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Update on Tabby Jean

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  • sandworm90292
    Folks, Took Tabby in for her one week check-up. No response, so far, to the Atenolol; her arrhythmia appears the same, EKG nearly the same. The vet wants me to
    Message 1 of 6 , Jun 2, 2004
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      Folks,


      Took Tabby in for her one week check-up. No response, so far, to the Atenolol; her
      arrhythmia appears the same, EKG nearly the same. The vet wants me to increase the
      dosage from 1/4 of a 25mg pill to a little less than half, and then, after a few days, half a
      pill.

      The good news: Dr. Barrett, Tabby's vet, is one of the top cardiologists around, and her
      boss, Dr. Ettinger, wrote the book that is the standard in Veterinary internal medicine.

      Dr. B is headed to a cardiology conference in Minneapolis next week and is taking all of
      Tabby's data with her to share with the conference. She says Tabby has an odd
      combination of symptoms of different kinds of myopathy. Her left ventricle is 40%
      enlarged, but the walls of the heart are only slightly thickened, so it isn't the kind where
      the walls get thick. She has 20% thickening in two of her valves and a slight mitrial valve
      leak too.

      Dr. B can't yet give a firm diagnosis because of this.

      Right now, because of the expertise of the vets at California Animal Hospital(they do
      clinical trials there of drugs from time to time so they are cutting edge) and because Dr. B
      is taking Tabby's results to a cardiology conference, I am pretty confident she is in good
      hands on that score. I want to see what they all have to say about her condition at the
      conference.

      On my mind right now if anyone has any answers:


      1. Is there ANY research at all to show that treatments such as acupuncture and/or giving
      supplements can improve the condition of the heart?? E.g. ,making the muscle stronger,
      correcting arrhythmia, slowing or stopping the growth of the heart etc or is it all bullshit?

      I don't want to waste time with treatments that do nothing but make ME feel better or give
      me a sense of control, but don't, in reality, help Tabby. If they do help. I'll spare no
      expense. But I want to know if there is ANY science behind it, or if it is just a palliative to
      help us hopelessly in love with our cat folks feel better.

      2. Is there ANYONE in the Los Angeles area who can recommend, from consistent personal
      experience, a holistic/complimentary medicine vet who will work WITH the cardiologist
      and who has a good reputation? I won't even speak to a vet who will demand I take Tabby
      off her meds or stop seeing a "western" Doctor. I'm looking for a level headed specialist
      who can accept different treatment modalities(my brother, for example, is an MD who also
      does(and has done TO him) accupuncture.

      I want to thank everyone who has responded to my posts. This group is of incredible
      value to me. My hope is that I can find some good solultions to keep Tabby alive and
      kicking. She is such a sweet cat; Dr. B and her vet techs love her and have pointed out
      what a good kitty she is.
    • Susan
      ... Rudy is on the half pill dose and it does resolve his murmur and improve his exercise tolerance. ... Is this by any chance a condference that Dr. Clarke
      Message 2 of 6 , Jun 3, 2004
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        --- sandworm90292 <erosla77@...> wrote:
        >
        > Folks,
        >
        >
        > Took Tabby in for her one week check-up. No
        > response, so far, to the Atenolol; her
        > arrhythmia appears the same, EKG nearly the same.
        > The vet wants me to increase the
        > dosage from 1/4 of a 25mg pill to a little less than
        > half, and then, after a few days, half a
        > pill.

        Rudy is on the half pill dose and it does resolve his
        murmur and improve his exercise tolerance.


        >
        > The good news: Dr. Barrett, Tabby's vet, is one of
        > the top cardiologists around, and her
        > boss, Dr. Ettinger, wrote the book that is the
        > standard in Veterinary internal medicine.
        >
        > Dr. B is headed to a cardiology conference in
        > Minneapolis next week and is taking all of
        > Tabby's data with her to share with the conference.

        Is this by any chance a condference that Dr. Clarke
        Atkins will be speaking at? If it is you may be able
        to get some definitive answers on the nutraceuticals
        question as he has been lecturing on nutraceuticals in
        cardiology.


        >
        >
        > 1. Is there ANY research at all to show that
        > treatments such as acupuncture and/or giving
        > supplements can improve the condition of the heart??
        > E.g. ,making the muscle stronger,
        > correcting arrhythmia, slowing or stopping the
        > growth of the heart etc or is it all bullshit?

        Most of the nutraceuticals that people do use such as
        carnitine and taurine are indicated for the type of
        cardiomyopathy that dogs suffer from which is dilated
        rather than hypertrophic. I have read everything
        publicly available by veterinary cardiologists and all
        references and studies supporting these nutraceuticals
        pertain to DCM rather than HCM. Taurine deficient DCM
        is now rarely seen in cats unless they have been fed
        dog food or homemade diets with inadequate taurine.

        There has been some recent promising research in rats
        and growth hormone. Considering recent interest in
        growth hormones role in feline HCM I thought this was
        interesting. (I will paste the abstract and link at
        the bottom of this email.)
        >
        > I don't want to waste time with treatments that do
        > nothing but make ME feel better or give
        > me a sense of control, but don't, in reality, help
        > Tabby. If they do help. I'll spare no
        > expense. But I want to know if there is ANY science
        > behind it, or if it is just a palliative to
        > help us hopelessly in love with our cat folks feel
        > better.


        Here is a link to a website where you can hopefully
        find some answers:

        Task Force For Veterinary Science
        http://www.vet-task-force.com/index.html

        They have collected Medline abstracts on:

        Alternative Medicine in General (Via Medline)
        Acupuncture and TCM (Via Medline)
        Homeopathy (Via Medline)
        Chiropractic (Via Medline and Chirobase) (External
        Link)
        Herbal Medicine (Via Medline)
        FDA Adverse Event Reports and other material

        Growth Hormone Improves Bioenergetics and Decreases
        Catecholamines in Postinfarct Rat Hearts1
        from:
        http://endo.endojournals.org/cgi/content/full/141/12/4592

        Effects of GH on catecholamines and �-adrenoceptors
        One rather unexpected result was that of markedly
        decreased myocardial content of NA in animals treated
        with rhGH. Not only myocardial content of NA but also
        plasma NA were significantly lower in rats receiving
        rhGH. The interaction between GH and sympathetic
        system is probably complex and is not completely
        understood at the present time. Previous clinical
        studies indicate that GH may have pronounced effects
        in the regulation of sympathetic function, which is
        based on the fact that patients with GH deficiency
        have markedly increased activation of the sympathetic
        nerve fibers firing in skeletal muscle (16).
        Furthermore, GH treatment of patients with dilated
        cardiomyopathy results in attenuation of cardiac
        sympathetic activation under stress conditions (37).
        Our findings are congruent with these observations.
        The marked lowering of myocardial catecholamine
        content, after rhGH treatment, suggests an important
        role of rhGH in regulation of the cardiac sympathetic
        system and catecholamines. The present study does not
        allow any conclusions regarding the mechanisms and
        pathophysiological importance for these findings, and
        further studies are necessary. However, it is unlikely
        that diminished stores of myocardial NA are a result
        of increased release and/or decreased uptake. This
        assumption is supported by the fact that neither HR
        nor myocardial content of �-adrenoceptors was
        different between the groups. It has been established
        that down-regulation of �-adrenoceptors is one
        consequence of cellular exposure to high NA levels
        (38). In the early phase of heart failure, there is an
        organ-selective activation of the cardiac sympathetic
        system, and the catecholamine spillover from the heart
        is 3�4 times higher than normal (14). If GH
        specifically increases release and/or decreases
        reuptake of NA, one would expect depletion of
        myocardial stores to be associated with increased
        plasma NA levels. Even if the long-term consequences
        of this effect are not known, lowering of tissue NA
        content in the early postinfarct phase, together with
        low plasma NA concentration, could have protective
        effects on damaged and remodeling myocardium.
        Experimental studies have shown that NA, in high
        concentration (similar to that known to occur in the
        neuromuscular synapses of failing myocardium), exerts
        direct pathological effects on cardiomyocytes. These
        effects include cell necrosis, stimulation of
        apoptosis, increase in interstitial fibrosis,
        arrhythmias, and others (39, 40). Furthermore,
        increased adrenergic drive can decrease the contents
        of creatine and CK in the heart, indicating adverse
        effects on cellular energetic homeostasis (41). While
        improving LV function by other mechanisms independent
        of the sympathetic system, addition of rhGH could, at
        the same time, protect myocardium from the side
        effects of sympathetic overactivation. This
        hypothesis, however, has to be taken with caution and
        proven in future experiments. One has to keep in mind
        that depletion of myocardial catecholamines is a
        consistent finding in patients with advanced heart
        failure. Exhaustion of catecholamine stores in cardiac
        neurons is proposed to be involved in mechanisms
        behind LV dysfunction.

        Susan

        =====
        Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin 2x week administered via pilling




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      • savionna@aol.com
        Hi Paul, In a message dated 6/2/04 7:24:10 PM, erosla77@aol.com writes: Yes. Eg, the Univ of Michigan just conducted a
        Message 3 of 6 , Jun 4, 2004
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          Hi Paul,

          In a message dated 6/2/04 7:24:10 PM, erosla77@... writes:

          << 1. Is there ANY research at all >>

          Yes. Eg, the Univ of Michigan just conducted a 5-yr study on complementary
          treatment for cardic disease (in humans). Also, the Univ of Maryland, for one,
          already treats (human) cardiac patients with complementary medicine, which
          presupposes it has valid reason to do so.

          << to show that treatments such as acupuncture and/or giving supplements can
          improve the condition of the heart?? >>

          No, b/c it is not the purpose of acpuncture (etc) to "improve" the heart.
          It's important to keep in mind that complementary medicine is not just about
          different tools (eg acupuncture needles), but about an entirely diff. approach,
          based on very diff. concepts of physiology and pathology. Understanding this
          changes the nature of the questions.

          That said, there is a minimum of the type of conventional "research" as it is
          conducted in the US (eg, randomized controlled trials), b/c typical research
          models are generally inappropriate to complementary medicine for various
          reasons, incl:

          1. Perhaps the primary reason is due to the conflict between standardization
          and individualization. The techniques that we call "complementary" in the
          US...which refer to a range of healing modalities diff. from what we are familiar
          with as "conventional" medicine but which are common in other parts of the
          world...are *individual* to the *body* and *not* standard to a disease. The tools
          of conventional medicine (synthetic medication and surgery) act relatively
          uniformly and predictably and their effect can therefore be "measured" using
          typical research methods. Eg, an antibx will kill or inhibit susceptible bacteria
          no matter what. So if Patient A and Patient B both have Bacteria X, then
          Antibiotic Y will work roughly the same in both patients, with measurable results.
          Complementary modalities (eg homeopathy, Western herbs, Traditional Chinese
          Medicine, nutraceuticals, etc) work *in conjunction with* the individual...and
          their "success" depends on many factors, incl the ability of the particular
          body to be affected by the particular remedy (which is in turn affected by
          countless factors).

          Here is an analogy that may be useful, even if it's not completely point for
          point. Say you have a fly in your house. Conventional medicine sprays
          pesticide, which will act uniformly on flies no matter where they are. Complementary
          medicine hangs fly paper...and its "success" depends on *interaction* between
          the paper and the fly, which in turn depends on the characteristics of the fly,
          the paper, and their relationship.

          That said, homeopathic remedies have been researched since the late
          1700s...on countless millions of humans (not on animals or in petri dishes)...in a
          testing method called "provings." Further, the first known double-blind study was
          done in 1906 by homeopaths, and there have subsequently been numerous studies
          done on homeopathy (primarily in France, Germany, and the UK). Traditional
          Chinese Medicine has also been studied extensively (primarily in China, Japan,
          and Australia). There are also other types of testing methods that can indicate
          whether a particular treatment is appropriate for a particular body.

          2. A second reason is that complementary modalities have a diff. chemical
          composition and/or a diff. type of activity from synthetic meds. Synthetic meds
          are single isolated chemical substances with a specific set of activities that
          affect specific target cells. Eg, loratadine (Claritin Rx) is a specific
          compound (C22-H23-ClN2-O2), manufactured in a specific quantity, that blocks H1
          receptors...nothing else. So it is easy to measure its effect. Complementary
          remedies are complex substances, with varied activities, that have the potential
          to affect various cells thruout the entire body. Eg, the herbs used in Western,
          Chinese, and Ayurvedic botanical medicine (which are just a few of the known
          plant-based healing systems) contain dozens if not hundreds of compounds, each
          in varying amts (depending in part on how the source plant was raised,
          processed, etc) and each with a diff. potential action that can affect various parts
          of the body. Homeopathic remedies, which are derived from plants, minerals,
          and animals, are also complex (altho in a diff. way than medicinal herbs) and
          are formulated to interact with the body's energy (as opposed to its
          chemistry). Acupuncture acts on an network of energy thruout the body. This makes them
          less amenable to typical testing methods that measure the action of one
          substance on one type of cell.

          3. Another reason there is little typical research is b/c it is not
          financially profitable to do so. Conventional medicine is concomitant with two
          technology industries: drugs and devices. Conducting the research that is required for
          a drug or device to come to market, or to maintain market position, costs
          money, and it is undertaken primarily when there is a solid prospect that the
          investment can be recooped by selling the product to the largest possible market.
          There is too little money to be made in selling plants, vitamins, and
          acupuncture needles to be of interest to most American pharmaceutical firms (altho
          various European companies, among others, that produce synthetic meds either
          also produce nonsynthetic remedies or distribute nonsynthetic remedies produced
          by partner companies).

          And one other issue that's important to keep in mind. It is only in the US
          (and to some extent Canada) that there is such a divisive split between
          conventional and complementary medicine. And to understand why it exists, it would be
          necessary to understand the history of medicine in this country, incl the
          advent of the AMA in the mid-1800s, as well as the role of the pharmaceutical
          industry in the early 1900s. In much of the rest of the developed world,
          conventional and complementary medicine co-exist side by side. Pharmacies in, eg,
          Germany (where 90 percent of the population uses complementary medicine) carry just
          as many plant-based and homeopathic remedies as synthetic ones, if not more.
          Hospitals in Switzerland, eg, treat not only with synthetic meds and surgery
          but also with acupuncture and Reiki...not to mention with air, mud, and mineral
          waters. In France, homeopathic physicians outnumber allopathic physicians 5
          to 1. Even Queen Elizabeth II's personal physician is a homeopath. Traditional
          Chinese Medicine has been practiced for more than 2000 yrs. Western botanical
          medicine for nearly as long. Ayurvedic for more than 1200 yrs. Homeopathy for
          more than 200 yrs. *Every* culture...from the Aleuts of Alaska on down...has
          systems of health care that don't necessarily follow the same model as that of
          the US, which emerged as we know it around the 1940s. That doesn't mean they
          are bogus or ineffective. They are just different and largely unknown in the
          US.

          << E.g. ,making the muscle stronger,

          correcting arrhythmia, slowing or stopping the growth of the heart etc or is
          it all bullshit? >>

          See above. Whether a particular treatment affects a particular heart in a
          particular body in a particular way is largely individual...which is why it is
          essential to work with an experienced complementary practitioner who can make
          informed decisions on which treatment is appropriate for the individual.
          Further, the purpose of acupuncture, nutritional supplements, etc is not necessarily
          to make a muscle stronger, etc. The goal of these treatments is, very broadly
          stated, to rebalance the body so that it can return to a state of health, to
          the extent possible, which in turn can affect the condition of a particular
          organ. This is very diff. from conventional medicine's linear model of Drug A
          acts on Cell B in Disease C.


          << But I want to know if there is ANY science behind it, or if it is just a
          palliative to

          help us hopelessly in love with our cat folks feel better. >>

          What do you consider "science"? If complementary medicine has no "scientific"
          validity, then why are 60% of US medical institutions...incl some of the most
          prestigious, eg Johns Hopkins, Harvard, Duke, Columbia, UCLA, UPenn, and
          Georgetown...treating patients and/or training physicians with some form of
          complementary medicine? Why has the National Institutes of Health included a center
          for complementary medicine since 1991? Why is complementary medicine among the
          fastest growing segments of the US health-care industry, with more than 40
          percent of the population (projected to exceed 60 percent by 2010) currently
          spending about $35 billion annually on treatments? Why are visits to
          complementary practitioners in the US currently about double the number of visits to
          conventional physicians? Does everyone without access to "scientific" medicine as
          we know it suffer and succumb for lack of effective care? More than 25 percent
          of the world's population uses Traditional Chinese Medicine as the primary
          health care system...is it just one big placebo for the unenlightened?


          << Is there ANYONE in the Los Angeles area who can recommend, from consistent
          personal

          experience, a holistic/complimentary medicine vet who will work WITH the
          cardiologist

          and who has a good reputation? >>

          There is a directory of complementary vets at
          www.ahvma.org/referral/index.html, some of whom I know thru reputation and contacts but not personal
          experience.

          << I won't even speak to a vet who will demand I take Tabby

          off her meds or stop seeing a "western" Doctor. >>

          Before having any conversation it might be valuable to understand what
          complementary medicine is and how it is practiced. *All* holistic vets have already
          earned their DVM or VMD (or comparable degrees) in conventional veterinary
          medicine and then continue to study in the modality(ies) of their choice, some
          for the rest of their careers; so they are all already "Western" doctors. This
          allows them, esp those who are experienced and skilled in many modalities, to
          practice true *integrative* medicine, which means they use the modality(ies)
          that is/are most appropriate to the individual case, whether it's a conventional
          or complementary technique or, often, both...and they coordinate with any
          number of specialists as needed. Each healing technique has its benefits and
          limitations...and each body may require a diff. combination of therapies; holistic
          vets simply have more options to chose from than synthetic meds and surgery.
          That said, there are some instances where synthetic meds may conflict with
          another therapy or interfere with a certain goal being reached...but an
          experienced integrative vet will be able to manage that. // Rosemary
        • sandworm90292
          Well folks, the Atenolol did NOT work. So we have had TJ on Propanolol, 1/2 pill in the morning and then 1/2 8 hours later, for the past 5 days. Brought her
          Message 4 of 6 , Jun 16, 2004
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            Well folks, the Atenolol did NOT work. So we have had TJ on Propanolol, 1/2 pill in the
            morning and then 1/2 8 hours later, for the past 5 days. Brought her in today for a check
            up and still no change with THAT either. Same gallop rhythm and same cardiac arrhythmia
            on the EKG

            We are going to keep her on the Propanolol another week and then bring her back, but the
            vet things that the Propanolol may not work either.

            This is VERY frustrating, because I keep getting "I'm not sure" and "we don't know".

            How many different beta-blockers are there to run through and try? I feel like they are
            doing clinical experiments on my cat.

            The good news is she is STILL asymptomatic in every way. One of the vets said it may well
            be that the condition is untreatable and that we eventually just watch her carefully.

            That's a pretty annoying and long and expensive set of trials just to find out it didn't
            make any difference in the end.

            ARRRRRRGH.

            God, I'm glad this group is here for me to vent.

            PR
          • Susan
            ... The new beta-blockers that people and some dogs are getting are carvedilol and metropolol. They are new drugs so they are expensive. It seems like vets try
            Message 5 of 6 , Jun 16, 2004
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              --- sandworm90292 <erosla77@...> wrote:
              >
              >
              > Well folks, the Atenolol did NOT work. So we have
              > had TJ on Propanolol, 1/2 pill in the
              > morning and then 1/2 8 hours later, for the past 5
              > days. Brought her in today for a check
              > up and still no change with THAT either. Same gallop
              > rhythm and same cardiac arrhythmia
              > on the EKG
              >
              > We are going to keep her on the Propanolol another
              > week and then bring her back, but the
              > vet things that the Propanolol may not work either.
              >
              > This is VERY frustrating, because I keep getting
              > "I'm not sure" and "we don't know".
              >
              > How many different beta-blockers are there to run
              > through and try? I feel like they are
              > doing clinical experiments on my cat.

              The new beta-blockers that people and some dogs are
              getting are carvedilol and metropolol. They are new
              drugs so they are expensive. It seems like vets try
              new things with dogs first. Carvedilol is interesting
              because of its antioxidant properties and i think
              metropolol is time release.

              VetGo Cardiology Concepts is temporarily unavailable,
              but I will see what I can dig up for refractory
              arrythmias when I get home. Can you send me a capsule
              synopsis of her diagnostics and treatment regimens?

              Susan

              =====
              Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin 2x week administered via pilling



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            • Susan
              I stumbled on a good article on cat house soiling while searching for something else. http://www.hilltopanimalhospital.com/feline%20housesoiling2.htm Susan
              Message 6 of 6 , Jun 16, 2004
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                I stumbled on a good article on cat house soiling
                while searching for something else.

                http://www.hilltopanimalhospital.com/feline%20housesoiling2.htm

                Susan



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