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mrsgreenjeens Agreed, but the main thing is making Dusty feel better.
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Urgent: Anti-anemia shot 9 times overdosed on late-stage CKD cat
- Thread starter tommy2015
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Oh yes, OF COURSE! First things first
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- #23
Thanks. Tomorrow （Monday）morning we will first call the Gulf Coast Specialists to urge them to treat Dusty immediately, hopefully free of charge, as they made all these troubles. If they refuse, then we will have to go to the family vet. Now we've realized how inexperienced the family vet is, but at this stage we may not have time to switch to another one.
Dusty still eats, urinates, and poops today, but ate much less than a few days ago. The most concerned part is she's become much less active. When we tried to play with her, she mostly just wagged her tail.
Dusty still eats, urinates, and poops today, but ate much less than a few days ago. The most concerned part is she's become much less active. When we tried to play with her, she mostly just wagged her tail.
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Why not take her to the emergency vet?
As far as i am concerned, the vet who overdosed your cat is liable for any and all medical damages that occur due to the overdose.
The problem is your cat was already sick to begin with, so the vets can say it is "not their fault" as her declining condition may not be due to the shot but due to the underlying disorder. Regardless, I would take your cat to the emergency vet and call the local university veterinary hospital to consult on the case, as this overdose could very well be the reason your cat is going downhill.
Overdosage of Darbepoetin can cause serious heart issues in people. Overdose may also cause polycythaemia (or high red blood count), or hypertension, blood clots, congestive heart failure, strokes, or heart attacks. These effects usually occur when red blood cells increase too much or too quickly. If red blood cells increase too much during treatment, overdose treatment may involve removing blood.
I would want recent bloodwork done ASAP, as that will tell you how badly she has overdosed or if she is sick from the overdose rather than the kidney failure.
As far as i am concerned, the vet who overdosed your cat is liable for any and all medical damages that occur due to the overdose.
The problem is your cat was already sick to begin with, so the vets can say it is "not their fault" as her declining condition may not be due to the shot but due to the underlying disorder. Regardless, I would take your cat to the emergency vet and call the local university veterinary hospital to consult on the case, as this overdose could very well be the reason your cat is going downhill.
Overdosage of Darbepoetin can cause serious heart issues in people. Overdose may also cause polycythaemia (or high red blood count), or hypertension, blood clots, congestive heart failure, strokes, or heart attacks. These effects usually occur when red blood cells increase too much or too quickly. If red blood cells increase too much during treatment, overdose treatment may involve removing blood.
I would want recent bloodwork done ASAP, as that will tell you how badly she has overdosed or if she is sick from the overdose rather than the kidney failure.
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Agreed with Sarah Ann. But its already Monday, which in the post is tomorrow which is now today. Hopefully Dusty is being treated now. I think even a normal non-kidney cat would have some issues given it being over-dosed at 9 times the dosage. I'm sorry Dusty has not received adequate care from the ones who did the damage. They pretty much seem to be afraid to touch her realizing what they've done.
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@tommy2015 Any updates on Dusty?
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- #27
Thanks for asking. Dusty is at the family vet now for IVF. Her recent CRE is 8.2, the red blood cell is said no change, and the blood pressure is normal. A bad news is she may have a serious heart problem. In the past few days she started to develop a strange noise in breathing. Tomorrow there will be an ultrasonic to explore more.
It seems after over one week the overdose produced almost ZERO effects in terms of blood pressure and red blood cell count. How could that be? The red blood count responded to the first week's Darbopoetin shot (in correct dose), and then made no response to the 9 times overdose? I don't have the detailed results yet. Will see to it tomorrow.
We contacted the Gulf Coast Specialists. Their admin called back and argued that Dusty's downhill was not related to the overdose. They didn't accept our suggestion to provide free medical care to pull Dusty through this round of slump, and was willing to reimburse the expense for our last visit.
It seems after over one week the overdose produced almost ZERO effects in terms of blood pressure and red blood cell count. How could that be? The red blood count responded to the first week's Darbopoetin shot (in correct dose), and then made no response to the 9 times overdose? I don't have the detailed results yet. Will see to it tomorrow.
We contacted the Gulf Coast Specialists. Their admin called back and argued that Dusty's downhill was not related to the overdose. They didn't accept our suggestion to provide free medical care to pull Dusty through this round of slump, and was willing to reimburse the expense for our last visit.
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Hey again Tommy, glad your rDVM can help Dusty at least. ECG lines should be attached to her limbs constantly, with readings of her heart rhythm so they can hear and see any arrhythmia or premature ventricular contractions, which injectable and oral drugs can treat.
With strange noises upon auscultation, she really should see a cardiologist.
The onset of symptoms many days after the injection is not a coincedence. She had lethargy and anorexia after darbepoetin toxicity, a huge concern. This is your rationale. Administration "being willing" to refund your last visit's total fees is unsufficient. Ignore this, and prepare your paperwork legally. Your rDVM should have documented in Dusty's medical record that rather than the volume they logged for their 2nd injection of her Aranesp she truly received XmL, or Xmcg.
"I administered Xmcg 5/23 per the instructions on the bottle's label. Depletion of the bottle at the last visit was discussed with the owner. I recommended the owner contact the internist at Gulf Coast Specialty regarding the erroneous label of the prescribed injectable drug, and reviewed the symptoms of erythropoetin toxicity with the owner, including, but not limited to, hypertension, cardiac insufficiency, cardiac overload, bone marrow insult, spleen and kidney damage, fever, tachycardia, etc. Our treatment now, some clinical signs developed in the last 24 hours, are: intravenous fluids at <rate>, blood pressure monitoring, PCV/TS monitoring, heart rate and rhythm monitoring, respiratory rate and effort monitoring, etc"
All copies of medical records should be thorough as such. These medical records are your proof of GCVS' negligence, Dusty's veritable emergent status, and their lack of response. Ensure, in private conversation, your rDVM has learned from this error, will read labels closely, interpret the dose, and recognize a label error better in the future; is more comfortable with Aranesp and Epogen use in the future; both to the advantage of their medical practicing and their patients. Have a real conversation with them, hear what they thought they administered, what was going on that day, how they felt about it and their reaction, and their future protocol changes.
With diuresis, hope they get her creatinine down while her PCV/HCT holds steady. Is her potassium, K, normal, and her phosphorus within normal limits still also, after such insult and stress to the blood? Kidneys filter blood. It's just ridiculous the internist wouldn't want to follow up with Dusty in earnest. You're obviously not an ambulance chaser, didn't argue treatments or procedures during your first visit or your second, so you're not looking to mistrust doctors and point fingers to accuse them of negligence or malpractice and sue. They brought this on themselves, and no amount of backpedaling or over-rationalizing their actions, or hiding/lying about their treatment, will change what happened.
Hope Dusty maintains, and continues to show us what a determined, stubborn old lady she can be ;] Sweet, but strong. Don't mess with the refined and aged queens, puny humans!
Hugs, Becky
With strange noises upon auscultation, she really should see a cardiologist.
The onset of symptoms many days after the injection is not a coincedence. She had lethargy and anorexia after darbepoetin toxicity, a huge concern. This is your rationale. Administration "being willing" to refund your last visit's total fees is unsufficient. Ignore this, and prepare your paperwork legally. Your rDVM should have documented in Dusty's medical record that rather than the volume they logged for their 2nd injection of her Aranesp she truly received XmL, or Xmcg.
"I administered Xmcg 5/23 per the instructions on the bottle's label. Depletion of the bottle at the last visit was discussed with the owner. I recommended the owner contact the internist at Gulf Coast Specialty regarding the erroneous label of the prescribed injectable drug, and reviewed the symptoms of erythropoetin toxicity with the owner, including, but not limited to, hypertension, cardiac insufficiency, cardiac overload, bone marrow insult, spleen and kidney damage, fever, tachycardia, etc. Our treatment now, some clinical signs developed in the last 24 hours, are: intravenous fluids at <rate>, blood pressure monitoring, PCV/TS monitoring, heart rate and rhythm monitoring, respiratory rate and effort monitoring, etc"
All copies of medical records should be thorough as such. These medical records are your proof of GCVS' negligence, Dusty's veritable emergent status, and their lack of response. Ensure, in private conversation, your rDVM has learned from this error, will read labels closely, interpret the dose, and recognize a label error better in the future; is more comfortable with Aranesp and Epogen use in the future; both to the advantage of their medical practicing and their patients. Have a real conversation with them, hear what they thought they administered, what was going on that day, how they felt about it and their reaction, and their future protocol changes.
With diuresis, hope they get her creatinine down while her PCV/HCT holds steady. Is her potassium, K, normal, and her phosphorus within normal limits still also, after such insult and stress to the blood? Kidneys filter blood. It's just ridiculous the internist wouldn't want to follow up with Dusty in earnest. You're obviously not an ambulance chaser, didn't argue treatments or procedures during your first visit or your second, so you're not looking to mistrust doctors and point fingers to accuse them of negligence or malpractice and sue. They brought this on themselves, and no amount of backpedaling or over-rationalizing their actions, or hiding/lying about their treatment, will change what happened.
Hope Dusty maintains, and continues to show us what a determined, stubborn old lady she can be ;] Sweet, but strong. Don't mess with the refined and aged queens, puny humans!
Hugs, Becky
The chest ultrasound, specifically echocardiogram, will convey more information than a chest Xray, by a cardiologist. See if Memorial-610 Hospital for Animals http://www.mem610.com/services/cardiology.php can monitor her with their upgraded cardio monitoring equipment, as they seem to have a good AAFP gold cat clinic record also, and may be a good future rDVM. Then, she can be referred to a board certified cardiologist if warranted. I've seen a good cardiologist pull a severely tachycardic cat away from death, and a chronic VPC throwing Briard into normal rhythm and rate. Katy Freeway Emergency Clinic (VERGI) and the Animal Emergency Clinic on the West Loop South are the ER/critical care hospitals Memorial-610 uses for overnight, then their patients transfer back to them if stable enough.
Their philosophical position statement:
Memorial-610 hospital for Animals was the first Gold Level Cat Friendly Practice establshed in Texas. We provide education to cat owners to increase their understanding of feline behavior, the value of veterinary care and the need to actively participate in their cats’ individual healthcare plan. We attempt to minimize the stress the veterinary visit places on both clients and feline patients. We also strive to address the distinct needs of cats, including facility environment, equipment, staff knowledge, and feline friendly handling.
reads better than GCVS:
We consider GCVS to be an extension of your primary veterinarian, and work closely with them to provide advanced diagnostic procedures, sophisticated technology, and the exceptional skills of our many board-certified specialists. Combined with the exciting opportunities for veterinary specialty medicine and our hospital’s vision, our goal is to provide incomparable service to our clients, patients, and the veterinary community. We constantly strive to enhance each patient’s care using cutting-edge technology, innovative thinking, and a state-of-the-art facility. As members of your family, pets deserve nothing less than the best care available. Our priority lies with giving you and your family all the support you need – through communication, care and compassion. We are committed to being Houston’s Veterinary Medical Center.
They obviously don't adhere to or personify their position statement.
Their philosophical position statement:
Memorial-610 hospital for Animals was the first Gold Level Cat Friendly Practice establshed in Texas. We provide education to cat owners to increase their understanding of feline behavior, the value of veterinary care and the need to actively participate in their cats’ individual healthcare plan. We attempt to minimize the stress the veterinary visit places on both clients and feline patients. We also strive to address the distinct needs of cats, including facility environment, equipment, staff knowledge, and feline friendly handling.
reads better than GCVS:
We consider GCVS to be an extension of your primary veterinarian, and work closely with them to provide advanced diagnostic procedures, sophisticated technology, and the exceptional skills of our many board-certified specialists. Combined with the exciting opportunities for veterinary specialty medicine and our hospital’s vision, our goal is to provide incomparable service to our clients, patients, and the veterinary community. We constantly strive to enhance each patient’s care using cutting-edge technology, innovative thinking, and a state-of-the-art facility. As members of your family, pets deserve nothing less than the best care available. Our priority lies with giving you and your family all the support you need – through communication, care and compassion. We are committed to being Houston’s Veterinary Medical Center.
They obviously don't adhere to or personify their position statement.
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So very sorry to read this news. We will close the thread now out of respect for your loss. Please consider, if you wish, posting a tribute to your sweet kitty in our Crossing the Bridge forum: http://www.thecatsite.com/newsearch?search=crossing+the+bridge
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