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Wow--real info. Need help deciphering.

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  • Susan Aufieri
    Abby had an appointment today with the people down the street. The new owner of the clinic is certified in ultrasound and is also a cardiology doc. She s also
    Message 1 of 8 , Apr 2, 2004
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      Abby had an appointment today with the people down the street. The new
      owner of the clinic is certified in ultrasound and is also a cardiology
      doc. She's also done emergency med.

      The doc looked at her xrays from her first visit. Thought her liver
      looked small for her size. I thought, ut oh, *another* issue? Then we
      started the ultra sound. First was the heart ultrasound, more on the
      rest of the ultra sound later.

      I need a bit of clarification and some help on deciphering this. I sort
      of understand this, since my Mom has heart problems for almost 25
      years. But this is kind of new territory in that Mom's problem is
      plumbing, Abby's is enlargement.

      Straight from the sheet (forgive typos, I'm trying to read marginal
      handwriting):

      Auscultation:
      HR 200, sinus grd 3/6 w apical systolic murmur. Eupreic (?). Femorals
      s/s (or is it 5/5?). Plump cardiac silohuette, lungs & vasculatory wm
      (? I'm not quite sure if it's com, rm, rom or mm)

      Gait weak in hind end, almost plantar on hocks.

      ECG: N/A

      Echocardiogram:
      LA/AO = mild to moderate LAE (I think it's LAE)
      LV= septum normal, LV posterior wall mild to moderately hypertrophied,
      LV (can't read the rest, looks like lumen mm)

      Systolic function = good

      RA & RV = wm
      LVOT & RVOT = wm
      Doppler = mr 3+ posterior jet

      Assessment/recommendation:
      Asymetrical HCM with moderate LAE and tachycardia.
      1. Free t4 at this time
      2. Add enalapril 1.25 mg POSID now
      3. In 7 days add atenolol 12.5 mg POSID
      3. Decrease Lasic to 12.5 mg SID 7 days after atenolol starts
      (these steps are to make sure we can figure out what caused what if
      something happens).
      4. CBC profile, Urinary analysis in 4 to 6 weeks
      5. Echo repeat in 6 months
      6. For neuropathy, thiamine start 100 mg 1M initial dose, 100 mg SQ 1D
      x 10 D, then weekly

      I really, really think that this Vet is on the ball. She agreed with me
      that the "IBD" was more syndrome than disease and due to the
      antibiotics. She gave me a "huh" stare when I told her about her former
      vet wanting to do endoscopy. This is more of a let's try simple things
      first, natural things first (like the thiamine shots), work our way up
      to invasive stuff if we have to.

      After the echo, she roamed Abby's abdominal cavity to look at her
      liver, gall bladder, pancreas (scarring) and to find fluid. There was
      no extra fluid. She's got kind of a witty personality. As she roaming
      with the ultrasound she says, "See that cauliflower? That's Abby's
      tummy. She needs food, it's empty." "See that rope? Intestines." "See
      that blob? That's fat and the thing being squished is her liver, which
      is normal. See this blob move by? All these blobs were fat! She
      couldn't see any irritations anywhere. Of course, we can't see inside
      her intestines, but she's not inclined to think it's IBD. I told her
      how I ditched the Purina EN, the OvaBan (she refuses to prescribe it to
      kitties, and if she does it's for no more than 14 days and ONLY as an
      appetite stimulant), ditched the grains (she says "makes cats fat"),
      and got her on some high quality food (The Wellness). I told her about
      her fur growing back after I ditched the grains. Didn't really seem to
      surprise her, she said something to the effect of "grains bad". ;-) I
      also told her about Abby's diarrhea fiasco (owner induced w/new brand
      of catfood at 100% strength. doh!) and how the Phytomucil stopped it
      dead in it's tracks. She was impressed. I think she stored that one
      away.

      So, it was probably THE most informative vet visit I've ever taken an
      animal to. Abby also put on 2/10's of a pound from last Friday.
    • Susan Aufieri
      Thanks Bill. I can t wait to try the thiamine treatment to see if it helps the neuropathy. Three vets, including her first one, have seen her walking. All of
      Message 2 of 8 , Apr 5, 2004
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        Thanks Bill. I can't wait to try the thiamine treatment to see if it
        helps the neuropathy. Three vets, including her first one, have seen
        her walking. All of them said neuropathy. Doubtful it's saddle
        thrombus. Wouldn't that just be excellent if it was an absorption
        problem, and not a degenerative one?

        Susan


        On Apr 5, 2004, at 8:20 AM, William Draper <wedraper@... wrote:

        > i'll see what i can do:
        > - heart rate of 200 is the upper end of normal for a cat (mildly
        > stressed)
        > - your cat has a grade 3 out of 6 heart murmur
        > - judging by the ultrasound and doppler report, i think your cat has a
        > mitral valve insufficiency
        > - that assessment and recommendation are standard for feline HCM
        > - the thiamine is going to be for the hind limb weakness (she seems to
        > think it's a neuropathy)
        > - the hind limb weakness may be from a saddle thrombus
      • Susan
        ... Is there any chance it is diabetic neuropathy? __________________________________ Do you Yahoo!? Yahoo! Small Business $15K Web Design Giveaway
        Message 3 of 8 , Apr 5, 2004
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          --- Susan Aufieri <susanaufieri@...> wrote:
          > Thanks Bill. I can't wait to try the thiamine
          > treatment to see if it
          > helps the neuropathy. Three vets, including her
          > first one, have seen
          > her walking. All of them said neuropathy. Doubtful
          > it's saddle
          > thrombus. Wouldn't that just be excellent if it was
          > an absorption
          > problem, and not a degenerative one?
          >
          > Susan

          Is there any chance it is diabetic neuropathy?

          __________________________________
          Do you Yahoo!?
          Yahoo! Small Business $15K Web Design Giveaway
          http://promotions.yahoo.com/design_giveaway/
        • Deena
          ... wrote: I can t wait to try the thiamine treatment to see if it helps the neuropathy. Three vets, including her first one, have seen
          Message 4 of 8 , Apr 5, 2004
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            --- In feline-heart@yahoogroups.com, Susan Aufieri
            <susanaufieri@v...> wrote: I can't wait to try the thiamine
            treatment to see if it helps the neuropathy. Three vets, including
            her first one, have seen her walking. All of them said neuropathy.
            Doubtful it's saddle thrombus. Wouldn't that just be excellent if it
            was an absorption problem, and not a degenerative one?

            Susan, I'm curious what type of thiamine(B1)treatments you are
            using? Are you also watching her B6, B12 and others in the B-
            complex? I'm far from expert, but know that a synthetic thiamine
            can sometimes whack out other vitamins, minerals, trace elements,
            etc.
          • Chris Martin
            ... I m no expert either, but i *do* know that the B-complex should always be given in balance. throwing off that balance can give big problems. Perhaps just
            Message 5 of 8 , Apr 5, 2004
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              On Monday, April 5, 2004, at 09:51 AM, Deena wrote:

              >
              > Susan, I'm curious what type of thiamine(B1)treatments you are
              > using? Are you also watching her B6, B12 and others in the B-
              > complex? I'm far from expert, but know that a synthetic thiamine
              > can sometimes whack out other vitamins, minerals, trace elements,
              > etc.
              >
              >
              I'm no expert either, but i *do* know that the B-complex should always
              be given in balance. throwing off that balance can give big problems.
              Perhaps just going with a B-complex instead of thiamine only would be
              better?

              Chris
              "My cat's job is to rest between naps."
            • William Draper
              thiamine in this instance is not being given as a dietary supplement, but as a specific treatment for a neuropathy. nerves operate a little differently than
              Message 6 of 8 , Apr 5, 2004
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                thiamine in this instance is not being given as a dietary supplement, but as a specific treatment for a neuropathy. nerves operate a little differently than other cells in the body, and they are much more fragile from a metabolic standpoint. once a cell body of a neuron dies, that's it for the nerve. thiamine is a vitamin specifically required for energy production in the brain.

                bill
                dvm in 2005

                ----- Original Message -----
                From: Chris Martin
                To: Deena
                Cc: feline-heart@yahoogroups.com
                Sent: Monday, April 05, 2004 3:42 PM
                Subject: Re: [FH] Thiamine for Neuropathy



                On Monday, April 5, 2004, at 09:51 AM, Deena wrote:

                >
                > Susan, I'm curious what type of thiamine(B1)treatments you are
                > using? Are you also watching her B6, B12 and others in the B-
                > complex? I'm far from expert, but know that a synthetic thiamine
                > can sometimes whack out other vitamins, minerals, trace elements,
                > etc.
                >
                >
                I'm no expert either, but i *do* know that the B-complex should always
                be given in balance. throwing off that balance can give big problems.
                Perhaps just going with a B-complex instead of thiamine only would be
                better?

                Chris
                "My cat's job is to rest between naps."



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                [Non-text portions of this message have been removed]
              • Susan Aufieri
                Her cardio vet has an 18 year old cat that has neuropathy, like Abby does. She tried the thiamine first as it s non-toxic and not really all that invasive (IM
                Message 7 of 8 , Apr 6, 2004
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                  Her cardio vet has an 18 year old cat that has neuropathy, like Abby does. She tried the
                  thiamine first as it's non-toxic and not really all that invasive (IM or sub-q). I'm not exactly
                  sure what's on order for her, I will know more this week when I can see the bottle.

                  Here's hoping though.

                  Susan

                  --- In feline-heart@yahoogroups.com, "Deena" <mottola@c...> wrote:
                  > Susan, I'm curious what type of thiamine(B1)treatments you are
                  > using? Are you also watching her B6, B12 and others in the B-
                  > complex? I'm far from expert, but know that a synthetic thiamine
                  > can sometimes whack out other vitamins, minerals, trace elements,
                  > etc.
                • Susan Aufieri
                  Her cardio vet also tells me that if it is a thiamine induced neuropathy from absorbtion problems, the disease behaves much like pernicious anemia. You can eat
                  Message 8 of 8 , Apr 6, 2004
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                    Her cardio vet also tells me that if it is a thiamine induced neuropathy from absorbtion
                    problems, the disease behaves much like pernicious anemia. You can eat all the b-12 you
                    want, but w/out injections you will get sick and die. My friend had pernicious anemia and
                    had shots of b-12 very frequently, despite having a well rounded diet.

                    Susan

                    --- In feline-heart@yahoogroups.com, William Draper <wedraper@e...> wrote:
                    > thiamine in this instance is not being given as a dietary supplement, but as a specific
                    treatment for a neuropathy. nerves operate a little differently than other cells in the body,
                    and they are much more fragile from a metabolic standpoint. once a cell body of a neuron
                    dies, that's it for the nerve. thiamine is a vitamin specifically required for energy
                    production in the brain.
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