Friday, April 8, 2011

A Double Double-Dose

I gave Snicky and Snalbert their pills last night: three medications for Snicky (appetite stimulant, potassium, and hypertension tablet) smooshed into a salmon-flavored pill pocket. For Bertie, just the soft, chicken-flavored hypertension tablet, amiodipine, which he loves. "I gave the cats their pills," I said to my husband, who was napping on the sofa. "Okay," I thought I heard him reply.

Later that evening, I was on the phone, and heard him moving around in the kitchen. After I hung up, he told me that he'd just given the cats their pills.

Hysteria ensued. We have a system to prevent double-dosing — or so I thought. Every night, we cut the hypertension pill in quarters. Two are given to the cats, and two are wrapped in their packaging and stored in a little plastic box for the next morning. When my husband cut the extra pill last night, he spotted the two quartered pills already in the storage box, but it didn't sound an alarm for him. He stuffed two more in there without thinking. Nor had he heard me tell him I'd given the pills.

Some system.

It was 9:30, our vet's office was closed. I called Angell Memorial Animal Hospital, Boston's 24-hour pet  ER. They directed me to the national poison control hotline. There's usually a $65 charge for their advice, but they told me that the maker of Snicky's potassium supplement would pay for the call. (How nice! And how odd. But fine with me.) They also told me that double-dosing happens all the time.

Amiodipine, which lowers heart rate and blood pressure, was the only drug they were concerned about. They recommended that we take both cats to Angell for overnight monitoring in case their heart rates became too low (or too high) when the medicine reached peak absorption, in about 5 hours.

We packed up the cats, who seemed fine, and headed to the ER. Snalbert hollered the whole way. It was a slow night there, mercifully. You never know what you might encounter in that waiting area; I've witnessed heart-breaking situations. I have sad memories, too; Bunnelina died there less than two years ago.

The vet we spoke to was reassuring. "We see this all the time," she said. Because our cats are old and weakened from chronic renal failure, monitoring them overnight would be the safest thing. The vet promised to call me with a report at 8 am and, if all went well, we could pick them up at 9.

When I finally fell asleep, I had one nightmare after another. Several times, I was mauled by bear cubs. I got lost on the Orange Line, on the way to an important class. I was late for some important business meeting and wasn't dressed. At all. Then more bear cubs attacking. I think Possum's claws need trimming; he was sleeping with me and I must have felt them on my arms.

The vet's call awakened me; she said the cats were fine and were ready to come home. Snalbert had talked all night long, and everyone had enjoyed our entertaining Persians. Even their discharge papers described what charming cats they were. And the people at the front desk demanded the story of their unusual names.

The bill was less than $500, which surprised me; I'd expected it to be at least double that, especially with two cats. But they had't needed a lot of treatment, just monitoring and blood-pressure checks. (They also received a lot of cat kisses, according to the vet.)

For that price, I'm glad the cats managed to have a good time.

Snalbert hollered all the way home; Snicky had diarrhea in her carrier. Snicky always gets in the last word, and spectacularly. Thank you, Snicky, for making your feelings so poetically clear.

Now we need a better system to prevent double-dosing, whether it's marking it on a calendar or making sure the other person really, really knows that pills have been administered. Maybe pouring a glass of ice water on the other person will guarantee that it registers, in case he or she is in a trance-like state, as happened last night. I haven't figured it out yet, but we'll come up with something.

1 comment:

  1. Happens just like this for people dosing, too. I'm so relieved that both cats are A-OK. Perhap's Snicky's take on the whole this is akin to "all's well that ENDS well".

    One wee suggestion in your safety strategy might be to limit the pill cutter to just you or hubby. That way, pill slicing and dicing becomes a separate, out-of-the-medication-administration-loop. Use a multi day pill dispenser to store the cut pills. Put up a magnetic calendar on the fridge with magnets marking the dates given. Keep the magnets with the pills and "dispense" a magnet to the calendar as you prepare the last pill pocket.

    Hope your nightmares scrammed and that you all caught up on well deserved zzzz's.

    (Of note - word verification is catinunh. That says it all, don't you think?)

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