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  • emartisi
    Hi, all, I m new to this group and to Yahoo, so bear with me! I worked for a vet for seven years as an assistant/receptionist until recently, so I know some
    Message 1 of 7 , Jun 5, 2003
      Hi, all, I'm new to this group and to Yahoo, so bear with me!

      I worked for a vet for seven years as an assistant/receptionist until
      recently, so I know some things about veterinary medicine and the
      technical aspect of things...but the one one both great and bad thing
      about veterinary medicine is, no matter how much you know it's never
      enough!

      Which is why I'm here now.

      In late February I rescued a kitten outside my aunt's house while I
      was house-sitting for her. Took me a week to finally get the little
      buger! I figured on testing/fixing and either re-releasing if her
      was feral or keeping him if he was not. Anyway, he was not and he
      became number six at my house. He's my baby.

      I took Ezra the night I trapped him for testing at the only place
      that was open, then took him to a real vet three days later for a
      real exam and vaccinations. (My opinion of the late-night vet has
      always been VERY low, but I figured they couldn't botch a FeLv/FIV
      test, and they didn't- I had Ezra re-tested again later.)

      The vet (the real one) heard a heart murmur, which she guessed was
      about a grade III or IV. All his bloodwork and his BP was normal.
      Chest x-ray showed his heart to be somewhat enlongated. He was four
      months old at that time.

      When I took him for an ultrasound with a doctor of internal medicine,
      he was an angel and purred the whole time, as usual. I try to tell
      him purry kitties don't make good heart patients...no one can hear
      his heart! She diagnosed slight to moderate HCM and he is getting
      another ultrasound in two weeks (three months from his original
      scan). She did not begin any medication and told me she wanted to
      wait until his re-check scan since he was still growing. His septum
      was thickened only a little more than normal, but his murmur is
      apparently quite audible. He has absolutely no outward symptoms. I
      monitor his respiratory rate and it is normal as compared with my
      other cats. He acts healthy in every way.

      The closest cardiologist is at least two hours away from here if what
      I found online is still current. I've asked a friend of mine who is
      a vet about whether taking him to a cardiologist would provide him
      any more benefit than seeing a doctor of internal medicine. She
      didn't seem to think it would matter greatly either way.

      So, I'm here to learn and to gather experienced opinions on some
      things:

      Would he benefit any more from a cardiologist than where he is goig
      now? I'm familiar with this doctor's work only indirectly from my
      previous job, but always thought she did good work with our clients.
      Would a two hour drive be worth that consultation? Should I ask his
      current internist this question? Will a cardiologist do more than
      what will be done here -- deciding what medication to use?

      Should he be started on medication now? From my reading and for my
      peace of mind I would like to do so. I want to do everything I can
      to keep him around a while. Which brings me to....

      Does anyone have any information on HCM in a cat this young? Most of
      my reading addresses adult cats, and my only work experience was with
      adult HCM cats. Are his odds bad for having it this young? Or are
      they better because it was caught early?

      The only medications I'm familiar with are Enacard and Lasix. I've
      seen others mentioned on here. Any suggestions?

      Thanks a bunch!
    • Susan
      ... She diagnosed slight to moderate HCM and ... My asymptomatic young HCM cat is under the care of an Internal Medicine vet. IM includes cardiology and as
      Message 2 of 7 , Jun 5, 2003
        --- emartisi <Taycey@...> wrote:

        >
        > When I took him for an ultrasound with a doctor of
        > internal medicine,
        She diagnosed slight to moderate HCM and
        > he is getting
        > another ultrasound in two weeks (three months from
        > his original
        > scan). She did not begin any medication and told me
        > she wanted to
        > wait until his re-check scan since he was still
        > growing. His septum
        > was thickened only a little more than normal, but
        > his murmur is
        > apparently quite audible. He has absolutely no
        > outward symptoms. I
        > monitor his respiratory rate and it is normal as
        > compared with my
        > other cats. He acts healthy in every way.
        >
        > The closest cardiologist is at least two hours away
        > from here if what
        > I found online is still current. I've asked a
        > friend of mine who is
        > a vet about whether taking him to a cardiologist
        > would provide him
        > any more benefit than seeing a doctor of internal
        > medicine. She
        > didn't seem to think it would matter greatly either
        > way.

        My asymptomatic young HCM cat is under the care of an
        Internal Medicine vet. IM includes cardiology and as
        long as they have the equipment and knowlege and
        experience to read the ultrasound, I do not think you
        are going to get a different result by driving 2 hrs.
        My vet does believe in medicating asymptomatic cats.
        Rudy takes atenolol which slows his heart rate and
        allows the ventricle to fill. On atenolol he has no
        murmur however his murmur was of a slightly lower
        grade. On atenolol his mitral valve no longer slams
        shut. While there has been no study to evaluate meds
        vs. no meds for asymptomatic cats atenolol is a pretty
        innocuous med. I have seen improvement in his very
        subtle exercise induced symptoms and of course his
        ultrasound is better on atenolol. Hope this helps.

        Susan

        =====
        Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin 2x week administered via pilling

        __________________________________
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        Yahoo! Calendar - Free online calendar with sync to Outlook(TM).
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      • emartisi
        Wow, thanks. And I see his meds are only given twice weekly? Ezra is a brown tabby too, although he s just now only seven months old, and his mother and
        Message 3 of 7 , Jun 6, 2003
          Wow, thanks. And I see his meds are only given twice weekly? Ezra
          is a brown tabby too, although he's just now only seven months old,
          and his mother and relations are also feral. I haven't noticed
          slight symptoms after exertion, but it's hard to tell. He's such a
          good kitten, I can't tell if he doesn't pester the others to death
          because of physical reasons or because he's really just that good of
          a kitten.

          The doctor didn't tell me that she was not going to medicate him as
          an asymptomaic cat when I asked about medication, but rather
          indicated that at his age she felt that, while HCM isn't going to go
          away, the nature of his condition might change in the past three
          months since his original ultrasound. From what you say, it sounds
          to me that if she begins him on medication this month after his re-
          check, that he will probably have to be checked by ultrasound again
          soon after to see how the medication affects his condition (i.e. your
          kitty's improvement on ultra sound and no murmur while medicated.)

          Kind of makes me wish she had just begun the meds in March!

          So, taking into consideration your thoughts, I really am being just
          over-cautious, as I suspected. Upon his visit I think I will insist,
          if she doesn't offer, that he begin meds.

          Thanks again.



          --- In feline-heart@yahoogroups.com, Susan <somnamblst@y...> wrote:
          >
          > --- emartisi <Taycey@a...> wrote:
          >
          > >
          > > When I took him for an ultrasound with a doctor of
          > > internal medicine,
          > She diagnosed slight to moderate HCM and
          > > he is getting
          > > another ultrasound in two weeks (three months from
          > > his original
          > > scan). She did not begin any medication and told me
          > > she wanted to
          > > wait until his re-check scan since he was still
          > > growing. His septum
          > > was thickened only a little more than normal, but
          > > his murmur is
          > > apparently quite audible. He has absolutely no
          > > outward symptoms. I
          > > monitor his respiratory rate and it is normal as
          > > compared with my
          > > other cats. He acts healthy in every way.
          > >
          > > The closest cardiologist is at least two hours away
          > > from here if what
          > > I found online is still current. I've asked a
          > > friend of mine who is
          > > a vet about whether taking him to a cardiologist
          > > would provide him
          > > any more benefit than seeing a doctor of internal
          > > medicine. She
          > > didn't seem to think it would matter greatly either
          > > way.
          >
          > My asymptomatic young HCM cat is under the care of an
          > Internal Medicine vet. IM includes cardiology and as
          > long as they have the equipment and knowlege and
          > experience to read the ultrasound, I do not think you
          > are going to get a different result by driving 2 hrs.
          > My vet does believe in medicating asymptomatic cats.
          > Rudy takes atenolol which slows his heart rate and
          > allows the ventricle to fill. On atenolol he has no
          > murmur however his murmur was of a slightly lower
          > grade. On atenolol his mitral valve no longer slams
          > shut. While there has been no study to evaluate meds
          > vs. no meds for asymptomatic cats atenolol is a pretty
          > innocuous med. I have seen improvement in his very
          > subtle exercise induced symptoms and of course his
          > ultrasound is better on atenolol. Hope this helps.
          >
          > Susan
          >
          > =====
          > Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19
          months of age with idiopathic HCM: grade 2 murmur, hyperkinetic
          heart, borderline normal thickening, considered asymptomatic, 12.5 mg
          Atenolol 1x day, 1/2 baby aspirin 2x week administered via pilling
          >
          > __________________________________
          > Do you Yahoo!?
          > Yahoo! Calendar - Free online calendar with sync to Outlook(TM).
          > http://calendar.yahoo.com
        • Susan
          ... No, aspirin is 2x weekly because it is toxic in cats, Atenolol is usually 1x or 2x daily. Ezra ... I personally have theorized (no proof) that ferals are
          Message 4 of 7 , Jun 6, 2003
            --- emartisi <Taycey@...> wrote:
            > Wow, thanks. And I see his meds are only given
            > twice weekly?

            No, aspirin is 2x weekly because it is toxic in cats,
            Atenolol is usually 1x or 2x daily.

            Ezra
            > is a brown tabby too, although he's just now only
            > seven months old,
            > and his mother and relations are also feral.

            I personally have theorized (no proof) that ferals are
            always on edge (adrenaline)

            I
            > haven't noticed
            > slight symptoms after exertion, but it's hard to
            > tell. He's such a
            > good kitten, I can't tell if he doesn't pester the
            > others to death
            > because of physical reasons or because he's really
            > just that good of
            > a kitten.

            My slight symptoms were outside after running, brief
            open mouth breathing and laying down stretched out
            suddenly after a sprint.
            >
            > The doctor didn't tell me that she was not going to
            > medicate him as
            > an asymptomaic cat when I asked about medication,
            > but rather
            > indicated that at his age she felt that, while HCM
            > isn't going to go
            > away, the nature of his condition might change in
            > the past three
            > months since his original ultrasound.

            Murmurs do sometimes go away on their own in very
            young cats.

            From what you
            > say, it sounds
            > to me that if she begins him on medication this
            > month after his re-
            > check, that he will probably have to be checked by
            > ultrasound again
            > soon after to see how the medication affects his
            > condition (i.e. your
            > kitty's improvement on ultra sound and no murmur
            > while medicated.)

            It may be apples and oranges. Rudy had a very rapid
            heart rate and a mitral valve that slammed shut (SAM)
            There are many different manifestaions of HCM. I
            recommend:
            Advances in Feline Cardiology
            http://www.walthamusa.com/articles/BONAGURA.pdf

            Drs. Bonagura and Kittleson are the experts in the
            field. Bonagura is at Ohio State, not sure about
            Kittleson.

            Susan

            =====
            Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin 2x week administered via pilling

            __________________________________
            Do you Yahoo!?
            Yahoo! Calendar - Free online calendar with sync to Outlook(TM).
            http://calendar.yahoo.com
          • emartisi
            ... Ezra is indoor-only, so he perhaps doesn t do true sprinting like Rudy, but he certainly plays, runs, leaps, etc. Probably not exactly the same. In any
            Message 5 of 7 , Jun 6, 2003
              > My slight symptoms were outside after running, brief
              > open mouth breathing and laying down stretched out
              > suddenly after a sprint.

              Ezra is indoor-only, so he perhaps doesn't do true sprinting like
              Rudy, but he certainly plays, runs, leaps, etc. Probably not exactly
              the same. In any case, he's never panted or stretched out more than
              the other young guy after playing.


              > Murmurs do sometimes go away on their own in very
              > young cats.
              >

              Yes, but his regular vet and the specialist have indicated to me that
              this will likely not be the case with him. Mostly, they think if he
              were going to outgrow his murmur it would not be the grade his is at
              this age.


              > It may be apples and oranges. Rudy had a very rapid
              > heart rate and a mitral valve that slammed shut (SAM)
              > There are many different manifestaions of HCM. I
              > recommend:
              > Advances in Feline Cardiology
              > http://www.walthamusa.com/articles/BONAGURA.pdf
              >
              > Drs. Bonagura and Kittleson are the experts in the
              > field. Bonagura is at Ohio State, not sure about
              > Kittleson.
              >


              I'm not certain on the details of the functioning of the mitral
              valve. Obviously, there is an issue there, but his heart rate was
              not significantly elevated in March. Will check out the link, thanks.

              Ohio State is roughly three hours from here. See? There's that darn
              cardiologist/travel issue I'm unsure about again!
            • Sally J.Smith
              Hi! I live in an area where the nearest Cardiologist was 2 hrs away. My vet has a nice referral system...she sends all the data; x-rays, scans and blood
              Message 6 of 7 , Jun 6, 2003
                Hi!

                I live in an area where the nearest Cardiologist was 2 hrs away. My
                vet has a nice referral system...she sends all the data; x-rays, scans
                and blood results to the cardiologist over the internet and for a mere
                $55 to me, he adds his 2 cents worth. Your vet could probably do
                something like this for you.
                The upside is that you get the consult for a much smaller fee, the
                downside is that you don't get to talk to the cardio, but you can send
                along a list of questions usually.

                Good for you for giving Ezra a great home! I know of another feral
                "Ezra"...he was taken in by a frined of mine after having been hit by
                a car in front of her house. He lost a rear leg to the accident, but
                that was 12 years ago and he is the alpha cat/animal in his house so
                apparently having just 3 legs has not been a problem for him! He purrs
                like crazy too!

                I have also taken in a feral girl and was very worried after I
                brought her in at 3 months for her first exam....she had a grade III
                murmur and I was very concerned, especially since I had recently lost
                my best boy of 18.5 years to CHF. She recently went back to be spayed
                and wonder of wonders, there is NO heart murmur! Nada! It was
                checked and re-checked because the vet could not believe it
                herself...I did nothing except love her and give her good food and a
                safe home...nature took care of the rest, so have hope! Ezra may have
                a similar story to tell!

                Please keep us posted on his progress!

                Sally
              • emartisi
                Wow! What a hopeful story about the heart murmur in your little girl kitty. That s fantastic! I m certainly not ruling out the possibility that it might be
                Message 7 of 7 , Jun 11, 2003
                  Wow! What a hopeful story about the heart murmur in your little girl
                  kitty. That's fantastic! I'm certainly not ruling out the
                  possibility that it might be gone...but the several vets I've had
                  listen to him didn't seem to think so, given his age, etc. After all,
                  his ultrasound was done nearly a month after hearing the murmur. But
                  who knows??

                  I will check to see if there is such a referral system in place at
                  the specialist's office. I'm not certain that it is, I would hope
                  I'd heard about it before during my years of animal work with various
                  vets around here, but then again, I can't recall referring very many
                  heart patients to her, especially felines. It seems most cat owners
                  don't want to pursue it with their kitties.

                  When I call to get his records, I will ask them. I have an
                  appointment with Ohio State University for the first week in July.
                  If there is a very thorough consultation service, perhaps I will go
                  with that.

                  Oh, and Ezra is definitely far from feral now. He's definitely
                  living it up with his status as the household baby.

                  Heidi

                  --- In feline-heart@yahoogroups.com, "Sally J.Smith"
                  <sallymerlin@y...> wrote:
                  > Hi!
                  >
                  > I live in an area where the nearest Cardiologist was 2 hrs away.
                  My
                  > vet has a nice referral system...she sends all the data; x-rays,
                  scans
                  > and blood results to the cardiologist over the internet and for a
                  mere
                  > $55 to me, he adds his 2 cents worth. Your vet could probably do
                  > something like this for you.
                  > The upside is that you get the consult for a much smaller fee,
                  the
                  > downside is that you don't get to talk to the cardio, but you can
                  send
                  > along a list of questions usually.
                  >
                  > Good for you for giving Ezra a great home! I know of another
                  feral
                  > "Ezra"...he was taken in by a frined of mine after having been hit
                  by
                  > a car in front of her house. He lost a rear leg to the accident,
                  but
                  > that was 12 years ago and he is the alpha cat/animal in his house
                  so
                  > apparently having just 3 legs has not been a problem for him! He
                  purrs
                  > like crazy too!
                  >
                  > I have also taken in a feral girl and was very worried after I
                  > brought her in at 3 months for her first exam....she had a grade
                  III
                  > murmur and I was very concerned, especially since I had recently
                  lost
                  > my best boy of 18.5 years to CHF. She recently went back to be
                  spayed
                  > and wonder of wonders, there is NO heart murmur! Nada! It was
                  > checked and re-checked because the vet could not believe it
                  > herself...I did nothing except love her and give her good food and
                  a
                  > safe home...nature took care of the rest, so have hope! Ezra may
                  have
                  > a similar story to tell!
                  >
                  > Please keep us posted on his progress!
                  >
                  > Sally
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