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Thoracentesis for Pleural Effusion

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  • 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 1 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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