Dear Dave,

I'm beside myself.  It's been five weeks since Daisy died .  Not only did her death leave a huge hole in my life, but I feel as if it was totally avoidable , in spite of her vet's assurance that meloxicam was "approved" for pain relief in cats . 

Daisy had arthritis, and it was causing her some pain.  I took her to the U of MN veterinary clinic and was told by a professor there that Daisy should lose some weight but that there was really not much that could be done for her arthritis short of very iffy neurological surgery.  Early in 2010, her vet prescribed oral meloxicam, .3 ml, 2x a week.  It helped her immediately.  The vet continued to prescribe it into early 2011 , until Daisy coughed up blood and showed a spot of blood in her urine, at which time I discontinued the meloxicam.   

In March 2011, I heard about laser therapy for arthritis, so I took Daisy to the vet who offered it.  He took an x-ray so he'd know where to apply the laser and discovered one enlarged kidney (more than 2x normal) and one small-than-normal kidney.  Blood work showed extremely high bun and creatinine.  He pronounced Daisy as good as dead, offering no treatment plan for her kidney problems, telling me should would probably die within the week.  

He did the laser therapy, however, and it helped her that day.  

I thought i t was odd that Daisy showed no signs of kidney failure, such as reduced appetite or lethargy.  In fact, far from dying within the week, she seemed her normal self, except that she was more mobile following laser therapy.  As days and weeks went by I continued the laser treatment and Daisy continued to improve. 

Returning to the vet who prescribed meloxicam for more  blood work (I was still ignorant of the FDA warning not to use  it), Daisy's bun and creatinine  improved.  

Not knowing what or who to believe, I asked Daisy's original vet for advice, and she did some research with the U of MN veterinary clinic, and there, she was advised that if Daisy's blood work  was improving (even though it was not even near normal) and she was asymptomatic for renal failure, we should do nothing. She  told me that if the enlarged kidney was due to a cyst, that the only solution would be to remove the kidney, and that Daisy wouldn't survive surgery due to her bun and creatinine levels.  If it was cancer, possible surgery, which wasn't an option for Daisy due to her kidney values.  If hydronephrosis, then surgery, which again  wasn't an option.     

So with all vets reporting that there were no options, I nevertheless insisted on starting subcu fluids with Daisy, and her kidney values improved even more.  

But that enlarged kidney was growing.  I reported this to the vets, but they showed NO INTEREST.  The kidney was taking up so much of her abdomen that it was hard to find enough skin to make a tent for the subcu needle.  The vets' response?  They  just shrugged.  

But  I pursued treatment, contacting the surgeon myself in order to  get my questions answered , and insisting on  an ultrasound.    

Days before the ultrasound date and 3 months after I was told Daisy had only days to live , Daisy became paralyzed in her rear legs.  (It was eerie that Daisy seemed so unconcerned about the paralysis; it was as if she trusted that I would fix it.  She didn't complain, wasn't upset at all.  She was her usual alert, affectionate self, although she couldn't walk or stand.) 

I immediately took her to one of the vets (the one who had discovered the kidney problems), who took an x-ray which showed the enlarged kidney had grown so big it was pressing on her spine.  I heard Daisy screaming all the way across the clinic and through closed doors, which concerned me greatly because she had been so calm.  When she came back from x-ray, she was in tremendous pain .  Her condition was completely different condition than when she went to x-ray, and it appeared that she had recovered some feeling in her legs .  I realize it may be preferable to stretch her out a bit for the x-ray, but she was immobile and it would not have been difficult to gently manipulate her; it leaves me wondering what happened and only adds to the distrust. 

The vet again refused to offer any alternatives, again telling me that Daisy was as good as dead, and that my only option was to euthanize her, that she wouldn't survive surgery, and even if she did there was no guarantee that she'd be able to walk or stand.   So she was euthanized (although that too was botched; it 45 minutes and 6 injections and extreme distress for us for Daisy to die).   

In retrospect, I believe we got horrible advice and medical care .  But who should I have turned to?  Who should I have trusted?  I just don't know to this day.  Daisy deserved a chance, and I deserved the opportunity to make those informed choices.  That did not happen.  It looks to me that the vets decided Daisy wasn't worth the effort.  But that shouldn't be their decision.  


Here's how I think it should have gone:   

Of course, Daisy should not have been receiving a sustained oral meloxicam dosage. 

The U of MN veterinary school professor should have told me about laser therapy for pain relief (but of course the U of MN doesn't offer it so it would not be a cost center for them ).

When she was first diagnosed with an enlarged kidney, an ultrasound should have been done immediately so we'd have known what was going on with that kidney. 

Then an aggressive treatment plan set out, including subcu fluids and weekly blood work.   

Surgery should have been scheduled for the week when her kidney values showed enough improvement to indicate she could survive surgery. 


When we came home without Daisy, I couldn't help but feel that it was a nightmare, and that one horrible mistake after another had been made.  It's been five weeks, and I still feel that way.  I'm just heartbroken.  And incredibly distrusting about the competence and compassion of veterinarians.  I don't know where to turn anymore , and I'm filled with anger about the blunders that have caused me so much pain. 


Please continue to tell people about meloxicam.



Elizabeth