Ketamine... is your time almost up? Are people finally learning they have options?

Today marks the 3rd anniversary of the day we lost Gimli. We lost him during a routine dental cleaning due to the use of Ketamine. Gimmie suffered a heart attack on the table, not twenty minutes after we left him in their "care". As stated in this blog previously, I asked questions, we did a blood panel, I specifically asked about the anesthesia, I thought I had covered all bases and left both Gimli and his brother, Bilbo, with our vets thinking they were in good hands. It didn't turn out that way. We lost him there in his physical form but he is with us and fighting for others in his "spiritual" form. I do not mean that in a religious way. But his spirit lives on in my determination to share his story with others through this blog. I thank those of you who have stopped for a while to read and consider - or better yet - reconsider the use of Ketamine. For three years I have tried, in a very small way, to bring attention to the potential dangers of the drug, Ketamine, used to anesthetize Sphynx. This drug is of potential danger to all pets but my platform is not *all* pets, it is all Sphynx. Even the heart healthy ones could be at risk, why? Because even confirmed clear hearts - free from HCM - can become at risk for HCM. Your Sphynx that scanned clear this year at age x,y,z could scan positive the next year or year after, etc. Until the genetic marker is found (Sphynx Research through Dr. Kate Meurs) all of our breed is at risk for the disease. But, we all understand that. We scan, or most of us do, now. We monitor them, we medicate them if they have scanned positive, we rescan them .. yearly for breeders (reputable ones, I should say) ..or at intervals that our vet cardiologist suggest, if we are pet owners. Scanning is a must. Ketamine, in our breed in particularly, can prove fatal. It may not happen the first, second or even third time used, but if your Sphynx has an undiagnosed case of HCM then this drug can kill. It can also kill for other reasons as well. On a public Sphynx forum one member, who is also a breeder of cats, writes:

"An injectable like Ketamine is far slower and harder to quickly reverse than gas. That has been confirmed by every vet I have spoken to that uses either/or both drugs. Being in the bloodstream, vs. an inhalant is an obvious difference. An example is that different people taking Ketamine often have very different reactions. One person may tolerate Ketamine well but not get the desired effect, another may have side effects or adverse reactions that make Ketamine intolerable, and yet another may get the desired effect with no side effects. These variations in response and side effects are caused by many variables, but genetic variation and metabolism-based drug, herbal, and food interactions are among the most common Drugs are metabolized by the body in much the same way as food, herbals, and environmental pollutants; they are broken down by liver, kidney and gut enzymes or other mechanisms so they can be absorbed and eliminated in the bile and urine. Enzymes are available to metabolize specific substances- a medication is referred to as a substrate of the enzyme that can metabolize it. Often an enzyme will be capable of breaking down more than one substance, but sometimes if two or more drugs that use the same enzyme are taken (and metabolized) at the same time, an interaction can occur. Enzyme-related drug interactions can be brought about because some drugs, called inducers, increase the activity of an enzyme and others, called inhibitors, reduce it. Additionally, genetics can determine your inborn ability to create many of the enzymes in the liver or gut, and the amount of an enzyme that is available can dramatically alter how you process medication. In humans (so it seems likely in pets too) approximately 50% of individuals have inherited DNA alterations that can affect how they process the majority of the most commonly prescribed medications. Don’t forget that Ketamine is a respiratory depressant (though can also act as a stimulant) Also its psychotropic properties must be taken into account. People have reported vivid hallucinations, "going into other worlds" or "seeing God" while anesthetized, and these unwanted psychological side-effects have reduced the use of Ketamine in human medicine. All drugs are metabolize through the kidney, and one of the things a vet wants to do a blood test for is current kidney function, and, from what I understand, if it is compromised they choose a different med. This tells me that there are clear issues/risks in using Ketamine. Gas is, from every source I have seen, a much preferred choice of forward thinking, current vet practices. The reasons for this as I have been told by vets and have read from AVMA sources, are the reasons I have questioned." The following is the warning from the manufacturer: Adverse Effects/Warnings - In approved species the following adverse reactions are listed by the manufacturer: “respiratory depression....following high doses, emesis, vocalization, erratic and prolonged recovery, dyspnea, spastic jerking movements, convulsions, muscular tremors, hypertonicity, opisthotonos and cardiac arrest. In the cat, myoclonic jerking and/or tonic/clonic convulsions can be controlled by ultrashortacting barbiturates or acepromazine. These latter drugs must be given intravenously, cautiously, and slowly, to effect (approximately 1/6 to 1/4 the normal dose may be required).” (Package Insert; Ketaset® - Bristol) Seizures have been reported to occur in up to 20% of cats that receive ketamine at thera­peutic dosages. Diazepam is suggested to be been used for treatment if necessary. Pain after IM injection may occur. To reduce the incidence of hypersalivation and other autonomic signs, atropine or glycopyrrolate is often administered. Interesting reading: Vet Anesthesiology - an except on Ketamine WebMD - Risks or Complications No one wants to lose their pets. No breeder wants to put their cats or kittens at risk? Why do so because a vet caters to the use of the cheapest anesthetic? They're watching their bottom line. They already have vet techs trained to assist with Ket/Val. Iso and Sevo are more expensive and involves more training time and equipment. They don't want pet owners or breeders to "shop around" for a better price. So many reasons that this drug is still used in many vet clinics. BUT... the tide is changing. People are taking note, educating themselves, networking on forums to share experiences they've had. While there still is not sufficient documented research on Ketamine deaths in Sphynx there are sufficient anecdotal instances that are known and shared. Many breeders and owners now have their vet denote that Ketamine will not be used on their pet. If their vet balks about offering options many are leaving and finding another clinic with progressive and up to date practices. Leave the archaic behind and do so now, for the benefit of your "Gimli". Much love, my little boy.

Memories are made of these...

Gimli (top) and Bilbo in their KittyWalk Town & Country
06 April 2006

You would've been five today, my darling boy.

Two years.... have we forgotten, no. Will we forget, no. Has Tupelo Animal Clinic or the vet that killed you shown responsibility (even with a necropsy stating that Gimmie was killed due to the Ketamine given to him during a DENTAL CLEANING)? .... No...

We have three more Sphynx in our lives - four including Gimli's "brother" Bilbo who turned five on 28 Feb. of this year. Rose and Lily are Gimil's nieces from his brother, "DZ", aka GC GODZ My Dadza Mooner. And we added another sweet (but mischievious boy, GoNaked FreudianSlip of RmplSlkSknz, aka, Siggy) boy to our home last November.

We still miss our Gimmie Gims. He, in the three years he lived with us, was our delight. He loved his life and I shall never fully remove the guilt I feel for putting him in the unnecessary peril that led - w/in 20 minutes - to his untimely death.

We miss you, Gimli. You were ours and you were a gift. You, and your story, have saved countless others from the same fate that you suffered. You have no idea how many people - the world over - who write to me about you, who know you, who thank me for sharing your story.

I am selfish. But a small part of my heart rejoices that your death was not in vain... that you have helped others, and shall continue to do so through this blog, and ...hopefully through the slow and encumbered rumblings of news that some companies making and dispensing veterniary Ketamine are now being investigated.

http://gimmiesfishes.blogspot.com/2010/02/teva-animal-health-inc-expands.html

Time will tell, but for now your story.. your life.. and even your death, may help others be spared the sorrow and loss that those that loved you so very much have lived with.

We miss you, darling boy. We will lay another remembrance memorial at your bridge this weekend... you are not forgotten, and never will be.

Love,

Mom and Dad

Humble Pie

Eating humble pie is not as bad as, say, eating a bug or walking into an unseen (and quite large) spider web (as I did today)... but it's, well, humbling.
My ranting last post still has some small measure of validity with an emphasis on *small*.

I just spoke to the vet that made the calls... yes, that's plural... to the number I provided to her for Dr. Michel Houard. No, she didn't update me on the fact that she had tried and was unsuccessful. Had she done that I would have been back on the trail enforce.
However, as a person who doesn't really believe in FATE but who likes to leave her options open on that subject (to some extent), I guess - as with many things - timing is everything.

My timing this past month was extraordinary. I was, shall we say, hell-bent on gaining some ground on my lost time. I posted to a group of Sphynx breeders - a Yahoo based group I help moderate - asking for any more assistance on finding a person willing to make a call to gay old Paree. By luck I was offered help from four kind breeders; one in Tennessee, one in Texas, one in the UK, and one in France.
Here's how it played out and why I am eating this tasty pie.

My UK contact and my Texas contact both put me in touch with the Project Manager International Marketing for Royal Canin Group in France. I contacted her - she is moving to Brazil. She gave me another vet's name that will be taking her place. Both of those outlets were a no-go.

Then I decided to phone the breeder in Texas. While we spoke she found not one, but two more possible French "connections" tucked away in her files. One, a TICA judge and the other, the president of FiFe (Federation Internationale Feline). I wrote first to FiFe president, Annette Sjödin. She responded back within thirty minutes to offer me two more contacts. I wrote to both.
Another scant few minutes passed and then an email came in to me at gimmiesfishes from one of the contacts. She was willing to help and she gave me another contact as well.
... you know what's coming next, I suppose... Yes, I wrote the new contact.
The first contact is a Sphynx breeder in France. She had a new document containing scientific information on a research study conducted by a team of researchers studying Ketamine use in felines. [ see document ]

The second contact took me back once again to the International TICA judge. Her email to me has had me on cloud nine for days. She stated:

"You found the right person. I know well Michel Houard. I worked with him as his vet tech for 22 years. I can translate things for you or bring him material because I go in France every month. Tell me what you need."

As tears streamed down my face I composed myself as well as an email reply to this kind person. Her advice to me was to draft a letter to Dr. Houard (who is apparently not a member of the virtual community) and outline my mission and my reasons for it. She also told me that the telephone number that I have for Dr. Houard was incorrect. One little number was off... umm, now are you following me?

So... that brings me to today and the meal upon which I now feast.
In my letter to Dr. Houard I am including the names of all of my contacts - people who have stated that they clearly want to help. I wanted to include the vet cardiologist who was trying to contact him as she is fluent in spoken and written French... so I phoned her this afternoon to ask if she would allow me to list her as an Alabama contact for Dr. Houard. In our conversation she mentioned to me that she had tried two or three times to phone him with no success -- umm -- no wonder. I told her about my recent streak of good fortune and that my latest contact corrected the incorrect telephone number. "AHHHHhhhhh, she said, so that's why I couldn't connect with him!".
Yes, indeed. *chomp-chomp*

As for being kind enough - and most importantly, interested enough to allow me to list her as a contact for him, she also offered to translate my letter to him from English to French. I most likely will accept that offer even though I have already arranged for the Tennessee breeder to "loan" me her native French brother-in-law.

Always have a backup plan. I've learned that about ten weeks too late but...

"To every thing there is a season, and a time to every purpose under the heaven; A time to kill, and a time to heal; a time to break down, and a time to build up; A time to weep, and a time to laugh; a time to mourn, and a time to dance..."

Today I am dancing for Gimli.



Gimli looks back at Mom - taken two days before his death.

These video's would have been longer had we known his life would be cut short

Some videos of Gimli taken in February.

If this boy *did* have HCM there were, absolutely, no signs. Especially telling since his heart - at death - weighed 28 grams. Even yet, the pathologist agreed that Ketamine ended his life on 08 April, not a "possible" disease. Was Gimmie's heart tested unequivocally for HCM... No.

The only thing certain was that Gimli went into CHF after being given Ketamine. Everything else is speculative.







I hate the last video is sideways. I'm primarily a still photographer and took these videos from my digital camera. I'd flipped the camera sideways - as I normally to - and completely forgot that I'd have trouble with it later. Just turn your heads for now...

I did just order a Canon PIXIA high definition camcorder. My husband and I do not want to miss anything with Bilbo and the girls. I have real regrets over not having more video of Gimmie... I just never expected his life would be over before we made this planned purchase for our anniversary gift. Twelve years on 18 June. :-)