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Thoracentesis for Pleural Effusion

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  • mouseytonguesmom
    Mousey Tongue was diagnosed with HCM in March. He has previously had some episodes of fluid on his lungs that were remedied by changing his dose of Lasix.
    Message 1 of 4 , Sep 30, 2003
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      Mousey Tongue was diagnosed with HCM in March. He has previously had
      some episodes of fluid on his lungs that were remedied by changing
      his dose of Lasix. Last week, he also had pleural effusion and
      thoracentesis to drain 100 ccs of fluid.

      If anyone has any experience with this procedure, I am wondering
      whether this is a one-time procedure or can it be performed safely
      more than once? Mousey Tongue spent several hours in an oxygen cage
      before the thoracentesis and seemed much better afterwards. However,
      fluid seems to be building up again. Before the oxygen and
      thoracentesis last week, Mousey Tongue's vet indicated that Mousey
      Tongue may not survive continued fluid buildup and it appeared to be
      leading to congestive heart failure. I don't want him to suffer.
      However, I want to give him every chance so long as his quality of
      life isn't suffering, which it did seem to when the pleural effusion
      was found.

      Mousey Tongue get 0.7 cc Lasix twice daily, 1/4 Atenelol twice daily
      and 1/2 aspirin every 72 hours.

      If any has any suggestions on other ways to address the fluid buildup
      or any experience with similar symptoms, please help.

      Maggie
    • jenmcgovern2001
      Hi Maggie and Mousey Tongue, My kitty Urchin had three thoracocentesis procedures, so yes, it can be done more than once, but you ll have to find a willing
      Message 2 of 4 , Oct 1, 2003
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        Hi Maggie and Mousey Tongue,

        My kitty Urchin had three thoracocentesis procedures, so yes, it can
        be done more than once, but you'll have to find a willing vet. The
        pleural effusion developed from his HCM/hyperthyroid condition and was
        the beginning of his congestive heart failure. Both oxygen and the
        procedures seemed to help Urchin a lot, since the fluid build up
        caused breathing difficulties. He was on atenolol, lasix, and
        methimazole. The continued fluid build up was a problem for Urchin as
        well--we had difficulty balancing higher doses of lasix against
        dehydration (we did sub-cu fluids at home) and the fluid build up
        continued to increase. My vet said that the third one was the last
        one he'd do, since Urchin was becoming weaker each time. I don't
        think that fluid build up can be reduced with anything other than
        lasix and lung taps.

        I wish I could give you better news, but my vet did say that as long
        as his breathing wasn't labored (which it wasn't after the lung taps),
        then he wasn't suffering. My kitty passed away at home without
        difficulty breathing, and I think the thoracocentesis procedures were
        very beneficial to him in his last days. If Mousey Tongue continues
        to have fluid build up, I'd encourage you to seek another procedure.
        However, in my kitty's case, the procedures became closer and closer
        together--7 days between the first and second, 5 days between the
        second and third, and he passed away less than a day after the third
        one. So the procedures may not help your kitty for very long *sniff*.

        I wish you and Mousey Tongue many more good days ahead and hope you
        know that there are others who have been in the difficult place that
        you are now. Sounds like your vet's doing everything s/he can for
        your kitty and you are taking extra good care of him.

        Best wishes--Jen and Urchin (angel kitty)
      • Sally J.Smith by way of diane
        Hello Maggie, I m so sorry you both are having to go thru this...we all know how scary this journey can be sometimes. Firstly let me say that I am not a vet
        Message 3 of 4 , Oct 2, 2003
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          Hello Maggie,

          I'm so sorry you both are having to go thru this...we all know
          how scary this journey can be sometimes.

          Firstly let me say that I am not a vet and your question is a very
          good one that deserves careful consideration by a professional...that
          said, I can share my experience, limited as it is.

          Have you taken Mousey Tongue to a cardiologist? The reason I ask
          is that most of the HCM kitties that I know of are usually on some
          additional meds from the ones you mentioned. These meds usually assist
          the heart in pumping more efficiently and/or dialating the blood
          vessels to make it easier on the inefficient heart's pumping
          production. I am surprised your kitty is not on any of these meds yet.
          A cardiologist would also be the best one to ask about these meds.
          When my kitty was first dx with HCM I asked for details about all
          the possibile paths we might go down. Pleural Effusion was one
          possibility and at the time my vet said that they always hope that the
          patient will respond favourably with drug treatment and many/most do
          but sometimes it takes several trys to get the balance just right. But
          that sometimes fluid still builds up and often needs to be removed
          manually. (BTW, fluid can also build up in the abdomen and this is
          called "Ascites" though this is less common)
          Manually removing fluid is a difficult procedure and has some risks
          to it so my vet gave me the impression that it was best done very
          infrequently and only when absolutely necessary. She gave me the
          impression that depending on the amount of time between procedures,
          she really did not think it was a good idea to do a thoracentesis more
          than once or twice, three times was possible, but at that point the
          treatments might be too invasive and if the need was coming frequently
          then it might be sending a message.She also said that sometimes when a
          kitty's condition changes from HCM into CHF (again, only a
          cardiologist and an echocardiogram can verify this) that often
          initially there is an initial event of fluid build-up that signals
          this change in dx. and that after the initial even things stabilize
          for awhile longer all on their own.
          Additionally, sometimes changing meds or dosing or reducing subQ
          fluids (if kitty is taking these) will help stabilize the kitty after
          the first event and things level out for awhile longer with no more
          need to do a manual drain, something we all hope for...but this really
          does vary from patient to patient.

          Since MT responded well to the extra O2, you might consider
          creating some sort of an at-home O2 tent that he could relax in for a
          few minutes/hours each day. It would be best to talk this over with
          your vet and with other members here who have done this for their
          kits....it is a nice way to support a CHF kitty but it is not always
          possible/practical for caregivers to go this route. Also look into the
          files and do a search here in these files for discussions on
          CoQ10...you may want to consider adding it to MT's treatment plan.

          But again, all these questions are best fielded by your vet and a
          cardiologist. Best wishes to you and Mousey Tongue...hopefully this
          crisis will be behind you and with an update on his meds hopefully he
          will make a better adjustment to his situation and you won't have to
          do this again. Please keep us updated!

          Best wishes,

          Sally


          --- In feline-heart@yahoogroups.com, "mouseytonguesmom" <mcoons@e...>
          wrote:
          > Mousey Tongue was diagnosed with HCM in March. He has previously
          had
          > some episodes of fluid on his lungs that were remedied by changing
          > his dose of Lasix. Last week, he also had pleural effusion and
          > thoracentesis to drain 100 ccs of fluid.
          >
          > If anyone has any experience with this procedure, I am wondering
          > whether this is a one-time procedure or can it be performed safely
          > more than once? Mousey Tongue spent several hours in an oxygen cage
          > before the thoracentesis and seemed much better afterwards.
          However,
          > fluid seems to be building up again. Before the oxygen and
          > thoracentesis last week, Mousey Tongue's vet indicated that Mousey
          > Tongue may not survive continued fluid buildup and it appeared to be
          > leading to congestive heart failure. I don't want him to suffer.
          > However, I want to give him every chance so long as his quality of
          > life isn't suffering, which it did seem to when the pleural effusion
          > was found.
          >
          > Mousey Tongue get 0.7 cc Lasix twice daily, 1/4 Atenelol twice daily
          > and 1/2 aspirin every 72 hours.
          >
          > If any has any suggestions on other ways to address the fluid
          buildup
          > or any experience with similar symptoms, please help.
          >
          > Maggie
        • Margaret Coons by way of diane
          Hi Sally, Thank you for your response. Since several people mentioned medicine changes may make a difference and that a cardiologist might be helpful at this
          Message 4 of 4 , Oct 2, 2003
          • 0 Attachment
            Hi Sally,

            Thank you for your response. Since several people mentioned medicine
            changes may make a difference and that a cardiologist might be helpful at
            this point, I called around to find a cardiologist and one nearby had a
            cancellation for tomorrow, when usually it takes a month to get an initial
            appointment. So, it looks like this is Mousey Tongue's lucky day!

            Mousey Tongue had another chest tap yesterday (his second in a week). The
            vet got 100 ccs from the right side of his chest. The last time, a week ago,
            he got 100 ccs total from both sides of his chest. Mousey Tongue has been
            sleeping peacefully since then. He seems much better to me after the chest
            taps than he has for months, but I hope I am not getting false hope, and
            twice in a week sounds like a lot. Mousey Tongue's condition has been such
            that I am afraid he could go any time, but suddenly, he's purring more and
            doing cat-like things again after the chest taps. For those whose cats have
            gone through chest taps, is this normal?

            Any suggestions for what to ask the cardiologist or anything I should know
            before we go? . Thank you for all of your help and support. It has been
            very helpful to hear from people who have been through this before.

            Maggie

            Message -----
            From: Sally J.Smith (by way of diane)
            To: feline-heart@yahoogroups.com
            Sent: Thursday, October 02, 2003 6:05 AM
            Subject: [FH] Re: Thoracentesis for Pleural Effusion


            Hello Maggie,

            I'm so sorry you both are having to go thru this...we all know
            how scary this journey can be sometimes.

            Firstly let me say that I am not a vet and your question is a very
            good one that deserves careful consideration by a professional...that
            said, I can share my experience, limited as it is.

            Have you taken Mousey Tongue to a cardiologist? The reason I ask
            is that most of the HCM kitties that I know of are usually on some
            additional meds from the ones you mentioned. These meds usually assist
            the heart in pumping more efficiently and/or dialating the blood
            vessels to make it easier on the inefficient heart's pumping
            production. I am surprised your kitty is not on any of these meds yet.
            A cardiologist would also be the best one to ask about these meds.
            When my kitty was first dx with HCM I asked for details about all
            the possibile paths we might go down. Pleural Effusion was one
            possibility and at the time my vet said that they always hope that the
            patient will respond favourably with drug treatment and many/most do
            but sometimes it takes several trys to get the balance just right. But
            that sometimes fluid still builds up and often needs to be removed
            manually. (BTW, fluid can also build up in the abdomen and this is
            called "Ascites" though this is less common)
            Manually removing fluid is a difficult procedure and has some risks
            to it so my vet gave me the impression that it was best done very
            infrequently and only when absolutely necessary. She gave me the
            impression that depending on the amount of time between procedures,
            she really did not think it was a good idea to do a thoracentesis more
            than once or twice, three times was possible, but at that point the
            treatments might be too invasive and if the need was coming frequently
            then it might be sending a message.She also said that sometimes when a
            kitty's condition changes from HCM into CHF (again, only a
            cardiologist and an echocardiogram can verify this) that often
            initially there is an initial event of fluid build-up that signals
            this change in dx. and that after the initial even things stabilize
            for awhile longer all on their own.
            Additionally, sometimes changing meds or dosing or reducing subQ
            fluids (if kitty is taking these) will help stabilize the kitty after
            the first event and things level out for awhile longer with no more
            need to do a manual drain, something we all hope for...but this really
            does vary from patient to patient.

            Since MT responded well to the extra O2, you might consider
            creating some sort of an at-home O2 tent that he could relax in for a
            few minutes/hours each day. It would be best to talk this over with
            your vet and with other members here who have done this for their
            kits....it is a nice way to support a CHF kitty but it is not always
            possible/practical for caregivers to go this route. Also look into the
            files and do a search here in these files for discussions on
            CoQ10...you may want to consider adding it to MT's treatment plan.

            But again, all these questions are best fielded by your vet and a
            cardiologist. Best wishes to you and Mousey Tongue...hopefully this
            crisis will be behind you and with an update on his meds hopefully he
            will make a better adjustment to his situation and you won't have to
            do this again. Please keep us updated!

            Best wishes,

            Sally


            --- In feline-heart@yahoogroups.com, "mouseytonguesmom" <mcoons@e...>
            wrote:
            > Mousey Tongue was diagnosed with HCM in March. He has previously
            had
            > some episodes of fluid on his lungs that were remedied by changing
            > his dose of Lasix. Last week, he also had pleural effusion and
            > thoracentesis to drain 100 ccs of fluid.
            >
            > If anyone has any experience with this procedure, I am wondering
            > whether this is a one-time procedure or can it be performed safely
            > more than once? Mousey Tongue spent several hours in an oxygen cage
            > before the thoracentesis and seemed much better afterwards.
            However,
            > fluid seems to be building up again. Before the oxygen and
            > thoracentesis last week, Mousey Tongue's vet indicated that Mousey
            > Tongue may not survive continued fluid buildup and it appeared to be
            > leading to congestive heart failure. I don't want him to suffer.
            > However, I want to give him every chance so long as his quality of
            > life isn't suffering, which it did seem to when the pleural effusion
            > was found.
            >
            > Mousey Tongue get 0.7 cc Lasix twice daily, 1/4 Atenelol twice daily
            > and 1/2 aspirin every 72 hours.
            >
            > If any has any suggestions on other ways to address the fluid
            buildup
            > or any experience with similar symptoms, please help.
            >
            > Maggie
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