Reptile & Amphibian Forums

Wanted to give a Stanley Update. He went to the vet yesterday (is 15 1/2ish now).

Since the Steriods are working SO well on his brain swelling and his liver number has elevated again slightly since the last check 5 months ago, she is going to have me reduce the steriod slightly (2 days on, one day off, vs. every day).

More notably, his kidney values came back with one number higher than the last check and one number lower than the last check, but the food (Science Diet KD) is esentially holding at a pretty stable value for now... However, he has picked up another problem as a result of the Kidney Failure (CRF), Anemia. I hear Anemia is pretty common side-effect of Kidney problems. The vet is going to have me start on a human anemia med for him (have to get it at a human pharmacy). I am to give him a .1 ml shot twice a week for now and recheck in 3 months. May be able to go to once a week. Practiced giving him a shot at the vets w/sterile water yesterday and it was pretty easy (he's an easy cat to medicate).

I won't start the steroid change or the anemia shots until I get back from Texas in a couple weeks. We agreed no major changes while I am gone to levy on the cat sitter... I want to be around to catch any symptoms of the reduced steroid or new anemia med... She said he'll be OK until then, no worries waiting.

I do have a question for KitKat or anyone else with Anemia experience. Are you familiar with the shots? I can't remember the human meds he can use, but she wrote down erythropoietin. I thought something like Procit and something that started with an "E" as sutible meds... Anyway, I have been reading online about it (Cornell site, etc.) and understand that one side effect of the human drug is that the cats develop antibodies against it and become immune and can even have worse anemia as a result of the antibodies... Is human grade meds a common treatment for feline anemia? Is it fairly commonly practiced? Is it pretty successful? Are there any alternatives to treat? I am assuming not as she prescribed this and she is an excellent geriatric vet. I know MA and KitKat have had experience w/CRF. Any thoughts or experience w/Anemia?

Thanks!!
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Tammy
Stanley and Pookey

Hi Tammy,

Both Procrit and Epogen are used to treat anemia in CRF kitties. Although there is a very minimal risk of cats developing antibodies to these drugs, I would not hesitate to use them on my own babies. Most cats do extremely well and have no problems at all. Where I work we use Epogen and we have several patients on this drug at all times. Presently one of our clinic kitties is on it and doing much better.

I have to say that your vet is really on the ball and I can tell from your posts that she is one to be trusted. She has helped Stanley to be comfortable for a long time without taking any unnecessary risks with his health, and that says a lot.

When it comes time to fill the prescription for Stanley, I would check prices in more than one pharmacy. Epogen and Procrit are both expensive and you might as well get the best price you can. We always keep some onhand since we are a cat practice with lots of CRF patients so we just dispense it from the hospital.

Take care, thanks for the update, and have a great trip!

Regards,
PHKitkat

I would not hesitate to use them on my own babies. Most cats do extremely well and have no problems at all. Where I work we use Epogen and we have several patients on this drug at all times...

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Thanks. I appreciate your feedback -- I was hoping it was a widely used treatment. I feel much better hearing your clinic uses it. I do trust my vet 100% and was planning on going with the drug regardless, but had concerns after really only finding Cornell studies and antibody concerns on the web (expected to see many sites on how well it works with cats with CRF, etc...) It made me believe it might not be widely used since so little was on it on the web... Usually you get a million hits on a subject.

They don't keep the drug at the clinic -- the last she personally priced it was for her sister's cat about 4-5 years ago and it was $100 for 1ml. She thought it dropped in price and ran about $40 for 1ml currently... I am having to special order it thru CVS (pharmacy chain out east). Procit and the E drug (Epogen from your post) run about $60 for 1ml (which is ten .1 doses for Stanley's weight). So, about $6 per shot. For 3 months, he'll get 2 shots a week, then we'll retest and hopefully I can take him down to 1 shot a week. It is great to hear your clinic uses it a lot and has had good results...

I will likely fill this at CVS this first fill, and price it at WalMart and other local pharmacies for the refill... I want to have it on hand the day I return from Texas to start...

I'd like to start him immediately, but since he'll have a cat sitter the last week of this month, won't start until the first week in June. Vet said it was OK to wait...
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Tammy
Stanley and Pookey

I am having a problem finding the anemia meds in a small enough dose for him. They sell the 1ml bottle, but it is single use (could become contaminated with multi-use). He needs to use 10 doses out of it ( .1ml ). Can't throw it away after one shot at $60 for a bottle!

The pharmacy also offers a larger, more expensive multi-use bottle (has stuff in it to block contamination) that would last him several months, but I'd need to get a new prescription and sell my car... Kidding. It is something like $336 for the bottle, but would give him 66 doses...

Waiting on the vet to advise as she wrote out the smaller bottle prescript.

KitKat -- How does your office dispense it?
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Tammy
Stanley and Pookey

Don't forget to check the grocery store pharmacys - the price of my lung meds dropped a bit at the grocery when Walmart annouced their $4 generic drug plan. But when Walmart announced they were opening new locations here, the price dropped like a stone - for a big brand name drug. You may get lucky

Hi Tammy,

What we do is dispense the Epogen already drawn up into syringes for single dose use. We use insulin syringes because very little is used each time and the needles are very small. This is more comfortable for the cat.

Epogen is kept refrigerated and as long as you use sterile technique it's ok to use the bottle until all the medication is gone. Remember this is a human drug and almost all human injectable drugs are labeled for one time use only.

Please let me know if you have any other questions.

Regards,
PHKitkat

Thanks, KitKat.

My vet advised to go ahead and re-use the smaller vial all 10 times (using a clean syringe each time). She's not had problems w/patients doing that.

The pharmacist was great. Made sure I had the smallest insulin needles to use on him and went over how to draw the meds out with me. The vet had done so, as well. I feel pretty comfortable doing it (when I get back from Texas) as I practiced and it was pretty easy. I've been giving Stanley meds for a year or so now, so I am use to man-handling him and he is used to letting me.

My main concern was difficulty finding the meds and then when the pharmacist told me one time use. And I was curious as to how you guys dispensed it as my vet doesn't carry the med.

Appreciate your quick feedback on this. Knowing that you have had good luck with the med in your clinic makes me feel good. I don't know that my vet has a high volume of patients that use it. She did mention when she called back about the one time use vs. multi use prescriptions that one other patient has been on it since November and doing well. His owner works in a pharmacy and uses the small vial until gone, as I will...
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Tammy
Stanley and Pookey

WTG Stanley! Hang in there fella, glow always heading your way..
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PHTessie