Page 18 - Spring 12

PREM, A Tale of Ketamine Abuse?
by Jane Keogh, UK
Whilst attending our veterinary homeopathic conference, Animal Energy 12, last Summer, I listened to Don Hamilton talk about the ill effects of Ketamine. As so often happens during these talks, I experienced one of those “light bulb” moments with respect to a case that up until then had proved stubbornly difficult to treat with homeopathy.
Don described a picture of fear and aggression and anxiety disorders, plus neurological behaviours in both dogs and cats that he relates to the use of Ketamine. The syndrome seems more common in cats, probably because the drug is more commonly used in this species.
The cases quoted involved fear based aggression, tail chasing and hyper- sensitivity of the skin with self trauma in some individuals.
My light bulb moment concerned an elderly neutered female cat called Prem, belonging to a lady who works in a cat rescue centre and who takes home the “no hopers”, those with a terminal diagnosis or with seriously anti social behaviour..
Prem first came to see me in 2008 when she was 15 years old. Mrs H. had owned her since 1994. She had had an RTA not long previously with a fractured jaw, a tail injury and damage to her right eye.
The reason for the consultation with me was her chronic skin condi- tion. This had started at the end of 1999 when she had been ill. I have never managed to get to the bottom of this “illness” but she appears to have had an irritable bowel condition (gut biopsies were taken) with chronic diarrhoea which responded to Prednisolone.
Her character changed after this time. Previously she had been loving and affectionate, and she still had moments of affection, especially if there were no visitors around.
At the time of presentation, however, she had become very intolerant of visitors, glaring at them and lashing out, whereas before she used to love them. “She can change in an instant”. She would behave similarly with the owner at these times and for a while after the visitors had gone. She would occasionally lash out at the owner when there were no visitors present and Mrs H could not work out what triggered these attacks.
In general the other cats in the household tended to chase her. She had a habit of urinating on objects in the house. As a result she was main- ly confined to one bedroom, partly by her own choice. If she was brought out of her room she became very anxious, and restless, pacing endlessly, and usually urinating on something.
The facial eczema that she was now suffering from followed the bowel problems in 1999. The problem was almost entirely confined to the face, usually the right side. Prem would traumatise her face until it bled. She tended to scratch over her right eye and jaw, both sites of injury in
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the 1994 car crash. The skin around her right eye was scarred. She would scratch the whiskers on the right side of her face (sometimes until no whiskers were left) and when really severe would traumatise the left side of her face also.
Although she did not have eczema anywhere else, Prem had incred- ibly sensitive skin and would scratch her face or groom obsessively if stroked on her back. To the point where Mrs H felt unhappy stroking her. She washed herself constantly.
There were very few modalities, possibly a worsening in the evenings, and she was markedly worse for fat intake.
Staphisagria 200c was prescribed
There was a slight initial aggravation and very little improvement. Nat mur 200c was prescribed, also with little effect.
During this time Prem continued on a low dose of Prednisolone (2.5 mg twice weekly) which kept the facial trauma to a manageable level, and the stools normal.
A year later Mrs H. reported that Prem had become angrier and was attacking visitors feet.
Staphisagria 200c was repeated – I’m not sure of the logic here, and of course it didn’t help much.I didn’t hear about Prem for a while, until Mrs H. mentioned in March of this year that she was still scratching and angry.
I prescribed Stramonium 1m to no effect.
In June Mrs H. mentioned that Prem’s skin was still very itchy when she was touched though not scabby at the moment. She was very grumpy with everyone and keeping herself to herself.
A split dose of Nat mur was advised, followed by Rhus tox 30c sid. Two weeks later there had been no response at all.
Time for the Peter Gregory approach with Tuberculinum bov 30c bid. By mid July (and post conference) Prem was still no better. So fired with enthusiasm (and hope) I prescribed Ketamine 30c bid for 3 days.
I think Mrs H’s own words best describe Prem’s response:
“Before Ketamine 30c she was grooming frequently, always if I stroked her, almost obsessively, and also when I stroked her (and at some other times) her skin rippled so her fur looked like corn in a breeze. She would scratch both ears. She suffers from quite large fur balls but I did not like to groom her too much as it made her skin so irritated.
After the Ketamine 30c I was able to stroke her from the top of her head to the middle of her back without the ear scratching and obsessive grooming, though if I went beyond the middle of her back these behav- iours would start. It was marvellous to see her face when I stroked her.