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Re: Thoracocentesis for Pleural Effusion

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  • 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 1 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 2 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 3 of 4 , Oct 2, 2003
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          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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