Lasix Alone - Anecdote - Advice
- Based on your experiences, what do you think you would
My vet card has been telling me about this "lasix
alone" study for the last few months - since about the
time my HOCM cat was hospitalized in renal failure
with CHF. Just before the hospitalization, my cat was
dehydrated so we cut back on her lasix. After getting
her blood chemistry back and finding elevated renal
values we also dropped her ACE-inhibitor. The
cardiologist had my cat weaned off her beta-blocker
during hospitalization and also had them stop her
anti-platelet med, Plavix.
Just prior to this time my cat had also developed an
arrhythmia (she had previously had a normal sinus
rhythm), but we did not do an EKG to determine the
source of the irregular heart beat (early beats-
sounds like a skipped beat).
I told my cardiologist that from everything I had read
that I was very uncomfortable with the lasix alone
treatment plan. She reiterated the info about this
"lasix alone" study.
When my cat came home, I started her back on the
beta-blocker as her heart rate was between 180 and
220, even when seemingly calm, with an early beat
about every 15th beat. She was originally put on the
beta-blocker because of the systolic anterior motion
of her mitral valve (the O for obstructive in HOCM).
I also reduced the dose from what it had been before,
partly because I always believed the dose was too high
and that my cat had lost 1/3 of her body weight since
she was originally diagnosed.
I would like to put her back on benazepril as well,
but the vets fear that since introduction of an
ACE-inhibitor will reduce the glomular filtration rate
- at least for the short term, they don't want to risk
I think that I DO want to risk it - because I think
she did better when she took it and it did keep her
potassium in check. My cardiologist has left it up to
me. Currently, I am supplementing my cat with with 6
mEq KCl (potassium chloride)/day. Originally it was 4
mEq, but her potassium level is low and my cat has a
I am also trying to get her to prescribe
spironolactone based on the RALES human study, but she
prescribed hydrochlorothiazide instead (HCTZ). The
RALES study (Randomized Aldactone Evaluation Study),
in a nutshell, showed that spironolactone significanly
improved outcomes for humans in CHF who were all
treated with furosemide and many of whom were also
treated with ACE-inhibitors. Patients in early renal
failure or who were already moderately hyperkalemic
(high levels of potassium) were excluded from the
study. A follow-up study noted, however that
hyperkalemia was on the rise in CHF patients treated
with both an ACE-inhibitor and spironolactone. (Too
much K+ can cause fatal heart arrhythmia).
Thanks for your input,
ps - she quit vomiting blood, and has been eating well
on her own- she has gained 1/3 of a pound in the past
4 days. .
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