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Dr. Louis Gotthelf
Dr. Louis Gotthelf, Veterinarian
Category: Cat
Satisfied Customers: 2438
Experience:  35 years owning a dog and cat veterinary practice. President of an animal emergency clinic
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Fosamax vs prednisone for treating hypercalcemia in cats

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My cat is hypercalcemic. He had mulitple stones removed in bladder surgery last week. Multiple biopsies taken (spleen, liver, bone marrow) and results show no sign of cancer. As idiopathic hypercalcemia is the diagnosis, in addition to a diet change, the vet has recommended prednisone or Fosamax. Fosamax sounds daunting as it has horrendous potenial side effects and we would have to be very careful in dosing and keep him upright for 15 minutes each week after giving it to him. But it would most likely help the hypercalcemia in such a way the the prednisone would not (forcing calcium in to his bones instead of into his urine). I hesitate though to try the prednisone long term as we have had negative experiences with it in the past in ill cats (effecting other organs). Can anyone recommend which med, and any input on experience with Fosamax use in cats?
Hypercalcemia in cats almost always results from a malignant tumor, so I'm sure your vet is looking for that with all of the biopsies. Prednisolone and the diet k/d are the most common treatments for hypercalcemia in cats.

Although I have never used it, Fosamax has been reported to be effective, but it causes so much esophageal erosions, there is no concrete recommendation for how to administer it. Some vets have tried the liquid form, but that may cause more irritation to the esophagus. Some have tried coating the esophagus first, but that hasn't helped prevent the erosions. The big problem is that it has to be taken with lots of water. That's hard to do in a cat. Perhaps if the cat was stomach tubed with water after the administration of Fosamax, it may be easier. But that's something the vet would have to do when the cat takes the medicine.
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