CVC Highlight: Your toolbox for troublesome toxicoses in cats - Veterinary Medicine
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CVC Highlight: Your toolbox for troublesome toxicoses in cats
For cats, just a little snack in the garden—or the inappropriate treatment of common ailments by well-meaning owners—can result in an emergency situation.


VETERINARY MEDICINE


KAOPECTATE TOXICOSIS

"I thought I'd try this and see how she was in the morning."

Kaopectate (Chatten Inc.) was not considered toxic to cats until 2002 when bismuth subsalicylate was added. Salicylate is conjugated with glucuronic acid in the liver. So cats are especially susceptible to this xenobiotic. Toxicosis in cats can occur with > 25 mg/kg/day of aspirin (acetyl salicylate or acetylsalicylic acid). A tablespoon (about 15 ml) of regular strength Kaopectate (8.7 mg subsalicylate/ml) given to a 5-kg cat would be the equivalent of 26.1 mg/kg of salicylate. A tablet, which might be more convenient and, therefore, more tempting for owners, contains 102 mg salicylate. A 5-kg cat receiving one tablet would receive 20 mg/kg of salicylate. While both doses are either within or just above the toxic range, many owners will administer the dose more than once a day because the directions on the package instruct the patient to take a dose every 30 minutes to one hour for up to 16 tablets (326 mg/kg) or 16 tablespoon (418 mg/ml). Although it is unlikely an owner will give a cat 16 tablespoons or tablets of Kaopectate, even two or three doses can be fatal for the cat.

Clinical signs

  • Lethargy
  • Vomiting
  • Diarrhea
  • Hematemesis
  • Melena
  • Abdominal pain
  • Severe gastric ulceration and rupture

Treatment

  • Gastrointestinal decontamination with emetics and activated charcoal, if ingested within four hours of presentation
  • Initiate fluid diuresis.
  • Administer gastrointestinal protectants.
  • Evaluate for bacterial translocation from a compromised gastrointestinal tract.

MELOXICAM TOXICOSIS

"It worked for the dog, and Tiger was limping, so..."

The manufacturer of this nonsteroidal anti-inflammatory drug (NSAID) approved for use in cats for various painful conditions (Metacam—Boehringer Ingelheim Vetmedica) recently announced reports of adverse events associated with its use in cats. Renal failure and death in cats were seen with use of the oral suspension formulation.4 A one-time injection after elective surgery is now the only recommended use for this medication in cats.

For more information on approved NSAIDs for use in cats, see the International Society of Feline Medicine and American Association of Feline Practitioner's released consensus guidelines at http://www.isfm.net/toolbox/info_sheets/NSAIDs_guidelines.pdf.

Kristy L. Dowers, DVM, MS, DACVIM
Department of Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Colorado State University
Fort Collins, CO 80523

REFERENCES

1. Rumbeiha WK, Francis JA, Fitzgerald SD, et al. A comprehensive study of Easter lily poisoning in cats. J Vet Diagn Invest 2004;16(6):527–541.

2. Langston CE. Acute renal failure caused by lily ingestion in six cats. J Am Vet Med Assoc 2002;220(1):49-52.

3. Fitzgerald KT. Lily toxicity in the cat. Top Companion Anim Med 2010;25(4):213-217.

4. FDA announces addition of boxed warning to Metacam (meloxicam) labels. Available at: http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm231254.htm.


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Source: VETERINARY MEDICINE,
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