--- sandworm90292 <erosla77@...
> 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
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
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
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:
beta blocker therapy: propranolol metoprolol
calcium channel blocker therapy: diltiazem
cat: 1/4 of 0.125 mg (PO) q 48h - SID
cat: 0.21-1.0 mg/kg BID-TID (PO); 0.04 mg/kg (IV)
cat: 2-15 mg TID (PO)
cat: 5-12.5 mg SID (PO)
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
> 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?
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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