular client.

((( Linda and Bear )))
 
Linda,

I am so sorry this happened. Like others already said, this is NOT your fault. It's the vet's fault for changing the dose and not giving you clear instructions. Just because something is written on the box, does not mean that you are going to read it, especially if you've been using the same drug for a while. It really is the dispensers responsibility to tell you of any changes, special handling, instructions,etc.

I sure hope Bear doesn't have any adverse effects from this.
 
Hey Linda,
Question- do you see any correlation between the prilosec and bear man's liquid poo?
Im just asking because I was doing my research (as I always feel I need to ;) ) and noticed that can be a side effect, usually on high doses, tho. And its rare. Thought of you when I was reading it. If you want the link I can try to find it...think it was on petplace.com

Hope you are doing okay. Worried about ya!
 
((Linda)) So glad that you caught this! Sounds like you caught it in time...
Sending good thoughts and prayers that Bear will be feeling better soon!

Great advice from everyone..
 
Oh Linda I am so sorry to hear about this. Do not beat yourself up nothing you did wrong. You caught it in time and i am sure Bear Man will be fine. Sending you prayers!
 
Linda and Bear Man said:
I would be interested in what the nature of the reaction between Omeprazole and Tapazole is, and what the serious side effects are.
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I can't speak for the Tap side effects, but on the other side of the coin with levothyroxine, Omeprazole can change/lessen absorption of it (oral form). Interested if there is anything else that could happen.

Omeprazole should always be given at least 4 hours away from other meds & supplements for that reason.
 
(((LINDA))) You are the best momma bean that any of us know--Dont beat yourself up over something that isnt your fault..Bear will be OK, he has survived so much more than this!! We all are victims of lousy vet care or we wouldnt be here!!
Until things are clear, we go along on blind faith..Then we arrive at FDMB & it becomes perfectly clear!
You are all in my heart & wishing for Bear to turn around & be well quickly..
 
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