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Is there really any effective treatment for HCM... ?

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  • Guy DuBord
    My cat was diagnosed with HCM several months ago. Based on some of the info I ve received here, every week I give him either vitamin supplements (fish oil or
    Message 1 of 8 , Nov 28, 2004
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      My cat was diagnosed with HCM several months ago.
      Based on some of the info I've received here, every
      week I give him either vitamin supplements (fish oil
      or CoQ10) and a baby aspirin twice a week (on the
      advice of my vet). Right now he has a healthy
      appetite, and is quite playful and loving - but like
      many of you, I expect the worst to happen sooner
      rather than later.

      My question: is there really any effective treatment,
      or is it really just a matter of luck? My
      highly-recommended vet here in San Francisco so far
      has cost me about $1000 for various tests and the
      original diagnosis (as well as a consulation with a
      radiologist!) - but nothing I've heard from him or
      read so far convinces me that there's much I can do to
      make a difference.

      I'd love to hear your thoughts, and be corrected if
      I'm wrong.

      Thanks, Jim



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    • brinkett
      ... There is effective treatment for the symptoms but there is no cure. It sounds like your cat is asymptomatic since he s not on any heart meds. He may
      Message 2 of 8 , Nov 29, 2004
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        > My question: is there really any effective treatment,
        > or is it really just a matter of luck?

        There is effective treatment for the symptoms but there is no cure.
        It sounds like your cat is asymptomatic since he's not on any heart
        meds. He may remain that way for the rest of his life. For cats
        who progress to congestive heart failure, the meds are a life
        saver. However, they are not a cure.

        It's not a matter of luck. Each cat's case is different, and there
        is still a lot to learn about feline heart disease. The current
        meds will work better for some cats than they will for others. And
        some cats will remain asymptomatic while others won't. It all
        depends on each cat's heart.

        Sarah.
      • jen
        Jim, I m sorry to hear that your kitty is one of our group. This disease is so frustrating and the treatments have no well controlled studies into their
        Message 3 of 8 , Nov 29, 2004
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          Jim,

          I'm sorry to hear that your kitty is one of our group. This disease is so
          frustrating and the treatments have no well controlled studies into their
          effectiveness.

          However, many of us with asymptomatic kitties have noticed an
          increased exercise tolerance once our kitties started their meds. Some
          signs of the disease, like murmur ratings and atrial wall thicknesses,
          have also improved with medications. Certainly for the symptomatic
          kitties, medications are essential to their continued survival.

          There is no cure for the disease, the best we can hope to do is slow its
          progression and treat the signs and symptoms as they arise.

          jen, deagan and kira the dog

          3yo DSH, asymptomatic; Atenolol 12.5mg BID and CoQ10 30mg SID
        • Susan
          Jim, I agree with Jen. My current HCM kitty who was diagnosed early based on subtle symptoms has been taking atenolol for over 2 years. Vet cardiologists
          Message 4 of 8 , Nov 30, 2004
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            Jim,

            I agree with Jen. My current HCM kitty who was
            diagnosed early based on subtle symptoms has been
            taking atenolol for over 2 years.

            Vet cardiologists cannot agree on whether early
            treatment to slow heart rate does anything to slow
            progression because there have been no double blind
            studies to evaluate treatment vs. no treatment in
            asymptomatics. However in the most recent articles I
            do detect a greater willingness among certain
            cardiologists to advocate treatment vs. no treatment.
            I will try to dig up that article later.

            The most frequent treatment advocated is beta-blockade
            (atenolol) which serves to slow the heart rate,
            allowing the left ventricle to have a longer time to
            fill and reduces the myocardial oxygen demand. A heart
            that is beating fast needs more oxygen, and when there
            is not enough oxygen there is ischemia which is a type
            of damage the heart muscle suffers.

            My own vet does believe in treating asymptomatics
            based on his clinical experience. He has had over 100
            cats on atenolol. Some cats on this list have been on
            atenolol for even longer, some as long as 5-6 years.

            Susan

            --- jen <lundgren_jennifer@...> wrote:

            >
            >
            > Jim,
            >
            > I'm sorry to hear that your kitty is one of our
            > group. This disease is so
            > frustrating and the treatments have no well
            > controlled studies into their
            > effectiveness.
            >
            > However, many of us with asymptomatic kitties have
            > noticed an
            > increased exercise tolerance once our kitties
            > started their meds. Some
            > signs of the disease, like murmur ratings and atrial
            > wall thicknesses,
            > have also improved with medications. Certainly for
            > the symptomatic
            > kitties, medications are essential to their
            > continued survival.
            >
            > There is no cure for the disease, the best we can
            > hope to do is slow its
            > progression and treat the signs and symptoms as they
            > arise.
            >
            > jen, deagan and kira the dog
            >
            > 3yo DSH, asymptomatic; Atenolol 12.5mg BID and CoQ10
            > 30mg SID





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          • Susan Aufieri
            It just makes me absolutely crazy that vets do not treat asymptomatic heart kitties. In human medicine, if there is a problem they go after it with a vengence.
            Message 5 of 8 , Nov 30, 2004
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              It just makes me absolutely crazy that vets do not treat asymptomatic heart kitties. In
              human medicine, if there is a problem they go after it with a vengence. This I know,
              because my mom has fought heart disease for nearly 25 years. I really have to wonder that
              if I'd pushed harder when she was first diagnosed a few years ago, if things would be
              better for her now. It's something that I kick myself about on a regular basis. Shoulda,
              coulda, woulda....

              another Susan

              --- In feline-heart@yahoogroups.com, Susan <somnamblst@y...> wrote:
              > My own vet does believe in treating asymptomatics
              > based on his clinical experience. He has had over 100
              > cats on atenolol. Some cats on this list have been on
              > atenolol for even longer, some as long as 5-6 years.
            • Susan
              We have to realize that allopathic vets are scientists. They have to be able to establish efficacy. Otherwise they must first do no harm and second can t
              Message 6 of 8 , Nov 30, 2004
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                We have to realize that allopathic vets are
                scientists. They have to be able to establish
                efficacy. Otherwise they must first do no harm and
                second can't justify the expense of medicating if it
                makes absolutely no difference. They feel it is wrong
                for owners to pay for treatments that don't do
                anything. We don't know for a fact that treatment of
                asymptomatics with beta-blockade or calcium channel
                blockers has any effect on mortality and morbidity.
                And we may never as such a trial would last years and
                be really expensive. When my cat went on atenolol I
                read everything I could and asked vets and human
                pharmacists if there was a downside to atenolol. They
                assured me there was not. Except in asthmatics and
                some geriatric cats atenolol is usually very well
                tolerated. If my cat is a guinea pig for atenolol I'm
                fine with that. A too fast heart rate is not good even
                if it isn't ultimately responsible for the
                hypertrophy.


                --- Susan Aufieri <susanaufieri@...> wrote:

                >
                >
                > It just makes me absolutely crazy that vets do not
                > treat asymptomatic heart kitties. In
                > human medicine, if there is a problem they go after
                > it with a vengence. This I know,
                > because my mom has fought heart disease for nearly
                > 25 years. I really have to wonder that
                > if I'd pushed harder when she was first diagnosed a
                > few years ago, if things would be
                > better for her now. It's something that I kick
                > myself about on a regular basis. Shoulda,
                > coulda, woulda....
                >
                > another Susan
                >
                > --- In feline-heart@yahoogroups.com, Susan
                > <somnamblst@y...> wrote:
                > > My own vet does believe in treating asymptomatics
                > > based on his clinical experience. He has had over
                > 100
                > > cats on atenolol. Some cats on this list have been
                > on
                > > atenolol for even longer, some as long as 5-6
                > years.
                >




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              • fraay11
                ... It makes me crazy that in human medicine the goal seems to be to medicate people for anything and everything. I m personally glad that there are vets who
                Message 7 of 8 , Nov 30, 2004
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                  > It just makes me absolutely crazy that vets do not treat
                  > asymptomatic heart kitties. In human medicine, if there is a
                  > problem they go after it with a vengence.

                  It makes me crazy that in human medicine the goal seems to be to
                  medicate people for anything and everything.

                  I'm personally glad that there are vets who feel differently then I
                  do about the the way this disease should be treated in early stages.
                  Different vets trying a variety of methods could lead to a cure.

                  I think its a pretty complicated situation to try to treat an
                  uncurable disease for which the cause is unknown, and the future
                  (life span, quality of life, cause of death, etc) of the cat is
                  impossible to predict.

                  I'm not sure how anyone could say definetly without a doubt that ANY
                  kind of treatment (or none at all) is the best way to go, when the
                  progression of this disease varies so much from cat to cat and the
                  definition of feline HCM basically boils down to "somethings wrong,
                  we don't know why, and we can't fix it".
                • brinkett
                  ... wrong, ... I agree with the sentiment, but to be fair, the definition of HCM is pretty clear. That s why some cats are classified as having HCM, some DCM,
                  Message 8 of 8 , Dec 1, 2004
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                    >the
                    > definition of feline HCM basically boils down to "somethings
                    wrong,
                    > we don't know why, and we can't fix it".

                    I agree with the sentiment, but to be fair, the definition of HCM is
                    pretty clear. That's why some cats are classified as having HCM,
                    some DCM, some RCM. However, the "we don't know why and can't fix
                    it" part is about right. :-)

                    As far as medications go, the treatment of asymptomatic cats is
                    still up in the air. But once a cat enters congestive heart
                    failure, if they aren't medicated, they die. It's as simple as that.

                    Sarah.
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