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Re: [FH] Wow--real info. Need help deciphering.

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  • William Draper
    you could notice b/c the thrombus will cause a decreased blood flow to the limb. you will see cyanotic (blue from low oxygen) nail beds if there is a clot.
    Message 1 of 2 , Apr 5, 2004
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      you could notice b/c the thrombus will cause a decreased blood flow to
      the limb. you will see cyanotic (blue from low oxygen) nail beds if
      there is a clot. which pain killers were being used?

      bill
      dvm in 2005

      p.s. 3 hours from the mountains and 2 hours from the beach is perfect for
      me ;)


      On Mon, 5 Apr 2004 06:54:44 -0400, "Susan Aufieri"
      <susanaufieri@...> said:
      > Oh great. So if she throws a clot, I wouldn't notice that it's not her
      > neuropathy (assuming the thiamine doesn't help).
      >
      > I started her on the heart meds Saturday. Forgot to ask the vet if her
      > pain killer would cause problems so she hasn't had any since Friday
      > night. HUGE difference in her. Not eating much (I know, get her to
      > eat), and doing the feline equivalent of swearing when she walks. I
      > hope the thiamine works...
      >
      > Susan
      >
      > ps: too bad. NC is nice, but NH is nicer. Best state to live for 2004
      > ;-)
      >
      >
      > On Apr 4, 2004, at 2:46 PM, William Draper wrote:
      >
      > > LAE = left atrial enlargement. this is a sequela from the left
      > > ventricular
      > > HCM. this enlargement can also cause thrombi to form, as it creates
      > > turbulence in the blood.
      > >
      > > bill
      > > dvm in 2005
      > > ----- Original Message -----
      > > From: "Susan Aufieri" <susanaufieri@...>
      > > To: "William Draper" <wedraper@...>
      > > Sent: Sunday, April 04, 2004 1:58 PM
      > > Subject: Re: [FH] Wow--real info. Need help deciphering.
      > >
      > >
      > > Pretty certain the hind limbs' weakness isn't the thrombus. She's
      > > walked oddly for eons, never been a graceful kitty. :-) It is most
      > > definitely neuropathy, it's gotten worse over the years. Though I did
      > > bring up the fact that I'd read it can be associated with HCM, though
      > > not often (I think I saw that on VIN).
      > >
      > > What is an LAE? I guess it's all the abbreviations that confuse me. My
      > > mom has heart issues, but it's the plumbing parts, not the heart
      > > itself. So I know nothing about these things...
      > >
      > > thanks!
      > >
      > > Susan and lil Miss Queen Abby
      > >
      > > On Apr 4, 2004, at 8:59 AM, William Draper 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
      > >>
      > >> bill
      > >> dvm in 2005
      > >> ----- Original Message -----
      > >> From: Susan Aufieri
      > >> To: feline-heart@yahoogroups.com
      > >> Sent: Friday, April 02, 2004 7:14 PM
      > >> Subject: [FH] Wow--real info. Need help deciphering.
      > >>
      > >> 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.
      > >>
      > >>
      > >>
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      --
      William Draper
      wedraper@...
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