Tapazole problems

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jwr4@webtv.net - 22 Dec 2003 20:22 GMT

My 15 year old tabby began using Tapazole a little over a year ago. He
began to eat better and gained some weight.

A couple weeks ago his progress went downhill and his appetitie greatly
decreased and he has been very quiet. Turns out now his kidneys are bad.
The vet confirmed the Tapazole probably did the damage.

WHY THE HELL WASN'T I TOLD ABOUT THIS POSSIBILITY????

If I had known there was a danger of serious kidney problems I would
have really tried to dig up the money for surgery.

Sparky is now at the vet's getting his kidney's flushed. He has to go
through it again tomorrow. Next week he'll have another blood test to
see how well his kidney's are working. If they can't handle the waste,
the vet said the only other choice will be to kill him (the cat, not the
vet).

Yeah I know there are other terms for it, but it all means the same.

If your vet suggests Tapazole, question him/her carefully about the
danger of kidney failure caused by the drug.

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PawsForThought - 22 Dec 2003 21:48 GMT

>From: jwr4@webtv.net

>My 15 year old tabby began using Tapazole a little over a year ago. He
>began to eat better and gained some weight.
[quoted text clipped - 18 lines]
>If your vet suggests Tapazole, question him/her carefully about the
>danger of kidney failure caused by the drug.

I'm so sorry to hear about your kitty. I would suggest at least getting a
second opinion before you decide on euthanisia.

I hope your kitty gets better,

Lauren
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Helen - 22 Dec 2003 23:24 GMT

> My 15 year old tabby began using Tapazole a little over a year ago. He
> began to eat better and gained some weight.
[quoted text clipped - 18 lines]
> If your vet suggests Tapazole, question him/her carefully about the
> danger of kidney failure caused by the drug.

I can understand your fear and anger, but in fact your vet was being
conservative recommending the use of Tapazole - if you'd had surgery
performed, your cat would probably have had kidney problems much earlier.
I'm surprised that apparently the kidneys weren't being monitored though,
treating hyperT can often unmask latent CRF. More info:

http://www.felinecrf.org/related_diseases.htm#hyperT_treatments

I'd suggest you read more of the site, there are many people who juggle CRF
and hyperT successfully. I certainly wouldn't be considering euthanasia
after only two days on IV - you may well need to treat Sparky at home with
treatments such as sub-Qs for a while before he stabilises.

HTH

Helen

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Laura R. - 23 Dec 2003 02:16 GMT

circa Mon, 22 Dec 2003 23:24:04 -0000, in rec.pets.cats.health+behav,
Helen (helenandcats@DONOTSPAMntlworld.com) said,

> I certainly wouldn't be considering euthanasia
> after only two days on IV - you may well need to treat Sparky at home with
> treatments such as sub-Qs for a while before he stabilises.

I'll second this. My 15.5 year-old, Jacob, was first diagnosed with
CRF two years ago. He's not hyper-t yet, but his thyroid values have
climbed over the past couple of years, so it's on the horizon.

Jacob gets 100ml of Ringer's Lactate every night, and both his
behavior and his bloodwork indicate that he he is *nowhere* near the
point where I'd consider euthanasia. In fact, he's still referred to
as being in renal "insufficiency" as opposed to "failure". As soon as
the signs showed up, he was switched to K/D, and he only recently
began fluid therapy.

While CRF *is* fatal if something else doesn't kill the cat first,
it's not necessarily *immediately* fatal. Get a second opinion as far
as the euthanasia.

Laura

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I am Dyslexia of Borg,
Your a.s will be laminated.

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Cathy Friedmann - 23 Dec 2003 02:28 GMT

> circa Mon, 22 Dec 2003 23:24:04 -0000, in rec.pets.cats.health+behav,
> Helen (helenandcats@DONOTSPAMntlworld.com) said,
[quoted text clipped - 18 lines]
>
> Laura

Right; I third this. It sounds to me - from the OP's post - that perhaps
Sparky is in a renal failure "crash", but he may well pull out of it after
his system's been flushed. And he may be able to do quite well for a
considerable time on sub-Q treatments at home, perhaps along w/ any other
recommended diet &/or treatment. If he pulls through this phase, & sub
cutaneous fluids are then recommended at "x" intervals, the vet can show you
how to give them at home. It's easier than you may think.

I also second what Helen said, re: the Tapazole/methimazole. It's a
conservative & standard treatment (incl. for humans - I take it for
hyperthyroidism) - Vs. surgery or radioactive treatment, & if anything -
AFAIK, it's usually the liver one has to sort of watch out for - esp. when
the med is first started, for possible adverse effects. I don't think the
vet was being negligent - Tapazole's usually the first choice of treatment,
even if the other treatments are later considered.

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble") Paul Simon

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Laura R. - 23 Dec 2003 05:21 GMT

circa Mon, 22 Dec 2003 21:28:33 -0500, in rec.pets.cats.health+behav,
Cathy Friedmann (clfr@adelphia.net) said,

> It sounds to me - from the OP's post - that perhaps
> Sparky is in a renal failure "crash", but he may well pull out of it after
[quoted text clipped - 3 lines]
> cutaneous fluids are then recommended at "x" intervals, the vet can show you
> how to give them at home. It's easier than you may think.

Definitely! The first time I tried to do Jacob's fluids, it didn't go
particularly well because I made such a big deal out of it. Now it's
a nightly ritual that Jacob *wants*. If he feels like it's time for
his fluids, he goes to the spot where he gets them and stares
pointedly at me until I go get a needle out of the freezer and hook
up the line. All I have to do is start lightly picking up the fur on
the back of his neck and he knows I'm getting ready to make the
"tent" that the needle goes into. He immediately lies down and starts
purring, and as soon as the fluids are in, he starts snacking on the
kibble I put down in front of him. I can't get over how docile he is
with the fluid administration, and it's clear that it makes him feel
better. Once you get past the fear of "hurting" your cat by sticking
him with a needle, the entire experience can be very calm and even
pleasant.

Most important, it can significantly lengthen the amount of quality
time your cat has. The veterinarian who prescribed Jacob's fluids
said that they have found that they have the most success with cats
who get daily fluids, even if it's just a small amount like Jacob
gets. When the cat gets daily fluids, s/he doesn't go through that
roller-coaster of dehydration/rehydration, instead maintaining
hydration at a relatively steady rate, which is much easier on the
cat's body.

A crash doesn't necessarily mean that it's the end of the line- in
fact, AIUI, *most* CRF cats crash at some point. I've been lucky in
that Jacob's CRF was caught very early and we've been very proactive
in his treatment.

Laura

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Your a.s will be laminated.

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Arjun Ray - 23 Dec 2003 06:45 GMT

| The first time I tried to do Jacob's fluids, it didn't go
| particularly well because I made such a big deal out of it. Now it's
| a nightly ritual that Jacob *wants*.

That's great. I never got to that point with Scruffy. He plays half
hearted avoidance games at "that time of night", and of late he has
started fidgeting during the fluids, I'm not sure why. But there's no
question that he likes the feeling afterwards - hes' almost beatific in
his mellowness :)

| Once you get past the fear of "hurting" your cat by sticking him
| with a needle, the entire experience can be very calm and even
| pleasant.

Definitely. I *like* the idea of giving him fluids, and I think he
picks that up.

| A crash doesn't necessarily mean that it's the end of the line- in
| fact, AIUI, *most* CRF cats crash at some point.

And, as I understand it, more than once. When Scruffy crashed in
February, he was in for 4 days of IV. About two months ago, there were
some early warning signs, but he pulled through without mishap, tough
customer that he is. Still, I expect that he'll crash again at some
point, and it'll be another round of IV fluids at the vets.

A lot of this is human mental preparation. Your CRF cat *will* crash,
and the odds are that this will happen more than once. Just keep your
head, and once you've had the satisfaction - enormous for me - of seeing
your cat pull through, you'll realize that it will take an awful lot to
finally claim your cat. Until that dread time, keep on truckin'.

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Cathy Friedmann - 23 Dec 2003 16:00 GMT

I found myself in agreement w/ your post, except for...

> Your CRF cat *will* crash,
> and the odds are that this will happen more than once.

Not necessarily. My 2 CRF cats didn't crash.

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble") Paul Simon

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MacCandace - 23 Dec 2003 02:36 GMT

<< A couple weeks ago his progress went downhill and his appetitie greatly
decreased and he has been very quiet. Turns out now his kidneys are bad.
The vet confirmed the Tapazole probably did the damage. >>

I'm sorry about your kitty but agree that he very possibly will improve and
live much longer. My cat is 17.5 and has been on tapazole for 1.5 years and
also has mild CRF. He was diagnosed with that before the hyper-t and, in fact,
once he was diagnosed with hyper-t and put on tapazole, he improved
dramatically. I knew hyper-t can mask kidney disease but I never heard that
tapazole causes kidney damage. Is that correct?

Candace
(take the litter out before replying by e-mail)

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Grinder - 23 Dec 2003 03:10 GMT

> My 15 year old tabby began using Tapazole a little over a year ago. He
> began to eat better and gained some weight.
[quoted text clipped - 4 lines]
>
> WHY THE HELL WASN'T I TOLD ABOUT THIS POSSIBILITY????

Because it doesn't exist. You probably misunderstood what you were
told. Tapazole does'nt cause kidney problems but hyperthyroidism masks
them in part by accellerating kidney function. With some cats,
completely controlling the hyperthyrodism causes the problem with
degreaded renal function to become a bigger problem.

> If I had known there was a danger of serious kidney problems I would
> have really tried to dig up the money for surgery.

Wouldn't have helped his kidney problems. Might have made it harder
to control them. Cats with both CRF and hyperthyroidism are caught
between a rock and a hard place-treating both is often a balancing
act.

> Sparky is now at the vet's getting his kidney's flushed. He has to go
> through it again tomorrow. Next week he'll have another blood test to
[quoted text clipped - 6 lines]
> If your vet suggests Tapazole, question him/her carefully about the
> danger of kidney failure caused by the drug.

Completely unnecessary. Quesion him instead about the possibility of
CRF (which any decent vet would know to investigate) and how to best
control both conditions if the cat has both.

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Phil P - 23 Dec 2003 09:05 GMT

> My 15 year old tabby began using Tapazole a little over a year ago. He
> began to eat better and gained some weight.
>
> A couple weeks ago his progress went downhill and his appetitie greatly
> decreased and he has been very quiet. Turns out now his kidneys are bad.
> The vet confirmed the Tapazole probably did the damage.

Unlikey... Tapazole can cause a variety of adverse effects.... but kidney
damage ain't one of them.... You need to find another vet.... A.S.A.P.

> WHY THE HELL WASN'T I TOLD ABOUT THIS POSSIBILITY????

Your vet should have explained to you that hyperthyroidism can mask
underlying renal disease by falsely elevating kidney function - and that
hyperthyroidism can delay the onset of clinical signs of CRF. In all
likelihood, your cat's hyperthyroidism probably augmented deteriorating
kidney function for the last few months.

> If I had known there was a danger of serious kidney problems I would
> have really tried to dig up the money for surgery.

Bad idea. There's a high fatality rate associated with thyroid surgery -
Its crucial to save at least one of the parathyroid glands associated with
the thyroid glands -- maintaining that microscopic blood supply to those
tiny little organs can be very tricky - even for seasoned surgeons with keen
surgical skill and vision. Even so, there's always a question of how well
the parathyroid glands will function after surgery -- if they fail the cat
could have a fatal seizure from a severe drop in blood calcium. Nope...
surgery is absolutely the *worst* treatment option.

> Sparky is now at the vet's getting his kidney's flushed. He has to go
> through it again tomorrow. Next week he'll have another blood test to
> see how well his kidney's are working. If they can't handle the waste,

His appetite should pick up as his BUN comes down... Uremia makes a cat feel
queasy and not very much like eating.

If he's able to urinate without a problem after fluid therapy, he's probably
in polyuric renal failure -- fluid diuresis should improve his renal numbers
and overall clinical condition fairly rapidly. However, after initial
diuresis has begun, fluid therapy should be used only to maintain hydration
and replace ongoing losses -- and not as "dialysis". Fluid therapy makes
the indivudual nephrons in the kidneys work harder which can actually
contribute to the progression.

the vet said the only other choice will be to kill him (the cat, not the

> vet).

Bullsh!t! There are other alternatives... Your vet screwed up - he's just
rying to cover his a.s. Btw, no need to explain what you meant - I don't
have a problem with the "other" meaning... I'm not as forgiving as most
people are with their incompetent vets...

> Yeah I know there are other terms for it, but it all means the same.

In this case... incompetence and probably negligence....

> If your vet suggests Tapazole, question him/her carefully about the
> danger of kidney failure caused by the drug.

Your vet has misled you. Tapazole does not cause kidney failure. Tapazole
or any treatment for hyperthyroidism can unmask kidney failure in cats with
underlying CRF.

Please seek a second opinion and do not opt for killing you cat on the word
of an incompetent vet.

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