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ACE Inhibitors for Tabby Jean?

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  • sandworm90292
    Here s the update, fellow fur luvers! TJ, as you know, was diagnosed with some form of cardiomyopathy about 3 months ago. She has an enlarged left ventricle, a
    Message 1 of 2 , Jul 31, 2004
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      Here's the update, fellow fur luvers!

      TJ, as you know, was diagnosed with some form of cardiomyopathy about 3 months ago.

      She has an enlarged left ventricle, a gallop rhythm, irregular EKG with premature
      ventricular contractions. Has moderate lesions on her aortic valve that is causing
      moderate blood flow reguritation. Is asymptomatic-runs around like a maniac with her
      sister, Tazzleberry Marie.

      Atenolol and another beta-blocker have not worked.

      Doctor B is discussing ACE Inhibitors; I showed her Susan's post on the subject. Tabby is
      stable; her recent sonogram is identical to the first one from 3 months ago.

      I don't know if the ACE Inhibitors are worth the risk of damage to TJ's kidneys. Doctor B
      things the entire problem is the result of an old an inactive infection: endocarditis. That
      explains the valve lesions, the blood backflow, and the resultant strain is what probably
      caused the ventricle to enlarge.

      I'm thinking at this point taking her for holistic treatment(Dr. B. has recommended a
      holistic vet) instead of the ACE inhibitors.

      Your thoughts? Suggestions? TJ says the WHOLE thing is best addressed by giving her a
      constant supply of salmon treats, live mice from the Pet Store, and plenty of catnip toys,
      round the clock, 24-7. Plus tossing her little sister, Taz, into the trash chute(they've got a
      SERIOUS love/hate thing going).

      I think she's off base.

      I'd appreciate any feedback here.

      TJ and Taz's Dad, Paul R.
    • Susan
      ... By not worked do you mean that beta-blockade has not slowed her heart rate or have not addressed the PVCs? from VetGo cardiology concepts: Consequences of
      Message 2 of 2 , Aug 1, 2004
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        --- sandworm90292 <erosla77@...> wrote:

        > Here's the update, fellow fur luvers!
        >
        > TJ, as you know, was diagnosed with some form of
        > cardiomyopathy about 3 months ago.
        >
        > She has an enlarged left ventricle, a gallop
        > rhythm, irregular EKG with premature
        > ventricular contractions. Has moderate lesions on
        > her aortic valve that is causing
        > moderate blood flow reguritation. Is
        > asymptomatic-runs around like a maniac with her
        > sister, Tazzleberry Marie.
        >
        > Atenolol and another beta-blocker have not worked.

        By not worked do you mean that beta-blockade has not
        slowed her heart rate or have not addressed the PVCs?

        from VetGo cardiology concepts:

        Consequences of PVCs:
        Several isolated premature beats are of no hemodynamic
        significance.
        However, when enough of these beats are present, a
        marked reduction in cardiac output may result (due to
        a loss of atrial induced ventricular filling and high
        heart rate).

        Treatment:
        Several isolated beats do not warrant therapy.
        However, such individuals should be frequently
        monitored for exacerbation of their rhythm
        disturbance. In addition, attention should be directed
        toward identification and management of the underlying
        disorder.
        Criteria for therapy include:
        if the animal is symptomatic with this disorder
        if paroxysms of sustained tachycardia develop such as
        a burst lasting greater than 60 sec.
        Drugs commonly used include:
        digoxin
        beta blocker therapy: propranolol metoprolol
        atenolol
        calcium channel blocker therapy: diltiazem
        Dosages:

        Digoxin:
        cat: 1/4 of 0.125 mg (PO) q 48h - SID
        Propranolol:
        cat: 0.21-1.0 mg/kg BID-TID (PO); 0.04 mg/kg (IV)
        slowly
        Metoprolol:
        cat: 2-15 mg TID (PO)
        Atenolol:
        cat: 5-12.5 mg SID (PO)
        Diltiazem:
        cat:
        cardizem: 1-2 mg/kg TID (PO)
        cardizem CD: 10 mg/kg SID (PO)
        Comment: Although propranolol is the best known beta
        blocker in veterinary medicine, it has drawbacks in
        its combined beta 1 and beta 2 blocking activity. We
        should attempt to use beta-1 selective beta blocker
        such as metoprolol and atenolol. As well the Ca
        channel blockers, such as diltiazem, may be
        particularly useful in these disorders.

        >
        > Doctor B is discussing ACE Inhibitors; I showed
        > her Susan's post on the subject. Tabby is
        > stable; her recent sonogram is identical to the
        > first one from 3 months ago.

        I cannot remember if Tabby Jean is on lasix. The vast
        majority of cats on Lasix are also on an ACE-I because
        the activation of the renin angiotensin system has the
        effect of causing further remodeling of the left
        ventricle. If TJ is not on lasix then she is not
        considered to be in CHF and certainly no treatment is
        an option. Was a calcium channel blocker tried and was
        a CCB plus BB tried? I know I have seen references to
        that combo for refractory tachycardia (fast heart
        rate)
        >
        > I don't know if the ACE Inhibitors are worth the
        > risk of damage to TJ's kidneys.

        Is TJ CRF and how old is she?

        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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