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Re: [FH] Heart transplant (or LVAD?), what does it require

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  • MarisaKatnic@aol.com
    Hello, I have a three-year old hybrid, a Savannah who is a year younger and a little heavier than your Sam with heart issues too. I, as I am sure everyone
    Message 1 of 6 , Dec 1, 2007
      Hello,

      I have a three-year old hybrid, a Savannah who is a year younger and a
      little heavier than your Sam with heart issues too. I, as I am sure everyone on
      this list would like to hear what takes place if you are able to get Sam a
      heart transplant. Good luck to you and of course, to Sam.

      Marisa and Oliver





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    • nala nala
      Dear Sam s People: First, welcome to you! I am sorry to read about Sam, as you probably already know, HCM is relatively common in the Maine Coon and the first
      Message 2 of 6 , Dec 2, 2007
        Dear Sam's People:

        First, welcome to you!
        I am sorry to read about Sam, as you
        probably already know, HCM is relatively
        common in the Maine Coon and the first
        feline HCM genetic mutation was identified
        in this breed.

        Second, most of us here at the feline heart group
        have had a cat with a heart disease resulting in
        congestive heart failure. It seems from reading
        the old posts, that most of the cats manage to
        recover from CHF (more than the 65% number
        you quoted), but it is sometimes tricky to get
        the proper lasix dosage worked out for any
        one cat. I would also not rely on the 1 year
        estimate. Some cats manage to live for several
        years after having gone into CHF, but of course
        some don't.

        Third, I think it is very exciting that you are
        considering this as an option. I looked into
        the possibility of a alcohol septal ablation or
        surgical myectomy for my cat's obstructive
        HCM, but I didn't find anyone willing to try
        in a cat (contacted a 5-6 veterinary schools).

        As far as keeping Sam stable until a surgery
        might become possible, you did not mention what meds
        Sam is taking currently. Most HCM/CHF cats take a
        combination
        of lasix and an ACE inhibitor (e.g. benazepril,
        enalapril).
        Many cats also take the beta-blocker atenolol or
        a calcium channel blocker such as diltiazem. Also,
        if his HCM has already caused left atrial enlargement,
        one would usually consider an anticlotting medication
        (e.g. aspirin, plavix, low molecular weight heparin,
        or
        the over-the-counter and not yet studied in cats -
        nattokinase). Many members here believe that
        certain supplements might be useful as well as
        a high protein low-grain canned food. My cat
        received fish oil (omega-3 fatty acids)
        and CoEnzyme Q 10. Some members here
        also supplement their cats with Taurine and
        Carnitine.

        As you mentioned, heart transplantation in
        felines is virtually unknown which makes it
        difficult to advise on what might or might
        not work. There is more extensive information
        on canine heart transplants. I would suspect
        that the transplant specialists you have talked
        to would tell you what kind of requirements Sam
        would have to meet as far as his own disease being
        stable
        enough to be a sugery candidate. There was
        a case of a heart being placed into the abdominal
        cavity of a cat in the early 1970s. I don't
        remember the details of that - other than that
        the purpose was to study some other process
        and that the heart started to beat very rapidly
        after several days.

        I know very little about LVADs other than what
        I saw on the recent PBS series "The Mysterious
        Human Heart." One question I would consider
        is whether or not I would want my cat to
        undergo two surgeries, one to place an LVAD
        and the second to replace the heart. I have
        read a bit about pacemaker placement in
        cats with AV-block (not HCM or another
        cardiomyopathy) and even that technology
        doesn't seem terribly advanced. There was
        one case at feline-heart that you can read
        about in the archives. There
        was a case in the UK as well and I think
        I saw another case in the US.
        My recollection is that for the UK case, the
        implant caused irritation resulting in
        fluid build-up (chylothorax) - so I would wonder
        whether
        an LVAD device placed in the chest
        could do the same?

        Another question I would ask the transplant
        specialist about is recovery time. I think
        that if they needed to open the chest cavity,
        that could pose some difficulty for a cat
        who bears the weight of his chest on his
        front legs. I also wonder about pain
        management. It seems like because of
        their anatomy (we don't walk on
        our arms - can you imagine doing that with
        your sternum healing?) and that unlike dogs,
        cats do not tolerate NSAIDs well, how
        pain would be controlled post-surgery.

        Finally, I wonder whether a heart transplant
        is a long-term cure. A new heart would
        relieve all the symptoms for now, but as the disease
        is a genetic disease, I do wonder whether the donor
        heart, as the myocytes are replenished, is remodeled
        from healthy donor tissue or from the HCM cat tissue.
        I don't know the answer to this question. If the
        normal
        turnover of heart muscle is from the HCM kitty,
        I would wonder how long it would take before the
        heart would be remodeled back toward an HCM
        heart (2 yrs? 15 yrs?). These
        are questions to discuss with your veterinary
        cardiologist and surgeon. I imagine they
        won't be able to easily answer these questions.

        In the meantime, give Sam and your other
        two kitties as much love and attention
        as you can muster. You have some big
        decisions coming up.

        Best to your, your wife, Sam, your
        Somali and your Siamese mix.

        Nala with Camille and Cozette in spirit.


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      • elanonuevo@aol.com
        In a message dated 12/2/2007 5:34:46 P.M. Eastern Standard Time, nala_zq@yahoo.com writes: Some cats manage to live for several years after having gone into
        Message 3 of 6 , Dec 2, 2007
          In a message dated 12/2/2007 5:34:46 P.M. Eastern Standard Time,
          nala_zq@... writes:

          Some cats manage to live for several
          years after having gone into CHF, but of course
          some don't.



          definitely, Oz is over five years since the first HF and CRF and the HCM
          diagnosis. He had another CHF about 3 years ago too but fortunately I knew
          enough to see the oncoming signs.

          Tia



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        • nala nala
          FYI for those interested: Link to The Mysterious Human Heart http://www.pbs.org/wnet/heart/
          Message 4 of 6 , Dec 2, 2007
            FYI for those interested:

            Link to "The Mysterious Human Heart"

            http://www.pbs.org/wnet/heart/




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