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Lasix Alone - Anecdote - Advice

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  • nala nala
    Based on your experiences, what do you think you would do?? My vet card has been telling me about this lasix alone study for the last few months - since
    Message 1 of 1 , Feb 19, 2007
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      Based on your experiences, what do you think you would
      do??

      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
      it.

      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
      funny gait.

      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,

      Sincerely,

      Nala

      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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