Feline lower urinary tract disease
This is a hard post to write. And it’s going to be a hard post to read. But please read it. And tell your friends to read it. And help spread the word so this doesn’t happen to anyone else.
On November 10, 2010 I took Holly, my McNab (border collie mix), to see the vet for a limp she’d developed a couple of days earlier. We’d been playing fetch, as we did every night while the kids brushed their teeth. Part of the bedtime routine. She landed funny on one leg while catching the ball and after that began limping. We were heading to California for a quick vacation and decided she needed to be seen to be sure it was going to be okay to board her while we were gone.
The vet — someone we’ve trusted for years and who has literally saved two of our pets’ lives in the last two years — checked her out and prescribed a medication called Deramaxx. He said it was an anti-inflammatory which would help her limp. Because we trusted him, we gave Holly the medicine, no questions asked. He also put her on a diet dog food to help shed some extra pounds so she wouldn’t be carrying around extra weight. Made sense.
The following week, Holly continued to limp and become wobbly. We also noticed she had very bad breath. Still she was eating and wanting to play. However, she was less reluctant to run after the ball when we were playing, or she’d let our other dog, Hannah, get the ball for her. We continued to give her the Deramaxx, hoping it was going to help with this limping and wobbling problem.
Around midnight on November 23 — the Tuesday before Thanksgiving — our cat, Henry, developed a block in his urinary tract, and I took him to the emergency clinic. This was the second time Henry had blocked up — he has FLUTD — so I knew the signs to look for. The doctor at the emergency clinic was unable to unblock him, so on Wednesday, we transferred him to our regular vet, who performed emergency surgery, called perineal urethrostomy. It saved Henry’s life. On Thanksgiving night, the vet called me to say Henry could come home to recover, and gave us instructions for his aftercare. This event was unexpected and had me very anxious, taking care of a sick cat. He had most of my attention during this time.
On Friday, when the vet called to see how Henry was recovering, I mentioned to him that Holly, our dog on Deramaxx, wasn’t eating. The vet suggested she might not like her diet dog food (which she’d been scarfing up like crazy until this point), and that we should mix in some of her regular food. We did and she ate some, but not much.
Over the weekend, she grew wobblier and weaker. She slept a lot. She didn’t want to eat. She had diarrhea. We’d entice her with roast beef and other temptations and she’d eat them reluctantly.
It was over this weekend, I googled “Dermaxx side effects” and found this list of symptoms:
- kidney damage or failure – change in water intake, increased urination, changes in urine odor
- gastrointestinal ulcers/GI disorders – loss of appetite, vomiting, dark of bloody stool, diarrhea, constipation
- liver damage or failure – jaundice-yellowing eyes, skin or gums
- high blood pressure
- lack of coordination
- behavioral changes – restlessness, lethargy
- allergic reaction – scratching, facial swelling, seizures, sudden vomiting or diarrhea, shock
At this point, she had lack of coordination, diarrhea, lethargy and loss of appetite.
On Monday, November 29, I called my vet and made an appointment to see Holly. She could barely get in and out of the car. She couldn’t hold her legs up strong enough to stand on tile. Whenever she wasn’t moving, she’d just lay down because it was easier.
The vet took a blood sample to run tests. I asked him if it was possible the Deramaxx was causing these problems. I told him I’d read some of her symptoms as side effects on the internet. He said no, it wasn’t the Deramaxx. He’d given it to lots of dogs over the years and never had any problems with it or seen symptoms like this in his patients.
I trusted him. We continued to give her the Deramaxx.
I wish I had listened to my gut instinct instead. But by then it was probably already too late.
My last good memory of Holly was Monday night. Even though she was weak and didn’t want to eat, she still brought me a toy to play. I didn’t want to hurt her, so we’d just pass it back and forth to each other. Her sweet face still had that, “Come on, Mom, throw it” look. And when I wouldn’t throw the toy, she’d make a little yip noise at me, as she always did when she wanted to play. We played as best we could that night until bedtime.
Tuesday morning, I let her out to do her business. She was unable to walk back inside. I had to help her walk back into the house. She got inside and immediately lay down and slept with her legs stretched way out straight, which was something I’d never seen her do before. She threw up the previous night’s dinner. I was crying over her when the phone rang. It was the vet with the blood test results.
He said she had kidney failure and hypothyroid. He said her cholesterol was very high, and said sometimes cholesterol could act like clots in the bloodstream. I asked him if he thought she’d suffered something like a stroke, and he said perhaps. He said we had to start giving her fluids and the same kidney supplements we’d been giving our cat (with much success). I told him I wanted to bring her down for him to see her. He agreed he’d keep her for the day and get her on fluids to help her kidneys.
I could barely get her into the car.
I could barely get her out of the car.
She couldn’t walk on the vet’s tile floor. The assistant and I had to carry her back to the kennel, where I scratched her ears and told her I loved her. She couldn’t get comfortable in the kennel. She wanted to stretch her legs out.
The vet was in surgery when I’d arrived, so I didn’t get to talk to him, only with the nurse. Crying, I told her I to tell the vet that I thought the Deramaxx had poisoned Holly. She said she would tell him.
I went home and googled hypothyroidism. I read the list of symptoms:
- lethargy, mental dullness
- hair loss
- weight gain
- dry hair coat, excessive shedding
- hyperpigmentation of the skin
- cold intolerance
- slow heart rate
- high blood cholesterol
OK, I thought, she has hypothyroidism. The vet will get her going on thyroxine and we’ll get her kidneys back up to par like we did with the cat and all will be good again.
The vet called that afternoon and said Holly wasn’t responding like he’d hoped. He said she’d been unable to get comfortable all day. He said she’d been nauseous, so they gave her an intravenous anti-nausea medicine to settle her stomach. He’d done a chest cavity x-ray and saw nothing unusual. He did an ultrasound and found that fluid was collecting in her abdomen. He suspected she had some kind of tumor activity going on that he wasn’t able to see with his x-rays and ultrasound. He made an appointment with an ultrasound specialist for the next morning, and he asked us to take her home and gave us some pain medication to help keep her comfortable. He made a point of showing us her liver numbers on the blood work and insisted this had nothing to do with the Deramaxx. He said she wasn’t showing the symptoms of his regular kidney and thyroid patients. That this was “something else”.
Holly didn’t make it through the night.
We brought home a very, very sick dog. She was bloated and breathing hard unable to get any comfort. We laid her down on a blanket in the living room, told the kids to kiss her goodnight and sent them to bed. My husband and I stayed with Holly all night, listening as her whimpers turned to cries of pain and watching her stretch her legs out and her head back trying to get comfort.
We made a couple of calls to the emergency clinic. We explained the situation, that we had an appointment with a specialist in the morning, but that she was gravely ill. The staff at the emergency clinic said they wouldn’t be able to do much more than the kind of ultrasound our vet had performed. We asked if they thought it sounded like tumor activity, and they said without seeing her they couldn’t know for sure, but that it was a possibility.
We didn’t know what to do, because we didn’t know what we were dealing with. Looking back now, it makes perfect sense, but in the moment, we just wanted her to be well, and we wanted to hold out hope for this specialist in the morning. But it was SO GOD AWFUL listening to her cry out in pain. I can’t even put it into word. The worst sound IN THE WORLD.
Around 3am, Wednesday morning, Holly began vomiting blood. And that was when we knew what had to be done.
My husband took her to the emergency clinic. They immediately administered pain meds and put Holly to sleep. They said we’d made the right decision, that there was no saving her.
Our sweet girl — who up to this point had been a vigorous, beautiful, healthy dog — died of internal bleeding.
When my husband returned home, we sat together and cried and told each other our favorite stories about our Holly.
When the kids woke up an hour or so later, we had to tell them the devastating news.
Later the next morning, our vet called to tell us he was sorry that we’d had to have Holly put down, and that if he’d known how grave she was that he would never have sent her home. He said he suspected an undiagnosed tumor had ruptured or “something put pressure on something until it gave” and caused the bleeding.
I still believed him. Until I googled “Deramaxx deaths”.
And that’s when I read these stories:
- Deramaxx Kills
- Zena (she survived after massive intervention efforts)
- Deramaxx Warning! Dead in 3 Days!
I also found a letter from Novartis — the makers of Deramaxx — to veterinarians, explaining their take on potential adverse reactions to Deramaxx. In their eyes, this drug is safe.
And finally I found this story about Abby and explained the dangers of Deramaxx.
I am 100% convinced our Holly developed gastric ulcers from taking Deramaxx, and like Abby in the link above, developed a perforation in her abdomen which caused her internal bleeding and her death.
I am compiling this information to give to the vet in hopes he’ll see the truth and not let this happen to any of his other patients or their families.
We are devastated. We are in shock. We miss Holly. We don’t know how to grieve her untimely and UNNECESSARY death.
On November 10, she had a limp. On December 1, she was dead. Because of a medication she didn’t even need to be on.
Here is the last picture I took of Holly, the Saturday before she died. She and her sister Hannah were laying in the shade outside. It was her last “good” day.
If you are a dog owner or know any dog owners, please pass this information along to them. Please trust your instincts. Please research any medications you give to your pets.
I wish we had. I wish we’d known. I wish Holly was still alive. She didn’t deserve this. No animal does.
UPDATE December 2010: Saturday, December 4, we talked with the vet. We presented him all of the information we’d found on the internet regarding the dangers of Deramaxx and all of the memorial stories we’d found of dogs who’d died from Deramaxx complications. We told him we were 100% convinced this drug killed Holly. He said the very words we’d wanted to say to him: that while he may have never seen these adverse reactions before in his patients, Holly could be the first case and “one case is too many”. He told us he would read through the information we provided, would contact the drug rep and the manufacturer and would be in contact with us. He showed humility in our exchange. The encounter went much better than I thought it would. I feel like I’ve done what I can, and hopefully this won’t happen to any of his other patients. Maybe I can start moving forward now, and focus on the joy and love Holly brought to our lives.
UPDATE June 2015: Here is an article that explains the science behind the adverse reaction dogs experience with Deramaxx. This is exactly what happened to Holly.