Trink's home but needs a TON of after-care (long)

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Traci and Boomer

Traci and Boomer

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Hi Friends-

Boy, I had no idea how much care poor little Trink would need after this horrible ordeal. I went to the ER hospital after work to get her and I had about an hour long chat with the vet tech about her needs for the next 4 weeks. I'm not sure what I was thinking, but I didn't think it would be this much and that she'd look THAT bad. Holy crap!!!!

The good news is that her pain is being managed very well by the bupe. It seems to konk her out...thank goodness because is she a wiggle worm. I was shocked when I saw her leg. It's shaved up to her back and very bruised. Her poor foot is double it's size. The incision is about 3 or more inches long and closed with staples. She's got a collar on to prevent her from licking it. Her appetite is GREAT which makes me SUPER happy.

She needs her incision cold compressed 3-4 times a day. She gets the bupe twice a day and metacam one time a day. She needs her leg exercised in 3 different ways, "physical therapy" 3-4 times a day. At first I wasn't sure I'd be able to do this - it's so scary to touch something that looks so painful. She's not in pain though so I'm able to move it around without her squealing. I've discovered that if I give her treats she'll lay down for me and let me do it....otherwise she won't stay still. She can not run, play or jump for 4 weeks. I've got a cage in my bedroom that I could fit in. It's got everything in it - food, bed and LB. This keeps her safe and is a GODSEND! My landlords are letting me borrow it.

Merlin is okay-he knows she's home but doesn't go in her room. He's very curious and nervous. I feel bad for him because she's getting all the attention and he's not allowed to be part of it. The leg is still broken and being help together by the plate so we have to be VERY careful.

The best part of this whole ordeal is that Dave, my long time BF is being very, very helpful and hands-on with BOTH cats. His help is so key to my sanity. He's out of work right now so he's at my house playing cat nurse. I am SO lucky.

Trinket's exrays - the red circle is the break. There also is a little hole that needs to fill in with bone.
 

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Traci,

That poor baby, I feel so sorry for her. I can not imagine what you and Dave are going through right now. Thank goodness you have Dave. I will be saying prayers for all of you. Ask the other members about giving cats Metacam, I read somewhere that you are not supposed to give that to cats. But please inquire on the board for more input from other members. The bup. is great though, gave it to my poor cat(GA) when she had a lung tumor.

Terri
 
Traci - NO DO NOT GIVE METACAM!!!!!!!!!

This is the biggest no no for cats! Stop giving it immediately. I have all the links as to why at home and will forward later, but STOP don't give metacam.

This is off label in cats and can severely harm and kill a cat.

Stefani and Toonces and Linda and Bear Man can tell you all about it.

They both have first hand bad experience.

I'll look for other discussions in the meantime.
 
Animal bones heal very fast, particularly cat bones. The last time I had my cats in for a checkup, the vet had just finished surgery on a dog with a broken leg, and he was in a real stew because the owner had delayed bringing the dog in for a few days (just a few - 2? 3?) and the bone had already started fusing, so the vet had to rebreak the bone and remove a little to make the ends of the bone fit right. So if 2 or 3 days delay had let the bone start to fuse in that case, I bet Trink's leg will start fusing in a similar amount of time. It'll still need lots of care - I don't mean to imply otherwise - but within less than a week, you won't still have a fully-broken bone on your hands.

Once she starts feeling better, watch carefully that she doesn't get to worrying those staples. She doesn't need a staple in her tummy!
 
what you describe about the way it looks and the cage setup sounds just like Spazzie's way back when. hers was bruised from top to bottom on the inside of her leg and she was shaved from her spine on down and around onto her belly a little too. when Spazzie's hair grew back, it was a different color on her tummy than the rest of her and coarser up on her spine. you could stand her spine hair up like a mohawk :-)

i don't recall ever being told about doing physical therapy for her but then again, times have changed since hers was broken. thank goodness Dave is helping out for sure.

fwiw, metacam may have a warning for use in cats but it can be used without problems, as long as kitty is otherwise healthy and dosing is appropriate and not overdosed. maybe make sure the vet who prescribed it is aware of the problems with it and that the dose is not too much. and if there's another drug that will work just as well maybe ask to switch if the idea of metacam worries you too much.
 
Traci,

I'm sure little Trinket will heal up well. Your cage setup for her sounds ideal.

Hopefully, Merlin won't feel too bad about not being able to play with her for a while.

Best to both of them, and to you.

Claudia
 
Hi Traci .. boy I can't believe how bad her leg must look! Poor little kitty .. and poor merlin too, for being nervous and unsure of what is going on .. Glad to hear the bupe is helping her keep calm, hopefully her leg starts healing up fast .. As far as I know, metacam has a black box warning label on it for the use in cats .. Carolyn (latte) had a very bad experience with it and I believe they pushed and pushed to help get the black box warning label on it .. You might be able to look up her name and then check out the links in her signature ...

Hugs to you all!
 
Glad she is home and cooperating for now. You will know when she is better when she decides she doesn't want to cooperate any more ;-)

Metacam is contra-indicated for use in cats. Even those who believe it can be safely used in a single emergency use situation, do not believe it should be used on a continuous basis. I would do some research and talk to the vet about an alternative. I think it was Metacam that caused all the organ damage in Latte of Carole and Latte too wasn't it??

Cats can't metabolise NSAID the way people do so it builds in their organs and become toxic. If you need to give it, it shouldn't be closer than 48hrs, no longer than 7 days, and keep the fluids flowing through her.

The UofMN prescribed a NSAID to Smokey when we were down there. Though it wasn't Metacam, but an older school one I believe, the insert that came with it said not to give it to cats! After discussing it with my vet, we decided to try one dose and see how she handled it. I could hear her stumach gurgling from sitting at the computer and she was laying behind a chair 7 feet away and it did that throughout the even. Did we have any bad side effects? Who knows. That was last nov or dec. She now has pancreatitis and her liver doesn't look right on ultrasound with the biopsies saying the results look like hepatitis (not sure where she'd have picked up hepatitis). Are the changes from the drug? No way for us to know one way or the other since she caught calicivirus right before that too, but her organs had definitely taken turn for the worse 6 months later.
 
Hey Guys-

Thanks for your posts. Regarding the metacam - I just called Dave cuz he's her nurse right now. Trink has 3 more doses on the metacam and her dose is .1 ml a day which seems like a teeny tiny amount.

I remember Carolyn and Latte's story and Stephanie and Toonces. I'm guessing their cats would have been on it for much longer and the wrong dose, no? Why on earth would an educated surgeon from a prestigous referral hospital give her something that could put her in danger? My head is spinning. I'm going to PM Jess to see what she thinks.
 
Oral Metacam is approved in Europe for felines and has been successfully used for many years. Like most drugs, it can have adverse side effects for some felines.
 
Thanks Mel, this is helpful. Trinket is getting the liquid form which as far as I can tell from the Metacam site is ONLY for dogs. I just called Metacam and the customer serice person said it is considered off label for cats but vets in the US can and do prescibe it. It is available in Europe for cats. Testing for the product has to be done in the US for it to be approved here and it's not been done here. I asked her straighy out if the reason why is that it can cause kidney failure and she said it can but it depends on many different factors. I will call her surgeon next....okay surgeon isn't there today so I left a message. I talked to the pharmacist and he says that even though it's not approved for cats in the US it's used all the time.
 
Larry and Kitties said:
Oral Metacam is approved in Europe for felines and has been successfully used for many years. Like most drugs, it can have adverse side effects for some felines.
Click to expand...

Thanks Larry. It's hard to know what the "right" thing to do is.
 
Another member joined the FAF board this week with acute renal failure after a single dose. Her cat is dying and she is struggling to save him. I wouldn't use it under any circumstances in a young healthy cat. In an old terminal cat with quality of life issues - yes. It is horrible and has made me so depressed reading about it. I'm resentful that vets even stock it and provide it to cats.
 
My vet will use Metacam on a post surgical one time only basis but otherwise refuses to prescribe it ....... apparently he has had some bad experiences. I certainly would be cautious.

Poor little Trink.....sure sounds like you will have your hands full for awhile. It's great that you have some help with this!
 
hi Traci,
Im really sorry to hear about the situation with your kitties. I hope healing goes well and they both go back to being best friends!

I was alerted to this post and thought I would take a moment to stop by to talk about the metacam.

Yes, Latte was a survivor of acute renal failure from the use of metacam. THough she did have kidney disease the remainder of her life.

Yes, myself and others fought for years to get a black box warning which DID happen. A black box warning is the most serious warning given by the FDA. It is given when the potential undesirable effects ( often serious or life threatening) do not outweigh the benefits. OR, as a reminder that using it properly can greatly reduce the potential for serious/life threatening reactions.

But no, I am not going to tell you to use it or not. My stance over the years is to educate, inform and let pet owners make the best decision for their companion animals. If you want my personal experience and how it effected Latte's remaining years, myself, and what I learned about drug companies...well that would be a good pm or different topic all together. ;-)

One important thing to consider is that the formula used in the U.S. is of higher concentration than what is used in the U.k. When U.S. vets go off U.k. dosing guidelines and do not account for the higher concentration, they are effectively overdosing. There is a narrow therapeutic safety margin. This means the smallest misjudgment in dosage can lead to a life threatening emergency. Over the years, with all the stories I have heard, this seems to be a great contributor to adverse reactions.
Here is a link to dosing in the UK
http://www.noahcompendium.co.uk/Boe...Ds-mg_ml_Oral_Suspension_for_Cats/-40679.html
*you will not find anything like this for the U.S. because it is off label (cannot promote its use or dosage).*

I will also share a link for you regarding adverse reactions to look for:
http://www.noahcompendium.co.uk/Boe...Ds-mg_ml_Oral_Suspension_for_Cats/-40680.html
*again, you will not find this in the U.S. You will find client information sheets for dogs and for the use of injectible in cats*

For anyone reading this, it is vital before you give metacam (or any NSAID) to have a blood panel done PRIOR to and a week or so AFTER using metacam. If using it regularly, than regular bloodwork would be called for. If there are any kidney issues, it is HIGHLY recommended to find an alternative. Only if there is no other alternative would you want to go this route. Please also make sure kitty is very well hydrated (during surgery and while on the medication).

In my signature is a link to a somewhat 'controversial' site called "Metacam Kills". I keep this link readily available, not only because it shares stories of kitties who had one dose, to those who were on it long term, or even over dosed...but because in the very beginning are some important links. You will find a link to the letter from metacam to vets regarding the black box warning and other changes in their label having to do with safety. You will also find a client information sheet for both the oral and injectible. This sheet will list symptoms you should watch for if your cat has been given metacam. Sadly, your vet will probably not offer any of this information to you. Take these symptoms seriously and act immediately. Its much better to be safe than sorry.

I know this is a lot of information. But I find it extremely important to make well informed choices after our experience, and I want everyone and anyone to be able to avoid what we had to go through if possible.

If you have any other questions, feel free to ask. I wont be around the rest of the night, but I could chime in a little more tomorrow.

I hope you all have a restful night in your household!
 
Hi Traci - Just getting in from work. I didn't want to further upset or cause you any stress. I knew there were issues and several members had problems and well before you give or don't give, wanted you to be sure you had information to make your own decision.

While I may have gone overboard with the big bold letters, I didn't want this issue to be overlooked. I don't know a lot about it, just what I've read on here and see that Carolyn has provided you with good, relevant information.

If it were me, I'd ask about other drugs that could be used and then after reading everything decide what to do.

I also wanted to say, I'm happy to hear that she is home and very sorry that this happened.
 
Hi Traci

The Metacam decision is personal. I did use it in my healthy cat after he had a ton of teeth and tooth root fragments dug out of his mouth (all four quadrants). Two doses, two days. It works for pain and inflammation. It may be the combo of Metacam and Buprenex that are keeping her so comfy. You can delay tomorrow's dose and see how she feels, if you're worried. Having had orthopedic surgery, I can tell you that opioids alone didn't cut it for me but you can see how it goes with her.

As Larry mentioned, Metacam has been used for years in Europe without leaving a trail of renal kitties behind. Perhaps it has something to do with how it's used, or the formula (they do have a less concentrated liquid formulation specifically for cats which might make it harder to mis-dose), or it could be that there is a genetic quirk in some cats on this side of the pond which makes them susceptible to a horrible yet idiosyncratically dramatic reaction. The FDA recently approved a new NSAID for cats in the US but it is not yet on the market; hopefully this one will be a good option for all cats.

The bruising is so dramatic isn't it? It's amazing what's underneath the fur.
 
Thanks Jess for your information. I've just reviewed all the procedures/meds she got while in the hospital and saw that she also got a shot of metacam pre-op. :? This of course adds to my stress and confusion.

I did talk to a surgical vet tech who tried to assure me that all of the is standard. Before they gave her any meds they did a blood panel and everything was normal. They also have her on what's considered a "low dose", though I can't find dosing information for cats. nailbite_smile

Her swelling has gone down quite a bit. She did a lot of walking around in the kitchen earlier and she's resting now. Overall she's doing well.

Merlin has been good, though very cautious and confused. I've moved her out to the living room so she has a view out my back doors to see plants, birds and stuff. We cover her cage so Merlin can some out for short periods of time. He's in my bedroom right now with the door closed. It's hard to know how to do this. We have let them look at each other briefly a few times today while he was held and she was in her crate. She seemed scared the first time. The next few times not as much. I'm thinking of using an AC to help smooth out this situation. Frankly I'm scared because I nervous to hear what they are going to say. They are both still freaked out by what happened. :sad:

Still don't know what I'm going to do about the Metacam. THere are two doses left. I'm thinking of skipping tonight's and seeing what the leg looks like (swelling) in the AM.
 
Traci and Boomer said:
I did talk to a surgical vet tech who tried to assure me that all of the is standard. Before they gave her any meds they did a blood panel and everything was normal. They also have her on what's considered a "low dose", though I can't find dosing information for cats. nailbite_smile
Click to expand...

Traci- here is what I posted above about dosing:

One important thing to consider is that the formula used in the U.S. is of higher concentration than what is used in the U.k. When U.S. vets go off U.k. dosing guidelines and do not account for the higher concentration, they are effectively overdosing. There is a narrow therapeutic safety margin. This means the smallest misjudgment in dosage can lead to a life threatening emergency. Over the years, with all the stories I have heard, this seems to be a great contributor to adverse reactions.
Here is a link to dosing in the UK
http://www.noahcompendium.co.uk/Boe...Ds-mg_ml_Oral_Suspension_for_Cats/-40679.html
*you will not find anything like this for the U.S. because it is off label (cannot promote its use or dosage).*
Click to expand...
And please remember you cannot go off this dosing. It is NOT relevant due to the different concentration we have. Aside from the calculations you would have to do, there are too many other unknown factors.

I have often wondered if metacam would be a safer drug if it were just approved (YES,*I* said that ;-) ), because then a standard and potentially safer dose could be determined which would be used across the board.

Its good the inflammation is down! if you are nervous about the metacam and inflammation stays down, maybe talk to them about other pain management options...they are out there! My foster kitty is just about 1yr. She had her eye removed about a month ago. The vet used bupe for that. Other vets use fentanyl patches for things such as that, dentals, etc. Im not sure if either of those would be appropriate for a broken leg and a young kitty? Maybe Jess could address the options and you could talk to the vet about them? Just hate to see kitty in any pain, ya know!

If you think an animal communicator would be a good idea, I say go for it! I think all of us who have used them before had that fear as well...are they going to tell us something which will make us feel worse? In the end, they are usually pretty good at relaying the message in a way that we can help our kitties rather making us feel bad.
 
Hi Carolyn-

Thanks for that link on the dosing. Dave and I converted her weight (6lbs) to kilograms and then multiplied her weight in kg's x 0.05 and got 0.136 as the dose in the UK. The dose they put Trink on is 0.1.

I gave her 2 doses of 0.1 over the last two days. She's supposed to get it for four days. I skipped tonight because I couldn't make up my mind what to do. If her inflamation is back tomorrow I'll have to come up with something. Maybe give her half her dose or something like that? She is on bupe also. That is just for pain. He leg looks great and so does her incision. Her foot used to be double it's size, now it's about normal. She's walking on the leg and she had two "play" sessions today - "play" =walking around sniffing things batting around a mouse in a track. Nothing major. She's eating pretty well still and finally pooped. She seems happy and purrs a lot which makes me very happy too.

We've been working on light integration....letting then be in the same room supervised. She's still scared. When she first sees him you can see her react a little and then she seems to relax a bit. We hold him and keep him at a good distance just let them see each other without extended eye contact.

This is so depressing for me. They were best friends. I was SO thrilled that they seemed to be a perfect match. She was the alpha....miss confident and he followed her around fascinated. I want this back!
 
Just read this yesterday and you have my wishes and prayers for a quick recovery. Poor Trinket, and poor Merlin, too. I know he didn't mean to do this. One time I had Kaely and Shi out in their harnesses and the cat from across the street came over. Kaely got so mad she attacked Shiloh. I got the worse of it as I got in the middle to save Shi.

I think this will work out if you give it time. It's a good thing you took Trink to the hospital when you did. Keep us posted, Traci. Donna
 
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