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Re: Understanding HCM

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  • peteycat9
    They say they have never encountered a case where an asymptomatic, mild HCM patient turned up with a clot this early in the progression of the disease. Dear
    Message 1 of 2 , May 31, 2004
      They say they have
      never encountered a case where an asymptomatic, mild HCM patient
      turned up
      with a clot this early in the progression of the disease.

      Dear Kelly,
      I am truly sorry this happened to you and your baby. I had to
      respond to this posting because I too had a cat that was just like
      yours. He was assymptomatic to my observation and look like the
      picture of health. Checkers never presented even a heart murmur when
      he was examined by my vet. Then one night, he collapsed in a
      frenzied, panting state. I rushed him to the hospital with no clue
      what was wrong. The attending vets suspected HCM because of the
      panting, but because his heart rate still sounded NORMAL, they were
      quite puzzled by his condition. They kept asking me if I thought my
      cat was poisoned. My cat was also showing neurological symptoms,
      something that again, doesn't fit the usual HCM crisis scernerio. I
      even had to find documentation that Checkers was vaccinated against
      rabies because it was another possibility the vets considered. A
      chest X-ray was done and the results were normal, no fluid build up.
      And yet, he couldn't breathe outside his oxygen cage. During this
      whole time, his heart rate remained "normal" with no unusual heart
      sounds. Twenty eight hours of being at the hospital, he had a
      seizure that left him hopelessly comatose. He was euthanized with us
      still not knowing really what was wrong. He was only 18 months old!
      But a necropsy confirmed that he did indeed have "significant
      thickening" of the heart muscle. It was believed that it was a
      shower of blood clots that caused the fatal neurological symptoms, a
      very unusual event for cardiac cats. We were completely devastated
      by his sudden loss. I needed answers, just like you. Why was there
      no heart murmur, even when he was dying? Why did the clots go to his
      brain instead of his legs? Through my exstensive research, I have
      come to learn that there are indeed cases of HCM cats that don't have
      a significant amount of heart disease and yet, still throw a clot.
      It's very frustrating and unfair to think that these rare events have
      to happen to OUR cat. I felt so guilty that I didn't know Checkers
      was sick. But it's like what everyone says, cats do hide their
      illness very well! Please know that you did nothing to fail your
      precious baby. Losing a cat suddenly to this disease is a very
      traumatic thing. Please know I will keep you in my thoughts and
      prayers during this difficult time. Take care.
    • Facies Family
      My beloved Facie, a doll-faced Persian, died at 14 1/2 on May 9. She was just diagnosed with HCM on April 12. I am grieving and also in shock because the vets
      Message 2 of 2 , May 31, 2004
        My beloved Facie, a doll-faced Persian, died at 14 1/2
        on May 9. She was just diagnosed with HCM on April 12.
        I am grieving and also in shock because the vets have
        told me her case is mysterious and I'm not getting
        answers to help resolve this loss. I am hoping
        someone, particularly a specialist vet or
        cardiologist, can help me understand this better to
        come to grips with it.

        Facie had annual exams with full blood profiles, plus
        in-between appointments for any minor issues that
        might crop up. She was in prime condition, kidneys et
        al just great, only a bit of arthritis in the shoulder
        that made her limp now and then. She looked so great
        that even the folks at the vet's office thought she
        was only 4 or 5 year old. We had an annual visit May
        '03, everything great. Nov. 29 she had a visit for
        chin acne and vitals checked (weight and heart OK).
        Her appetite is always great, and she keeps herself in
        good trim--between 8-9 pounds since she was young. We
        took her in early for her big exam on Mar. 30 and
        discovered she had lost 6.5 ounces, had a heart rate
        of 210, and a gallop rhythm (irregularly irregular).
        No breathing trouble, she had not seemed
        lethargic--she does sleep more in the winter months,
        but she always got sporty on sunny days in our
        enclosed garden. My husband and I both have home
        offices so we've been able to watch her closely
        through her senior years and she is an affectionate
        mate during the day, perched on our desks or laps. We
        were referred to a cardiologist who made the diagnosis
        of HCM with ultrasound and ECG. He said it was so mild
        (patchy thickening, 35% at most, most of the
        chamber normal) that he felt she had another 2 years
        of quality life with regular treatment. He prescribed
        1/4 tab atenolol per day and bring her for a check-up
        in 4 weeks, when he would consider adding aspirin to
        her regimen. I was due for medical treatment in the US
        which could not be postponed (we are in the UK). I was
        torn about leaving and also about starting her meds
        without being here, but he assured us that beta
        blockers do not have a downside and she did *not* need
        close observation to adjust the dose. My in-laws care
        for her regularly, at our house or theirs, and she has
        an immensely fun time at their house (we're always
        afraid she's going to resent going home when we take
        her down for holidays together), so my husband and I
        decided to take her there during our absence. They are
        also retired and one of them is home 24 hrs a day. We
        sent records to the local vet and set up the contact
        so he would take instructions from the cardiologists,
        and in an emergency, she would be taken to the Bristol
        University feline center, one of the two top feline
        cardio research units in the UK. My husband stayed at
        his parents' for the first 5 days of her atenolol, and
        she seemed great. She was springtime frisky, playing
        and enjoying herself and appetite increasing
        above normal (which happens when she's physically
        really active in the spring and summer). All reports
        from my in-laws were great. They took photos for us,
        and she looks great. Then, 3 weeks to the day from
        starting the meds, she walked across the kitchen and
        collapsed. The local vet diagnosed a saddle thrombosis
        and recommended euthanasia. We had a system in place
        to alert our cardiologist, who was on the phone and
        evaluating her condition. She was not in pain (no
        crying, no indication in vitals that she was in pain)
        and he said to get her to Bristol , 2 hours away. She
        was up and walking before they arrived, and strolled
        out of her carrier in such good shape that the
        specialist there was concerned that it might not have
        been a clot. Ultrasound & ECG, also blood screen for
        enzymes confirmed that it had been, but her body was
        clearing it effectively. Her heart condition had
        actually improved since she started the
        meds too. She was seen by a top feline cardiac
        researcher the next day, and her own cardiologist came
        to see her. He said he was shocked to see her, that
        with her mild HCM he would not have believed a clot
        was possible. I arrived and saw her for an hour each
        day for the next two days--she was clearly dopey from
        the analgesics, but walking, responsive, and eating
        well. The hospital wanted to keep her for observation
        for several days before releasing her. I will hold off
        on detailing the rest of her treatment in intensive
        care, but I will tell you that 84 hours after her
        collapse, she had another embolism and died instantly
        in her sleep. We decided against a post-mortem when
        the vet told us that clots often dissipate before they
        can have a look and leave no evidence. Given that poor
        outlook, we decided against it as it was all too

        What is most distressing is that all of the vets and
        cardiologists who treated her say they are mystified
        by her first embolism episode, her fast almost
        "miraculous" recovery from it, and her death. They say
        they have never encountered a case where an
        asymptomatic, mild HCM patient turned up
        with a clot this early in the progression of the
        disease. It just seems too coincidental that this
        happens 3 weeks after the atenolol is started, but I
        can't find any data that suggests that it is risky.
        Nor did I before we started the treatment. I wonder if
        positive changes in the morphology of the
        could cause cell damage and thus clots as easily as
        negative changes (thickening)-change is change--but
        I'm not a doctor and this is just an intuitive

        I was deeply anxious about leaving her and would have
        put my own medical treatment behind her own, but for
        the assurance of the vet who said she did not need
        constant observation. I am not blaming the vet, but
        myself, and finding it hard to live with this. If her
        case is so atypical, I can't help wondering if we did
        something or could have done something different. She
        was not stressed going to or at my in-laws (she is the
        rare cat who likes car trips and doesn't cry in the
        car). I keep thinking I would have seen some sign that
        something was wrong and could have stopped it. Does
        anyone have any knowledge of the disease that it can
        be this capricious and unpredictable? She was healthy
        and beautiful and a wonderful friend for 14 1/2 years
        and her loss is unbearable.

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