Anyone Else ever do Epogen shots themselves?

mews2much

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I gave Coco her Epogen shot for the first time tonight.
The vet showed me how to do it and I hope I did it right.
Her PCV was 20% last Thurs up from 18% the week before.
I sure hope the Epogen will help her.
She also may have a clotting problem now also or liver problems.
 

cruiser

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I have never had to administor any shots before on any of my cats,just do what the vet showed you how to do,you must have just felt nervous being it your first time.I hope someone here can be more helpful then myself.
 
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mews2much

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Thanks,
I have done fluids since Jan/Feb 2009 with a 18 G needle but this is my first time giving the Epogen.

 

snickerdoodle

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I know the Epogen syringes looked much smaller, like regular needles. I was told I was supposed to give Boo his sub-q. Are you giving them sub-q? If you are unsure ask the vet to show you again. I made my vet show me for a week how to give fluids because I didn't feel comfortable with it after only three days.
 

footersownsme

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Originally Posted by mews2much


She also may have a clotting problem now also or liver problems.
if she is having clotting problems please be sure to use the smallest needle possible and make sure you pinch off where you injected the epogen. I've seen animals bleed for hours from a 22g needle injection who have clotting issues. Our rule with patients who have platelet issues or clotting issues is a minimum 10 minute hold off (after drawing blood). Hope the epogen helps
 

otto

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Not epogen, but I gave Ootay
subq Vitamin B-12 and Vitamin B complex shots for many months.

The needles were very tiny, #25 I think. My biggest trouble was making sure the needle stayed under the skin until I was done plunging. My hands are arthritic and the angle was kind of difficult for me.

Keep us posted on how it's going for you.
 
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mews2much

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Thanks Everyone,
I gave Coco the shot last night and it went ok but I stuck her 3 times because the needle fell out.
There was no blood.
I use a 18 G for her fluids and there has only been blood one or 2 times.
 

otto

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I use #18 for fluids too. I just prefer (as does the cat receiving it) the quicker flow that comes with the larger needle.

The B shots Ootay took came prefilled, with the tiny needles already attached.

You and Coco will get better with the epogen injections as time goes on. How often is she getting them?
 

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Injection technique is not where the problems lie IMO. I know people who wish they never heard of Epogen, and I know people who consider it a godsend.

My only feedback FWIW... is to ensure the product is not past due, or counterfeit, or is starting to go bad due to mishandling during it's product lifecycle, or being pushed "willy nilly" by a reckless vet practice. When the FDA issues a black box warning for certain products, one can't be too careful, and one needs to be told of all the downsides of any powerful, potential life-saver drug. If there is any hint of clouding, take it back. If it got accidentally shaken, take it back. It's a recomb DNA product for humans.

I have had ruinous experiences and good experiences with this. Have actually been in a long written dialog with the FDA about it, and how the use for pets is not an FDA issue since companion animals are not food animals. In other words, you just have the pet-vet industry speaking for/monitoring/controlling this drug, which in many cases may not be the best thing. The drug is very pricey, so IMHO this is a classic conflict of interest situation, and many are the cases this life saver drug can actually promote a normal decline in health to a horrific decline. You won't hear the bad stories.

Just my two cents.
 
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mews2much

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Thanks Everyone,
I did hear the bad stories and know it can make her worse.
We did talk about that.

Otto the syringes are pre wrapped with needles.
I will have to see what size they.
She gets them every 3 days and sees the vet every week for blood and bp tests.
Footers Coco has only bled a few times when I have done the fluids since Jan/Feb 2009.
We are hoping the clotting problem is caused by her bp meds.
That would be the best outcome.
The others are way worse.
DIC,Liver and non virus Leukemia.
 

2furgirls

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Originally Posted by Snickerdoodle

That's interesting 2fungirls, I was never told about the not shaking part.

Thinking of Coco, Mews, and you
Hi - several years ago when I first started the research into Epogen/Procrit I went to some FDA sites, but they have moved... however by googling "epogen fda warning shaking vial" I just got these ones:

http://www.drugs.com/epogen.html
"Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of needles, IV tubing, and other items used in giving the medicine.

Do not shake the medication vial (bottle). Vigorous shaking can ruin the medicine. Do not draw your Epogen dose into a syringe until you are ready to give yourself an injection. Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.
Read more: http://www.drugs.com/epogen.html#ixzz0xZefhIc7"

The FDA site had had the biochemical reasons why it denatures. They say "prolonged vigorous". In fact, repeated shaking by turning the vial upside down once or twice may denature it according to human users. This is why for human users the FDA insisted on a separate vial per use after a class action lawsuit. Not so for pets. All this was a real eye-opener and led me to studying recombinant DNA drug bio-technology, still very much in its infancy. The worst part is this: when the human experimental drug is passed to vets, there are no objective checks and balances wrt. facts, figures, outcomes. E.g., Human kidney clinics make 70% of their profits by giving this drug to their kidney patients, all subject to tighter controls, so the left overs and rejects often end up guess where. In most cases the vets aren't even aware of all this.

IMO pet owners with the bucks for this are very much part of an experiment. Perhaps that OK for many, as long as they have their eyes wide open. Some say they know what the bad stories are. But few have seen with their own eyes the downside of a recombinant DNA human drug originating with pig DNA designed for humans given to an already sick cat may do.

The vet industry that comes up through vet schools are inured to "sideeffects", as vet schools are part of the equation to test drugs for humans. It's all considered the price to pay for "scientific progress".

And that's OK, I think, as long as pet owners are told the whole nine yards, and not just the first one, or two or three yards of bad outcomes. It's not just "your pet may die" on this drug anyway, it's "are you prepared for exactly how your pet may react and die on this".

In any case, I would still use Epo if I had a CRF cat that passed a rigorous checklist for it. Good luck to everyone using it, and may we find a natural cure for this disease that hits too many of our feline companions.
 

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I haven't done Epogen but I have injected various other meds, insulin, vitamins, fluids in cats. Just follow your vet's instructions/ demonstration. Speaking generally I was taught the syringe goes in at an angle about 45 degrees and the hole in the syringe should face up . If it is for a subcutaneous injection you pull up some skin and inject into the tent. but make sure it does not poke out the other side! usually with small needles you wont get any bleeding but if she has a clotting problem this is something you need to pay particular attention to. You could hold a cotton to the site and keep holding firmly until it clots.

Ask your vet if there is ANYthing you do not understand about injection site, technique, handling the medicine, drawing it up (like do you or dont you inject air into the vial before drawing up the medicine? Normally they tell you to do this as a matter of course, to even the air pressure. but I know with Lantus insulin which is another rDNA thing that also must not be shaken, dropped, etc., it turns out that injecting the air into the vial makes it go bad faster. I have no idea if the same is true of Epo, i just mean that is one thing to check out from people who are using it. like maybe go on the Yahoo groups, the Feline CRF Support group and ask there to get some more perspectives )

As far as Epogen i have not used it, I have had cats with CRF but not recently. When I get to that point with one of my cats again I will have to do plenty of research. My older cat is getting kind of borderline

2furgirls, what do you mean by a cat that passed a rigorous checklist for Epogen?

Good luck mews2much, your kitty is lucky to have you.
 

snickerdoodle

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Thank you for that info 2furgirls (I'm sorry I mistyped your name! I need glasses!!!) I was not made aware of that shaking thing.

Thinking of Coco, how is she doing?
 

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I remember when I was administering Epogen to patients when I was in nursing school. Many of the patients complained of bone/joint pain early in the treatment. It made sense to me, when you consider that the long bones are where the red blood cells are produced. When Samson was on Epogen, we kept a pet heating pad on for him all the time. I really think it helped with the bone discomfort early in his treatment. Epogen gave us nearly a full year of good quality time with Sam, before his body quit responding to it. It was a Godsend, and I wouldn't hesitate to recommend it (for the appropriate condition, such as CRF induced, non-regenerative anemia.)

Coco continues to be in my prayers.
 
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mews2much

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Thanks Everyone,
Coco already has Arthritis.
She has at it since she was 10.
My vet did weigh all the options before Coco was put on the Epogen.
I bet Coco is having bone pain.
Coco is about the same today and sees the vet tomorrow for her PCV test.

 

pookie-poo

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I remember when I was administering Epogen to patients when I was in nursing school. Many of the patients complained of bone/joint pain early in the treatment. It made sense to me, when you consider that the long bones are where the red blood cells are produced. When Samson was on Epogen, we kept a pet heating pad on for him all the time. I really think it helped with the bone discomfort early in his treatment. Epogen gave us nearly a full year of good quality time with Sam, before his body quit responding to it. It was a Godsend, and I wouldn't hesitate to recommend it (for the appropriate condition, such as CRF induced, non-regenerative anemia.)

Coco continues to be in my prayers.
 

2furgirls

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Originally Posted by maewkaew

I haven't done Epogen but I have injected various other meds, insulin, vitamins, fluids in cats. Just follow your vet's instructions/ demonstration. Speaking generally I was taught the syringe goes in at an angle about 45 degrees and the hole in the syringe should face up . If it is for a subcutaneous injection you pull up some skin and inject into the tent. but make sure it does not poke out the other side! usually with small needles you wont get any bleeding but if she has a clotting problem this is something you need to pay particular attention to. You could hold a cotton to the site and keep holding firmly until it clots.

Ask your vet if there is ANYthing you do not understand about injection site, technique, handling the medicine, drawing it up (like do you or dont you inject air into the vial before drawing up the medicine? Normally they tell you to do this as a matter of course, to even the air pressure. but I know with Lantus insulin which is another rDNA thing that also must not be shaken, dropped, etc., it turns out that injecting the air into the vial makes it go bad faster. I have no idea if the same is true of Epo, i just mean that is one thing to check out from people who are using it. like maybe go on the Yahoo groups, the Feline CRF Support group and ask there to get some more perspectives )

As far as Epogen i have not used it, I have had cats with CRF but not recently. When I get to that point with one of my cats again I will have to do plenty of research. My older cat is getting kind of borderline

2furgirls, what do you mean by a cat that passed a rigorous checklist for Epogen?

Good luck mews2much, your kitty is lucky to have you.
Not every CRF cat is a candidate for Epogen, in fact, in some cases, depending on the cat, Epo may precipitate a horrific decline, that requires euthanization within 24-28 hours of giving it. THIS is just one worst case scenario, and let no one - vet or not - tell you otherwise.

Interesting that there is no "official" list of contraindications for Epogen use in a cat. There are just blogs out there.

Contraindications of course, are rife with Epogen use. One example, well known in kidney humans (and cats), is uncontrolled hypertension. That means it can stroke. Does the cat parent then, want to monitor their cat's BP... did your vet assess the CRF's cat initial BP before selling Epo? There is what I compiled, a dirty dozen on a "Do I give Epo to THIS cat?" which are almost never tested for. Not for nothing are Human Recombinant DNA drugs referred to as Frankendrugs.

Even asking your vet to assess the CRF cat most conservatively, there are vet practices that will cuddle your pretty kitty with an eye on his or her bottom line.

Some of "goto" places with info for helping CRF kitties IMHO have become "say-so" arms of the epogen lobbies, as they starrry-eyed insist Epo is a wonder drug, there is nothing that can go wrong, as a CRF cat is going to die anyway.

I can't have enough praise for a cat parent who will consider going the Epo route, as it says so much for the spirit of the person who is willing to go that far. You have your hearts and pocket books wide open, just make sure your eyes are the same, I would recommend an objective knowledgeable best friend with some med training go along to the vet visits.

PS A very sick cat's parents who ask too many of the hard questions run the risk of having to go for a second, thrid, fourth opinion. All $$$ Don't think they don't know this.
 

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As a nurse, I'm well aware of the contraindications of giving a human medicine to a (non-human) feline. My vet explained, in great detail, the possibility of antibody reaction to the Epogen. She explained that it can happen in as many as 30% of cats receiving Epogen. She also told me what to look for, and EXACTLY what to do if it occurred. She also explained, in great detail, pulmonary edema and angioedema secondary to antibody reaction.

The risk of uncontrolled hypertension from use of erythropoiesis stimulating agents (ESAs) is common knowledge in human medicine. This is why it is imperative to increase the HGB/HCT very slowly. It is also imperative to measure the bloodpressure frequently...not as easy in cats, but not impossible. As a matter of fact, my vet purchased a Parks Doppler machine specifically because I wanted to monitor Sam's and Cleo's BP (Sam's because of the Epogen, Cleo, because of her CRF diagnosis.)

As with all veterinary care, your best friend is knowledge. Arm yourself, ask questions....make sure you have a vet who will allow you to be an active participant in, and advocate for, your cat's care. Make sure your vet is up-to-date and current in the techniques of state-of-the-art care, and is willing to answer your questions, and help you learn about the treatment options available.
 
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