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New here - two kitties with HCM

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  • Tracy
    Hi everyone! I am unfortunately new, dealing with two HCM kitties, one also has CRF and I m really afraid for him these days. My less sick kitty is named
    Message 1 of 8 , Feb 27, 2007
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      Hi everyone! I am unfortunately new, dealing with two HCM kitties,
      one also has CRF and I'm really afraid for him these days.

      My less sick kitty is named Pumpkin, he's about 7 we think, we
      adopted him from the SPCA back in December. He was a stray who had
      been at the shelter for 15 months. He's an absolute doll! On his
      first appointment with our vet she thought she heard a slight heart
      murmur but wasn't sure. He was scheduled for a dental at the
      beginning of February so she took another listen and the murmur was
      definitely there - so no dental, cardiac ultrasound instead.
      Cardiologist confirmed HCM. So Pumpkin is now on Attenolol 1/4
      tablet daily for his heart and he's doing very well, no side effects
      or other health issues - he's a mooch so pilling him is easy, last
      night he got it crushed in cheese. His bloodwork and a urinalysis
      did show some reduced kidney function but not enough that it's an
      issue at this point, just something to monitor. Vet did say he is
      at risk for clots and she may put him on aspirin but we haven't come
      back to that yet.

      My problem child as I refer to him is Oscar, he is 17 and is CRF
      with HCM, cardiac ultrasound done in January '06 showed thickening
      of his heart muscle. He also has a galloping heart rhythm. We've
      been treating his CRF since April '05 but not his heart, we tried
      heart meds in January '06 but they didn't agree with him, they made
      him very ill. Took us months to get him back on track. His kidney
      values have continued to decline, he's prone to infection due to a
      stone in his bad kidney. February 6 he took a turn for the worse
      and developed fluid in and around his lungs, x-rays confirmed it.
      He was prescribed 1/4 tablet twice daily Lasix and it took about a
      week for him to start feeling better. He then started on the
      Attenolol 1/8 tablet daily; check up on the 17th confirmed his
      galloping rhythm is now gone so it's doing it's job. Lasix was
      reduced to once daily. Vet wanted to wean him off the Lasix to see
      if he can keep the fluid off his lungs so we started every other day
      dosing middle of last week but he's been very poorly most of this
      past weekend and last night I noticed definite laboured breathing so
      he is back on daily Lasix - breathing did seem better this morning,
      less laboured. He's also on Fortekor for his kidneys, 1/2 tablet
      daily and Pepcid AC for stomach acid. Getting him to eat has become
      a bit of an ordeal, he didn't eat much this weekend and yesterday he
      didn't touch his wet food while I was away at work. I gave him some
      Fancy Feast last night and he set on that bowl like he hadn't seen
      food for a week! But he only ate the gravy, not much of the chicken
      slices (it was Marinated Chicken Feast). Gave him the same food
      this morning but I mushed it into more of a slurry hoping that it
      would go down better, he was at his food bowl when I left for work.
      He sees his vet tomorrow afternoon. I'm hoping with being back on
      the Lasix he'll start brightening up a bit. He had follow up x-rays
      on the 17th that showed only a little bit of fluid but they also
      revealed some spots on his lungs which the vet was not at all happy
      about seeing - we are not sure what they are but worst case scenario
      could be cancerous. He may get more x-rays tomorrow to check his
      lungs. It just breaks my heart him being like this. Before he
      developed the fluid issue he was a normal happy kitty, teasing
      Pumpkin merciliessly because it was fun. Pumpkin is surprisingly
      upset about Oscar, considering he's only been with us 2 months he's
      really attached himself to Oscar, though Oscar not to him.

      We have a third cat as well, 17 y.o. Barney, who is hyper-t and is
      doing just fine - he'll probably outlive us all - must be his happy-
      cat nature. Barney & Oscar have been together for 15 years so I
      know Barney will be devastated when we lose Oscar.

      Thanks all for listening. I look forward to learning more about HCM
      and what I can do to help my kitties.

      Tracy
      Barney (hyper-t), Oscar (CRF + HCM)
      and Pumpkin (HCM)
    • Leah Ferron
      Tracy, Welcome to you and your kitties. I am sorry to hear about their conditions but glad that you found us. We have quite a few poeple in the group that are
      Message 2 of 8 , Feb 27, 2007
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        Tracy,

        Welcome to you and your kitties. I am sorry to hear about their conditions but glad that you found us. We have quite a few poeple in the group that are dealing with hyper-t and HCM in the group so all your bases may be covered here.

        You say that Oscar isn't eating well. This is a big problem with heart kitties and when you add kidney problems to the mix, oy vay! I suggest you join the Yahoo Feline Assisted Feeding group. They have lots of info to help coax kitties to eat. Most of us in this group have had to join for our heart kitties too. But Oscar must eat. If he doesn't, you will have to add liver problems to his list of ailments. Try whatever you can to get him to eat even if you have to open 10 cans of food.

        Something that we suggest for heart kitties is to give supplements like CoEnzyme Q10 (CoQ10) and some others. Most vets feel the supplements won't help but won't hurt either. We think they help tremendously. If you want some more info about supplements, just email me. Along with supplements, a good quality canned food is best if possible. Sometimes, kitties with CRF eat special food. My Angel Alec had CRF and RCM and was on special food for the CRF. But I supplemented the food with other canned food. It is all about what you think is best for your kitty given their condition.

        I am glad that Pumpkin and now Oscar are on heart meds. If Oscar is in congestive heart failure, CHF, as you say then the meds are best for him. It may take a while to figure out the best dosage of lasix. This is normal. And it changes with time too. Don't be afraid to call your vet or go the ER if you think Oscar needs it. Oscar's breathing is going to be your first sign of problems in most cases. Regular respiration rate for kitties is usually between 20-30 breathes per minute. Get to know his normal rate by counting occassionally. It is best to do this when he is at rest, preferably sleeping, but not purring or dreaming as this will increase the rate. If Oscar is breathing hard, this is a sign of distress too. In most instances, an increased dosage of lasix will help but you should talk to your vet about it.

        Be sure to ask us any question that you may have even if it isn't heart related because it often is. We have lots of info to share. I hope I have given some insight to you but more will come the longer you are in the group. Again, glad you and your kitties joined! If my reply seems choppy, I apologize, I have a raging sinus infection and the meds are making me zone at times!

        Leah and her cats and Angel Alec




        ---------------------------------
        TV dinner still cooling?
        Check out "Tonight's Picks" on Yahoo! TV.

        [Non-text portions of this message have been removed]
      • Tracy
        Thanks Leah! Oscar is off to the vet this afternoon to be checked. He was better last night, his breathing is better. I might get them to run more x-rays
        Message 3 of 8 , Feb 28, 2007
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          Thanks Leah! Oscar is off to the vet this afternoon to be checked.
          He was better last night, his breathing is better. I might get them
          to run more x-rays today just to check on the amount of fluid that
          is probably there. This has just been such a tough month!
          He's still not eating tons, did lap up most of the gravy in his
          Fancy Feast last night but I think I definitely need to puree it to
          make it really wet, when I got up this morning there was still a lot
          of food in his bowl. He was eating when I left for work so I'll see
          what he actually ate when I get home after lunch. I'm thinking
          he'll need the appetite stimulant, vet did mention starting him on
          it when I talked to her after his last visit on the 17th. I think
          it's a certainty that he'll be on Lasix indefinitely.

          Tracy

          --- In feline-heart@yahoogroups.com, Leah Ferron
          <leahandhercats@...> wrote:
          >
          > Tracy,
          >
          > Welcome to you and your kitties. I am sorry to hear about their
          conditions but glad that you found us. We have quite a few poeple in
          the group that are dealing with hyper-t and HCM in the group so all
          your bases may be covered here.
          >
          > You say that Oscar isn't eating well. This is a big problem with
          heart kitties and when you add kidney problems to the mix, oy vay! I
          suggest you join the Yahoo Feline Assisted Feeding group. They have
          lots of info to help coax kitties to eat. Most of us in this group
          have had to join for our heart kitties too. But Oscar must eat. If
          he doesn't, you will have to add liver problems to his list of
          ailments. Try whatever you can to get him to eat even if you have to
          open 10 cans of food.
          >
          > Something that we suggest for heart kitties is to give
          supplements like CoEnzyme Q10 (CoQ10) and some others. Most vets
          feel the supplements won't help but won't hurt either. We think they
          help tremendously. If you want some more info about supplements,
          just email me. Along with supplements, a good quality canned food is
          best if possible. Sometimes, kitties with CRF eat special food. My
          Angel Alec had CRF and RCM and was on special food for the CRF. But
          I supplemented the food with other canned food. It is all about what
          you think is best for your kitty given their condition.
          >
          > I am glad that Pumpkin and now Oscar are on heart meds. If Oscar
          is in congestive heart failure, CHF, as you say then the meds are
          best for him. It may take a while to figure out the best dosage of
          lasix. This is normal. And it changes with time too. Don't be afraid
          to call your vet or go the ER if you think Oscar needs it. Oscar's
          breathing is going to be your first sign of problems in most cases.
          Regular respiration rate for kitties is usually between 20-30
          breathes per minute. Get to know his normal rate by counting
          occassionally. It is best to do this when he is at rest, preferably
          sleeping, but not purring or dreaming as this will increase the
          rate. If Oscar is breathing hard, this is a sign of distress too. In
          most instances, an increased dosage of lasix will help but you
          should talk to your vet about it.
          >
          > Be sure to ask us any question that you may have even if it
          isn't heart related because it often is. We have lots of info to
          share. I hope I have given some insight to you but more will come
          the longer you are in the group. Again, glad you and your kitties
          joined! If my reply seems choppy, I apologize, I have a raging sinus
          infection and the meds are making me zone at times!
          >
          > Leah and her cats and Angel Alec
          >
          >
          >
          >
          > ---------------------------------
          > TV dinner still cooling?
          > Check out "Tonight's Picks" on Yahoo! TV.
          >
          > [Non-text portions of this message have been removed]
          >
        • Tracy
          Oscar went back to the vet yesterday, though not an overly positive appointment. We re just all stymied by him. On the upside he did gain 1/2 a lb since the
          Message 4 of 8 , Mar 1 5:59 AM
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            Oscar went back to the vet yesterday, though not an overly positive
            appointment. We're just all stymied by him. On the upside he did
            gain 1/2 a lb since the 17th so he's back over 11 lbs. He clearly
            needs to remain on Lasix but dosing is a senstitive thing. He is
            dehydrated but with the fluid on his lungs subQ's are very scary.
            The vet has recommended that we remove him from all meds, except
            Lasix as needed - I've moved him to an every other day dosing, so he
            didn't get a dose last night. For food I need to add more liquid to
            it to help him rehydrate. Vet gave me some anti-nausia drug that
            costs the earth, he had 1/2 a tablet but I'm not sure that it made
            him eat. She also prescribed the appetitie stimulant cypro....
            which I haven't given to him yet since he ate last night, not a huge
            amount but enough. He was up and about this morning and had his
            head down in the food bowl when I left for work - he's now addicted
            to Fancy Feast - and he was drinking. He's a tough little guy but
            his body can only take so much. They did a recheck of his kidney
            values and found his BUN up and his Creatinine down from the 17th -
            elevated BUN explains why he's feeling poorly. Vet said he must
            have been quite fragile before he developed the fluid on his lungs
            at the beginning of February when he was boarded for 4 days with my
            other two. He's usually just fine being boarded, we've never had
            any issues before at all so he must really have been going downhill
            for a while before and just hiding it, the way cats do. I'm hoping
            he'll turn around but his heart is in really bad shape, he should be
            on the heart meds but if they are causing him to feel horrid and not
            eat then sure they are helping his heart but hurting him otherwise.

            So now we are in a wait and see situation, we'll just carry on from
            here and see how much longer he will be with us.

            Heart disease and CRF - not a fun thing to deal with.

            Tracy
          • nala_zq
            Tracy, When my cat was recently hospitalized with CHF and renal failure she was taken off all meds except for lasix - and reglan was added to help with nausea
            Message 5 of 8 , Mar 1 10:44 AM
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              Tracy,

              When my cat was recently hospitalized with CHF and renal failure she was
              taken off all meds except for lasix - and reglan was added to help with
              nausea - she kept licking her lips and licking her lips and sort of making
              gagging motions.

              I have slowly been adding back some of her other meds - and none of those
              really seem to have hurt her appetite. I think the appetite loss was due to her
              high renal numbers and dehydration.

              I have been trying to encourage my cat to drink as much as she wants to
              try to avoid having to give her subQs. I also don't have a "set" lasix schedule
              anymore. I adjust the dose daily based on her respirations and how dehydrated
              she seems.

              I hope you get things settled with Oscar soon and that your other kitty stays
              stable for a long long time.

              Best,
              Nala

              --- In feline-heart@yahoogroups.com, "Tracy" <tracyontario@...> wrote:
              >
              > Oscar went back to the vet yesterday, though not an overly positive
              > appointment. We're just all stymied by him. On the upside he did
              > gain 1/2 a lb since the 17th so he's back over 11 lbs. He clearly
              > needs to remain on Lasix but dosing is a senstitive thing. He is
              > dehydrated but with the fluid on his lungs subQ's are very scary.
              > The vet has recommended that we remove him from all meds, except
              > Lasix as needed - I've moved him to an every other day dosing, so he
              > didn't get a dose last night. For food I need to add more liquid to
              > it to help him rehydrate. Vet gave me some anti-nausia drug that
              > costs the earth, he had 1/2 a tablet but I'm not sure that it made
              > him eat. She also prescribed the appetitie stimulant cypro....
              > which I haven't given to him yet since he ate last night, not a huge
              > amount but enough. He was up and about this morning and had his
              > head down in the food bowl when I left for work - he's now addicted
              > to Fancy Feast - and he was drinking. He's a tough little guy but
              > his body can only take so much. They did a recheck of his kidney
              > values and found his BUN up and his Creatinine down from the 17th -
              > elevated BUN explains why he's feeling poorly. Vet said he must
              > have been quite fragile before he developed the fluid on his lungs
              > at the beginning of February when he was boarded for 4 days with my
              > other two. He's usually just fine being boarded, we've never had
              > any issues before at all so he must really have been going downhill
              > for a while before and just hiding it, the way cats do. I'm hoping
              > he'll turn around but his heart is in really bad shape, he should be
              > on the heart meds but if they are causing him to feel horrid and not
              > eat then sure they are helping his heart but hurting him otherwise.
              >
              > So now we are in a wait and see situation, we'll just carry on from
              > here and see how much longer he will be with us.
              >
              > Heart disease and CRF - not a fun thing to deal with.
              >
              > Tracy
              >
            • Tracy
              Hi Nala! That s what my vet thinks too, I just got off the phone with her, his kidney values are causing the most problems. His BUN went up but his Creatinine
              Message 6 of 8 , Mar 1 11:11 AM
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                Hi Nala!

                That's what my vet thinks too, I just got off the phone with her,
                his kidney values are causing the most problems. His BUN went up
                but his Creatinine went down and she's not happy about the elevated
                BUN. She phoned in a prescrption to my pharmacy for a stronger
                antacid though I'm not sure what the name is as I'll pick it up
                tonight. She wants to wait til maybe Monday to restart his
                atenolol. Lasix we are going to try and keep on an every other day
                or so dosing dependent on how he is. He was drinking this morning
                and I added some extra water to his breakfast to help with
                hydration.

                I'm pretty much at the point that it's a quality of life issue for
                him now, I want him to eat and be comfortable but if his life gets
                so unbearable than I'll probably have to make a decision which
                breaks my heart. I was sitting next to him last night on our spare
                bed and I just started sobbing and while in the midst of this I felt
                a paw on my hand, he was trying to reassure me I think. He's such a
                wonderful kitty. I feel guilty for probably causing this by
                boarding him but he's never had bad reactions to boarding before.
                He was in for 10 days last September and sailed through but I guess
                his heart has just been letting him down.

                Big sigh.....

                Tracy
              • Tracy
                Hi everyone! Thought I d post an update on my two boys, Pumpkin with HCM, and Oscar with HCM+CRF. Pumpkin had his follow up at the vet on Saturday and the vet
                Message 7 of 8 , Mar 12 12:59 PM
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                  Hi everyone! Thought I'd post an update on my two boys, Pumpkin
                  with HCM, and Oscar with HCM+CRF.

                  Pumpkin had his follow up at the vet on Saturday and the vet is very
                  pleased with him. We talked about his murmur - when the vet first
                  thought she heard it back at end of '06 she characterized it as
                  Grade I. When she listened a month later it apparently was very
                  bad, she called it Grade IV-V. He's been on atenolol since early
                  Feb. (he's so easy to pill, just crush it and smear it on deli
                  turkey - he hoovers it back so fast!). So she listened to his heart
                  on Saturday and she said if she didn't know he had HCM she'd never
                  have guessed - his heart sounds great. He's gained a bit of weight
                  too and she said overall he looks great. The vets are still
                  debating putting him on something to prevent clots. He goes for a
                  recheck at the end of May.

                  Now Oscar, my problem child. He's continuing to hang in there.
                  He's back on Fortekor (1/2 pill/day) and gets Periactin to stimulate
                  his appetite (1/4 pill 2x per day) and it works - takes about 2
                  hours to kick in but then he eats. His weight feels okay
                  considering - he doesn't feel like the feather he did when he came
                  home from the vet early February with the CHF. He's also on Pepcid
                  but I have a prescription antacid too that I tried (sorry can't
                  remember name) but that didn't seem to make much difference. It's
                  so hard to know what he's feeling when I look at him. He breathes
                  fast but then I look at the other two and they seem to be breathing
                  just as fast. I guess I'm afraid to give him Lasix for fear that he
                  feels crummy not because of fluid but because of something else. He
                  was looking sickly yesterday afternoon until I pulled his brush out
                  of the drawer then he was all over me meowing and loving getting
                  brushed. His BUN was up at his last check with creat. down which
                  would explain his feeling crummy. I'll probably haul him back in to
                  the vet in a month to get his bloodwork retested to see how he's
                  doing. He's not taking his atenolol, he should be but he's just so
                  fragile.......

                  We're on the "one day at a time approach" with Oscar. His current
                  quality of life is definitely not good but he's not ready to give up
                  yet and neither are we.

                  Tracy
                • Tracy
                  Thanks Nala! Oscar is actually do much, much better. He s eating and acting almost completely normal - okay, normal for him! He was really low on Sunday and
                  Message 8 of 8 , Mar 16 10:02 AM
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                    Thanks Nala! Oscar is actually do much, much better. He's eating
                    and acting almost completely normal - okay, normal for him! He was
                    really low on Sunday and Monday didn't seem much better but I
                    changed his food and kept giving him the periactin (he gets Pepcid
                    in the am and periactin at bedtime) and every day this week he's
                    gotten brighter and more like himself. I'm assuming that it's maybe
                    because his BUN is coming down with the new food, lower proten and
                    phos than what I was feeding him (Friskies). He's eating Science
                    Diet Adult Savoury Cuts in Gravy both the chicken and beef flavours
                    and he's definitely enjoying it. He's been eating almost two 6 oz
                    cans a day since Tuesday. Only other med he's on is his Fortekor.
                    He really is a fighter. I think now that spring is almost here and
                    it's getting warmer he's going to perk up a lot more too. I'm
                    thinking he may have been a tad depressed over the past month, I
                    guess feeling yucky and it being so cold and gloomy looking
                    outside. He just seemed very down. But I'm hopeful now he's going
                    to be with us a bit longer.

                    As for his heart meds, that's something I want to talk to the vet
                    about. It might be that we just let him be, stay on the Fortekor
                    and that's it since he is quite fragile. Continue to monitor him
                    for stress and potential fluid buildup. I guess we'll see how
                    things go over the next little while. I'm going to check his
                    breathing this weekend when I can hopefully catch him sleeping.
                    Sometimes it looks like he's breathing too fast then I realize he's
                    purring so of course that makes all the difference - it's just so
                    nice to hear him purr!

                    Tracy


                    -------------------
                    nala_zq <nala_zq@...> wrote:
                    Dear Tracy,

                    I don't remember whether I responded to your note previously
                    or not - I know that I had intended to!

                    That is great news for Pumpkin! It is my opinion that if his heart is
                    enlarged, particular the left atrium, that it might not be a bad
                    idea to
                    put him on a clot prevention med, but that is just my opinion.

                    Of course, as you say, things are trickier with Oscar. I'm glad the
                    periactin is working well for him. My heart/renal kitty didn't do
                    so well with it. I didn't think the Pepcid mattered to my cat
                    much either, until I quit giving it to her for a couple of days and
                    her eating tapered off.

                    I wouldn't be afraid of the lasix. I know it is hard with heart
                    and renal kitties to manage both diseases, but if you think he
                    is breathing fast I would try to keep it in check. My cat no
                    longer gets any kind of standard lasix dosing. It is pretty much -
                    count respirations - hmm 28 - well normally they should be
                    about 22 when she is sleeping like this, I am going to give her
                    10 mg instead of 7.5 and see if they come down at all. Oh goodness,
                    now they are up to 36. Now she gets 10 mg. (it really drives me
                    crazy).

                    I think it is important to try to figure out what kind of respiratory
                    rate is "normal" for Oscar when his fluid is under control. You
                    can't always rely on the respiration rates of your other kitties,
                    but you can also determine what is "normal" for them.

                    Try to get your counting done when Oscar is sleeping, not when
                    he is dreaming, not when he is awake. I also count the resps. when
                    my cat is awake, but completely relaxed - falling asleep - as she
                    wakes up when a piece of dust settles on the floor and her breathing
                    is always rapid when she is startled awake.

                    Best to you and the crew!

                    Nala
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