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[FH] Re: Severe Heart murmur Leading to heart failure

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  • kittyluva12
    Hi me again!Again thanks for all your help so far but I have another question.I live in Manchester,NH and as far as veterinary care goes were not too up to
    Message 1 of 20 , Apr 3 12:28 PM
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      Hi me again!Again thanks for all your help so far but I have another
      question.I live in Manchester,NH and as far as veterinary care goes
      were not too up to date.Their are no Feline cardiologists near me at
      all,the closest one is 30 or so miles from me and Figero can't take a
      long car trip.Figero already gets stressed out in the 2 minutes it
      takes us to get to the vet now.I am going to my regular vet on
      saturday and was wondering if there is anything i should be aware of?
      My regular vet is not a cardiologist and doesnt know very much about
      heart problems.Also is their any particular medicines(diuretics)that
      anyone could suggest?Figero seems to take lasix alright but it does
      not seem to work as well as it once did.Figero is only 11 years old
      and was always in the peak of health before this so I really want to
      do everything within my power(and my bank account)to help him get
      better.One last thing has anyone else noticed that cats with heart
      issues get upper-respiratory Infections more often?Do cats with heart
      issues have a lowered immune system?Thanks again for all your help.

      P.S You can see a picture of Figero(and my other babys)
      in My photo album.My photo album is called "Jessicas Cats"
    • barbara
      Don t let go. Sometimes they need us to hold on for them when they are too tired to do it for themselves, until they get more strength. Maybe you should get
      Message 2 of 20 , Apr 3 1:18 PM
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        Don't let go. Sometimes they need us to hold on for them when they are too tired to do it for themselves, until they get more strength. Maybe you should get a second opinion. My Freddie Mon has fluid around his heart, in all his cavities and the doctor said draining it could be dangerous at his age. However, he did put him on lasix which is a diuretic and hellps flush out the excess fluid. Ask about it. Keep on holding on, don't give up on her. Barbara and the KittyBabies
        ----- Original Message -----
        From: Marja van Die
        To: feline-heart@yahoogroups.com
        Cc: sallymerlin@...
        Sent: Thursday, April 03, 2003 1:30 PM
        Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



        Hi :-)
        Have read posts on this subject with very much interest because I am having the same problems with my cat I think.
        First of all, I am dutch, from Holland so want to mention I dont speak english that well, so pls excuse spelling mistakes plus a simple way of writing, specially with medical terms it is hard for me.
        I have a 17 1/2 year old female cat and end 2001 she first started to have problems with her rear legs, I went to the vet and they found nothing wrong with her. A few days later, at night, she crawled to me in bed having pain attacks as I saw it, moaning and falling over each time, this went on for hours. The next day the vet said she heard a ' galop rythym' in her heart. She has been taking fortekor ( benazepril ) each day since then. In the meantime she has had numurous bladder infections and in the end her woomb was taken out because it was badly infected and triggered off the bladder infections . Also bloodtests said she had CRF end 2002 so she has been on a diet for a while now.
        All this time, since she first started to have heartproblems, she hasnt been well at all. Everytime we thought we had found what was wrong, tried to fix it and something else popped up :-( A few weeks ago, within a few days, her belly became huge. At first I was happy, thinking she was putting on weight, now I know it is because she is holding fluids inside. She has been on medications to make her pee more but this doesnt seem to help much and according to the vet it is real bad for her kidneys.
        The vet said the reason for her big belly is because her heart is not functioning well. I asked the vet today if draining the fluids out of her would be an option, she said it is done but it is not without risk because the fluids are not just in one place and is hard to find where to drain it from. This is a dissapointment to me because im sure that if she gets rid of her big tummy she would feel so much better.
        I did get the impression that if I wanted the vet to do it, she would but she advised against it for the reasons I mentionned above.
        I realize my cat is real old but I love her so much, after all she has been through I wish she had at least some weeks feeling pretty happy. But perhaps I am holding on to her too much and it is time for me to let her go?
        greetings
        Marja


        "Sally J.Smith" <sallymerlin@...> wrote:Hi there,

        I am sorry to hear of Figaro's condition but you have found a good
        place of support.

        My cat Muffin had a heart murmur most of his long life. When he got
        to be nearly 16 years old it changed and we went to see a
        cardiologist...we discovered he now had HCM which we treated it quite
        successfully for another 2 years. Then he began to develop fluid in
        the abdomen....this is called "Ascites" and is actually easier to deal
        with in most cases, than the fluid that can build up in and around the
        lungs because it can be drained manually.

        You need first to see a cardiologist to assess Figaro's condition.
        Once that is done it may be possible that he will respond well to the
        drug therapy...it does take some time balancing everything, but hang
        in there...another semi-positive effect of having the fluids manually
        drained is that it acts as a kind of dialysis of sort. CHF kitties
        often have reduced blood flow thru the kidneys so this actually helps
        keep their systems more "flushed". It needs to be done carefully and
        with a sterile proceedure but it does not usually require anesthesia,
        unless your kitty is especially nervous and wiggly at the vets...your
        vet will advise, I'm sure...and Figaro will feel so much better
        afterwards. They can also test the fluid for cancer cells as a
        precaution.

        The "basketball" can be uncomfortable, it can reduce breathing
        efficiency and it also often has a constipating effect so keeping th
        ebowls moving is important...ask your vet about the wonders of
        lactulose!

        Every kitty is different...my vets said that we had weeks not
        months once he begain to fill up...but they were wrong...we had over 7
        glorious months together after the diagnosis....yes, in the end he did
        pass away, but we had time to adjust and enjoy each and every day we
        were given. It was a real roller coaster some times, but this group
        helped so much.

        Please keep us posted on Figaros progress!

        Sally and Angel Muffin


        --- In feline-heart@yahoogroups.com, "rutebaga13" <jennadi2@h...>
        wrote:
        > My cat Figero is 11 and has a severe heart murmur,because of a
        > negligent vet we were not informed of his heart problem till he was
        > 9.Figero is now on 12.5mg of lasix once a day it makes him mildly
        > sick but seems to help with his breathing.My question is that Figero
        > now has a fluid-filled belly and the lasix does not seem to help as
        > much anymore has anyone else had experience with These issues
        before?
        > Figero i s VERY frail and cannot take much stress so i am very
        > hesitant to Bring him to him to his vet.Does anyone have any info
        on
        > Fluid in abdomen asssociated with A heart murmur?I would like to
        know
        > if It is causing him any pain And if there is anything to be done
        > about it.Thank you


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      • diane
        Can your vet have a cardiologist come to them (or even your home?) We have travelling cardiologists here in Ct Diane
        Message 3 of 20 , Apr 3 1:28 PM
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          Can your vet have a cardiologist come to them (or even your home?)

          We have travelling cardiologists here in Ct


          Diane


          > Hi me again!Again thanks for all your help so far but I have another
          >question.I live in Manchester,NH and as far as veterinary care goes
          >were not too up to date.Their are no Feline cardiologists near me at
          >all,the closest one is 30 or so miles from me and Figero can't take a
          >long car trip.Figero already gets stressed out in the 2 minutes it
          >takes us to get to the vet now.I am going to my regular vet on
          >saturday and was wondering if there is anything i should be aware of?
          >My regular vet is not a cardiologist and doesnt know very much about
          >heart problems.Also is their any particular medicines(diuretics)that
          >anyone could suggest?Figero seems to take lasix alright but it does
          >not seem to work as well as it once did.Figero is only 11 years old
          >and was always in the peak of health before this so I really want to
          >do everything within my power(and my bank account)to help him get
          >better.One last thing has anyone else noticed that cats with heart
          >issues get upper-respiratory Infections more often?Do cats with heart
          >issues have a lowered immune system?Thanks again for all your help.
          >
          > P.S You can see a picture of Figero(and my other babys)
          >in My photo album.My photo album is called "Jessicas Cats"
          >
          >
          >
          >
          >
          >To unsubscribe from this group, send an email to:
          >feline-heart-unsubscribe@yahoogroups.com
          >
          >
          >
          >Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms/
        • kittyluva12
          No,I dont beleive we have a traveling cardiologist in NH.Even if we did have a traveling cardiologist I am sure his prices would be VERY high and i dont know
          Message 4 of 20 , Apr 3 5:05 PM
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            No,I dont beleive we have a traveling cardiologist in NH.Even if we
            did have a traveling cardiologist I am sure his prices would be VERY
            high and i dont know if you read my earlier posts but i am running a
            rescue and dont have alot of money to spare.Thank you anyways for you
            input.
          • diane
            I would call Tufts or Agnel in Boston and see what they say. I think many places have traveling cardiologists, and you aren t in a very remote part of NH. :)
            Message 5 of 20 , Apr 3 5:38 PM
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              I would call Tufts or Agnel in Boston and see what they say. I think
              many places have traveling cardiologists, and you aren't in a very
              remote part of NH. :)

              I can well understand the money issues


              Diane


              > No,I dont beleive we have a traveling cardiologist in NH.Even if we
              >did have a traveling cardiologist I am sure his prices would be VERY
              >high and i dont know if you read my earlier posts but i am running a
              >rescue and dont have alot of money to spare.Thank you anyways for you
              >input.
              >
              >
              >
              >To unsubscribe from this group, send an email to:
              >feline-heart-unsubscribe@yahoogroups.com
              >
              >
              >
              >Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms/
            • Steph
              There is a female vet in NH who does travel around & performs ultrasounds/echos. She is not a board certififed cardiologist, however. We initially saw her
              Message 6 of 20 , Apr 3 6:40 PM
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                There is a female vet in NH who does travel around & performs
                ultrasounds/echos. She is not a board certififed cardiologist,
                however. We initially saw her but eventually brought Gus to Angell
                Memorial in Boston for a 2nd op. We live in southern Maine and it's
                about 50 miles for us. I know that is probably too far for your
                kitty but they are really great there if you can make the trip.
                Maybe, like Diane said, you could call them and speak to them about
                your situation and see what they suggest.

                Also, I know of a vet hospital in Stratham, NH that does have its
                own ultrasound machine and they send the results to a cardiologist
                for interpretation. That might be another closer option.

                Also, Angell does have payment plans and actually we find their
                prices very reasonable.

                Good luck to you & your kitty,

                Steph, Gus & Louise
                www.gussielou.com

                --- In feline-heart@yahoogroups.com, "kittyluva12"
                <kittyluva12@y...> wrote:
                > No,I dont beleive we have a traveling cardiologist in NH.Even if
                we
                > did have a traveling cardiologist I am sure his prices would be
                VERY
                > high and i dont know if you read my earlier posts but i am running
                a
                > rescue and dont have alot of money to spare.Thank you anyways for
                you
                > input.
              • Marja van Die
                Hi Pam, Thank you for telling me your story about Maggie. I have been having this feeling that if only she, my cat, wouldnt have this big belly she would be
                Message 7 of 20 , Apr 4 12:11 PM
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                  Hi Pam,
                  Thank you for telling me your story about Maggie. I have been having this feeling that if only she, my cat, wouldnt have this big belly she would be so much better! She has been sick and troubled for months now, we found what caused it and dealt with it and the future looked bright, then suddenly her heart started to play up. I feel that after fighting for so long and so hard, she deserves at least a few weeks feeling fairly good.
                  I have been giving her medicine to get rid of the fluids, and have doubled the dose but still it isn't working as well as we hoped. I need a few days to let it all sink in, I am thinking now of visiting the vet with my cat and tell the vet what I have learned from all the information I find online. The coming days I will double the medicine again, although they are bad for her kidneys. I was told that when my cat stopped eating and drinking it was time to end her life too. Your story confirms what I have learned all this time my cat as been ill, you as a caretaker have to stay contantly on top of things.
                  Thank you for your kind words, and will ofcause keep you posted on what goes on .
                  Marja and a big hug from Suteruni



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                • Debbie Raikes-May
                  Dear Marja You know your cat best. She relies on you and I am sure you will do the right thing for her. Thinking of you Debbie, Treacle and Kippurr ... From:
                  Message 8 of 20 , Apr 4 12:28 PM
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                    Dear Marja

                    You know your cat best. She relies on you and I am sure you will do the right thing for her.
                    Thinking of you
                    Debbie, Treacle and Kippurr
                    ----- Original Message -----
                    From: Marja van Die
                    To: Pam.Vojtas@...
                    Cc: feline-heart@yahoogroups.com
                    Sent: Friday, April 04, 2003 9:11 PM
                    Subject: RE: [FH] Re: Severe Heart murmur Leading to heart failure



                    Hi Pam,
                    Thank you for telling me your story about Maggie. I have been having this feeling that if only she, my cat, wouldnt have this big belly she would be so much better! She has been sick and troubled for months now, we found what caused it and dealt with it and the future looked bright, then suddenly her heart started to play up. I feel that after fighting for so long and so hard, she deserves at least a few weeks feeling fairly good.
                    I have been giving her medicine to get rid of the fluids, and have doubled the dose but still it isn't working as well as we hoped. I need a few days to let it all sink in, I am thinking now of visiting the vet with my cat and tell the vet what I have learned from all the information I find online. The coming days I will double the medicine again, although they are bad for her kidneys. I was told that when my cat stopped eating and drinking it was time to end her life too. Your story confirms what I have learned all this time my cat as been ill, you as a caretaker have to stay contantly on top of things.
                    Thank you for your kind words, and will ofcause keep you posted on what goes on .
                    Marja and a big hug from Suteruni



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                  • Marja van Die
                    Hi Debbie, Thanks so much for giving me more confidence. My cats name is Suteruni, I first heard of that name in New Zealand, where I was on holiday and my
                    Message 9 of 20 , Apr 4 12:40 PM
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                      Hi Debbie,
                      Thanks so much for giving me more confidence. My cats name is Suteruni, I first heard of that name in New Zealand, where I was on holiday and my aunt had a black cat with that name and I thought it was beautiful and decided if I should ever have a black cat, I would name her Suteruni. Years later I chose this skinny black kitten from a nest with many others. Well I thought she was cute but when I see old pics, she was ugly really, big bold spots from flea bites on her body. She grew up to be a beautifull shiny black cat, very communitave with me and became my best friend :-)
                      Sut has been having health problems for 1 1/2 years now and I have found that even vets don't want to bother to do much for a cat with that age. I get information from internet and use that. I read here that draining is a possibilty but no way any vet sugested it yet.
                      will keep you posted on what happens, thanks again!
                      Marja

                      Debbie Raikes-May <debbie.raikesmay@...> wrote: Dear Marja
                      Your English is fine, a lot better than my Dutch would be so don't worry.

                      My Girlie Treacle is 15 and she is on Fortekor too. It has really helped her. Has your vet put your cat on diuretics?
                      These are to make her wee /pee the fluid out...it has worked very well on Treacle. A drainage like you describe is sometimes done too but I imagine your vet is reluctant because of the bladder infections she has had.

                      The pain you describe she had in her legs sounds like a blood clot which can happen. It is very painful for the cat. Has your vet put her on any anti clotting drug like a VERY small dose of aspirin?
                      DON'T EVER GIVE HER THIS YOURSELF sorry to shout - but it is very poisonous to cats and has to be given in tiny amounts and under prescription.

                      I hope this helps a bit. Ask lots of questions....many people here know lots and lots.
                      Let us know how she is...what is her name?
                      And don't let being 17 deter you. Someone here had a kitty of 19 who only went to the stars last week, God bless her.
                      Love and jeep posting
                      Debbie, Treacle and Kippurr
                      ----- Original Message -----
                      From: Marja van Die
                      To: feline-heart@yahoogroups.com
                      Cc: sallymerlin@...
                      Sent: Thursday, April 03, 2003 8:30 PM
                      Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



                      Hi :-)
                      Have read posts on this subject with very much interest because I am having the same problems with my cat I think.
                      First of all, I am dutch, from Holland so want to mention I dont speak english that well, so pls excuse spelling mistakes plus a simple way of writing, specially with medical terms it is hard for me.
                      I have a 17 1/2 year old female cat and end 2001 she first started to have problems with her rear legs, I went to the vet and they found nothing wrong with her. A few days later, at night, she crawled to me in bed having pain attacks as I saw it, moaning and falling over each time, this went on for hours. The next day the vet said she heard a ' galop rythym' in her heart. She has been taking fortekor ( benazepril ) each day since then. In the meantime she has had numurous bladder infections and in the end her woomb was taken out because it was badly infected and triggered off the bladder infections . Also bloodtests said she had CRF end 2002 so she has been on a diet for a while now.
                      All this time, since she first started to have heartproblems, she hasnt been well at all. Everytime we thought we had found what was wrong, tried to fix it and something else popped up :-( A few weeks ago, within a few days, her belly became huge. At first I was happy, thinking she was putting on weight, now I know it is because she is holding fluids inside. She has been on medications to make her pee more but this doesnt seem to help much and according to the vet it is real bad for her kidneys.
                      The vet said the reason for her big belly is because her heart is not functioning well. I asked the vet today if draining the fluids out of her would be an option, she said it is done but it is not without risk because the fluids are not just in one place and is hard to find where to drain it from. This is a dissapointment to me because im sure that if she gets rid of her big tummy she would feel so much better.
                      I did get the impression that if I wanted the vet to do it, she would but she advised against it for the reasons I mentionned above.
                      I realize my cat is real old but I love her so much, after all she has been through I wish she had at least some weeks feeling pretty happy. But perhaps I am holding on to her too much and it is time for me to let her go?
                      greetings
                      Marja


                      "Sally J.Smith" <sallymerlin@...> wrote:Hi there,

                      I am sorry to hear of Figaro's condition but you have found a good
                      place of support.

                      My cat Muffin had a heart murmur most of his long life. When he got
                      to be nearly 16 years old it changed and we went to see a
                      cardiologist...we discovered he now had HCM which we treated it quite
                      successfully for another 2 years. Then he began to develop fluid in
                      the abdomen....this is called "Ascites" and is actually easier to deal
                      with in most cases, than the fluid that can build up in and around the
                      lungs because it can be drained manually.

                      You need first to see a cardiologist to assess Figaro's condition.
                      Once that is done it may be possible that he will respond well to the
                      drug therapy...it does take some time balancing everything, but hang
                      in there...another semi-positive effect of having the fluids manually
                      drained is that it acts as a kind of dialysis of sort. CHF kitties
                      often have reduced blood flow thru the kidneys so this actually helps
                      keep their systems more "flushed". It needs to be done carefully and
                      with a sterile proceedure but it does not usually require anesthesia,
                      unless your kitty is especially nervous and wiggly at the vets...your
                      vet will advise, I'm sure...and Figaro will feel so much better
                      afterwards. They can also test the fluid for cancer cells as a
                      precaution.

                      The "basketball" can be uncomfortable, it can reduce breathing
                      efficiency and it also often has a constipating effect so keeping th
                      ebowls moving is important...ask your vet about the wonders of
                      lactulose!

                      Every kitty is different...my vets said that we had weeks not
                      months once he begain to fill up...but they were wrong...we had over 7
                      glorious months together after the diagnosis....yes, in the end he did
                      pass away, but we had time to adjust and enjoy each and every day we
                      were given. It was a real roller coaster some times, but this group
                      helped so much.

                      Please keep us posted on Figaros progress!

                      Sally and Angel Muffin


                      --- In feline-heart@yahoogroups.com, "rutebaga13" <jennadi2@h...>
                      wrote:
                      > My cat Figero is 11 and has a severe heart murmur,because of a
                      > negligent vet we were not informed of his heart problem till he was
                      > 9.Figero is now on 12.5mg of lasix once a day it makes him mildly
                      > sick but seems to help with his breathing.My question is that Figero
                      > now has a fluid-filled belly and the lasix does not seem to help as
                      > much anymore has anyone else had experience with These issues
                      before?
                      > Figero i s VERY frail and cannot take much stress so i am very
                      > hesitant to Bring him to him to his vet.Does anyone have any info
                      on
                      > Fluid in abdomen asssociated with A heart murmur?I would like to
                      know
                      > if It is causing him any pain And if there is anything to be done
                      > about it.Thank you


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                    • Susan
                      ... Marja, The only thing I found particular to atenolol and aortic stenosis using Google is a case study pertaining to a dog. It recommends: a Holter monitor
                      Message 10 of 20 , Apr 4 1:07 PM
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                        --- Marja van Die <suteruni@...> wrote:

                        Marja,

                        The only thing I found particular to atenolol and
                        aortic stenosis using Google is a case study
                        pertaining to a dog. It recommends:

                        a Holter monitor is recommended. Discontinue Lasix.
                        Exercise restriction is recommended.


                        http://www.vmth.ucdavis.edu/cardio/cases/case4/casediscuss.htm

                        The vet is Mark D. Kittleson who wrote Small Animal
                        Cardiovascular Medicine. Perhaps you could email him.
                        I get the impression that subaortic stenosis is rather
                        rare so many vets may have little experience treating
                        it.

                        Susan


                        >
                        > Hi Pam,
                        > Thank you for telling me your story about Maggie. I
                        > have been having this feeling that if only she, my
                        > cat, wouldnt have this big belly she would be so
                        > much better! She has been sick and troubled for
                        > months now, we found what caused it and dealt with
                        > it and the future looked bright, then suddenly her
                        > heart started to play up. I feel that after fighting
                        > for so long and so hard, she deserves at least a few
                        > weeks feeling fairly good.
                        > I have been giving her medicine to get rid of the
                        > fluids, and have doubled the dose but still it isn't
                        > working as well as we hoped. I need a few days to
                        > let it all sink in, I am thinking now of visiting
                        > the vet with my cat and tell the vet what I have
                        > learned from all the information I find online. The
                        > coming days I will double the medicine again,
                        > although they are bad for her kidneys. I was told
                        > that when my cat stopped eating and drinking it was
                        > time to end her life too. Your story confirms what I
                        > have learned all this time my cat as been ill, you
                        > as a caretaker have to stay contantly on top of
                        > things.
                        > Thank you for your kind words, and will ofcause keep
                        > you posted on what goes on .
                        > Marja and a big hug from Suteruni
                        >
                        >
                        >
                        > ---------------------------------
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                        >
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                        > removed]
                        >
                        >
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                        >
                        >


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                      • Carol Thompson
                        Susan, thanks so much for the reference on subaortic stenosis and atenolol. (Actually, it is Clipsie rather than Marja s kitty that has the subaortic
                        Message 11 of 20 , Apr 4 2:21 PM
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                          Susan, thanks so much for the reference on subaortic stenosis and atenolol. (Actually, it is Clipsie rather than Marja's kitty that has the subaortic stenosis. It is hard to keep everyone straight.)

                          I was glad to see this in that atenolol is what Clipsie was initially given as this author recommends for dogs -- so it confirms the initial treatment. When she was first diagnosed, the cardiologist said that if Clipsie were a dog, her condition would be considered "moderate" on a scale of mild, moderate, severe -- but that it is so rare in cats that there is no data on it so we're not sure of the relative severity. She doesn't have any symptoms, though. And as it turns out, the cardiologist that will be seeing her when we go back on April 28 also has done extensive research on subaortic stenosis in dogs. (In contrast to lots of you who have to travel many hours and miles (or kilometers) to get to a cardiologist, I am extremely fortunately to live within 20 minutes of a specialty practice and a vet school, each of which has more than one board-certified cardiologist. I count my blessings in that regard!) I just checked the Web site of the specialty practice we go to and they do have Holter monitors available if needed. So far Clipsie hasn't had any fluid buildup so no Lasix at the moment. We'll just be taking things one step at a time.

                          Thanks again for your help!

                          Carol and Clipsie (and Charlie and angels Blizzard, Simba, and Max)

                          ----- Original Message -----
                          From: Susan
                          To: feline-heart@yahoogroups.com
                          Sent: Friday, April 04, 2003 4:07 PM
                          Subject: RE: [FH] Re: Severe Heart murmur Leading to heart failure



                          --- Marja van Die <suteruni@...> wrote:

                          Marja,

                          The only thing I found particular to atenolol and
                          aortic stenosis using Google is a case study
                          pertaining to a dog. It recommends:

                          a Holter monitor is recommended. Discontinue Lasix.
                          Exercise restriction is recommended.


                          http://www.vmth.ucdavis.edu/cardio/cases/case4/casediscuss.htm

                          The vet is Mark D. Kittleson who wrote Small Animal
                          Cardiovascular Medicine. Perhaps you could email him.
                          I get the impression that subaortic stenosis is rather
                          rare so many vets may have little experience treating
                          it.

                          Susan


                          >
                          > Hi Pam,
                          > Thank you for telling me your story about Maggie. I
                          > have been having this feeling that if only she, my
                          > cat, wouldnt have this big belly she would be so
                          > much better! She has been sick and troubled for
                          > months now, we found what caused it and dealt with
                          > it and the future looked bright, then suddenly her
                          > heart started to play up. I feel that after fighting
                          > for so long and so hard, she deserves at least a few
                          > weeks feeling fairly good.
                          > I have been giving her medicine to get rid of the
                          > fluids, and have doubled the dose but still it isn't
                          > working as well as we hoped. I need a few days to
                          > let it all sink in, I am thinking now of visiting
                          > the vet with my cat and tell the vet what I have
                          > learned from all the information I find online. The
                          > coming days I will double the medicine again,
                          > although they are bad for her kidneys. I was told
                          > that when my cat stopped eating and drinking it was
                          > time to end her life too. Your story confirms what I
                          > have learned all this time my cat as been ill, you
                          > as a caretaker have to stay contantly on top of
                          > things.
                          > Thank you for your kind words, and will ofcause keep
                          > you posted on what goes on .
                          > Marja and a big hug from Suteruni
                          >
                          >
                          >
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                        • bcowell
                          Marja, I think it is so sad when vets think that when a cat is old it is not worth trying to save. A bit like some doctors that tell an elderly person that
                          Message 12 of 20 , Apr 4 4:07 PM
                          • 0 Attachment
                            Marja,
                            I think it is so sad when vets think that when a cat is old it is not
                            worth trying to save. A bit like some doctors that tell an elderly
                            person that they are just getting old and must expect not to feel so
                            great, instead of searching for the cause of illness. It still
                            happens and it is so wrong! Suteruni deserves to have the best chance
                            to live and be happy, I wonder if you call phone a few more vets and
                            see if any had a more positive attitude to treating a more mature cat?
                            Best of luck,
                            Brigitte


                            --- In feline-heart@yahoogroups.com, Marja van Die <suteruni@y...>
                            wrote:
                            >
                            > Hi Debbie,
                            > Thanks so much for giving me more confidence. My cats name is
                            Suteruni, I first heard of that name in New Zealand, where I was on
                            holiday and my aunt had a black cat with that name and I thought it
                            was beautiful and decided if I should ever have a black cat, I would
                            name her Suteruni. Years later I chose this skinny black kitten from
                            a nest with many others. Well I thought she was cute but when I see
                            old pics, she was ugly really, big bold spots from flea bites on her
                            body. She grew up to be a beautifull shiny black cat, very
                            communitave with me and became my best friend :-)
                            > Sut has been having health problems for 1 1/2 years now and I have
                            found that even vets don't want to bother to do much for a cat with
                            that age. I get information from internet and use that. I read here
                            that draining is a possibilty but no way any vet sugested it yet.
                            > will keep you posted on what happens, thanks again!
                            > Marja
                            >
                            > Debbie Raikes-May <debbie.raikesmay@d...> wrote: Dear Marja
                            > Your English is fine, a lot better than my Dutch would be so don't
                            worry.
                            >
                            > My Girlie Treacle is 15 and she is on Fortekor too. It has really
                            helped her. Has your vet put your cat on diuretics?
                            > These are to make her wee /pee the fluid out...it has worked very
                            well on Treacle. A drainage like you describe is sometimes done too
                            but I imagine your vet is reluctant because of the bladder infections
                            she has had.
                            >
                            > The pain you describe she had in her legs sounds like a blood clot
                            which can happen. It is very painful for the cat. Has your vet put
                            her on any anti clotting drug like a VERY small dose of aspirin?
                            > DON'T EVER GIVE HER THIS YOURSELF sorry to shout - but it is very
                            poisonous to cats and has to be given in tiny amounts and under
                            prescription.
                            >
                            > I hope this helps a bit. Ask lots of questions....many people here
                            know lots and lots.
                            > Let us know how she is...what is her name?
                            > And don't let being 17 deter you. Someone here had a kitty of 19
                            who only went to the stars last week, God bless her.
                            > Love and jeep posting
                            > Debbie, Treacle and Kippurr
                            > ----- Original Message -----
                            > From: Marja van Die
                            > To: feline-heart@yahoogroups.com
                            > Cc: sallymerlin@y...
                            > Sent: Thursday, April 03, 2003 8:30 PM
                            > Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure
                            >
                            >
                            >
                            > Hi :-)
                            > Have read posts on this subject with very much interest because I
                            am having the same problems with my cat I think.
                            > First of all, I am dutch, from Holland so want to mention I dont
                            speak english that well, so pls excuse spelling mistakes plus a
                            simple way of writing, specially with medical terms it is hard for me.
                            > I have a 17 1/2 year old female cat and end 2001 she first
                            started to have problems with her rear legs, I went to the vet and
                            they found nothing wrong with her. A few days later, at night, she
                            crawled to me in bed having pain attacks as I saw it, moaning and
                            falling over each time, this went on for hours. The next day the vet
                            said she heard a ' galop rythym' in her heart. She has been taking
                            fortekor ( benazepril ) each day since then. In the meantime she has
                            had numurous bladder infections and in the end her woomb was taken
                            out because it was badly infected and triggered off the bladder
                            infections . Also bloodtests said she had CRF end 2002 so she has
                            been on a diet for a while now.
                            > All this time, since she first started to have heartproblems, she
                            hasnt been well at all. Everytime we thought we had found what was
                            wrong, tried to fix it and something else popped up :-( A few weeks
                            ago, within a few days, her belly became huge. At first I was happy,
                            thinking she was putting on weight, now I know it is because she is
                            holding fluids inside. She has been on medications to make her pee
                            more but this doesnt seem to help much and according to the vet it is
                            real bad for her kidneys.
                            > The vet said the reason for her big belly is because her heart is
                            not functioning well. I asked the vet today if draining the fluids
                            out of her would be an option, she said it is done but it is not
                            without risk because the fluids are not just in one place and is hard
                            to find where to drain it from. This is a dissapointment to me
                            because im sure that if she gets rid of her big tummy she would feel
                            so much better.
                            > I did get the impression that if I wanted the vet to do it, she
                            would but she advised against it for the reasons I mentionned above.
                            > I realize my cat is real old but I love her so much, after all
                            she has been through I wish she had at least some weeks feeling
                            pretty happy. But perhaps I am holding on to her too much and it is
                            time for me to let her go?
                            > greetings
                            > Marja
                            >
                            >
                            > "Sally J.Smith" <sallymerlin@y...> wrote:Hi there,
                            >
                            > I am sorry to hear of Figaro's condition but you have found a
                            good
                            > place of support.
                            >
                            > My cat Muffin had a heart murmur most of his long life. When
                            he got
                            > to be nearly 16 years old it changed and we went to see a
                            > cardiologist...we discovered he now had HCM which we treated it
                            quite
                            > successfully for another 2 years. Then he began to develop fluid
                            in
                            > the abdomen....this is called "Ascites" and is actually easier to
                            deal
                            > with in most cases, than the fluid that can build up in and
                            around the
                            > lungs because it can be drained manually.
                            >
                            > You need first to see a cardiologist to assess Figaro's
                            condition.
                            > Once that is done it may be possible that he will respond well to
                            the
                            > drug therapy...it does take some time balancing everything, but
                            hang
                            > in there...another semi-positive effect of having the fluids
                            manually
                            > drained is that it acts as a kind of dialysis of sort. CHF
                            kitties
                            > often have reduced blood flow thru the kidneys so this actually
                            helps
                            > keep their systems more "flushed". It needs to be done carefully
                            and
                            > with a sterile proceedure but it does not usually require
                            anesthesia,
                            > unless your kitty is especially nervous and wiggly at the
                            vets...your
                            > vet will advise, I'm sure...and Figaro will feel so much better
                            > afterwards. They can also test the fluid for cancer cells as a
                            > precaution.
                            >
                            > The "basketball" can be uncomfortable, it can reduce breathing
                            > efficiency and it also often has a constipating effect so keeping
                            th
                            > ebowls moving is important...ask your vet about the wonders of
                            > lactulose!
                            >
                            > Every kitty is different...my vets said that we had weeks not
                            > months once he begain to fill up...but they were wrong...we had
                            over 7
                            > glorious months together after the diagnosis....yes, in the end
                            he did
                            > pass away, but we had time to adjust and enjoy each and every day
                            we
                            > were given. It was a real roller coaster some times, but this
                            group
                            > helped so much.
                            >
                            > Please keep us posted on Figaros progress!
                            >
                            > Sally and Angel Muffin
                            >
                            >
                            > --- In feline-heart@yahoogroups.com, "rutebaga13" <jennadi2@h...>
                            > wrote:
                            > > My cat Figero is 11 and has a severe heart murmur,because of a
                            > > negligent vet we were not informed of his heart problem till he
                            was
                            > > 9.Figero is now on 12.5mg of lasix once a day it makes him
                            mildly
                            > > sick but seems to help with his breathing.My question is that
                            Figero
                            > > now has a fluid-filled belly and the lasix does not seem to
                            help as
                            > > much anymore has anyone else had experience with These issues
                            > before?
                            > > Figero i s VERY frail and cannot take much stress so i am very
                            > > hesitant to Bring him to him to his vet.Does anyone have any
                            info
                            > on
                            > > Fluid in abdomen asssociated with A heart murmur?I would like
                            to
                            > know
                            > > if It is causing him any pain And if there is anything to be
                            done
                            > > about it.Thank you
                            >
                            >
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                          • diane
                            I have found the attitude of vets to make all the difference in the world. They differ even within the practice I go to but they are all very good about not
                            Message 13 of 20 , Apr 4 5:59 PM
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                              I have found the attitude of vets to make all the difference in the
                              world. They differ even within the practice I go to but they are all
                              very good about not going against what one has started for treatment
                              (as least to us, the customers <G>)

                              My vet is very pro-active and when one of our cats gets sick she says
                              "this is what you are going to do". She does it with such conviction
                              that I have to step back and think "Ok, so do I want to do this?". I
                              always do. But she pulls no punches, when it's bad I know it. <sigh>

                              Anyway, often a vet who feels the pet is too old or doomed or
                              whatever, will not try treatments another vet will take for granted.
                              So another vet may do wonders.


                              Diane



                              >Marja,
                              >I think it is so sad when vets think that when a cat is old it is not
                              >worth trying to save. A bit like some doctors that tell an elderly
                              >person that they are just getting old and must expect not to feel so
                              >great, instead of searching for the cause of illness. It still
                              >happens and it is so wrong! Suteruni deserves to have the best chance
                              >to live and be happy, I wonder if you call phone a few more vets and
                              >see if any had a more positive attitude to treating a more mature cat?
                              >Best of luck,
                              >Brigitte
                            • Debbie Raikes-May
                              ... From: Marja van Die To: feline-heart@yahoogroups.com Cc: debbie.raikesmay@dial.pipex.com Sent: Friday, April 04, 2003 9:40 PM Subject: Re: [FH] Re: Severe
                              Message 14 of 20 , Apr 5 7:40 AM
                              • 0 Attachment
                                ----- Original Message -----
                                From: Marja van Die
                                To: feline-heart@yahoogroups.com
                                Cc: debbie.raikesmay@...
                                Sent: Friday, April 04, 2003 9:40 PM
                                Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



                                Hi Debbie,
                                Thanks so much for giving me more confidence. My cats name is Suteruni, I first heard of that name in New Zealand, where I was on holiday and my aunt had a black cat with that name and I thought it was beautiful and decided if I should ever have a black cat, I would name her Suteruni. Years later I chose this skinny black kitten from a nest with many others. Well I thought she was cute but when I see old pics, she was ugly really, big bold spots from flea bites on her body. She grew up to be a beautifull shiny black cat, very communitave with me and became my best friend :-)
                                Sut has been having health problems for 1 1/2 years now and I have found that even vets don't want to bother to do much for a cat with that age. I get information from internet and use that. I read here that draining is a possibilty but no way any vet sugested it yet.
                                will keep you posted on what happens, thanks again!
                                Marja

                                Debbie Raikes-May <debbie.raikesmay@...> wrote: Dear Marja
                                Your English is fine, a lot better than my Dutch would be so don't worry.

                                My Girlie Treacle is 15 and she is on Fortekor too. It has really helped her. Has your vet put your cat on diuretics?
                                These are to make her wee /pee the fluid out...it has worked very well on Treacle. A drainage like you describe is sometimes done too but I imagine your vet is reluctant because of the bladder infections she has had.

                                The pain you describe she had in her legs sounds like a blood clot which can happen. It is very painful for the cat. Has your vet put her on any anti clotting drug like a VERY small dose of aspirin?
                                DON'T EVER GIVE HER THIS YOURSELF sorry to shout - but it is very poisonous to cats and has to be given in tiny amounts and under prescription.

                                I hope this helps a bit. Ask lots of questions....many people here know lots and lots.
                                Let us know how she is...what is her name?
                                And don't let being 17 deter you. Someone here had a kitty of 19 who only went to the stars last week, God bless her.
                                Love and jeep posting
                                Debbie, Treacle and Kippurr
                                ----- Original Message -----
                                From: Marja van Die
                                To: feline-heart@yahoogroups.com
                                Cc: sallymerlin@...
                                Sent: Thursday, April 03, 2003 8:30 PM
                                Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



                                Hi :-)
                                Have read posts on this subject with very much interest because I am having the same problems with my cat I think.
                                First of all, I am dutch, from Holland so want to mention I dont speak english that well, so pls excuse spelling mistakes plus a simple way of writing, specially with medical terms it is hard for me.
                                I have a 17 1/2 year old female cat and end 2001 she first started to have problems with her rear legs, I went to the vet and they found nothing wrong with her. A few days later, at night, she crawled to me in bed having pain attacks as I saw it, moaning and falling over each time, this went on for hours. The next day the vet said she heard a ' galop rythym' in her heart. She has been taking fortekor ( benazepril ) each day since then. In the meantime she has had numurous bladder infections and in the end her woomb was taken out because it was badly infected and triggered off the bladder infections . Also bloodtests said she had CRF end 2002 so she has been on a diet for a while now.
                                All this time, since she first started to have heartproblems, she hasnt been well at all. Everytime we thought we had found what was wrong, tried to fix it and something else popped up :-( A few weeks ago, within a few days, her belly became huge. At first I was happy, thinking she was putting on weight, now I know it is because she is holding fluids inside. She has been on medications to make her pee more but this doesnt seem to help much and according to the vet it is real bad for her kidneys.
                                The vet said the reason for her big belly is because her heart is not functioning well. I asked the vet today if draining the fluids out of her would be an option, she said it is done but it is not without risk because the fluids are not just in one place and is hard to find where to drain it from. This is a dissapointment to me because im sure that if she gets rid of her big tummy she would feel so much better.
                                I did get the impression that if I wanted the vet to do it, she would but she advised against it for the reasons I mentionned above.
                                I realize my cat is real old but I love her so much, after all she has been through I wish she had at least some weeks feeling pretty happy. But perhaps I am holding on to her too much and it is time for me to let her go?
                                greetings
                                Marja


                                "Sally J.Smith" <sallymerlin@...> wrote:Hi there,

                                I am sorry to hear of Figaro's condition but you have found a good
                                place of support.

                                My cat Muffin had a heart murmur most of his long life. When he got
                                to be nearly 16 years old it changed and we went to see a
                                cardiologist...we discovered he now had HCM which we treated it quite
                                successfully for another 2 years. Then he began to develop fluid in
                                the abdomen....this is called "Ascites" and is actually easier to deal
                                with in most cases, than the fluid that can build up in and around the
                                lungs because it can be drained manually.

                                You need first to see a cardiologist to assess Figaro's condition.
                                Once that is done it may be possible that he will respond well to the
                                drug therapy...it does take some time balancing everything, but hang
                                in there...another semi-positive effect of having the fluids manually
                                drained is that it acts as a kind of dialysis of sort. CHF kitties
                                often have reduced blood flow thru the kidneys so this actually helps
                                keep their systems more "flushed". It needs to be done carefully and
                                with a sterile proceedure but it does not usually require anesthesia,
                                unless your kitty is especially nervous and wiggly at the vets...your
                                vet will advise, I'm sure...and Figaro will feel so much better
                                afterwards. They can also test the fluid for cancer cells as a
                                precaution.

                                The "basketball" can be uncomfortable, it can reduce breathing
                                efficiency and it also often has a constipating effect so keeping th
                                ebowls moving is important...ask your vet about the wonders of
                                lactulose!

                                Every kitty is different...my vets said that we had weeks not
                                months once he begain to fill up...but they were wrong...we had over 7
                                glorious months together after the diagnosis....yes, in the end he did
                                pass away, but we had time to adjust and enjoy each and every day we
                                were given. It was a real roller coaster some times, but this group
                                helped so much.

                                Please keep us posted on Figaros progress!

                                Sally and Angel Muffin


                                --- In feline-heart@yahoogroups.com, "rutebaga13" <jennadi2@h...>
                                wrote:
                                > My cat Figero is 11 and has a severe heart murmur,because of a
                                > negligent vet we were not informed of his heart problem till he was
                                > 9.Figero is now on 12.5mg of lasix once a day it makes him mildly
                                > sick but seems to help with his breathing.My question is that Figero
                                > now has a fluid-filled belly and the lasix does not seem to help as
                                > much anymore has anyone else had experience with These issues
                                before?
                                > Figero i s VERY frail and cannot take much stress so i am very
                                > hesitant to Bring him to him to his vet.Does anyone have any info
                                on
                                > Fluid in abdomen asssociated with A heart murmur?I would like to
                                know
                                > if It is causing him any pain And if there is anything to be done
                                > about it.Thank you


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                                [Non-text portions of this message have been removed]
                              • Debbie Raikes-May
                                Hi Marja I am so pleased you feel a bit better as our cats pick up on our feelings. You are right totally not to give up on her. Just because sheis a senior
                                Message 15 of 20 , Apr 5 7:48 AM
                                • 0 Attachment
                                  Hi Marja
                                  I am so pleased you feel a bit better as our cats pick up on our feelings. You are right totally not to give up on her. Just because sheis a senior does not mean she is worth any less effort. Boo to your vet!
                                  love Debbie, Treacle and Kippurr-- Original Message -----
                                  From: Marja van Die
                                  To: feline-heart@yahoogroups.com
                                  Cc: debbie.raikesmay@...
                                  Sent: Friday, April 04, 2003 9:40 PM
                                  Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



                                  Hi Debbie,
                                  Thanks so much for giving me more confidence. My cats name is Suteruni, I first heard of that name in New Zealand, where I was on holiday and my aunt had a black cat with that name and I thought it was beautiful and decided if I should ever have a black cat, I would name her Suteruni. Years later I chose this skinny black kitten from a nest with many others. Well I thought she was cute but when I see old pics, she was ugly really, big bold spots from flea bites on her body. She grew up to be a beautifull shiny black cat, very communitave with me and became my best friend :-)
                                  Sut has been having health problems for 1 1/2 years now and I have found that even vets don't want to bother to do much for a cat with that age. I get information from internet and use that. I read here that draining is a possibilty but no way any vet sugested it yet.
                                  will keep you posted on what happens, thanks again!
                                  Marja

                                  Debbie Raikes-May <debbie.raikesmay@...> wrote: Dear Marja
                                  Your English is fine, a lot better than my Dutch would be so don't worry.

                                  My Girlie Treacle is 15 and she is on Fortekor too. It has really helped her. Has your vet put your cat on diuretics?
                                  These are to make her wee /pee the fluid out...it has worked very well on Treacle. A drainage like you describe is sometimes done too but I imagine your vet is reluctant because of the bladder infections she has had.

                                  The pain you describe she had in her legs sounds like a blood clot which can happen. It is very painful for the cat. Has your vet put her on any anti clotting drug like a VERY small dose of aspirin?
                                  DON'T EVER GIVE HER THIS YOURSELF sorry to shout - but it is very poisonous to cats and has to be given in tiny amounts and under prescription.

                                  I hope this helps a bit. Ask lots of questions....many people here know lots and lots.
                                  Let us know how she is...what is her name?
                                  And don't let being 17 deter you. Someone here had a kitty of 19 who only went to the stars last week, God bless her.
                                  Love and jeep posting
                                  Debbie, Treacle and Kippurr
                                  ----- Original Message -----
                                  From: Marja van Die
                                  To: feline-heart@yahoogroups.com
                                  Cc: sallymerlin@...
                                  Sent: Thursday, April 03, 2003 8:30 PM
                                  Subject: Re: [FH] Re: Severe Heart murmur Leading to heart failure



                                  Hi :-)
                                  Have read posts on this subject with very much interest because I am having the same problems with my cat I think.
                                  First of all, I am dutch, from Holland so want to mention I dont speak english that well, so pls excuse spelling mistakes plus a simple way of writing, specially with medical terms it is hard for me.
                                  I have a 17 1/2 year old female cat and end 2001 she first started to have problems with her rear legs, I went to the vet and they found nothing wrong with her. A few days later, at night, she crawled to me in bed having pain attacks as I saw it, moaning and falling over each time, this went on for hours. The next day the vet said she heard a ' galop rythym' in her heart. She has been taking fortekor ( benazepril ) each day since then. In the meantime she has had numurous bladder infections and in the end her woomb was taken out because it was badly infected and triggered off the bladder infections . Also bloodtests said she had CRF end 2002 so she has been on a diet for a while now.
                                  All this time, since she first started to have heartproblems, she hasnt been well at all. Everytime we thought we had found what was wrong, tried to fix it and something else popped up :-( A few weeks ago, within a few days, her belly became huge. At first I was happy, thinking she was putting on weight, now I know it is because she is holding fluids inside. She has been on medications to make her pee more but this doesnt seem to help much and according to the vet it is real bad for her kidneys.
                                  The vet said the reason for her big belly is because her heart is not functioning well. I asked the vet today if draining the fluids out of her would be an option, she said it is done but it is not without risk because the fluids are not just in one place and is hard to find where to drain it from. This is a dissapointment to me because im sure that if she gets rid of her big tummy she would feel so much better.
                                  I did get the impression that if I wanted the vet to do it, she would but she advised against it for the reasons I mentionned above.
                                  I realize my cat is real old but I love her so much, after all she has been through I wish she had at least some weeks feeling pretty happy. But perhaps I am holding on to her too much and it is time for me to let her go?
                                  greetings
                                  Marja


                                  "Sally J.Smith" <sallymerlin@...> wrote:Hi there,

                                  I am sorry to hear of Figaro's condition but you have found a good
                                  place of support.

                                  My cat Muffin had a heart murmur most of his long life. When he got
                                  to be nearly 16 years old it changed and we went to see a
                                  cardiologist...we discovered he now had HCM which we treated it quite
                                  successfully for another 2 years. Then he began to develop fluid in
                                  the abdomen....this is called "Ascites" and is actually easier to deal
                                  with in most cases, than the fluid that can build up in and around the
                                  lungs because it can be drained manually.

                                  You need first to see a cardiologist to assess Figaro's condition.
                                  Once that is done it may be possible that he will respond well to the
                                  drug therapy...it does take some time balancing everything, but hang
                                  in there...another semi-positive effect of having the fluids manually
                                  drained is that it acts as a kind of dialysis of sort. CHF kitties
                                  often have reduced blood flow thru the kidneys so this actually helps
                                  keep their systems more "flushed". It needs to be done carefully and
                                  with a sterile proceedure but it does not usually require anesthesia,
                                  unless your kitty is especially nervous and wiggly at the vets...your
                                  vet will advise, I'm sure...and Figaro will feel so much better
                                  afterwards. They can also test the fluid for cancer cells as a
                                  precaution.

                                  The "basketball" can be uncomfortable, it can reduce breathing
                                  efficiency and it also often has a constipating effect so keeping th
                                  ebowls moving is important...ask your vet about the wonders of
                                  lactulose!

                                  Every kitty is different...my vets said that we had weeks not
                                  months once he begain to fill up...but they were wrong...we had over 7
                                  glorious months together after the diagnosis....yes, in the end he did
                                  pass away, but we had time to adjust and enjoy each and every day we
                                  were given. It was a real roller coaster some times, but this group
                                  helped so much.

                                  Please keep us posted on Figaros progress!

                                  Sally and Angel Muffin


                                  --- In feline-heart@yahoogroups.com, "rutebaga13" <jennadi2@h...>
                                  wrote:
                                  > My cat Figero is 11 and has a severe heart murmur,because of a
                                  > negligent vet we were not informed of his heart problem till he was
                                  > 9.Figero is now on 12.5mg of lasix once a day it makes him mildly
                                  > sick but seems to help with his breathing.My question is that Figero
                                  > now has a fluid-filled belly and the lasix does not seem to help as
                                  > much anymore has anyone else had experience with These issues
                                  before?
                                  > Figero i s VERY frail and cannot take much stress so i am very
                                  > hesitant to Bring him to him to his vet.Does anyone have any info
                                  on
                                  > Fluid in abdomen asssociated with A heart murmur?I would like to
                                  know
                                  > if It is causing him any pain And if there is anything to be done
                                  > about it.Thank you


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