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Azithromycin and cat death.

Species: Cat
Breed: DSH
Age: 1-2 years
I run my own rescue group. I do all the cleaning, transporting, adopting, and I apply all medicines that I need to everyday. It is a cat specific rescue and I have done a lot to save a lot of cats.

What happened today was tragic. A cat I was treating with Azimycin for 5 days (the vet suggested this) had some kind of weird episode on the second shot today. Up to now the cat had been sneezing, coughing, wheezing and acting lethargic.

After administering the Azimycin shot today the cat flipped around the kennel, bled out of the nose, twitched a little - and just died in seconds. I have no idea why this happened as I have used Azimycin for years and years successfully with no problems!

Hoping you can shed some light on this... and offer advice on what happened. I feel so bad and that I have no right to give medicine again ;(.

Online vet, Dr. Marie

Dr. Marie replied:

I'm so sorry to hear that this happened. It must have been very traumatic for you.

There is some evidence that azithromycin (Azimycin) can cause death if given to a patient with a heart condition. Here is an article for you. It is a human study, but likely also applies to cats:

Use of Azithromycin and Death from Cardiovascular Causes

If this is what happened then it could only happen if the cat had a heart condition. Some cats can be born with hypertrophic cardiomyopathy where the walls of the heart are too thick and they can die suddenly even at a young age.

There are other possibilities. If the drug was accidentally injected into an artery, it could cause serious problems. It is very hard to do this though and I would be surprised if this is what happened.

I have heard of cases where someone who was not trained in giving subcutaneous injections actually injected into the spinal cord of an animal. This could result in a similar reaction. But, again, it would be very difficult to get a needle into the spinal cord and inject medication into it.

An anaphylactic shock reaction could do this as well. It is possible that this kitten was allergic to this drug. If this was the case then there was not much you could do if things happened that quickly.

If you feel that your injection technique is good, then I would not worry that this is your fault. If you think that it is at all possible that you injected into a blood vessel or the spinal cord then it may be a good idea to have your vet monitor you to make sure you are doing these injections correctly.

I hope that helps. We will never know what the cause is, but my guess is that this was probably a fluke and will never happen again.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Hello Dr. Marie

I would have to guess I give upwards of 1000-1500 or so injections a year combined on mostly kittens so I am pretty confident in my technique. That being said, I am thinking it is something having to do with the cat or one of the other possibilities you pointed out. It is just so hard to fathom that it COULD be my fault since the first injection went so well.

I am guessing the best thing to do is to learn from this situation and move on - especially not knowing exactly what had caused it to happen in the first place.

I do have one more question. The other three siblings are healthy. If they were to need to be treated for something in the future (either with me or the adopter) should precautions be taken before using azimycin with them?

Thank you!

Online vet, Dr. Marie

Dr. Marie replied:

I really don't think there is much precaution you could take. *If* this cat had a congenital heart condition like HCM, there is not much you can do to test siblings for it. You could possibly have an ultrasound done on the hearts but this is expensive and may not conclusively diagnose the condition. Plus, if there is HCM then there is not much that can be done.

I really don't think this is an azimycin problem. It probably was a fluke thing and I am quite suspicious that there was a heart problem there. Most likely the other kittens are not at extra risk.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.