Azithromycin and cat death.

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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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.